bluuebunny/crossref_metadata_2025 huggingface dataset:
Individualized procedures for splenic artery dissection during laparoscopic distal pancreatectomy
Authors: Wada Yusuke , Aoki Takeshi , Murakami Masahiko , Fujimori Akira , Koizumi Tomotake , Kusano Tomokazu , Matsuda Kazuhiro , Nogaki Koji , Hakozaki Tomoki , Shibata Hideki , Tomioka Kodai
Published: February 2020

Background

There are no established standard criteria for choosing the most appropriate procedure of splenic artery dissection during laparoscopic distal pancreatectomy (LDP). The aim of this study was to evaluate the clinical benefits of individualized procedures for splenic artery dissection during LDP based on the variations in arterial structure visualized on preoperative three-dimensional computed tomography (3D-CT).

Methods

Patients who underwent LDP following 3D-CT at a single center were retrospectively evaluated. 3D-CT images were used to construct virtual 3D laparoscopic images for surgical planning. The splenic artery was classified into two major anatomic types: type S that curves and runs suprapancreatic and type D that runs straight and dorsal to the pancreas. Splenic artery dissection was planned according to these two variations, with type S dissected using an suprapancreatic approach and type D using a dorsal approach.

Results

Type-specific dissection was applied for 30 patients: 25 (83%) with type S and 5 (17%) with type D splenic artery anatomies. In 25 (83%) patients, the splenic artery was successfully dissected using the planned surgical procedure, whereas the surgical plan had to be altered in 5 cases (17%) due to difficulty in dissecting the splenic artery.

Conclusion

The individualized procedures for splenic artery dissection according to anatomic variations visualized on 3D-CT images can help improve the success and safety of LDP.
Limited knowledge and access to palliative care among women with cervical cancer: an opportunity for integrating oncology and palliative care in Zimbabwe
Authors: Tapera O. , Nyakabau A. M.
Published: February 2020

Background

Cervical cancer is mostly diagnosed at advanced stages among the majority of women in low-income settings, with palliative care being the only feasible form of care. This study was aimed at investigating palliative care knowledge and access among women with cervical cancer in Harare, Zimbabwe.

Methods

Sequential mixed methods design was used, consisting of two surveys and a qualitative inquiry. A census of 134 women diagnosed with cervical cancer who visited two cancer treating health facilities and one palliative care provider in Harare between January and April, 2018 were enrolled in the study. Seventy-eight health workers were also enrolled in a census in the respective facilities for a survey. Validated structured questionnaires in electronic format were used for both surveys. Descriptive statistics were generated from the surveys after conducting univariate analysis using STATA. Qualitative study used interview/discussion guides for data collection. Thematic analysis was conducted for qualitative data.

Results

Mean ages of patients and health workers in the surveys were 52 years (SD = 12) and 37 years (SD = 10,respectively. Thirty-two percent of women with cervical cancer reported knowledge of where to seek palliative care. Sixty-eight percent of women with cervical cancer had received treatment, yet only 13% reported receiving palliative care. Few women with cervical cancer associated treatment with pain (13%) and side effects (32%). More women associated cervical cancer with bad smells (81%) and death (84%). Only one of the health workers reported referring patients for palliative care. Seventy-six percent of health workers reported that the majority of patients with cervical cancer sourced their own analgesics from private pharmacies. Qualitative findings revealed a limited or lack of cervical cancer knowledge among nurses especially in primary health care, the existence of stigma among women with cervical cancer and limited implementation of palliative policy.

Conclusions

This study revealed limited knowledge and access to palliative care in a low-income setting due to multi-faceted barriers. These challenges are not unique to the developing world and they present an opportunity for low-income countries to start considering and strategizing the integration of oncology and palliative care models in line with international recommendations.
Prevalence of complementary and alternative medicine (CAM) use in Brazil
Authors: de Moraes Mello Boccolini Patricia , Siqueira Boccolini Cristiano
Published: February 2020

Background

The use of medicinal plants or other alternative practices can be the only therapeutic resources for many communities and ethnic groups, especially in developing countries. In Brazil, the Ministry of Health incorporated Complementary and Alternative Medicine (CAM) as a public health policy since 2006. The aim of this study was to evaluate the prevalence of CAM use in Brazil.

Methods

This was a cross-sectional study performed as an epidemiological survey, with data from the National Health Survey, 2013 that evaluated a sample of adult Brazilians (18+ years old). The outcome was the use of CAM therapies, such as acupuncture, homeopathy, medicinal plants and herbal medicines in the last 12 months. We employed a logistic regression model (CI 95%) to evaluate the chances of CAM use.

Results

The prevalence of CAM use in Brazil was 4.5%. The subjects with higher chances to use CAM were: women (AOR = 1.42), aged > 40 years (AOR = 1.64), with higher educational levels (AOR = 2.35), and residents at North (AOR = 2.02) and South (AOR = 1.67) regions of Brazil, all with p-value < 0.001. According to the socioeconomic status, subjects from upper classes had higher chances to use acupuncture and homeopathy when compared to the other classes, and individuals from lower classes had higher chances to use medicinal plants and herbal medicines. Almost half of all individuals reporting CAM use did so outside the health care system. The Brazilian Unified Health System (SUS) was the least used funding for CAM when compared to other types of funding.

