bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between the difference in electric pulp test values and the diagnostic type of pulpitis
Authors: Sui Huachao , Lv Yangyang , Xiao Mo , Zhou Liwen , Qiao Feng , Zheng Jinxin , Sun Cuicui , Fu Jieni , Chen Yufan , Liu Yimeng , Zhou Jie , Wu Ligeng
Published: July 2021

Background

According to the diagnosis criteria of the American Association of Endodontists (AAE), sensitive responses to cold and/or heat tests of suspected teeth compared with those of control teeth can be used for the diagnosis of pulpitis, but the role of electric pulp test (EPT) is not mentioned. It is believed that EPT has some limitations in determining the vitality of the pulp. The aim of this study was to explore the association between the difference in EPT values and the differential diagnoses of reversible pulpitis (RP) and symptomatic irreversible pulpitis (SIRP) caused by dental caries.

Methods

A total of 203 cases with pulpitis caused by dental caries were included. A diagnosis of pulpitis was made on the basis of the diagnostic criteria of AAE. Patient demographic and clinical examination data were collected. The EPT values of the suspected teeth and control teeth were measured, and the differences between them were calculated. The correlation between the difference in the EPT values and diagnosis of pulpitis was analyzed using univariate and multivariate logistic regression.

Results

In the 203 cases (78 males and 125 females; 115 cases of RP, 88 cases of SIRP; 9 anterior teeth, 59 premolars, and 135 molars), the mean patient age was 34.04 ± 13.02 (standard deviation) years. The unadjusted (crude) model, model 1 (adjusted for age), model 2 (adjusted for age and sex), and model 3 (adjusted for age, sex, and tooth type) were established for the statistical analyses. In model 3 [odds ratio (OR) = 1.025; 95% confidence interval (CI) 1.002–1.050; P = 0.035], the difference in EPT values between RP and SIRP was statistically significant. However, the areas under the curve of predictive probability of the crude model, model 1, model 2, and model 3 were 0.565, 0.570, 0.585, and 0.617, respectively, showing that the model accuracy was low. The P-value for the trend in differences between the EPT values as a categorical variable showed that the differences in the EPT values, comparing RP and SIRP, were not statistically significant.

Conclusions

Based on the present data, the difference in EPT values was not sufficient to differentiate RP from SIRP.
Assessment of the relationship between the maxillary sinus and the canine root tip using cone beam computed tomography
Authors: Khojastepour Leila , Movahhedian Najmeh , Zolghadrpour Mohadeseh , Mahjoori-Ghasrodashti Mohammad
Published: July 2021

Background

The purpose of the present study is to investigate the relationship between the maxillary sinus and the canine root apices in cone beam computed tomographic images (CBCT) and to assess the amount of extension of the maxillary sinus to the anterior region of the jaw in different sexes and age groups.

Methods

CBCT of 300 individuals (154 males and 146 females) over 20 years (with a mean age of 35.12 ± 8.40 years) were evaluated. The subjects were categorized into three age groups (20–30, 30–40, and 40–50 years). When the maxillary sinus extended to the canine area, the vertical distance between them was measured, and their relationship was classified into three types: I (more than 2 mm distance), II (less than 2 mm distance or in-contact), and III (interlock).

Results

413 out of 600 maxillary sinuses (68.8%) were extended into the canine area or beyond. Among them, 15 maxillary sinuses pneumatized into the incisor area (2.5%). The prevalence of the maxillary sinuses extended to the anterior region of the jaw was not significantly different between genders. However, it was significantly less frequent in the older age group and more frequent on the left side. In addition, the mean amount of anterior extension of the maxillary sinus (mm) was significantly lower in the older age group. Type I was the most frequent vertical relationship between the maxillary sinuses and canine apices with no significant difference in gender, side, and age groups.

Conclusions

In most cases, the maxillary sinus extended to the canine area and sometimes reached the incisor region. This necessitates paying more attention to the maxillary anterior sextant during surgical procedures.
Medical students’ perception towards E-learning during COVID 19 pandemic in a high burden developing country
Authors: Gismalla Mohamed Daffalla-Awadalla , Mohamed Mohamed Soud , Ibrahim Omaima Salah O , Elhassan Moawia Mohammed Ali , Mohamed Mohamed NaserEldeen
Published: July 2021

Background

In High-income countries, many academic institutions are using E-learning during COVID 19 Pandemic. However, in limited-resource countries, like Sudan, shifting towards E-learning requires many adjustments to be made to make sure the E-learning is held in a proper manner, as best as possible. This study was undertaken to assess medical students’ perception towards implementing E-learning during COVID 19 Pandemic and to highlight for E-learning implementation in Sudan as an example of a limited-resource setting.

Methods

A cross-sectional survey was conducted between 10 and 25 of May 2020 among the undergraduate medical students at the Faculty of Medicine, University of Gezira, Sudan. The study used self-administered online-based questionnaire. E-mail and social media platforms such as Facebook and WhatsApp were utilized to disseminate the questionnaire.

