bluuebunny/crossref_metadata_2025 huggingface dataset:
A duodenal ampullary tumor with malignant transformation of papillary polyps: a case report and literature review
Authors: Mo Wenhui , Li Jingjing , Dai Ying , Chen Jianqing , Xu Xuanfu
Published: October 2021

Periampullary carcinoma refers to a malignant tumor within 2 cm of the duodenal ampulla. Primary ampullary carcinoma is very rare, accounting for only 0.2% of malignant gastrointestinal tumors. The small intestine accounts for 75% of the length of the gastrointestinal tract, and primary tumors in the small intestine account for only 2% of all gastrointestinal tumors. Here, we report the case of a duodenal ampullary tumor with malignant transformation of parapapillary polyps. The patient had both a primary ampullary tumor and high-grade intraepithelial neoplasia of juxtapapillary adenomatous duodenal polyps.
Driving and Flying Simulators: A Review on Relevant Considerations and Trends
Authors: Serje David , Acuña Estefany
Published: October 2021

Flying and driving simulation has encouraged an enormous and growing community in a wide variety of areas such as research centers, driver or pilot training academies, vehicle-testing facilities, amusement parks, and even at home by household enthusiasts, providing carefully integrated visual and perceptual illusions of driving or flying real vehicles. The global research on this subject is explored during the period 2000 to 2019 from an interdisciplinary perspective based on a systematic methodology, providing both new and experienced researchers with broad guidance toward key aspects for further investigations and developments. Emphasis is given to the analysis of the findings and in particular to their applicability, to an extent not attempted earlier, by considering both human and machine aspects.
Parametric analysis and optimization of fused deposition modeling technique for dynamic mechanical properties of acrylic butadiene styrene parts
Authors: Dev Saty , Srivastava Rajeev
Published: October 2021

Fused deposition modeling (FDM) technology is catching the fast global market in the real-time production of polymeric parts. Process variables highly influence the performance characteristics of FDM-generated parts, so mechanical performance is not perfect for all applications. In actual conditions, parts produced by FDM are constantly subjected to loading at different temperatures. The former studies mainly concentrated on the properties of FDM products to static loading environments. There is a scope of effective investigation on the influence of FDM processing conditions on dynamic mechanical properties using artificial intelligence (AI) based techniques. The present study focused on investigation and optimization the manufacturing process parameters to evaluate the dynamic mechanical performance of FDM-produced part. The experimental runs were obtained through central composite design in Minitab software. A DMA8000 instrument was used to test the specimens for dynamic mechanical performance. The mathematical models were developed and optimized through different approaches like response surface methodology-genetic algorithm (RSM-GA) and artificial neural network-genetic algorithm (ANN-GA). The techniques for order preference by similarity to an ideal solution (TOPSIS) is employed to obtain the best parameter settings from sets of optimized solutions. The sequential use of ANN-GA and TOPSIS methods predicted the highest values of storage modulus 1619.61 MPa and loss modulus 257.38 MPa corresponding to 68.94° raster angle, 81.48% infill density, 0.10 mm layer thickness, 237.73°C nozzle temperature and 38.97 mm/s print head speed. The confirmation tests were conducted to validate the predicted result that upscale the desired properties. The RSM-GA-TOPSIS occurred with a prediction error of 2.40% and −3.31%, corresponding to storage and loss modulus. Similarly, ANN-GA-TOPSIS shows 2.17% and 2.89% prediction error corresponding to storage and loss modulus. The experimental and analytical outcome of present study will be helpful for the designers of intricate functional parts which come under thermo-mechanical loading conditions.
MsrB1 Promotes Proliferation and Invasion of Colorectal Cancer Cells via GSK-3β/β-catenin Signaling Axis
Authors: Chen Xiao-Yu , Yang Sheng-Yong , Ruan Xiao-Jie , Ding Hong-Yue , Wang Ning-Xi , Liu Fang , Li Jia-Chu , Li Yi
Published: October 2021

Methionine sulfoxide reductase B1 (MsrB1) can catalyze both free and protein-bound R-methionine sulfoxides (R-MetO) to methionine (Met). It has been reported that MsrB1 plays an important role in the development of HCC and human bone osteosarcoma. However, little is known about the functions of MsrB1 in human colorectal cancer (CRC). Herein, we detected MsrB1 expression level in CRC tissue and cell lines, and investigated the effect of MsrB1 knockdown on CRC phenotypes and possible mechanisms involved in. The results showed that MsrB1 was highly expressed in both CRC tissues and cell lines, and that cell proliferation, migration and invasion were significantly inhibited, but apoptosis was increased after MsrB1 knockdown in colorectal cancer HCT116 and RKO cell lines, compared to control siRNA group. In addition, E-cadherin protein level was increased, vimentin and Snail protein were greatly decreased after knockdown of MsrB1 in cells. Furthermore, pGSK-3β (Ser9) and β-catenin protein levels were reduced, the promoter activity of TCF/LEF construction was inhibited after MsrB1 knockdown in cells, suggesting that GSK-3β/β-catenin signaling axis was involved in the tumorigenesis of CRC. In conclusion, the oncogenic role and related mechanisms of MsrB1 in CRC discovered in our work determined the potential role of MsrB1 as a biomarker and may provide a new target for clinical therapy of CRC.
Treatment Effect of Regional Sodium Citrate Anticoagulation in Elderly Patients With High-Risk Bleeding Receiving Continuous Renal Replacement Therapy
Authors: Xun Kang , Qiu Hong , Jia Miao , Lin Lihua , He Meiling , Li Damei , Jin Donghua
Published: October 2021

Objective

To investigate the safety and efficacy of regional citrate anticoagulation (RCA) on elderly patients at high risk of bleeding after continuous renal replacement therapy (CRRT).