Conclusions

We recommend that the Ministry of Health invests in capacity building for health professionals who work with CAM, providing structure for those practices in health services, increasing the access of CAM therapies for SUS users, and improving the registering of information about those therapies, encouraging the use of CAM by the Brazilian population.
The effect of brushing with Salvadora persica (miswak) sticks on salivary Streptococcus mutans and plaque levels in children: a clinical trial
Authors: Sabbagh Heba J. , AlGhamdi Khalil S. , Mujalled Hattan T. , Bagher Sara M.
Published: February 2020

Background

The aim of the randomized double-blinded clinical trial was to evaluate the effect of tooth brushing with Salvadora persica (miswak) sticks on Streptococcus mutans count and the mean plaque score relative to brushing with fluoridated tooth paste (FTP).

Methods

Our sample included 94 healthy, high caries-risk, 8 to 9-year-old students recruited from a government school, in Jeddah, Saudi Arabia between February and April 2016. Subjects were randomly grouped into test (provided with miswak sticks) and control groups (provided with FTP and soft brushes). Both groups were introduced to a preparatory period (PPP) of 3 weeks. Plaque score and saliva sampling were conducted prior to the PPP and in follow-up visits by a single, calibrated and blinded dentist.

Results

Both groups showed a statistically significant decrease in the mean plaque score across the study (P = 0.007 and P = 0.001, respectively). In addition, subjects in the test group with abundant S. sanguinis increased from zero to six after 3 months.

Conclusions

Salvadora Persica (miswak) and brushing with FTP significantly reduced plaque scores among school children. In addition, Salvadora persica was found to change the proportions of salivary bacteria in favor of species with less risk of inducing caries.

Trial registration

ClinicalTrials.gov ID #: NCT04137393.
Effects of taichi on grade 1 hypertension: A study protocol for a randomized controlled trial
Authors: Lee Sang-Hyun , Kim Byung-Jun , Park In-Hwa , Hwang Eui-Hyoung , Park Eun Ju , Jang Insoo , Hwang Man-Suk
Published: February 2020

Background

Medication is generally recommended to reduce the morbidity and mortality caused by cardiovascular disease in hypertensive patients. However, considering the difficulties and economic factors associated with long-term medication, interest in taichi as an exercise treatment method has increased recently in Korean medical practice. Numerous studies have suggested that taichi can be used to treat various diseases and that is can affect psychosomatic factors such as anxiety. This study aims to evaluate the effect of taichi in reducing blood pressure among grade 1 hypertensive patients.

Methods/design

In this randomized, active-controlled, assessor-blinded, two parallel-armed trial, 80 grade 1 hypertension patients will be recruited and randomly assigned to the usual care group or to the taichi group (n = 40 in each group). Subjects who voluntarily sign a study agreement will be educated in managing their own blood pressure by restricting salt intake, losing weight, moderating alcohol consumption, performing exercise, and regulating dietary intake at their first visit. In addition to self-management, the taichi group will perform two 60-min taichi sessions per week for a total of 8 weeks. Blood pressure will be measured as the primary outcome. In addition, body composition, heart rate, and the perceived intensity and difficulty of the exercise will be measured as secondary outcomes.

Discussion

This study is a randomized controlled trial of taichi, which is not widely practiced in Korea. It may provide valuable data on the effects of taichi on hypertension, which will inform non-pharmaceutical treatment options for this disorder.

Trial registration

Clinical Research Information Service, KCT0003632. Registered on 18 March 2019.
Pharmacokinetics, SAfety/tolerability, and EFficacy of high-dose RIFampicin in tuberculosis-HIV co-infected patients on efavirenz- or dolutegravir-based antiretroviral therapy: study protocol for an open-label, phase II clinical trial (SAEFRIF)
Authors: Nabisere Ruth , Musaazi Joseph , Denti Paolo , Aber Florence , Lamorde Mohammed , Dooley Kelly E. , Aarnoutse Rob , Sloan Derek J. , Sekaggya-Wiltshire Christine
Published: February 2020

Background

Tuberculosis (TB) is a significant public health problem that causes substantial morbidity and mortality. Current first-line anti-TB chemotherapy, although very effective, has limitations including long-treatment duration with a possibility of non-adherence, drug interactions, and toxicities. Dose escalation of rifampicin, an important drug within the regimen, has been proposed as a potential route to higher treatment efficacy with shorter duration and some studies have suggested that dose escalation is safe; however, these have almost entirely been conducted among human immunodeficiency (HIV)-negative TB patients. TB-HIV co-infected patients on antiretroviral therapy (ART) are at increased risk of drug-drug interactions and drug-related toxicities. This study aims to determine the safety of higher doses of rifampicin and its effect on the pharmacokinetics of efavirenz (EFV) and dolutegravir (DTG) in TB-HIV co-infected patients.

