bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors for cervical cancer in women in China: A meta-model
Authors: Aballéa Samuel , Beck Ekkehard , Cheng Xiao , Demarteau Nadia , Li Xiao , Ma Fangfang , Neine Mohamed , Zhao Fang-Hui
Published: August 2020

Objectives:

Cervical cancer is a leading cause of cancer-related mortality in women in China. This analysis is a quantitative evidence synthesis pooling information about each cervical cancer risk factor.

Methods:

A meta-model was developed to estimate the risk of cervical cancer for a woman aged 18–85 years in Mainland China based on her risk profile at the time of assessment. The meta-model was built using findings of a systematic literature review that identified 21 case–control studies reporting data on 105 groups of cervical cancer risk factors in Chinese women. Extracted risk factors were ranked, and 17 were selected by Chinese clinical experts for inclusion in the meta-model. Risk equations were developed for each selected study. Predicted risks for each study were dependent on the risk profile under consideration and study-specific risks were pooled to an overall risk estimate using a random-effects meta-analysis. Sensitivity analysis was conducted using 100 artificial patient profiles (in the absence of patient data).

Results:

Predicted risks for the 100 profiles suggested that the model had good face validity and could differentiate between high and non-high cervical cancer risk profiles.

Conclusion:

This innovative meta-model approach assesses cervical cancer risk in Chinese women from a holistic perspective and could be adapted for other diseases and settings.
Towards a better integration of social sciences in arbovirus research and decision-making: an experience from scientific collaboration between Cuban and Quebec institutions
Authors: Carabali Mabel , Pérez Dennis , Degroote Stephanie , Reyes Alicia , Kaufman Jay S. , Ridde Valery
Published: August 2020

In 2017, the Institute of Tropical Medicine Pedro Kourí, University of Montreal Public Health Research Institute, and McGill University joined efforts to provide scenarios for scientific exchange and knowledge dissemination about the social science contribution on arboviral research. This commentary describes the scientific collaboration between Cuban and Canadian (Quebec) institutions, illustrating the need and opportunities to facilitate research and effective decision-making processes for arboviral prevention and control, going beyond traditional biomedical aspects. We organized a set of scientific activities within three international events conducted in Cuba between 2017 and 2018. Given the collaborating institutions’ expertise and the knowledge gaps in arboviral research, we selected three main thematic areas: social determinants and equity, community-based interventions and use of evidence for decision-making. The partnership shows that interdisciplinary collaboration and the use and integration of quantitative and qualitative methods from the social sciences is essential to face the current challenges in arbovirus research.
A Novel and Precise Profiling Tool to Predict Gestational Diabetes
Authors: McLaren Rodney , Haberman Shoshana , Moscu Moshe , Atallah Fouad , Friedmann Hila
Published: August 2020

Background:

There is a trend in healthcare for developing models for predictions of disease to enable early intervention and improve outcome.

Instrument:

We present the use of artificial intelligence algorithms that were developed by Gynisus Ltd. using mathematical algorithms.

Experience:

Data were retrospectively collected on pregnant women that delivered at a single institution. Hundreds of parameters were collected and found to have different importance and correlation with the likelihood to develop gestational diabetes mellitus (GDM). We highlight 3 of 29 specific parameters that were important in pregestation and in early pregnancy, which have not been previously correlated with GDM.

Conclusion:

This predictive tool identified parameters that are not currently being used as predictors in GDM, even before pregnancy. This tool opens the possibility of intervening on patients identified at risk for GDM and its complications. Future prospective studies are needed.
Detecting undiagnosed atrial fibrillation in UK primary care: Validation of a machine learning prediction algorithm in a retrospective cohort study
Authors: Sekelj Sara , Sandler Belinda , Johnston Ellie , Pollock Kevin G , Hill Nathan R , Gordon Jason , Tsang Carmen , Khan Sadia , Ng Fu Siong , Farooqui Usman
Published: August 2020

Aims

To evaluate the ability of a machine learning algorithm to identify patients at high risk of atrial fibrillation in primary care.

Methods

A retrospective cohort study was undertaken using the DISCOVER registry to validate an algorithm developed using a Clinical Practice Research Datalink (CPRD) dataset. The validation dataset included primary care patients in London, England aged ≥30 years from 1 January 2006 to 31 December 2013, without a diagnosis of atrial fibrillation in the prior 5 years. Algorithm performance metrics were sensitivity, specificity, positive predictive value, negative predictive value (NPV) and number needed to screen (NNS). Subgroup analysis of patients aged ≥65 years was also performed.

Results

Of 2,542,732 patients in DISCOVER, the algorithm identified 604,135 patients suitable for risk assessment. Of these, 3.0% (17,880 patients) had a diagnosis of atrial fibrillation recorded before study end. The area under the curve of the receiver operating characteristic was 0.87, compared with 0.83 in algorithm development. The NNS was nine patients, matching the CPRD cohort. In patients aged ≥30 years, the algorithm correctly identified 99.1% of patients who did not have atrial fibrillation (NPV) and 75.0% of true atrial fibrillation cases (sensitivity). Among patients aged ≥65 years (n = 117,965), the NPV was 96.7% with 91.8% sensitivity.