Methods

A total of 31 patients at high risk of bleeding who received CRRT in the intensive care unit were collected. The patients were divided into RCA group (n = 17) and no anticoagulation group (NA, n = 14) according to whether RCA was used or not. The levels of creatinine (Cr), blood urea nitrogen (BUN), prothrombin time (PT), activated partial thromboplastin time (APTT), total calcium (tCa), ionized calcium ion (iCa2+), sodium ion (Na+), bicarbonate ion (HCO3−), tCa/iCa2+ ratio, and pH were observed after treatment. The filter use time, number of filters used, filter obstruction events, clinical outcomes, and safety evaluation indexes were compared post-treatment.

Results

After treatment, serum Cr and BUN levels, APTT and PT levels in the RCA group were significantly lower than the NA group. The tCa, iCa2+, HCO3−, tCa/iCa2+, and pH were within the normal range after RCA treatment while Na+ levels saw a significant increase. In the RCA group, the filter using time was significantly longer, with significantly reduced numbers of filter use within 72 h and filter disorder events. Additionally, patients in the RCA group showed significant recovery of renal function and a significant reduction in bleeding events and in-hospital mortality.

Conclusion

RCA treatment significantly improves clinical outcome of patients at high risk of bleeding after CRRT, safely and effectively prolongs the filter life and avoids coagulation incidences.
Modelling of transient flow of piston ring-liner contact using synthetic lubricants
Authors: Zavos Anastasios , Nikolakopoulos Pantelis G
Published: October 2021

The paper contains the results of the transient flow of piston ring conjunction of a single-cylinder motorbike engine. Calculations of piston ring forces, asperity contact and gas blow-by are determined in computational fluid dynamics. The stochastic model of Greenwood-Tripp approach is used to predict the load of asperities. The hydrodynamic friction is also calculated by means of computational fluid dynamics including the multi-phase flow through Rayleigh–Plesset equation and a discrete phase model for simulating nanoparticles interaction. The major contribution of this analysis is to specifically investigate the impact of the lubricant with additives and the corresponding transient effects such as hydrodynamic pressure, cavitation and lubricant film within the contact. The results indicate that to investigate realistic mechanisms of multi-phase flow in piston ring-liner contact, the contribution of nanoparticles should be matched with the type of lubricants. In addition, this advanced computational fluid dynamics model showed that nanoparticles motion is important in reciprocating line contacts, leading to lower boundary friction in the order of 8.8% than a simple model where cavitation and nanoparticles are ignored.
An ex-post analysis of trade effects of the ASEAN–Korea Free Trade Area (AKFTA) from Korea’s Perspective
Authors: Lee Ga Eun , Park Innwon
Published: October 2021

This paper empirically analyzes the effectiveness of the ASEAN–Korea Free Trade Area (AKFTA) focusing on the ex-post trade creation and diversion effects with controlling related intra-bloc and extra-bloc regional trade agreements (RTAs) and economic characteristics of interconnected economies. The quantitative analysis applies a gravity model regression analysis by specifying standard pooled ordinary least squares and fixed effects regression models. We observe that the AKFTA turned out to be more favorable for Korea in terms of trade balance with ASEAN. We find that the AKFTA is a desirable trade creating RTA strongly driven by intra-bloc export activities between members and does not divert but generates more export to and import from non-members. Thus, we strongly support that the AKFTA facilitates trade between intra-bloc members and their trade with extra-bloc non-members as well. Besides which, we find that the trade creation effects of the AKFTA are industry-specific and sector-specific. For the manufacturing industry, the trade creation effects of the AKFTA are generated by both intra-bloc and extra-bloc import activity but not from extra-bloc export activity. However, for the services industry, all the intra-bloc and extra-bloc export and import activities contribute to the trade creation effects. Interestingly, we find that the trade creation effects of the manufacturing industry are smaller than those of the services industry. Considering restrictive service schedules of specific commitments in the AKFTA agreement on trade-in services compared to trade-in goods provisions, rearranging the trade-in services provisions is necessary to generate more trade gains in the future.
Preoperative Psychometric Properties of PROMIS Upper Extremity, Pain Interference, and Depression in Bankart Repair and Rotator Cuff Repair (115)
Authors: Vadhera Amar , Beletsky Alexander , Singh Harsh , Chahla Jorge , Cole Brian , Verma Nikhil
Published: October 2021

Objectives:

To examine the preoperative and postoperative performance of PROMIS Upper Extremity 2.0 across various orthopedic procedures for the upper extremity. Secondarily, to define susceptibility to pre- and post-operative floor and ceiling effects.

Methods:

Retrospective analysis of prospectively collected patient-reported outcome (PRO) data was conducted utilizing an electronic outcome registry for procedures between May 2017 and August 2018. Current procedural terminology (CPT) codes were utilized to examine cohorts for various upper extremity orthopedic procedures including Bankart repair and arthroscopic rotator cuff repair (ARCR). Shapiro-Wilks normality testing was used to assess score distributions for normalcy; given non-normal score distributions, Spearman correlation coefficients were calculated for preoperative patient-reported outcome (PRO) scores. Absolute floor and ceiling effects were calculated for each time point based on CPT code.

