bluuebunny/crossref_metadata_2025 huggingface dataset:
Large autologous ilium with periosteum for tibiotalar joint reconstruction in Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures: a pilot study
Authors: Li Dong , Li Jiao Jiao , Zhu Yuanyuan , Hou Fushan , Li Yuan , Zhao Bin , Wang Bin
Published: September 2020

Background

Management of Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture presents numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction.

Methods

Twenty-five patients according to Tscherne/Oestern FxCO-I closed fracture and FxOI open fractures classification after Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis.

Results

Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3–36).

Conclusions

Large autologous ilium with periosteum in combination with ORIF can be performed for tibiotalar joint reconstruction. This experimental procedure reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures in short follow-up.

Level of evidence

Level III, retrospective cohort study.
The status and associated factors of early childhood caries among 3- to 5-year-old children in Guangdong, Southern China: a provincial cross-sectional survey
Authors: Li Jianbo , Fan Weihua , Zhou Yueshan , Wu Linmei , Liu Wei , Huang Shaohong
Published: September 2020

Background

Dental caries of deciduous teeth (Early Childhood Caries, ECC) has become a crucial oral health problem over the decades in China. The aim of this study was to examine the prevalence and severity of ECC among preschool children from Guangdong Province, Southern China. In addition, to assess the association of ECC with reported oral health-related behaviors.

Methods

A cross-sectional survey of 2592 participants was carried out in Guangdong Province by means of an equal-sized, stratified, multistage random sampling method during December 2015 and April 2016. The participants were divided into three groups according to their ages (3-, 4-, and 5-year-olds). Half of the participants were derived from urban areas, while the other from rural areas. According to the standard for clinical dentition examination of the WHO 2013 criteria, the presence of ECC was determined by the dmft (decayed-missing-filled tooth) index using a CPI (Community Periodontal Index) probe. A questionnaire about caries-related factors was completed by each of the participants’ parents or grandparents through a face-to-face and one-on-one interview. Then, t-test, Chi2 tests, One-Way ANOVA served for statistical analysis, and logistic regression analysis as well as covariance analysis were executed to identify potential associated factors for ECC.

Results

The prevalence (% dmft > 0) of ECC was 68.3 (95% CI: 66.5–70.1), the mean dmft was 4.36 (95% CI: 4.17–4.55), and the filled rate was 1.2%. In multivariable modeling, associated factors for both prevalence and mean dmft were older age, rural areas, consumption of sweets before sleep, dental visit history, low household income, and low parental education level. Initiating toothbrushing after 3 years of age and being exclusively/ predominantly breastfed indicated only the prevalence; being female and frequently consuming sweetened milk/powdered milk indicated only the mean dmft.

Conclusions

Preschool children in Guangdong Province, especially children from rural areas, experienced a significant amount of ECC. Associated factors for ECC included demographics, oral health measures, dietary factors, and socioeconomic factors. More attention should be given to prevention of ECC from early life. The construction of social support for oral health should be strengthened. Oral health education and promotion, especially of rural areas, should be intensified to reduce the inequality between urban and rural areas.
“Teach for ethics in palliative care”: a mixed-method evaluation of a medical ethics training programme
Authors: De Panfilis Ludovica , Tanzi Silvia , Perin Marta , Turola Elena , Artioli Giovanna
Published: September 2020

Background

Training in medical ethics aims to educate health care professionals in dealing with daily care ethical issues. To guarantee quality of life and spiritual and emotional support, palliative care professionals have to develop ethical and relational skills. We propose the implementation and evaluation of a specialized training programme in medical ethics dedicated to a hospital-based Palliative Care Unit.

Methods

This study is a mixed-method before-after evaluation with data triangulation.

Results

The results highlight that participants developed their ethical knowledge, and a deeper ethical awareness. They also felt more confident and motivated to widely apply ethical reflections and reasonings in their daily practice.

Conclusion

The participants appreciated the innovative structure of the training, especially regarding the integration of the theoretical-interactive and practical parts. However, they recommended increasing the number of concrete occasions for ethical supervision and practical application of what they learned during the programme. The training programme also has some potential practical implications: the development of advanced ethical skills within a hospital-based PC team may improve the quality of life of the patients and their families. In addition, health care professionals with advanced ethical competencies are able to educate patients and their families towards more active participation in the decision-making process.
Pre-graduation medical training including virtual reality during COVID-19 pandemic: a report on students’ perception
Authors: De Ponti Roberto , Marazzato Jacopo , Maresca Andrea M. , Rovera Francesca , Carcano Giulio , Ferrario Marco M.
Published: September 2020

Background

The Coronavirus Disease 19 (COVID-19) pandemic brought significant disruption to in-hospital medical training. Virtual reality simulating the clinical environment has the potential to overcome this issue and can be particularly useful to supplement the traditional in-hospital medical training during the COVID-19 pandemic, when hospital access is banned for medical students. The aim of this study was to assess medical students’ perception on fully online training including simulated clinical scenarios during COVID-19 pandemic.

