bluuebunny/crossref_metadata_2025 huggingface dataset:
Embodying Meaning Visually: From Perceptual Dynamics to Motion Kinematics
Authors: Coëgnarts Maarten , Slugan Mario
Published: January 2022

This paper adopts an embodied cognitive perspective to review the significance of dynamic patterns in the visual expression of meaning. Drawing upon the work of Rudolf Arnheim we first show how perceptual dynamics of inanimate objects might be extended in order to structure abstract meaning in fixed images such as paintings. Second, we evaluate existing experimental work that shows how simple kinematic structures within a stationary frame might embody such high-level properties as perceptual causality and animacy. Third and last, we take inspiration from these experiments to shed light on the expressiveness of dynamic patterns that unfold once the frame itself becomes a mobile entity (i.e., camera movement). In the latter case we will also present a filmic case study, showing how filmmakers might resort to these dynamic patterns so as to embody a film’s story content, while simultaneously offering a further avenue for film scholars to deepen their engagement with the experimental method.
An unknown world in the Neotropical region: a complete life cycle of a new species of Monoclona Mik, 1886 (Diptera: Mycetophilidae: Sciophilinae)
Authors: AMARAL EDNA MARIA , OLIVEIRA SARAH SIQUEIRA , FALASCHI RAFAELA LOPES
Published: January 2022

Popularly known as fungus gnats, Mycetophilidae are found in humid environments usually associated with mushrooms and decaying wood. Their immature forms often feed on fungus fruiting bodies. Similar to most bibionomorphans, mycetophilids need due attention concerning their taxonomy and information on their natural history, especially in the Neotropical region. This work describes Monoclona carambeiensis sp. nov., a new species of Monoclona Mik, and furnishes information on the morphology of adults and immatures, besides notes and photographs on the life cycle of the species. Immature forms present on a piece of decaying wood with lichens and fungi were collected from Carambeí, Paraná, and reared in the laboratory. The emerged adult male was fixed in 80% ethanol. This is the first study describing an immature of a Neotropical species of Monoclona, and also the first record of the genus in the state of Paraná, Brazil. This is the third Neotropical species of Mycetophilidae to have its life cycle described, for a fauna with over 1,100 known species.
A new species of Nigrobaetis Novikova & Kluge, 1987 (Ephemeroptera, Baetidae) from Tamil Nadu, India
Authors: SIVARUBAN T. , SRINIVASAN PANDIARAJAN , BARATHY S. , ISACK RAJASEKARAN
Published: January 2022

Nigrobaetis klugei sp. nov. is described based on nymphs from the Sastha falls of Western Ghats, Southern India. The nymph of Nigrobaetis klugei sp. nov. can be distinguished from other Oriental species of Nigrobaetis by the following combination of characters: (i) dorsal surface of the labrum with 1+3 long simple stout setae on the distal half; (ii) paraproct distally not expanded, with a reduced number of spines on distal margin (three large and two small spines); (iii) paraglossae slender, approximately as wide as glossae; (iv) absence of medioproximal spots in the abdominal tergites and (v) long and pointed triangular spines at the distal margin of abdominal tergites.
Rural Otolaryngology Care Disparities: A Scoping Review
Authors: Urban Matthew J. , Shimomura Aoi , Shah Swapnil , Losenegger Tasher , Westrick Jennifer , Jagasia Ashok A.
Published: January 2022

Objective

To broadly synthesize the literature regarding rural health disparities in otolaryngology, categorize findings, and identify research gaps to stimulate future work.

Study Design

Scoping review.

Data Sources

A comprehensive literature search was performed in the following databases: PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar, and CINAHL.

Review Methods

The methods were developed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews checklist. Peer‐reviewed, English‐language, US‐based studies examining a rural disparity in otolaryngology‐related disease incidence, prevalence, diagnosis, treatment, or outcome were included. Descriptive studies, commentaries, reviews, and letters to the editor were excluded. Studies published prior to 1980 were excluded.

Results

The literature search resulted in 1536 unique abstracts and yielded 79 studies that met final criteria for inclusion. Seventy‐five percent were published after 2010. The distribution of literature was as follows: otology (34.2%), head and neck cancer (20.3%), endocrine surgery (13.9%), rhinology and allergy (8.9%), trauma (5.1%), laryngology (3.8%), other pediatrics (2.5%), and adult sleep (1.3%). Studies on otolaryngology health care systems also accounted for 10.1%. The most common topics studied were practice patterns (41%) and epidemiology (27%), while the Southeast (47%) was the most common US region represented, and database study (42%) was the most common study design.

