bluuebunny/crossref_metadata_2025 huggingface dataset:
Illicit financial flows and the provision of child and maternal health services in low- and middle-income countries
Authors: Ortega Bienvenido , Sanjuán Jesús , Casquero Antonio
Published: July 2020

Background

Illicit financial flows (IFFs) drain domestic resources with harmful social effects, especially in countries which are too poor to mobilise the revenues required to finance the provision of essential public goods and services. In this context, this article empirically examined the association between IFFs and the provision of essential health services in low- and middle-income countries.

Methods

Firstly, a set of indicators was selected to represent the overall coverage of essential health services at the country level. Next, a linear multivariate regression model was specified and estimated for each indicator using cross-sectional data for 72 countries for the period 2008–2013.

Results

After controlling for other relevant factors, the main result of the regression analysis was that an annual 1 percentage point (p.p.) increase in the ratio of IFFs to total trade was associated with a 0.46 p.p. decrease in the level of family planning coverage, a 0.31 p.p. decrease in the percentage of women receiving antenatal care, and a 0.32 p.p. decrease in the level of child vaccination coverage rates.

Conclusions

These findings suggest that, for the whole sample of countries considered, at least 3.9 million women and 190,000 children may not receive these basic health care interventions in the future as a consequence of a 1 p.p. increase in the ratio of IFFs to total trade. Moreover, given that family planning, reproductive health, and child immunisation are foundational components of health and long-term development in poor countries, the findings show that IFFs could be undermining the achievement of the 2030 Agenda for Sustainable Development.
Design and development of a chimeric vaccine candidate against zoonotic hepatitis E and foot-and-mouth disease
Authors: Behloul Nouredine , Baha Sarra , Liu Zhenzhen , Wei Wenjuan , Zhu Yuanyuan , Rao Yuliang , Shi Ruihua , Meng Jihong
Published: July 2020

Background

Zoonotic hepatitis E virus (HEV) infection emerged as a serious threat in the industrialized countries. The aim of this study is exploring a new approach for the control of zoonotic HEV in its main host (swine) through the design and development of an economically interesting chimeric vaccine against HEV and against a devastating swine infection: the foot-and-mouth disease virus (FMDV) infection.

Results

First, we adopted a computational approach for rational and effective screening of the different HEV-FMDV chimeric proteins. Next, we further expressed and purified the selected chimeric immunogens in Escherichia coli (E. coli) using molecular cloning techniques. Finally, we assessed the antigenicity and immunogenicity profiles of the chimeric vaccine candidates. Following this methodology, we designed and successfully produced an HEV-FMDV chimeric vaccine candidate (Seq 8-P222) that was highly over-expressed in E. coli as a soluble protein and could self-assemble into virus-like particles. Moreover, the vaccine candidate was thermo-stable and exhibited optimal antigenicity and immunogenicity properties.

Conclusion

This study provides new insights into the vaccine development technology by using bioinformatics for the selection of the best candidates from larger sets prior to experimentation. It also presents the first HEV-FMDV chimeric protein produced in E. coli as a promising chimeric vaccine candidate that could participate in reducing the transmission of zoonotic HEV to humans while preventing the highly contagious foot-and-mouth disease in swine.
The MRTF-A/miR-155/SOX1 pathway mediates gastric cancer migration and invasion
Authors: Yin Libin , Liu Tao , Li Chenyao , Yan Guoqiang , Li Chao , Zhang Jiantao , Wang Lei
Published: July 2020

Background

Gastric cancer (GC) is the leading cause of death worldwide and is closely related to metastasis. MRTF-A is one of the most well-characterized genetic markers in cancer. However, the mechanism whereby MRTF-A mediate gastric cancer (GC) tumorigenesis is not fully clear. Increasing evidence has confirmed that miRNA dysregulation is involved in MRTF-A-mediated tumorigenesis, supporting their potential as therapeutic targets for cancer. Although miR-155 has been reported as an upregulated miRNA, the interplay between miR-155 and MRTF-A-mediated gastric cancer progression remain largely elusive.

Methods

Real-time PCR was performed to determine miR-155 expression after transfected with MRTF-A encoding plasmids and siRNA. Potential target genes were identified by Western blot and luciferase reporter assay. Chip assay was proved that MRTF-A binds in the promoter region of miR-155. Transwell assay and Scratch-healing migration assay was used to investigate the role of MRTF-A and SOX1 in gastric cancer cell migration and invasion.

Results

MRTF-A can interact with the miR-155 promoter to promote histone acetylation and RNA polymerase II recruitment via the Wnt-β-catenin pathway. miR-155 promotes gastric cancer cell migration by suppressing SOX1 expressiom by targeting its 3′UTR in vitro and in vivo. MRTF-A inhibited the inhibitory effects of SOX1 on gastric cancer cell migration by promoting the express -ion of miR-155.

Conclusion

Our data therefore provide important and novel insights into how the MRTF-A/miR-155/SOX1 pathway mediates migration and invasion in GC.
Successful treatment of refractory hyperferritinemic syndromes with canakinumab: a report of two cases
Authors: Papa Riccardo , Natoli Valentina , Caorsi Roberta , Minoia Francesca , Gattorno Marco , Ravelli Angelo
Published: July 2020

Background

Hyperferritinemic syndromes are systemic inflammatory disorders characterized by a dysfunctional immune response, which leads to excessive activation of the monocyte-macrophage system with hypercytokinemia and may pursue a rapidly fatal course.

