bluuebunny/crossref_metadata_2025 huggingface dataset:
Destabilizing the privilege of the knower to establish forms of solidarity: Reflections on conducting fieldwork with vulnerable communities in India and Romania
Authors: Dragomir Cristina-Ioana
Published: December 2020

In this article, I interrogate the researcher’s role in conducting ethnographic and qualitative fieldwork with vulnerable communities and argue that increased epistemological reflexiveness is needed to support solidarity ties between researchers and participants. In line with critical feminist literature and methodology, I present the inconsistencies of the power relations I entered as a researcher, as well as the systemic inequalities I found operating in the background. Using several vignettes based on my fieldwork with communities labeled as “Gypsy” in Romania and India, I make the argument that power dynamics encountered in the field reveal the researchers’ simultaneous privilege and their subaltern status, creating an epistemological position grounded in the intersection of gender, race/ ethnicity, and class, which in turn could deter from bonds of solidarity. In line with feminist methodologies and intersectionality literature, I argue that the researcher’s gender, race, ethnicity, and class (co)generate epistemological outcomes, and that without critical reflection researchers may reinforce hierarchies of power. Thus, I both adopt and innovate this approach, by showing how as researchers we inhabit concomitantly different and fluctuating positionalities. I end by advocating for reflexiveness on the researchers’ power to create epistemological categories and processes, which may (re)enforce solidarity relations between researchers and communities.
Elementary School Counselor Experiences Teaching Lessons on a Related Arts Schedule
Authors: Milsom Amy , Robinson Emily , Mann Shayla , Rumsey Amanda D.
Published: December 2020

When and how often school counselors teach lessons varies; sometimes they go into classrooms in collaboration with teacher requests, and other times they have a set schedule rotation in conjunction with nonacademic classes like art, music, or physical education—often referred to as a related arts rotation. In this phenomenological study, we interviewed 10 elementary school counselors regarding their experiences teaching classroom lessons as part of the related arts rotation. Three themes emerged: (a) systemic factors, (b) frustrations, and (c) visibility. We discuss implications for school counselor advocacy.
Posterior stability in posterior-stabilized vs medially congruent total knee replacement: A radiological comparison of two polyethylene designs in a single model
Authors: Stramazzo Leonardo , Bassi Nicolo’ , Ghirardelli Stefano , Amoroso Tommaso , Osti Leonardo , Indelli Pier Francesco
Published: December 2020

Objective:

The purpose of this radiological study was to assess the posterior laxity of a single model of a total knee arthroplasty design (TKA) having a medially constrained (MC) or a Posterior-Stabilized (PS) polyethylene insert using a well-documented stress x-ray. To the authors knowledge, this is the first report evaluating MC TKA outcomes according to the “kneeling view.”

Materials and Methods:

Sixty patients with non-traumatic primary knee osteoarthritis undergoing TKA were first matched by age, sex, BMI and diagnosis and then divided in two groups: group A (37 knees) received a MC TKA and group B (23 knees) a PS implant made by the same manufacturer. In all cases the posterior cruciate ligament (PCL) was resected. All patients underwent the same postoperative “kneeling view” and were also clinically evaluated according to the Knee Society Score (KSS) and Oxford Knee Score (OKS). Radiographic measurements were taken by tracing a line along the posterior cortex of the tibia and then measuring the perpendicular distance to a point marked at the posterior corner of Blumensaat’s line.

Results:

At 12 months minimum FU, no statistically significant differences were found between the two groups in all the clinical scores. There was a statistically significant difference on kneeling view values between the two groups (P = 0.0002): the mean value in the MC group was −1.97 ± 3.8 mm while was −5.6 ± 3.1 mm in the PS group. In both groups, the average position of the posterior cortex of the tibia was anterior to the posterior corner of Blumensaat’s line, showing absence of instability in flexion.

Conclusion:

This study highlighted that the PCL removal, accompanied by a precise surgical technique, did not increase the instability in flexion in two groups of patients having the same TKA design but polyethylene inserts characterized by different levels of constraint.
Restructuring Institutional Care: Challenges and Coping Measures for Children and Caregivers in Post-COVID-19 Era
Authors: Roy Sudeshna
Published: December 2020

The sudden outbreak of COVID-19 pandemic has rattled the world and has severely compromised not only the public health system but has decelerated the global economy. In this backdrop, the article explores the dynamics of the institutional care of the out-of-home care (OHC) children, adolescents and children who are residing in alternative care homes, childcare institutions (CCIs), foster homes and who are in conflict with law like refugees or in juvenile correctional centres. The article attempts to highlight the risk factors and systematic barriers that CCIs and associated functionaries have been confronting in the aftermath of the COVID-19 pandemic worldwide. It would also catalogue the remedial, preventive and protective initiatives undertaken as best practices. The qualitative content analysis method is used to identify major themes related to the ongoing COVID-19 pandemic and institutional care of children. Critical evaluation of literature reviews, published newspaper reports and articles and documentation of webinar proceedings is performed for theoretical and thematic conceptualisation of this article. The fundamental barriers that surfaced include financial barriers, health and nutrition, social justice, educational barriers, safety issues, administrative barriers, management, rehabilitation and integration of children living in CCIs and the ones who are leaving the CCIs. The unprecedented challenges have exposed the emergency unpreparedness and lacunae in functioning of CCIs in diverse ways. This has necessitated the undeniable need for reframing the regulatory directives for protection of child rights; accounting for the newer structural reforms aiming for standard operating procedures (SOPs); compliance and accountability guidelines; upgrading training and capacity building of the caregivers; addressing issues of psycho-social, mental health and well-being of the children and caregivers; building resilient coping strategies and enhancing the dignity, flexibility, inclusivity and sustainability in the responsive policy formulation regarding overall childcare system. This entails a multi-sectoral, participatory and coordinated approach as envisaged in United Nations Convention on the Rights of the Child (UNCRC) where the concerned stakeholders, including government legislations, non-governmental organisations (NGOs), civil societies, grassroot organisations, individual CCIs and management staff, would ensure non-discriminatory measures protecting the best interests of the children.
Biomass logistics: Mythistory and sociotechnical imaginary in trans-Atlantic wood pellet assemblage
Authors: Ramos Stephen J
Published: December 2020

