bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of hip impingement syndrome in patients with multiple hereditary exostoses
Authors: Ahn Yeong-Seub , Kim Sungmin , Kim Woo-Jong , Lim Jun-Hyuk , Jung Sung-Taek
Published: February 2021

Backgrounds

This study aimed to investigate the characteristic deformities of the hip in multiple hereditary exostoses patients (MHE) and its association with the hip impingement syndrome.

Materials and methods

Between 2001 and 2019, total 51 patients (102 hips) were evaluated in this study. Patients with MHE were classified to femoro-acetabular impingement (FAI) symptom group, ischio-femoral impingement (IFI) symptom group and non-impingement symptom group by comparing the symptoms, clinical signs and imaging studies. To assess the morphometry of the hip in patients with MHE, the femoral neck-shaft angle, Sharp’s acetabular angle and center-edge (CE) angle were evaluated. Alpha angle was further evaluated to investigate the FAI using radiographs, and the minimum ischio-femoral distance was further measured to investigate the IFI using computed-tomographic (CT) study.

Results

On hip impingement symptom analysis, FAI symptom and IFI symptom were confirmed in 14 hip joints and 18 hip joints, respectively. Unlike general population, the number of the hip with IFI-symptom was higher than those with FAI symptom in this study. In morphometric evaluation of MHE hips, coxa valga was most prominent deformity with occasional tendency of mild acetabular dysplasia. In a comparison of morphometric study between the impingement symptom group and non-symptom group, the FAI symptom showed significant differences of morphometric measure values than those of the non-symptom group (FAI symptom group vs. Non-FAI symptom group; Femoral neck-shaft angle (153.9 vs 142.6), Sharp’s angle (45.0 vs 41.5), CE angle (21.1 vs 28.8) and alpha angle (76.7 vs 57.9)). Similarly, the IFI symptom group also showed significant differences of morphometric measure values than those of the non-symptom group (IFI-symptom vs. Non-IFI symptom; Femoral neck-shaft angle (150.9 vs 142.7), Sharp’s angle (44.7 vs 41.4), CE angle (21.1 vs 29.3) and alpha angle (73.3 vs 56.8)). In addition, the minimum ischio-femoral distance measured using CT was significantly decreased in the IFI symptom group (IFI symptom group: 6.6, Non-IFI symptom group: 16.4).

Conclusion

The results suggest that the characteristic deformities represented by coxa valga in the MHE hip act as an offset for FAI symptoms, on the contrary, act as a trigger for IFI symptoms.

Level of evidence

Level III.
Common social determinants for overweight and obesity, and dental caries among adolescents in Northern Norway: a cross-sectional study from the Tromsø Study Fit Futures cohort
Authors: Stangvaltaite-Mouhat Lina , Furberg Anne-Sofie , Drachev Sergei N. , Trovik Tordis A.
Published: February 2021

Background

Non-communicable general and oral health conditions share common risk factors. Studies investigating common social determinants as risk factors for overweight/obesity and dental caries among the same adolescents are scarce and inconclusive.

Methods

This cross-sectional study included data from 464 girls and 494 boys from the population-based Tromsø study Fit Futures, which included first-year students attending upper secondary school in 2010–2011 from two municipalities in Northern Norway (1038 participants in total, 93% participation rate). Multivariable binary logistic regression analyses stratified by sex were used to investigate the association between socioeconomic position indicators (adolescent’s own study program, parents’ education and employment status) and overweight/obesity indicated by body weight and waist circumference, untreated dental caries in dentine, and when these conditions were considered simultaneously.

Results

Boys enrolled in the general studies and sports programs (versus vocational) had lower odds of being overweight/obese (POR 0.42, 95% CI 0.20–0.86 and POR 0.24, 95% CI 0.08–0.73, respectively), of having high waist circumference (POR 0.39, 95% CI 0.21–0.75 and POR 0.25, 95% CI 0.10–0.64, respectively), dental caries (POR 0.57, 95% CI 0.32–0.99 and POR 0.47, 95% CI 0.22–0.98, respectively), and being simultaneously overweight/obese, having high waist circumference and dental caries (POR 0.24, 95% CI 0.07–0.81 and POR 0.11, 95% CI 0.01–0.98, respectively). Girls enrolled in the general studies program (versus vocational) had lower odds of having dental caries (POR 0.50, 95% CI 0.30–0.84).

Conclusions

Adolescent’s own study program was identified to be a common social determinant for overweight/obesity and dental caries among boys. These results support the broader concept of social determinants as common risk factors for general and oral health conditions, and call for common health promotion strategies addressing these common social determinants among adolescents. However, there is a need for more studies to investigate and better understand the influence of social determinants on health conditions among adolescents.
Valuing end-of-life care: translation and content validation of the ICECAP-SCM measure
Authors: Gühne Uta , Dorow Marie , Grothe Jessica , Stein Janine , Löbner Margrit , Dams Judith , Coast Joanna , Kinghorn Philip , König Hans-Helmut , Riedel-Heller Steffi G.
Published: February 2021

Background

The evaluation of care strategies at the end of life is particularly important due to the globally increasing proportion of very old people in need of care. The ICECAP-Supportive Care Measure is a self-complete questionnaire developed in the UK to evaluate palliative and supportive care by measuring patient’s wellbeing in terms of ‘capability’. It is a new measure with high potential for broad and international use. The aims of this study were the translation of the ICECAP-Supportive Care Measure from English into German and the content validation of this version.