Results:

A total of 488 patients were included across Bankart repair (n=109, 29.3 + 12.5 years) and ARCR (n=379, 57.5 + 9.5 years) cohorts. In the Bankart repair cohort, PROMIS PI demonstrate strong correlations with ASES (r=-0.63), Constant (r=-0.75), PROMIS UE (r=-0.75), and the VR6D (r=-0.61). PROMIS Depression (r=0.23 vs. 0.17), SF12 MCS (r=0.34 vs. 0.11), and VR12 MCS (r=0.44 vs. 0.15) exhibited poor correlations with PROMIS PI and UE, respectively. In the ARCR cohort, PROMIS PI scores demonstrated a good correlation with PROMIS UE (r=0.61). Constant (r=0.58 vs. 0.67), VR12 PCS (r=0.58 vs. 0.47), and VR6D (r=0.67 vs. 0.53) exhibited good correlations with both PROMIS PI and UE measures, respectively. No significant absolute floor or ceiling effects were observed for the PROMIS instruments except PROMIS Depression; an absolute floor was noted for both Bankart (n=12, 30%) and ARCR (n=38, 14.7%) groups.

Conclusions:

PROMIS PI and UE instruments perform comparably to legacy outcome instruments in patients receiving Bankart repair, as well as those receiving ARCR. Furthermore, in both populations, the PROMIS Depression instrument exhibits absolute floor effects, whereas PROMIS PI and UE instruments fail to demonstrate any absolute floor or ceiling effects.
Rotator Cuff Repair and the Bovine Bioinductive Patch: Excellent Functional Outcomes and Satisfaction in Patients with Comorbidities (238)
Authors: Plancher Kevin , Petterson Stephanie
Published: October 2021

Objectives:

Structural failure of rotator cuff repair (RCR) has been reported to occur in 20-94% at one to two-year follow-up with 80% of these failures occurring within three months of surgical intervention. Poor functional outcomes as well as higher rates of retear have been reported in patients with compromised healing potential due to comorbidities such as diabetes, smoking, obesity, and hypercholesterolemia. Augmentation with growth factors and stem cells and/or biologically augmented patches has been shown to decrease re-tear rates. Biologically-augmented patches provide an environment that is conducive for cell and vessel migration. We investigated patient outcomes following RCR plus bovine bioinductive patch augmentation.

Methods:

A consecutive series of patients (2015-2018) that underwent RCR plus bovine bioinductive patch by a single surgeon were identified. Patients with diabetes, obesity, hypercholesterolemia, and smokers were included. Patients were excluded with revision rotator cuff repairs. Physical exam included shoulder ROM and manual muscle strength. Patients completed DASH, SF-12 physical and mental, VAS pain and patient satisfaction scores to assess postoperative functional outcomes. Paired sample t-tests were used to assess differences before and after surgery (p<0.05).

Results:

Sixteen patients (5 females, 62.3±14 years of age, BMI 32.3±13.7) that underwent arthroscopic RCR plus bovine bioinductive patch augmentation were included. Twelve patients had symptomatic 50-90% partial tears and four patients had full thickness tears. Average follow-up was 25.8±13.1 months. Mean shoulder flexion increased from 148.8°±17.5° to 164.7°±15.0° (p=0.0097), external rotation at 90° abduction increased from 67.8°±36.4° to 88.4°±3.5° (p=0.0316). No significant changes were seen in internal rotation behind the back (p=0.1750) or shoulder muscle strength measurements (all p>0.4471). Postoperative DASH score was 10.4±12.8, SF-12 physical score was 52.8±5, SF-12 mental score was 54.2±5.6, VAS pain score was 0.56±0.88, and patient satisfaction was 8.5±0.55. There were no complications or clinical failures at average 3-year follow-up. Patients returned to preoperative sports, including tennis, swimming, bowling, and weightlifting at an average of 21.9±14.3 weeks.

Conclusions:

RCR with bovine bioinductive patch augmentation is a good alternative treatment for patients with multiple comorbidities and partial and full thickness rotator cuff tears yielding high patient satisfaction, no loss of shoulder ROM or strength, good functional outcomes, and return to preoperative sports.
Flexible Bronchoscopy Simulation as a Tool to Improve Surgical Skills in Otolaryngology Residency
Authors: Santa Maria Chloe , Sung Chi‐Kwang , Lee Jennifer Y. , Chhetri Dinesh K. , Mendelsohn Abie H. , Dewan Karuna
Published: October 2021

Objective

To evaluate the benefits of simulation to teach flexible bronchoscopy.

Study Design

A prospective cohort study to assess the bronchoscopic skills of residents in an otolaryngology training program using a commercially available bronchoscopy simulator.

Setting

Tertiary care otolaryngology residency program.

Methods

Thirty‐two otolaryngology residents and 4 expert faculty across 2 academic institutions were assessed on 3 flexible bronchoscopy tasks: diagnostic bronchoscopy, foreign body removal, and tracheal lesion biopsy. Performance was evaluated with a modified version of the validated Bronchoscopy Skills and Tasks Assessment Tool. At 1 of the 2 academic institutions, an additional tool was implemented to evaluate the simulator.