The paper focuses on the role of mythistory and the sociotechnical imaginary in stabilizing the links of a particular biomass supply chain running from the forests of Georgia in the US Southeast to diffuse markets across the European Union. Trans-Atlantic wood pellet assemblage demonstrates how mythistories and sociotechnical imaginaries are deployed to opportunistically frame wood as nature, agriculture, and energy as part of governance strategies to coordinate and operationalize the “multiple, spontaneous spatial strategies” that the biomass industry requires. I use assemblage theory to explore how Georgia’s mythistory and the European sociotechnical imaginary form the abstract machine that conditions relationships for the functionality and maintenance of the wood pellet supply chain. I then chart the concrete assemblage of the trans-Atlantic biomass supply chain, which requires the collaboration of a broad network of state and non-state actors. The case helps to ground the current global energy transition period in material and political practices that are contingent, opportunistic, and likely also transitional, even though the sector involves deep capital and political investment throughout the supply chain.
Calcium Hypothesis of Gulf War Illness: Role of Calcium Ions in Neurological Morbidities in a DFP-Based Rat Model for Gulf War Illness
Authors: Phillips Kristin F , Deshpande Laxmikant S
Published: December 2020

Gulf War Illness (GWI) refers to a multi-system disorder that afflicts approximately 30% of First Gulf War (GW) veterans. Amongst the symptoms exhibited, mood and memory impairment are commonly reported by GW veterans. Exposure to organophosphate (OP) compounds which target the cholinergic system is considered a leading cause for GWI symptoms. It is hypothesized that chronic OP-based war-time stimulation of cholinergic signaling led to recruitment of excitatory glutamatergic signaling and other downstream signaling cascades leading to neuronal injury, neuroinflammation, generation of reactive oxygen species, oxidative stress, and mitochondrial damage within the central nervous system. These findings have been observed in both experimental models and GWI veterans. In this context the role of calcium (Ca2+) signaling in GWI has come to the forefront. Here we present our Ca2+ hypothesis of GWI that suggests sustained neuronal Ca2+ elevations serve as a molecular trigger for pathological synaptic plasticity that has allowed for the persistence of GWI symptoms. Subsequently we discuss that therapeutic targeting of Ca2+ homeostatic mechanisms provides novel targets for effective treatment of GWI-related neurological signs in our rodent model.
Autosomal dominant polycystic kidney disease and pioglitazone for its therapy: a comprehensive review with an emphasis on the molecular pathogenesis and pharmacological aspects
Authors: Saini Aryendu Kumar , Saini Rakesh , Singh Shubham
Published: December 2020

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited chronic kidney disorder (CKD) that is characterized by the development of numerous fluid-filled cysts in kidneys. It is caused either due to the mutations in the PKD1 or PKD2 gene that encodes polycystin-1 and polycystin-2, respectively. This condition progresses into end-stage renal disorder if the renal or extra-renal clinical manifestations remain untreated. Several clinical trials with a variety of drugs have failed, and the only Food and Drugs Administration (FDA) approved drug to treat ADPKD to date is tolvaptan that works by antagonizing the vasopressin-2 receptor (V2R). The pathology of ADPKD is complex and involves the malfunction of different signaling pathways like cAMP, Hedgehog, and MAPK/ERK pathway owing to the mutated product that is polycystin-1 or 2. A measured yet substantial number of preclinical studies have found pioglitazone to decrease the cystic burden and improve the renal function in ADPKD. The peroxisome proliferator-activated receptor-gamma is found on the epithelial cells of renal collecting tubule and when it gets agonized by pioglitazone, confers efficacy in ADPKD treatment through multiple mechanisms. There is only one clinical trial (ongoing) wherein it is being assessed for its benefits and risk in patients with ADPKD, and is expected to get approval from the regulatory body owing to its promising therapeutic effects. This article would encompass the updated information on the epidemiology, pathophysiology of ADPKD, different mechanisms of action of pioglitazone in the treatment of ADPKD with preclinical and clinical shreds of evidence, and related safety updates.
Laparoscopic versus open nephrectomy in resource-constrained developing world hospitals: a retrospective analysis
Authors: Singh Avikar , Urry Ronald James
Published: December 2020

Background

Laparoscopic nephrectomy is the standard of care for nephrectomy in most developed countries. Its adoption in our setting has been limited due to lack of equipment and expertise. This paper sets out to show that laparoscopic nephrectomy is technically feasible in the state sector in South Africa.

Methods

A retrospective chart review was performed of all patients having undergone nephrectomy over a five-year period at two state hospitals in KwaZulu-Natal Province, South Africa. Demographic information, pre-operative imaging findings, operative information and post-operative outcomes were analysed.