Results

The total numbers of 358 undergraduate medical students responded to the online survey questionnaire. The majority (87.7 %) of students agreed that the closure of the university is an essential decision to control the spread of the COVID-19 infection. Approximately two-thirds (64 %) of students perceived that E-learning is the best solution during COVID 19 lockdown. The level of medical students (Pre-clerkship and Clerkship) and place of residence had significant correlation (p-value < 0.05) with medical students opinion regards starting the E-learning. Internet bandwidth and connectivity limitation, unfamiliarity with E-learning system, technical support limitation and time flexibility in case of technical problems during online exams, and lack of face-to-face interaction were the factors considered by medical students to be against the E-learning implementation.

Conclusions

Most medical students had a positive perception of E-learning. However, there are many challenges considered as an inhibitory factor for utilizing electronic technologies for medical education. We recommend that challenges of E-learning in our limited-resource setting should be systematically evaluated and that effective strategies should be developed to overcome their inhibitory effects.
Improvement of the management of mental well-being and empathy in Chinese medical students: a randomized controlled study
Authors: Rong Rong , Chen Wei , Dai Zihao , Gu Jingli , Chen Weiying , Zhou Yanbin , Kuang Ming , Xiao Haipeng
Published: July 2021

Background

Among Chinese medical students, there is a high prevalence of mental health-related issues and low empathy. Effective strategies to improve this situation are lacking. This study aims to investigate the efficacy of the intervention courses designed to enhance the mental health and empathy of senior Chinese medical students.

Methods

A total of 146 3rd - and 4th -year medical students were randomized to an intervention group (n = 74) and a control group (n = 72). A pilot study including 5 pre-clinical students and 5 interns was first carried out to determine the themes and content of the intervention courses. The designed courses were delivered in the intervention group once a month three times, while the control group had no specific intervention. Five self-assessment questionnaires, including the General Self-Efficacy (GSE) scale, Medical Outcomes Study Short Form 8 (SF-8), Patient Health Questionnaire-9 (PHQ-9), Maslach Burnout Inventory (MBI), and Jefferson Scale of Empathy-Health Care Provider Student version (JSE-HPS), were completed by the students before and one month after the courses to evaluate their levels of self-efficacy (SE), quality of life (QoL), depression, burnout, and empathy, respectively. Qualitative data were collected via e-mail two years after the intervention.

Results

Compared to the control group, the intervention group showed significantly higher scores for empathy (111.0 [IQR 102.0, 118.0] vs. 106.0 [IQR 93.0, 111.5]; P = .01) and QoL (32.0 [IQR 28.0, 35.0] vs. 29.5 [IQR 26.0, 34.0]; P = .04). The rate of depression was significantly lower in the intervention group than in the control group (13.5 % vs. 29.2 %; chi-square test, P = .02). However, no significant differences in self-efficacy (25.6 ± 4.8 vs. 24.3 ± 6.3; P = .16) or burnout (27.0 % vs. 34.7 %; Chi-square test, P = .31) were observed between the two groups.

Conclusions

The intervention courses had a positive impact on mental well-being and empathy in senior Chinese medical students, which might help provide novel information for their incorporation into the medical school curriculum.

Trial registration

ClinicalTrials.gov Identifier: NCT02645643; Date of registration: 05/01/2016.
Solitary death and new lifestyles during and after COVID-19: wearable devices and public health ethics
Authors: Nakazawa Eisuke , Yamamoto Keiichiro , London Alex John , Akabayashi Akira
Published: July 2021

Background

Solitary death (kodokushi) has recently become recognized as a social issue in Japan. The social isolation of older people leads to death without dignity. With the outbreak of COVID-19, efforts to eliminate solitary death need to be adjusted in line with changes in lifestyle and accompanying changes in social structure. Health monitoring services that utilize wearable devices may contribute to this end. Our goals are to outline how wearable devices might be used to (1) detect emergency situations involving solitary older people and swiftly connect them with medical treatment, to (2) reduce the frequency of deaths that remain undiscovered and (3) to reduce social isolation by promoting social interaction.

Methods

Theoretical and philosophical approaches were adopted to examine ethical issues surrounding the application of wearable devices and cloud-based information processing systems to prevent solitary death in the world with/after COVID-19.

Main body

(1) Technology cannot replace social connections; without social support necessary to foster understanding of the benefits of health management through wearable devices among older adults, such devices may remain unused, or not used properly. (2) Maturity of the technology; systems face the difficult task of detecting and responding to a wide range of health conditions and life-threatening events in time to avert avoidable morbidity and mortality. (3) Autonomy and personhood; promoting the voluntary use of wearable devices that are a part of larger efforts to connect isolated individuals to a community or social services might be effective. Legal force should be avoided if possible. There is some concern that landlords may require an older person to sign a contract agreeing to wear a device. The autonomy of solitary older people should be respected. (4) Governance: policies must be developed to limit access to data from wearables and the purposes for which data can be used.

Conclusion

If thoughtfully deployed under proper policy constraints, wearable devices offer a way to connect solitary older people to health services and could reduce cases of solitary death while respecting the personhood of the user.
Quality of maternal and newborn health care in Ethiopia: a cross-sectional study
Authors: Biadgo Abera , Legesse Aynalem , Estifanos Abiy Seifu , Singh Kavita , Mulissa Zewdie , Kiflie Abiyou , Magge Hema , Bitewulign Befikadu , Abate Mehiret , Alemu Haregeweyni
Published: July 2021

Background

Despite reports of universal access to and modest utilization of maternal and newborn health services in Ethiopia, mothers and newborns continue to die from preventable causes. Studies indicate this could be due to poor quality of care provided in health systems. Evidences show that high quality health care prevents more than half of all maternal deaths. In Ethiopia, there is limited knowledge surrounding the status of the quality of maternal and newborn health care in health facilities. This study aims to assess the quality of maternal and neonatal health care provision at the health facility level in four regions in Ethiopia.