Conclusions

This atrial fibrillation risk prediction algorithm, based on machine learning methods, identified patients at highest risk of atrial fibrillation. It performed comparably in a large, real-world population-based cohort and the developmental registry cohort. If implemented in primary care, the algorithm could be an effective tool for narrowing the population who would benefit from atrial fibrillation screening in the United Kingdom.
Orthogeriatric Trauma Unit Improves Patient Outcomes in Geriatric Hip Fracture Patients
Authors: Schuijt Henk Jan , Kusen Jip , van Hernen Jan Jonas , van der Vet Puck , Geraghty Olivia , Smeeing Diederik Pieter Johan , van der Velde Detlef
Published: August 2020

Introduction:

An aging population in developed countries has increased the number of osteoporotic hip fractures and will continue to grow over the next decades. Previous studies have investigated the effect of integrated orthogeriatric trauma units and care model on outcomes of hip fracture patients. Although all of the models perform better than usual care, there is no conclusive evidence which care model is superior. More confirmative studies reporting the efficacy of orthogeriatric trauma units are needed. The objective of this study was to evaluate outcomes of hip fracture patients admitted to the hospital before and after implementation of an orthogeriatric trauma unit.

Materials and methods:

This retrospective cohort study was conducted at a level 2 trauma center between 2016 and 2018. Patients aged 70 years or older with a hip fracture undergoing surgery were included to evaluate the implementation of an orthogeriatric trauma unit. The main outcomes were postoperative complications, patient mortality, time spent at the emergency department, time to surgery, and hospital length of stay.

Results:

A total of 806 patients were included. After implementation of the orthogeriatric trauma unit, there was a significant decrease in postoperative complications (42% vs. 49% in the historical cohort, p = 0.034), and turnaround time at the emergency department was reduced by 38 minutes. Additionally, there was significantly less missing data after implementation of the orthogeriatric trauma unit. After correcting for covariates, patients in the orthogeriatric trauma unit cohort had a lower chance of complications (OR 0.654, 95% CI 0.471-0.908, p = 0.011) and a lower chance of 1-year mortality (OR 0.656, 95% CI 0.450-0.957, p = 0.029).

Conclusions:

This study showed that implementation of an orthogeriatric trauma unit leads to a decrease in postoperative complications, 1-year mortality, and time spent at the emergency department, while also improving the quality of data registration for clinical studies.

Level of Evidence:

Level III.
Living on the Own Island? Aligned Collaboration Between Family Physicians, Nurses, Dieticians, and Patients With Diabetes Type 2 in an Outpatient Care Setting in Northern Italy: Findings From a Qualitative Study
Authors: Wieser Heike , Piccoliori Giuliano , Siller Marianne , Comploj Evi , Stummer Harald
Published: August 2020

Introduction: Diabetes mellitus type 2 (DM2), one of the four most important chronic diseases worldwide, is generally considered to be preventable. However, it is not yet sufficiently clear whether an aligned collaboration between different health professions could facilitate behavioral changes to be made by patients with DM2 regarding their eating and physical activity habits. Objective: To explore if and how far in current outpatient care for 3 health-care professions it is an objective to collaborate with each other supporting patients with DM2 in changing their eating and physical activity habits. Methods: We conducted 18 qualitative problem centered interviews with selected family physicians, nurses, dieticians working in outpatient setting and patients with DM2, transcribed verbatim, and analyzed with qualitative content analysis. Results: Issues identified ranged from description and reflection of current health-care practice, strategies, and hindrances to cope with changes of eating and physical activity behaviors as well as for health-care practice regarding interprofessional collaboration and patient-centered care up to considerations about collaboration and patient centricity (for health professionals and patients to achieve goals) and changes and ideas of “ideal care practice”. Discussion: The included professional groups work predominantly for themselves. Collaboration currently only takes place when individually triggered and neither structured nor organized.
Epstein-Barr Virus Versus Novel Coronavirus-Induced Hemophagocytic Lymphohistocytosis: The Uncharted Waters
Authors: Amir Rawan , Kichloo Asim , Singh Jagmeet , Bhanot Ravinder , Aljadah Michael , Kumar Akshay , Albosta Michael Stanley , Solanki Shantanu
Published: August 2020

Hemophagocytic lymphohistocytosis (HLH) is a hyperinflammatory syndrome characterized by fever, hepatosplenomegaly, and pancytopenia. It may be associated with genetic mutations or viral/bacterial infections, most commonly Epstein-Barr virus (EBV) and cytomegalovirus. As for the novel coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), also known as COVID-19 (coronavirus disease-2019), the cytokine storm it triggers can theoretically lead to syndromes similar to HLH. In this article, we report a case of a 28-year-old female who presented with high-grade fevers, found to have both SARS-CoV-2 and EBV infections, and eventually began to show signs of early HLH. To our knowledge, this is the first case reported in literature that raises the possibility of SARS-CoV-2–related HLH development.
Exploring Dimensions of Empowerment from the Patients’ Perspective in One Specialist Epilepsy Service in Ireland
Authors: Bennett Louise , Bergin Michael , Wells John S G
Published: August 2020