Results

Nephrectomy was performed in 196 patients. Open nephrectomy (ON) was the intended surgical approach in 73% (n = 143) and laparoscopic nephrectomy (LN) in 27% (n = 53). The conversion rate from LN to ON was 11% (n = 6). For malignancies, there was no difference in surgical resection margin status across the ON, LN and conversion groups; however, tumour size was larger in the conversion group compared to the LN group. Estimated blood loss and transfusion rates were lower in the LN group. The average length of hospital stay was shorter in the LN group (5 vs 10 days). High dependency unit (HDU) admission rate was lower in the LN group (12.1%) compared to the ON group (50%) and the conversion group (40%). No difference in high-grade complications was noted between the ON and LN groups, and more patients in the LN group (82.5%) had no complications compared to the open group (9.9%).

Conclusion

LN is non-inferior to ON in terms of operative time, oncology outcomes and high-grade complications. LN is superior in terms of blood loss, transfusion rate, length of hospital stay and overall complication rate. LN appears to show technical feasibility in the state sector and highlights the need for laparoscopic training.
Proteome sequencing and analysis of Ophiocordyceps sinensis at different culture periods
Authors: Zhang Bo , Li Bo , Men Xiao-Hui , Xu Zhe-Wen , Wu Hui , Qin Xiang-Tian , Xu Feng , Teng Yi , Yuan Shui-Jin , Jin Li-Qun , Liu Zhi-Qiang , Zheng Yu-Guo
Published: December 2020

Background

Ophiocordyceps sinensis is an important traditional Chinese medicine for its comprehensive active ingredients, such as cordycepin, cordycepic acid, and Cordyceps polysaccharide. O. sinensis zjut, a special strain isolated from O. sinensis, has similar pharmacological functions to wild O. sinensis. Currently, O. sinensis with artificial cultivation has been widely studied, but systematic fundamental research at protein levels has not been determined.

Results

Proteomes of O. sinensis zjut at different culture periods (growth period, 3rd day; pre-stable period, 6th day; and stable period, 9th day) were relatively quantified by relative isotope markers and absolute quantitative technology. In total, 4005 proteins were obtained and further annotated with Gene Ontology, Kyoto Encyclopedia of Genes and Genomes database. Based on the result of the annotations, metabolic pathways of active ingredients, amino acids and fatty acid were constructed, and the related enzymes were exhibited. Subsequently, comparative proteomics of O. sinensis zjut identified the differentially expressed proteins (DEPs) by growth in different culture periods, to find the important proteins involved in metabolic pathways of active ingredients. 605 DEPs between 6d-VS-3d, 1188 DEPs between 9d-VS-3d, and 428 DEPs between 9d-VS-6d were obtained, respectively.

Conclusion

This work provided scientific basis to study protein profile and comparison of protein expression levels of O. sinensis zjut, and it will be helpful for metabolic engineering works to active ingredients for exploration, application and improvement of this fungus.
Comparative evaluation for the globin gene depletion methods for mRNA sequencing using the whole blood-derived total RNAs
Authors: Jang Jin Sung , Berg Brianna , Holicky Eileen , Eckloff Bruce , Mutawe Mark , Carrasquillo Minerva M. , Ertekin-Taner Nilüfer , Cuninngham Julie M.
Published: December 2020

Background

There are challenges in generating mRNA-Seq data from whole-blood derived RNA as globin gene and rRNA are frequent contaminants. Given the abundance of erythrocytes in whole blood, globin genes comprise some 80% or more of the total RNA. Therefore, depletion of globin gene RNA and rRNA are critical steps required to have adequate coverage of reads mapping to the reference transcripts and thus reduce the total cost of sequencing. In this study, we directly compared the performance of probe hybridization (GLOBINClear Kit and Globin-Zero Gold rRNA Removal Kit) and RNAse-H enzymatic depletion (NEBNext® Globin & rRNA Depletion Kit and Ribo-Zero Plus rRNA Depletion Kit) methods from 1 μg of whole blood-derived RNA on mRNA-Seq profiling. All RNA samples were treated with DNaseI for additional cleanup before the depletion step and were processed for poly-A selection for library generation.

Results

Probe hybridization revealed a better overall performance than the RNAse-H enzymatic depletion method, detecting a higher number of genes and transcripts without 3′ region bias. After depletion, samples treated with probe hybridization showed globin genes at 0.5% (±0.6%) of the total mapped reads; the RNAse-H enzymatic depletion had 3.2% (±3.8%). Probe hybridization showed more junction reads and transcripts compared with RNAse-H enzymatic depletion and also had a higher correlation (R > 0.9) than RNAse-H enzymatic depletion (R > 0.85).

Conclusion

In this study, our results showed that 1 μg of high-quality RNA from whole blood could be routinely used for transcriptional profiling analysis studies with globin gene and rRNA depletion pre-processing. We also demonstrated that the probe hybridization depletion method is better suited to mRNA sequencing analysis with minimal effect on RNA quality during depletion procedures.
Overexpression of AtAHL20 causes delayed flowering in Arabidopsis via repression of FT expression
Authors: Tayengwa Reuben , Sharma Koirala Pushpa , Pierce Courtney F. , Werner Breanna E. , Neff Michael M.
Published: December 2020

Background

The 29-member ArabidopsisAHLgene family is classified into three main classes based on nucleotide and protein sequence evolutionary differences. These differences include the presence or absence of introns, type and/or number of conserved AT-hook and PPC domains.AHLgene family members are divided into two phylogenetic clades, Clade-A and Clade-B. A majority of the 29 members remain functionally uncharacterized. Furthermore, the biological significance of the DNA and peptide sequence diversity, observed in the conserved motifs and domains found in the different AHL types, is a subject area that remains largely unexplored.