Methods

This study is a randomized, open-label, phase IIb clinical trial among TB-HIV infected adult outpatients attending an HIV clinic in Kampala, Uganda. Patients newly diagnosed with TB will be randomized to either standard-dose or high-dose rifampicin (35 mg/kg) alongside standard TB treatment. ART-naïve patients will be randomly assigned to first-line ART regimens (DTG or EFV). Those who are already on ART (DTG or EFV) at enrollment will be continued on the same ART regimen but with dose adjustment of DTG to twice daily dosing. Participants will be followed every 2 weeks with assessment for toxicities at each visit and measurement of drug concentrations at week 6. At the end of intensive-phase therapy (8 weeks), all participants will be initiated on continuation-phase treatment using standard-dose rifampicin and isoniazid.

Discussion

This study should avail us with evidence about the effect of higher doses of rifampicin on the pharmacokinetics of EFV and DTG among TB-HIV co-infected patients. The trial should also help us to understand safety concerns of high-dose rifampicin among this vulnerable cohort.

Trial registration

ClinicalTrials.gov, ID:NCT03982277. Registered retrospectively on 11 June 2019.
Atrial myxoma with cerebellar signs: a case report
Authors: Shrestha Suraj , Raut Akash , Jayswal Amar , Yadav Randhir Sagar , Poudel Chandra Mani
Published: February 2020

Background

Atrial myxoma remains a rare clinical entity with an incidence of surgically resected cases of 0.5–0.7 per million population and prevalence of < 5 per 10,000. It typically manifests in woman after third decade of life; symptoms vary greatly and may present with arrhythmia, intracardiac flow obstruction, embolic phenomenon, and associated constitutional symptoms. Neurological complications associated with atrial myxoma most frequently include cerebral infarct due to embolus. Cerebellar involvement is very rare and only a few cases have been reported in the literature.

Case presentation

A 55-year-old Brahmin man with no history of diabetes mellitus and hypertension, presented with complaints of dizziness, headache, vomiting, double vision, and unsteadiness of gait for 2 weeks. His headache was sudden in onset, of a pulsating type and localized on left temporal side. Vomiting was projectile and bilious. Double vision was present in all directions of gaze and he had uncoordinated movement of his body and tilting to the left side. On examination, his cerebellar functions were impaired. He was thoroughly investigated for the cause of stroke after abnormal magnetic resonance imaging results with normal computed tomography angiography of his brain. Echocardiography and computed tomography of his chest showed a mass attached to intra-atrial septum and prolapsing through mitral valve, which was suggestive of left atrial myxoma. Five days following admission, he developed abdominal pain due to thromboembolism causing splenic and renal infarct.

Conclusion

Although rare, atrial myxoma has to be considered a cause of stroke and other embolic phenomenon causing multiorgan infarctions. Early and timely diagnosis of the condition can prevent further recurrence and inappropriate anticoagulant therapy. It would be pertinent to have echocardiography done in patients who present with a stroke, arrhythmias, and other constitutional symptoms. The tumor once detected must be removed surgically as early as possible, which not only reduces serious thromboembolic complications but can be potentially curative.
Metabolite profiles of live or dead carp (Cyprinus carpio) exposed to endosulfan sulfate using a targeted GC–MS analysis
Authors: Lee Hwa-Kyung , Lee Junghak , Lee Jonghwa , Lee Hyeri , Kim Jeong-Han
Published: February 2020

Endosulfan sulfate is a major oxidized metabolite of endosulfan, which is a broad-spectrum chlorinated cyclodiene insecticide. In this study, GC–MS-based metabolic profiles of dead or live carp (Cyprinus carpio) exposed to endosulfan sulfate were investigated to elucidate the molecular toxicological effects of endosulfan sulfate on carp. Three different extraction methods were compared, and a 50% methanol solution was chosen as an efficient extraction method. Carp was exposed to endosulfan sulfate at a concentration of 8 ppb for 2 days. After exposure, the whole body of the fish was homogenized with liquid N2, extracted with the 50% methanol solution and dried before TMS derivatization for GC–MS analyses of the dead and live carp. A SIM (selected ion monitoring)-library of 373 metabolites was applied after GC–MS analysis to detect 146 metabolites in carp. Based on the one-way ANOVA results (P < 0.001) and fold changes of metabolites in dead carp versus control (fold change > 1.5 or < 0.667), 30 metabolites were identified as biomarkers that were significantly different in the metabolic profiles among the control, dead and live carp. A metabolic pathway analysis using MetaboAnalyst 4.0 revealed that those biomarkers were important for the living or death response to endosulfan sulfate. The pathways indicated by the metabolic pathway analysis included starch and sucrose metabolism, galactose metabolism, glycerolipid metabolism, the citrate cycle and linoleic acid metabolism. These results suggest that these pathways underwent significant perturbations over the exposure period.
Impact of resettlement scheme on vegetation cover and its implications on conservation in Chewaka district of Ethiopia
Authors: Abera Alemayehu , Yirgu Teshome , Uncha Abera
Published: February 2020

Background

Resettlement has been conceived as a viable solution to the continual impoverishment and destitution of Ethiopian rural communities. However, it has considerable impacts on natural resources of the environment at destination areas. This study was carried out to evaluate impact of resettlement scheme on vegetation cover and its implications on conservation in Chewaka district of Ethiopia.