Conclusion

Overall, there was low‐quality evidence with large gaps in the literature in all subspecialties, most notably facial plastic surgery, laryngology, adult sleep, and pediatrics. Importantly, there were few studies on intervention and zero studies on resident exposure to rural populations, which will be critical to making rural otolaryngology care more equitable in the future.
Solution of steering angle based on homogeneous transformation
Authors: Kou Farong , Zhang Xinqian , Xu Jiannan
Published: January 2022

Steering Angle is related to the design and optimization of steering mechanism and suspension, but it is not equal to the angle of knuckle around kingpin because of the existence of wheel alignment parameters. To calculate the steering angle, this paper derives based on homogeneous transformation its function expression by analyzing spatial geometric relation between the two angles and calculating coordinates related to steering trajectory of wheel center. Then, multi-body model of McPherson suspension with steering system is built and the calculation correctness is verified by comparing the function curve plotted by MATLAB software with the curve simulated by Adams/Car software. The calculation and simulation indicate that between the two angles, there is a ratio which is related to wheel alignment parameters and greater than 1.
Genetic barcoding systematically compares genes in del(5q) MDS and reveals a central role for CSNK1A1 in clonal expansion
Authors: Stalmann Ursula S. A. , Ticconi Fabio , Snoeren Inge A. M. , Li Ronghui , Gleitz Hélène F. E. , Cowley Glenn S. , McConkey Marie E. , Wong Aaron B. , Schmitz Stephani , Fuchs Stijn N. R. , Sood Shubhankar , Leimkühler Nils B. , Martinez-Høyer Sergio , Banjanin Bella , Root David , Brümmendorf Tim H. , Pearce Juliette E. , Schuppert Andreas , Bindels Eric M. J. , Essers Marieke A. , Heckl Dirk , Stiehl Thomas , Costa Ivan G. , Ebert Benjamin L. , Schneider Rebekka K.
Published: January 2022

How genetic haploinsufficiency contributes to the clonal dominance of hematopoietic stem cells (HSCs) in del(5q) myelodysplastic syndrome (MDS) remains unresolved. Using a genetic barcoding strategy, we performed a systematic comparison on genes implicated in the pathogenesis of del(5q) MDS in direct competition with each other and wild-type (WT) cells with single-clone resolution. Csnk1a1 haploinsufficient HSCs expanded (oligo)clonally and outcompeted all other tested genes and combinations. Csnk1a1−/+ multipotent progenitors showed a proproliferative gene signature and HSCs showed a downregulation of inflammatory signaling/immune response. In validation experiments, Csnk1a1−/+ HSCs outperformed their WT counterparts under a chronic inflammation stimulus, also known to be caused by neighboring genes on chromosome 5. We therefore propose a crucial role for Csnk1a1 haploinsufficiency in the selective advantage of 5q-HSCs, implemented by creation of a unique competitive advantage through increased HSC self-renewal and proliferation capacity, as well as increased fitness under inflammatory stress.
Classifying microscopic images as acute lymphoblastic leukemia by Resnet ensemble model and Taguchi method
Authors: Chen Yao-Mei , Chou Fu-I , Ho Wen-Hsien , Tsai Jinn-Tsong
Published: January 2022

Background

Researchers have attempted to apply deep learning methods of artificial intelligence for rapidly and accurately detecting acute lymphoblastic leukemia (ALL) in microscopic images.

Results

A Resnet101-9 ensemble model was developed for classifying ALL in microscopic images. The proposed Resnet101-9 ensemble model combined the use of the nine trained Resnet-101 models with a majority voting strategy. Each trained Resnet-101 model integrated the well-known pre-trained Resnet-101 model and its algorithm hyperparameters by using transfer learning method to classify ALL in microscopic images. The best combination of algorithm hyperparameters for the pre-trained Resnet-101 model was determined by Taguchi experimental method. The microscopic images used for training of the pre-trained Resnet-101 model and for performance tests of the trained Resnet-101 model were obtained from the C-NMC dataset. In experimental tests of performance, the Resnet101-9 ensemble model achieved an accuracy of 85.11% and an F1-score of 88.94 in classifying ALL in microscopic images. The accuracy of the Resnet101-9 ensemble model was superior to that of the nine trained Resnet-101 individual models. All other performance measures (i.e., precision, recall, and specificity) for the Resnet101-9 ensemble model exceeded those for the nine trained Resnet-101 individual models.

Conclusion

Compared to the nine trained Resnet-101 individual models, the Resnet101-9 ensemble model had superior accuracy in classifying ALL in microscopic images obtained from the C-NMC dataset.
A scaffold-level genome assembly of a minute pirate bug, Orius laevigatus (Hemiptera: Anthocoridae), and a comparative analysis of insecticide resistance-related gene families with hemipteran crop pests
Authors: Bailey Emma , Field Linda , Rawlings Christopher , King Rob , Mohareb Fady , Pak Keywan-Hassani , Hughes David , Williamson Martin , Ganko Eric , Buer Benjamin , Nauen Ralf
Published: January 2022

Background

Orius laevigatus, a minute pirate bug, is a highly effective beneficial predator of crop pests including aphids, spider mites and thrips in integrated pest management (IPM) programmes. No genomic information is currently available forO. laevigatus, as is the case for the majority of beneficial predators which feed on crop pests. In contrast, genomic information for crop pests is far more readily available. The lack of publicly available genomes for beneficial predators to date has limited our ability to perform comparative analyses of genes encoding potential insecticide resistance mechanisms between crop pests and their predators. These mechanisms include several gene/protein families including cytochrome P450s (P450s), ATP binding cassette transporters (ABCs), glutathione S-transferases (GSTs), UDP-glucosyltransferases (UGTs) and carboxyl/cholinesterases (CCEs).