Results

There was a correlation between postgraduate training year and time taken to complete tasks, including bronchoscopy, foreign body extraction, and passing through the glottis (P <. 001, P =. 04, and P <. 01, respectively). There was a significant difference between residents and faculty laryngologists for a range of skills and tasks, including percentage of time in middle lumen, contact with bronchial walls, inadvertent esophagus entry, and biopsy of healthy tissue (P <. 001, P =. 003, P <. 001, and P <. 001). Additionally, increasing postgraduate level was correlated with a higher percentage of time in the center of the lumen and reduced time to task completion (P =. 05 and P <. 001). Of 32 residents, 20 evaluated the simulator on its realism, with an average score of 4.1 of 5.

Conclusion

The commercially available flexible bronchoscopy simulator provides a valid assessment of bronchoscopic skill and is a useful tool for practicing bronchoscopy in a safe, controlled environment.

Level of Evidence

Individual cohort study.
Psychosocial Contributors to Depressive Symptoms in Hispanic Patients With Type 2 Diabetes
Authors: Mansyur Carol L. , Rustveld Luis O. , Nash Susan G. , Jibaja-Weiss Maria L.
Published: October 2021

Purpose

The purpose of this study is to identify psychosocial factors associated with depressive symptoms in Hispanic patients with diabetes and explore the extent to which their effects may vary by gender and acculturation.

Methods

The authors completed a secondary analysis of data from 247 Hispanic adults with type 2 diabetes. Gender and language groups were compared using chi-square and t tests. Hierarchical multiple regression was used to examine associations of depressive symptoms with perceived support, diabetes-related distress, and social and personal factors.

Results

Women reported less support than men. English speakers reported more depressive symptoms than Spanish speakers. When adjusting for age, gender, and acculturation, psychosocial factors significantly associated with depressive symptoms included less support received, greater emotional burden, and less ability to socialize or pursue normal activities because of diabetes.

Conclusions

Social support provided by family among less acculturated Hispanics may play an important role in reducing emotional burden and lowering the risk of comorbid depression. The quality of interpersonal relationships and the ability to continue normal activities may also be important. More acculturated Hispanic women with diabetes may be at greater risk for comorbid depression and worse health outcomes. Screening for depression and assessment of support needs is warranted for Hispanic women.
How I treat high-risk multiple myeloma
Authors: Zamagni Elena , Barbato Simona , Cavo Michele
Published: November 2021

Survival of multiple myeloma (MM) has significantly improved over the past decade; however, a composed group of patients (15% to 20%), named high-risk (HR) MM, still experiences reduced survival. Both tumor biology and suboptimal/absent responses to therapy may underlie HR definition and a clear uniform identification of risk factors is crucial for proper management of these patients. In biologic HRMM, MRD attaining and sustaining negativity, inside and outside bone marrow, should be the primary goal and therapy should be adapted in patients with frailty to reduce toxicity and improve quality of life. MM treatment has traditionally been tailored to age and more recently frailty or comorbidities, but very rarely to the biology of the disease, mainly because of the lack of a clear benefit derived from a specific drug/combination, inhomogeneity in HR definition, and lack of data coming from prospective, properly designed clinical trials. Some attempts have been successfully made in this direction. In this review, we discuss the current definitions of HR and the need for a consensus, the results of available trials in HR patients, and the way through risk-adapted treatment strategies. For this purpose, we propose several clinical cases of difficult-to-treat patients throughout different treatment phases.
A drug repositioning algorithm based on a deep autoencoder and adaptive fusion
Authors: Chen Peng , Bao Tianjiazhi , Yu Xiaosheng , Liu Zhongtu
Published: October 2021

Background

Drug repositioning has caught the attention of scholars at home and abroad due to its effective reduction of the development cost and time of new drugs. However, existing drug repositioning methods that are based on computational analysis are limited by sparse data and classic fusion methods; thus, we use autoencoders and adaptive fusion methods to calculate drug repositioning.

Results

In this study, a drug repositioning algorithm based on a deep autoencoder and adaptive fusion was proposed to mitigate the problems of decreased precision and low-efficiency multisource data fusion caused by data sparseness. Specifically, a drug is repositioned by fusing drug-disease associations, drug target proteins, drug chemical structures and drug side effects. First, drug feature data integrated by drug target proteins and chemical structures were processed with dimension reduction via a deep autoencoder to characterize feature representations more densely and abstractly. Then, disease similarity was computed using drug-disease association data, while drug similarity was calculated with drug feature and drug-side effect data. Predictions of drug-disease associations were also calculated using a top-k neighbor method that is commonly used in predictive drug repositioning studies. Finally, a predicted matrix for drug-disease associations was acquired after fusing a wide variety of data via adaptive fusion. Based on experimental results, the proposed algorithm achieves a higher precision and recall rate than the DRCFFS, SLAMS and BADR algorithms with the same dataset.