Case presentation

We describe two patients of 11 and 9 years of age with hyperferritinemic syndromes, one with impending macrophage activation syndrome (MAS) and one with overt MAS, who were refractory or intolerant to conventional therapies, but improved dramatically with canakinumab.

Conclusions

Our report indicates that canakinumab may be efficacious in the management of hyperferritinemic syndromes, including MAS.
Exploring MR regression patterns in rectal cancer during neoadjuvant radiochemotherapy with daily T2- and diffusion-weighted MRI
Authors: Bostel T. , Dreher C. , Wollschläger D. , Mayer A. , König F. , Bickelhaupt S. , Schlemmer H. P. , Huber P. E. , Sterzing F. , Bäumer P. , Debus J. , Nicolay N. H.
Published: July 2020

Background

To date, only limited magnetic resonance imaging (MRI) data are available concerning tumor regression during neoadjuvant radiochemotherapy (RCT) of rectal cancer patients, which is a prerequisite for adaptive radiotherapy (RT) concepts. This exploratory study prospectively evaluated daily fractional MRI during neoadjuvant treatment to analyze the predictive value of MR biomarkers for treatment response.

Methods

Locally advanced rectal cancer patients were examined with daily MRI during neoadjuvant RCT. Contouring of the tumor volume was performed for each MRI scan by using T2- and diffusion-weighted-imaging (DWI)-sequences. The daily apparent-diffusion coefficient (ADC) was calculated. Volumetric and functional tumor changes during RCT were analyzed and correlated with the pathological response after surgical resection.

Results

In total, 171 MRI scans of eight patients were analyzed regarding anatomical and functional dynamics during RCT. Pathological complete response (pCR) could be achieved in four patients, and four patients had a pathological partial response (pPR) following neoadjuvant treatment. T2- and DWI-based volumetry proved to be statistically significant in terms of therapeutic response, and volumetric thresholds at week two and week four during RCT were defined for the prediction of pCR. In contrast, the average tumor ADC values widely overlapped between both response groups during RCT and appeared inadequate to predict treatment response in our patient cohort.

Conclusion

This prospective exploratory study supports the hypothesis that MRI may be able to predict pCR of rectal cancers early during neoadjuvant RCT. Our data therefore provide a useful template to tailor future MR-guided adaptive treatment concepts.
Effect of unilateral pulsed jet lavage prior to vertebroplasty on the intravertebral pressure and cement distribution
Authors: Yan Jun , Liu Qiaohui , Zheng Yanping , Liu Ziqun , Liu Xinyu , Guo Xun , Liu Penghui , Chen Peng , Yuan Suomao , Tian Yonghao , Xu Wanlong
Published: July 2020

Background

Percutaneous vertebroplasty is the most common treatment for osteoporotic vertebral compression fracture. However, the morbidity of vertebroplasty-related complications, such as cement leakage, remains high. We tested a new technique of unilateral pulsed jet lavage and investigated its effect on the intravertebral pressure and bone cement distribution.

Methods

Thirty lumbar vertebrae (L1-L5) from six cadaver spines were randomly allocated into two groups (with and without irrigation). Prior to vertebroplasty, pulsed jet lavage was performed through one side of the pedicle by using a novel cannula with two concentric conduits to remove the fat and bone marrow of the vertebral bodies in the group with irrigation. The control group was not irrigated. Then, standardized vertebroplasty was performed in the vertebral bodies in both groups. Changes in the intravertebral pressure during injection were recorded. Computed tomography (CT) was performed to observe the cement distribution and extravasations, and the cement mass volume (CMV) was calculated.

Results

During cement injection, the average maximum intravertebral pressure of the unirrigated group was higher than that of the irrigated group (4.92 kPa versus 2.22 kPa, P < 0.05). CT scans showed a more homogeneous cement distribution with less CMV (3832 mm3 vs. 4344 mm3, P < 0.05) and less leakage rate (6.7% vs. 46.7%, P < 0.05) in the irrigated group than in the control group.

Conclusions

Unilateral pulsed jet lavage can reduce intravertebral pressure and lower the incidence of cement leakage during vertebroplasty. An enhanced bone cement distribution can also be achieved through this lavage system.
A comparison of screening tests for detection of high-grade cervical abnormalities in women living with HIV from Cameroon
Authors: Castle Philip E. , Ajeh Rogers , Dzudie Anastase , Kendowo Ernestine , Fuhngwa Norbert , Simo-Wambo Andre Gaetan , Nsame Denis , Orock Enow , Hebert Tiffany M. , Pierz Amanda J. , Murokora Daniel , Anastos Kathryn , Adedimeji Adebola
Published: July 2020

Background

Women living with human immunodeficiency virus (WLWH), especially those living in low- and middle-income countries (LMIC), are at increased risk of cervical cancer. The optimal cervical-cancer screening strategy for WLWH has not been determined. We therefore conducted a pilot study of screening methods in WLWH living in Limbe, Cameroon.

Methods

Five-hundred sixty-six WLWH, aged 25–59 years, were enrolled. After self-collecting a cervicovaginal specimen, they underwent a pelvic exam, during which a provider also collected a cervical specimen and visual inspection after acetic acid (VIA) was performed. Both self- and provider-collected specimens were tested for high-risk HPV by the Xpert HPV Test (Cepheid, Sunnyvale, CA, USA), with the residual of the latter used for liquid-based cytology. Women testing HPV positive on either specimen and/or VIA positive were referred to colposcopy and biopsies. However, because of poor attendence for follow-up colposcopy for the screen positives due to civil strife and technical issues with biopsies, high-grade cytology and/or clinical diagnosis of cancer was used as the primary high-grade cervical abnormality endpoint. Clinical performances for high-grade cervical abnormality of HPV testing and VIA for screening WLWH, and the most carcinogenic HPV genotypes and/or VIA to triage high-risk HPV-positive WLWH, were evaluated.