Methods

A multi-step and team-based translation process based on the TRAPD model was performed. An expert survey was carried out to assess content validity. The expert panel (n = 20) consisted of four expert groups: representative seniors aged 65+, patients aged 65+ living in residential care, patients aged 65+ receiving end-of-life care, and professionals in end-of-life care.

Results

The German version of the ICECAP-Supportive Care Measure showed an excellent content validity on both item- and scale-level. In addition, a high agreement regarding the length of the single items and the total length of the questionnaire as well as the number of answer categories was reached.

Conclusions

The German ICECAP-SCM is a valid tool to assess the quality of life at the end of life that is suitable for use in different settings. The questionnaire may be utilized in multinational clinical and economic evaluations of end-of-life care.
Relationship between admission criteria and academic performance in basic science courses in health science colleges in KAU
Authors: Alamoudi Aliaa Amr , Fallatah Hind Ibrahim , Eldakhakhny Basmah Medhat , Kamel Fatemah Omar , AlShawwa Lana Adey , Elsamanoudy Ayman Zaky
Published: February 2021

Background

At King Abdulaziz University, medical and health science schools depend on admission exams (aptitude and achievement) and preparatory year scores in their students’ selection. However, with the growing number of applicants and the drastic changes in teaching and assessment in these colleges, continuous assessment and development of admission criteria are needed. In this study, we aimed to evaluate the correlation of admission exam scores, in addition to the preparatory year Grade Point Average (GPA), with academic performance in the basic science subjects such as Clinical Biochemistry and Clinical Pharmacology in health science colleges.

Methods

The study was conducted on four cohort studies, two faculty of nursing cohorts; nursing students (2017-2018,n=146) nursing students (2018-2019,n=81), and two faculty of applied medical sciences cohorts, clinical nutrition students (2017-2018,n=33), and clinical nutrition students (2018-2019,n=28). The students’ scores of General Aptitude Test (GAT), Scholastic Achievement Admission Test (SAAT), and preparatory year GPA were all recorded at the beginning of each semester before the beginning of courses. Clinical Biochemistry and Clinical Pharmacology exam results were recorded at the end of the semester. Correlation was done for each cohort and all cohorts pooled.

Results

Results showed only a weak correlation detected between SAAT and the overall achievement in Clinical Biochemistry (r= 0.192,P= 0.042) in nursing students (2017-2018), but no correlation was seen with SAAT or preparatory year scores. There was also no significant correlation between admission exams scores and the students’ academic achievement in Clinical Biochemistry or Clinical Pharmacology. On the other hand Clinical Pharmacology exam results showed a significant positive correlation with Clinical Biochemistry results (r=0.688,P=0.000).

Conclusion

Our results could indicate the need to revisit the admission criteria for these colleges. Furthermore, specific preparatory year tracks for health science colleges can ensure that students improve the specific skills and knowledge required for their future college years3
“It’s all about delivery”: researchers and health professionals’ views on the moral challenges of accessing neurobiological information in the context of psychosis
Authors: Corsico Paolo
Published: February 2021

Background

The convergence of neuroscience, genomics, and data science holds promise to unveil the neurobiology of psychosis and to produce new ways of preventing, diagnosing, and treating psychotic illness. Yet, moral challenges arise in neurobiological research and in the clinical translation of research findings. This article investigates the views of relevant actors in mental health on the moral challenges of accessing neurobiological information in the context of psychosis.

Methods

Semi-structured individual interviews with two groups: researchers employed in the National Health Service (NHS) or a university in England (n = 14), and mental health professionals employed in NHS mental health services (n = 14). This article compares results in the two groups (total n = 28).

Results

This article presents findings around three conceptual areas: (1) research ethics as mostly unproblematic, (2) psychosis, neurobiological information, and mental health care, and (3) identity, relationships, and the future. These areas are drawn from the themes and topics that emerged in the interviews across the two groups of participants. Researchers and health professionals provided similar accounts of the moral challenges of accessing—which includes acquisition, communication, and use of—neurobiological information in the context of psychosis. Acquiring neurobiological information was perceived as mostly unproblematic, provided ethical safeguards are put in place. Conversely, participants argued that substantive moral challenges arise from how neurobiological information is delivered—that is, communicated and used—in research and in clinical care. Neurobiological information was seen as a powerful tool in the process through which individuals define their identity and establish personal and clinical goals. The pervasiveness of this narrative tool may influence researchers and health professionals’ perception of ethical principles and moral obligations.

Conclusions

This study suggests that the moral challenges that arise from accessing neurobiological information in the context of psychosis go beyond traditional research and clinical ethics concerns. Reflecting on how accessing neurobiological information can influence individual self-narratives will be vital to ensure the ethical translation of neuroscience and genomics into mental health.

