bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-course compared to long-course palliative radiotherapy for oesophageal cancer: a single centre observational cohort study
Authors: Ólafsdóttir Halla Sif , Klevebro Fredrik , Ndegwa Nelson , Alexandersson von Döbeln Gabriella
Published: August 2021

Background

Common symptoms of oesophageal cancer are dysphagia, pain, and bleeding. These symptoms can be relieved with palliative radiotherapy. The aim of this study was to analyse the outcome of two different palliative radiotherapy schedules.

Methods

We conducted a retrospective cohort study on palliative radiotherapy for oesophageal cancer given at Karolinska University Hospital. Patients included were treated with either short-course (20 Gy in 4 Gy fractions daily, 5 consecutive workdays) or long-course (30–39 Gy in 3 Gy fractions, 10–13 consecutive workdays) palliative external beam radiotherapy between January 2009 and December 2013. The primary endpoint was dysphagia relief and secondary endpoints were adverse events, re-interventions, and overall survival. Cox regression analyses were used to estimate the effect of treatment schedule on survival.

Results

A total of 128 patients received external beam radiotherapy under the study period, of these 75 (58.6%) received short-course radiotherapy and 53 (41.4%) long-course radiotherapy. Sixteen (30.8%) patients experienced dysphagia relief after short-course radiotherapy and 9 (22.0%) patients after long-course radiotherapy (p = 0.341). Acute toxicity was less frequent after short-course radiotherapy than after long-course radiotherapy, particularly oesophagitis (35.4% vs. 56.0%,p = 0.027) and nausea/emesis (18.5% vs. 36.0%p = 0.034). Re-interventions tended to be more common after short-course radiotherapy (32.0%) than after long-course radiotherapy (18.9%) (p = 0.098). There was no difference in overall survival between the two groups.

Conclusions

Short- and long-course palliative radiotherapy for oesophageal cancer were equally effective to relieve dysphagia and no difference was seen in overall survival. Acute toxicity was, however, more frequent and more severe after long-course radiotherapy. Our results suggest that short-course radiotherapy is better tolerated with equal palliative effects as long-course radiotherapy.
Femoral neck system versus inverted cannulated cancellous screw for the treatment of femoral neck fractures in adults: a preliminary comparative study
Authors: Tang Yunfeng , Zhang Zhen , Wang Limin , Xiong Wei , Fang Qian , Wang Guanglin
Published: August 2021

Background

The femoral neck system (FNS) may be a valid alternative for treating femoral neck fractures, but few studies have compared the outcomes between FNS and cannulated cancellous screws. This study aimed to compare the clinical efficacy and complications of FNS with those of inverted cannulated cancellous screws (ICCS) for the treatment of femoral neck fractures in adults.

Methods

This retrospective study evaluated patients with femoral neck fractures who underwent FNS or ICCS internal fixation between June 2019 and January 2020. The operative time, intraoperative blood loss, number of fluoroscopies, length of surgical incision, length of hospital stay, time to fracture healing, and other indicators were compared between the two groups. The incidence of complications such as nonunion, avascular necrosis of the femoral head, loosening of the internal fixation, and shortening of the femoral neck during follow-up was also assessed in both groups.

Results

Among the 92 patients included, 47 and 45 patients were categorized into the FNS and ICCS groups, respectively. Follow-up ranged from 14 to 24 months. There were no significant between-group differences in sex, age, side of the injured limb, and type of fracture and in operative time, intraoperative blood loss, incision length, and length of hospital stay (allP> 0.05). The incidence of complications such as fracture nonunion, avascular necrosis of the femoral head, and screw loosening was also comparable between the two groups. However, the number of fluoroscopies was significantly lower in the FNS group than in the ICCS group (P< 0.05). The fracture healing time was also significantly lower in the FNS group than in the ICCS group (P< 0.05). Furthermore, the femoral neck shortening and Harris hip score at the last follow-up were significantly better in the FNS group than in the ICCS group (P< 0.05).

Conclusions

FNS for femoral neck fractures improves hip functional recovery and reduces the femoral neck shortening rate and fluoroscopy exposure postoperatively. Thus, FNS can be an alternative to ICCS for the treatment of femoral neck fractures.
Natural history of Lafora disease: a prognostic systematic review and individual participant data meta-analysis
Authors: Pondrelli Federica , Muccioli Lorenzo , Licchetta Laura , Mostacci Barbara , Zenesini Corrado , Tinuper Paolo , Vignatelli Luca , Bisulli Francesca
Published: August 2021

Background

Lafora disease (LD) is a rare fatal autosomal recessive form of progressive myoclonus epilepsy. It affects previously healthy children or adolescents, causing pharmacoresistant epilepsy, myoclonus and severe psychomotor deterioration. This work aims to describe the clinical course of LD and identify predictors of outcome by means of a prognostic systematic review with individual participant data meta-analysis.

Methods

A search was conducted on MEDLINE and Embase with no restrictions on publication date. Only studies reporting genetically confirmed LD cases were included. Kaplan–Meier estimate was used to assess probability of death and loss of autonomy. Univariable and multivariable Cox regression models with mixed effects (clustered survival data) were performed to evaluate prognostic factors.