Results

Transgenic plants overexpressingAtAHL20flowered later than the wild type under both short and long days. Transcript accumulation analyses showed that35S:AtAHL20plants contained reducedFT, TSF, AGL8andSPL3mRNA levels. Similarly, overexpression ofAtAHL20’sorthologue inCamelina sativa,Arabidopsis’ closely relatedBrassicaceaefamily member species, conferred a late-flowering phenotype via suppression ofCsFTexpression. However, overexpression of an aberrantAtAHL20gene harboring a missense mutation in the AT-hook domain’s highly conserved R-G-R core motif abolished the late-flowering phenotype. Data from targeted yeast-two-hybrid assays showed that AtAHL20 interacted with itself and several other Clade-A Type-I AHLs which have been previously implicated in flowering-time regulation: AtAHL19, AtAHL22 and AtAHL29.

Conclusion

We showed via gain-of-function analysis thatAtAHL20is a negative regulator ofFTexpression, as well as other downstream flowering time regulating genes. A similar outcome inCamelina sativatransgenic plants overexpressingCsAHL20suggest that this is a conserved function. Our results demonstrate thatAtAHL20acts as a photoperiod-independent negative regulator of transition to flowering.
On Jones et al.’s method for extending Bland-Altman plots to limits of agreement with the mean for multiple observers
Authors: Christensen Heidi S. , Borgbjerg Jens , Børty Lars , Bøgsted Martin
Published: December 2020

Background

To assess the agreement of continuous measurements between a number of observers, Jones et al. introduced limits of agreement with the mean (LOAM) for multiple observers, representing how much an individual observer can deviate from the mean measurement of all observers. Besides the graphical visualisation of LOAM, suggested by Jones et al., it is desirable to supply LOAM with confidence intervals and to extend the method to the case of multiple measurements per observer.

Methods

We reformulate LOAM under the assumption the measurements follow an additive two-way random effects model. Assuming this model, we provide estimates and confidence intervals for the proposed LOAM. Further, this approach is easily extended to the case of multiple measurements per observer.

Results

The proposed method is applied on two data sets to illustrate its use. Specifically, we consider agreement between measurements regarding tumour size and aortic diameter. For the latter study, three measurement methods are considered.

Conclusions

The proposed LOAM and the associated confidence intervals are useful for assessing agreement between continuous measurements.
The curious incident of a cavum velum interpositum cyst in twins of a mother carrying May-Hegglin anomaly: a case report and short literature review
Authors: Giordano Giulio , Tiscia Giovanni L. , Favuzzi Giovanni , Chinni Elena , Intrieri Mariano , Mastroianno Mario , Di Meglio Letizia , Margaglione Maurizio , Grandone Elvira
Published: December 2020

Background

May-Hegglin anomaly is an autosomal dominant inherited condition, characterized by thrombocytopenia, giant platelets and Dohle-like bodies. Incidence is unknown and affected individuals can show from mild to moderate-severe haemorrhagic symptoms. The cyst of cavum veli interpositi (a virtual space filled with fluid within the third ventricle) is rarely reported in the foetal period. Furthermore, it is unclear whether isolated cavum veli interpositi cysts are a normal variant or developmental malformations. The simultaneous presence of these two anomalies was never described.

Case presentation

We describe a very rare case of a twin monochorionic pregnancy in a woman with the May-Hegglin anomaly, whose foetuses carried cavum veli interpositi cysts. Since childhood, our patient had shown macro-thrombocytopenia, deafness and bleeding (epistaxis and menorrhagia), but she was misdiagnosed until the age of 30 years when our Centre identified a de novo allelic variant in the gene MYH9 coding for the non-muscle myosin heavy chain IIa. Our patient bled neither during the pregnancy, nor in the peripartum period. Children are now eight-months-old and have never bled, although both inherited the MYH9 variant and have thrombocytopenia with giant platelets. Furthermore, none of them developed psychomotor disorders.

Conclusions

To the best of our knowledge, this is the sixth case of twin pregnancy in a woman carrying May-Hegglin anomaly and the first one with cavum veli interpositi cysts in the neonates. We speculate that MYH9 could have, at least in part, played a role in the development of both conditions, as this gene has a pleiotropic effect.
Network meta-analysis of targeted therapies for diffuse large B cell lymphoma
Authors: Wang Jie , Huang Jun , Zeng Qing
Published: December 2020

Background

The purpose of this network meta-analysis of randomized controlled trials (RCTs) was to compare rank targeted therapies for patients with diffuse large B-cell lymphoma (DLBCL).

Methods

The PubMed, EmBase, and Cochrane library electronic databases were systematically searched throughout December 2019. Direct and indirect evidence from relevant RCTs was identified for network meta-analysis. The pooled results for grade 3 or greater adverse events between targeted therapies and chemotherapy were calculated using a random-effects model.