Methodology

This study employed a facility-based cross-sectional study design. It included 32 health facilities which were part of the facilities for prototyping maternal and neonatal health quality improvement interventions. Data was collected using a structured questionnaire, key informant interviews and record reviews. Data was entered in Microsoft Excel and exported to STATA for analysis. Descriptive analysis results are presented in texts, tables and graphs. Quality of maternal and neonatal health care was measured by input, process and outputs components. The components were developed by computing scores using standards used to measure the three components of the quality of maternal and neonatal health care.

Result

The study was done in a total of 32 health facilities: 5 hospitals and 27 health centers in four regions. The study revealed that the average value of the quality of the maternal and neonatal health care input component among health facilities was 62%, while the quality of the process component was 43%. The quality of the maternal and neonatal health output component was 48%. According to the standard cut-off point for MNH quality of care, only 5 (15.6%), 3 (9.3%) and 3 (10.7%) of health facilities met the expected input, process and output maternal and neonatal health care quality standards, respectively.

Conclusion

This study revealed that the majority of health facilities did not meet the national MNH quality of care standards. Focus should be directed towards improving the input, process and output standards of the maternal and neonatal health care quality, with the strongest focus on process improvement.
Genetic susceptibility to multiple sclerosis: interactions between conserved extended haplotypes of the MHC and other susceptibility regions
Authors: Goodin D. S. , Khankhanian P. , Gourraud P. A. , Vince N.
Published: July 2021

Background

To study the accumulation of MS-risk resulting from different combinations of MS-associated conserved-extended-haplotypes (CEHs) of theMHCand three non-MHC“risk-haplotypes” nearby genesEOMES, ZFP36L1,andCLEC16A. Many haplotypes are MS-associated despite having population-frequencies exceeding the percentage of genetically-susceptible individuals. The basis of this frequency-disparity requires explanation.

Methods

TheSNP-data from the WTCCC was phased at theMHCand three non-MHCsusceptibility-regions.CEHsat theMHCwere classified into five haplotype-groups: (HLA-DRB1*15:01 ~ DQB1*06:02 ~ a1)-containing (H +); extended-risk (ER); all-protective (AP); neutral (0); and the single-CEH(c1). MS-associations for different “risk-combinations” at theMHCand other non-MHC“risk-loci” and the appropriateness of additive and multiplicative risk-accumulation models were assessed.

Results

Different combinations of “risk-haplotypes” produce a final MS-risk closer to additive rather than multiplicative risk-models but neither model was consistent. Thus, (H +)-haplotypes had greater impact when combined with (0)-haplotypes than with (H +)-haplotypes, whereas, (H +)-haplotypes had greater impact when combined with a (c1)-haplotypes than with (0)-haplotypes. Similarly, risk-genotypes (0,H +), (c1,H +), (H + ,H +) and (0,c1) were additive with risks from non-MHCrisk-loci, whereas risk-genotypes (ER,H +) and (AP,c1) were unaffected.

Conclusions

Genetic-susceptibility to MS is essential for MS to develop but actually developing MS depends heavily upon both an individual’s particular combination of “risk-haplotypes” and how these loci interact.
Mechanistic within-host models of the asexual Plasmodium falciparum infection: a review and analytical assessment
Authors: Camponovo Flavia , Lee Tamsin E. , Russell Jonathan R. , Burgert Lydia , Gerardin Jaline , Penny Melissa A.
Published: July 2021

Background

Malaria blood-stage infection length and intensity are important drivers of disease and transmission; however, the underlying mechanisms of parasite growth and the host’s immune response during infection remain largely unknown. Over the last 30 years, several mechanistic mathematical models of malaria parasite within-host dynamics have been published and used in malaria transmission models.

Methods

Mechanistic within-host models of parasite dynamics were identified through a review of published literature. For a subset of these, model code was reproduced and descriptive statistics compared between the models using fitted data. Through simulation and model analysis, key features of the models were compared, including assumptions on growth, immune response components, variant switching mechanisms, and inter-individual variability.

Results

The assessed within-host malaria models generally replicate infection dynamics in malaria-naïve individuals. However, there are substantial differences between the model dynamics after disease onset, and models do not always reproduce late infection parasitaemia data used for calibration of the within host infections. Models have attempted to capture the considerable variability in parasite dynamics between individuals by including stochastic parasite multiplication rates; variant switching dynamics leading to immune escape; variable effects of the host immune responses; or via probabilistic events. For models that capture realistic length of infections, model representations of innate immunity explain early peaks in infection density that cause clinical symptoms, and model representations of antibody immune responses control the length of infection. Models differed in their assumptions concerning variant switching dynamics, reflecting uncertainty in the underlying mechanisms of variant switching revealed by recent clinical data during early infection. Overall, given the scarce availability of the biological evidence there is limited support for complex models.