Trial registration

The study did not involve a health care intervention on human participants. It was retrospectively registered on 11 July 2018, registration number: researchregistry4255.
An empirical analysis of dealing with patients who are lost to follow-up when developing prognostic models using a cohort design
Authors: Reps Jenna M. , Rijnbeek Peter , Cuthbert Alana , Ryan Patrick B. , Pratt Nicole , Schuemie Martijn
Published: February 2021

Background

Researchers developing prediction models are faced with numerous design choices that may impact model performance. One key decision is how to include patients who are lost to follow-up. In this paper we perform a large-scale empirical evaluation investigating the impact of this decision. In addition, we aim to provide guidelines for how to deal with loss to follow-up.

Methods

We generate a partially synthetic dataset with complete follow-up and simulate loss to follow-up based either on random selection or on selection based on comorbidity. In addition to our synthetic data study we investigate 21 real-world data prediction problems. We compare four simple strategies for developing models when using a cohort design that encounters loss to follow-up. Three strategies employ a binary classifier with data that: (1) include all patients (including those lost to follow-up), (2) exclude all patients lost to follow-up or (3) only exclude patients lost to follow-up who do not have the outcome before being lost to follow-up. The fourth strategy uses a survival model with data that include all patients. We empirically evaluate the discrimination and calibration performance.

Results

The partially synthetic data study results show that excluding patients who are lost to follow-up can introduce bias when loss to follow-up is common and does not occur at random. However, when loss to follow-up was completely at random, the choice of addressing it had negligible impact on model discrimination performance. Our empirical real-world data results showed that the four design choices investigated to deal with loss to follow-up resulted in comparable performance when the time-at-risk was 1-year but demonstrated differential bias when we looked into 3-year time-at-risk. Removing patients who are lost to follow-up before experiencing the outcome but keeping patients who are lost to follow-up after the outcome can bias a model and should be avoided.

Conclusion

Based on this study we therefore recommend (1) developing models using data that includes patients that are lost to follow-up and (2) evaluate the discrimination and calibration of models twice: on a test set including patients lost to follow-up and a test set excluding patients lost to follow-up.
Health care provider time in public primary care facilities in Lima, Peru: a cross-sectional time motion study
Authors: Leslie Hannah H. , Laos Denisse , Cárcamo Cesar , Pérez-Cuevas Ricardo , García Patricia J.
Published: February 2021

Background

In Peru, a majority of individuals bypass primary care facilities even for routine services. Efforts to strengthen primary care must be informed by understanding of current practice. We conducted a time motion assessment in primary care facilities in Lima with the goals of assessing the feasibility of this method in an urban health care setting in Latin America and of providing policy makers with empirical evidence on the use of health care provider time in primary care.

Methods

This cross-sectional continuous observation time motion study took place from July – September 2019. We used two-stage sampling to draw a sample of shifts for doctors, nurses, and midwives in primary health facilities and applied the Work Observation Method by Activity Timing tool to capture type and duration of provider activities over a 6-h shift. We summarized time spent on patient care, paper and electronic record-keeping, and non-work (personal and inactive) activities across provider cadres. Observations are weighted by inverse probability of selection.

Results

Two hundred seventy-five providers were sampled from 60 facilities; 20% could not be observed due to provider absence (2% schedule error, 8% schedule change, 10% failure to appear). One hundred seventy-four of the 220 identified providers consented (79.1%) and were observed for a total of 898 h of provider time comprising 30,312 unique tasks. Outpatient shifts included substantial time on patient interaction (110, 82, and 130 min for doctors, nurses, and midwives respectively) and on paper records (132, 97, and 141 min) on average. Across all shifts, 1 in 6 h was spent inactive or on personal activities. Two thirds of midwives used computers compared to half of nurses and one third of doctors.

Conclusions

The time motion study is a feasible method to capture primary care operations in Latin American countries and inform health system strengthening. In the case of Lima, absenteeism undermines health worker availability in primary care facilities, and inactive time further erodes health workforce availability. Productive time is divided between patient-facing activities and a substantial burden of paper-based record keeping for clinical and administrative purposes. Electronic health records remain incompletely integrated within routine care, particularly beyond midwifery.
Hermansky-Pudlak syndrome-2 alters mitochondrial homeostasis in the alveolar epithelium of the lung
Authors: Cuevas-Mora Karina , Roque Willy , Shaghaghi Hoora , Gochuico Bernadette R. , Rosas Ivan O. , Summer Ross , Romero Freddy
Published: February 2021

Background

Mitochondrial dysfunction has emerged as an important player in the pathogenesis of idiopathic pulmonary fibrosis (IPF), a common cause of idiopathic interstitial lung disease in adults. Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder that causes a similar type of pulmonary fibrosis in younger adults, although the role of mitochondrial dysfunction in this condition is not understood.

Methods

We performed a detailed characterization of mitochondrial structure and function in lung tissues and alveolar epithelial cells deficient in the adaptor protein complex 3 beta 1 (Ap3b1) subunit, the gene responsible for causing subtype 2 of HPS (HPS-2).

Results

We observed widespread changes in mitochondrial homeostasis in HPS-2 cells, including the acquisition of abnormally shaped mitochondria, with reduced number of cristae, and markedly reduced activity of the electron transport chain and the tricarboxylic acid cycle. We also found that mitochondrial redox imbalance and activity of the mitochondrial unfolded protein response were dysregulated in HPS-2 cells and this associated with various other changes that appeared to be compensatory to mitochondrial dysfunction. This included an increase in glycolytic activity, an upregulation in the expression of mitochondrial biogenesis factors and enhanced activation of the energy-conserving enzyme AMP-activated protein kinase.