Results

Seventy-three papers describing 298 genetically confirmed LD cases were selected. Mean age at disease onset was 13.4 years (SD 3.7), with 9.1% aged ≥ 18 years. Overall survival rates in 272 cases were 93% [95% CI 89–96] at 5 years, 62% [95% CI 54–69] at 10 years and 57% [95% CI 49–65] at 15 years. Median survival time was 11 years. The probability of loss of autonomy in 110 cases was 45% [95% CI 36–55] at 5 years, 75% [95% CI 66–84] at 10 years, and 83% [95% CI 74–90] at 15 years. Median loss of autonomy time was 6 years. Asian origin and age at onset < 18 years emerged as negative prognostic factors, while type of mutated gene and symptoms at onset were not related to survival or disability.

Conclusions

This study documented that half of patients survived at least 11 years. The notion of actual survival rate and prognostic factors is crucial to design studies on the effectiveness of upcoming new disease-modifying therapies.
The role of machine learning in clinical research: transforming the future of evidence generation
Authors: Weissler E. Hope , Naumann Tristan , Andersson Tomas , Ranganath Rajesh , Elemento Olivier , Luo Yuan , Freitag Daniel F. , Benoit James , Hughes Michael C. , Khan Faisal , Slater Paul , Shameer Khader , Roe Matthew , Hutchison Emmette , Kollins Scott H. , Broedl Uli , Meng Zhaoling , Wong Jennifer L. , Curtis Lesley , Huang Erich , Ghassemi Marzyeh
Published: August 2021

Background

Interest in the application of machine learning (ML) to the design, conduct, and analysis of clinical trials has grown, but the evidence base for such applications has not been surveyed. This manuscript reviews the proceedings of a multi-stakeholder conference to discuss the current and future state of ML for clinical research. Key areas of clinical trial methodology in which ML holds particular promise and priority areas for further investigation are presented alongside a narrative review of evidence supporting the use of ML across the clinical trial spectrum.

Results

Conference attendees included stakeholders, such as biomedical and ML researchers, representatives from the US Food and Drug Administration (FDA), artificial intelligence technology and data analytics companies, non-profit organizations, patient advocacy groups, and pharmaceutical companies. ML contributions to clinical research were highlighted in the pre-trial phase, cohort selection and participant management, and data collection and analysis. A particular focus was paid to the operational and philosophical barriers to ML in clinical research. Peer-reviewed evidence was noted to be lacking in several areas.

Conclusions

ML holds great promise for improving the efficiency and quality of clinical research, but substantial barriers remain, the surmounting of which will require addressing significant gaps in evidence.
Effectiveness of integrated Aedes albopictus management in southern Switzerland
Authors: Ravasi Damiana , Parrondo Monton Diego , Tanadini Matteo , Flacio Eleonora
Published: August 2021

Background

The exotic invasive tiger mosquito, Aedes albopictus, appeared in southern Switzerland in 2003. The spread of the mosquito has been surveyed constantly since then, and an integrated vector management (IVM) has been implemented to control its numbers. The control measures focus on the aquatic phase of the mosquito with removal of breeding sites and applications of larvicides in public areas whereas private areas are reached through extensive public information campaigns. Here, we evaluated the efficacy of the IVM.

Methods

Since all the municipalities with Ae. albopictus in southern Switzerland are currently implementing the IVM, Italian municipalities just across the Swiss-Italian border, where Ae. albopictus is present but no coordinated intervention programme is in place, served as control. Ovitraps and adult female traps were used to measure mosquito abundance in 2019. Generalised mixed-effects models were used to model the numbers of Ae. albopictus eggs and adult females collected. These numbers of Ae. albopictus eggs were compared to the numbers of eggs collected in 2012 and 2013 in a previous assessment of the IVM, using a hurdle model.

Results

Mean numbers of Ae. albopictus eggs and adult females in 2019 were consistently higher in the municipalities not following an IVM programme. In these municipalities, there were about four times (3.8) more eggs than in the municipalities implementing an IVM programme. Also, the numbers of eggs and adult females increased steadily from the beginning of the Ae. albopictus reproductive season, reaching a peak in August. In contrast, the increase in numbers of Ae. albopictus was much more contained in the municipalities implementing an IVM programme, without reaching an evident peak. Comparison with data from 2012 and 2013 indicates that the gap between intervention and non-intervention areas may have almost doubled in the past 6 years.

Conclusions

The results of the survey strongly support the efficacy of the IVM programme implemented in southern Switzerland compared to municipalities without defined control measures. With the constant implementation of an IVM, it appears possible to contain the numbers of Ae. albopictus at a manageable level, reducing the nuisance for the human population and the risk of arbovirus epidemics.

Graphical Abstract
Evaluation of two Plasmodium vivax sexual stage antigens as transmission-blocking vaccine candidates
Authors: Zhang Yongzhe , Liu Fei , Zhao Yan , Yang Fan , Bai Jie , Jia Xitong , Roobsoong Wanlapa , Sattabongkot Jetsumon , Cui Liwang , Cao Yaming , Luo Enjie , Wang Meilian
Published: August 2021

Background

Plasmodium vivax transmission-blocking vaccines (TBVs) are receiving increasing attention. Based on excellent transmission-blocking activities of the PbPH (PBANKA_0417200) and PbSOP26 (PBANKA_1457700) antigens in Plasmodium berghei, their orthologs in P. vivax, PVX_098655 (PvPH) and PVX_101120 (PvSOP26), were selected for the evaluation of their potential as TBVs.