Empowerment is integral to patient-centered practice, particularly as this relates to people with chronic conditions, though operationally it is poorly understood in this context. Empowerment, therefore, as experienced by patients with a chronic condition needs exploration. This article reports the experience of empowerment by patients in one specialist epilepsy service in Ireland as an exemplar of broader issues affecting empowerment of patients with chronic conditions. A Frameworks Approach was used to analyze in-depth interviews with patients (n = 10) in one Irish epilepsy service. Analysis was further informed by nonparticipatory observation of service delivery. Results indicate that patients’ negative experiences of empowerment appear to be derived from traditional social norms relating to clinician patient power dimensions and social stigma internalized by clinicians at an unconscious level. With this in mind, educational approaches based upon critical social theory may provide a framework and guide to enable services to engage with these issues and embrace empowerment of patients with chronic conditions within therapeutic engagement.
Evaluation of Patient Perceptions With Orthopedic Oncology Telehealth: A Pilot Project
Authors: Evenski Andrea , Honig Rachel , Gupta Deepika , Wallach Emmanuelle , Sheets Lincoln R , Becevic Mirna
Published: August 2020

Telehealth has been used for decades to improve access to care for rural and underserved patients. The adoption of telehealth in orthopedic oncology is novel and expected to positively impact patient access and compliance. However, no previous evaluation has been published of this expected impact. The objective of this pilot project was to evaluate patients’ perceptions regarding orthopedic oncology telehealth services. A 13-question satisfaction survey was distributed to patients who used tele-orthopedic oncology. Fifteen respondents (a response rate of 42%) reported satisfaction with services at 9.7 of 10. Median travel distance to the nearest in-person orthopedic oncologist was greater than 150 miles (241 km). These results are consistent with the previous findings of high satisfaction with telehealth in other specialties. Health care organizations are likely to benefit from offering telehealth to orthopedic oncology patients with limited access.
Three-dimensional nonlinear response history analyses for earthquake damage assessment: A reinforced concrete wall building case study
Authors: Vásquez Jorge A , Jünemann Rosita , de la Llera Juan C , Hube Matías A , Chacón Matías F
Published: August 2020

Nonlinear dynamic analysis techniques have made significant progress in the last 20 years, providing powerful tools for assessing structural damage and potential building collapse mechanisms. The fact that several reinforced concrete shear wall residential buildings underwent severe structural damage in walls at the lower building levels during the 2010 Maule earthquake (Chile) presents a scientific opportunity to assess the predictive quality of these techniques. The objective of this research is to compare building responses using two completely different three-dimensional nonlinear dynamic models and study in detail the observed damage pattern and wall collapse of one reinforced concrete shear wall building in Santiago, Chile. The first model is a mixed fiber-shell model developed in MATLAB, and the second is a shell finite element model developed in the software DIANA. Results of both models are consistent with the hypothesis that high axial loads trigger a limited ductility failure in critical walls at roof-to-base drift ratios less than 0.34% with little capacity of hysteretic energy dissipation, which contradicts the ductile design philosophy of current code provisions.
Efficacy of folinic acid rescue following MTX GVHD prophylaxis: results of a double-blind, randomized, controlled study
Authors: Yeshurun Moshe , Rozovski Uri , Pasvolsky Oren , Wolach Ofir , Ram Ron , Amit Odelia , Zuckerman Tsila , Pek Anat , Rubinstein Maly , Sela-Navon Michal , Raanani Pia , Shargian-Alon Liat
Published: August 2020

The use of methotrexate (MTX) for graft-versus-host disease (GVHD) prophylaxis is associated with increased rates of organ-specific toxicities. Despite limited data, the European Society for Blood and Marrow Transplantation-European LeukemiaNet working group recommend the use of folinic acid (FA) rescue to reduce MTX toxicity after allogeneic hematopoietic cell transplantation (allo-HCT). In a multicenter, double-blind, randomized, controlled trial, we explored whether FA rescue reduces MTX-induced toxicity. We enrolled patients undergoing allo-HCT with myeloablative conditioning with peripheral blood stem cell grafts, with GVHD prophylaxis consisting of cyclosporine and MTX. Patients were randomized to receive FA or placebo starting 24 hours after each MTX dose and continuing over 24 hours in 3 to 4 divided doses. The primary end point was the rate of grades 3 and 4 oral mucositis. After enrollment of 52 patients (FA, n = 28; placebo, n = 24), preplanned interim analysis revealed similar rates of grade 3 and 4 (46.6% vs 45.8%; P = .97) and grades 1 to 4 (83.3% vs 77.8%; P = .65) oral mucositis. With a median follow-up of 17 (range, 4.5-50) months, there was no difference in the rates of acute and chronic GVHD, disease relapse, nonrelapse mortality, and overall survival. These interim results did not support continuation of the study. We conclude that FA rescue after MTX GVHD prophylaxis does not decrease regimen-related toxicity or affect transplantation outcomes. This study was registered at clinicaltrials.gov as #NCT02506231.
Impact of body mass index on development of nontuberculous mycobacterial pulmonary disease
Authors: Song Jin Hwa , Kim Bong Seong , Kwak Nakwon , Han Kyungdo , Yim Jae-Joon
Published: August 2020

The incidence and prevalence of nontuberculous mycobacterial pulmonary disease (NTM-PD) have been increasing worldwide. The risk of NTM-PD may be higher in undernourished populations. In this study, we tried to elucidate the impact of body mass index (BMI) and its change on development of NTM-PD.