Results

A total of 18 RCTs enrolling 8207 DLBCL patients were selected for the final meta-analysis. The results of the network analysis indicated that the addition of dacetuzumab (74.8%) to rituximab-based regimens or lenalidomide (77.1%) was associated with better therapeutic effects on overall survival, whereas dacetuzumab (80.4%) or bortezomib (70.8%) added to rituximab was most likely to improve events-free survival. Moreover, lenalidomide (93.8%) and I-tositumomab (77.2%) were associated with higher overall response rates. Finally, patients receiving targeted therapies were associated with an increased risk of diarrhea (RR: 2.63; 95%CI: 1.18–5.86;P = 0.019), and thrombocytopenia (RR: 1.41; 95%CI: 1.05–1.90;P = 0.023).

Conclusions

This study provides the best treatment strategy for DLBCL patients in terms of overall survival, events-free survival, and overall response rate. The findings of this study require validation with further large-scale RCTs.
Survival rate of patients with bladder cancer and its related factors in Kurdistan Province (2013–2018): a population-based study
Authors: Amiri Mozhdeh , Heshmatollah Sofimajidpour , Esmaeilnasab Nader , Khoubi Jamshid , Ghaderi Ebrahim , Roshani Daem
Published: December 2020

Background

Bladder cancer is one of the most common urinary tract cancers. This study aims to estimate the survival rate of patients with bladder cancer according to the Cox proportional hazards model based on some key relevant variables.

Methods

In this retrospective population-based cohort study that explores the survival of patients with bladder cancer and its related factors, we first collected demographic information and medical records of 321 patients with bladder cancer through in-person and telephone interviews. Then, in the analysis phase, Kaplan–Meier method and log-rank test were used to draw the survival curve, compare the groups, and explore the effect of risk factors on the patient survival rate using Cox proportional hazards model.

Results

The median survival rate of patients was 63.2 (54.7–72) months and one, three and five-year survival rates were 87%, 68% and 54%, respectively. The results of multiple analyses using Cox's proportional hazards model revealed that variables of sex (male gender) (HR = 11.8, 95% CI: 0.4–100.7), more than 65 year of age (HR = 4.1, 95% CI: 0.4–11), occupation, income level, (HR = 0.4, 95% CI: 0.2–0.8), well differentiated tumor grade (HR = 3.2, 95% CI: 1.7–6) and disease stage influenced the survival rate of patients (p < 0.05).

Conclusion

The survival rate of patients with bladder cancer in Kurdistan province is relatively low. Given the impact of the disease stage on the survival rate, adequate access to appropriate diagnostic and treatment services as well as planning for screening and early diagnosis, especially in men, can increase the survival rate of patients.
Hugan Qingzhi medication ameliorates free fatty acid-induced L02 hepatocyte endoplasmic reticulum stress by regulating the activation of PKC-δ
Authors: Yang Miaoting , Chen Zhijuan , Xiang Shijian , Xia Fan , Tang Waijiao , Yao Xiaorui , Zhou Benjie
Published: December 2020

Background

Previous studies have found that Hugan Qingzhi tablet (HQT) has significant lipid-lowering and antioxidant effects on non-alcoholic fatty liver disease (NAFLD). Moreover, the results of proteomic analysis confirmed that various proteins in endoplasmic reticulum stress (ERS) pathway were activated and recovered by HQT. However, its mechanism remains confused. The purpose of this study was to explore the effects of HQT-medicated serum on hepatic ERS and its relevant mechanisms.

Methods

L02 cells were induced by Free Fatty Acid (FFA) for 24 h to establish a model of hepatic ERS and pretreated with the drug-medicated rat serum for 24 h. Accumulation of intracellular lipid was evaluated using Oil Red O staining and Triglyceride detection kit. The morphological changes of ER were observed by TEM. PKC-δ was silenced by specific siRNA. Western blot and RT-qPCR were applied to detect the expression of markers related to ERS, calcium disorder, steatosis and insulin resistance. The fluorescence of Ca2+ influx was recorded using fluorescence spectrophotometer.

Results

HQT-medicated serum significantly decreased the intracellular TG content. Furthermore, it caused significant reduction in the expression of ERS markers and an improvement in ER structure of L02 cells. PKC-δ was activated into phosphorylated PKC-δ in FFA-induced L02 hepatocytes while these changes can be reversed by HQT-medicated serum. Silencing PKC-δ in L02 cells can restore the expression and activity of SERCA2 in ER and down-regulate the expression of IP3R protein to maintain intracellular calcium homeostasis, so as to relieve FFA-induced ERS and its lipid accumulation and insulin resistance.

Conclusions

The results concluded that HQT-medicated serum exerts protective effects against hepatic ERS, steatosis and insulin resistance in FFA-induced L02 hepatocyte. And its potential mechanism might be down-regulating the activation of PKC-δ and stabilization of intracellular calcium.
Applying SF-6D to measure health state utilities among the middle and old aged patients with hypertension in China
Authors: Liu Xiaohan , Bai Guannan , Li Hui , Li Shunping
Published: December 2020

Purpose

Hypertension is a growing public health problem in China; however, little is known about health-related quality of life (HRQoL) especially health state utility (HSU) of patients with hypertension in rural China. This study aimed to examine the HSU as measured by SF-6D and to investigate its associated factors among middle and old aged patients with hypertension in rural China.

Methods

Data were collected from twelve villages in Shandong Province in 2016. SF-36 was administrated to measure HRQoL of middle and old aged patients with hypertension and was got to the SF-6D values using Hong Kong’s tariff. Descriptive analyses, such as demographic characteristics, socio-economic status, and utility, were stratified by hypertension classification. Multiple linear regression models were applied to assess the associated factors of HSU.