Methods

Fragments of PvPH (amino acids 22–304) and PvSOP26 (amino acids 30–272) were expressed in the yeast expression system. The recombinant proteins were used to immunize mice to obtain antisera. The transmission-reducing activities of these antisera were evaluated using the direct membrane feeding assay (DMFA) using Anopheles dirus mosquitoes and P. vivax clinical isolates.

Results

The recombinant proteins PvPH and PvSOP26 induced robust antibody responses in mice. The DMFA showed that the anti-PvSOP26 sera significantly reduced oocyst densities by 92.0 and 84.1% in two parasite isolates, respectively, whereas the anti-PvPH sera did not show evident transmission-reducing activity. The variation in the DMFA results was unlikely due to the genetic polymorphisms of the two genes since their respective sequences were identical in the clinical P. vivax isolates.

Conclusion

PvSOP26 could be a promising TBV candidate for P. vivax, which warrants further evaluation.

Graphical Abstract
Aeromonas species obtained from different farmed aquatic species in India and Taiwan show high phenotypic relatedness despite species diversity
Authors: Dubey Saurabh , Maiti Biswajit , Girisha Shivani Kallappa , Das Rakesh , Lamkhannat Mustapha , Mutoloki Stephen , Chen Shih-Chu , Karunasagar Indrani , Evensen Øystein , Munang´andu Hetron M.
Published: August 2021

Objectives

Aeromonads cause severe diseases in farmed aquatic organisms. Herein, we examined 28 isolates causing disease in farmed aquatic organisms from India (n = 24) and Taiwan (n = 4) to gain insight of their genotypic and phenotypic properties.

Results

API 20NE biochemical phenotyping showed ≥ 90% similarity classifying all isolates as Aeromonas hydrophila. 16S rRNA genotyping showed ≥ 98% homology among all isolates with A. sobria (NR119044.1ATCC), A. veronii (MK990549.1), A. caviae (NR029252.1) and A. hydrophila (MG984625.1ATCC) and other reference strains. In contrast, gyrB showed a higher intraspecies diversity (≥ 96%) than 16S rRNA delineating the 28 isolates into three groups. Group-I consisted of seven Indian isolates clustered with A. sobria (MK484163.1ATCC), group-II comprised of five Indian and two Taiwanese isolates clustered with A. veronii AF417626.1ATCC while group-III had 11 Indian and three Taiwanese isolates grouped with A. hydrophila (AY987520.1 and DQ519366.1) reference strains. None of our isolates clustered with A. caviae (AJ868400.1ATCC) reference strain. These findings suggest that A. sobria, A. veronii and A. hydrophila could be the etiological agents of diseases observed in farmed fish and soft-shelled turtles (Pelodiscus sinensis) examined in this study. Overall, our findings accentuate the importance of combining phenotyping with genotyping for correct taxonomic classification of Aeromonas spp. in Aquaculture.
Monitoring bond-slip behavior of CFRP-RCESC beams using piezoelectric active sensing method
Authors: Jiang Tianyong , Yu Donghai , Xiao Min , Li Lingyun , Wang Lei
Published: August 2021

Combination of carbon fiber reinforced polymer (CFRP) tendon and reinforced concrete encased steel composite (RCESC) beam can improve the workability and the energy dissipation capacity of members. In this paper, three RCESC beams reinforced with steel bars or CFRP bars were designed and fabricated to study the bond-slip behavior between I-shaped steel and CFRP reinforced concrete and the damage states between bond-slip interfaces of the beams. The lead zirconate titanate (PZT) patch as stress wave actuator, the smart aggregates (SAs) were installed in concrete as the sensors to collect the stress wave signal. A method based on piezoelectric active sensing was developed to monitor the bond-slip damage of CFRP-RCESC beam. The changes of responding signals were characterized in time- and frequency- domains. The characteristic information of bond-slip damage was further quantified by wavelet packet energy. Results show the bond-slip resistance of the CFRP-RCESC beams can be improved by increasing reinforcement ratio and elastic modulus of the main bars. The bond-slip damage process of the specimens can be effectively monitored by the active sensing method.
Development of public stigma toward people with mental health problems in Czechia 2013–2019
Authors: Winkler Petr , Formánek Tomáš , Mladá Karolína , Evans Lacko Sara
Published: August 2021

Background

We aimed to assess the changes in public stigma towards people with mental health problems in Czechia; and to investigate the association between these and the exposure to the ongoing mental health care reform and one of its implementation projects focused on reducing stigma.

Methods

We analyzed data from three cross-sectional surveys representative of the Czech adult population. We used linear regression models to compare population attitudes and desire for future contact with people with mental health problems between the 2013/2014 baseline and the 2019 follow-up. In our 2019 sample, we employed linear regression models to assess the relationship between exposure to mental health care reform and nation-wide anti-stigma campaign, and population stigmatizing attitudes and intended behavior. We utilized a propensity score matching procedure to mitigate potential bias.

Results

The 2013, 2014, and 2019 datasets consisted of 1797, 1810, and 1077 participants, respectively. Population attitudes improved significantly between 2014 and 2019 (B = 0.99, 95% CI = 0.06; 1.93), but we did not detect a change in population desire for future contact with people with mental health problems. Exposure to the nationwide anti-stigma campaign or mental health care reform was associated with more favorable attitudes (B = 4.25, 95% CI = 2.07; 6.42 and B = 7.66, 95% CI = 3.91; 11.42), but not with higher desire for future contact with people with mental health problems.

