bluuebunny/crossref_metadata_2025 huggingface dataset:
Needs assessment for the creation of a community of practice in a community health navigator cohort
Authors: Livergant Rachel J. , Ludlow Natalie C. , McBrien Kerry A.
Published: July 2021

Background

Community Health Navigators (CHNs) are members of a patient’s care team that aim to reduce barriers in accessing healthcare. CHNs have been described in various healthcare settings, including chronic disease management. The ENhancing COMmunity health through Patient navigation, Advocacy, and Social Support (ENCOMPASS) program of research employs CHNs, who are trained to improve access to care and community resources for patients with multiple chronic diseases. With complex and demanding roles, it is essential that CHNs communicate with each other to maintain knowledge exchange and best practices. A Community of Practice (CoP) is a model of situated learning that promotes communication, dedication, and collaboration that can facilitate this communication. The objective of this study was to engage with CHNs to determine how a CoP could be implemented to promote consistency in practices and knowledge for CHNs across primary care sites.

Methods

A needs assessment for a CHN CoP was conducted using sequential steps of inquiry. A preliminary focused literature review (FLR) was done to examine the ways in which other healthcare CoPs have been implemented. Results from the FLR guided the creation of an exploratory survey and group interview with key informants to understand best approaches for CoP creation. Political, economic, social, and technological (PEST) and strengths, weaknesses, opportunities, and threats (SWOT) analyses synthesized results in a comprehensive manner for strategic recommendations.

Results

The FLR identified different approaches and components of healthcare CoPs and guided analyses of mitigatable risk factors and leverageable assets for the intervention. The survey and group interview revealed an informal and effective CoP amongst current CHNs, with preferred methods including coffee meetings, group trainings, and seminars. A well-maintained web platform with features such as an encrypted discussion forum, community resource listing, calendar of events, and semi-annual CHN conferences were suggested methods for creating an inter-regional, formal CoP.

Conclusion

The study findings recognise the presence of an informal CoP within the studied CHN cohort. Implementation of a formal CoP should complement current CoP approaches and aid in facilitating expansion to other primary care centres utilizing digital communication methods, such as a comprehensive web platform and online forum.
Community socioeconomic disadvantage drives type of 30-day medical-surgical revisits among patients with serious mental illness
Authors: Germack Hayley D. , Mahmoud Khadejah , Cooper Mandy , Vincent Heather , Koller Krista , Martsolf Grant R.
Published: July 2021

Background

Patients with serious mental illness (SMI) are vulnerable to medical-surgical readmissions and emergency department visits.

Methods

We studied 1,914,619 patients with SMI discharged after medical-surgical admissions in Florida and New York between 2012 and 2015 and their revisits to the hospital within 30 days of discharge.

Results

Patients with SMI from the most disadvantaged communities had greater adjusted 30-day revisit rates than patients from less disadvantaged communities. Among those that experienced a revisit, patients from the most disadvantaged communities had 7.3 % greater 30-day observation stay revisits.

Conclusions

These results suggest that additional investments are needed to ensure that patients with SMI from the most disadvantaged communities are receiving appropriate post-discharge care.
Healthcare delivery and information provision in bariatric surgery in Germany: qualitative interviews with bariatric surgeons
Authors: Breuing Jessica , Könsgen Nadja , Doni Katharina , Neuhaus Annika Lena , Pieper Dawid
Published: July 2021

Background

There are several healthcare professionals involved in health information provision regarding bariatric surgery, such as bariatric surgeons, nutritionists, and medical doctors in outpatient settings. Trustworthy health information supports patients in understanding their diagnosis, treatment decisions, and possible prognosis. Therefore, it is necessary to provide health information on bariatric surgery. This study has two distinct objectives. The first is to outline the delivery of healthcare regarding bariatric surgery in Germany. The second is to describe the information provision within healthcare delivery.

Methods

We conducted 15 semi-structured telephone interviews with bariatric surgeons between April 2018 and February 2019. The interviews were audio recorded and transcribed verbatim. The interview guide consisted of four sections (information about the clinic/surgeon and surgical procedures, preoperative procedure, postoperative procedure, information needs). The transcribed interviews were analyzed using qualitative content analysis supported by MAXQDA software.

Results

The pre- and postoperative processes differed substantially between clinics. Additionally, every bariatric clinic had its own information provision concept. There were several cost-related issues the surgeons claimed to be relevant for patients, such as nutritional blood tests or postoperative psychotherapy. These issues were often caused by unclearness of responsibility within the medical disciplines involved.

Conclusion

Healthcare delivery in bariatric surgery in Germany is heterogeneous in terms of pre- and postoperative care. Therefore, preoperative information provision between the clinics differs. The impact of this heterogeneous healthcare delivery and information provision on patients’ information needs regarding bariatric surgery should be further investigated among patients and other healthcare professionals involved.
Difficulties encountered by public health workers in COVID-19 outbreak: a cross-sectional study based on five provinces
Authors: Du Zhicheng , You Hua , Zhou Huan , Wang Xiaohui , Xu Jingdong , Li Yan , Li Shan , Ma Lina , Gu Jing , Hao Yuantao
Published: July 2021

Objectives

The aim of this study is to address the difficulties encountered by public health workers in the early and middle stages of their efforts to combat COVID-19, compare the gaps among different types of institutions, and identify shortcomings in epidemic control.