Methods and findings

In this study, a high-quality scaffold level de novo genome assembly forO. laevigatushas been generated using a hybrid approach with PacBio long-read and Illumina short-read data. The final assembly achieved a scaffold N50 of 125,649 bp and a total genome size of 150.98 Mb. The genome assembly achieved a level of completeness of 93.6% using a set of 1658 core insect genes present as full-length genes. Genome annotation identified 15,102 protein-coding genes - 87% of which were assigned a putative function.

Comparative analyses revealed gene expansions of sigma class GSTs and CYP3 P450s. Conversely the UGT gene family showed limited expansion. Differences were seen in the distributions of resistance-associated gene families at the subfamily level betweenO. laevigatusand some of its targeted crop pests. A target site mutation in ryanodine receptors (I4790M, PxRyR) which has strong links to diamide resistance in crop pests and had previously only been identified in lepidopteran species was found to also be present in hemipteran species, includingO. laevigatus.

Conclusion and significance

This assembly is the first published genome for the Anthocoridae family and will serve as a useful resource for further research into target-site selectivity issues and potential resistance mechanisms in beneficial predators. Furthermore, the expansion of gene families often linked to insecticide resistance may be an indicator of the capacity of this predator to detoxify selective insecticides. These findings could be exploited by targeted pesticide screens and functional studies to increase effectiveness of IPM strategies, which aim to increase crop yields by sustainably, environmentally-friendly and effectively control pests without impacting beneficial predator populations.
A modified decision tree approach to improve the prediction and mutation discovery for drug resistance in Mycobacterium tuberculosis
Authors: Deelder Wouter , Napier Gary , Campino Susana , Palla Luigi , Phelan Jody , Clark Taane G.
Published: January 2022

Background

Drug resistant Mycobacterium tuberculosis is complicating the effective treatment and control of tuberculosis disease (TB). With the adoption of whole genome sequencing as a diagnostic tool, machine learning approaches are being employed to predict M. tuberculosis resistance and identify underlying genetic mutations. However, machine learning approaches can overfit and fail to identify causal mutations if they are applied out of the box and not adapted to the disease-specific context. We introduce a machine learning approach that is customized to the TB setting, which extracts a library of genomic variants re-occurring across individual studies to improve genotypic profiling.

Results

We developed a customized decision tree approach, called Treesist-TB, that performs TB drug resistance prediction by extracting and evaluating genomic variants across multiple studies. The application of Treesist-TB to rifampicin (RIF), isoniazid (INH) and ethambutol (EMB) drugs, for which resistance mutations are known, demonstrated a level of predictive accuracy similar to the widely used TB-Profiler tool (Treesist-TB vs. TB-Profiler tool: RIF 97.5% vs. 97.6%; INH 96.8% vs. 96.5%; EMB 96.8% vs. 95.8%). Application of Treesist-TB to less understood second-line drugs of interest, ethionamide (ETH), cycloserine (CYS) and para-aminosalisylic acid (PAS), led to the identification of new variants (52, 6 and 11, respectively), with a high number absent from the TB-Profiler library (45, 4, and 6, respectively). Thereby, Treesist-TB had improved predictive sensitivity (Treesist-TB vs. TB-Profiler tool: PAS 64.3% vs. 38.8%; CYS 45.3% vs. 30.7%; ETH 72.1% vs. 71.1%).

Conclusion

Our work reinforces the utility of machine learning for drug resistance prediction, while highlighting the need to customize approaches to the disease-specific context. Through applying a modified decision learning approach (Treesist-TB) across a range of anti-TB drugs, we identified plausible resistance-encoding genomic variants with high predictive ability, whilst potentially overcoming the overfitting challenges that can affect standard machine learning applications.
Transcriptome analysis provides new insights into plants responses under phosphate starvation in association with chilling stress
Authors: Gao Xiaoning , Dong Jinsong , Rasouli Fatemeh , Pouya Ali Kiani , Tahir Ayesha T. , Kang Jun
Published: January 2022

Background

Chilling temperature reduces the rate of photosynthesis in plants, which is more pronounced in association with phosphate (Pi) starvation. Previous studies showed that Pi resupply improves recovery of the rate of photosynthesis in plants much better under combination of dual stresses than in non-chilled samples. However, the underlying mechanism remains poorly understood.

Results

In this study, RNA-seq analysis showed the expression level of 41 photosynthetic genes in plant roots increased under phosphate starvation associated with 4 °C (-P 4 °C) compared to -P 23 °C. Moreover, iron uptake increased significantly in the stem cell niche (SCN) of wild type (WT) roots in -P 4 °C. In contrast, lower iron concentrations were found in SCN of aluminum activated malate transporter 1 (almt1) and its transcription factor, sensitive to protein rhizotoxicity 1 (stop1) mutants under -P 4 °C. The Fe content examined by ICP-MS analysis in -P 4 °C treated almt1 was 98.5 ng/µg, which was only 17% of that of seedlings grown under -P 23 °C. Average plastid number in almt1 root cells under -P 4 °C was less than -P 23 °C. Furthermore, stop1 and almt1 single mutants both exhibited increased primary root elongation than WT under combined stresses. In addition, dark treatment blocked the root elongation phenotype of stop1 and almt1.