Conclusions

This study suggests that much of the inter-individual variability observed in clinical malaria infections has traditionally been attributed in models to random variability, rather than mechanistic disease dynamics. Thus, it is proposed that newly developed models should assume simple immune dynamics that minimally capture mechanistic understandings and avoid over-parameterization and large stochasticity which inaccurately represent unknown disease mechanisms.
Knowledge, attitudes and practices (KAP) to assess the impact of school children's awareness of malaria using the MOSKI KIT® tool: study case of some Dakar schools in Senegal
Authors: Manga Isaac Akhénaton , Gaye Aïssatou , Dia Aliou , Kouevidjin Ekoue , Dos Reis Maria Rosa , Niang Aboubakry Sadikh , Fall Amy Ndao , Anquetil Christelle Maitre , Ndiaye Jean Louis Abdourahim
Published: July 2021

Background

MOSKI KIT® is a fun tool designed to interest children for prevention and management of malaria. This study was carried out with the objective to assess the short- and long-term impacts of this tool on the knowledge, attitudes, and practices of school children, and on the transmission of the knowledge received at the household level as well.

Method

The study took place in elementary schools in the city centre (with relatively low endemicity) and in the Niayes area (at high risk of anopheline and malaria) in the Dakar region of Senegal. The various schools chosen for this study were divided into an intervention group and a control group. The intervention schools were also divided into two subgroups, a full package subgroup and another partial package. During this study three surveys were conducted, the first one before exposure to the MOSKI KIT®, the second one a week later and the third a year later. For the control schools only one survey was conducted and at the same time than the third for the intervention schools. Two household surveys (a week and a year after exposure) were also conducted for the intervention schools against one for the control schools.

Results

Before sensitization, the proportion of school children with a grade above or equal to the average was 50% for the complete package subgroup (CPS) and 53% for the partial package subgroup (PPS). A week later, these proportions were 69% and 71%, respectively for the complete and PPSs. A year later, they were 99.4% for the CPS, 98.1% for the PPS and 99.5% for the control group; The number of children who spoke to their parents about malaria was greater in intervention schools than that of control schools. They were 46.63% and 32.58%, respectively in intervention and control schools.

Conclusion

The MOSKI KIT, has enabled an increase of the knowledge of school children about malaria in the short term and favoured its retention in the long term. However, its impact was not felt on their attitudes and practices.
Sequence analysis of Plasmodium vivax Duffy binding proteins reveals the presence of unique haplotypes and diversifying selection in Ethiopian isolates
Authors: Golassa Lemu , Messele Alebachew , Oriero Eniyou Cheryll , Amambua-Ngwa Alfred
Published: July 2021

Background

Red blood cell invasion by the Plasmodium vivax merozoite requires interaction between the Duffy antigen receptor for chemokines (DARC) and the P. vivax Duffy-binding protein II (PvDBPII). Given that the disruption of this interaction prevents P. vivax blood-stage infection, a PvDBP-based vaccine development has been well recognized. However, the polymorphic nature of PvDBPII prevents a strain transcending immune response and complicates attempts to design a vaccine.

Methods

Twenty-three P. vivax clinical isolates collected from three areas of Ethiopia were sequenced at the pvdbpII locus. A total of 392 global pvdbpII sequences from seven P. vivax endemic countries were also retrieved from the NCBI archive for comparative analysis of genetic diversity, departure from neutrality, linkage disequilibrium, genetic differentiation, PvDBP polymorphisms, recombination and population structure of the parasite population. To establish a haplotype relationship a network was constructed using the median joining algorithm.

Results

A total of 110 variable sites were found, of which 44 were parsimony informative. For Ethiopian isolates there were 12 variable sites of which 10 were parsimony informative. These parsimony informative variants resulted in 10 nonsynonymous mutations. The overall haplotype diversity for global isolates was 0.9596; however, the haplotype diversity was 0.874 for Ethiopia. Fst values for genetic revealed Ethiopian isolates were closest to Indian isolates as well as to Sri Lankan and Sudanese isolates but further away from Mexican, Papua New Guinean and South Korean isolates. There was a total of 136 haplotypes from the 415 global isolates included for this study. Haplotype prevalence ranged from 36.76% to 0.7%, from this 74.2% were represented by single parasite isolates. None of the Ethiopian isolates grouped with the Sal I reference haplotype. From the total observed nonsynonymous mutations 13 mapped to experimentally verified epitope sequences. Including 10 non-synonymous mutations from Ethiopia. However, all the polymorphic regions in Ethiopian isolates were located away from DARC, responsible for junction formation.