Conclusion

The proposed algorithm contributes to investigating the novel uses of drugs, as shown in a case study of Alzheimer's disease. Therefore, the proposed algorithm can provide an auxiliary effect for clinical trials of drug repositioning.
Impact of model assumptions on demographic inferences: the case study of two sympatric mouse lemurs in northwestern Madagascar
Authors: Teixeira Helena , Salmona Jordi , Arredondo Armando , Mourato Beatriz , Manzi Sophie , Rakotondravony Romule , Mazet Olivier , Chikhi Lounès , Metzger Julia , Radespiel Ute
Published: November 2021

Background

Quaternary climate fluctuations have been acknowledged as major drivers of the geographical distribution of the extraordinary biodiversity observed in tropical biomes, including Madagascar. The main existing framework for Pleistocene Malagasy diversification assumes that forest cover was strongly shaped by warmer Interglacials (leading to forest expansion) and by cooler and arid glacials (leading to forest contraction), but predictions derived from this scenario for forest-dwelling animals have rarely been tested with genomic datasets.

Results

We generated genomic data and applied three complementary demographic approaches (Stairway Plot,PSMCandIICR-simulations) to infer population size and connectivity changes for two forest-dependent primate species (Microcebus murinusandM. ravelobensis) in northwestern Madagascar. The analyses suggested major demographic changes in both species that could be interpreted in two ways, depending on underlying model assumptions (i.e., panmixia or population structure). Under panmixia, the two species exhibited larger population sizes across the Last Glacial Maximum (LGM) and towards the African Humid Period (AHP). This peak was followed by a population decline inM. ravelobensisuntil the present, whileM. murinusmay have experienced a second population expansion that was followed by a sharp decline starting 3000 years ago. In contrast, simulations under population structure suggested decreasing population connectivity between the Last Interglacial and the LGM for both species, but increased connectivity during the AHP exclusively forM. murinus.

Conclusion

Our study shows that closely related species may differ in their responses to climatic events. Assuming that Pleistocene climatic conditions in the lowlands were similar to those in the Malagasy highlands, some demographic dynamics would be better explained by changes in population connectivity than in population size. However, changes in connectivity alone cannot be easily reconciled with a founder effect that was shown forM. murinusduring its colonization of the northwestern Madagascar in the late Pleistocene. To decide between the two alternative models, more knowledge about historic forest dynamics in lowland habitats is necessary. Altogether, our study stresses that demographic inferences strongly depend on the underlying model assumptions. Final conclusions should therefore be based on a comparative evaluation of multiple approaches.
Independence estimators for re-randomisation trials in multi-episode settings: a simulation study
Authors: Kahan Brennan C. , White Ian R. , Eldridge Sandra , Hooper Richard
Published: October 2021

Background

Re-randomisation trials involve re-enrolling and re-randomising patients for each new treatment episode they experience. They are often used when interest lies in the average effect of an intervention across all the episodes for which it would be used in practice. Re-randomisation trials are often analysed using independence estimators, where a working independence correlation structure is used. However, research into independence estimators in the context of re-randomisation has been limited.

Methods

We performed a simulation study to evaluate the use of independence estimators in re-randomisation trials. We focussed on a continuous outcome, and the setting where treatment allocation does not affect occurrence of subsequent episodes. We evaluated different treatment effect mechanisms (e.g. by allowing the treatment effect to vary across episodes, or to become less effective on re-use, etc), and different non-enrolment mechanisms (e.g. where patients who experience a poor outcome are less likely to re-enrol for their second episode). We evaluated four different independence estimators, each corresponding to a different estimand (per-episode and per-patient approaches, and added-benefit and policy-benefit approaches).

Results

We found that independence estimators were unbiased for the per-episode added-benefit estimand in all scenarios we considered. We found independence estimators targeting other estimands (per-patient or policy-benefit) were unbiased, except when there was differential non-enrolment between treatment groups (i.e. when different types of patients from each treatment group decide to re-enrol for subsequent episodes). We found the use of robust standard errors provided close to nominal coverage in all settings where the estimator was unbiased.

Conclusions

Careful choice of estimand can ensure re-randomisation trials are addressing clinically relevant questions. Independence estimators are a useful approach, and should be considered as the default estimator until the statistical properties of alternative estimators are thoroughly evaluated.
Characteristics of the corpus callosum in chronic schizophrenia treated with clozapine or risperidone and those never-treated
Authors: Tao Bo , Xiao Yuan , Cao Hengyi , Zhang Wenjing , Yang Chengmin , Lencer Rebekka , Gong Qiyong , Lui Su
Published: October 2021

Background

The corpus callosum (CC) deficits have been well documented in chronic schizophrenia. However, the long-term impacts of antipsychotic monotherapies on callosal anatomy remain unclear. This cross-sectional study sought to explore micro- and macro-structural characteristics of the CC in never-treated patients and those with long-term mono-antipsychotic treatment.

Methods

The study included 23 clozapine-treated schizophrenia patients (CT-SCZ), 19 risperidone-treated schizophrenia patients (RT-SCZ), 23 never-treated schizophrenia patients (NT-SCZ), and 35 healthy controls (HCs). High resolution structural images and diffusion tensor imaging (DTI) data for each participant were obtained via a 3.0 T MR scanner. FreeSurfer was used to examine the volumes and fractional anisotropy (FA) values of the CC for each participant.

Results

There were significant deficits in the total and sub-regional CC volume and white matter integrity in NT-SCZ in comparison with healthy subjects. Compared with NT-SCZ, both CT-SCZ and RT-SCZ showed significantly increased FA values in the anterior CC region, while only RT-SCZ showed significantly increased volume in the mid-anterior CC region. Moreover, the volume of the mid-anterior CC region was significantly smaller in CT-SCZ compared to HCs. No correlations of clinical symptoms with callosal metrics were observed in schizophrenia patients.