Conclusions

Induction of photosynthetic gene expression and increased iron accumulation in roots is required for plant adjustment to chilling in association with phosphate starvation.
What constitutes ‘good’ home care for people with dementia? An investigation of the views of home care service recipients and providers
Authors: Goh Anita M. Y. , Polacsek Meg , Malta Sue , Doyle Colleen , Hallam Brendan , Gahan Luke , Low Lee Fay , Cooper Claudia , Livingston Gill , Panayiotou Anita , Loi Samantha M. , Omori Maho , Savvas Steven , Burton Jason , Ames David , Scherer Samuel C. , Chau Nadia , Roberts Stefanie , Winbolt Margaret , Batchelor Frances , Dow Briony
Published: January 2022

Background

Our objective was to explore what people receiving and providing care consider to be ‘good’ in-home care for people living with dementia.

Methods

We conducted 36 in-depth interviews and two focus groups with key stakeholders in Australia in the first quarter of 2018. Participants included those receiving care (4 people living with dementia, 15 family carers) or providing care (9 case managers, 5 service managers, 10 home care workers). Qualitative thematic analysis was guided by Braun and Clarke’s six-step approach.

Results

Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers’ understanding of dementia and its impact; 2) Home care workers’ demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers’ knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers.

Conclusions

It is crucial to consider the views and opinions of each stakeholder group involved in providing/receiving dementia care from home care workers, to inform workforce training, education program design and service design. Results can be used to inform and empower home care providers, policy, and related decision makers to guide the delivery of improved home care services.

Trial registration

ACTRN 12619000251123.
Utility of fetal facial markers on a second trimester genetic sonogram in screening for Down syndrome in a high-risk Thai population
Authors: Pranpanus Savitree , Keatkongkaew Kanokkarn , Suksai Manaphat
Published: January 2022

Background

To establish the reference ranges and evaluate the efficacy of the fetal facial sonomarkers prenasal thickness (PT), nasal bone length (NBL), PT/NBL ratio and NBL/PT ratio for Down syndrome screening in the second trimester of high-risk pregnancies using two-dimensional (2D) ultrasound.

Methods

A prospective study was done in Thai pregnant women at high risk for structural and chromosomal abnormalities between May 2018 and May 2019. The main exclusion criteria were any fetal anatomical anomaly detected on ultrasonography or postpartum examination, abnormal chromosome or syndrome other than Down syndrome. Ultrasounds were performed in 375 pregnant women at 14 to 22 weeks’ gestation and the fetal facial parameters were analyzed. Down syndrome results were confirmed by karyotyping. The reference ranges of these facial ultrasound markers were constructed based on the data of our population. The Down syndrome screening performance using these facial ultrasound markers was evaluated.

Results

In total, 340 euploid fetuses and 11 fetuses with Down syndrome met the inclusion criteria. The PT, NBL, and PT/NBL ratios in the euploid fetuses gradually increased with gestation progression while the NBL/PT ratio gradually decreased between 14–22 weeks’ gestation. The NBL, PT/NBL ratio, and NBL/PT ratio all had 100% sensitivity and PT had 91% sensitivity. These facial markers had 100% negative predictive value for Down syndrome screening in the second trimester. The Bland–Altman analysis showed the intra- and inter-observer variations of PT and NBL had high intraclass correlation coefficients (ICC) in both operators, with ICCs of 0.98 and 0.99 and inter-observer ICCs of 0.99 for both operators.

Conclusion

The facial ultrasound markers are very useful for second trimester Down syndrome screening in our population. These facial ultrasound markers were easily identifiable and highly consistent either intra- or inter-operator by using widely-available 2D ultrasound. However, the reference ranges for these markers need to be constructed based on individual populations.

Trial registration

Registration number: REC 61–029-12–3. Date of registration: 18 May 2018.
Anti-PD-1 combined sorafenib versus anti-PD-1 alone in the treatment of advanced hepatocellular cell carcinoma: a propensity score-matching study
Authors: Chen San-Chi , Huang Yi-Hsiang , Chen Ming-Huang , Hung Yi-Ping , Lee Rheun-Chuan , Shao Yu-Yun , Chao Yee
Published: January 2022

Background

Vascular endothelial growth factor (VEGF) plays a role in the tumor microenvironment. Sorafenib, which inhibits the VEGF pathway, has an immune-modulation function but lacks substantial clinical data. This study aims to explore the efficacy of anti-PD-1 combined sorafenib in advanced hepatocellular carcinoma (HCC).

Methods

HCC patients who underwent anti-PD-1 treatment at Taipei Veterans General Hospital (Taipei, Taiwan) between January 2016 and February 2019 were reviewed. The efficacy was compared between groups after propensity-score matching.