Results

Four-hundred eighty-seven (86.0%) WLWH had results for HPV testing on both specimen, VIA, and cytology and were included in the analysis. Forty-nine (10.1%) had a high-grade cervical abnormality. HPV testing on provider- and self-collected specimens was more sensitive than VIA (95.9 and 91.8% vs. 43.8%, respectively, p < 0.01 for both comparisons) for identifying women with high-grade cervical abnormalities. HPV testing on provider- and self-collected specimens was less specific than VIA (57.5 and 51.6% vs. 89.7%, respectively, p < 0.01 for both comparisons) for identifying women with high-grade cervical abnormalities; HPV testing on provider-collected specimens was more specific than on self-collected specimens (p < 0.01). Among HPV-positive women, HPV16/18/45 detection or VIA positivity had a sensitivity and positive predictive value of 73.5 and 29.0%, respectively, for provider-collected specimens and 68.8 and 22.9%, respectively, for self-collected specimens for high-grade cervical abnormalities.

Conclusions

HPV testing was more sensitive but less specific than VIA for detection of high-grade cervical abnormality in WLWH. Improved triage methods for HPV-positive WLWH are needed.

Trial registration

NCT04401670 (clinicaltrials.gov); retrospectively registered on May 26, 2020
Circular RNA circNTRK2 facilitates the progression of esophageal squamous cell carcinoma through up-regulating NRIP1 expression via miR-140-3p
Authors: Chen Xiaoqi , Jiang Jing , Zhao Yunxia , Wang Xinting , Zhang Chuanlei , Zhuan Lv , Zhang Danyang , Zheng Yuling
Published: July 2020

Background

Esophageal squamous cell carcinoma (ESCC) is one of the most prevalent gastrointestinal malignancies with high mortality. Circular RNAs (CircRNAs) have become a research hotspot in recent years for their vital roles in cancer development and progression. This study aims to clarify the roles of circNTRK2 and its underlying molecular mechanisms in ESCC.

Methods

The levels of circNTRK2, miR-140-3p, and nuclear receptor-interacting protein 1 (NRIP1) mRNA were examined by qRT-PCR. The cell proliferation ability was detected via CCK-8, EdU and colony formation assays. The invasion capacity was tested by using transwell assay. The apoptotic rate was evaluated through flow cytometry. The protein levels of cleaved PARP, cleaved caspase-3, E-cadherin, vimentin, and NRIP1 were measured by western blot assay. The validation of circular structure was performed by Sanger sequencing, divergent primer PCR, and RNase R treatments. The ceRNA regulatory mechanism of circNTRK2 was observed via dual-luciferase reporter, RIP and RNA pull-down assays. The mice xenograft models were constructed to confirm the oncogenicity of circNTRK2 in ESCC in vivo.

Results

CircNTRK2 was highly expressed in ESCC tissues and cells. High expression of circNTRK2 was correlated with advanced TNM stage, lymph node metastasis and short survival. Knockdown of circNTRK2 inhibited ESCC cell proliferation, invasion and epithelial-mesenchymal transition (EMT), and accelerated apoptosis in vitro. Mechanistic assays disclosed that circNTRK2 could act as a sponge for miR-140-3p to abate its suppression on target NRIP1 expression. Moreover, miR-140-3p-induced inhibitory effects on ESCC cell malignant phenotypes were attenuated by the overexpression of circNTRK2. In addition, depletion of NRIP1 impeded cell proliferation, invasion and EMT, while enhanced apoptosis. Furthermore, silencing of circNTRK2 suppressed cell proliferation and invasion through regulating NRIP1 expression. Also, knockdown of circNTRK2 slowed ESCC tumor growth in vivo.

Conclusion

CircNTRK2 promoted ESCC progression by regulating miR-140-3p/NRIP1 pathway. Our findings contribute to a better understanding of circRNAs as miRNA sponges and highlight a promising therapy target in ESCC.
Impact of a smartphone application (KAIA COPD app) in combination with Activity Monitoring as a maintenance prOgram following PUlmonary Rehabilitation in COPD: the protocol for the AMOPUR Study, an international, multicenter, parallel group, randomized, controlled study
Authors: Spielmanns Marc , Boeselt Tobias , Huber Stephan , Kaur Bollinger Pawandeep , Ulm Bernhard , Peckaka-Egli Anna-Maria , Jarosch Inga , Schneeberger Tessa , Schoendorf Sabine , Gloeckl Rainer , Koczulla A. Rembert
Published: July 2020

Background

Increasing physical activity (PA) is considered to be an important factor for the efficient management of chronic obstructive pulmonary disease (COPD). Successful methods required to achieve improvements in PA following pulmonary rehabilitation (PR), however, are rarely reported. Therefore, we will conduct this trial to evaluate the effectiveness of using a COPD management program delivered to the patient via the KAIA COPD app, a mobile medical application, after the completion of PR.