Conclusion

In summary, our findings indicate that mitochondrial function is dramatically altered in HPS-2 lung tissues, suggesting dysfunction of this organelle might be a driver of HPS lung disease.
Direct RBS Engineering of the biosynthetic gene cluster for efficient productivity of violaceins in E. coli
Authors: Zhang Yuyang , Chen Hongping , Zhang Yao , Yin Huifang , Zhou Chenyan , Wang Yan
Published: February 2021

Background

Violaceins have attracted much attention as potential targets used in medicines, food additives, insecticides, cosmetics and textiles, but low productivity was the key factor to limit their large-scale applications. This work put forward a direct RBS engineering strategy to engineer the violacein biosynthetic gene cluster cloned from Chromobacterium violaceum ATCC 12,472 to efficiently improve the fermentation titers.

Results

Through four-rounds of engineering of the native RBSs within the violaceins biosynthetic operon vioABCDE, this work apparently broke through the rate-limiting steps of intermediates conversion, resulting in 2.41-fold improvement of violaceins production compared to the titers of the starting strain Escherichia coli BL21(DE3) (Vio12472). Furthermore, by optimizing the batch-fermentation parameters including temperature, concentration of IPTG inducer and fermentation time, the maximum yield of violaceins from (BCDE)m (tnaA−) reached 3269.7 µM at 2 mM tryptophan in the medium. Interestingly, rather than previous reported low temperature (20 ℃), we for the first time found the RBS engineered Escherichia coli strain (BCDE)m worked better at higher temperature (30 ℃ and 37 ℃), leading to a higher-level production of violaceins.

Conclusions

To our knowledge, this is the first time that a direct RBS engineering strategy is used for the biosynthesis of natural products, having the potential for a greater improvement of the product yields within tryptophan hyperproducers and simultaneously avoiding the costly low temperature cultivation for large-scale industrial production of violaciens. This direct RBS engineering strategy could also be easily and helpfully used in engineering the native RBSs of other larger and value-added natural product biosynthetic gene clusters by widely used site-specific mutagenesis methods represented by inverse PCR or CRISPR-Cas9 techniques to increase their fermentation titers in the future.
Signaling pathways of EBV-induced oncogenesis
Authors: Luo Yin , Liu Yitong , Wang Chengkun , Gan Runliang
Published: February 2021

Epstein-Barr virus (EBV) is closely associated with multiple human cancers. EBV-associated cancers are mainly lymphomas derived from B cells and T cells (Hodgkin lymphoma, Burkitt lymphoma, NK/T-cell lymphoma, and posttransplant lymphoproliferative disorder (PTLD)) and carcinomas derived from epithelial cells (nasopharyngeal carcinoma and gastric carcinoma). EBV can induce oncogenesis in its host cell by activating various signaling pathways, such as nuclear factor-κB (NF-κB), phosphoinositide-3-kinase/protein kinase B (PI3K/AKT), Janus kinase/signal transducer and transcription activator (JAK/STAT), mitogen-activated protein kinase (MAPK), transforming growth factor-β (TGF-β), and Wnt/β-catenin, which are regulated by EBV-encoded proteins and noncoding RNA. In this review, we focus on the oncogenic roles of EBV that are mediated through the aforementioned signaling pathways.
Automatic segmentation of coronary lumen and external elastic membrane in intravascular ultrasound images using 8-layer U-Net
Authors: Dong Liang , Jiang Wenbing , Lu Wei , Jiang Jun , Zhao Ya , Song Xiangfen , Leng Xiaochang , Zhao Hang , Wang Jian’an , Li Changling , Xiang Jianping
Published: February 2021

Background

Intravascular ultrasound (IVUS) is the golden standard in accessing the coronary lesions, stenosis, and atherosclerosis plaques. In this paper, a fully automatic approach by an 8-layer U-Net is developed to segment the coronary artery lumen and the area bounded by external elastic membrane (EEM), i.e., cross-sectional area (EEM-CSA). The database comprises single-vendor and single-frequency IVUS data. Particularly, the proposed data augmentation of MeshGrid combined with flip and rotation operations is implemented, improving the model performance without pre- or post-processing of the raw IVUS images.

Results

The mean intersection of union (MIoU) of 0.937 and 0.804 for the lumen and EEM-CSA, respectively, were achieved, which exceeded the manual labeling accuracy of the clinician.

Conclusion

The accuracy shown by the proposed method is sufficient for subsequent reconstruction of 3D-IVUS images, which is essential for doctors’ diagnosis in the tissue characterization of coronary artery walls and plaque compositions, qualitatively and quantitatively.
Sharpening our public health lens: advancing im/migrant health equity during COVID-19 and beyond
Authors: Machado Stefanie , Goldenberg Shira
Published: February 2021

Background

Differential impacts of the COVID-19 pandemic have brought deeply rooted inequities to the forefront, where increasing evidence has shown that racialized immigrant and migrant (im/migrant) populations face a disproportionate burden of COVID-19. Im/migrant communities may be worst affected by lockdowns and restrictive measures, face less opportunity to physically distance or stay home sick within ‘essential’ jobs, and experience severe barriers to healthcare. Insufficient attention to experiences of racialized im/migrants in current pandemic responses globally highlights an urgent need to more fulsomely address unmet health needs through an anti-racist, equity-oriented lens. This commentary aims to highlight the need for public health and clinical training, research, and policy to thoughtfully prioritize im/migrant health equity during and beyond the COVID-19 pandemic.