Methods

Using multi-stage sampling, a survey of public health workers involved in the prevention and control of COVID-19 was conducted from 18 February to 1 March 2020 through a self-administered questionnaire. These public health workers were from the primary health care center (defined as “primary-urban” and “primary-rural” for those in urban and rural areas, respectively) and the center for disease control and prevention (defined as “non-primary”) in five provinces including Hubei, Guangdong, Sichuan, Jiangsu and Gansu, China.

Results

A total of 9,475 public health workers were surveyed, of which 40.0 %, 27.0 % and 33.0 % were from the primary-rural, primary-urban and non-primary, respectively. The resources shortage were reported by 27.9 % participants, with the primary-rural being the worst affected (OR = 1.201, 95 %CI: 1.073–1.345). The difficulties in data processing were reported by 31.5 % participants, with no significant differences among institutions. The difficulties in communication and coordination were reported by 29.8 % participants, with the non-primary being the most serious (primary-rural: OR = 0.520, 95 %CI: 0.446–0.606; primary-urban: OR = 0.533, 95 %CI: 0.454–0.625). The difficulties with target audiences were reported by 20.2 % participants, with the primary-urban being the worst (OR = 1.368, 95 %CI: 1.199–1.560). The psychological distress were reported by 48.8 % participants, with no significant differences among institutions.

Conclusions

Psychological distress is the most serious problem in the prevention and control of COVID-19. Resources shortage in primary-rural, difficulties in communication and coordination in non-primary, and difficulties with target audiences in the primary-urban deserve attention. This study will provide scientific evidences for improving the national public health emergency management system, especially for reducing the urban-rural differences in emergency response capacity.
Traumatic brain injury results in unique microglial and astrocyte transcriptomes enriched for type I interferon response
Authors: Todd Brittany P. , Chimenti Michael S. , Luo Zili , Ferguson Polly J. , Bassuk Alexander G. , Newell Elizabeth A.
Published: July 2021

Background

Traumatic brain injury (TBI) is a leading cause of death and disability that lacks neuroprotective therapies. Following a TBI, secondary injury response pathways are activated and contribute to ongoing neurodegeneration. Microglia and astrocytes are critical neuroimmune modulators with early and persistent reactivity following a TBI. Although histologic glial reactivity is well established, a precise understanding of microglia and astrocyte function following trauma remains unknown.

Methods

Adult male C57BL/6J mice underwent either fluid percussion or sham injury. RNA sequencing of concurrently isolated microglia and astrocytes was conducted 7 days post-injury to evaluate cell-type-specific transcriptional responses to TBI. Dual in situ hybridization and immunofluorescence were used to validate the TBI-induced gene expression changes in microglia and astrocytes and to identify spatial orientation of cells expressing these genes. Comparative analysis was performed between our glial transcriptomes and those from prior reports in mild TBI and other neurologic diseases to determine if severe TBI induces unique states of microglial and astrocyte activation.

Results

Our findings revealed sustained, lineage-specific transcriptional changes in both microglia and astrocytes, with microglia showing a greater transcriptional response than astrocytes at this subacute time point. Microglia and astrocytes showed overlapping enrichment for genes related to type I interferon signaling and MHC class I antigen presentation. The microglia and astrocyte transcriptional response to severe TBI was distinct from prior reports in mild TBI and other neurodegenerative and neuroinflammatory diseases.

Conclusion

Concurrent lineage-specific analysis revealed novel TBI-specific transcriptional changes; these findings highlight the importance of cell-type-specific analysis of glial reactivity following TBI and may assist with the identification of novel, targeted therapies.
Red nucleus IL-33 facilitates the early development of mononeuropathic pain in male rats by inducing TNF-α through activating ERK, p38 MAPK, and JAK2/STAT3
Authors: Li Hao-Nan , Yang Qing-Qing , Wang Wen-Tao , Tian Xue , Feng Fan , Zhang Shu-Ting , Xia Yu-Tong , Wang Jia-Xue , Zou Yuan-Wu , Wang Jun-Yang , Zeng Xiao-Yan
Published: July 2021

Background

Our recent studies have identified that the red nucleus (RN) dual-directionally modulates the development and maintenance of mononeuropathic pain through secreting proinflammatory and anti-inflammatory cytokines. Here, we further explored the action of red nucleus IL-33 in the early development of mononeuropathic pain.

Methods

In this study, male rats with spared nerve injury (SNI) were used as mononeuropathic pain model. Immunohistochemistry, Western blotting, and behavioral testing were used to assess the expressions, cellular distributions, and actions of red nucleus IL-33 and its related downstream signaling molecules.

Results

IL-33 and its receptor ST2 were constitutively expressed in the RN in naive rats. After SNI, both IL-33 and ST2 were upregulated significantly at 3 days and peaked at 1 week post-injury, especially in RN neurons, oligodendrocytes, and microglia. Blockade of red nucleus IL-33 with anti-IL-33 neutralizing antibody attenuated SNI-induced mononeuropathic pain, while intrarubral administration of exogenous IL-33 evoked mechanical hypersensitivity in naive rats. Red nucleus IL-33 generated an algesic effect in the early development of SNI-induced mononeuropathic pain through activating NF-κB, ERK, p38 MAPK, and JAK2/STAT3, suppression of NF-κB, ERK, p38 MAPK, and JAK2/STAT3 with corresponding inhibitors markedly attenuated SNI-induced mononeuropathic pain or IL-33-evoked mechanical hypersensitivity in naive rats. Red nucleus IL-33 contributed to SNI-induced mononeuropathic pain by stimulating TNF-α expression, which could be abolished by administration of inhibitors against ERK, p38 MAPK, and JAK2/STAT3, but not NF-κB.

