bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment and outcomes of basicervical femoral neck fractures: A systematic review
Authors: Dekhne Mihir S , Thomas Hannah M. , Haider Thomas , Mortensen Sharri , Rodriguez Edward K. , Weaver Michael J. , von Keudell Arvind
Published: March 2021

Purpose:

This study aims to systematically review the literature comparing surgical treatments options and respective failure rates for basicervical hip fractures.

Methods:

A comprehensive search of databases, including MEDLINE, Embase, Web of Science, and Cochrane Central for studies published in English on or before June 21, 2019 was performed. Selected search terms included “basicervical,” “basi cervical,” “AO/OTA type 31-B,” “femoral neck fracture” AND “bone nails,” “bone screws,” “fracture fixation,” “internal fixation,” “arthroplasty,” “cephalomedullary,” “sliding hip screw,” “ORIF,” and “treatment outcome.” We included studies that assessed outcomes of basicervical fracture fixation using open reduction internal fixation or arthroplasty. Two authors extracted the following data from each paper: study design, country, cohort year, definition of basicervical, intervention type, sample size, patient demographics, follow-up length, percent of fractures that required revision, and the percent of implants that failed.

Results:

Sixteen articles encompassing 910 patients were included. The main outcome was the percent of implants that required revision. The total revision rates were 8% (8 studies, 157 patients, range 0%–55%) for cephalomedullary nails, 7% (10 studies, 584 patients, range 0%–18%) for sliding hip screws, 23% (3 studies, 40 patients, range 16%–50%) for cannulated screws, 0% (1 study, 6 patients) for total hip arthroplasty, and 8% (2 studies, 13 patients, range 0%–11%) for hemiarthroplasty.

Conclusion:

Management of basicervical fractures with SHS and CMN produces similar failure and re-operation rates. Limited evidence is available on the use of cannulated screws and arthroplasty, but available studies suggest that cannulated screws have an unacceptable revision rate (23%) while arthroplasty may be acceptable. Future studies examining the comparative efficacy of various fixation methods would benefit from strict definition of fracture type as well as consistent reporting of functional outcomes, re-operation rates, and mortality.
Standard MRI May Not Predict Specific Acute Anterior Cruciate Ligament Rupture Characteristics
Authors: Hoogeslag Roy A.G. , Buitenhuis Margje B. , Brouwer Reinoud W. , Derks Rosalie P.H. , van Raak Sjoerd M. , Veld Rianne Huis in ‘t
Published: March 2021

Background:

There has been renewed interest in the concept of anterior cruciate ligament (ACL) suture repair (ACLSR). Morphologic characteristics of the ruptured ACL remnant play a role in deciding whether a patient is eligible for ACLSR. However, no classification of these characteristics of ACL rupture on magnetic resonance imaging (MRI) scans has yet been compared with intraoperative findings in the context of ACLSR.

Purpose:

To investigate the value of using preoperative MRI to predict specific characteristics of acute complete ACL rupture.

Study Design:

Cohort study (diagnostic); Level of evidence, 2.

Methods:

A total of 25 patients were included. Two radiologists classified ACL rupture location and pattern on preoperative 1.5-T MRI scans with a standard sequence; the results were compared with the corresponding findings at arthroscopy conducted by a single surgeon. The agreement between the MRI and surgical findings was calculated using Cohen κ values. Furthermore, the reliability coefficients of the MRI classifications within and between radiologists were calculated.

Results:

The agreement between MRI classification and arthroscopic findings for ACL rupture location was slight (Cohen κ, 0.016 [radiologist 1] and 0.087 [radiologist 2]), and for ACL rupture pattern, this was poor to slight (Cohen κ, <0 and 0.074). The intraobserver reliability of MRI classification for ACL rupture location was moderate for radiologist 1 and slight for radiologist 2 (Cohen κ, 0.526 and 0.061, respectively), and for ACL rupture pattern, this was slight for radiologist 1 and 2 (Cohen κ, 0.051 and 0.093, respectively). The interobserver reliability of MRI classification for ACL rupture location and pattern was slight between radiologists (Cohen κ, 0.172 and 0.040, respectively).