Methods

From May to July 2020 when in-hospital training was not possible, 122 students attending the sixth year of the course of Medicine and Surgery underwent online training sessions including an online platform with simulated clinical scenarios (Body Interact™) of 21 patient-based cases. Each session focused on one case, lasted 2 h and was divided into three different parts: introduction, virtual patient-based training, and debriefing. In the same period, adjunctive online training with formal presentation and discussion of clinical cases was also given. At the completion of training, a survey was performed, and students filled in a 12-item anonymous questionnaire on a voluntary basis to rate the training quality. Results were reported as percentages or with numeric ratings from 1 to 4. Due to the study design, no sample size was calculated.

Results

One hundred and fifteen students (94%) completed the questionnaire: 104 (90%) gave positive evaluation to virtual reality training and 107 (93%) appreciated the format in which online training was structured. The majority of participants considered the platform of virtual reality training realistic for the initial clinical assessment (77%), diagnostic activity (94%), and treatment options (81%). Furthermore, 97 (84%) considered the future use of this virtual reality training useful in addition to the apprenticeship at patient’s bedside. Finally, 32 (28%) participants found the online access difficult due to technical issues.

Conclusions

During the COVID-19 pandemic, online medical training including simulated clinical scenarios avoided training interruption and the majority of participant students gave a positive response on the perceived quality of this training modality. During this time frame, a non-negligible proportion of students experienced difficulties in online access to this virtual reality platform.
Quality of care in dysphagia patients: adaptation and validation of the Swedish SWAL-CARE questionnaire
Authors: Hedström Johanna , Johansson Mia , Olsson Caroline , Tuomi Lisa , Finizia Caterina
Published: September 2020

Background

The aim of this study was to adapt the instrument and evaluate the psychometric properties of the Swedish version of the Swallowing Quality of Care questionnaire (S-SWAL-CARE) in patients with oropharyngeal dysphagia.

Methods

Translation and adaptation of the original SWAL-CARE into Swedish was performed according to established international guidelines. Field testing was performed using 100 patients with oropharyngeal dysphagia due to multiple reasons such as head and neck cancer and neurologic/neuromuscular disease, who had undergone swallowing evaluation within 6 months prior to the study. The patients answered the S-SWAL-CARE, the Quality from the Patient’s Perspective (QPP) and the Swallowing Quality of Life (SWAL-QOL). Test–retest was performed in 20% of the participants. The reliability and validity of the S-SWAL-CARE were assessed by Pearson correlation coefficient and Cronbach’s alpha as well as convergent and discriminative validity, respectively.

Results

The field testing of the S-SWAL-CARE resulted in sufficient reliability, with Cronbach’s alpha values exceeding 0.90 for all domains. All items correlated strongly to their own domain, with weaker correlations to the other domains, indicating proper scale structure. Results also indicate sufficient convergent and discriminant validity when tested for association to the QPP domains and the SWAL-QOL Total score. The test–retest reliability of the S-SWAL-CARE demonstrated sufficient intraclass correlation coefficient (ICC) for the General advice domain (0.73) and Clinical advice domain (0.82). The ICC for the Patient satisfaction domain was lower (0.44).

Conclusion

The S-SWAL-CARE can be considered a reliable and valid tool to assess the dysphagia-related quality of care in a mixed Swedish dysphagia patient population.
Technology-aided assessment of functionally relevant sensorimotor impairments in arm and hand of post-stroke individuals
Authors: Kanzler Christoph M. , Schwarz Anne , Held Jeremia P. O. , Luft Andreas R. , Gassert Roger , Lambercy Olivier
Published: September 2020

Background

Assessing arm and hand sensorimotor impairments that are functionally relevant is essential to optimize the impact of neurorehabilitation interventions. Technology-aided assessments should provide a sensitive and objective characterization of upper limb impairments, but often provide arm weight support and neglect the importance of the hand, thereby questioning their functional relevance. The Virtual Peg Insertion Test (VPIT) addresses these limitations by quantifying arm and hand movements as well as grip forces during a goal-directed manipulation task requiring active lifting of the upper limb against gravity. The aim of this work was to evaluate the ability of the VPIT metrics to characterize arm and hand sensorimotor impairments that are relevant for performing functional tasks.

Methods

Arm and hand sensorimotor impairments were systematically characterized in 30 chronic stroke patients using conventional clinical scales and the VPIT. For the latter, ten previously established kinematic and kinetic core metrics were extracted. The validity and robustness of these metrics was investigated by analyzing their clinimetric properties (test-retest reliability, measurement error, learning effects, concurrent validity).

Results

Twenty-three of the participants, the ones with mild to moderate sensorimotor impairments and without strong cognitive deficits, were able to successfully complete the VPIT protocol (duration 16.6 min). The VPIT metrics detected impairments in arm and hand in 90.0% of the participants, and were sensitive to increased muscle tone and pathological joint coupling. Most importantly, significant moderate to high correlations between conventional scales of activity limitations and the VPIT metrics were found, thereby indicating their functional relevance when grasping and transporting objects, and when performing dexterous finger manipulations. Lastly, the robustness of three out of the ten VPIT core metrics in post-stroke individuals was confirmed.