Conclusions

Mental health care reform and its nation-wide anti-stigma project seems to have a positive impact on population attitudes, but not on desire for future contact with people with mental health problems.
Pharmacokinetic Analysis of Peptide-Modified Nanoparticles with Engineered Physicochemical Properties in a Mouse Model of Traumatic Brain Injury
Authors: Waggoner Lauren E. , Madias Marianne I. , Hurtado Alan A. , Kwon Ester J.
Published: August 2021

Peptides are used to control the pharmacokinetic profiles of nanoparticles due to their ability to influence tissue accumulation and cellular interactions. However, beyond the study of specific peptides, there is a lack of understanding of how peptide physicochemical properties affect nanoparticle pharmacokinetics, particularly in the context of traumatic brain injury (TBI). We engineered nanoparticle surfaces with peptides that possess a range of physicochemical properties and evaluated their distribution after two routes of administration: direct injection into a healthy mouse brain and systemic delivery in a mouse model of TBI. In both administration routes, we found that peptide-modified nanoparticle pharmacokinetics were influenced by the charge characteristics of the peptide. When peptide-modified nanoparticles are delivered directly into the brain, nanoparticles modified with positively charged peptides displayed restricted distribution from the injection site compared to nanoparticles modified with neutral, zwitterionic, or negatively charged peptides. After intravenous administration in a TBI mouse model, positively charged peptide-modified nanoparticles accumulated more in off-target organs, including the heart, lung, and kidneys, than zwitterionic, neutral, or negatively charged peptide-modified nanoparticles. The increase in off-target organ accumulation of positively charged peptide-modified nanoparticles was concomitant with a relative decrease in accumulation in the injured brain compared to zwitterionic, neutral, or negatively charged peptide-modified nanoparticles. Understanding how nanoparticle pharmacokinetics are influenced by the physicochemical properties of peptides presented on the nanoparticle surface is relevant to the development of nanoparticle-based TBI therapeutics and broadly applicable to nanotherapeutic design, including synthetic nanoparticles and viruses.

Graphical abstract
Enablers of gender equitable scientific career progression in Sub-Saharan Africa: Insights from the DELTAS Africa Initiative
Authors: Liani Millicent L. , Nyamongo Isaac K. , Pulford Justin , Tolhurst Rachel
Published: August 2021

Background: This paper present findings on current strategies utilised within selected Developing Excellence in Leadership, Training and Science in Africa’ (DELTAS Africa) consortia to promote gender equitable scientific career progression for researchers, as well as participants’ recommendations for change. Findings are drawn from a wider research study nested within this health-based scientific research capacity strengthening initiative that was aimed at gaining an in-depth understanding of the barriers and enablers of gender equitable scientific career progression for researchers in Sub-Saharan Africa. 

Methods: We adopted an exploratory qualitative cross-sectional study design. The main method of data collection was in-depth interviews (IDIs) with trainees/research fellows at various career stages affiliated to three purposively selected DELTAS Africa Research Consortia. In addition, key informant interviews (KIIs) with consortia research leaders/directors, co-investigators, and management team were also conducted to corroborate information gathered from the IDIs, and to provide additional insights on the enabling factors/actions and policy processes that were currently in place or proposed to enhance gender equitable career progression. In total, fifty-eight IDIs (32 female and 26 male) and twenty KIIs (4 female and 16 male) were conducted. Interviews were carried out between May and December 2018 in English. Data were analysed inductively based on emergent themes, and aligned to the developed integrated conceptual framework.

Results: Three overarching themes were identified. First: micro level efforts - individual coping mechanisms and familial level support. Second: Meso level efforts -existing enabling mechanisms at the institutional level. Third: proposed solutions for positive change towards enhancing gender equitable career progression at micro, meso and macro levels. 

Conclusions: These findings have implications for future research capacity strengthening programming, including DELTAS Africa II initiative (2021-2025); they provide valuable insights on potential strategies and actions aiming to narrow gender inequities in scientific career progression in the context of sub-Saharan African research institutions.
Preparing Teachers for Developing a Safety Culture in Younger Schoolchildren
Authors: Timofeeva Liliya
Published: August 2021

The article reveals the ways of increasing the competence in the field of safe life among teachers who work with primary school students. Safety culture is considered as one of the components of social functional literacy of primary schoolchildren. On the basis of the professional standard “Teacher”, the author determines the actual knowledge and skills that must be mastered by the teacher for the successful formation of safe behavior skills in children of primary school age in different situations and areas of the surrounding reality. The article presents the results of the initial and repeated questionnaires of teachers after their training in special programs, which allow eliminating professional deficits and increasing teachers’ readiness to foster a safety culture in younger schoolchildren that ensures their positive socialization.
Managing obesity in individuals with type 2 diabetes
Authors: Morris David
Published: August 2021

David Morris looks at how nurses can advise overweight patients with diabetes
Nutrition and oncology: best practice and the development of a traffic light system
Authors: Atkinson Emma , Atkinson Judith
Published: August 2021