Conclusions

Our findings provide insight into micro- and macro-structural characteristics of the CC in chronic schizophrenia patients with or without antipsychotics. These results suggest that the pathology itself is responsible for cerebral abnormalities in schizophrenia and that chronic exposure to antipsychotics may have an impact on white matter structure of schizophrenia patients, especially in those with risperidone treatment.
Defending the city’s cleanliness with their lives? A study of road traffic collisions involving sanitation workers in China over five years
Authors: Wei Lifeng , Sha Zhuowa , Jia Haonan , Wang Yidong , Zhang Gangyu , Li Yuanheng , Wang Yameng , Zhou Shuang , Wang Ying , Liu Chao , Jiao Mingli , Mao Jingfu , Wu Qunhong
Published: November 2021

Background

With increasing urbanization in developing countries, sanitation workers are frequently involved in road traffic collisions. Our purpose was to study specific collisions involving sanitation workers and provide decision-making suggestions and reference measures for the sanitation industry and urban managers to reduce the occurrence of collisions.

Methods

We obtained online news data about sanitation worker road traffic collisions in China between 2013 and 2017 and analyzed occurrence time and location, victim characteristics, and causes of collisions.

Results

In China, between 2013 and 2017, 511 road traffic collisions were reported, with the fewest in February and July. Most occurred around 5:00 a.m. in Eastern regions and in urban areas. Victims were mainly over 50 years old, with more females than males. Collisions usually resulted in death at the scene. The ambiguity of laws, the exploitation of workers through industry outsourcing, and the difficulty of processing claims may be the main factors preventing victims from obtaining legal compensation.

Conclusions

The most common cause of collisions was drivers’ speeding, but workers also regularly risk death by crossing the road in pursuit of their duties. The absence of legal controls for environmental protection, the excessive pursuit of efficiency in urban governance, and the lack of basic education of sanitation workers are underlying causes of collisions. Raising awareness about sanitation worker road traffic collisions will help protect the work safety rights of this vulnerable group.
Repeated bronchoscopy in health and obstructive lung disease: is the airway microbiome stable?
Authors: Nielsen Rune , Xue Yaxin , Jonassen Inge , Haaland Ingvild , Kommedal Øyvind , Wiker Harald G. , Drengenes Christine , Bakke Per S. , Eagan Tomas M. L.
Published: November 2021

Objective

Little is known concerning the stability of the lower airway microbiome. We have compared the microbiota identified by repeated bronchoscopy in healthy subjects and patients with ostructive lung diseaseases (OLD).

Methods

21 healthy controls and 41 patients with OLD completed two bronchoscopies. In addition to negative controls (NCS) and oral wash (OW) samples, we gathered protected bronchoalveolar lavage in two fractions (PBAL1 and PBAL2) and protected specimen brushes (PSB). After DNA extraction, we amplified the V3V4 region of the 16S rRNA gene, and performed paired-end sequencing (Illumina MiSeq). Initial bioinformatic processing was carried out in the QIIME-2 pipeline, identifying amplicon sequence variants (ASVs) with the DADA2 algorithm. Potentially contaminating ASVs were identified and removed using the decontam package in R and the sequenced NCS.

Results

A final table of 551 ASVs consisted of 19 × 106 sequences. Alpha diversity was lower in the second exam for OW samples, and borderline lower for PBAL1, with larger differences in subjects not having received intercurrent antibiotics. Permutational tests of beta diversity indicated that within-individual changes were significantly lower than between-individual changes. A non-parametric trend test showed that differences in composition between the two exams (beta diversity) were largest in the PSBs, and that these differences followed a pattern of PSB > PBAL2 > PBAL1 > OW. Time between procedures was not associated with increased diversity.

Conclusion

The airways microbiota varied between examinations. However, there is compositional microbiota stability within a person, beyond that of chance, supporting the notion of a transient airways microbiota with a possibly more stable individual core microbiome.
Quantitative analysis of the ACL and PCL using T1rho and T2 relaxation time mapping: an exploratory, cross-sectional comparison between OA and healthy control knees
Authors: Ranmuthu Chanuka D. S. , MacKay James W. , Crowe Victoria A. , Kaggie Joshua D. , Kessler Dimitri A. , McDonnell Stephen M.
Published: October 2021

Background

Quantitative magnetic resonance imaging (MRI) methods such as T1rho and T2 mapping are sensitive to changes in tissue composition, however their use in cruciate ligament assessment has been limited to studies of asymptomatic populations or patients with posterior cruciate ligament tears only. The aim of this preliminary study was to compare T1rho and T2 relaxation times of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) between subjects with mild-to-moderate knee osteoarthritis (OA) and healthy controls.

Methods

A single knee of 15 patients with mild-to-moderate knee OA (Kellgren-Lawrence grades 2–3) and of 6 age-matched controls was imaged using a 3.0 T MRI. Three-dimensional (3D) fat-saturated spoiled gradient recalled-echo images were acquired for morphological assessment and T1ρ- and T2-prepared pseudo-steady-state 3D fast spin echo images for compositional assessment of the cruciate ligaments. Manual segmentation of whole ACL and PCL, as well as proximal / middle / distal thirds of both ligaments was carried out by two readers using ITK-SNAP and mean relaxation times were recorded. Variation between thirds of the ligament were assessed using repeated measures ANOVAs and differences in these variations between groups using a Kruskal-Wallis test. Inter- and intra-rater reliability were assessed using intraclass correlation coefficients (ICCs).