Conclusions

These results suggest that red nucleus IL-33 facilitates the early development of mononeuropathic pain through activating NF-κB, ERK, p38 MAPK, and JAK2/STAT3. IL-33 mediates algesic effect partly by inducing TNF-α through activating ERK, p38 MAPK and JAK2/STAT3.
Infectious spondylodiscitis and kyphosis correction in an infant: a case report
Authors: Romano Sara , Vittoria Francesca , Cattaruzzi Elisabetta , Barbi Egidio , Carbone Marco
Published: July 2021

Background

Neonatal infectious spondylodiscitis is a rare bony infection with atypical clinical presentation and non-specific systemic symptoms. Diagnosis and treatment are often delayed resulting in vertebral destruction and severe complications. We retrospectively reviewed the case of an infant with infectious spondylodiscitis resulting in T12 body destruction and marked angular kyphosis.

Case-report

A 4-week-old infant developed an infectious spondylodiscitis resulting in destruction of the T12 vertebral body and involvement of disc between T12 and L1. At 6 months of age, X-ray showed a marked thoracolumbar angular kyphosis above 50 Cobb degrees. Therefore, the patient underwent single time surgery with double anterior and posterior approach. At 9 years follow up, clinical and radiological findings show a stable correction with good aesthetic appearance.

Conclusion

Neonatal spondylodiscitis could lead to marked kyphosis similar to the congenital one. Since treatment with casts and tutors is often inefficacious, prompt surgery should be considered. The double anterior and posterior approach is the best option in this condition.
Underestimation of airway luminal eosinophilia by quantitative sputum cytometry
Authors: Kjarsgaard Melanie , Adatia Adil , Bhalla Anurag , LaVigne Nicola , Radford Katherine , Huang Chynna , Mukherjee Manali , Nair Parameswaran
Published: July 2021

Rationale

On Wright-stained sputum cytospins, eosinophil differential of ≥ 1.2% is considered abnormal, and ≥ 2.3% identifies an eosinophilic endotype. We hypothesized that failure to consider free eosinophil granules (FEG), and the re-emergence (unmasking) of eosinophilia due to various reasons underestimate the prevalence of the eosinophilic endotype.

Methods

This is a retrospective analysis of our Institutional Review Board-approved clinical sputum database. Of the 24,176 examinations of sputa from patients with various airway diseases, 17,693 were viable cell counts from 9570 patients (6604 on a single occasion, 2967 from multiple occasions). The prevalence of intact eosinophil % at 1.2 and 2.3% thresholds was first examined. Then, additional evidence of eosinophilia was assessed by semi-quantitative enumeration of FEGs. In those patients whose sputa were examined on multiple occasions (at the time of an exacerbation or after corticosteroid dose was reduced), re-emergence (unmasking) of eosinophilia was assessed

.

Results

Using the threshold of eosinophilia ≥ 1.2%, 6289/17693 (35.6%) of sputa were classified as eosinophilic. This increased to 7850/17693 (44.4%) when the presence of FEGs was considered. Using the threshold of eosinophilia ≥ 2.3%, 4647/17693 (26.3%) of sputa were classified as eosinophilic. This increased to 5435/17693 (30.7%) when the presence of FEG were considered. Extrapolating from the prevalence of re-emergence observed in the 2967 patients who had sputa examined on multiple occasions to the whole sample, we estimated that eosinophilia at 1.2% threshold would be observed in at least 60% of the samples, and a clinically relevant eosinophilia at 2.3% threshold would be observed in at least 48.5% of the samples.

Conclusions

Using a large sputum cytometry clinical database (17,693 viable cell counts), we demonstrate that a single time point intact cell count underestimates the prevalence of eosinophilia in a variety of airway diseases. The prevalence of eosinophilia increases from 35.6 to 60% (40% underestimation) at the 1.2% threshold, and from 26.3 to 48.5% (45% underestimation) at the 2.3% clinically relevant threshold, when free granules and a second examination are considered. This has important implications to identify the eosinophilic and Th2 high endotype both for clinical trials of anti-eosinophil therapies, and to select patients who may respond well to glucocorticosteroids and anti-IL5 therapies.
In vitro proof of concept studies of radiotoxicity from Auger electron-emitter thallium-201
Authors: Osytek Katarzyna M. , Blower Philip J. , Costa Ines M. , Smith Gareth E. , Abbate Vincenzo , Terry Samantha Y. A.
Published: July 2021

Background

Auger electron-emitting radionuclides have potential in targeted treatment of small tumors. Thallium-201 (201Tl), a gamma-emitting radionuclide used in myocardial perfusion scintigraphy, decays by electron capture, releasing around 37 Auger and Coster–Kronig electrons per decay. However, its therapeutic and toxic effects in cancer cells remain largely unexplored. Here, we assess 201Tl in vitro kinetics, radiotoxicity and potential for targeted molecular radionuclide therapy, and aim to test the hypothesis that 201Tl is radiotoxic only when internalized.