Conclusion

The results of this study are concurrent with the multivalent vaccine approach to design an effective treatment. However, the presence of novel haplotypes in Ethiopian isolates that were not shared by other global sequences warrant further investigation.
Fe3O4@Pt nanoparticles to enable combinational electrodynamic/chemodynamic therapy
Authors: Chen Tong , Chu Qiang , Li Mengyang , Han Gaorong , Li Xiang
Published: July 2021

Electrodynamic therapy (EDT) has recently emerged as a potential external field responsive approach for tumor treatment. While it presents a number of clear superiorities, EDT inherits the intrinsic challenges of current reactive oxygen species (ROS) based therapeutic treatments owing to the complex tumor microenvironment, including glutathione (GSH) overexpression, acidity and others. Herein for the first time, iron oxide nanoparticles are decorated using platinum nanocrystals (Fe3O4@Pt NPs) to integrate the current EDT with chemodynamic phenomenon and GSH depletion. Fe3O4@Pt NPs can effectively induce ROS generation based on the catalytic reaction on the surface of Pt nanoparticles triggered by electric field (E), and meanwhile it may catalyze intracellular H2O2 into ROS via Fenton reaction. In addition, Fe3+ ions released from Fe3O4@Pt NPs under the acidic condition in tumor cells consume GSH in a rapid fashion, inhibiting ROS clearance to enhance its antitumor efficacy. As a result, considerable in vitro and in vivo tumor inhibition phenomena are observed. This study has demonstrated an alternative concept of combinational therapeutic modality with superior efficacy.
Using genetic variants to evaluate the causal effect of serum vitamin D concentration on COVID-19 susceptibility, severity and hospitalization traits: a Mendelian randomization study
Authors: Cui Zhiyong , Tian Yun
Published: July 2021

Background

The coronavirus disease 2019 (COVID-19) pandemic has struck globally and is exerting a devastating toll on humans. The pandemic has led to calls for widespread vitamin D supplementation in public. However, evidence supporting the role of vitamin D in the COVID-19 pandemic remains controversial.

Methods

We performed a two-sample Mendelian randomization (MR) analysis to analyze the causal effect of the 25-hydroxyvitamin D [25(OH)D] concentration on COVID-19 susceptibility, severity and hospitalization traits by using summary-level GWAS data. The causal associations were estimated with inverse variance weighted (IVW) with fixed effects (IVW-fixed) and random effects (IVW-random), MR-Egger, weighted edian and MR Robust Adjusted Profile Score (MR.RAPS) methods. We further applied the MR Steiger filtering method, MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) global test and PhenoScanner tool to check and remove single nucleotide polymorphisms (SNPs) that were horizontally pleiotropic.

Results

We found no evidence to support the causal associations between the serum 25(OH)D concentration and the risk of COVID-19 susceptibility [IVW-fixed: odds ratio (OR) = 0.9049, 95% confidence interval (CI) 0.8197–0.9988, p = 0.0473], severity (IVW-fixed: OR = 1.0298, 95% CI 0.7699–1.3775, p = 0.8432) and hospitalized traits (IVW-fixed: OR = 1.0713, 95% CI 0.8819–1.3013, p = 0.4878) using outlier removed sets at a Bonferroni-corrected p threshold of 0.0167. Sensitivity analyses did not reveal any sign of horizontal pleiotropy.

Conclusions

Our MR analysis provided precise evidence that genetically lowered serum 25(OH)D concentrations were not causally associated with COVID-19 susceptibility, severity or hospitalized traits. Our study did not provide evidence assessing the role of vitamin D supplementation during the COVID-19 pandemic. High-quality randomized controlled trials are necessary to explore and define the role of vitamin D supplementation in the prevention and treatment of COVID-19.
Motherhood and decision-making among women living with HIV in developed countries: a systematic review with qualitative research synthesis
Authors: Huertas-Zurriaga Ariadna , Palmieri Patrick A. , Edwards Joan E. , Cesario Sandra K. , Alonso-Fernandez Sergio , Pardell-Dominguez Lidia , Dominguez-Cancino Karen A. , Leyva-Moral Juan M.
Published: July 2021

Background

Women living with HIV (WLH) lack evidence-based information about reproductive options while managing pressures from family, clinicians, and communities to give up the idea of having children. As the reproduction intentions of WLH are not well understood, stigmatizing behaviors force them to hide their disease to avoid rejection by their family, partner, and social networks. Compliance with social norms, fear of stigma, and discrimination influence their experience. Current research is individual qualitative studies lacking the synthesis perspective necessary to guide intervention development. The purpose of this study was to synthesize the evidence to explain the reproductive decision-making process for WLH in developed countries.

Methods

A systematic review with qualitative research synthesis was conducted through searches in 10 electronic databases (CINAHL, EMBASE, MEDLINE, Scopus, Social Science Citation Index, Web of Science, Google Scholar, Cuidatge, Cuiden Enfispo, and SciELO). Studies published in journals from 1995 to 2019 with qualitative data about reproductive decision-making among WLH in developed countries were eligible for inclusion. Developed country was operationalized by membership in the OECD for comparative conditions of social wellbeing and economic stability. The CASP and JBI checklists for qualitative research were used to assess study quality and methodological integrity. Thematic analysis and qualitative meta-summary techniques were used for the synthesis.

Results

Twenty studies from 12 developed countries were included in the synthesis. Findings were organized into 3 meta-themes from 15 themes and 45 subthemes, including: (1) Shattered identity, (2) Barriers, inequities, and misinformation, (3) Coping, resiliency, and support. Reproductive decision-making was perceived as a complex process influenced by facilitators and barriers. The facilitators helped WLH cope with their new situation to become more resilient, while the barriers made their situation more difficult to manage.