Results

In OA knees, both T1rho and T2 values were significantly higher in the distal ACL when compared to the rest of the ligament with the greatest differences in T1rho (e.g. distal mean = 54.5 ms, proximal = 47.0 ms, p < 0.001). The variation of T2 values within the PCL was lower in OA knees (OA: distal vs middle vs proximal mean = 28.5 ms vs 29.1 ms vs 28.7 ms, p = 0.748; Control: distal vs middle vs proximal mean = 26.4 ms vs 32.7 ms vs 33.3 ms, p = 0.009). ICCs were excellent for the majority of variables.

Conclusion

T1rho and T2 mapping of the cruciate ligaments is feasible and reliable. Changes within ligaments associated with OA may not be homogeneous. This study is an important step forward in developing a non-invasive, radiological biomarker to assess the ligaments in diseased human populations in-vivo.
Nattokinase crude extract enhances oral mucositis healing
Authors: Zhang Junyao , Tang Yu , Yuan Tao , Yang Mengting , Fang Wenjing , Li Li , Fei Fei , Gong Aihua
Published: October 2021

Background

Nattokinase (NK) is a promising alternative in the prevention and treatment of cardiovascular diseases due to its potent fibrinolytic activity. In this study, we investigated the effect of crude nattokinase extract on the healing of acetic acid-induced oral mucositis in mice.

Methods

Bacillus subtilis culture media (BSCM) was isolated into the supernatant, named nattokinase crude extract (NCE), and the pellet was named Bacillus subtilis mass (BSM). An oral mucositis model was established in mice by applying 50% glacial acetic acid to the buccal mucosa. According to the treatment conditions, the mice were divided into BSCM, NCE, BSM and phosphate buffered saline (PBS) groups. The weight of the mice, oral mucositis healing score and histopathological examination were used to evaluate the treatment.

Results

Fibrinolytic activities of BSCM, NCE and BSM were approximately 8069, 10,800 and 80 U/ml, respectively. The weight gain of mice in the NCE group was significantly different from the PBS group after three days’ treatment (p < 0.05). The oral mucositis score of NCE group was significantly higher than other groups (p < 0.05). The differences in histopathology scores between the NCE and other groups were statistically significant (p < 0.01).

Conclusions

NCE could possess remarkable potential to reduce pain and promote oral mucositis healing with minimal safety concerns. In this study, we first report that NCE from the supernatant of Bacillus subtilis can promote the healing of oral mucositis, which extends the application scope of NK.
Coping strategies mediate the association between stigma and fertility quality of life in infertile women undergoing in vitro fertilization-embryo transfer
Authors: Jing Xiaoyu , Gu Wei , Zhang Lu , Miao Runna , Xu Xiuli , Wang Min , Ramachandran Hadassah Joann , Wang Wenru
Published: November 2021

Background

The mediating role of coping strategies and its relationship with psychological well-being and quality of life has been considered in the literature. However, there is little research to explore the mechanism of coping strategies on stigma and fertility quality of life (FertiQoL) in infertile women undergoing In Vitro Fertilization Embryo Transfer (IVF-ET). The aim of this study was to examine the mediating effect of coping strategies on the relationship between stigma and fertility quality of life (FertiQoL) in Chinese infertile women undergoing In Vitro Fertilization Embryo Transfer (IVF-ET).

Methods

In this cross-sectional study, a total of 768 infertile women undergoing IVF-ET were recruited from Assisted Reproductive Center of Shaanxi Province, China. The personal information, infertility stigma scale, coping strategy scale and FertiQoL scale were measured using a set of questionnaires. The multiple mediator model was performed using AMOS 21.0.

Results

The model showed a significant negative direct effect between stigma on FertiQoL. There were significantly negative indirect effects of stigma on FertiQoL through active-avoidance, active-confronting and passive-avoidance, respectively. The meaning-based coping played a positive intermediary role. The model explained 69.4% of the variance in FertiQoL.

Conclusion

Active-avoidance coping strategy is the most important mediator factor between stigma and FertiQoL in infertile women undergoing IVF-ET treatment. Meaning-based coping strategy plays a positive mediating role between stigma and FertiQoL.
Developing best practices for PPE Portraits across 25 sites: a systematic assessment of implementation and spread of adaptations using FRAME
Authors: Baratta Juliana , Amano Alexis , Parsons Paige K , Vilendrer Stacie , Winter Shira G. , Verano Mae-Richelle , Perez Cynthia , Kalanithi Lucy , Asch Steven M , Heffernan Mary Beth , Brown-Johnson Cati
Published: October 2021

Background

Adaptation, a form of modification that aims to improve an intervention’s acceptability and sustainability in each context, is essential to successful implementation in some settings. Due to the COVID-19 pandemic, clinicians have rapidly adapted how they deliver patient care. PPE Portraits are a form of adaptation, whereby health workers affix a postcard size portrait of themselves to the front of their personal protective equipment (PPE) to foster human connection during COVID-19.