Methods

Breast cancer MDA-MB-231 and prostate cancer DU145 cells were incubated with 200–8000 kBq/mL [201Tl]TlCl. Potassium concentration varied between 0 and 25 mM to modulate cellular uptake of 201Tl. Cell uptake and efflux rates of 201Tl were measured by gamma counting. Clonogenic assays were used to assess cell survival after 90 min incubation with 201Tl. Nuclear DNA damage was measured with γH2AX fluorescence imaging. Controls included untreated cells and cells treated with decayed [201Tl]TlCl.

Results

201Tl uptake in both cell lines reached equilibrium within 90 min and washed out exponentially (t1/2 15 min) after the radioactive medium was exchanged for fresh medium. Cellular uptake of 201Tl in DU145 cells ranged between 1.6 (25 mM potassium) and 25.9% (0 mM potassium). Colony formation by both cell lines decreased significantly as 201Tl activity in cells increased, whereas 201Tl excluded from cells by use of high potassium buffer caused no significant toxicity. Non-radioactive TlCl at comparable concentrations caused no toxicity. An estimated average 201Tl intracellular activity of 0.29 Bq/cell (DU145 cells) and 0.18 Bq/cell (MDA-MB-231 cells) during 90 min exposure time caused 90% reduction in clonogenicity. 201Tl at these levels caused on average 3.5–4.6 times more DNA damage per nucleus than control treatments.

Conclusions

201Tl reduces clonogenic survival and increases nuclear DNA damage only when internalized. These findings justify further development and evaluation of 201Tl therapeutic radiopharmaceuticals.
Reduction in self-reported influenza-like-illness in school children and household members following influenza vaccine administration – a cohort study, Israel, 2016–7
Authors: Shviro Roseman Noa , Bilenko Natalya , Sheffer Rivka , Mor Zohar
Published: July 2021

Background

Second-grade pupils in Israel have been vaccinated against influenza since the winter of 2016–2017. This study aims to appraise the rate reduction of seasonal influenza vaccine among vaccinated children and their household members, and that of the vaccinated cohort and their household members.

Methods

This retrospective cohort study was performed in winter 2016–2017 in Tel-Aviv District, Israel and compared second-grade pupils who were vaccinated at school, with third-grade pupils- who were not vaccinated at school. Parents in nine schools were asked to report prior vaccination against influenza and influenza-like illness (ILI) of their children and other household members. Rate reduction was defined as [(ILI among unvaccinated) – (ILI among vaccinated)] / (ILI among vaccinated) (%).

Results

Of 527 participants, 359 (68.1%) were unvaccinated and 168 (31.9%) vaccinated. Unvaccinated children reported more ILI compared with vaccinated children (19.5% vs. 7.7%), yielding a rate reduction of 60.5%. Unvaccinated children also had a greater number of physicians’ visits and missed school days (35.7% vs. 14.9 and 42.9% vs. 25.6%, respectively). The rate of ILI among household members of unvaccinated children was 34.5%, compared with 25.0% among household members of vaccinated children.

The vaccinated cohort (defined as all children in second grade) reported less ILI compared with the unvaccinated cohort (defined as all children in third grade), with a rate reduction of 44.6%. Pupils of the unvaccinated cohort were more likely to miss school days (42.1% vs. 32.0%, respectively), and a higher rate of ILI was reported among household members of the unvaccinated cohort (35.4% vs. 27.3%, respectively).

Conclusion

Influenza vaccine administered in school setting reduced ILI among the vaccinated cohort and their household members by 60.5 and 27.5%, respectively, compared with the unvaccinated cohort. Expansion of the vaccination program in a school setting increased the public health benefit of influenza vaccines among both school children and their household members.
Establishing a controlled hookworm human infection (CHHI) model for Africa: A report from the stakeholders meeting held in Lambaréné, Gabon, November 10–11, 2019
Authors: Alabi Ayodele , Hussain Mosarrof , Hoogerwerf Marie-Astrid , Mengome Christine Ndong , Egesa Moses , Driciru Emmanuella , Wammes Linda J. , Kruize Yvonne C. M. , Sartono Erliyani , Adegnika Ayola Akim , Kremsner Peter G. , Yazdanbakhsh Maria , Agnandji Selidji Todagbe
Published: July 2021

Background

Hookworm is a major contributor to worldwide disease burden with over 230 million people infected. It has been identified as one of the Neglected Tropical Diseases that can be controlled and even eliminated through mass drug administration and other effective interventions. Mathematical models have shown that hookworm can only be eliminated via a vaccine. Controlled Hookworm Human Infection (CHHI) models can facilitate rapid development of vaccines and drugs.

Methods

As a first step towards the establishment of CHHI in Africa, we held a stakeholders meeting in Lamberene, Gabon from 10 to 11 November 2019.

Results

Discussions revolved around the roles of the different regulatory institutions concerned; the need to strengthen existing regulatory capacity and the role of legislation; creating Gabon-specific ethical guidelines to govern Controlled Human Infection (CHI) studies; development of a study protocol; consideration of cultural and social peculiarities; the need for regular joint review meetings between interested parties throughout the process of protocol implementation; and participant compensation. Moreover, operational considerations concerning the introduction of CHHI in Gabon include the use of the local strain of hookworm for the challenge infections, capacity building for the local production of challenge material, and the establishment of adequate quality assurance procedures.