We performed a retrospective cohort study including South Koreans aged >40 years who underwent biennial National Health Insurance System (NHIS) health check-ups in both 2005 and 2009 or 2006 and 2010. We monitored eligible individuals from the study initiation date (NHIS health check-up date in 2009 or 2010) until the diagnosis of NTM-PD or until December 31, 2017. Enroled individuals were classified based on BMI at initiation date. By calculating hazard ratios, we compared NTM-PD incidence per 100 000 person-years by BMI group and by BMI change.

A total of 5 670 229 individuals were included in the final analysis. Compared with the BMI <18.5 kg·m−2group, the incidence of NTM-PD gradually decreased with increased BMI (adjusted hazard ratio 0.38, 95% confidence interval (CI) 0.35–0.42 for BMI 18.5–22.9; 0.17, 95% CI 0.15–0.19 for BMI 23–24.9; 0.1, 95% CI 0.09–0.11 for BMI 25–29.9; and 0.1, 95% CI 0.07–0.13 for BMI ≥30). A BMI decrease of ≥1 kg·m−2over 4 years increased the incidence of NTM-PD (adjusted hazard ratio 1.08, 95% CI 1.01–1.16) whereas a BMI increase of ≥1 kg·m−2decreased the incidence of NTM-PD (adjusted hazard ratio 0.77, 95% CI 0.71–0.83).

In conclusion, BMI was inversely related to development of NTM-PD and weight loss increased the risk of NTM-PD.
Abiotrophia defectiva liver abscess in a teenage boy after a supposedly mild blunt abdominal trauma: a case report
Authors: Rasic Petar , Bosnic Srdjan , Vasiljevic Zorica V. , Djuricic Slavisa M. , Topic Vesna , Milickovic Maja , Savic Djordje
Published: August 2020

Background

A pyogenic liver abscess (PLA) represents a pus-filled cavity within the liver parenchyma caused by the invasion and multiplication of bacteria. The most common offender isolated from the PLA in children is Staphylococcus aureus. Abiotrophia defectiva is a Gram-positive pleomorphic bacterium, commonly found in the oral cavity, intestinal, and genitourinary mucosa as part of the normal microbiota. It has been proven to be an etiological factor in various infections, but rarely in cases of PLA. The case presented here is, to the best of our knowledge, the first pediatric case of PLA caused by A. defectiva.

Case presentation

A 13-year-old Caucasian boy presented with a two-day history of abdominal pain, fever up to 40 °C, and polyuria. Contrast-enhanced computed tomography (CT) scan revealed a single, multiloculated liver lesion, suggestive of a liver abscess. The boy had sustained a bicycle handlebar injury to his upper abdomen 3 weeks before the symptoms appeared and had been completely asymptomatic until 2 days before admission. He was successfully treated with antibiotic therapy and open surgical drainage. A. defectiva was isolated from the abscess material. Histopathology report described the lesion as a chronic PLA.

Conclusions

A. defectiva is a highly uncommon cause of liver abscess in children. In such cases, various predisposing factors should be considered, including antecedent blunt abdominal trauma.
Barriers and facilitators of kangaroo mother care adoption in five Chinese hospitals: a qualitative study
Authors: Yue Jieya , Liu Jun , Williams Sarah , Zhang Bo , Zhao Yingxi , Zhang Qiannan , Zhang Lin , Liu Xin , Wall Stephen , Wetzel Greta , Zhao Gengli , Bouey Jennifer
Published: August 2020

Background

Kangaroo mother care (KMC) has been proved to be a safe and cost-effective standard of care for preterm babies. China hasn’t adopted the KMC practice widely until recently. We aim to assess barriers and facilitators of KMC adoption in neonatal intensive care units (NICUs) and postnatal wards in China.

Methods

We conducted clinical observations and semi-structured interviews with nurses, physicians, and parents who performed KMC in seven NICUs and postnatal wards housed in five hospitals in different provinces of China between August and September 2018. The interviews provided first-hand stakeholder perspectives on barriers and facilitators of KMC implementation and sustainability. We further explored health system’s readiness and families’ willingness to sustain KMC practice following its pilot introduction. We coded data for emerging themes related to financial barriers, parent- and hospital-level perceived barriers, and facilitators of KMC adoption, specifically those unique in the Chinese context.

Results

Five hospitals with KMC pilot programs were selected for clinical observations and 38 semi-structured interviews were conducted. Common cultural barriers included concerns with the conflict with traditional postpartum confinement (Zuo-yue-zi) practice and grandparents’ resistance, while a strong family support is a facilitator for KMC adoption. Some parents reported anxiety and guilt associated with having a preterm baby, which can be a parental-level barrier to KMC. Hospital-level factors such as fear of nosocomial infection and shortage of staff and spaces impeded the KMC implementation, and supportive community and peer group organized by the hospital contributed to KMC uptake. Financial barriers included lodging costs for caregivers and supply costs for hospitals.