Methods

We used the expanded framework for reporting adaptations and modifications to evidence-based interventions (FRAME) method to better understand the reasoning behind and results of each adaptation. We hypothesized that using the FRAME in conjunction with design-thinking would lead to emerging best practices and that we would find adaptation similarities across sites. Throughout multiple implementations across 25 institutions, we piloted, tracked, and analyzed adaptations using FRAME and design thinking. For each adaptation, we assessed the stage of implementation, whether the change was planned, decision makers involved, level of delivery impacted, fidelity to original intervention, and the goal and reasoning for adaptation. We added three crucial components to the FRAME: original purpose of the adaptation, unintended consequences, and alternative adaptations.

Results

When implementing PPE Portraits across settings, from a local assisted living center’s memory unit to a pediatric emergency department, several requests for adaptations arose during early development stages before implementation. Adaptations primarily related to (1) provider convenience and comfort, (2) patient populations, and (3) scale. Providers preferred smaller portraits and rounded (rather than square) laminated edges that could potentially injure a patient. Affixing the portrait with a magnet was rejected given the potential choking hazard the magnetic strip presented for children. Other adaptations, related to ease of dissemination, included slowing the process down during early development and providing buttons, which could be produced easily at scale.

Conclusions

The FRAME was used to curate the reasoning for each adaptation and to inform future dissemination. We look forward to utilizing FRAME including our additions and design thinking, to build out a range of PPE Portrait best practices with accompanying costs and benefits.
Whether high government subsidies reduce the healthcare provision of township healthcare centers in rural China
Authors: Shen Chi , Zhou Zhongliang , Lai Sha , Dong Wanyue , Zhao Yaxin , Cao Dan , Zhao Dantong , Ren Yangling , Fan Xiaojing
Published: October 2021

Background

China’s government launched a large-scale healthcare reform from 2009. One of the main targets of this round reform was to improve the primary health care system. Major reforms for primary healthcare institutions include increasing government investment. However, there are insufficient empirical studies based on large sample to catch long-term effect of increased government subsidy and lack of sufficient incentives on township healthcare centers (THCs), therefore, this study aims to provide additional empirical evidence on the concern by conducting an empirical analysis of THCs in Shaanxi province in China.

Methods

We collected nine years (2009 to 2017) data of THCs from the Health Finance Annual Report System (HFARS) that was acquired from the Health Commission of Shaanxi Province. We applied two-way fixed effect model and continue difference-in-difference (DID) model to estimate the effect of percentage of government subsidy on medical provision.

Results

A clear jump of the average percentage of government subsidy to total revenue of THCs can be found in Shaanxi province in 2011, and the average percentage has been more than 60% after 2011. Continue DID models indicate every 1% percentage of government subsidy to total revenue increase after 2011 resulted in a decrease of 1.1 to 3.5% in THCs healthcare provision (1.9% in medical revenue, 1.2% in outpatient visit, 3.5% in total occupy beds of inpatient, 1.1% in surgery revenue, 2.1% in sickbed utilization rate). The results show that the THCs with high government subsidy reduce the number of medical services after 2011.

Conclusions

We think that it is no doubt that the government should take more responsibility for the financing of primary healthcare institutions, the problem is when government plays a central role in the financing and delivery of primary health care services, more effective incentives should be developed.
The degree of equity and coupling coordination of staff in primary medical and health care institutions in China 2013–2019
Authors: Ren Weicun , Tarimo Clifford Silver , Sun Lei , Mu Zihan , Ma Qian , Wu Jian , Miao Yudong
Published: October 2021

Background

Primary medical and health care facilities are the first lines of defense for the health of population. This study aims to evaluate the current state and trend of equity and coupling coordination degree (CCD) of staff in primary medical and health care institutions (SPMHCI) based on the quantity and living standards of citizens in China 2013–2019. The research findings are expected to serve as a guideline for the allocation of SPMHCI.

Methods

The data used in this study including the quantity and living standards of citizens, as well as the number of SPMHCI in 31 provincial administrative regions of China, were obtained from the China Statistical Yearbook and the China Health Statistics Yearbook. The equity and CCD for SPMHCI were analyzed by using the Gini coefficient and the CCD model, and the Grey forecasting model GM (1, 1) (GM) was used to predict the equity and CCD from 2020 to 2022.

Results

Between 2013 and 2019, the number of SPMHCI increased from 3.17 million to 3.50 million, and the population-based Gini coefficient declined from 0.0704 to 0.0513. In urban and rural areas, the Gini coefficients decreased from 0.1185 and 0.0737 to 0.1025 and 0.0611, respectively. The CCD between SPMHCI and citizens’ living standards (CLS) changed from 0.5691, 0.5813, 0.5818 to 0.5650, 0.5634, 0.6088 at national, urban, and rural levels, respectively. The forecasting results of GM revealed that at the national, urban and rural levels from 2020 to 2022, the Gini coefficient would rise at a rate of − 13.53, − 5.77%, and − 6.10%, respectively, while the CCD would grow at a rate of - 0.89, 1.06, and 0.87%, respectively.

Conclusions

In China, the number of SPMHCI has increased significantly, with an equitable allocation based on the population. The interaction between SPMHCI and CLS is sufficient, but the degree of mutual promotion is moderate. The government could optimize SPMHCI and improve the chronic disease management services to improve CLS and to ensure the continued operation of primary medical and health care institutions in urban areas.