Conclusions

This work provides evidence that technology-aided assessments requiring goal-directed manipulations without arm weight support can provide an objective, robust, and clinically feasible way to assess functionally relevant sensorimotor impairments in arm and hand in chronic post-stroke individuals with mild to moderate deficits. This allows for a better identification of impairments with high functional relevance and can contribute to optimizing the functional benefits of neurorehabilitation interventions.
Challenges to peer support in low- and middle-income countries during COVID-19
Authors: Mpango Richard , Kalha Jasmine , Shamba Donat , Ramesh Mary , Ngakongwa Fileuka , Kulkarni Arti , Korde Palak , Nakku Juliet , Ryan Grace K.
Published: September 2020

Background

A recent editorial urged those working in global mental health to “change the conversation” on coronavirus disease (Covid-19) by putting more focus on the needs of people with severe mental health conditions. UPSIDES (Using Peer Support In Developing Empowering mental health Services) is a six-country consortium carrying out implementation research on peer support for people with severe mental health conditions in high- (Germany, Israel), lower middle- (India) and low-income (Tanzania, Uganda) settings. This commentary briefly outlines some of the key challenges faced by UPSIDES sites in low- and middle-income countries as a result of Covid-19, sharing early lessons that may also apply to other services seeking to address the needs of people with severe mental health conditions in similar contexts.

Challenges and lessons learned

The key take-away from experiences in India, Tanzania and Uganda is that inequalities in terms of access to mobile technologies, as well as to secure employment and benefits, put peer support workers in particularly vulnerable situations precisely when they and their peers are also at their most isolated. Establishing more resilient peer support services requires attention to the already precarious situation of people with severe mental health conditions in low-resource settings, even before a crisis like Covid-19 occurs. While it is essential to maintain contact with peer support workers and peers to whatever extent is possible remotely, alternatives to face-to-face delivery of psychosocial interventions are not always straightforward to implement and can make it more difficult to observe individuals’ reactions, talk about emotional issues and offer appropriate support.

Conclusions

In environments where mental health care was already heavily medicalized and mostly limited to medications issued by psychiatric institutions, Covid-19 threatens burgeoning efforts to pursue a more holistic and person-centered model of care for people with severe mental health conditions. As countries emerge from lockdown, those working in global mental health will need to redouble their efforts not only to make up for lost time and help individuals cope with the added stressors of Covid-19 in their communities, but also to regain lost ground in mental health care reform and in broader conversations about mental health in low-resource settings.
The therapeutic effects of methylphenidate and matrix-methylphenidate on addiction severity, craving, relapse and mental health in the methamphetamine use disorder
Authors: Aryan Nazanin , Banafshe Hamid Reza , Farnia Vahid , Shakeri Jalal , Alikhani Mostafa , Rahimi Habibollah , Sehat Mojtaba , Mamsharifi Peyman , Ghaderi Amir , Omidi Abdollah
Published: September 2020

Background

Little evidence has examined the therapeutic effects of methylphenidate (MPH) and Matrix Model treatment on addiction severity, craving, relapse and mental health in people who use methamphetamine (PWUM). This study was conducted to determine the effects of MPH, Matrix Model treatment, and Matrix-MPH on addiction severity, craving, relapse and mental health in PWUM.

Methods

This clinical trial was conducted among 100 patients with METH users. Participants were randomly divided into four groups who received: 1) 22 sessions of 45-min, twice a week for Matrix Model treatment (n = 25); 2) MPH 10 mg/day in the first month, 7.5 mg/day in the second month and 5 mg/day in the third month (n = 25); 3) Matrix Model treatment combined with MPH (n = 25); 4) control group (n = 25) for 12 weeks. Addiction severity, craving, relapse and mental status were evaluated at baseline and end-of-trial.

Results

Matrix Model treatment combined with MPH significantly reduced MA craving (P < 0.001) and addiction severity (P < 0.001). In addition, Matrix Model treatment combined with MPH resulted in a significant increase of mental health (P = 0.001), compared with Matrix Model treatment, MPH, and control group. Also, negative METH urine test significantly increased in the Matrix Model treatment combined with MPH group compared with the other groups (P < 0.001).

Conclusions

In conclusion, Matrix Model treatment combined with MPH for 12 weeks had beneficial effects on addiction severity, craving, relapse, and mental health in PWUM, compared with Matrix Model treatment, MPH, and control group.

Trial registration

This study was retrospectively registered in the Iranian website (www.irct.ir) for clinical trials registration (http://www.irct.ir: IRCT20171105037245N1). Registration date: 9 December 2017.
Larval ecology and infestation indices of two major arbovirus vectors, Aedes aegypti and Aedes albopictus (Diptera: Culicidae), in Brazzaville, the capital city of the Republic of the Congo
Authors: Wilson-Bahun Theodel A. , Kamgang Basile , Lenga Arsène , Wondji Charles S.
Published: September 2020

Background

Invasive mosquito species, such as Aedes albopictus in Congo can affect the distribution of native species, changing the vector composition and pattern of disease transmission. Here, we comparatively establish the geographical distribution and larval habitat preference of Ae. aegypti and Ae. albopictus and the risk of arbovirus disease outbreaks using Stegomyia indices in the city of Brazzaville, the capital of the Republic of the Congo.