Malnutrition is common in oncology patients, with age, disease stage and tumour type all influencing malnutrition risk. There are several detrimental effects of malnutrition in oncology patients, including weight loss, which is associated with negative oncological outcomes, and reduced survival. The causes of malnutrition in this group may be multifactorial and include effects from the tumour itself, altered metabolism, increased nutritional requirements, and cancer treatments and their associated side effects, which can impact on an individual's ability and desire to eat. Nutritional screening to identify early nutritional risk is essential and should involve the use of a validated screening tool, with commonly used tools usually assessing nutritional risk and weight loss over a period of months, for example a 3- to 6-month period. It is also important to consider weight changes over a shorter time period to identify rapid weight changes. Multidisciplinary teamworking is essential in tackling malnutrition, with collaborative working between the dietitians and the nutrition nurses shown to be beneficial in the authors' practice to develop community pathways and improve their service and manage increasing patient numbers. Malnutrition within oncology can often be managed with additional supplementation with oral nutritional supplements or enteral nutrition, where indicated. A low-volume, energy-dense, high-protein supplement can help to meet nutritional needs and to achieve dietetic aims, with compliance improved by the use of a low-volume product.
The role of multiple metabolic genes in predicting the overall survival of colorectal cancer: A study based on TCGA and GEO databases
Authors: Shi Weijun , Li Xincan , Su Xu , Wen Hexin , Chen Tianwen , Wu Huazhang , Liu Mulin
Published: August 2021

The recent advances in gene chip technology have led to the identification of multiple metabolism-related genes that are closely associated with colorectal cancer (CRC). Nevertheless, none of these genes could accurately diagnose or predict CRC. The prognosis of CRC has been made by previous prognostic models constructed by using multiple genes, however, the predictive function of multi-gene prognostic models using metabolic genes for the CRC prognosis remains unexplored. In this study, we used the TCGA-CRC cohort as the test dataset and the GSE39582 cohort as the experimental dataset. Firstly, we constructed a prognostic model using metabolic genes from the TCGA-CRC cohort, which were also associated with CRC prognosis. We analyzed the advantages of the prognostic model in the prognosis of CRC and its regulatory mechanism of the genes associated with the model. Secondly, the outcome of the TCGA-CRC cohort analysis was validated using the GSE39582 cohort. We found that the prognostic model can be employed as an independent prognostic risk factor for estimating the CRC survival rate. Besides, compared with traditional clinical pathology, it can precisely predict CRC prognosis as well. The high-risk group of the prognostic model showed a substantially lower survival rate as compared to the low-risk group. In addition, gene enrichment analysis of metabolic genes showed that genes in the prognostic model are enriched in metabolism and cancer-related pathways, which may explain its underlying mechanism. Our study identified a novel metabolic profile containing 11 genes for prognostic prediction of CRC. The prognostic model may unravel the imbalanced metabolic microenvironment, and it might promote the development of biomarkers for predicting treatment response and streamlining metabolic therapy in CRC.
Medium-term monitoring reveals effects of El Niño Southern Oscillation climate variability on local salinity and faunal dynamics on a restored oyster reef
Authors: Beseres Pollack Jennifer , Palmer Terence A. , Williams Abby E.
Published: August 2021

Human activities and regional-scale climate variability drive changes in the ecology of coastal and marine ecosystems. Ecological restoration has emerged as a best-management practice to combat habitat degradation and restore lost ecological functions. However, relatively short project monitoring timeframes have limited our understanding of the effects of interannual climate cycles on water quality and restoration dynamics. We collected measurements on a 23-ha oyster reef constructed in the Gulf of Mexico to determine the relationship between El Niño Southern Oscillation (ENSO)-driven climate variability and local salinity patterns, and to evaluate the effects of this climate variability and salinity on oyster population dynamics and faunal community composition over a medium-term (five-year) timeframe. The role of ENSO-driven climate variability on local salinity patterns (primarily from changes in precipitation and evaporation) and faunal dynamics was investigated using the Oceanic Niño Index (ONI). Salinity was negatively correlated with ONI with an approximately 4-month lag. Higher ONI values (El Niño periods) were followed by reductions in salinity, increases in oyster recruitment and density, and reductions in resident motile fauna density and species richness. Lower ONI values (La Niña periods) had higher and less variable salinities, and higher areal coverage of restoration substrates by large oysters. ENSO-driven salinity reductions in the second year after reef construction coincided with a shift in resident motile faunal community composition that was maintained despite a second strong salinity reduction in year 5. Our results indicate that it is important to expand the typical monitoring timeframes to at least five years so that resource managers and restoration practitioners can better understand how both short-term environmental variability and longer-term climate cycles can affect the outcomes of restoration actions.
Online evaluation method of coal mine comprehensive level based on FCE
Authors: Shen Ling , Jing Guoxun , Zeng Qiang
Published: August 2021