Methods

The study utilized ArcGIS10.3, ERDAS Imagine 9.1, Landsat imageries of 2000, 2009, 2018 and socio-economic data to analyze the LULC of the district. Normalized Difference Vegetation Index was employed to detect vegetation cover changes of the area. The study was conducted on the seven kebeles of Chewaka district and the total households of the sample kebeles are 3340. Through multistage sampling procedure a total of 384 households were selected from sample kebeles. Data were collected using questionnaires, GPS, interviews, focus group discussions and field observations. The collected data were analyzed both quantitatively and qualitatively.

Results

The results showed that Chewaka district has undergone substantial LULC change since population resettlement in the area. A rapid reduction of woodland (34.6%), forest (59.9%), grassland (50.5%) and bareland (46.8%) took place between 2000 and 2018, while built-up areas and cultivated lands have expanded at an average rate of 90.7 and 1515.7 ha/year respectively. The results of NDVI revealed that the extent of dense and sparse vegetation cover have decreased by 26.1% and 20.6% respectively, whereas non-vegetation cover has increased by 14,340.2 ha during the study period. It was found that rapid population growth following resettlement program, farmland and settlement expansion, deforestation, human-induced forest fire, lack of land use plan, unwise utilization and low management practices were the major factors that underpin the observed changes in the area.

Conclusions

Resettlement scheme has resulted in the depletion and dynamics of vegetation cover in Chewaka district. Therefore, the study suggests urgent attention on conservation of the remaining vegetation resources for sustainable utilization.
Using toponomics to characterize phenotypic diversity in alveolar macrophages from male mice treated with exogenous SP-A1
Authors: Phelps David S. , Chinchilli Vernon M. , Weisz Judith , Shearer Debra , Zhang Xuesheng , Floros Joanna
Published: February 2020

Background

We used the Toponome Imaging System (TIS) to identify “patterns of marker expression”, referred to here as combinatorial molecular phenotypes (CMPs) in alveolar macrophages (AM) in response to the innate immune molecule, SP-A1.

Methods

We compared 114 AM from male SP-A deficient mice. One group (n = 3) was treated with exogenous human surfactant protein A1 (hSP-A1) and the other with vehicle (n = 3). AM obtained by bronchoalveolar lavage were plated onto slides and analyzed using TIS to study the AM toponome, the spatial network of proteins within intact cells. With TIS, each slide is sequentially immunostained with multiple FITC-conjugated antibodies. Images are analyzed pixel-by-pixel identifying all of the proteins within each pixel, which are then designated as CMPs. CMPs represent organized protein clusters postulated to contribute to specific functions.

Results

1) We compared identical CMPs in KO and SP-A1 cells and found them to differ significantly (p = 0.0007). Similarities between pairs of markers in the two populations also differed significantly (p < 0.0001). 2) Focusing on the 20 most abundant CMPs for each cell, we developed a method to generate CMP “signatures” that characterized various groups of cells. Phenotypes were defined as cells exhibiting similar signatures of CMPs. i) AM were extremely diverse and each group contained cells with multiple phenotypes. ii) Among the 114 AM analyzed, no two cells were identical. iii) However, CMP signatures could distinguish among cell subpopulations within and between groups. iv) Some cell populations were enriched with SP-A1 treatment, some were more common without SP-A1, and some seemed not to be influenced by the presence of SP-A1. v) We also found that AM were more diverse in mice treated with SP-A1 compared to those treated with vehicle.

Conclusions

AM diversity is far more extensive than originally thought. The increased diversity of SP-A1-treated mice points to the possibility that SP-A1 enhances or activates several pathways in the AM to better prepare it for its innate immune functions and other functions shown previously to be affected by SP-A treatment. Future studies may identify key protein(s) responsible for CMP integrity and consequently for a given function, and target it for therapeutic purposes.
Increased PD-1+Tim-3+ exhausted T cells in bone marrow may influence the clinical outcome of patients with AML
Authors: Tan Jiaxiong , Yu Zhi , Huang Jingying , Chen Youchun , Huang Shuxin , Yao Danlin , Xu Ling , Lu Yuhong , Chen Shaohua , Li Yangqiu
Published: February 2020

Background

Altered expression of T cell immune inhibitory receptors may result in immunosuppression and associate with the poor prognosis of leukemia patients in which the leukemic bone marrow (BM) microenvironment may contribute to such immunosuppression. We found higher numbers of programmed death-1 (PD-1) + exhausted T cells in peripheral blood (PB) from acute myeloid leukemia (AML) patients. To investigate the leukemic BM influence on immunosuppression, we further compared the distributions of PD-1 and T cell immunoglobulin mucin-3 (Tim-3) and the exhausted T cell phenotype in PB and BM from AML patients and characterized their relationship with clinical outcome.

Methods

PB and BM samples from 15 patients with newly diagnosed AML were collected and analyzed for the expression of PD-1, Tim-3, CD244, and CD57 on CD3+, CD4+, and CD8+ T cells by multicolor flow cytometry.