Methods

Human dwelling surveys of water-holding containers for immature stages of Aedes was carried out in December 2017 in Brazzaville through a random cluster sampling method. A total of 268 human dwellings distributed in 9 boroughs and 27 neighbourhoods were surveyed across the city.

Results

Overall, 455 potential larval habitats were surveyed. Both Ae. aegypti and Ae. albopictus were collected across the city with an overall high prevalence of Ae. aegypti (53.1%) compared to Ae. albopictus (46.9%). Geographical distribution analysis showed that Ae. aegypti was more abundant (mean = 6.6 ± 1.4) in neighbourhoods located in downtown, while the abundance of Ae. albopictus was low (mean = 3.5 ± 0.6) in suburbs. Peridomestic containers, especially discarded tanks, were the most strongly colonized productive larval habitat for both mosquito species with the prevalence of 56.4% and 53.1% for Ae. aegypti and Ae. albopictus, respectively. Globally, the house index (HI), Breteau index (BI) and container index (CI) were high for Ae. aegypti (26.6%, 38.4% and 22.6%) and Ae. albopictus (33.3%, 49.6% and 26.6%) compared to the transmission risk threshold (5%, 5% and 20%) established by the WHO/PAHO. Overall, pupae-based indices (the pupae index and the pupae per person index) were not significantly different between Ae. aegypti (273.4% and 23.2%) and Ae. albopictus (228.8% and 19.5%).

Conclusions

The findings of this study suggest a high risk for transmission of arbovirus diseases in Brazzaville and call for an urgent need to implement vector control strategies against these vectors in the Republic of the Congo.
Psychosocial and productivity impact of caring for a child with peanut allergy
Authors: Acaster Sarah , Gallop Katy , de Vries Jane , Marciniak Anne , Ryan Robert , Vereda Andrea , Knibb Rebecca
Published: September 2020

Background

Limited previous research has assessed the psychosocial burden and productivity impact of caring for a child with peanut allergy and factors associated with burden. The objective of this research was to explore caregiver burden in terms of psychosocial and productivity impact of caring for a child with peanut allergy, the influence of caregiver and child gender on caregiver burden, and factors predicting caregiver burden in peanut allergy.

Methods

A cross-sectional survey of caregivers of children with peanut allergy was conducted in the United Kingdom, and included sociodemographic and clinical questions, EQ-5D, Hospital Anxiety and Depression Scale, Food Allergy Quality of Life-Parental Burden, Food Allergy Independent Measure, and productivity questions.

Results

One hundred caregivers (55% female) of children with peanut allergy (aged 4–15 years) completed the survey. Male and female caregivers reported mean levels of anxiety significantly higher than United Kingdom population norms. Caregivers of children with severe peanut allergy reported significant impacts on their careers and health-related quality of life. Neither caregiver nor child gender impacted burden, indicating that male and female caregivers are equally anxious and suffer the same level of negative career, productivity, and health-related quality-of-life impact due to their child’s peanut allergy. Caregivers’ perceived risk of outcomes related to their child’s peanut allergy (e.g., death or severe reaction) as measured by the Food Allergy Independent Measure independently predicted burden.

Conclusions

Caregivers of children with peanut allergy in the United Kingdom experience health-related quality-of-life, psychosocial, and productivity burden; this study demonstrates the high levels of anxiety reported by both male and female caregivers.
Long noncoding RNA H19 regulates the therapeutic efficacy of mesenchymal stem cells in rats with severe acute pancreatitis by sponging miR-138-5p and miR-141-3p
Authors: Song Guodong , Zhou Jia , Song Ruimei , Liu Dalu , Yu Weidi , Xie Wangcheng , Ma Zhilong , Gong Jian , Meng Hongbo , Yang Tingsong , Song Zhenshun
Published: September 2020

Background

Patients with severe acute pancreatitis (SAP), which is characterized by high morbidity and mortality, account for an increasing medical burden worldwide. We previously found that mesenchymal stem cells (MSCs) could attenuate SAP and that expression of long noncoding RNA H19 (LncRNA H19) was upregulated in rats receiving MSCs. In the present study, we investigated the mechanisms of LncRNA H19 regulating the therapeutic efficacy of MSCs in the alleviation of SAP.

Methods

MSCs transfected with LncRNA H19 overexpression and knockdown plasmids were intravenously injected into rats 12 h after sodium taurocholate (NaT) administration to induce SAP.

Results

Overexpressing LncRNA H19 in MSCs significantly enhanced the anti-inflammatory capacity of the MSCs, inhibited autophagy via promotion of focal adhesion kinase (FAK)-associated pathways, and facilitated cell proliferation by increasing the level of β-catenin in rats with SAP. LncRNA H19 functioned as a competing endogenous RNA by sponging miR-138-5p and miR-141-3p. Knocking down miR-138-5p in MSCs increased the expression of protein tyrosine kinase 2 (PTK2, encoding FAK) to suppress autophagy, while downregulating miR-141-3p enhanced the level of β-catenin to promote cell proliferation.