An online evaluation method of coal mine comprehensive level based on Fuzzy Comprehensive Evaluation method (FCE) is proposed. Firstly, following the principles of fairness, systematicness and hierarchy, taking research and development, production, sales, finance, safety and management as the first level indicators, a set of multi-level evaluation indicator system of coal mine comprehensive level combining objective and subjective evaluation indicators is established. Secondly, according to the characteristics of the indicator system, the specific process of FCE of coal mine comprehensive level is given. Then, taking SQL Server as the database management system and C#.NET as the development language, a set of B/S structure online evaluation system of coal mine comprehensive level based on FCE is designed and developed. Finally, the proposed method is applied to Coal group PM for test. The application shows that the method proposed can provide an efficient and convenient online evaluation platform to evaluate the comprehensive level of coal mines for the Coal group, and the horizontal and longitudinal comparison of the evaluation results can urge the coal mines to maintain their advantages and avoid their disadvantages, which is of some significance for improving the overall competitiveness of the Coal group.
No difference in biomarkers of ischemic heart injury and heart failure in patients with COVID-19 who received treatment with chloroquine phosphate and those who did not
Authors: Beck-Friis Josefine , Leach Susannah , Omerovic Elmir , Zeijlon Rickard , Gisslen Magnus , Yilmaz Aylin
Published: August 2021

Background

Chloroquine was promoted as a COVID-19 therapeutic early in the pandemic. Most countries have since discontinued the use of chloroquine due to lack of evidence of any benefit and the risk of severe adverse events. The primary aim of this study was to examine if administering chloroquine during COVID-19 imposed an increased risk of ischemic heart injury or heart failure.

Methods

Medical records, laboratory findings, and electrocardiograms of patients with COVID-19 who were treated with 500 mg chloroquine phosphate daily and controls not treated with chloroquine were reviewed retrospectively. Controls were matched in age and severity of disease.

Results

We included 20 patients receiving chloroquine (500 mg twice daily) for an average of five days, and 40 controls. The groups were comparable regarding demographics and biochemical analyses including C-reactive protein, thrombocytes, and creatinine. There were no statistically significant differences in cardiac biomarkers or in electrocardiograms. Median troponin T was 10,8 ng/L in the study group and 17.9 ng/L in the control group, whereas median NT-proBNP was 399 ng/L in patients receiving chloroquine and 349 ng/L in the controls.

Conclusions

We found no increased risk of ischemic heart injury or heart failure as a result of administering chloroquine. However, the use of chloroquine to treat COVID-19 outside of clinical trials is not recommended, considering the lack of evidence of its effectiveness, as well as the elevated risk of fatal arrythmias.
Inter-database validation of a deep learning approach for automatic sleep scoring
Authors: Alvarez-Estevez Diego , Rijsman Roselyne M.
Published: August 2021

Study objectives

Development of inter-database generalizable sleep staging algorithms represents a challenge due to increased data variability across different datasets. Sharing data between different centers is also a problem due to potential restrictions due to patient privacy protection. In this work, we describe a new deep learning approach for automatic sleep staging, and address its generalization capabilities on a wide range of public sleep staging databases. We also examine the suitability of a novel approach that uses an ensemble of individual local models and evaluate its impact on the resulting inter-database generalization performance.

Methods

A general deep learning network architecture for automatic sleep staging is presented. Different preprocessing and architectural variant options are tested. The resulting prediction capabilities are evaluated and compared on a heterogeneous collection of six public sleep staging datasets. Validation is carried out in the context of independent local and external dataset generalization scenarios.

Results

Best results were achieved using the CNN_LSTM_5 neural network variant. Average prediction capabilities on independent local testing sets achieved 0.80 kappa score. When individual local models predict data from external datasets, average kappa score decreases to 0.54. Using the proposed ensemble-based approach, average kappa performance on the external dataset prediction scenario increases to 0.62. To our knowledge this is the largest study by the number of datasets so far on validating the generalization capabilities of an automatic sleep staging algorithm using external databases.

Conclusions

Validation results show good general performance of our method, as compared with the expected levels of human agreement, as well as to state-of-the-art automatic sleep staging methods. The proposed ensemble-based approach enables flexible and scalable design, allowing dynamic integration of local models into the final ensemble, preserving data locality, and increasing generalization capabilities of the resulting system at the same time.
A novel model to quantify balance alterations in older adults based on the center of pressure (CoP) measurements with a cross-sectional study
Authors: Estévez-Pedraza Ángel Gabriel , Parra-Rodríguez Lorena , Martínez-Méndez Rigoberto , Portillo-Rodríguez Otniel , Ronzón-Hernández Zoraida
Published: August 2021

Background

The timely detection of fall risk or balance impairment in older adults is transcendental because, based on a reliable diagnosis, clinical actions can be taken to prevent accidents. This study presents a statistical model to estimate the fall risk from the center of pressure (CoP) data.

Methods

This study is a cross-sectional analysis from a cohort of community-dwelling older adults aged 60 and over living in Mexico City. CoP balance assessments were conducted in 414 older adults (72.2% females) with a mean age of 70.23 ± 6.68, using a modified and previously validated Wii Balance Board (MWBB) platform. From this information, 78 CoP indexes were calculated and analyzed. Multiple logistic regression models were fitted in order to estimate the relationship between balance alteration and the CoP indexes and other covariables.

Results

The CoP velocity index in the Antero-Posterior direction with open eyes (MVELAPOE) had the best value of area under the curve (AUC) to identify a balance alteration (0.714), and in the adjusted model, AUC was increased to 0.827. Older adults with their mean velocity higher than 14.24 mm/s had more risk of presenting a balance alteration than those below this value (OR(Odd Ratio) = 2.94,p<0.001, 95%C.I.(Confidence Interval) 1.68–5.15). Individuals with increased age and BMI were more likely to present a balance alteration (OR1.17,p<0.001, 95%C.I.1.12–1.23;OR1.17,p<0.001, 95%C.I.1.10–1.25). Contrary to what is reported in the literature, sex was not associated with presenting a balance alteration (p= 0.441, 95%C.I.0.70–2.27).