Conclusions

We provided a comprehensive in-depth report on the multi-level KMC barriers and facilitators in China. We recommend policy interventions specifically addressing these barriers and facilitators and increase family and peer support to improve KMC adoption in China. We also recommend that well-designed local cultural and economic feasibility and acceptability studies should be conducted before the KMC uptake.
Sulfated polysaccharides of some seaweeds exhibit neuroprotection via mitigation of oxidative stress, cholinergic dysfunction and inhibition of Zn – induced neuronal damage in HT-22 cells
Authors: Olasehinde Tosin A. , Olaniran Ademola O. , Okoh Anthony I.
Published: August 2020

Background

Sulfated polysaccharides from marine algae are known to possess antioxidative activities, however, their therapeutic role in metal-induced neurodegeneration has not been explored. In this study, the neuroprotective potentials of sulfated polysaccharides isolated from Ecklonia maxima (PKPM), Gelidium pristoides (PMNP), Ulva lactuca (PULV), Ulva rigida (PURL) and Gracilaria gracilis (PGCL) against Zn-induced neurodegeneration in rats’ hippocampal neuronal cells (HT-22) were assessed.

Methods

Cells were cultured and maintained at 37 °C. Control cells did not contain Zinc sulphate (ZnSO4) while other experimental groups contain Zn (50 μM) alone or in combination with sulfated polysaccharides (0.4 or 0.8 mg/mL). Cell viability was assessed using MTT assay while apoptotic assay was also determined using acridine orange and ethidium bromide staining technique. Oxidative stress parameters (superoxide dismutase and catalase activities, glutathione and nitric oxide levels) and acetylcholinesterase activity were also assessed in neuronal cells treated with or without Zn.

Results

Zn significantly reduced cell viability to about 50%. However, sulfated polysaccharides improved cell viability to about 95%. The sulfated polysaccharides also prevented late apoptosis and necrosis triggered by Zn. Furthermore, superoxide dismutase and catalase activities including glutathione content were significantly low in cells induced with Zn. Treatment with sulfated polysaccharides triggered a significant increase in antioxidant enzymes and glutathione content as well as a decrease in the activity of acetylcholinesterase in cells treated with Zn.

Conclusion

PKPM, PGCL, PURL, PULV and PMNP exhibit neuroprotective effects against neuronal damage induced by Zn and this may be attributed to inhibition of apoptosis, oxidative damage and acetylcholinesterase activity. These polysaccharides may be good therapeutic agents to protect neuronal cells against Zn - induced pathological processes associated with Alzheimer’s disease.
HGF alleviates septic endothelial injury by inhibiting pyroptosis via the mTOR signalling pathway
Authors: Peng Fei , Chang Wei , Sun Qin , Xu Xinyi , Xie Jianfeng , Qiu Haibo , Yang Yi
Published: August 2020

Background

Endothelial injury is one of the predominant pathophysiological characteristics of sepsis and is the major cause of sepsis-induced multiple organ failure. Endothelial pyroptosis is a fatal mechanism of endothelial injury in sepsis, and specific, effective therapies are lacking. Although hepatocyte growth factor (HGF) has been shown to have anti-apoptotic and anti-necrotic effects, whether it prevents pyroptosis to improve endothelial injury in sepsis remains unclear.

Methods

Recombinant HGF was intravenously injected into mice with sepsis caused by caecal ligation puncture (CLP). Histopathological examination and transmission electron microscopy (TEM) were used to measure lung vascular endothelial injury. Lipopolysaccharide (LPS) was transfected into EA.hy926 cells to induce endothelial pyroptosis, and the cells were treated with HGF in the presence of inhibitors of c-Met and mTOR, namely, PHA-665752 and rapamycin, respectively. The mTOR signalling pathway and mitochondrial physiology were assessed using Western blot and flow cytometry.

Results

Intravenous HGF effectively alleviated pulmonary vascular endothelial injury and acute lung injury in the septic mice. The TEM results of lung tissue revealed that HGF attenuated pulmonary vascular endothelial pyroptosis, which was confirmed in vitro. Transfected LPS induced the pyroptosis of EA.hy926 cells and damaged their paracellular permeability, and these effects were ameliorated by treating the cells with recombinant HGF. The protective effect of HGF against pyroptosis was dependent on c-Met/mTOR signalling. mTOR activation effectively protected mitochondrial physiology and decreased reactive oxygen species (ROS) production in EA.hy926 cells in vitro.

Conclusions

These results demonstrated that HGF protected mitochondrial physiology by activating mTOR signalling to partially ameliorate endothelial pyroptosis and attenuate vascular endothelial injury and acute lung injury in sepsis animal model.
Invisible contaminants and food security in former coal mining areas of Santa Catarina, Southern Brazil
Authors: Blanco Graziela Dias , Sühs Rafael Barbizan , Brizola Escarlet , Corrêa Patrícia Figueiredo , Campos Mari Lucia , Hanazaki Natalia
Published: August 2020

Background

Mining activities have environmental impacts due to sediment movement and contamination of areas and may also pose risks to people’s food security. In Brazil, the majority of coal mining activities are in the south, in the Santa Catarina carboniferous region. In this region, previously mined areas contaminated with heavy metals frequently occur nearby inhabited zones. Mining is part of the daily lives of local communities, and its environmental impacts are visible in the landscape; however, plants with medicinal and food use from these areas can be still consumed. Heavy metals are contaminants that do not have odor, color, or taste, and are therefore difficult to detect. We aimed to verify whether people use plants from contaminated mine areas, and understand which factors can influence the use of these resources, even from areas visibly impacted.