Conclusions

In conclusion, LncRNA H19 effectively increased the therapeutic efficacy of MSCs in rats with SAP via the miR-138-5p/PTK2/FAK and miR-141-3p/β-catenin pathways.
Differential expression of microRNA between normally developed and underdeveloped female worms of Schistosoma japonicum
Authors: Han Yu , Feng Jintao , Ren Yuqi , Wu Luobin , Li Hao , Liu Jinming , Jin Yamei
Published: September 2020

Eggs produced by bisexual infected mature female worms (MF) of Schistosoma japonicum are important in the transmission of the parasite and responsible for the pathogenesis of schistosomiasis. The single-sex infected female worms (SF) cannot mature and do not produce normal eggs; also they do not induce severe damage to the host. In this study, the microRNA (miRNA) expression profiles of 25d MF and 25d SF were investigated through Solexa deep-sequencing technology to explore the developmental mechanisms of schistosome female worms. There were 36 differentially expressed miRNA, 20 up-regulated and 16 down-regulated found in MF/SF worms, including some development related miRNA such as bantam (ban), let-7, miR-124, miR-8, miR-1, miR-7. There were 166 target genes of up-regulated miRNA and 201 target genes of down-regulated miRNA after comparing the target gene prediction software results with RNA-Seq transcriptome results. Analysis of the target genes shows that different ones are involved in MF and SF worms in Gene Ontology terms, with a similar situation in KEGG. This observation indicates that different genes regulated by differentially expressed miRNA take part in MF and SF and lead to differential sexual status. This means that the sexual status of female worms is regulated by miRNA.
On entrepreneurial decision logics under conditions of uncertainty: an attempt to advance the current debate
Authors: Rapp David J. , Olbrich Michael
Published: September 2020

Uncertainty plays a crucial role for most entrepreneurship theories and is thus at the core of entrepreneurship research. Despite decades of research efforts, the notion of uncertainty is still somewhat vague and elusive, however. Consequently, desirable improvement of our understanding of uncertainty requires further considerations. Fortunately, in a recent paper published in the Academy of Management Review, Packard and Clark (Academy of Management Review, 2019) contribute their ideas on the subject. The study in question offers a novel dichotomy of uncertainty types and normatively prescribes entrepreneurial strategies associated with those different settings. The remarks of Packard and Clark have attracted opposition, however, and while appreciating the study’s efforts to refine the uncertainty construct, the present paper aims to advance the current debate. One stance adopted in the current paper to do so is to suggest supplementing research on uncertainty itself with the notion of ill-structuredness affecting decision problems. That approach makes it possible to theorize about entrepreneurial decision-making in a broader yet more nuanced way.
Little Akaki River sediment enrichment with heavy metals, pollution load and potential ecological risks in downstream, Central Ethiopia
Authors: Mekuria Deshu Mamo , Kassegne Alemnew Berhanu , Asfaw Seyoum Leta
Published: September 2020

Addis Ababa City’s river ecosystem is under extreme pressure as a result of inappropriate practices of dumping domestic and industrial wastes; thus, threatening its ability to maintain basic ecological, social and economic functions. Little Akaki River which drains through Addis Ababa City receives inorganic and organic pollutants from various anthropogenic sources. Most of inorganic pollutants such as toxic heavy metals released into the river are eventually adsorbed and settle in the sediment. The objective of this study was to evaluate the enrichment levels, pollution load and ecological risks of selected heavy metals (Zn, Cr, Cd and Pb) using various indices. The mean concentrations of heavy metals in Little Akaki River sediment were: Zn (78.96 ± 0.021–235.2 ± 0.001 mg/kg); Cr (2.19 ± 0.014–440.8 ± 0.003 mg/kg); Cd (2.09 ± 0.001–4.16 ± 0.0001 mg/kg) and Pb (30.92 ± 0.018–596.4 ± 0.066 mg/kg). Enrichment factor values indicated that sediments were moderate to significantly enriched with Zn and Cr; moderate to very highly enriched with Pb, and very highly enriched in all sampled sites with Cd. Geo-accumulation index and contamination factor values indicated that the sediments were moderate to very highly contaminated with toxic Cd and Pb. The decreasing order of pollution load index (PLI) in downstream was: (S9) > (S4) > (S8) > (S3) > (S6) > (S10) > (S5) > (S2) > (S7) > (S1). PLI and hierarchical cluster analysis revealed that the highest pollution load occurred in the lower course of the river (S9) which may be due to metals inputs from anthropogenic sources. The ecological risk (RI = 350.62) suggested that the contaminated Little Akaki River sediment can pose considerable ecological risks of pollution. The concentrations of Zn, Cr, Cd and Pb in Little Akaki River sediment surpassed eco-toxicological guideline limits of USEPA (threshold effect concentration) and CCME (Interim Sediment Quality Guidelines). Thus, the contaminated sediments can pose adverse biological effects on sediment dwelling organisms.
Body mass index-associated molecular characteristics involved in tumor immune and metabolic pathways
Authors: Hu Chao , Chen Xiong , Yao Chengyun , Liu Yu , Xu Haojun , Zhou Guoren , Xia Hongping , Xia Jinglin
Published: September 2020

Background

Overweight or obesity has been evidenced as an important risk factor involved in the incidence, mortality, and therapy response of multiple malignancies. However, the differences between healthy and obesity tumor patients at the molecular and multi-omics levels remain unclear.