Methods

This is the protocol for a randomized, controlled, open-label, multicentered trial that will be carried out at inpatient PR hospital centers in Germany and Switzerland. The interventions will involve the use of the KAIA COPD app program (Arm 1) or an active comparator, i.e., usual care (Arm 2). Patients completing an in-hospital PR program and consenting to participate in the study will be screened with the inclusion and exclusion criteria and enrolled in the study. After fulfilling the screening requirements, the patients will be randomized into one of the two arms with parallel group assignment in a 1:1 ratio. The training program will be delivered to the participants grouped in Arm 1 via the KAIA COPD app and to participants grouped in Arm 2 via the regular recommendations or standard of care by the PI. In total, 104 participants will be included in the trial. The treatment period will last for 24 weeks. Electronic versions of questionnaires will be used to collect patient-reported assessments remotely. The primary outcome measure is the change in physical activity of the intervention group in comparison to the control group, measured over 1 week as the mean steps per day with a Polar A 370 activity tracker, from baseline (end of PR) to the 6-month follow-up. The secondary outcome measures are functional exercise capacity, health status, sleep quality, exacerbation rate, and depression and anxiety symptoms assessed at several intervals.

Discussion

This study seeks to prove the effects of the KAIA COPD mobile application in COPD patients after PR. The app offers educational, exercise training plus activity monitoring and motivational programs that can be easily implemented in the patient’s home setting, enabling patients to maintain the effects that are typically elicited in the short term after pulmonary rehabilitation for the long term.

Trial registration

German Clinical Trials Register (DRKS00017275). Protocol version 2.0 dated 3 June 2019.
Effects of high-protein diet combined with exercise to counteract frailty in pre-frail and frail community-dwelling older adults: study protocol for a three-arm randomized controlled trial
Authors: Buhl Sussi F. , Beck Anne Marie , Christensen Britt , Caserotti Paolo
Published: July 2020

Background

The proportion of older citizens is increasing worldwide. A well-known syndrome in old age is physical frailty which is associated with a greater risk of disabilities in activities of daily living, greater reliance on in-home services, hospitalization, institutionalization, and premature mortality. The purpose of this study is to determine the effects of an intervention with high-protein diet alone or in combination with power training in pre-frail and frail old adults.

Methods

The study is a community-based assessor-blinded parallel randomized controlled trial (RCT), consisting of two phases. Phase 1 is a 1-month stabilization phase, where self-reliant community-dwelling adults + 80 years old will receive individual guidance regarding protein intake, to prevent the risk of negative protein balance prior to phase 2 and to only include participants who have reached the minimum recommended level of protein intake (1.0 g/kg/day) in the randomized controlled trial. Phase 2 is a 4-month RCT where 150 participants will be randomized into the following three arms: protein-only where participants will be provided with dairy products to increase their protein intake to 1.5 g/kg/day, protein + exercise where participants will be provided with the protein intervention in combination with power training two times a week, and recommendation group where participants will continue as in phase 1. Primary outcome is lower leg muscle power. Secondary outcomes include physical function and mobility, frailty status, muscle mechanical function, body composition, nutritional status, and health-related quality of life. The statistical analysis will include an intention-to-treat analysis of all randomized participant and per-protocol analysis of all compliant participants. The study hypothesis will be tested with mixed linear models to assess changes in the main outcomes over time and between study arms.

Discussion

The finding of this study may add to the knowledge about the beneficial effects of high-protein diet from dairy products combined with power training to counteract frailty in community-dwelling older adults. This may ultimately have an impact on the ability to live well and independent for longer.

Trial registration

ClinicalTrials.gov NCT03842579. Registered on 15 February 2019, version 1
Hospital costs associated with post-traumatic stress disorder in somatic patients: a retrospective study
Authors: von der Warth Rieka , Hehn Philip , Wolff Jan , Kaier Klaus
Published: July 2020

Background

Post-traumatic stress disorder is likely to affect clinical courses in the somatic hospital ward when appearing as comorbidity. Thus, this study aimed to assess the costs associated with comorbid post-traumatic stress disorder in a somatic hospital and to analyze if reimbursement appropriately compensated additional costs.

Methods

The study used data from a German university hospital between 2011 and 2014, analyzing 198,819 inpatient episodes. Inpatient’s episodes were included for analysis if they had a somatic primary diagnosis and a secondary diagnosis of post-traumatic stress disorder. Costs were calculated based on resource use and compared to reimbursement. Analyses were adjusted for sex, age and somatic comorbidities.

Results

N = 219 Inpatient’s episode were found with primary somatic disorder and a comorbid post-traumatic stress disorder. Inpatients episodes with comorbid post-traumatic stress disorder were compared to 34,229 control episodes, which were hospitalized with the same main diagnosis. Post-traumatic stress disorder was associated with additional hospital costs of €2311 [95%CI €1268 - €3355], while reimbursement rose by €1387 [€563 - €2212]. Results indicate that extra costs associated with post-traumatic stress disorder are not fully reimbursed. Male patients showed higher hospital costs associated with post-traumatic stress disorder. On average, post-traumatic stress disorder was associated with an extra length of stay of 3.4 days [2.1–4.6 days].

Conclusion

Costs associated with post-traumatic stress disorder were substantial and exceeded reimbursement, indicating an inadequate reimbursement for somatic patients with comorbid post-traumatic stress disorder.
Study design to evaluate a group-based therapy for support persons of adults on buprenorphine/naloxone
Authors: Osilla Karen Chan , Becker Kirsten , Ecola Liisa , Hurley Brian , Manuel Jennifer K. , Ober Allison , Paddock Susan M. , Watkins Katherine E.
Published: July 2020

Background

Opioid use disorders (OUDs) have devastating effects on individuals, families, and communities. While medication treatments for OUD save lives and are increasingly utilized, rates of treatment dropout are very high. In addition, most existing medication treatments for OUD may often neglect the impact of untreated OUD on relationships and ignore the potential role support persons (SPs) could have on encouraging long-term recovery, which can also impact patient treatment retention.