Conclusion

The workshop addressed several of the anticipated hurdles to the successful implementation of CHHI in Gabon. It is our aim that this report will stimulate interest in the implementation of this model in the sub-Saharan African setting.
Does market access improve dietary diversity and food security? Evidence from Southwestern Ethiopian smallholder coffee producers
Authors: Usman Muhammed Abdella , Callo-Concha Daniel
Published: July 2021

Market access influences the dietary diversity and food security for smallholder households in many ways. In Ethiopia, most smallholders are subsistence farmers who have poor access to markets. This study used primary data from a household survey to examine the relationship between market access and the dietary diversity and food security for 324 smallholder households in the Yayu area of southwestern Ethiopia in early 2018. Multivariate regression analysis showed that households located far from market centers consumed not only less diverse foods but also spend less on food consumption than households located close to market centers. The correlation between market access and food security measured by Household Food Insecurity Access Scale (HFIAS) did not reach statistical significance, nor did the impact of market access on household consumption and dietary diversity through income. Rather, greater market access appeared to encourage smallholder households to rely on market purchases more than their own production to improve the diversity of household consumption. A direct action to improve the market accessibility would be investments in infrastructure to expand rural road connectivity, which would reduce transaction costs and benefit the welfare of smallholder farmers and communities.
Restoring scratched cine-film via reducing light scattering
Authors: Xu Qingmeng , Xu Feifan , Hu Daodao
Published: July 2021

Scratches on cine-film significantly affect the quality of projected film images forming blackness or brightness. Only blackness can be restored by restoration dispersion. However, why the scratches can or can not be restored is unknown. Herein, unscratched and scratched films were selected, treated with restoration dispersion and investigated from composition and microstructure and its interaction with light. Both superficial and penetrating scratches make film rough and the applying of restoration dispersion decreases the roughness. The darkness in the projected film image resulted by superficial scratch can be restored by restoration dispersion through reducing light scattering, while the brightness induced by penetrating scratch can not be restored by restoration dispersion due to the removal of emulsion layer. This investigation is beneficial for developing new restoration dispersion to improve the quality of projected film images.
3-D global hybrid simulations of magnetospheric response to foreshock processes
Authors: Shi Feng , Lin Yu , Wang Xueyi , Wang Boyi , Nishimura Yukitoshi
Published: July 2021

It has been suggested that ion foreshock waves originating in the solar wind upstream of the quasi-parallel (Q-||) shock can impact the planetary magnetosphere leading to standing shear Alfvén waves, i.e., the field line resonances (FLRs). In this paper, we carry out simulations of interaction between the solar wind and terrestrial magnetosphere under radial interplanetary magnetic field conditions by using a 3-D global hybrid model, and show the properties of self-consistently generated field line resonances through direct mode conversion in magnetospheric response to the foreshock disturbances for the first time. The simulation results show that the foreshock disturbances from the Q-|| shock can excite magnetospheric ultralow-frequency waves, among which the toroidal Alfvén waves are examined. It is found that the foreshock wave spectrum covers a wide frequency range and matches the band of FLR harmonics after excluding the Doppler shift effects. The fundamental harmonic of field line resonances dominates and has the strongest wave power, and the higher the harmonic order, the weaker the corresponding wave power. The nodes and anti-nodes of the odd and even harmonics in the equatorial plane are also presented. In addition, as the local Alfvén speed increases earthward, the corresponding frequency of each harmonic increases. The field-aligned current in the cusp region indicative of the possibly observable aurora is found to be a result of magnetopause perturbation which is caused by the foreshock disturbances, and a global view substantiating this scenario is given. Finally, it is found that when the solar wind Mach number decreases, the strength of both field line resonance and field-aligned current decreases accordingly.
Biometric and ICL-related risk factors associated to sub-optimal vaults in eyes implanted with implantable collamer lenses
Authors: Cerpa Manito Santiago , Sánchez Trancón Angel , Torrado Sierra Oscar , Baptista António Manuel , Serra Pedro Miguel
Published: July 2021

Background

To identify biometric and implantable collamer lens (ICL)-related risk factors associated with sub-optimal postoperative vault in eyes implanted with phakic ICL.

Methods

This study reports a retrospective case series of the first operated eye in 360 patients implanted with myopic spherical or toric ICL. Preoperatively, white-to-white (WTW), central keratometry (Kc) and central corneal thickness (CCT) were measured using the Pentacam. Anterior-segment optical coherence tomography (AS-OCT, Visante) was applied preoperatively for measuring the horizontal anterior-chamber angle-to-angle distance (ATA), internal anterior chamber depth (ACD), crystalline lens rise (CLR), anterior-chamber angle (ACA) and postoperatively the vault. Eyes were divided into three vault groups: low (LVG: ≤ 250 μm), optimal (OVG: > 250 and < 1000 μm) and high (HVG: ≥ 1000 μm). Multinomial logistic regression (MLR) was used to find the sub-optimal vault predictors.

Results

MLR showed that CLR, ICL size minus the ATA (ICL size-ATA), age, ICL spherical equivalent (ICLSE) and ICL size as contributing factors for sub-optimal vaults (pseudo-R2 = 0.40). Increased CLR (OR: 1.01, CI: 1.00–1.01) and less myopic ICLSE (OR: 1.22, CI: 1.07–1.40) were risk factors for low vaults. Larger ICL size-ATA (OR: 41.29, CI: 10.57–161.22) and the 13.7 mm ICL (OR: 7.08, CI: 3.16–15.89) were risk factors for high vaults, whereas less myopic ICLSE (OR: 0.85, CI: 0.76–0.95) and older age (OR: 0.92, CI: 0.88–0.98) were protective factors.