Methods

Our study performed a comprehensive and multidimensional analysis in fourteen tumor types of The Cancer Genome Atlas (TCGA) and found body mass index (BMI)-related genes in multiple tumor types. Furthermore, we compared composite expression between normal, overweight, and obese patients of each immune cell subpopulation and metabolism gene subset. Statistical significance was calculated via the Kruskal-Wallis rank-sum test.

Results

Our analysis revealed that BMI-related genes are enriched in multiple tumor-related biological pathways involved in intracellular signaling, immune response, and metabolism. We also found the different relationships between BMI and different immune cell infiltration and metabolic pathway activity. Importantly, we found that many clinically actionable genes were BMI-affect genes.

Conclusion

Overall, our data indicated that BMI-associated molecular characteristics involved in tumor immune and metabolic pathways, which may highlight the clinical importance of considering BMI-associated molecular signatures in cancer precision medicine.
Examining consistency among different rubrics for assessing writing
Authors: Shabani Enayat A. , Panahi Jaleh
Published: September 2020

The literature on using scoring rubrics in writing assessment denotes the significance of rubrics as practical and useful means to assess the quality of writing tasks. This study tries to investigate the agreement among rubrics endorsed and used for assessing the essay writing tasks by the internationally recognized tests of English language proficiency. To carry out this study, two hundred essays (task 2) from the academic IELTS test were randomly selected from about 800 essays from an official IELTS center, a representative of IDP Australia, which was taken between 2015 and 2016. The test takers were 19 to 42 years of age, 120 of them were female and 80 were males. Three raters were provided with four sets of rubrics used for scoring the essay writing task of tests developed by Educational Testing Service (ETS) and Cambridge English Language Assessment (i.e., Independent TOELF iBT, GRE, CPE, and CAE) to score the essays which had been previously scored officially by a certified IELTS examiner. The data analysis through correlation and factor analysis showed a general agreement among raters and scores; however, some deviant scorings were spotted by two of the raters. Follow-up interviews and a questionnaire survey revealed that the source of score deviations could be related to the raters’ interests and (un)familiarity with certain exams and their corresponding rubrics. Specifically, the results indicated that despite the significance which can be attached to rubrics in writing assessment, raters themselves can exceed them in terms of impact on scores.
Pancreatic neuroendocrine tumor with stenosis of the main pancreatic duct leading to pancreatic pleural effusion: a case report
Authors: Yoshida Yuta , Matsumoto Ippei , Tanaka Tomonori , Yamao Kentaro , Hayashi Akihiro , Kamei Keiko , Satoi Shumpei , Takebe Atsushi , Nakai Takuya , Takenaka Mamoru , Takeyama Yoshifumi
Published: September 2020

Background

Pancreatic pleural effusion and ascites are defined as fluid accumulation in the thoracic and abdominal cavity, respectively, due to direct leakage of the pancreatic juice. They usually occur in patients with acute or chronic pancreatitis but are rarely associated with pancreatic neoplasm. We present here an extremely rare case of pancreatic neuroendocrine tumor with stenosis of the main pancreatic duct, leading to pancreatic pleural effusion.

Case presentation

A 51-year-old man complained of dyspnea. Left-sided pleural effusion was detected on the chest X-ray. Pleural puncture was performed, and the pleural fluid indicated a high amylase content (36,854 IU/L). Hence, the patient was diagnosed with pancreatic pleural effusion. Although no tumor was detected, the computed tomography (CT) scan showed a pseudocyst and dilation of the main pancreatic duct in the pancreatic tail. Magnetic resonance cholangiopancreatography showed a fistula from the pseudocyst into the left thoracic cavity. Endoscopic retrograde pancreatic drainage was attempted; however, it failed due to stenosis in the main pancreatic duct in the pancreatic body. Endoscopic ultrasound revealed a hypoechoic mass measuring 15 × 15 mm in the pancreatic body that was not enhanced in the late phase of contrast perfusion and was thus suspected to be an invasive ductal carcinoma. The patient underwent distal pancreatectomy with splenectomy and the postoperative course was uneventful. Histopathological examination confirmed a neuroendocrine tumor of the pancreas (NET G2). The main pancreatic duct was compressed by the tumor. Increased pressure on the distal pancreatic duct by the tumor might have caused formation of the pseudocyst and pleural effusion. To the best of our knowledge, this is the first case report of pancreatic pleural effusion associated with a neuroendocrine tumor.