Methods/design

The current study adapts Community Reinforcement and Family Training (CRAFT) for use with SPs (family member, spouse or friend) of patients using buprenorphine/naloxone (buprenorphine) in an outpatient community clinic setting. The study will evaluate whether the adapted intervention, also known as integrating support persons into recovery (INSPIRE), is effective in increasing patient retention on buprenorphine when compared to usual care. We will utilize a two-group randomized design where patients starting or restarting buprenorphine will be screened for support person status and recruited with their support person if eligible. Support persons will be randomly assigned to the INSPIRE intervention, which will consist of 10 rolling group sessions led by two facilitators. Patients and SPs will each be assessed at baseline, 3 months post-baseline, and 12 months post-baseline. Patient electronic medical record data will be collected at six and 12 months post-baseline. We will examine mechanisms of intervention effectiveness and also conduct pre/post-implementation surveys with clinic staff to assess issues that would affect sustainability.

Discussion

Incorporating the patient’s support system may be an important way to improve treatment retention in medication treatments for OUD. If SPs can serve to support patient retention, this study would significantly advance work to help support the delivery of effective treatments that prevent the devastating consequences associated with OUD.

Trial registrationThis study was registered with ClinicalTrials.gov, NCT04239235. Registered 27 January 2020,https://clinicaltrials.gov/ct2/show/NCT04239235.
High multiple mutations of Plasmodium falciparum-resistant genotypes to sulphadoxine-pyrimethamine in Lagos, Nigeria
Authors: Quan Hong , Igbasi Uche , Oyibo Wellington , Omilabu Sunday , Chen Shen-Bo , Shen Hai-Mo , Okolie Chukwuma , Chen Jun-Hu , Zhou Xiao-Nong
Published: July 2020

Background

Plasmodium falciparum-resistance to sulphadoxine-pyrimethamine (SP) has been largely reported among pregnant women. However, the profile of resistance markers to SP dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) in the general population are varied and not frequently monitored. Currently, SP is used as partner drug for artemisinin combination therapy (SP-artesunate) in some sub-Saharan African countries or as a prophylactic drug in intermittent preventive treatment of malaria during pregnancy and infants and in seasonal malaria chemoprevention (SMC). Profiling of P. falciparum-resistant genotypes to SP is dynamic and critical in providing data that would be useful for malaria control programmes. This study assessed the profile of dhfr and dhps genes genotypes among individuals with malaria in Lagos, Nigeria.

Methods

Molecular markers of SP resistance were identified by nested PCR and sequenced among malaria positive dried blood spots (DBS) that were collected from individuals attending health facilities from January 2013 to February 2014 and during community surveys from October 2010 to September 2011 across different Local Government Areas of Lagos State, Nigeria.

Results

A total of 242 and 167 samples were sequenced for dhfr and dhps, respectively. Sequence analysis of dhfr showed that 95.5% (231/242), 96.3% (233/242) and 96.7% (234/242) of the samples had N51I, C59R and S108N mutant alleles, respectively. The prevalence of dhps mutation at codons A437G, A613S, S436A, A581G, I431V and K540E were 95.8% (160/167), 41.9% (70/167), 41.3% (69/167), 31.1% (52/167), 25.1% (42/167), and 1.2% (2/167) respectively. The prevalence of triple mutations (CIRNI) in dhfr was 93.8% and 44.3% for the single dhps haplotype mutation (SGKAA). Partial SP-resistance due to quadruple dhfr-dhps haplotype mutations (CIRNI-SGKAA) and octuple haplotype mutations (CIRNI-VAGKGS) with rate of 42.6% and 22.0%, respectively has been reported.

Conclusions

There was increased prevalence in dhfr triple haplotype mutations when compared with previous reports in the same environment but aligned with high prevalence in other locations in Nigeria and other countries in Africa. Also, high prevalence of dhfr and dhps mutant alleles occurred in the study areas in Lagos, Nigeria five to eight years after the introduction of artemisinin combination therapy underscores the need for continuous monitoring.
Chemical assessment of the explosive chamber in the projector system of Hayabusa2 for asteroid sampling
Authors: Takano Yoshinori , Yamada Keita , Okamoto Chisato , Sawada Hirotaka , Okazaki Ryuji , Sakamoto Kanako , Kebukawa Yoko , Kiryu Kento , Shibuya Takazo , Igisu Motoko , Yano Hajime , Tachibana Shogo ,   Hayabusa2 project team
Published: July 2020

We report a chemical assessment of the explosive chamber in the projector system used during the sampling operation of the Hayabusa2 project at the surface of the C-type asteroid Ryugu. Although the explosion process was designed as a closed system, volatile combustion gases and semivolatile organics were produced together with quenched carbonaceous product. The chemical compositions of the gases, organics, and inorganics were investigated in the screening analysis. A solid-phase microextraction technique and thermal desorption coupled with gas chromatography/mass spectrometry analysis revealed that aliphatic (< C20n-alkanes) and aromatic (< pyrene) hydrocarbons were produced in the closed chamber system. The aromatic ring compositions of the latter showed a semilogarithmic decrease: one ring > two rings > three rings > four rings, resulting in abiogenic molecular patterns. The most intense inorganic fingerprints were due to potassium (K+) and chloride (Cl–) ions derived from the initial KTB explosive and RK ignition charge. We discuss quality control and quality assurance issues applicable to future sample processes during the Hayabusa2 project.
The role of resting-state functional MRI for clinical preoperative language mapping
Authors: Kumar Vinodh A. , Heiba Islam M. , Prabhu Sujit S. , Chen Melissa M. , Colen Rivka R. , Young Angela L. , Johnson Jason M. , Hou Ping , Noll Kyle , Ferguson Sherise D. , Rao Ganesh , Lang Frederick F. , Schomer Donald F. , Liu Ho-Ling
Published: July 2020