Results

There were 173 HCC patients receiving anti-PD-1. After excluding unsuitable cases, 140 patients were analyzed, of which 58 received combination therapy and 82 received anti-PD-1 alone. The combination therapy had a trend of higher CR rate (8.6% vs. 4.9%, ns.), ORR (22.4% vs. 19.5%, ns.) and significantly higher DCR (69.0% vs. 37.8%, p < 0.05) comparing to anti-PD-1 alone. After matching, combination group achieved longer progression-free survival (3.87 vs. 2.43 months, p < 0.05) and overall survival (not reached vs. 7.17 months, p < 0.05) than anti-PD-1 alone, without higher grade 3/4 AE (10.3% vs. 7.1%, p = 0.73). The tumor response varied among different metastatic sites, with high responses in adrenal glands, peritoneum and lungs. The more AFP declined (> 10, > 50 and > 66%), the higher the ORR (70, 80 and 92%) and CR rates (30, 35 and 58%) were achieved at day 28.

Conclusions

This is the first study to demonstrate the combination of anti-PD-1 and sorafenib had better efficacy and survival benefit. A prospective randomized study is needed to confirm this finding.
Which urban communities are susceptible to COVID-19? An empirical study through the lens of community resilience
Authors: Shi Chunyu , Liao Liao , Li Huan , Su Zhenhua
Published: January 2022

Background

After the lockdown of Wuhan on January 23, 2020, the government used community-based pandemic prevention and control as the core strategy to fight the pandemic, and explored a set of standardized community pandemic prevention measures that were uniformly implemented throughout the city. One month later, the city announced its first lists of “high-risk” communities and COVID-19-free communities. Under the standardized measures of pandemic prevention and mitigation, why some communities showed a high degree of resilience and effectively avoided escalation, while the situation spun out of control in other communities? This study investigated: 1) key factors that affect the effective response of urban communities to the pandemic, and 2) types of COVID-19 susceptible communities.

Methods

This study employs the crisp-set qualitative comparative analysis method to explore the influencing variables and possible causal condition combination paths that affect community resilience during the pandemic outbreak. Relying on extreme-case approach, 26 high-risk communities and 14 COVID-19 free communities were selected as empirical research subjects from the lists announced by Wuhan government. The community resilience assessment framework that evaluates the communities’ capacity on pandemic prevention and mitigation covers four dimensions, namely spatial resilience, capital resilience, social resilience, and governance resilience, each dimension is measured by one to three variables.

Results

The results of measuring the necessity of 7 single-condition variables found that the consistency index of “whether the physical structure of the community is favorable to virus transmission” reached 0.9, which constitutes a necessary condition for COVID-19 susceptible communities. By analyzing the seven condition configurations with high row coverage and unique coverage in the obtained complex solutions and intermediate solutions, we found that outbreaks are most likely to occur in communities populated by disadvantaged populations. However, if lacking spatial-, capital-, and governance resilience, middle-class and even wealthy communities could also become areas where COVID-19 spreads easily.

Conclusions

Three types of communities namely vulnerable communities, alienated communities, and inefficient communities have lower risk resilience. Spatial resilience, rather than social resilience, constitutes the key influencing factor of COVID-19-susceptible communities, and the dual deficiencies of social resilience and governance resilience are the common features of these communities.
Application effect of computer-aided design combined with three-dimensional printing technology in autologous tooth transplantation: a retrospective cohort study
Authors: Han Shuang , Wang Hui , Chen Jue , Zhao Jihong , Zhong Haoyan
Published: January 2022

Background

The activity of donor periodontal membrane is the key factor of autologous tooth healing. The application of digital aided design, 3D printing model and guide plate in autotransplantation of tooth (ATT) is expected to reduce the damage of periodontal membrane and preserve the activity of periodontal membrane, so as to improve the success rate of ATT. This study tried to prove the role of digital technology in improving the success rate of ATT, although there are differences in model accuracy in practice.

Methods

We included 41 tooth autotransplantation cases which assisted by 3D-printed donor models and surgical guides and divided them into two groups in accordance with whether the donor tooth could be placed successfully after the preparation of alveolar socket guided by the model tooth. Then, we compared and analyzed the preparation time of alveolar socket, extra-alveolar time, and number of positioning trials of the donor tooth between the two groups. We also included a comparison of the in vitro time of the donor tooth with that of 15 min. The incidence of complications was included in the prognostic evaluation.

Results

The mean preparation time of the alveolar socket, mean extra-alveolar time of donor tooth, and mean number of positioning trials with donor tooth of 41 cases were 12.73 ± 6.18 min, 5.56 ± 3.11 min, and 2.61 ± 1.00, respectively. The group wherein the donor tooth cannot be placed successfully (15.57 ± 6.14 min, 7.29 ± 2.57 min) spent more preparation time of alveolar socket and extra-alveolar time than the group wherein the donor tooth can be placed successfully (9.75 ± 4.73 min, 3.75 ± 2.57 min). The number of positioning trials with the donor tooth of the group wherein the donor tooth cannot be placed successfully (3.19 ± 0.75) was higher than that of the other group (2.00 ± 0.86). There was no significant difference in survival rates between the two groups.