Conclusion

High CLR and low ICLSE were the major risk factors in eyes presenting low vaults. In the opposite direction, ICL size-ATA was the major contributor for high vaults. This relationship was more critical in higher myopic ICLSE, younger eyes and when 13.7 mm ICL were used. The findings show that factors influencing the vault have differentiated weight of influence depending on the type of vault (low, optimal or high).
Preliminary toxicology profile of Dennettia tripetala (Pepper Fruit) methanolic leaves extract
Authors: Mordi Joseph Chukwufumnanya , Ichipi-Ifukor Patrick Chukwuyenum , Kweki Godfery Rume , Ichipi-Ifukor Rita Ngozi , Oyem John Chukwuma , Dennis-Eboh Uche
Published: July 2021

Background

Dennentia tripetalla (Pepper Fruit) belongs to the Annonaceae family and is abundant in Nigeria. Its fruit in folklore medicine is used for treatment of varying ailments. While ample research evidence exists on the plants fruit and seed, no current study exists on the toxicological profile of the plant leaves.

Methods

qualitative and quantitative phytochemicals and In vitro antioxidant assays were carried out using standard methods. The acute toxicity study indicates that the LD50 was higher than 2000 mg/Kg body weight. Sub-chronic toxicity studies was carried out using five groups of rats. Group 1 served as control, 2–5 received 100 mg/Kg, 200 mg/Kg, 500 mg/Kg and 1000 mg/Kg body weight orally for 28 days.

Results

Post-administration biochemical analysis indicates there was increased weight in rats administered 100 mg/kg and 200 mg/kg while it reduced in the 500 mg/kg group. Significant elevations of liver function markers were reported for 200 mg/kg and 500 mg/kg respectively. Serum and hepatic protein profiles remained unaltered. Renal function analysis revealed elevated serum urea and creatinine for 200 and 500 mg/kg groups, elevated serum Na+ and Ca+ and reduced serum Cl− for the 500 mg/Kg group. Elevated Kidney K+ and Ca+ levels, reduced Cl− were significantly observed in 500 mg/Kg group. Significant rise in hepatic and renal lipid peroxidation was observed in 200 and 500 mg/Kg groups. There were observed disarmament of the antioxidant defense systems occasioned by rise and drop in tissue (hepatic, renal, testes, heart) Superoxide dismutase (SOD), Catalase (Cat), Glutathione-s-transferase (GST), Glutathione peroxidase (GPx) activities in the test groups relative to control. Histopathological examination indicated architectural aberrations at 500 and 1000 mg/kg.

Conclusions

It concluded that the plant had significant phytochemical and antioxidant properties of medical interest and possessed toxic properties in rats when administered at a dose above 200 mg/Kg over a prolonged period of time.
Identification of potential biomarkers for pathogenesis of Alzheimer’s disease
Authors: Wang Huimin , Han Xiujiang , Gao Sheng
Published: July 2021

Background

Alzheimer’s disease (AD) is an extremely complicated neurodegenerative disorder, which accounts for almost 80 % of all dementia diagnoses. Due to the limited treatment efficacy, it is imperative for AD patients to take reliable prevention and diagnosis measures. This study aimed to explore potential biomarkers for AD.

Methods

GSE63060 and GSE140829 datasets were downloaded from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEG) between AD and control groups in GSE63060 were analyzed using the limma software package. The mRNA expression data in GSE140829 was analyzed using weighted gene co-expression network analysis (WGCNA) function package. Protein functional connections and interactions were analyzed using STRING and key genes were screened based on the degree and Maximal Clique Centrality (MCC) algorithm. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on the key genes.

Results

There were 65 DEGs in GSE63060 dataset between AD patients and healthy controls. In GSE140829 dataset, the turquoise module was related to the pathogenesis of AD, among which, 42 genes were also differentially expressed in GSE63060 dataset. Then 8 genes, RPS17, RPL26, RPS3A, RPS25, EEF1B2, COX7C, HINT1 and SNRPG, were finally screened. Additionally, these 42 genes were significantly enriched in 12 KEGG pathways and 119 GO terms.

Conclusions

In conclusion, RPS17, RPL26, RPS3A, RPS25, EEF1B2, COX7C, HINT1 and SNRPG, were potential biomarkers for pathogenesis of AD, which should be further explored in AD in the future.
A review and guide to creating patient specific 3D printed anatomical models from MRI for benign gynecologic surgery
Authors: Flaxman Teresa E. , Cooke Carly M. , Miguel Olivier X. , Sheikh Adnan M. , Singh Sukhbir S.
Published: July 2021

Background

Patient specific three-dimensional (3D) models can be derived from two-dimensional medical images, such as magnetic resonance (MR) images. 3D models have been shown to improve anatomical comprehension by providing more accurate assessments of anatomical volumes and better perspectives of structural orientations relative to adjacent structures. The clinical benefit of using patient specific 3D printed models have been highlighted in the fields of orthopaedics, cardiothoracics, and neurosurgery for the purpose of pre-surgical planning. However, reports on the clinical use of 3D printed models in the field of gynecology are limited.