Main text

Global pandemic responses have neglected im/migrants by continuing to ignore or insufficiently address inequities, exacerbating COVID transmission, xenophobia, and occupational injustice. Deaths, illness, stress, and other negative outcomes of the overlapping epidemics of COVID-19 and structural racism disproportionately borne by racialized im/migrants suggest the urgent need for action. As evidence mounts about how im/migrants have been left behind in times of crises, we need enhanced focus on health equity within COVID-19 research and interventions, including research that examines and pursues structural interventions necessary to mitigate these impacts, and that identifies patterns and harms of xenophobic policy, structural racism, and white supremacy in shaping im/migrant health outcomes. We must also strengthen anti-racist and equity-oriented curriculum within health education, and ensure sufficient attention to the needs of im/migrant communities within public health, clinical, and research training.

Conclusion

The COVID-19 pandemic has exacerbated and rendered more visible the deeply rooted health and social inequities faced by racialized im/migrants across diverse settings. We argue for a greater emphasis on equity-focused and anti-racist im/migrant health research, interventions, and training. Policymakers and practitioners must ensure that healthcare policies and practices do not exacerbate inequities, and instead meaningfully address unmet needs of communities, including racialized im/migrants. Ethical and respectful community engagement, commitment and collaboration with global, national, and local communities, policymakers, academics, and educators, as well as accountability across sectors, is critical.
The effectiveness of a men-only supportive expressive group therapy intervention for psychosocial health outcomes in gastrointestinal cancer patients: a 6-month longitudinal study
Authors: Oberoi Devesh , Martopullo Celestina , Bultz Barry D. , Carlson Linda E.
Published: February 2021

Background

An increasing number of gastrointestinal cancer (GI) patients suffer from side effects of cancer treatment that can affect their mood states and quality of life. Despite its demonstrated effectiveness in female cancer patients, Supportive Expressive Group Therapy (SEGT) has not been tested in male cancer patients. The current study sought to examine the longitudinal effects of a professionally-led, men-only SEGT on mood states, coping, and quality of life (QoL) in male GI cancer patients.

Methods

A sample of male GI cancer patients (n = 31), at different stages of cancer treatment, was recruited from an ongoing, men-only biweekly GI cancer SEGT. Data were collected at baseline (before or near the beginning of group attendance) and at three months and six months follow-up. All study outcomes were patient-reported and included socio-demographic data as well as validated questionnaires: Profile of Mood States (POMS) for mood states, Functional Assessment of Cancer Therapy-General (FACT-G) for QoL, and Ways of Coping-Cancer Version (WOC) for coping. Linear mixed models were used to examine the change in outcomes over time. Effect sizes were estimated using Cohen’s d.

Results

The Anxiety (p = .04; d = 0.70), Depression (p = .03; d = 0.93) and Anger (p = .04; d = 1.28) subscales of the POMS decreased between baseline and six months. Participants also reported improvements in coping through Distancing (distancing oneself from negative thoughts, being more accepting of the situation, and looking for positives) of the WOC (p = .04; d = 0.4) between baseline and six months. There was no change in any of the FACT subscales (QoL) over time.

Conclusions

This is the first study to investigate the effects of a SEGT intervention in male cancer patients. Participation in the intervention was associated with improved mood states and coping in male GI cancer patients; however, there was no change in measures of QoL.
Effect of edaravone on pregnant mice and their developing fetuses subjected to placental ischemia
Authors: Atallah Marwa , Yamashita Toru , Abe Koji
Published: February 2021

Growing evidence indicates that reduced uterine perfusion pressure (RUPP) triggers the cascade of events leading to preeclampsia. Edaravone is a powerful free radical scavenger used for the treatment of ischemia/reperfusion diseases due to its anti-oxidative stress and anti-inflammatory properties. Here we investigate the effect of edaravone (3 mg/kg) on different maternal and fetal outcomes of RUPP-induced placental ischemia mice model. RUPP surgery was performed on gestation day (GD) 13 followed by edaravone injection from GD14 to GD18, sacrifice day. The results showed that edaravone injection significantly decreased the maternal blood pressure (113.2 ± 2.3 mmHg) compared with RUPP group (131.5 ± 1.9 mmHg). Edaravone increased fetal survival rate (75.4%) compared with RUPP group (54.4%), increased fetal length, weights, and feto-placental ratio (7.2 and 5.7 for RUPP and RUPP-Edaravone groups, respectively) compared with RUPP group. In addition, RUPP resulted in many fetal morphological abnormalities as well as severe delayed ossification, however edaravone decreased the morphological abnormalities and increased the ossification of the fetal endoskeleton. Edaravone improved the histopathological structure of the maternal kidney and heart as well as decreased the elevated blood urea and creatinine levels (31.5 ± 0.15 mg/dl (RUPP), 25.6 ± 0.1 mg/dl (RUPP+edaravone) for urea and 5.4 ± 0.1 mg/dl (RUPP), 3.5 ± 0.1 mg/dl (RUPP+edaravone) for creatinine) and decreased cleaved caspase-3 expression in the maternal kidney. In conclusion, this study demonstrated that our RUPP mice model recapitulated preeclampsia symptoms and edaravone injection ameliorated most of these abnormalities suggesting its effectiveness and potential application in preeclampsia treatment regimes.
An assessment of implementation science research capacity in Uganda
Authors: Semeere Aggrey S. , Semitala Fred C. , Lunkuse Olivia , Katahoire Anne , Sewankambo Nelson K. , Kamya Moses R.
Published: February 2021