Conclusions

Compared with the traditional tooth autotransplantation, the introduction of computer-aided design combined with 3D printing of the model tooth and surgical guides evidently shortens the preparation time of the alveolar socket and the extra-alveolar time of the donor tooth and reduces the number of positioning trials with the donor tooth regardless of the shape deviation between the model and actual teeth.
Euterpe oleracea fruit (Açai)-enriched diet suppresses the development of experimental cerebral malaria induced by Plasmodium berghei (ANKA) infection
Authors: Oliveira Karen Renata Herculano Matos , Torres Marjorie Lujan Marques , Kauffmann Nayara , de Azevedo Ataíde Brenda Jaqueline , de Souza Franco Mendes Nívia , dos Anjos Larissa Medeiros , dos Santos Borges Rosivaldo , Bahia Carlomagno Pacheco , Leão Luana Ketlen Reis , da Conceição Fonseca Passos Adelaide , Herculano Anderson Manoel , de Jesus Oliveira Batista Evander
Published: January 2022

Background

Cerebral malaria is one of the most severe complications attributed to protozoal infection byPlasmodium falciparum, gaining prominence in children mortality rates in endemic areas. This condition has a complex pathogenesis associated with behavioral, cognitive and motor sequels in humans and current antimalarial therapies have shown little effect in those aspects. Natural products with antioxidant and anti-inflammatory properties have become a valuable alternative therapeutic option in the treatment of distinct conditions. In this context, this study investigated the neuroprotective effect ofEuterpe oleracea(açai) enriched diet during the development of experimental cerebral malaria induced by the inoculation of Swiss albino mice withPlasmodium bergheiANKA strain.

Methods

AfterPlasmodiuminfection, animals were maintained on a feeding withEuterpe oleraceaenriched ration and parameters such as survival curve, parasitemia and body weight were routinely monitored. The present study has also evaluated the effect of açai-enriched diet on the blood-brain barrier leakage, histological alterations and neurocognitive impairments in mice developing cerebral malaria.

Results

Our results demonstrate that between 7th–19th day post infection the survival rate of the group treated with açai enriched ration was higher when compared withPlasmodium-infected mice in which 100% of mice died until the 11th days post-infection, demonstrating that açai diet has a protective effect on the survival of infected treated animals. The same was observed in the brain vascular extravasation, where Evans blue dye assays showed significantly less dye extravasation in the brains ofPlasmodium-infected mice treated with açai enriched ration, demonstrating more preserved blood-brain barrier integrity. Açai-enriched diet also attenuate the histopathological alterations elicited byPlasmodium bergheiinfection. We also showed a decrease of the neurological impairments arising from the exposure of cerebral parenchyma in the group treated with açai diet, ameliorating motor and neuropsychiatric changes, analyzed through the SHIRPA protocol.

Conclusion

With these results, we conclude that the treatment with açai enriched ration decreased the mortality of infected animals, as well as protected the blood-brain barrier and the neurocognitive deficits inPlasmodium-infected animals.
Operationalising a real-time research ethics approach: supporting ethical mindfulness in agriculture-nutrition-health research in Malawi
Authors: Matandika Limbanazo , Millar Kate , Umar Eric , Joy Edward , Mfutso-Bengo Joseph
Published: January 2022

Background

There have been notable investments in large multi-partner research programmes across the agriculture-nutrition-health (ANH) nexus. These studies often involve human participants and commonly require research ethics review. These ANH studies are complex and can raise ethical issues that need pre-field work, ethical oversight and also need an embedded process that can identify, characterise and manage ethical issues as the research work develops, as such more embedded and dynamic ethics processes are needed. This work builds on notions of ‘ethics in practice’ by developing an approach to facilitate ethical reflection within large research programmes. This study explores the application of a novel ‘real-time research ethics approach’ (RTREA) and how this can support ethical mindfulness. This involves embedding ethical analysis and decision-making within research implementation, with a continuous dialogue between participants and researchers. The aim is to improve ethical responsiveness and participant experience, which in turn may ethically support adherence and retention. In this case study, a bioethics team (BT) was embedded in a community-based randomised, controlled trial conducted in rural Malawi, titled the ‘Addressing Hidden Hunger with Agronomy’. To identify ethical issues, the researchers conducted ten focus group discussions, fourteen in-depth interviews with key informants, two workshops, observed two sensitisation and three activity meetings conducted by the trial team, and analysed fifteen reports from pre-trial to trial implementation.

Results

The RTREA facilitated the identification of social and ethical concerns and made researchers aware of participants’ ‘lived research experience’. To address concerns and experiences, the BT worked with researchers to facilitate conversation spaces where social and ethical issues were discussed. Conversation spaces were designed to create partnerships and promote participatory methods to capture trial participants’ (TPs) perspectives and experiences.