Main text

This article aims to provide a brief overview of the principles of 3D printing and the steps required to derive patient-specific, anatomically accurate 3D printed models of gynecologic anatomy from MR images. Examples of 3D printed models for uterine fibroids and endometriosis are presented as well as a discussion on the barriers to clinical uptake and the future directions for 3D printing in the field of gynecological surgery.

Conclusion

Successful gynecologic surgery requires a thorough understanding of the patient’s anatomy and burden of disease. Future use of patient specific 3D printed models is encouraged so the clinical benefit can be better understood and evidence to support their use in standard of care can be provided.
Medicinal cannabis: knowledge, beliefs, and attitudes of Colombian psychiatrists
Authors: Orjuela-Rojas Juan Manuel , García Orjuela Xiomara , Ocampo Serna Sabina
Published: July 2021

Background

The use of cannabinoids in mental health has gained strength in recent years due to emerging scientific evidence and the lifting of prohibitionist laws that prevailed for years in many countries, including Colombia. This study describes the results of a survey of Colombian psychiatrists on some aspects of medicinal cannabis, such as attitudes towards its potential use, perceived knowledge, and beliefs surrounding its regulation and safety.

Methods

We conducted a cross-sectional survey of 145 psychiatrists in 14 territories of Colombia between November 2019 and July 2020. The survey consisted of 28 items on topics related to medicinal cannabis, including attitudes and clinical experience (4 items), perceived knowledge (4 items), indications for use in psychiatric pathologies (6 items), indications for use in nonpsychiatric pathologies (8 items), and concerns and awareness about safety and efficacy (6 items). The results were summarized using descriptive statistics. In addition, possible associations among variables were examined using Fisher’s exact test.

Results

Eighty-two percent of the psychiatrists agreed that medical cannabis should be available for different medical conditions, and 73.1% stated that they wanted to be able to prescribe it. However, 66.2% said they did not know how to help their patients legally access it, and only 25% understood the legal status of medicinal cannabis in the country. The mental health indications that received the highest approval levels for cannabis use were insomnia (35.2%), anxiety disorders (29%), and agitation in dementia (18.6%). The greatest disapproval of cannabis use was indicated for schizophrenia, with 66.9%. The most approved nonpsychiatric medical conditions were cancer-related chronic pain (87.6%), chemotherapy-related nausea and vomiting (78.6%), and chronic pain not associated with cancer (72.4%). Multinomial stepwise logistic regression analysis showed that female psychiatrists who did not agree with MC to treat psychiatric symptoms were more likely to agree with non-psychiatric use.

Conclusions

Our results showed that this sample of Colombian psychiatrists have a favorable attitude towards the prescription of medicinal cannabis; however, there is a serious lack of knowledge of the legal status of medicinal cannabis in the country and the methods through which patients can gain access to government-regulated products. Most of them approve the use of MC for nonpsychiatric conditions and, in general, disapprove of its use in mental illnesses. They generally consider medicinal cannabis as a safe treatment compared to other psychotropic drugs and medications with potential risk of dependence, such as opioids and/or benzodiazepines.
Genetic variability for yield and fiber related traits in genetically modified cotton
Authors: SAHAR Adeela , ZAFAR Muhammad Mubashar , RAZZAQ Abdul , MANAN Abdul , HAROON Muhammad , SAJID Sunaina , REHMAN Abdul , MO Huijuan , ASHRAF Muhammad , REN Maozhi , SHAKEEL Amir , YUAN Youlu
Published: July 2021

Background

Cotton (Gossypium hirsutum L.) is grown for fiber and oil purposes in tropical and sub-tropical areas of the world. Pakistan is the 4th largest producer of cotton. It has a significant contribution in the GDP of Pakistan. Therefore, the present study was performed to assess the genetic variations and genetic diversity of yield and fiber quality traits in cotton and to analyze the associations present among them.

Results

Analysis of variance exhibited significant variation for all studied traits except total number of nodes and the height to node ratio. The phenotypic coefficient of variation was higher than the genotypic coefficient of variation for all studied traits. Plant height, monopodial branches, total number of bolls, lint index, seed index, and seed cotton yield displayed high heritabilities in a broad sense with maximum genetic advance. Correlation analysis revealed that seed cotton yield had a significant positive association with plant height, the number of monopodial branches, the number of sympodial branches, ginning outturn (GOT), the number of bolls, seed per boll, seed index, uniformity index, the number of sympodial branches, reflectance, and seed index at the genotypic level while a significant positive relationship was observed with plant height, the number of sympodial branches, boll number, and GOT. Plant height, monopodial branches, GOT, boll weight, seeds per boll, and short fiber index exerted direct positive effects on seed cotton yield. The first 6 principal component analysis (PCs) out of the total fourteen PCs displayed eigenvalues (> 1) and had maximum share to total variability (82.79%). The attributes that had maximum share to total divergence included plant height, uniformity index, the number of sympodial branches, seed per boll, GOT, seed cotton yield, and short fiber index.