Results

The proportions of PD-1 + CD3+ and PD-1 + CD8+ T cells were significantly higher in BM compared with PB. Similarly, higher PD-1 + CD244 + CD3+ and PD-1 + CD244 + CD8+ T cells were found in BM, and an increased tendency for PD-1 + CD244 + CD4+ T cells was also detected in this group. In contrast, increased Tim-3 + CD4+/Tim-3 + CD244 + CD4+ T cells were predominant in BM compared with PB, but there was no statistically significant difference in Tim-3 + CD8+ T cells. Moreover, PD-1 and Tim-3 double-positive CD3+/CD4+/CD8+ T cells were significantly increased in the BM group. In addition, a higher proportion of PD-1 + Tim-3 + CD3+ T cells in the BM and PD-1 + Tim-3 + CD4+ T cells in PB was detected in non-complete remission (NCR) compared with complete remission (CR) patients after first-cycle chemotherapy.

Conclusions

Upregulation of PD-1 and Tim-3 and the exhausted phenotype of CD4+ and CD8+ T cells in the BM of AML patients may contribute to mediating the leukemic immunosuppressive microenvironment, and increased PD-1 + Tim-3+ CD8+ T cells may be related to T cell dysfunction in AML, which may influence clinical outcome.
Duration matters: peer effects on academic achievement with random assignment in the Chinese context
Authors: Cheng Cheng
Published: February 2020

This paper goes beyond the most popular perspective of family social capital among existing research and examines the effect of peer social capital on adolescent academic achievement. Using the official data from a Chinese university and taking into account the endogeneity problems, this paper finds that peer academic performance has a significant effect on human capital accumulation among university students. We have different findings, however, from research abroad. First, peer social capital has an indirect rather than a direct effect. Second, the influence of initial randomly assigned peers tends to increase over time. However, this increase of influence is only present among peers from similar social class backgrounds. Among peers from different backgrounds, the influence remains almost unchanged. In addition to this, the influence of peer social capital is not significantly different among students from different social class backgrounds.
A systematic scorecard-based approach to site assessment in preparation for Lassa fever vaccine clinical trials in affected countries
Authors: Salami Kolawole , Imbault Nathalie , Erlebach Aljoscha , Urban Johanna , Zoglowek Mike , Tornieporth Nadia G.
Published: February 2020

Background

We sought to develop and test an objective scorecard-based system for assessing and categorizing available research sites in Lassa fever-affected countries based on their preparedness and capability to host Lassa fever vaccine clinical trials.

Methods

We mapped available clinical research sites through interrogation of online clinical trial registries and relevant disease-based consortia. A structured online questionnaire was used to assess the capability of clinical trial sites to conduct Lassa fever vaccine clinical trials. We developed a new scoring template by allocating scores to questionnaire parameters based on perceived importance to the conduct of clinical trials as described in the WHO/TDR Global Competency Framework for Clinical Research. Cutoff points of 75% and 50% were used to categorize sites into categories A, B, or C.

Results

This study identified 44 clinical trial sites in 8 Lassa fever-affected countries. Out of these, 35 sites were characterized based on their capacity to hold Lassa fever vaccine clinical trials. A total of 14 sites in 4 countries were identified as ready to host Lassa fever vaccine trials immediately or with little support.

Conclusion

It is feasible to hold Lassa fever vaccine trials in affected countries based on the outcome of the survey. However, the findings are to be validated through sites’ visits. This experience with a standardized and objective method of the site assessment is encouraging, and the site selection method used can serve as an orientation to sponsors and researchers planning clinical trials in the region.
Parent empowerment and coaching in early intervention: study protocol for a feasibility study
Authors: Pellecchia Melanie , Beidas Rinad S. , Mandell David S. , Cannuscio Carolyn C. , Dunst Carl J. , Stahmer Aubyn C.
Published: February 2020

Background

Parent-mediated early interventions (EI) for children with autism spectrum disorder (ASD) can result in significant improvements in children’s cognitive ability, social functioning, behavior, and adaptive skills, as well as improvements in parental self-efficacy and treatment engagement. The common component to efficacious parent-mediated early interventions for ASD is clinician use of parent coaching and occurs when a clinician actively teaches the parent techniques to improve their child’s functioning. Available evidence suggests that community-based EI clinicians rarely coach parents when working with families of these children, although specific barriers to coaching are unknown. This consistent finding points to the need to develop strategies to improve the use of parent coaching in community EI programs. The purpose of this community-partnered study is to iteratively develop and pilot test a toolkit of implementation strategies designed to increase EI clinicians’ use of parent coaching.

Methods

This study has four related phases. Phase 1: examine how EI clinicians trained in Project ImPACT, an evidence-based parent-mediated intervention, coach parents of children with ASD. Phase 2: identify barriers and facilitators to clinician implementation of parent coaching by administering validated questionnaires to, and conducting semi-structured interviews with, clinicians, parents, and agency leaders. Phase 3: partner with a community advisory board to iteratively develop a toolkit of implementation strategies that addresses identified barriers and capitalizes on facilitators to improve clinician implementation of evidence-based parent coaching. Phase 4: pilot test the feasibility and effectiveness of the implementation strategy toolkit in improving EI clinicians’ use of parent coaching with nine EI clinicians and parent-child dyads using a multiple-baseline-across-participants single-case design.