Methods

We conducted 195 semi-structured interviews with residents from 14 areas nearby abandoned mines in the main municipalities of the Santa Catarina carboniferous region. We asked each interviewee about the length of time they lived in the region, their perception of the quality of the environment, and what plant species were used and for what purpose. We constructed generalized multivariate linear models to verify which variables can affect the group of species mentioned and generalized linear models to verify which variables can affect the total number of citations. We estimated the frequency of citing species collected using the Smith index.

Results

From all interviewees, 127 (65%) reported collecting plants for medicinal and food use, directly from contaminated mine areas. Long-term residents, as well as those who noticed more environmental changes (positive and negative), cited more plants used and had more detailed knowledge of plant use in their communities. When asked if they were aware of the possible contamination of mined areas, 85% said they knew about it. However, only 10% associated negative health effects with the use of plant species collected in contaminated mined areas.

Conclusions

Our study demonstrates that people living nearby contaminated areas use and consume locally sourced plants, e.g., people know little about the danger of this contamination in their food and the risk of these contaminants to their health. These results also reveal a lack of information about contamination, as well as a lack of actions that include local communities in contaminated area restoration strategies. This situation poses a risk to the food security of the people living nearby former coal mining areas.
Individualized approach to primary prevention of substance use disorder: age-related risks
Authors: Afuseh Eric , Pike Caitlin A. , Oruche Ukamaka M.
Published: August 2020

Background

The misuse of legal and illegal substances has led to an increase in substance use disorder (SUD) in the United States. Although primary prevention strategies have been successfully used to target chronic physical diseases, these strategies have been less effective with SUD, given misconceptions of SUD, shortages in behavioral health professionals, and the population-based focus on specific substances. A developmental approach to the identification and primary prevention of SUD that does not fully rely upon behavioral health workers is needed. The purpose of this paper was to examine age related risk factors for developing SUD and present a novel individualized approach to SUD prevention.

Methods

A literature search was conducted to identify risk factors for SUD among children, young adults, adults, and older adults. We searched CINAHL, PsycINFO, and PubMed between the years 1989–2019, and extracted data, analyzing similarities and differences in risk factors across life stages. Broader categories emerged that were used to group the risk factors.

Results

More than 370 articles were found. Across all age groups, risk factors included adverse childhood experiences, trauma, chronic health diseases, environmental factors, family history, social determinants, and grief and loss. Despite the similarities, the contextual factors and life challenges associated with these risks varied according to the various life stages. We proposed an approach to primary prevention of SUD based on risk factors for developing the disease according to different age groups. This approach emphasizes screening, education, and empowerment (SEE), wherein individuals are screened for risk factors according to their age group, and screening results are used to customize interventions in the form of education and empowerment. Given that trained persons, including non-healthcare providers, close to the at-risk individual could conduct the screening and then educate and mentor the individual according to the risk level, the number of people who develop SUD could decrease.

Conclusions

The risk factors for developing SUD vary across the various life stages, which suggests that individualized approaches that do not overtax behavioral healthcare workers are needed. Using SEE may foster early identification and individualized prevention of SUD.
The Toll-like receptor ligand, CpG oligodeoxynucleotides, regulate proliferation and osteogenic differentiation of osteoblast
Authors: Yu Wenwen , Zheng Yi , Li Hongyan , Lin Hongbing , Chen Zhen , Tian Yue , Chen Huishan , Zhang Peipei , Xu Xiaowei , Shen Yuqin
Published: August 2020

Background

This study aimed to investigate the regulation of CpG oligodeoxynucleotides (ODNs) on proliferation and osteogenic differentiation of MC3T3 cells.

Methods

The laser co-focusing and flow cytometry assay were employed to detect cell uptake of CpG ODN 2006. Twelve ODNs were sythesized, and their effects on proliferation and differentiation were detected by MTT and alkaline phosphatase (ALP) activity assay. Flow cytometry assay was used to examine the regulation of CpG ODN on cell cycle. Quantitative real-time PCR (qRT-PCR) and western blot were used to evaluate the regulation of CpG ODN on mRNA and protein expression of osteogenic differentiation genes.

Results

The phosphorothioate CpG ODN 2006 could efficiently enter the MC3T3 cells in 1 h and locate in the cytoplasm. The MTT assay demonstrated CpG ODNs could promote MC3T3 cell proliferation and differentiation in the early stage, and gradually attenuated along with the increase of treating time, except for BW001 and FC001. qRT-PCR assay demonstrated that all the 12 CpG ODNs could promote the relative expression level of osteogenic differentiated genes, SP7 and OCN. In addition, western blot analysis suggested the CpG ODNs of BW001 and FC001 could increase the protein expression of P27Kip1 and Runx2 and decrease the protein expression of cyclin D1.