Conclusion

WLH encounter reproductive decision-making with knowledge deficits and limited social support. An integrated approach to holistic care with comprehensive multidisciplinary counseling is needed to support WLH. Clinicians could benefit from professional development to learn how to be authentically present for WLH, including engaging in conversations, demonstrating compassion, and understanding situations. Evidence-based clinical practice guidelines need to be tailored for the family planning and sexual health needs of WLH.
In regard to Minniti et al.: Current status and recent advances in resection cavity irradiation of brain metastases—roundup to cover all angles
Authors: Sarria Gustavo R. , Cifarelli Christopher P. , Kahl Henning , Giordano Frank A.
Published: July 2021

We read with great interest the recent review, entitled “Current status and recent advances in resection cavity irradiation of brain metastases”. It is a comprehensive summary of currently available techniques for treatment of post-resection cavity in patients with this diagnosis. We would like to complement this manuscript by including intraoperative techniques as other viable approaches in the management of these patients.
Callous-unemotional traits in Chinese preschool children with attention-deficit/hyperactivity disorder
Authors: Zhang Jinsong , Li Wei , Zhang Huifeng , Wilson Amanda , Shuai Lan , Xia Weiping , Wang Zhouye , Qiu Meihui , Wang Yuanyuan
Published: July 2021

Background

Children with early onset of Callous-Unemotional (CU) traits are at a higher risk for long-term, persistent psychosocial problems. The current study aimed to explore the characteristics of CU in preschool children with Attention Deficit Hyperactivity Disorder (ADHD) and the diagnostic significance of CU traits in ADHD.

Methods

A total of 176 preschool children (89 with ADHD and 87 Typically Developing Children [TDC]) aged 4–5 years old were recruited to the study. The participants were assessed for CU traits, emotional and behavioral problems, and how their executive functioning was associated with ADHD using multiple assessment scales. Multiple linear regression analysis was performed to assess the incremental validity of the Inventory of Callous-Unemotional Traits (ICU), adjusting for possible covariates by child’s sex, conduct problems, and oppositional defiant symptoms.

Results

The results showed that there was a significant difference of ICU scores between the ADHD and TDC groups (F = 30.12, P < 0.001). In terms of callousness, ADHD + Oppositional Defiant Disorder (ODD) group showed a significant high score, and the ADHD only group scored significantly higher than the TDC group (F = 20.42, P < 0.001). The ICU was negatively associated with the prosocial behaviour subscale (γ = − 0.57, P < 0.01) and showed low to moderate positive correlations with emotional and behavioural problems, as well as executive function (γ = 0.24–0.67, P < 0.05). The ICU scores explained 6% of the incremental validity in ADHD symptoms. The diagnostic value of the ICU for ADHD was medium and acceptable.

Conclusions

The current study indicated that early identification of CU traits may help clinicians better understand symptoms and behavioural problems in children with ADHD. CU traits therefore could be considered as a useful assessment tool for ADHD.
Disruption of the astrocyte–neuron interaction is responsible for the impairments in learning and memory in 5XFAD mice: an Alzheimer’s disease animal model
Authors: Choi Moonseok , Lee Sang-Min , Kim Dongsoo , Im Heh-In , Kim Hye-Sun , Jeong Yun Ha
Published: July 2021

The morphological dynamics of astrocytes are altered in the hippocampus during memory induction. Astrocyte–neuron interactions on synapses are called tripartite synapses. These control the synaptic function in the central nervous system. Astrocytes are activated in a reactive state by STAT3 phosphorylation in 5XFAD mice, an Alzheimer’s disease (AD) animal model. However, changes in astrocyte–neuron interactions in reactive or resting-state astrocytes during memory induction remain to be defined. Here, we investigated the time-dependent changes in astrocyte morphology and the number of astrocyte–neuron interactions in the hippocampus over the course of long-term memory formation in 5XFAD mice. Hippocampal-dependent long-term memory was induced using a contextual fear conditioning test in 5XFAD mice. The number of astrocytic processes increased in both wild-type and 5XFAD mice during memory formation. To assess astrocyte–neuron interactions in the hippocampal dentate gyrus, we counted the colocalization of glial fibrillary acidic protein and postsynaptic density protein 95 via immunofluorescence. Both groups revealed an increase in astrocyte–neuron interactions after memory induction. At 24 h after memory formation, the number of tripartite synapses returned to baseline levels in both groups. However, the total number of astrocyte–neuron interactions was significantly decreased in 5XFAD mice. Administration of Stattic, a STAT3 phosphorylation inhibitor, rescued the number of astrocyte–neuron interactions in 5XFAD mice. In conclusion, we suggest that a decreased number of astrocyte–neuron interactions may underlie memory impairment in the early stages of AD.
Falsely diagnosed thyrotoxicosis caused by anti-streptavidin antibodies and pre-wash procedures
Authors: Ishikawa Takuya , Sakai Hiroyuki , Itaya Tokutaro , Hirotsugu Suwanai , Shikuma Jumpei , Miwa Takashi , Suzuki Ryo , Odawara Masato
Published: July 2021

Background

Anti-streptavidin antibodies are causal determinants of analytical interference during Thyroid function tests, and numerous reports have detailed such interference, with anti-streptavidin antibodies attracting attention.