Conclusions

Differential diagnosis of a pancreatic neoplasm should be considered, especially when a patient without a history of pancreatitis presents with pleural effusion.
A case of right hepatic duct entering cystic duct successfully treated by laparoscopic subtotal cholecystectomy through preoperatively placed biliary stent
Authors: Hirao Hiroki , Okabe HiroHisa , Ogawa Daisuke , Kuroda Daisuke , Taki Katsunobu , Tomiyasu Shinjiro , Hirota Masahiko , Hibi Taizo , Baba Hideo , Sugita Hiroki
Published: September 2020

Background

Laparoscopic cholecystectomy is a well-established surgical procedure and is one of the most commonly performed gastroenterological surgeries. Therefore, strategy for the management of rare anomalous cystic ducts should be determined.

Case presentation

A 56-year-old woman was admitted to our hospital owing to upper abdominal pain and diagnosed with acute cholecystitis. Magnetic resonance cholangiopancreatography suspected that several small stones in gallbladder and the right hepatic duct drained into the cystic duct. Endoscopic retrograde cholangiopancreatography confirmed the cystic duct anomaly, and an endoscopic nasobiliary drainage catheter (ENBD) was placed at the right hepatic duct preoperatively. Intraoperative cholangiography with ENBD confirmed the place of division in the gallbladder, and laparoscopic subtotal cholecystectomy was safely performed.

Conclusions

The present case exhibited rare right hepatic duct anomaly draining into the cystic duct, which might have caused biliary tract disorientation and bile duct injury (BDI) intraoperatively. Any surgical technique without awareness of this anomaly preoperatively might insufficiently prevent BDI, and preoperative ENBD would facilitate safe and successful surgery.
A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model
Authors: Barker Lisa T. , Bond William F. , Vincent Andrew L. , Cooley Kimberly L. , McGarvey Jeremy S. , Vozenilek John A. , Powell Emilie S.
Published: September 2020

Background

New technologies for clinical staff are typically introduced via an “in-service” that focuses on knowledge and technical skill. Successful adoption of new healthcare technologies is influenced by multiple other factors as described by the Consolidated Framework in Implementation Research (CFIR). A simulation-based introduction to new technologies provides opportunity to intentionally address specific factors that influence adoption.

Methods

The new technology proposed for adoption was a telehealth cart that provided direct video communication with electronic intensive care unit (eICU) staff for a rural Emergency Department (ED). A novel 3-Act-3-Debrief in situ simulation structure was created to target predictive constructs from the CFIR and connect debriefing to specific workflows. The structure and content of the simulation in relation to the framework is described. Participants completed surveys pre-simulation/post-simulation to measure change in their readiness to adopt the new technology.

Results

The scenario was designed and pilot tested before implementation at two rural EDs. There were 60 interprofessional participants across the 2 sites, with 58 pre-simulation and 59 post-simulation surveys completed. The post-simulation mean ratings for each readiness measure (feasibility, quality, resource availability, role clarity, staff receptiveness, and tech usability) increased significantly as a result of the simulation experience.

Conclusions

A novel 3-stage simulation-debriefing structure positively targets factors influencing the adoption of new healthcare technologies.
COVID-19 and regional shifts in Swiss retail payments
Authors: Kraenzlin Sébastien , Meyer Christoph , Nellen Thomas
Published: September 2020

This paper analyzes card payments to the retail sector in Switzerland during the COVID-19 crisis. We provide evidence on aggregate effects and regional shifts. Pronounced shifts—which persisted post-lockdown—can be observed from urban to suburban and rural areas and among cantons. Data allow us to identify directly two sources of shifts: “tourists and business travelers” and “e-commerce.” We indirectly identify additional sources: infection risk, lockdown measures, working from home, shopping tourism, and cash substitution. The COVID-19 crisis seems to have reinforced pre-existing trends that may have faster than anticipated effects on the economy. Our analysis underscores the usefulness of real-time card payment data to inform policymakers.
COVID-19 disease: CT Pneumonia Analysis prototype by using artificial intelligence, predicting the disease severity
Authors: Gouda Walaa , Yasin Rabab
Published: September 2020

Background

Since the beginning of 2020, coronavirus disease has spread widely all over the world and this required rapid adequate management; therefore, continuous searching for rapid and sensitive CT chest techniques was needed to give a hand for the clinician.

We aimed to assess the validity of computed tomography (CT) quantitative and qualitative analysis in COVID-19 pneumonia and how it can predict the disease severity on admission.

Results

One hundred and twenty patients were enrolled in our study, 98 (81.7%) of them were males, and 22 (18.3%) of them were females with a mean age of 52.63 ± 12.79 years old, ranging from 28 to 83 years. Groups B and C showed significantly increased number of involved lung segments and lobes, frequencies of consolidation, crazy-paving pattern, and air bronchogram. The total lung severity score and the total score for crazy-paving and consolidation are used as severity indicators in the qualitative method and could differentiate between groups B and C and group A (90.9% sensitivity, 87.5% specificity, and 93.2% sensitivity, 87.5% specificity, respectively), while the quantitative indicators could differentiate these three groups. Using the quantitative CT indicators, the validity to differentiate different groups showed 84.1% sensitivity and 81.2% specificity for the opacity score, and 90.9% sensitivity and 81.2% specificity for the percentage of high opacity.