Background

In Uganda and other resource-poor countries, relevant research findings face a tortuous path to translation into policy and routine practice. Implementation science (ImSc) research could facilitate faster translation. Presently it is unclear what ImSc research capacity and possible training needs exist among Ugandan researchers. To assess both components, we interviewed potential trainees in Kampala, Uganda.

Methods

We used a cross-sectional design to survey potential ImSc trainees who had some research training and involvement in generating or utilizing research. Using a questionnaire, we documented eligibility for ImSc training, knowledge and interest in training, existing self-assessed confidence in initiating clinical research (SCICR) and self-assessed confidence in initiating ImSc research (SCIIR), availability for training and preferred modes of training. We developed scores from the Likert scales and used descriptive statistics, logistic regression and ordinal logistic regression to evaluate predictors of SCIIR.

Results

Between November 2016 and April 2017, we interviewed 190 participants; 60% were men, with a median age of 37 years. Among participants, 33% comprised faculty, 37% were graduate students and 30% were project staff. The majority of respondents knew about ImSc (73%) and were research-trained (80%). Only 9% reported any ImSc-related training. Previous ImSc training was associated with higher odds of a SCIIR score ≥ 75th percentile. Previous ImSc training compared to not having any training was associated with higher odds of reporting abilities in behaviour change theory integration (OR: 3.3, 95% CI: 1.3–8.5,p = 0.01) and framework use in intervention design and implementation (OR: 2.9, 95% CI: 1.1–7.4,p = 0.03), accounting for age, sex and current employment. In addition, 53% of participants preferred in-person (face-to-face) short ImSc courses compared to a year-long training, while 33% preferred online courses. Participants reported median availability of 6 hours per week (IQR: 4, 10) for training.

Conclusion

Most participants had some understanding of ImSc research, had research training and were interested in ImSc training. Those with previous ImSc training had better skills and SCIIR, compared to those without previous training. A hybrid approach with modular face-to-face training and online sessions would suit the preferences of most potential trainees.
Neonatal and child mortality data in retrospective population-based surveys compared with prospective demographic surveillance: EN-INDEPTH study
Authors:   and the Every Newborn-INDEPTH Study Collaborative Group, Nareeba Tryphena , Dzabeng Francis , Alam Nurul , Biks Gashaw A. , Thysen Sanne M. , Akuze Joseph , Blencowe Hannah , Helleringer Stephane , Lawn Joy E. , Mahmud Kaiser , Yitayew Temesgen Azemeraw , Fisker Ane B.
Published: February 2021

Background

Global mortality estimates remain heavily dependent on household surveys in low- and middle-income countries, where most under-five deaths occur. Few studies have assessed the accuracy of mortality data or determinants of capturing births in surveys.

Methods

The Every Newborn-INDEPTH study (EN-INDEPTH) included a large, multi-country survey of women aged 15–49 interviewed about livebirths and their survival status in five Health and Demographic Surveillance Systems (HDSSs). The HDSSs undertake regular household visits to register births and deaths for a given population. We analysed EN-INDEPTH survey data to assess background factors associated with not recalling a complete date-of-birth. We calculated Kaplan-Meier survival estimates for both survey and HDSS data and describe age-at-death distributions during the past 5 years for children born to the same women. We assessed the proportion of HDSS-births that could be matched on month-of-birth to survey-births and used regression models to identify factors associated with matching.

Results

69,176 women interviewed in the survey reported 109,817 births and 3064 deaths in children under 5 years in the 5 years prior to the survey. In the HDSS data, the same women had 83,768 registered births and 2335 under-five deaths in the same period. A complete date-of-birth was not reported for 1–7% of survey-births. Birthdates were less likely to be complete for dead children and children born to women of higher parity or with little/no education. Distributions of reported age-at-death indicated heaping at full weeks (neonatal period) and at 12 months. Heaping was more pronounced in the survey data. Survey estimates of under-five mortality rates were similar to HDSS estimates of under-five mortality in two of five sites, higher in the survey in two sites (15%, 41%) and lower (24%) in one site. The proportion of HDSS-births matched to survey-births ranged from 51 to 89% across HDSSs and births of children who had died were less likely to be matched.