Discussion

Completion of these activities will lead to an in-depth understanding of EI clinicians’ implementation of parent coaching in usual practice following training in an evidence-based parent-mediated intervention, barriers to their implementation of parent coaching, a toolkit of implementation strategies developed through an iterative community-partnered process, and preliminary evidence regarding the potential for this toolkit to improve EI clinicians’ implementation of parent coaching. These pilot data will offer important direction for a larger evaluation of strategies to improve the use of parent coaching for young children with ASD.
Interference scores have inadequate concurrent and convergent validity: Should we stop using the flanker, Simon, and spatial Stroop tasks?
Authors: Paap Kenneth R. , Anders-Jefferson Regina , Zimiga Brandon , Mason Lauren , Mikulinsky Roman
Published: February 2020

Background

Two-hundred one college undergraduates completed four nonverbal interference tasks (Simon, spatial Stroop, vertical Stroop, and flanker) and trait scales of self-control and impulsivity. Regression analyses tested 11 predictors of the composite interference scores derived from three of the four tasks and each task separately. The purpose of the study was to examine the relationships between laboratory measures of self-control, self-report measures, and the degree to which control might be related to extensive experience in activities that logically require self-control.

Results

Fluid intelligence and sex were significant predictors of the composite measure, but bilingualism, music training, video gaming, mindfulness/meditation, self-control, impulsivity, SES, and physical exercise were not.

Conclusions

Common laboratory measures of inhibitory control do not correlate with self-reported measures of self-control or impulsivity and consequently appear to be measuring different constructs. Bilingualism, mindfulness/meditation, playing action video games, and music training or performance provide weak and inconsistent improvements to laboratory measures of interference control. Flanker, Simon, and spatial Stroop effects should not be used or interpreted as measures of domain-general inhibitory control.
Salivary alpha-synuclein (total and oligomeric form): potential biomarkers in Parkinson’s disease
Authors: Shaheen Hala , Sobhy Sayed , El Mously Sherine , Abuomira Marwa , Mansour Mohamed
Published: February 2020

Background

Parkinson’s disease (PD) is one of the most common degenerative diseases of the central nervous system (CNS). Alpha-synuclein (A-syn) plays a critical role in the pathogenesis of PD. The close relation between the salivary glands and the CNS could render the A-syn secretions in the saliva useful biomarkers for PD.

Aim of the work

To study the salivary A-syn levels in a cohort of PD Egyptian patients and to correlate these A-syn levels with the patients’ clinical data and disease severity.

Patients and methods

Twenty-five PD patients and 15 age- and sex-matched healthy subjects, as a control group, were enrolled. Evaluation of PD patients was performed using the Unified Parkinson’s Disease Rating Scale (UPDRS) and modified Hoehn and Yahr scale (HYS). Samples of the saliva were analyzed using the enzyme-linked immunosorbent assay (ELISA) technique for the specific anti A-syn total and anti A-syn oligomer (A-synolig).

Results

There was a statistically significant increase in A-synolig level and A-synolig/A-syn total ratio and a decrease in A-syn total level among PD patients. A statistically significant increase in A-synolig level was detected among patients having bradykinesia and rigidity as predominant symptoms. Also, there was a statistically significant positive correlation between A-synolig level and the disease duration. No statistically significant correlation was found between A-syn concentrations and disease severity.

Conclusion

Salivary A-syn total and A-synolig can be used as potential biomarkers for PD diagnosis.
Policy transfer processes and renewable energy penetration: a comparative analysis of Peru, Thailand, and Uganda
Authors: Bößner Stefan , Suljada Tim , Johnson Francis X. , Bruno Aina , Morales Jorge Rodriguez , Hu Mengyin , Bhamidipati Padmasai Lakshmi , Haselip James
Published: February 2020

Background

Low-carbon technologies must be widely adopted at a large scale to address climate change and enhance access to affordable, reliable and sustainable energy. The uptake of those technologies is often supported by specific policies developed at a national or regional level and those policies, like the technologies themselves, can diffuse from one place to another. This paper sheds some light on this ‘policy transfer’ and investigates the dynamics, the actors and the processes involved. We illustrate what happens when renewable energy support policies in one country inspire renewable support policies in another country using three case studies in Peru, Thailand and Uganda as examples.

Results

Using an adapted version of the policy transfer framework first elaborated by Dolowitz and Marsh (Polit Stud 44:343–57, 1996; Governance 13:5–23, 2000), we describe the policy transfer process in the three case study countries according to several criteria. We find that policy transfer is not a straightforward process where a ‘borrower’ country simply adopts policies from a ‘lender’ country, but instead a complex process where many actors - national and international – interact to shape the outcome of the process. And while experiences particularly in the EU as well as international developments have influenced the policy transfer in case study countries significantly, domestic issues also play a key role in shaping the transferred policies and in adapting them to local contexts. Moreover, the policy transfer process is not an one-off event, but a continuous process where iterative learning helps the policies to evolve over time.