Conclusion

The selected CpGODNs may be a potential gene therapy for bone regeneration of periodontitis.
MRI evaluation of resorbable poly lactic-co-glycolic acid (PLGA) screws used in pelvic osteotomies in children—a retrospective case series
Authors: Hedelin Henrik , Hebelka Hanna , Brisby Helena , Laine Tero
Published: August 2020

Purpose

The orthopaedic use of resorbable poly lactic-co-glycolic acid (PLGA) implants carries multiple potential benefits. To our knowledge, only one publication exists regarding the use of PLGA implants in pelvic osteotomies in children, and data regarding resorption and potential side effects are lacking for resorbable pelvic screws in children. The aim of this study is to present an MRI-based evaluation of the resorption pattern and local tissue reactions in a paediatric case series after pelvic osteotomies fixated with PLGA screws.

Methods

Twelve children who had undergone a Salter or triple pelvic osteotomy fixated with 4.5 mm PLGA screws were included. A total of 18 MRIs was performed 0.5–4.5 years after surgery and were retrospectively analysed. Eight parameters relating to screw resorption, local reactions and re-formation of bone were interpreted.

Results

The screw canals were > 90% replaced with solid bone after 2–4.5 years in all cases but one, where the canals were only partly replaced with bone. There were no major soft tissue reactions but small (< 12 mm) bone cysts were observed in 3 of the 18 MRIs and discrete fatty patches in the adjacent bone were common.

Conclusion

PLGA screws in the paediatric pelvis appear to be resorbed and replaced with solid bone in most cases but this process takes at least 2 years. Minor reactions could be seen in the adjacent bone but were judged to be of no clinical significance.
Health TAPESTRY Ontario: protocol for a randomized controlled trial to test reproducibility and implementation
Authors: Mangin Dee , Lamarche Larkin , Oliver Doug , Bomze Sivan , Borhan Sayem , Browne Tracy , Carr Tracey , Datta Julie , Dolovich Lisa , Howard Michelle , Marentette-Brown Sarah , Risdon Cathy , Talat Samina , Tarride Jean-Eric , Thabane Lehana , Valaitis Ruta , Price David
Published: August 2020

Background

Health TAPESTRY (Health Teams Advancing Patient Experience: STRengthening qualitY) aims to help people stay healthier for longer where they live by providing person-focused care through the integration of four key program components: (1) trained volunteers who visit clients in their homes, (2) an interprofessional primary health care team, (3) use of technology to collect and share information, and (4) improved connections to community health and social services. The initial randomized controlled trial of Health TAPESTRY found promising results in terms of health care use and patient outcomes, indicating a shift from reactive to preventive care. The trial was based on one clinical academic center, thus limiting generalizability. The study objectives are (1) to test reproducibility of the established effectiveness of Health TAPESTRY on physical activity and hospitalizations, (2) to test the feasibility of, and understand the contributing factors to, the implementation of Health TAPESTRY in six diverse communities across Ontario, Canada, and (3) to determine the value for money of implementing Health TAPESTRY.

Methods

This planned study is a pragmatic parallel randomized controlled trial with a delayed intervention for control participants at 6 months. This trial will simultaneously assess effectiveness and implementation in a real-world setting (type II hybrid) in six diverse communities across Ontario. Participants 70 years of age and older will be randomized into the Health TAPESTRY intervention or the control group (usual care). Intervention clients will receive an individualized plan of care from an interprofessional care team. The plan will be based on a client’s goals and current health risks identified through volunteer visits. The study’s outcomes are mapped onto the RE-AIM framework, with levels of physical activity and number of hospitalizations as the co-primary outcomes. The main analysis will be a comparison at 6 months.

Discussion

It is important to evaluate the effectiveness and implementation of Health TAPESTRY in multiple communities prior to scaling or widespread adoption.

Trial registration

ClinicalTrials.govNCT03397836. Registered on 12 January 2018
Antibacterial activity of Cu(II) and Co(II) porphyrins: role of ligand modification
Authors: Beyene Belete B. , Wassie Getaneh A.
Published: August 2020

In this study, we report antibacterial activity of metalloporphyrins; 5, 10, 15, 20-tetrakis (para-X phenyl)porphyrinato M (II) [where X = H, NH2 and COOMe for M = Cu and X = COOH  and OMe for M = Co]. The activity study of the as-synthesized metalloporphyrins toward two Gram-positive (S. aureus and S. pyogenes) and two Gram-negative (E. coli and K. pneumoniae) bacteria showed a promising inhibitory activity. Among the complexes under study, the highest antibacterial activity is observed for 5, 10, 15, 20-tetrakis (p-carboxyphenyl)porphyrinato cobalt (II), with inhibition zone of 16.5 mm against Staphylococcus aureus (S. aureus). This activity could be attributed to the high binding ability of COOH group to cellular components, membranes, proteins, and DNA as well as the lipophilicity of the complex. Moreover, consistent with literature report, the study revealed that metalloporphyrins with electron withdrawing group at para-positions have better antibacterial activity than metalloporphyrin which possess electron donating group at para position.
Bacterial laccase of Anoxybacillus ayderensis SK3-4 from hot springs showing potential for industrial dye decolorization
Authors: Wang Jingjing , Chang Fei , Tang Xiaoqing , Li Wei , Yin Qiang , Yang Yang , Hu Yang
Published: August 2020

Introduction

Laccases are green biocatalysts that possess attractive for the treatment of resistant environmental pollutants and dye effluents.