Conclusions

The use of RTREA showed the value of real-time and continuous engagement between TPs and researchers. These real-time processes could be embedded to complement traditional ethical guidance and expert opinions. A deeper engagement appeared to support greater operationalising of principles of inclusion, empowerment, and participant autonomy and supported researchers ‘ethical mindfulness’ which in turn may support instrumental outcomes of high recruitment, retention, and adherence levels.
Village health workers as health diplomats: negotiating health and study participation in a malaria elimination trial in The Gambia
Authors: Masunaga Yoriko , Muela Ribera Joan , Jaiteh Fatou , de Vries Daniel H. , Peeters Grietens Koen
Published: January 2022

Background

Although many success stories exist of Village Health Workers (VHWs) improving primary health care, critiques remain about the medicalisation of their roles in disease-specific interventions. VHWs are placed at the bottom of the health system hierarchy as cheap and low-skilled volunteers, irrespective of their highly valued social and political status within communities. In this paper, we shed light on the political role VHWs play and investigate how this shapes their social and medical roles, including their influence on community participation.

Method

The study was carried out within the context of a malaria elimination trial implemented in rural villages in the North Bank of The Gambia between 2016 and 2018. The trial aimed to reduce malaria prevalence by treating malaria index cases and their potentially asymptomatic compound members, in which VHWs took an active role advocating their community and the intervention, mobilising the population, and distributing antimalarial drugs. Mixed-methods research was used to collect and analyse data through qualitative interviews, group discussions, observations, and quantitative surveys.

Results and discussion

We explored the emic logic of participation in a malaria elimination trial and found that VHWs played a pivotal role in representing their community and negotiating with the Medical Research Council to bring benefits (e.g. biomedical care service) to the community. We highlight this representative role of VHWs as‘health diplomats’, valued and appreciated by community members, and potentially increasing community participation in the trial. We argue that VHWs aspire to be politically present and be part of the key decision-makers in the community through their health diplomat role.

Conclusion

It is thus likely that in the context of rural Gambia, supporting VHWs beyond medical roles, in their social and political roles, would contribute to the improved performance of VHWs and to enhanced community participation in activities the community perceive as beneficial.
What makes an effective Quality Improvement Manager? A qualitative study in the New Zealand Health System
Authors: Akmal Adeel , Podgorodnichenko Nataliya , Stokes Tim , Foote Jeff , Greatbanks Richard , Gauld Robin
Published: January 2022

Purpose

Quality improvement is an international priority, and health organisations invest heavily in this endeavour. Little, however, is known of the role and perspectives of Quality Improvement Managers who are responsible for quality improvement implementation. We explored the quality improvement managers’ accounts of what competencies and qualities they require to achieve day-to-day and long-term quality improvement objectives.

Design

Qualitative exploratory design using an interpretivist approach with semi-structured interviews analysed thematically.

Setting and participants.

Interviews were conducted with 56 quality improvement managers from 15 (out of 20) New Zealand District Health Boards. Participants were divided into two groups: traditional and clinical quality improvement managers. The former group consisted of those with formal quality improvement education—typically operations managers or process engineers. The latter group was represented by clinical staff—physicians and nurses—who received on-the-job training.

Results

Three themes were identified: quality improvement expertise, leadership competencies and interpersonal competencies. Effective quality improvement managers require quality improvement experience and expertise in healthcare environments. They require leadership competencies including sense-giving, taking a long-term view and systems thinking. They also require interpersonal competencies including approachability, trustworthiness and supportiveness. Traditional and clinical quality improvement managers attributed different value to these characteristics with traditional quality improvement managers emphasising leadership competencies and interpersonal skills more than clinical quality improvement managers.

Conclusions

We differentiate between traditional and clinical quality improvement managers, and suggest how both groups can be better prepared to be effective in their roles. Both groups require a comprehensive socialisation and training process designed to meet specific learning needs.
Exploring peer navigation and support in the quality of HIV care experiences of female sex workers in the Dominican Republic
Authors: Karver Tahilin Sanchez , Barrington Clare , Donastorg Yeycy , Perez Martha , Gomez Hoisex , Page Kathleen R. , Celentano David , Smith Katherine Clegg , Kerrigan Deanna
Published: January 2022

Background

Despite evidence on peer navigation’s association with positive HIV outcomes, such as engagement in HIV care and antiretroviral therapy (ART) initiation, the mechanisms through which peer navigation may influence these outcomes have been less explored. The purpose of this study is to describe the role of peer navigation and support on enhancing the quality of HIV treatment and care services experienced by female sex workers (FSWs).

Methods

Survey data was derived from a quantitative cohort (n = 211) of FSWs living with HIV in the Dominican Republic and complemented with data from two rounds of in-depth interviews (IDIs) from a qualitative subsample (n = 20 per round). Descriptive statistics and multivariable logistic regressions were used to explore the association between peer navigation and relational aspects of care and overall satisfaction of the quality of HIV treatment and care. Thematic analysis was employed to code and synthesize textual data from IDIs.

Results

41.2% of the participants reported having had contact with a peer navigator in the last 6 months. Qualitative data revealed that peer navigation and support was instrumental in assisting FSWs linkage to HIV care after diagnosis, elevating FSWs’ ability to access more comprehensive clinical care facilities, and promoting agency by improving FSWs’ skills to more strategically and effectively engage with the clinic environment and health care providers. Peer navigation was positively associated with experiencing more respectful treatment by clinic staff (AOR: 6.65, 95% CI: 2.32–19.02), and greater satisfaction with overall HIV care services (AOR: 2.57, 95% CI: 1.77–3.74).