Significance

The proposed model had a discriminatory capacity higher than those estimated by similar means and resources to this research and was implemented in an embedded standalone system which is low-cost, portable, and easy-to-use, ideal for non-laboratory environments. The authors recommend using this technology to support and complement the clinical tools to attend to the serious public health problem represented by falls in older adults.
Pre-gestational diabetes: Maternal body mass index and gestational weight gain are associated with augmented umbilical venous flow, fetal liver perfusion, and thus birthweight
Authors: Lund Agnethe , Ebbing Cathrine , Rasmussen Svein , Qvigstad Elisabeth , Kiserud Torvid , Kessler Jörg
Published: August 2021

Objectives

To assess how maternal body mass index and gestational weight gain are related to on fetal venous liver flow and birthweight in pregnancies with pre-gestational diabetes mellitus.

Methods

In a longitudinal observational study, 49 women with pre-gestational diabetes mellitus were included for monthly assessments (gestational weeks 24–36). According to the Institute Of Medicine criteria, body mass index was categorized to underweight, normal, overweight, and obese, while gestational weight gain was classified as insufficient, appropriate or excessive. Fetal size, portal flow, umbilical venous flow and distribution to the fetal liver or ductus venosus were determined using ultrasound techniques. The impact of fetal venous liver perfusion on birthweight and how body mass index and gestational weight gain modified this effect, was compared with a reference population (n = 160).

Results

The positive association between umbilical flow to liver and birthweight was more pronounced in pregnancies with pre-gestational diabetes mellitus than in the reference population. Overweight and excessive gestational weight gain were associated with higher birthweights in women with pre-gestational diabetes mellitus, but not in the reference population. Fetuses of overweight women with pre-gestational diabetes mellitus had higher umbilical (p = 0.02) and total venous liver flows (p = 0.02), and a lower portal flow fraction (p = 0.04) than in the reference population. In pre-gestational diabetes mellitus pregnancies with excessive gestational weight gain, the umbilical flow to liver was higher than in those with appropriate weight gain (p = 0.02).

Conclusions

The results support the hypothesis that umbilical flow to the fetal liver is a key determinant for fetal growth and birthweight modifiable by maternal factors. Maternal pre-gestational diabetes mellitus seems to augment this influence as shown with body mass index and gestational weight gain.
Detection of Cryptosporidium spp. and Giardia duodenalis in small wild mammals in northeastern Brazil
Authors: Fehlberg Hllytchaikra Ferraz , Matos Ribeiro Cássia , Brito Junior Pedro de Alcântara , Miranda Oliveira Bruno César , Albano dos Santos Camila , del Valle Alvarez Martín Roberto , Harvey Tatiane Vitor , Rêgo Albuquerque George
Published: August 2021

This study investigated the occurrence of Giardia duodenalis and Cryptosporidium spp. in rodents and marsupials from the Atlantic Forest in southern Bahia, northeastern Brazil. Two hundred and four fecal samples were collected from different forest areas in the municipalities of Ilhéus, Una, Belmonte, and Mascote. Identifications were performed using PCR and nested PCR followed by sequencing of the gdh and tpi genes for G. duodenalis, and the gp60 and Hsp-70 genes for Cryptosporidium. The total frequency of positive PCR samples for both G. duodenalis and Cryptosporidium spp. was 5.4% (11/204). Giardia duodenalis occurred in 2.94% (4/136) of rodents and 2.94% (2/68) of marsupials. The prevalence of Cryptosporidium in rodents and marsupials was 1.47% (2/136) and 4.41% (3/68), respectively. In the areas sampled, the frequency of parasitism was 50% (7/14), while the Mascote region alone had no parasitized animals. The G. duodenalis subgenotype AI was identified in the rodent species Hylaeamys laticeps, Oecomys catherinae, Oligoryzomys nigripes and Akodon cursor, and in the marsupials Gracilinanus agilis and Monodelphis americana. In the rodents Rhipidomys mastacalis, H. laticeps and in the marsupial Marmosa murina the protozoa Cryptosporidium fayeri, Cryptosporidium parvum and Cryptosporidium ubiquitum with subtypes IIa and IVg by the gp60 gene were found. In conclusion, this study provides the genetic characterization of Giardia and Cryptosporidium species and genotypes in rodents and marsupials. And, these findings reinforce that the rodent and marsupial species mentioned above play a role as new hosts for Giardia and Cryptosporidium.
Extracellular fluid volume: A suitable indexation variable to assess impact of bariatric surgery on glomerular filtration rate in patients with chronic kidney disease
Authors: Grangeon-Chapon Caroline , Laurain Audrey , Esnault Vincent L. M. , Cruzel Coralie , Iannelli Antonio , Favre Guillaume A.
Published: August 2021

Background

Bariatric surgery (BS) might be a nephroprotective treatment in obese patients with chronic kidney disease (CKD), and the non-linear relation between body surface area (BSA) and extracellular fluid volume (ECFV) in obese people raises the question of the most relevant way to scale glomerular filtration rate (GFR) for assessing renal function changes after BS.