Background

Task-based functional MRI (tb-fMRI) is a well-established technique used to identify eloquent cortex, but has limitations, particularly in cognitively impaired patients who cannot perform language paradigms. Resting-state functional MRI (rs-fMRI) is a potential alternative modality for presurgical mapping of language networks that does not require task performance. The purpose of our study is to determine the utility of rs-fMRI for clinical preoperative language mapping when tb-fMRI is limited.

Methods

We retrospectively reviewed 134 brain tumor patients who underwent preoperative fMRI language mapping. rs-fMRI was post-processed with seed-based correlation (SBC) analysis, when language tb-fMRI was limited. Two neuroradiologists reviewed both the tb-fMRI and rs-fMRI results. Six neurosurgeons retrospectively rated the usefulness of rs-fMRI for language mapping in their patients.

Results

Of the 134 patients, 49 cases had limited tb-fMRI and rs-fMRI was post-processed. Two neuroradiologists found rs-fMRI beneficial for functional language mapping in 41(84%) and 43 (88%) cases respectively; Cohen’s kappa is 0.83, with a 95% confidence interval (0.61, 1.00). The neurosurgeons found rs-fMRI “definitely” useful in 26 cases (60%) and “somewhat” useful in 13 cases (30%) in locating potential eloquent language centers of clinical interest. Six unsuccessful rs-fMRI cases were due to: head motion (2 cases), nonspecific functionality connectivity outside the posterior language network (1 case), and an unknown system instability (3 cases).

Conclusions

This study is a proof of concept that shows SBC rs-fMRI may be a viable alternative for clinical language mapping when tb-fMRI is limited.
Endocrine Significance of SARS-CoV-2’s Reliance on ACE2
Authors: Lazartigues Eric , Qadir Mirza Muhammad Fahd , Mauvais-Jarvis Franck
Published: July 2020

The current COVID-19 pandemic is the most disruptive event in the past 50 years, with a global impact on health care and world economies. It is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a coronavirus that uses angiotensin-converting enzyme 2 (ACE2) as an entry point to the cells. ACE2 is a transmembrane carboxypeptidase and member of the renin-angiotensin system. This mini-review summarizes the main findings regarding ACE2 expression and function in endocrine tissues. We discuss rapidly evolving knowledge on the potential role of ACE2 and SARS coronaviruses in endocrinology and the development of diabetes mellitus, hypogonadism, and pituitary and thyroid diseases.
The Immp2l Mutation Causes Ovarian Aging Through ROS-Wnt/β-Catenin-Estrogen Pathway: Preventive Effect of Melatonin
Authors: He Qing , Gu Lifang , Lin Qingyin , Ma Yi , Liu Chunlian , Pei Xiuying , Li P Andy , Yang Yanzhou
Published: July 2020

Mitochondria play important roles in ovarian follicle development. Mitochondrial dysfunction, including mitochondrial gene deficiency, impairs ovarian development. Here, we explored the role and mechanism of mitochondrial inner membrane gene Immp2l in ovarian follicle growth and development. Our results revealed that female Immp2l-/- mice were infertile, whereas Immp2l+/- mice were normal. Body and ovarian weights were reduced in the female Immp2l-/- mice, ovarian follicle growth and development were stunted in the secondary follicle stage. Although a few ovarian follicles were ovulated, the oocytes were not fertilized because of mitochondrial dysfunction. Increased oxidative stress, decreased estrogen levels, and altered genes expression of Wnt/β-catenin and steroid hormone synthesis pathways were observed in 28-day-old Immp2l-/- mice. The Immp2l mutation accelerated ovarian aging process, as no ovarian follicles were detected by age 5 months in Immp2l-/- mice. All the aforementioned changes in the Immp2l-/- mice were reversed by administration of antioxidant melatonin to the Immp2l-/- mice. Furthermore, our in vitro study using Immp2l knockdown granulosa cells confirmed that the Immp2l downregulation induced granulosa cell aging by enhancing reactive oxygen species (ROS) levels, suppressing Wnt16, increasing β-catenin, and decreasing steroid hormone synthesis gene cyp19a1 and estrogen levels, accompanied by an increase in the aging phenotype of granulosa cells. Melatonin treatment delayed granulosa cell aging progression. Taken together, Immp2l causes ovarian aging through the ROS-Wnt/β-catenin-estrogen (cyp19a1) pathway, which can be reversed by melatonin treatment.
Transforaminal Sacral Nerve Neurostimulation for the Treatment of Intractable Chronic Pelvic Pain: Case Report
Authors: Samaniego Elias Atencio , Romero Andrés Rocha , Cordero Rodrigo Alberto Benavides , Roychoudhury Priodarshi , Deibis Ulises Ochoa , Caballero Evelyn Rios
Published: July 2020