Conclusion

Advances in CT COVID-19 pneumonia assessment provide an accurate and rapid tool for severity assessment, helping for decision-making notably for the critical cases.
Mechanisms by Which Membrane and Nuclear ER Alpha Inhibit Adipogenesis in Cells Isolated From Female Mice
Authors: Ahluwalia Amrita , Hoa Neil , Ge Lisheng , Blumberg Bruce , Levin Ellis R
Published: September 2020

Mesenchymal stem cells can differentiate into mature chondrocytes, osteoblasts, and adipocytes. Excessive and dysfunctional visceral adipocytes increase upon menopause and importantly contribute to altered metabolism in postmenopausal women. We previously showed both plasma membrane and nuclear estrogen receptors alpha (ERα) with endogenous estrogen are required to suppress adipogenesis in vivo. Here we determined mechanisms by which these liganded ER pools collaborate to inhibit the peroxisome proliferator-activated gamma (PPARγ) gene and subsequent progenitor differentiation. In 3T3-L1 pre-adipocytes and adipose-derived stem cells (ADSC), membrane ERα signaled through phosphatidylinositol 3-kinase (PI3K)-protein kinase B (AKT) to enhance ERα nuclear localization, importantly at the PPARγ gene promoter. AKT also increased overall abundance and recruitment of co-repressors GATA3, β-catenin, and TCF4 to the PPARγ promoter. Membrane ERα signaling additionally enhanced wingless-integrated (Wnt)1 and 10b expression. The components of the repressor complex were required for estrogen to inhibit rosiglitazone-induced differentiation of ADSC and 3T3-L1 cells to mature adipocytes. These mechanisms whereby ER cellular pools collaborate to inhibit gene expression limit progenitor differentiation to mature adipocytes.
Tau interferes with axonal neurite stabilization and cytoskeletal composition independently of its ability to associate with microtubules
Authors: Boumil Edward F. , Vohnoutka Rishel B. , Lee Sangmook , Shea Thomas B.
Published: September 2020

Tau impacts overall axonal transport particularly when overexpressed by interfering with translocation of kinesin along microtubules (MTs) and/or as a cargo of kinesin by outcompeting other kinesin cargo. To discern between which of these mechanisms was more robust during axonal outgrowth, we overexpressed phosphomimetic (E18; which is incapable of MT binding), phospho-null (A18) or wild-type (WT) full-length human tau conjugated to EGFP, the latter two of which bind MTs. Expression of WT and A18 displayed increased acetylated MTs and resistance to colchicine, while expression of E18 did not, indicating that E18 did not contribute to MT stabilization. Expression of all tau constructs reduced overall levels of neurofilaments (NFs) within axonal neurites, and distribution of NFs along neurite lengths. Since NFs are another prominent cargo of kinesin during axonal neurite outgrowth, this finding is consistent with WT, A18 and E18 inhibiting NF transport to the same extent by competing as cargo of kinesin. These findings indicate that tau can impair axonal transport independently of association with MTs in growing axonal neurites.
Differential expression of Exaiptasia pallida GIMAP genes upon induction of apoptosis and autophagy suggests a potential role in cnidarian symbiosis and disease
Authors: Bailey Grace F. , Coelho Jenny C. , Poole Angela Z.
Published: September 2020

Coral reefs, one of the world's most productive and diverse ecosystems, are currently threatened by a variety of stressors that result in increased prevalence of both bleaching and disease. Therefore, understanding the molecular mechanisms involved in these responses is critical to mitigate future damage to the reefs. One group of genes that is potentially involved in cnidarian immunity and symbiosis is GTPases of Immunity Associated Proteins (GIMAP). In vertebrates, this family of proteins is involved in regulating the fate of developing lymphocytes and interacts with proteins involved in apoptosis and autophagy. Since apoptosis, autophagy, and immunity have previously shown to be involved in cnidarian symbiosis and disease, the goal of this research was to determine the role of cnidarian GIMAPs in these processes using the anemone Exaiptasia pallida. To do so, GIMAP genes were characterized in the E. pallida genome and changes in gene expression were measured using qPCR in response to chemical induction of apoptosis, autophagy, and treatment with the immune stimulant lipopolysaccharide (LPS) in both aposymbiotic and symbiotic anemones. The results revealed four GIMAP-like genes in E. pallida, referred to as Ep_GIMAPs. Induction of apoptosis and autophagy resulted in a general downregulation of Ep_GIMAPs, but no significant changes were observed in response to LPS treatment. This indicates Ep_GIMAPs may be involved in regulation of apoptosis and autophagy, and therefore could play a role in cnidarian-dinoflagellate symbiosis. Overall, these results increase our knowledge on the function of GIMAPs in a basal metazoan.