Results

A total of 933 (response rate:86.4%) middle and old aged patients (69.1 ± 8.2 years) with hypertension participated in the study. 39.4% of participants were male; 44.2% had stage I hypertension; 26.4% had stage II and above. The mean score of SF-6D utility score was 0.743 (SD: 0.14, range: 0.32–1.00, median: 0.756, Interquartile range:0.634–0.859). Being female (β = −0.046), having two or more comorbidities (2 vs. 1 β = −0.066; > 3 vs. 1 β = −0.098) and the health expenditure higher than 2000 RMB (2000–3999 vs.< 2000 β = −0.042; 4000–5999 vs. < 2000 β = −0.046; > 6000 vs. < 2000 β = −0.071) were significantly associated with lower SF-6D overall score; while being farmer (β = 0.032), having high household income (10,000–14,999 vs. < 5000 β = 0.045; > 15,000 vs. < 5000 β = 0.064) and having stage I and above hypertension (stage I vs. Normotensive β = 0.047; stage II vs. Normotensive β = 0.079; stage III vs. Normotensive β = 0.095) were significantly associated with higher SF-6D overall score.

Conclusion

SF-6D was capable to measure quality of life middle and old aged patients with hypertension in China. And multiple factors were demonstrated to be significantly associated with quality of life.
Quality assessment of the guidelines for the management of malignant pleural effusions and ascites
Authors: Li Jia-Xi , Shi Yan-Mei , An Li-Ya , Yang Jin-Xu , Qi Yu-Xing , Yang Ting , Cen Yun-Yun , Lin Yue-Ying , Sun Da-Li
Published: December 2020

Objectives

To fully assess the quality of the guidelines for the management of malignant pleural effusions (MPE) and ascites and reveal the heterogeneity of recommendations and possible reasons among guidelines.

Methods

A systematic search was performed in the database to obtain guidelines for the management of MPE and ascites. The AGREE IIGtool was used to assess the quality of these guidelines. The Measurement Scale of Rate of Agreement (MSRA) was introduced to assess the scientific agreement of formulated recommendations for the management of MPE and ascites among guidelines, and evidence supporting these recommendations was extracted and analyzed.

Results

Nine guidelines were identified. Only 4 guidelines scored more than 60% and are worth recommending. Recommendations were also heterogeneous among guidelines for the management of MPE, and the main reasons were the different emphases of the recommendations for the treatment of MPE, the contradictions in recommendations, and the unreasonably cited evidence for MPE.

Conclusions

The quality of the management guidelines for patients with MPE and malignant ascites was highly variable. Specific improvement of the factors leading to the heterogeneity of recommendations will be a reasonable and effective way for developers to upgrade the recommendations in the guidelines for MPE.
Risk of birth defects in children conceived by artificial oocyte activation and intracytoplasmic sperm injection: a meta-analysis
Authors: Long Rui , Wang Meng , Yang Qi Yu , Hu Shi Qiao , Zhu Li Xia , Jin Lei
Published: December 2020

Background

Whether artificial oocyte activation (ICSI-AOA) will increase the risk of birth defects remains controversial. Thus, we performed this study to evaluate the risk of birth defects and further compare the incidence of different birth defects types (chromosomal aberrations and non-chromosomal aberrations) in children conceived by ICSI-AOA and conventional intracytoplasmic sperm injection (ICSI) in an enlarged sample size.

Method

A comprehensive review of the literatures comparing birth defects in children conceived by ICSI-AOA and conventional ICSI by October 2020 was performed in PubMed, Embase, Cochrane Libraries, Web of Science, and Chinese databases including China National Knowledge Infrastructure, China Biology Medicine disc and Wan Fang. Risk ratios (RR) and 95% confidence intervals (CI) were calculated.

Results

Five studies were included in the final analysis. Compared with conventional ICSI, ICSI-AOA did not increase the birth defects rate (RR = 1.27, 95%CI 0.70–2.28) of children. Furthermore, in a subgroup analysis, birth defects were classified into two types (chromosomal aberrations and non-chromosomal aberrations) in four studies and no statistical difference were revealed.

Conclusion

Our analysis indicates that ICSI-AOA represents no significant difference in the prevalence of major birth defects or types of birth defects (chromosomal aberrations and non-chromosomal aberrations) comparing with conventional ICSI. This conclusion may provide clinicians evidence-based support in patient counseling and instruction of the application and safety concern about ICSI-AOA.
The potential of real-time analytics to improve care for mechanically ventilated patients in the intensive care unit: an early economic evaluation
Authors: Bakker Lytske , Vaporidi Katerina , Aarts Jos , Redekop William
Published: December 2020

Background

Mechanical ventilation services are an important driver of the high costs of intensive care. An optimal interaction between a patient and a ventilator is therefore paramount. Suboptimal interaction is present when patients repeatedly demand, but do not receive, breathing support from a mechanical ventilator (> 30 times in 3 min), also known as an ineffective effort event (IEEV). IEEVs are associated with increased hospital mortality prolonged intensive care stay, and prolonged time on ventilation and thus development of real-time analytics that identify IEEVs is essential. To assist decision-making about further development we estimate the potential cost-effectiveness of real-time analytics that identify ineffective effort events.