Conclusion

The genotype AA-802, IUB-13, FH-159, FH-458, and CIM-595 were genetically diverse for most of the yield and fiber quality traits and could be utilized for the selection of better performing genotypes for further improvement.
Better be prepared: the spectrum of neuropsychiatric impairment among Libyan war victims transferred to Germany for trauma rehabilitation
Authors: Dootz Felix , von Stackelberg Otto-Magnus , Abaya Joan , Jacobi Christian , Mohs Christoph , Craemer Eva Maria , Rangger Christoph , Meyding-Lamadé Uta , Lamadé Eva Kathrin
Published: July 2021

Background

The current Libyan civil war has originated many casualties, imposing medical challenges. War injuries are complex, requiring specialized knowledge and interdisciplinary assessment for adequate patient and intercultural management.

Methods

This retrospective study analyzed records of 78 Libyan patients admitted from July 2016 to November 2017 to neurological and trauma surgical departments of Krankenhaus Nordwest, Frankfurt, Germany. Issues of system preparation of the hospital, demographics, injury patterns and therapies were analyzed. The chi-squared test was used to analyze differences in injury patterns in explosion and gunshot injuries.

Results

Seventy-seven of seventy-eight patients were male (mean age 30.6 years). The patients received primary and secondary treatment in Tunisia (n = 39), Libya (n = 36) and Turkey (n = 23). Forty-eight patients had gunshot injuries, 37 explosion injuries, 11 both. Preparation for management of injuries included hygienic and isolation protocols, organization of interpreters and intercultural training. Patients presented with a broad variety of neurological, psychiatric and trauma surgical injuries. Fifty-six patients had sensory, 47 motor deficits. Nine reported headache, 5 vertigo, 13 visual impairment, 28 psychiatric symptoms. Eighteen patients had central nervous damage, 50 peripheral nervous damage. Central nervous damage was significantly more common in gunshot than explosion injuries (p = 0.015). Peripheral nervous damage was more common in explosion than gunshot injuries (p < 0.1). Fifty-one patients had polytrauma and 49 suffered from fractures. Therapy included surgical interventions (n = 56) and physiotherapy. Structured rehabilitation programs were often indicated.

Conclusion

Specialized knowledge about war injuries and their management including hospital preparation and planning regarding infrastructure may be required anytime. Injuries include a broad variety of neurological, psychiatric and trauma surgical injuries. Therefore, an interdisciplinary approach is crucial.
A development cycle for automated self-exploration of robot behaviors
Authors: Roehr Thomas M. , Harnack Daniel , Wöhrle Hendrik , Wiebe Felix , Schilling Moritz , Lima Oscar , Langosz Malte , Kumar Shivesh , Straube Sirko , Kirchner Frank
Published: July 2021

In this paper we introduce Q-Rock, a development cycle for the automated self-exploration and qualification of robot behaviors. WithQ-Rock, we suggest a novel, integrative approach to automate robot development processes.Q-Rockcombines several machine learning and reasoning techniques to deal with the increasing complexity in the design of robotic systems. TheQ-Rockdevelopment cycle consists of three complementary processes: (1) automated exploration of capabilities that a given robotic hardware provides, (2) classification and semantic annotation of these capabilities to generate more complex behaviors, and (3) mapping between application requirements and available behaviors. These processes are based on a graph-based representation of a robot’s structure, including hardware and software components. A central, scalable knowledge base enables collaboration of robot designers including mechanical, electrical and systems engineers, software developers and machine learning experts. In this paper we formalizeQ-Rock’s integrative development cycle and highlight its benefits with a proof-of-concept implementation and a use case demonstration.
Current advances on mechanisms and treatment of post-stroke seizures
Authors: Fu Yujiao , Feng Li , Xiao Bo
Published: July 2021

Cerebrovascular diseases are among the most common causes of seizures in adults, especially in the elderly. With the increased incidence of stroke, the population with post-stroke seizures has grown, leading to the increased awareness of this disorder in the society. The most common seizure type after stroke is the focal seizure with or without evolution into bilateral convulsive seizures. Post-stroke seizures impair the quality of life, as well as the physical and mental health of those patients. Currently, the pathological and physical processes of post-stroke seizures are not quite clear yet. In this review, we summarize current advances in the pathogenesis, risk factors, and therapeutic targets of post-stroke seizures.
The new ichnotaxon Eubrontes nobitai ichnosp. nov. and other saurischian tracks from the Lower Cretaceous of Sichuan Province and a review of Chinese Eubrontes-type tracks
Authors: Xing Li-Da , Lockley Martin G. , Klein Hendrik , Zhang Li-Jun , Romilio Anthony , Scott Persons W. , Peng Guang-Zhao , Ye Yong , Wang Miao-Yan
Published: July 2021

The Jiaguan Formation and the underlying Feitianshan Formation (Lower Cretaceous) in Sichuan Province yield multiple saurischian (theropod–sauropod) dominated ichnofaunas. To date, a moderate diversity of six theropod ichnogenera has been reported, but none of these have been identified at the ichnospecies level. Thus, many morphotypes have common “generic” labels such as Grallator, Eubrontes, cf. Eubrontes or even “Eubrontes-Megalosauripus” morphotype. These morphotypes are generally more typical of the Jurassic, whereas other more distinctive theropod tracks (Minisauripus and Velociraptorichnus) are restricted to the Cretaceous. The new ichnospecies Eubrontes nobitai ichnosp nov. is distinguished from Jurassic morphotypes based on a very well-preserved trackway and represents the first-named Eubrontes ichnospecies from the Cretaceous of Asia.