This article aims to report the successful treatment of 2 patients with intractable chronic pelvic pain treated with transforaminal sacral nerve neurostimulation. At 18-month follow-up, both patients reported significant pain relief and improved performance. The implantation of a percutaneous transforaminal sacral nerve neurostimulator is usually reserved for the treatment of bladder incontinence. In both reported cases, it proved to be useful for pain management. This technique should be evaluated in clinical trials.
ECG of the month
Authors: Regan Martin
Published: July 2020

In this issue's ECG of the month, Martin Regan discusses the case of a 55-year-old man who was admitted after collapsing at home
Prescribing to manage obesity
Authors: Paterson Ruth
Published: July 2020

Ruth Paterson provides an overview of recently published articles that may be of interest to non-medical prescribers. Should you wish to look at any of the papers in more detail, a full reference is provided
An exploration of why qualified mental health nurse prescribers do not prescribe
Authors: Oldknow Helen , Gillibrand Warren , Clifton Andrew
Published: July 2020

This article is an exploratory study of perceptions in mental health nurses who are qualified to prescribe yet choose not to do so. In-depth semi-structured face-to-face interviews, field notes and analysis of documents were used to investigate the perceptions of the non–prescribing nurse prescriber. A mapping exercise was conducted to identify potential participants. Interview data analysis was based on the principles of descriptive phenomenology and the research was theoretically framed within concepts of power, structure/agency and culture. This study has contributed to understanding the views of non-prescribing mental health nurse prescribers on why they do not use their prescribing qualification. The findings from this study suggest that there are complex, interlocking factors: power and knowledge; culture; and structure and agency, which may enable or prevent mental health nurse prescribers from independently prescribing.
Recognition and management of sepsis in the urgent care out of hours setting
Authors: Dexter Justine , Mortimore Gerri
Published: July 2020

As the majority of sepsis cases occur in the community, Justine Dexter and Gerri Mortimore provide an overview of the assessment, diagnosis and management of the condition for those working in out of hours settings

Sepsis is a life-threatening and common condition prompted by a microbial infection. Sepsis is responsible for the death of more people than prostate, bowel or breast cancer collectively, and it causes the second highest mortality rates after cardiovascular disease. The majority of sepsis cases occur in the community, with 30% developing while the patient is in hospital. In many instances, sepsis is avoidable and treatable. The aetiology of sepsis is not always known, making diagnosis difficult, with only 50% of cases having a confirmed pathogenic organism. The signs and symptoms most obviously connected with sepsis are confusion or unusual behaviour, hypotension and increased respiratory rate. However, some patients have non-specific symptoms, and just complain of feeling extremely unwell. Any patients who have these signs or symptoms should be assessed for the possibility of sepsis, regardless of whether pyrexia is present. To aid in detection and decision making about sepsis, the use of screening tools have been advocated to shorten the period prior to the administration of antibiotics. Children characteristically compensate physiologically for a considerable time and then deteriorate quickly; therefore, a crucial focus is to spot a sick child rapidly. Many urgent care out of hours (UCOOH) services are nurse-led. Therefore, it often falls on advanced nurse practitioners (ANPs) to educate healthcare assistants to spot the sick person, especially as they are usually the first person the patient sees. Leadership plays a key role for ANPs in UCOOH by helping to progress the pathway for patients to ensure the sickest are prioritised.
The quest to find an effective vaccine for COVID-19
Authors: Glasper Alan
Published: July 2020

Professor Alan Glasper delves into history and discusses the unprecedented international race to develop an effective vaccine against COVID-19
Problem-Based Learning Strategy: Its Impact on Students’ Critical and Creative Thinking Skills
Authors: Kardoyo Kardoyo , Nurkhin Ahmad , Muhsin Muhsin , Pramusinto Hengky
Published: July 2020

The ability to think critically and creatively is essential for students to be able to face the challenges of the industrial revolution 4.0. Lectures must be designed to enhance students’ critical and creative thinking skills. This study aims to examine the implementation of problem-based learning in learning management information systems courses to improve students critical and creative thinking skills. The research design carried out was classroom action research. The subject in this study was students of Economics Education, Faculty of Economics, Universitas Negeri Semarang. The research was conducted in April-May 2019. The procedure for implementing class action research are two cycles (plan, action, observation, and reflection). The research data was taken by observation and interview methods. The data analysis method used is descriptive quantitative and qualitative methods. The results showed that two class action research cycles were well implemented. The application of the problem-based learning method can improve students’ critical and creative thinking skills. Students are able to solve a given case by doing the right analysis and being able to provide alternative solutions. Students consider the learning process to be more exciting and challenging. Students can express their opinions well in front of the class. The implication of this research is that lecturers can apply PBL with various combinations of learning strategies to improve students' critical and creative thinking skills.
Perspectives of Teachers of High Performing Immigrant Youth in a German Secondary School
Authors: Hill Kirsten Dara
Published: July 2020

This study examined the perspectives of teachers of immigrant youth in a high performing school, Gymnasium Baden (a pseudonym), in the southern region of Germany. Academic success in the region has been traditionally designated for ethnic Germans and non-natives who suppress their culture and assimilate into normative German culture. The consequences of failed intercultural education in Europe have prompted increased demands to consider diversity in teacher training and to provide more equitable opportunities for immigrants. In a broader context of limited access and opportunity to higher education among immigrants, this study documented the voices of teachers of high performing immigrant youth. The perspectives of culturally responsive teachers were documented through interviews, within a broader conservative region that has experienced dilemmas of integrating immigrants into school and society. An examination of interview transcripts and ethnographic field notes of student interactions revealed teachers who were overwhelmingly supportive and responsive to immigrant youth.
Material educativo para pacientes com tuberculose pulmonar frente a pandemia de COVID-19.
Authors: Rocha Natália Loureiro , Araujo Katharina Ferreira , Da Motta Maria Catarina Salvador , Nakano Andreza Rodrigues , De Lima Hildegard Soares Barrozo , Marques Júlia Luiz Simões
Published: July 2020