Methods

We developed a cost-effectiveness model combining a decision tree and Markov model for long-term outcomes with data on current care from a Greek hospital and literature. A lifetime horizon and a healthcare payer perspective were used. Uncertainty about the results was assessed using sensitivity and scenario analyses to examine the impact of varying parameters like the intensive care costs per day and the effectiveness of treatment of IEEVs.

Results

Use of the analytics could lead to reduced mortality (3% absolute reduction), increased quality adjusted life years (0.21 per patient) and cost-savings (€264 per patient) compared to current care. Moreover, cost-savings for hospitals and health improvements can be incurred even if the treatment’s effectiveness is reduced from 30 to 10%. The estimated savings increase to €1,155 per patient in countries where costs of an intensive care day are high (e.g. the Netherlands). There is considerable headroom for development and the analytics generate savings when the price of the analytics per bed per year is below €7,307. Furthermore, even when the treatment’s effectiveness is 10%, the probability that the analytics are cost-effective exceeds 90%.

Conclusions

Implementing real-time analytics to identify ineffective effort events can lead to health and financial benefits. Therefore, it will be worthwhile to continue assessment of the effectiveness of the analytics in clinical practice and validate our findings. Eventually, their adoption in settings where costs of an intensive care day are high and ineffective efforts are frequent could yield a high return on investment.
Physical health examination in outpatients with schizophrenia: the cost effectiveness of laboratory screening tests
Authors: Eskelinen Saana , Suvisaari Janne V. J. , Suvisaari Jaana M.
Published: December 2020

Background

Guidelines on laboratory screening in schizophrenia recommend annual monitoring of fasting lipids and glucose. The utility and the cost effectiveness of more extensive laboratory screening have not been studied.

Methods

The Living Conditions and the Physical Health of Outpatients with Schizophrenia Study provided a comprehensive health examination, including a laboratory test panel for 275 participants. We calculated the prevalence of the results outside the reference range for each laboratory test, and estimated the cost effectiveness to find an aberrant test result using the number needed to screen to find one abnormal result (NNSAR) and the direct cost spent to find one abnormal result (DCSAR, NNSAR x direct cost per test) formulas. In addition, we studied whether patients who were obese or used clozapine had more often abnormal results.

Results

A half of the sample had 25-hydroxyvitamin D below, and almost one-fourth cholesterol, triglycerides or glucose above the reference range. One-fifth had sodium below and gamma glutamyltransferase above the reference range. NNSAR was highest for potassium (137) and lowest for 25-hydroxyvitamin D (2). DCSAR was below 5€ for glucose, all lipids and sodium, and below 10€ for creatinine and gamma glutamyltransferase. Potassium (130€), pH-adjusted ionized calcium (33 €) and thyroid stimulating hormone (33€) had highest DCSARs. Several abnormal results were more common in obese and clozapine using patients.

Conclusions

An annual laboratory screening panel for an outpatient with schizophrenia should include fasting glucose, lipids, sodium, creatinine, a liver function test and complete blood count, and preferably 25-hydroxyvitamin D.
A pilot protocol to assess the feasibility of a virtual multiple crossover, randomized controlled trial design using methylphenidate in mild cognitive impairment
Authors: DesRuisseaux Libby A. , Williams Victoria J. , McManus Alison J. , Gupta Anoopum S. , Carlyle Becky C. , Azami Hamed , Gerber Jessica A. , Bolling Anna M. , Cook Carolyn L. , Betensky Rebecca A. , Arnold Steven E.
Published: December 2020

Background

The conventional clinical trial design in Alzheimer’s disease (AD) and AD-related disorders (ADRDs) is the parallel-group randomized controlled trial. However, in heterogeneous disorders like AD/ADRDs, this design requires large sample sizes to detect meaningful effects in an “average” patient. They are very costly and, despite many attempts, have not yielded new treatments for many years. An alternative, the multi-crossover, randomized control trial (MCRCT) is a design in which each patient serves as their own control across successive, randomized blocks of active treatment and placebo. This design overcomes many limitations of parallel-group trials, yielding an unbiased assessment of treatment effect at the individual level (“N-of-1”) regardless of unique patient characteristics. The goal of the present study is to pilot a MCRCT of a potential symptomatic treatment, methylphenidate, for mild-stage AD/ADRDs, testing feasibility and compliance of participants in this design and efficacy of the drug using both standard and novel outcome measures suited for this design.

Methods

Ten participants with mild cognitive impairment or mild-stage dementia due to AD/ADRDs will undergo a 4-week lead-in period followed by three, month-long treatment blocks (2 weeks of treatment with methylphenidate, 2 weeks placebo in random order). This trial will be conducted entirely virtually with an optional in-person screening visit. The primary outcome of interest is feasibility as measured by compliance and retention, with secondary and exploratory outcomes including cognition as measured by neuropsychological assessment at the end of each treatment period and daily brain games played throughout the study, actigraphy, and neuropsychiatric and functional assessments.

Discussion

This pilot study will gauge the feasibility of conducting a virtual MCRCT for symptomatic treatment in early AD/ADRD. It will also compare home-based daily brain games with standard neuropsychological measures within a clinical trial for AD/ADRD. Particular attention will be paid to compliance, tolerability of drug and participation, learning effects, trends and stability of daily measures across blocks, medication carryover effects, and correlations between standard and brief daily assessments. These data will provide guidance for more efficient trial design and the use of potentially more robust, ecological outcome measures in AD/ADRD research.