Methods

We screened 1774 BS candidates and analysed 10 consecutive participants with CKD stage 3. True GFR (mGFR), measured by the renal clearance of 51Cr-ethylenediaminetetraacetic acid (EDTA), was scaled either to BSA (mGFRBSA) or to ECFV measured by 51Cr-EDTA distribution volume (mGFRECFV) before and one year after BS.

Results

The 10 candidates for BS had a mean body mass index of 43.3 ± 3.6 kg/m2 and a mean GFR of 48 ± 8 mL/min/1.73 m2. Six participants had a sleeve gastrectomy and four had a Roux-en-Y gastric bypass. One year after BS, ECFV decreased (23.2 ± 6.2 to 17.9 ± 4.3 L, p = 0.001), absolute mGFR was not significantly modified (74 ± 23 versus 68 ±19 mL/min), mGFRBSA did not change significantly (53 ± 18 versus 56 ± 17 mL/min/1.73 m2) whereas mGFRECFV significantly increased (42 ± 13 versus 50 ± 14 mL/min/12.9 L, p = 0.037). The relation between mGFRECFV and mGFRBSA was different from the identity line before (p = 0.014) but not after BS (p = 0.09).

Conclusion

There is a difference between mGFRBSA and mGFRECFV following BS and the latter might better reflect the adequacy between renal function and corpulence.
Transnational sports soundscapes: Soccer announcers and radio in Argentina and Chile, 1920s–60s
Authors: Acuña Pedro
Published: August 2021

The article contributes to the field of cultural studies and radio history by focusing on soccer (or fútbol), arguably the most significant mass spectacle in twentieth-century Latin America. By exploring the trajectories, iconic voices and styles of sportscasters, the article reconstructs the masculine soundscape of soccer in Argentina and Chile between the 1920s and 1960s. Play-by-play announcers, who ranged from second-rate actors and singers to professional journalists, crafted their own versions of masculinity and nationalism that were central to representing sports culture in an increasingly transnational context. The article pays special attention to the sporting press, audio records and sports films, since many commentators borrowed heavily from other forms of mass culture. Their oral representations of the game, loaded with moral evaluations and political statements, can be seen as cultural texts because they enabled new ways of imagining sports for much larger audiences than those sitting in the stadium.
Promoting peace: The role of radio journalism in conflict prevention
Authors: Ortiz dos Santos Fabíola
Published: August 2021

This article examines the role of radios in conflict by exploring the tenets of peace journalism in the United Nations sponsored Radio Okapi (Democratic Republic of Congo) and Radio Ndeke Luka (Central African Republic) run by the Swiss Fondation Hirondelle. It is a qualitative research that interviewed journalists on how they perceive their role in society and margin of autonomy. It aims at answering the question: To what extent do the conventions of professional practice of journalism affect the way newsmaking is shaped under the peace journalism approach in conflict-stressed environments? The findings pointed that peace journalism encompasses the idea of a symbolic rapprochement and reconcilement. Reporters stressed the notion of using journalism as a pedagogical tool. Many of the journalists have gone through life-threatening situations caused by opposition groups. Nonetheless, the testimonies accounted for a willingness to carry on with their commitment to a responsible journalism.
Treatment of knee joint osteoarthritis in overweight women in outpatient practice
Authors: Kovalenko P. S. , Dydykina I. S. , Aronova E. S. , Alekseeva O. G. , Shakhramanova E. L. , Kudryavtseva A. V. , Zotkin E. G.
Published: August 2021

Objectives: evaluation of the clinical efficacy and safety of the healthy joints maintaining compound Artroflex®in knee osteoarthritis (OA) in postmenopausal overweight women in outpatient clinical practice.Patients and methods. An open, prospective observational single-center post-marketing study included 30 postmenopausal women 50–75 years old (mean age 62.3±6.3 years) with knee OA. Patient body mass index (BMI) was >25 (mean body weight 85.3±15.3 kg). Radiographically confirmed primary gonarthrosis stage II according to Kellgren–Lawrence was detected in 26 (87.0%) patients, stage III – in 4 (13.0%). The duration of knee OA ranged from 1 to 21 years (average 7.8±6.1 years).Artroflex®was prescribed 1 capsule 2 times a day for 3 months. During three visits (baseline, after 1 and 3 months), the need for analgesics or non-steroidal anti-inflammatory drugs (NSAIDs) and the occurrence of adverse reactions (AR) were determined. Health status and pain level were also assessed using a visual analogue scale (VAS), the severity of pain and stiffness, limited function according to the WOMAC questionnaire, fatigue/fatigue according to the FACIT scale, the Charlson comorbidity index, satisfaction of the doctor with the results of treatment using the IMOS scale, and satisfaction of the patient with using the IMPSS scale.Results and discussion. A statistically significant decrease in the pain score according to the VAS, an improvement in health status, and the WOMAC index were found in the overwhelming number of patients, regardless of BMI. 90% of women noted decrease in fatigue/fatigue on the FACIT scale, and 93% of patients reported satisfaction with treatment, regardless of the Charlson comorbidity index. The need for NSAIDs after one month of use of the Artroflex®compound decreased by 7%, after 3 months – by 23%. A negative feedback was found between the baseline indicator of health status and the assessment of the effectiveness of therapy. No serious ARs were identified during the study.Conclusion. Feasibility of using the Artroflex®compound in real clinical practice in patients with knee OA and excessive body mass has been shown.