Este trabalho visa relatar a experiência na confecção de um material instrucional sobre os cuidados profiláticos que o paciente com tuberculose pulmonar deve seguir frente a pandemia de COVID-19. Desenvolvido a partir do projeto de extensão “Ações de extensão para prevenção do empobrecimento do doente de tuberculose droga resistente”. Objetiva-se com o estudo a demonstração do material confeccionado, bem como, discutir sua aplicabilidade no âmbito da atenção primária frente ao cenário global de saúde pública. Conclui-se que a experiência propõe agregar conhecimento a população de modo geral e principalmente ao indivíduo com tuberculose pulmonar que se encontra no epicentro do grupo de risco para o novo coronavírus. O material desenvolvido busca promover saúde, prevenir doenças e agravos, de forma a cumprir com as prerrogativas do Sistema Único de Saúde.
Maximal nighttime electrical power generation via optimal radiative cooling
Authors: Fan Lingling , Li Wei , Jin Weiliang , Orenstein Meir , Fan Shanhui
Published: July 2020

We present a systematic optimization of nighttime thermoelectric power generation system utilizing radiative cooling. We show that an electrical power density >2 W/m2, two orders of magnitude higher than the previously reported experimental result, is achievable using existing technologies. This system combines radiative cooling and thermoelectric power generation and operates at night when solar energy harvesting is unavailable. The thermoelectric power generator (TEG) itself covers less than 1 percent of the system footprint area when achieving this optimal power generation, showing economic feasibility. We study the influence of emissivity spectra, thermal convection, thermoelectric figure of merit and the area ratio between the TEG and the radiative cooler on the power generation performance. We optimize the thermal radiation emitter attached to the cold side and propose practical material implementation. The importance of the optimal emitter is elucidated by the gain of 153% in power density compared to regular blackbody emitters.
Large-field step-structure surface measurement using a femtosecond laser
Authors: Wang Yue , Xu Guangyao , Xiong Shilin , Wu Guanhao
Published: July 2020

We present a femtosecond laser-based interferometry for step-structure surface measurement with a large field of view. A height axial scanning range of 348 µm is achieved by using the method of repetition frequency scanning with reference to the Rb atomic clock and the optical path length difference design for 21 times of the pulse interval. A combined method, which includes the envelope peak positioning method for rough measurement, synthetic-wavelength interferometry for connection, and carrier wave interferometry for fine measurement, is proposed to reconstruct the surface. A three-step specimen with heights of approximately 20, 50, and 70 µm was successfully measured with a height precision of 7 nm, and the accuracy was verified by a commercial white light interferometer. The diameter of the field of view that was demonstrated was 17.3 mm, which could be much larger owing to the high spatial coherence of the femtosecond laser. The results show that the femtosecond laser system combines the step-structure measurement performance of white light interferometry and the high-precision large-field performance of phase shifting interferometry, indicating its potential for widespread use in ultra-precision manufacturing of micro/nano-devices, such as semiconductor chips, integrated circuits, and micro-electro-mechanical systems.
A Moral e a Ética nas Relações de Poder / Morals and Ethics in Power Relationships
Authors: Tolovi Carlos Alberto , Figueiredo João Batista De Albuquerque
Published: July 2020

A maior crise enfrentada pela humanidade nos tempos atuais pode ser identificada como ligada a dimensão de valores. E quando falamos em valoração, do ponto de vista axiológico, nos remetemos automaticamente ao campo onde estão inseridas a ética e a moral. E se este está ligado diretamente a uma aceitação coletiva, que define a visão de mundo de um determinado grupo social, ele está também conectado às relações de poder. Mesmo porque, em todos os processos de colonização, que se transformam em colonialidade, quem possui o poder de normatizar é também quem normaliza as hierarquias, determinando o que deve ser obedecido. Porém, enquanto a moral serve para normatizar e justificar as relações de poder, a ética pode servir como elemento de reflexão que, na busca de fundamentação, pode questionar esta estrutura, despertando a consciência crítica. E nosso objetivo neste ensaio consiste em explicitar as diferenças entre ética e moral tomando como referência as relações de poder. Palavras-chave: Moral; Ética; Relações de Poder.
Comunicação, Estigmatização e Transtorno mental: análise de uma matéria paraense em um Portal de Notícias / Communication, Stigmatization and Mental Disorder: analyze of a paraense story on a news portal
Authors: Borges Junior Dorivaldo Pantoja , Corradi Analaura , Assumpção Douglas Junio Fernandes
Published: July 2020

Este estudo objetiva exemplificar possíveis reverberações da representação superficial de transtornos mentais em matérias jornalísticas. Para isto, utilizou-se como exemplo, uma publicação do portal de notícias do G1 Pará, que foi analisada diante de categorias previamente estabelecidas a partir do texto de Nunes e Torrenté (2009). Com as análises, identificou-se que o transtorno mental é mencionado sem especificações necessárias. Dessa forma, indagou-se se isto pode reforçar estigmas referentes a estes sujeitos como naturalmente perigosos e/ou incapazes de se proteger. Problematizou-se, então, como notícias virtuais influenciam padrões cognitivos humanos, potencializando movimentos segregacionistas no comportamento social.