Conclusion

Promoting the full integration of peer navigation into healthcare structures is a strategic approach to enhance the quality of HIV care experienced by FSWs and improve their HIV-related outcomes.
A cost-minimisation analysis of performing point-of-care ultrasonography on patients with vaginal bleeding in early pregnancy in general practice: a decision analytical model
Authors: Kiritharan Swaathi , Johanson Mille Vang , Jensen Martin Bach , Thomsen Janus Nikolaj Laust , Andersen Camilla Aakjær , Jensen Cathrine Elgaard
Published: January 2022

Background

Spotting and light vaginal bleeding are common and usually harmless symptoms in early pregnancy. Still, vaginal bleeding may be the first sign of an abortion and often causes distress to pregnant women and leads to an expectation of an ultrasonography examination of the uterus. As point-of-care ultrasonography (POCUS) is increasingly being integrated into general practice, these patients may be clinically evaluated and managed by general practitioners (GPs). This can potentially reduce referrals of patients from the primary to the secondary healthcare sector resulting in societal cost-savings.

The primary purpose of this study was to investigate whether the accessibility of POCUS in general practice for patients with vaginal bleeding in early pregnancy is cost-saving compared to usual practice where GPs do not have access to POCUS. A secondary purpose of this study was to estimate a remuneration for GPs performing POCUS on these patients in general practice.

Methods

A cost-minimisation analysis was based on a decision tree model reflecting the two alternatives: general practice with and without GPs having access to POCUS. The robustness of the model results was investigated using probabilistic sensitivity analysis and the following deterministic sensitivity analyses: one-way analyses for the model input parameters and a scenario analysis with a change from a societal to a healthcare sector perspective.

An expected remuneration reflecting the add-on cost of Danish GPs performing POCUS was estimated based on the related costs: cost of an ultrasonography scanner, GP’s time consumption, ultrasonography training, and utensils per scanning.

Results

The difference in average cost between the two alternatives from a societal perspective was estimated to be €110, in favour of general practice with GPs using POCUS. The deterministic sensitivity analyses demonstrated robustness of the results to plausible changes in the input parameters.

The expected remuneration for performing POCUS in this specific setting was estimated to be €32 per examination.

Conclusion

Having GPs perform POCUS on patients with vaginal bleeding in early pregnancy is cost-saving compared to usual practice. The results should be taken with caution as this study was based on early modelling with uncertainties associated with the input parameters in the model.
Identification of the pivotal role of SPP1 in kidney stone disease based on multiple bioinformatics analysis
Authors: Hong Sen-Yuan , Xia Qi-Dong , Xu Jin-Zhou , Liu Chen-Qian , Sun Jian-Xuan , Xun Yang , Wang Shao-Gang
Published: January 2022

Background

Kidney stone disease (KSD) is a multifactorial disease involving both environmental and genetic factors, whose pathogenesis remains unclear. This study aims to explore the hub genes related to stone formation that could serve as potential therapeutic targets.

Methods

Based on the GSE73680 dataset with 62 samples, differentially expressed genes (DEGs) between Randall’s plaque (RP) tissues and normal tissues were screened and weighted gene co-expression network analysis (WGCNA) was applied to identify key modules associated with KSD. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed to explore the biological functions. The protein–protein interaction (PPI) network was constructed to identify hub genes. Meanwhile, CIBERSORT and ssGSEA analysis were used to estimate the infiltration level of the immune cells. The correlations between hub genes and immune infiltration levels were also investigated. Finally, the top hub gene was selected for further GSEA analysis.

Results

A total of 116 DEGs, including 73 up-regulated and 43 down-regulated genes, were screened in the dataset. The red module was identified as the key module correlated with KSD. 53 genes were obtained for functional enrichment analysis by taking the intersection of DEGs and genes in the red module. GO analysis showed that these genes were mainly involved in extracellular matrix organization (ECM) and extracellular structure organization, and others. KEGG analysis revealed that the pathways of aldosterone-regulated sodium reabsorption, cell adhesion molecules, arachidonic acid (AA) metabolism, and ECM-receptor interaction were enriched. Through PPI network construction, 30 hub genes were identified. CIBERSORT analysis revealed a significantly increased proportion of M0 macrophages, while ssGSEA revealed no significant differences. Among these hub genes, SPP1, LCN2, MMP7, MUC1, SCNN1A, CLU, SLP1, LAMC2, and CYSLTR2 were positively correlated with macrophages infiltration. GSEA analysis found that positive regulation of JNK activity was enriched in RP tissues with high SPP1 expression, while negative regulation of IL-1β production was enriched in the low-SPP1 subgroup.

Conclusions

There are 30 hub genes associated with KSD, among which SPP1 is the top hub gene with the most extensive links with other hub genes. SPP1 might play a pivotal role in the pathogenesis of KSD, which is expected to become a potential therapeutic target, while its interaction with macrophages in KSD needs further investigation.