Purpose

To exploit the laccase of Anoxybacillus ayderensis SK3-4 that possesses dye decolorization ability at room and higher temperature, we characterized the enzyme in considerable detail and investigated its ability to decolorize different dyes.

Results

A bacterial laccase gene designed as LacAn from Anoxybacillus ayderensis SK3-4 of hot springs was cloned and expressed in Escherichia coli. LacAn is a monomeric protein with a molecular weight of 29.8 kDa. The optimum pH and temperature for syringaldazine oxidation were 7.0 and 75 °C, respectively. LacAn was stable at pH values ranging from 6.5 to 8.5 above 65 °C. The enzyme activity was significantly enhanced by Cu2+ and Mg2+ but inhibited by Zn2+ and Fe2+. Furthermore, LacAn showed high decolorization capability toward five dyes (direct blue 6, acid black 1, direct green 6, direct black 19, and acid blue 93) in the absence of redox mediators. It also demonstrated a wide temperature range, and it can retain its high decolorization ability even at high temperatures.

Conclusions

These properties including better enzymatic properties and efficiency to decolorize dyes demonstrate that the bacterial laccase LacAn has potentials for further industrial applications.
Incidentally detected pancake kidney: a case report
Authors: Bakshi Sabyasachi
Published: August 2020

Background

Congenital anomalies of the urinary system are very common and have extremely varied presentation. Among them, the most rarely found structural anomaly is the pancake kidney. When both kidneys are fused along their medial surfaces to form a round-shaped single renal mass, it is termed as pancake kidney. In this case report, a pancake kidney was incidentally detected in a girl. The majority of individuals who have pancake kidney are usually asymptomatic but surgeons should be aware of coexisting malformation of other organs and its potential risk of developing malignancy.

Case presentation

A 12-year-old Bengali girl presented to our out-patient department with mild, dull aching, lower abdominal pain and dysuria. She had no history of fever, hematuria, menstrual abnormality, pelvic inflammatory disease, or trauma. Urine examination showed traces of albumin and 10–12 pus cells/high-power field. She had normal kidney function test but a digital X-ray of her kidney, ureter, and bladder region failed to demonstrate bilateral renal tissue shadows. Ultrasonography of her whole abdomen showed normal intra-abdominal organs except for empty bilateral renal fossa. A multi-detector computed tomography scan of her whole abdomen revealed one round-shaped mass measuring approximately 9 cm (vertical) × 10 cm (horizontal) in the pelvic cavity. That mass was finally identified as a pancake kidney. She was prescribed antibiotics based on urine culture and sensitivity test that cured her symptoms. She was advised to follow-up regularly in our out-patient department to evaluate her kidney function and to rule out any neoplastic change.

Conclusions

This condition can be managed conservatively, if the individual remains asymptomatic, by regular monitoring of renal function. Surgeons should remain alert for the development of infections, any obstructive manifestations leading to calculus formation, and any malignant changes. The individual should be careful in avoiding trauma to low-lying pelvic kidney. Extensive surgeries should be avoided and only selective procedures should be done so that the patient may lead a normal lifestyle.
Transcriptome profiles acquired during cell expansion and licensing validate mesenchymal stromal cell lineage genes
Authors: Wiese Danielle M. , Braid Lorena R.
Published: August 2020

Background

Mesenchymal stromal cells (MSCs) are rapidly advancing as commercial therapeutics. However, there are still no adequate tools to validate the identity of MSCs and support standardization of MSC-based products. Currently accepted metrics include cell surface marker profiling and tri-lineage differentiation assays, neither of which is definitive. Transcript profiling represents a cost- and time-effective approach amenable to MSC manufacturing processes. Two independent labs recently reported non-overlapping MSC-specific transcriptomic signatures of 489 and 16 genes.

Methods

Here, we interrogated our repository of transcriptome data to determine whether routine culture manipulations including cell expansion and immune activation affect expression of the reported MSC lineage genes. These data sets comprise 4 donor populations of human umbilical cord (UC) MSCs serially cultured from cryopreservation thaw through pre-senescence, and 3 donor populations each of naïve UC and bone marrow (BM) MSCs and licensed by 3 different cytokines.

Results

Overall, 437 of 456 proposed signature genes assessed in these data sets were reliably expressed, representing an enduring lineage profile in 96% agreement with the previous studies. Serial passaging resulted in the downregulation of 3 signature genes, and one was silenced. Cytokine stimulation downregulated expression of 16 signature genes, and 3 were uniformly silenced in one or the other MSC type. Fifteen additional genes were unreliably detected, independent of culture manipulation.

Conclusion

These results validate and refine the proposed transcriptomic tools for reliable identification of MSCs after isolation through cell expansion and after inflammatory activation. We propose a 24-gene signature to support standardized and accessible MSC characterization.