Conclusions

Mortality estimates in the survey and HDSS were not markedly different for most sites. However, neither source is a “gold standard” and both sources miss some events. Research is required to improve capture and accuracy to better track newborn and child survival targets.
Utility of adjuvant whole abdominal radiation therapy in ovarian clear cell cancer (OCCC): a pragmatic cohort study of women with classic immuno-phenotypic signature
Authors: Stevens Mark J. , West Simon , Gard Gregory , Renaud Christopher , Nevell David , Roderick Stephanie , Le Andrew
Published: February 2021

Background

To evaluate the initial experience and clinical utility of first-line adjuvant intensity-modulated whole abdominal radiation therapy (WART) in women with ovarian clear cell cancer (OCCC) referred to an academic center.

Methods

Progression-free and overall survival was analyzed in a pragmatic observational cohort study of histologically pure OCCC patients over-expressing HNF-1ß treated between 2013 and end-December 2018. An in-house intensity-modulated WART program was developed from a published pre-clinical model. Radiation dose-volume data was curated to American Association of Physics in Medicine (AAPM) Task Group 263 recommendations. A dedicated database prospectively recorded presenting characteristics and outcomes in a standardized fashion.

Results

Five women with FIGO (2018) stage IA to IIIA2 OCCC were treated with first-line WART. Median age was 58 years (range 47–68 years). At diagnosis CA-125 was elevated in 4 cases (median 56 kU/L: range 18.4–370 kU/L) before primary de-bulking surgery. Severe premorbid endometriosis was documented in 3 patients. At a median follow-up of 77 months (range 16–83 mo.), all patients remain alive and progression-free on clinical, biochemical (CA-125), and18Fluoro-deoxyglucose (FDG) PET/CT re-evaluation. Late radiation toxicity was significant (G3) in 1 case who required a limited bowel resection and chronic nutritional support at 9 months post-WART; 2 further patients had asymptomatic (G2) osteoporotic fragility fractures of axial skeleton at 12 months post-radiation treated with anti-resorptive agents (denosumab).

Conclusions

The clinical utility of intensity-modulated WART in OCCC over-expressing HNF-1β was suggested in this small observational cohort study. The hypothesis that HNF-1β is a portent of platinum-resistance and an important predictive biomarker in OCCC needs further confirmation. Curating multi-institutional cohort studies utilizing WART by means of “Big Data” may improve OCCC care standards in the future.
Effects of COVID-19 on in-hospital cardiac arrest: incidence, causes, and outcome – a retrospective cohort study
Authors: Roedl Kevin , Söffker Gerold , Fischer Dominik , Müller Jakob , Westermann Dirk , Issleib Malte , Kluge Stefan , Jarczak Dominik
Published: February 2021

Background

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), an emerging virus, has caused a global pandemic. Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has led to high hospitalization rates worldwide. Little is known about the occurrence of in-hospital cardiac arrest (IHCA) and high mortality rates have been proposed. The aim of this study was to investigate the incidence, characteristics and outcome of IHCA during the pandemic in comparison to an earlier period.

Methods

This was a retrospective analysis of data prospectively recorded during 3-month-periods 2019 and 2020 at the University Medical Centre Hamburg-Eppendorf (Germany). All consecutive adult patients with IHCA were included. Clinical parameters, neurological outcomes and organ failure/support were assessed.

Results

During the study period hospital admissions declined from 18,262 (2019) to 13,994 (2020) (− 23%). The IHCA incidence increased from 4.6 (2019: 84 IHCA cases) to 6.6 (2020: 93 IHCA cases)/1000 hospital admissions. Median stay before IHCA was 4 (1–9) days. Demographic characteristics were comparable in both periods. IHCA location shifted towards the ICU (56% vs 37%, p < 0.01); shockable rhythm (VT/VF) (18% vs 29%, p = 0.05) and defibrillation were more frequent in the pandemic period (20% vs 35%, p < 0.05). Resuscitation times, rates of ROSC and post-CA characteristics were comparable in both periods. The severity of illness (SAPS II/SOFA), frequency of mechanical ventilation and frequency of vasopressor therapy after IHCA were higher during the 2020 period. Overall, 43 patients (12 with & 31 without COVID-19), presented with respiratory failure at the time of IHCA. The Horowitz index and resuscitation time were significantly lower in patients with COVID-19 (each p < 0.01). Favourable outcomes were observed in 42 and 10% of patients with and without COVID-19-related respiratory failure, respectively.

Conclusion

Hospital admissions declined during the pandemic, but a higher incidence of IHCA was observed. IHCA in patients with COVID-19 was a common finding. Compared to patients with non-COVID-19-related respiratory failure, the outcome was improved.
The epidemiology of hospital death following pediatric severe community acquired pneumonia
Authors: Ao Xiao-Xiao
Published: February 2021

Background

Community acquired pneumonia is the primary cause of pediatric hospitalizations and deaths in children under 5 years of age. But the epidemiology of death in pediatric severe community acquired pneumonia was not well characterized.

Methods

This retrospective observational study was performed at the academic Emergency department and intensive care unit and we investigated the timing, cause, mode and attribution of death in children with severe community acquired pneumonia.