Trial registration

ClinicalTrials.gov, NCT03811847. Registered on 21 January 2019.
Extracts of medicinal plants with natural deep eutectic solvents: enhanced antimicrobial activity and low genotoxicity
Authors: Grozdanova Tsvetinka , Trusheva Boryana , Alipieva Kalina , Popova Milena , Dimitrova Lyudmila , Najdenski Hristo , Zaharieva Maya M. , Ilieva Yana , Vasileva Bela , Miloshev George , Georgieva Milena , Bankova Vassya
Published: December 2020

Natural deep eutectic solvents (NADES) are a new alternative to toxic organic solvents. Their constituents are primary metabolites, non-toxic, biocompatible and sustainable. In this study four selected NADES were applied for the extraction of two medicinal plants: Sideritis scardica, and Plantago major as an alternative to water-alcohol mixtures, and the antimicrobial and genotoxic potential of the extracts were studied. The extraction efficiency was evaluated by measuring the extracted total phenolics, and total flavonoids. Best extraction results for total phenolics for the studied plants were obtained with choline chloride-glucose 5:2 plus 30% water; but surprisingly these extracts were inactive against all tested microorganisms. Extracts with citric acid-1,2-propanediol 1:4 and choline chloride-glycerol 1:2 showed good activity against S. pyogenes, E. coli, S. aureus, and C. albicans. Low genotoxicity and cytotoxicity were observed for all four NADES and the extracts with antimicrobial activity. Our results confirm the potential of NADESs for extraction of bioactive constituents of medicinal plants and further suggest that NADES can improve the effects of bioactive extracts. Further studies are needed to clarify the influence of the studied NADES on the bioactivity of dissolved substances, and the possibility to use such extracts in the pharmaceutical and food industry.
Shotgun metagenomic analysis reveals new insights into bacterial community profiles in tempeh
Authors: Yulandi Adi , Suwanto Antonius , Waturangi Diana Elizabeth , Wahyudi Aris Tri
Published: December 2020

Objective

Amplicon sequencing targeting 16S ribosomal RNA (rRNA) has been widely used to profile the microbial community from fermented food samples. However, polymerase chain reaction (PCR) steps on amplicon sequencing analysis and intragenomic heterogeneity within 16S rRNA are believed to contribute to bias in estimating microbial community composition. As potential paraprobiotics sources, a comprehensive profiling study of tempeh microbial ecology could contribute to tempeh product development. This study employed a shotgun metagenomic approach, where metagenome fragments from tempeh samples were sequenced directly for taxonomic and functional profiling analysis.

Results

Taxonomic profiling showed that Proteobacteria, Firmicutes, and Bacteroidetes were the dominant phyla from the shotgun metagenomic analysis in all tempeh samples. In terms of composition, this shotgun metagenomic study revealed that Proteobacteria was the most abundant phylum. Functional profiling showed that iron complex outer-membrane recepter protein (KEGG ID: K02014) was the most transcribed gene based on this metagenomic analysis. The metagenome-assembled genomes (MAGs) results from the binning pipeline could reveal almost complete whole genome sequence of Lactobacillus fermentum, Enterococcus cecorum, Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii.
High repetitive arginine in the anterior of PCV3 capsid protein is a severe obstacle for its expression in E. coli
Authors: Liu Bing Yan , Gao Bin , Liu Meng Zhi , Zhang Ting Ting , Liu Bao Shan , Chen Ze Liang
Published: December 2020

Porcine circovirus type 3 (PCV3) is a novel circovirus identified in sows with PDNS-like clinical signs and reproductive failure. The capsid protein (CAP) of PCV3 is expected to be an effective vaccine candidate. Here, we expressed the original capsid protein, truncated capsid protein without anterior highly repetitive arginine (ΔCAP) and their codon-optimized counterparts in E. coli. These results showed that lots of repeated arginine could severely lower the expression of PCV3 capsid protein in E. coli. At the same time, the recombined truncated PCV3 capsid protein forms typic virions. The efficient expression of capsid protein is expected to serve the development of PCV3 vaccines and other studies of PCV3 capsid protein.
Unmanned aerial vehicles optimal airtime estimation for energy aware deployment in IoT-enabled fifth generation cellular networks
Authors: Majeed Saqib , Sohail Adnan , Qureshi Kashif Naseer , Kumar Arvind , Iqbal Saleem , Lloret Jaime
Published: December 2020

Cellular networks based on new generation standards are the major enabler for Internet of things (IoT) communication. Narrowband-IoT and Long Term Evolution for Machines are the newest wide area network-based cellular technologies for IoT applications. The deployment of unmanned aerial vehicles (UAVs) has gained the popularity in cellular networks by using temporary ubiquitous coverage in the areas where the infrastructure-based networks are either not available or have vanished due to some disasters. The major challenge in such networks is the efficient UAVs deployment that covers maximum users and area with the minimum number of UAVs. The performance and sustainability of UAVs is largely dependent upon the available residual energy especially in mission planning. Although energy harvesting techniques and efficient storage units are available, but these have their own constraints and the limited onboard energy still severely hinders the practical realization of UAVs. This paper employs neglected parameters of UAVs energy consumption in order to get actual status of available energy and proposed a solution that more accurately estimates the UAVs operational airtime. The proposed model is evaluated in test bed and simulation environment where the results show the consideration of such explicit usage parameters achieves significant improvement in airtime estimation.