Case presentation

We conducted a straightforward investigation of interference due to anti-streptavidin antibodies, with a case of a 60-year-old Japanese man who consulted our department for inconsistencies between his clinical course and Thyroid function tests. Experiments were conducted using Cobas8000 e602, which employs assay procedures with pre-wash to evaluate FT4 and FT3 levels.

Conclusions

To our knowledge, this is the first published report to clearly investigate such interferences using a combination of polyethylene glycol precipitation, heterophilic blocking tube precipitation, streptavidin-coated magnetic particle precipitation, and different instruments with or without pre-wash. Clinicians should consider that interferences caused by anti-streptavidin antibodies could lead to a misdiagnosis of thyrotoxicosis. Moreover, discussions between laboratory specialists, clinicians, and manufacturers are required to identify interferences and avoid unnecessary examinations and inappropriate treatment.
Wild ungulate species differ in their contribution to the transmission of Ixodes ricinus-borne pathogens
Authors: Fabri Nannet D. , Sprong Hein , Hofmeester Tim R. , Heesterbeek Hans , Donnars Björn F. , Widemo Fredrik , Ecke Frauke , Cromsigt Joris P. G. M.
Published: July 2021

Background

Several ungulate species are feeding and propagation hosts for the tick Ixodes ricinus as well as hosts to a wide range of zoonotic pathogens. Here, we focus on Anaplasma phagocytophilum and Borrelia burgdorferi (s.l.), two important pathogens for which ungulates are amplifying and dilution hosts, respectively. Ungulate management is one of the main tools to mitigate human health risks associated with these tick-borne pathogens. Across Europe, different species of ungulates are expanding their ranges and increasing in numbers. It is currently unclear if and how the relative contribution to the life-cycle of I. ricinus and the transmission cycles of tick-borne pathogens differ among these species. In this study, we aimed to identify these relative contributions for five European ungulate species.

Methods

We quantified the tick load and collected ticks and spleen samples from hunted fallow deer (Dama dama, n = 131), moose (Alces alces, n = 15), red deer (Cervus elaphus, n = 61), roe deer (Capreolus capreolus, n = 30) and wild boar (Sus scrofa, n = 87) in south-central Sweden. We investigated the presence of tick-borne pathogens in ticks and spleen samples using real-time PCR. We determined if ungulate species differed in tick load (prevalence and intensity) and in infection prevalence in their tissue as well as in the ticks feeding on them.

Results

Wild boar hosted fewer adult female ticks than any of the deer species, indicating that deer are more important as propagation hosts. Among the deer species, moose had the lowest number of female ticks, while there was no difference among the other deer species. Given the low number of infected nymphs, the relative contribution of all ungulate species to the transmission of B. burgdorferi (s.l.) was low. Fallow deer, red deer and roe deer contributed more to the transmission of A. phagocytophilum than wild boar.

Conclusions

The ungulate species clearly differed in their role as a propagation host and in the transmission of B. burgdorferi and A. phagocytophilum. This study provides crucial information for ungulate management as a tool to mitigate zoonotic disease risk and argues for adapting management approaches to the local ungulate species composition and the pathogen(s) of concern.

Graphic abstract
ADP/ATP translocase 1 protects against an α-synuclein-associated neuronal cell damage in Parkinson’s disease model
Authors: Ding Wenyong , Qi Minghua , Ma Li , Xu Xuefei , Chen Yingfei , Zhang Wenli
Published: July 2021

Background

ADP/ATP translocase 1 (ANT1) is involved in the exchange of cytosolic ADP and mitochondrial ATP, and its defection plays an important role in mitochondrial pathogenesis. To reveal an etiological implication of ANT1 for Parkinson’s disease (PD), a neurodegenerative disorder, a mouse model treated with 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine and neuroblastoma cell model induced by 1-methyl-4-pehny1-pyridine were utilized in this study.

Results

The tissue-specific abundance in ANT1 in mouse brains was accessed using the analysis of Western blot and immunohistochemistry. Down-regulated soluble ANT1 was found to be correlated with PD, and ANT1 was associated with PD pathogenesis via forming protein aggregates with α-synuclein. This finding was confirmed at cellular level using neuroblastoma cell models. ANT1 supplement in neuronal cells revealed the protective roles of ANT1 against cytotoxicity caused by MPP+. Protein interaction assay, coupled with the analysis of LC-MS/MS, silver-stained SDS-PAGE and Western blot against anti-ANT1 antibody respectively, illustrated the interaction of ANT1 with α-synuclein using the expressed α-synuclein as a bite. Additionally, a significant increasing ROSs was detected in the MPP+-treated cells.