Results

Of 962 subjects with severe community acquired pneumonia, there were 57 non-survivors (5.9% mortality). Median time to death was 7 [IQR 3,16] days from severe community acquired pneumonia recognition. Patients dying ≤7 days were younger, had greater illness severity and higher rate of congenital heart disease, who were more likely to die of a cardiovascular cause. Multiple organ dysfunction syndrome predominated in deaths > 7 days. Unsuccessful cardiopulmonary resuscitation was the most common mode of death at all timepoints. Our findings suggested that in pediatric severe community acquired pneumonia, early deaths were due primarily to cardiovascular dysfunction, while later deaths were more commonly due to multiple organ dysfunction syndrome.

Conclusions

Deaths from non-pulmonary factors accounted for a substantial portion of non-survivors. Respiratory dysfunction accounted for only a minority of deaths. Our study highlighted limitations associated with rescuing patients with severe pneumonia from death if extrapulmonary organ dysfunctions could not be simultaneously managed.
SARS-CoV-2 pneumonia—receptor binding and lung immunopathology: a narrative review
Authors: Menezes Maria Clara Saad , Pestana Diego Vinicius Santinelli , Gameiro Gustavo Rosa , da Silva Luiz Fernando Ferraz , Baron Ėlodie , Rouby Jean-Jacques , Auler Jr José Otavio Costa
Published: February 2021

The current pandemic of COVID-19 caused thousands of deaths and healthcare professionals struggle to properly manage infected patients. This review summarizes information about SARS-CoV-2 receptor binding dynamics and intricacies, lung autopsy findings, immune response patterns, evidence-based explanations for the immune response, and COVID-19-associated hypercoagulability.
Association between ratio for diameters of pulmonary artery to ascending aorta bifurcation in chest CT scan and number of involved vessels in coronary angiography
Authors: Mohseni Iman , Shiri Afshin , Mojahedin Simindokht
Published: February 2021

Objective

Coronary artery disease (CAD) is an important cause of mortality and morbidity, therefore, recognizing its severity and related factors is important. This study was performed to evaluate the association between ratio for diameters of pulmonary artery to ascending aorta bifurcation in chest CT scan and number of involved vessels in coronary angiography. In this observational cross-sectional comparative study, 110 patients who were under coronary angiography in Firoozgar Hospital in 2017 were enrolled, and the association between ratio for diameters of pulmonary artery to ascending aorta bifurcation in their chest CT scan and number of involved vessels in angiography were assessed.

Results

In this study, number of involved vessels in angiography was related to PA/Ao ratio (P = 0.001) and further vessels were accompanied with higher ratio. It may be concluded that, a higher ratio for diameters of pulmonary artery to ascending aorta bifurcation in chest CT scan is related to higher number of involved vessels in coronary angiography, and it may have a predictive role.
Structure-aware protein solubility prediction from sequence through graph convolutional network and predicted contact map
Authors: Chen Jianwen , Zheng Shuangjia , Zhao Huiying , Yang Yuedong
Published: February 2021

Protein solubility is significant in producing new soluble proteins that can reduce the cost of biocatalysts or therapeutic agents. Therefore, a computational model is highly desired to accurately predict protein solubility from the amino acid sequence. Many methods have been developed, but they are mostly based on the one-dimensional embedding of amino acids that is limited to catch spatially structural information. In this study, we have developed a new structure-aware methodGraphSolto predict protein solubility by attentive graph convolutional network (GCN), where the protein topology attribute graph was constructed through predicted contact maps only from the sequence.GraphSolwas shown to substantially outperform other sequence-based methods. The model was proven to be stable by consistent$${\text{R}}^{2}$$R2of 0.48 in both the cross-validation and independent test of theeSOLdataset. To our best knowledge, this is the first study to utilize the GCN for sequence-based protein solubility predictions. More importantly, this architecture could be easily extended to other protein prediction tasks requiring a raw protein sequence.
A port-based forwarding load-balancing scheduling approach for cloud datacenter networks
Authors: Liu Zhiyu , Zhao Aqun , Liang Mangui
Published: February 2021

Today’s datacenter networks (DCNs) scale is rapidly increasing because of the wide deployment of cloud services and the rapid rise of edge computing. The bandwidth consumption and cost of a DCN are growing sharply with the extensions of network size. Thus, how to keep the traffic balanced is a key and challenging issue. However, the traditional load balancing algorithms such as Equal-Cost Multi-Path routing (ECMP) are not suitable for high dynamic traffic in cloud DCNs. In this paper, we propose a port-based forwarding load balancing scheduling (PFLBS) approach for Fat-tree based DCNs with some new features which can overcome the disadvantages of the existing load balancing methods in the following aspects. Firstly, we define a port-based source-routing addressing scheme, which decreases the switch complexity and makes the table-lookup operation unnecessary. Secondly, based on this addressing scheme, we proposed an effective routing mechanism which can obtain multiple available paths for flow scheduling based in Fat-tree. All the path information is saved in servers and each server only needs to maintain its own path information. Thirdly, we propose an efficient algorithm to implement large flows scheduling dynamically in terms of current link utilization ratio. This method is suitable for cloud DCNs and edge computing, which can reduce the complexity of the switches and the power consumption of the whole network. The experiment results indicate that the PFLBS approach has better performance compared with the ECMP, Hedera and MPTCP approaches, which decreases the flow completion time and improves the average throughput significantly. PFLBS is simple and can be implemented with a few signaling overheads.