Conclusions

Policy transfer is a complex matter, involving many stakeholders during a continuous process over time. The Dolowitz and Marsh framework proved useful to analyse policy transfer and the actors involved although questions for further research remain. For instance, against what kind of criteria should the ‘success’ of a policy transfer be measured? Moreover, while comparing three illustrative case studies is a first, useful step, having a larger set of case studies and data might enhance our understanding of the details of the processes involved even further.
Correction to: Fuels, vegetation, and prescribed fire dynamics influence ash production and characteristics in a diverse landscape under active pine barrens restoration
Authors: Quigley K. M. , Wildt R. E. , Sturtevant B. R. , Kolka R. K. , Dickinson M. B. , Kern C. C. , Donner D. M. , Miesel J. R.
Published: February 2020

Following publication of the original article Quigley et al. 2019, the authors reported that an incorrect version of Additional 1 has been published. The corrected version of Additional file 1 is attached to this Correction. Additional file 1 was revised to include the following information which was omitted from the original publication: 1) Standard errors associated with all original supplementary tables 2) An additional supplementary table reporting Total C, PyC, and % of C as PyC in ash samples 3) A list of references for the section ‘S1 – Calibrated fuel consumption from maximum paint tag temperature’. Additionally, the authors reported that the standard errors associated with Table 2 in the main text were omitted from the original publication. In this Correction the incorrect and corrected version of Table 2 are shown.
Role of PET CT in comparison to triphasic CT in early follow-up of hepatocellular carcinoma after transarterial chemoemoblization
Authors: Hetta Waleed M. , Atyia Hany Rafat
Published: February 2020

Background

The aim of the study is to compare the role of PET/CT and that of triphasic CT in hepatocellular carcinoma post chemoembolization evaluation, thus guiding clinicians for proper management strategy.

Thirty patients who had transarterial chemoembolization done for HCC were subjected to both radiological modalities, 18F-FDG PET/CT and triphasic CT, with the results compared.

Results

In our study, triphasic CT revealed 20 true positive results, 3 true negative results, 7 false negative results, and no false positive cases thus exhibiting calculated sensitivity, specificity, and accuracy of 74%, 100.0%, and 76.7% respectively. On the other hand, PET/CT showed 26 true positive results, 2 true negative results, 1 false negative result, and 1 false positive result to exhibit calculated sensitivity, specificity, and accuracy of 96.3%, 66.7%, and 93.3%, respectively.

Conclusion

18F-FDG PET/CT showed high diagnostic accuracy over triphasic CT in interventional bed evaluation following TACE especially for patients with non-conclusive triphasic CT results and persistent elevated levels of AFP.
Cardiopulmonary health indices and diabetes risk scores in undergraduate students of a private university in Nigeria
Authors: Yesufu JolaOluwa Oluwatosin , Oluwasile Olaoluwa David , Oluranti Olufemi Idowu , Fasanmade Adesoji Adesipe , Soladoye Ayodele O.
Published: February 2020

Background

Cardiopulmonary health and its relationship with diabetes mellitus are very important but particularly underexplored in young undergraduate students of private Universities in Nigeria. This observational study investigated the effect of diabetic risk on cardiopulmonary health indices among healthy, consenting undergraduate students of a private university in Nigeria by a convenient sampling method. Cardiopulmonary health indices were assessed by anthropometry; cardiorespiratory fitness was determined by maximum oxygen uptake levels (VO2 max), blood pressure and heart rates were measured using the Bruce treadmill protocol; oxygen saturation was determined by pulse oximetry, pulmonary function was assessed by spirometry; diabetes mellitus was risk determined by fasting blood glucose levels and the FINDRISC (Finish Diabetes Risk Score questionnaire which is a validated tool, for determining Diabetes risk; heart health awareness was determined by a modification of the healthy heart questionnaire (HHQ-GP-1) which is a standardized tool for heart health awareness and practices.

Results

Results showed that the prevalence of diabetes risk was 38.8% in the sample population. The healthy heart questionnaire revealed that participants had poor diet (76%) or did little or no exercise (60%) and were also ignorant of what a normal blood pressure should be (72%). There was no significant difference between blood pressure (systolic and diastolic) and heart rates after physical exercise of those at diabetes risk and those not at risk (p > 0.05). Fasting blood glucose levels between those at diabetes risk and those not at risk was significantly different (p < 0.01). The cardiorespiratory fitness (VO2 max) of those not at diabetic risk was not significantly higher than of those at risk (p > 0.385). Respiratory functions (vital capacity, forced vital capacity, and forced expiratory volume) of those not at diabetic risk were higher than those at risk, showing that diabetes may impair lung function. Though this was not statistically significant (p > 0.05), the result obtained cannot be disregarded.

Conclusion

Universities and higher institutions of learning should incorporate regular health promotion and education programs that focus more on healthy lifestyles, physical exercise, and proper diet.
Long-Term Outcomes and Responses to Retreatment in Patients With Melanoma Treated With PD-1 Blockade
Authors: Betof Warner Allison , Palmer Jessica S. , Shoushtari Alexander N. , Goldman Debra A. , Panageas Katherine S. , Hayes Sara A. , Bajwa Raazi , Momtaz Parisa , Callahan Margaret K. , Wolchok Jedd D. , Postow Michael A. , Chapman Paul B.
Published: February 2020

PURPOSE

To analyze long-term outcomes after treatment discontinuation of anti–programmed death-1 (anti–PD-1) therapy in a cohort of patients with melanoma with the longest follow-up yet available to our knowledge, including a majority of patients treated outside of a clinical trial. We also assessed efficacy of retreatment with anti–PD-1 therapy with or without ipilimumab in relapsing patients.