Conclusions

This study indicated that ANT1 was a potentially causative factor of PD, and led to neuropathogenic injury via promoting the formation of protein aggregates with α-synuclein. This investigation potentially promotes an innovative understanding of ANT1 on the etiology of PD and provides valuable information on developing potential drug targets in PD treatment or reliable biomarkers in PD prognostication.
A novel two-phase cycle algorithm for effective cyber intrusion detection in edge computing
Authors: Gong Yiguang , Liu Yunping , Yin Chuanyang
Published: July 2021

Edge computing extends traditional cloud services to the edge of the network, closer to users, and is suitable for network services with low latency requirements. With the rise of edge computing, its security issues have also received increasing attention. In this paper, a novel two-phase cycle algorithm is proposed for effective cyber intrusion detection in edge computing based on a multi-objective genetic algorithm (MOGA) and modified back-propagation neural network (MBPNN), namely TPC-MOGA-MBPNN. In the first phase, the MOGA is employed to build a multi-objective optimization model that tries to find the Pareto optimal parameter set for MBPNN. The Pareto optimal parameter set is applied for simultaneous minimization of the average false positive rate (Avg FPR), mean squared error (MSE) and negative average true positive rate (Avg TPR) in the dataset. In the second phase, some MBPNNs are created based on the parameter set obtained by MOGA and are trained to search for a more optimal parameter set locally. The parameter set obtained in the second phase is used as the input of the first phase, and the training process is repeated until the termination criteria are reached. A benchmark dataset, KDD cup 1999, is used to demonstrate and validate the performance of the proposed approach for intrusion detection. The proposed approach can discover a pool of MBPNN-based solutions. Combining these MBPNN solutions can significantly improve detection performance, and a GA is used to find the optimal MBPNN combination. The results show that the proposed approach achieves an accuracy of 98.81% and a detection rate of 98.23% and outperform most systems of previous works found in the literature. In addition, the proposed approach is a generalized classification approach that is applicable to the problem of any field having multiple conflicting objectives.
School-based interventions targeting double burden of malnutrition and educational outcomes of adolescents in low- and middle-income countries: protocol for a systematic review
Authors: Shinde Sachin , Wang Dongqing , Fawzi Wafaie W
Published: July 2021

Background

Adolescence is a period of rapid physical growth and transition between childhood to adulthood. However, in many developing countries, nutritional and epidemiological transitions are contributing to surging overnutrition, which, together with prevalent undernutrition, is resulting in the double burden of malnutrition (DBM) among adolescents. Schools as social systems have tremendous but mostly underutilized capacity to facilitate change and address a range of nutritional and associated educational concerns of adolescents and young people. The main objective of this systematic review will be to describe school-based interventions that address the multiple forms of malnutrition, and synthesize their effects on nutrition and educational outcomes among adolescents (10 − 19 − years − old) from low- and middle-income countries (LMICs).

Methods

Comprehensive literature searches will be conducted in multiple electronic databases, including Medline (through PubMed), Embase, CENTRAL (through Cochrane Library), CINAHL, and Google Scholar. We will include randomized controlled trials (RCTs), non-RCTs including controlled before-after studies, examining the effects of nutrition interventions on nutrition and educational outcomes among adolescents in LMICs. Two reviewers will independently screen all citations and full-text articles and abstract data. The quality of the included studies will be assessed with the Cochrane Collaboration’s revised tool for assessing the risk of bias for RCTs and the Risk Of Bias In Non-randomized Studies of Interventions tool for controlled before-after studies and non-randomized controlled trials.

Discussion

To maximize the power of schools as a platform to reinforce the mutually beneficial relationship between adolescent nutrition and education, it is imperative to develop and implement integrated interventions connecting schools, adolescents, parents, communities, and the health care system. The results of this systematic review may provide a comprehensive state of current knowledge on the effectiveness of school-based interventions to enable future research that maximizes the impact and efficiency of integrated approaches to tackle multiple forms of malnutrition among school-going and out-of-school adolescents.

Systematic review registration

PROSPERO ID: CRD42020211109
Some new formulas of complete and incomplete degenerate Bell polynomials
Authors: Kim Dae San , Kim Taekyun , Lee Si-Hyeon , Park Jin-Woo
Published: July 2021

The aim of this paper is to study the complete and incomplete degenerate Bell polynomials, which are degenerate versions of the complete and incomplete Bell polynomials, and to derive some properties and identities for those polynomials. In particular, we introduce some new polynomials associated with the incomplete degenerate Bell polynomials. In fact, they are the coefficients of the reciprocal of the power series given by 1 plus the one appearing as the exponent of the generating function of the complete degenerate Bell polynomials.
Common fixed point theorem on Proinov type mappings via simulation function
Authors: Alqahtani Badr , Alzaid Sara Salem , Fulga Andreea , Yeşilkaya Seher Sultan
Published: July 2021

In this paper, we aim to discuss the common fixed point of Proinov type mapping via simulation function. The presented results not only generalize, but also unify the corresponding results in this direction. We also consider an example to indicate the validity of the obtained results.
Exploring internal business factors and their impact on firm performance: small business perspective in Ethiopia
Authors: Engidaw Abriham Ebabu
Published: July 2021

Mainly, the study is aimed at exploring the internal business factors and their impact on firm performance in micro- and small-scale enterprises. The study employed a descriptive and explanatory research design and used a quantitative research approach. The study is conducted on Amhara region, North Wollo zone, Lalibela city administration micro- and small-scale enterprise operators, and in this study, the dependent variable is the performance of SMEs while independent variables are managerial factors, workplace factors, and entrepreneurial factors. To achieve the objectives of the study, 199 sample micro and small enterprises are selected from the 395 target populations. It used an explanatory design with stratified and simple random sampling techniques. The study employed descriptive and inferential statistical data analysis methods. The finding shows that the independent variables managerial factors and workplace-related factors have a positive and significant effect on small business performance in the study area. Also, there is an insignificant relationship between entrepreneurial factors and the dependent variable.