METHODS

We retrospectively analyzed all patients with nonuveal, unresectable stage III/IV melanoma treated with single-agent anti–PD-1 therapy at Memorial Sloan Kettering from 2009-2018 who had discontinued treatment and had at least 3 months of follow-up after discontinuation (n = 396). Overall survival for patients with complete response (CR) was calculated from time of CR. Time to treatment failure for patients with CR was time from CR to the next melanoma treatment or death.

RESULTS

CRs were seen in 102 of 396 patients (25.8%). The median number of months of treatment after CR was zero (range, stopped before CR to 26 months after CR). With a median follow-up of 21.1 months from time of CR in patients who did not relapse, the probability of being alive and not needing additional melanoma therapy at 3 years was 72.1%. There was no significant association between treatment duration and relapse risk. In multivariable analysis, CR was associated with M1b disease and cutaneous versus mucosal or acral primaries. Among the 78 patients (of 396) retreated after disease progression, response was seen in 5 of 34 retreated patients with single-agent anti–PD-1 therapy and 11 of 44 patients escalated to anti–PD-1 plus ipilimumab.

CONCLUSION

In our cohort, most patients discontinued treatment at the time of CR. Most CRs were durable but the probability of treatment failure was 27% at 3 years. Responses to retreatment were infrequent. The optimal duration of treatment after CR is not yet established.
Forty-One Individuals With Mutations in the AVP-NPII Gene Associated With Familial Neurohypophyseal Diabetes Insipidus
Authors: García-Castaño Alejandro , Madariaga Leire , Pérez de Nanclares Gustavo , Vela Amaia , Rica Itxaso , Gaztambide Sonia , Martínez Rosa , Martinez de LaPiscina Idoia , Urrutia Inés , Aguayo Anibal , Velasco Olaia ,   Familial neurohypophyseal diabetes insipidus Spanish working group, Eizaguirre Javier , Antón María Ángeles , Rodríguez Amparo , Rodríguez-Arnao María Dolores , Luzuriaga Cristina , Villabona Carlos , Martínez Francisco , Carles Concha , Ramírez Joaquín , de Paz Fernando Nistal , José Francisco , Gómez Pomares , Chueca María Jesus , Temboury María del Carmen , Bahillo María Pilar , Castaño Luis
Published: February 2020

Context

Familial neurohypophyseal diabetes insipidus is a rare disease produced by a deficiency in the secretion of antidiuretic hormone and is caused by mutations in the arginine vasopressin gene.

Objective

Clinical, biochemical, and genetic characterization of a group of patients clinically diagnosed with familial neurohypophyseal diabetes insipidus, 1 of the largest cohorts of patients with protein neurophysin II (AVP-NPII) gene alterations studied so far.

Design

The AVP-NPII gene was screened for mutations by PCR followed by direct Sanger sequencing in 15 different unrelated families from Spain.

Results

The 15 probands presented with polyuria and polydipsia as the most important symptoms at the time of diagnosis. In these patients, the disease was diagnosed at a median of 6 years of age. We observed 11 likely pathogenic variants. Importantly, 4 of the AVP-NPII variants were novel (p.(Tyr21Cys), p.(Gly45Ser), p.(Cys75Tyr), p.(Gly88Cys)).

Conclusions

Cytotoxicity seems to be due to consequences common to all the variants found in our cohort, which are not able to fold correctly and pass the quality control of the ER. In concordance, we found autosomal dominant familial neurohypophyseal diabetes insipidus in the 15 families studied.
Ameloplasty is counterproductive in reducing microleakage around Resin Modified Glass Ionomer and Resin based fissure sealants
Authors: Khan Tabinda Nawaz , Khan Farhan Raza , Abidi Syed Yawar Ali
Published: February 2020

Objective: To compare the microleakage around resin modified glass ionomer cement (RMGIC) based sealants and flowable resin based sealants placed with or without ameloplasty in extracted human teeth.

Methods: This in-vitro experimental study was conducted at the Operative Dentistry Department, Dow University of Health Sciences, Karachi, Pakistan from June 2017 to December 2018. Sixty extracted human molars and premolars were assigned to four groups (n=15) each, according to the type of fissure sealant (flowable resin based sealant or resin modified glass ionomer based sealant) used and either placed with or without ameloplasty. Specimens were thermocycled and then immersed in 1% methylene blue for 24 hours. Specimens were then sectioned and examined using stereo-microscope (50X) for microleakage that was scored on an ordinal scale. Mann-Whitney U test and Ordinal regression were applied. Level of significance kept at 0.05.

Results: There was a statistically significant difference (p-value <0.001) between the two sealant types for the microleakage scores. Sealants placed with ameloplasty demonstrated significantly higher microleakage values (p-value <0.001).

Conclusion: Microleakage was found to be more pronounced in RMGIC based sealants compared to the resin based sealants. Ameloplasty resulted in higher leakage around the sealants irrespective of the chemistry of material.

doi: https://doi.org/10.12669/pjms.36.3.1268

How to cite this:Khan TN, Khan FR, Abidi SYA. Ameloplasty is counterproductive in reducing microleakage around Resin Modified Glass Ionomer and Resin based fissure sealants. Pak J Med Sci. 2020;36(3):544-549. doi: https://doi.org/10.12669/pjms.36.3.1268

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