Conclusion:

In the current study, we found poor to slight agreement between MRI classification and arthroscopic findings of specific ACL rupture characteristics. In addition, the intra- and interobserver reliability for MRI classification of the ACL rupture characteristics was slight to moderate.
PFAS accumulation in indigenous and translocated aquatic organisms from Belgium, with translation to human and ecological health risk
Authors: Teunen Lies , Bervoets Lieven , Belpaire Claude , De Jonge Maarten , Groffen Thimo
Published: March 2021

Background

Despite specific restrictions on their production and use, per- and polyfluoralkyl substances (PFAS) are still omnipresent in the environment, including aquatic ecosystems. Most biomonitoring studies have investigated the PFAS concentrations in indigenous organisms, whereas active biomonitoring has only been used sporadically. In the present study, accumulated PFAS concentrations were measured in indigenous fish, European perch (Perca fluviatilis) and European eel (Anguilla anguilla), and in translocated freshwater mussels (Dreissena bugensis and Corbicula fluminea) at 44 sampling locations within the main water basins of Flanders, the northern part of Belgium. Finally, both human health risk and ecological risk were assessed based on accumulated concentrations in fish muscle.

Results

Among locations, ΣPFAS concentrations ranged from 8.56–157 ng/g ww (median: 22.4 ng/g ww) in mussels, 5.22–67.8 ng/g ww (median: 20.8 ng/g ww) in perch, and 5.73–68.8 ng/g ww (median: 22.1 ng/g ww) in eel. Concentrations of PFOA and PFTeDA were higher in mussels compared to fish, whereas for PFDA and PFUnDA the opposite was true. A comparison of concentrations on a wet weight basis between both fish species showed significantly higher PFDoDA, PFTrDA, PFTeDA and PFOA concentrations in eel compared to perch and significantly higher concentrations of PFDA and PFOS in perch. In mussels, PFAS profiles were dominated by PFOA and showed a higher relative contribution of short-chained PFAS, while PFAS profiles in fish were dominated by PFOS. Furthermore, all mussel species clearly occupied a lower trophic level than both fish species, based on a stable isotope analysis.

Conclusions

Biomagnification of PFDA, PFUnDA and PFOS and biodilution of PFOA and PFTeDA were observed. Translocated mussels have been proven suitable to determine which PFAS are present in indigenous fish, since similar PFAS profiles were measured in all biota. Finally, mean PFAS concentrations in fish did pose a human health risk for eel, although tolerable daily intake values for perch were close to the reported daily consumption rates in Belgium and exceeded them in highly contaminated locations. Based on the ecological risk of PFOS, the standard was exceeded at about half of the sampling locations (44% for perch and 58% for eel).
Boosting heritability: estimating the genetic component of phenotypic variation with multiple sample splitting
Authors: Mai The Tien , Turner Paul , Corander Jukka
Published: March 2021

Background

Heritability is a central measure in genetics quantifying how much of the variability observed in a trait is attributable to genetic differences. Existing methods for estimating heritability are most often based on random-effect models, typically for computational reasons. The alternative of using a fixed-effect model has received much more limited attention in the literature.

Results

In this paper, we propose a generic strategy for heritability inference, termed as“boosting heritability”, by combining the advantageous features of different recent methods to produce an estimate of the heritability with a high-dimensional linear model. Boosting heritability uses in particular a multiple sample splitting strategy which leads in general to a stable and accurate estimate. We use both simulated data and real antibiotic resistance data from a major human pathogen,Sptreptococcus pneumoniae, to demonstrate the attractive features of our inference strategy.

Conclusions

Boosting is shown to offer a reliable and practically useful tool for inference about heritability.
In silico analysis of bacterial translation factors reveal distinct translation event specific pI values
Authors: Jana Soma , Datta Partha P.
Published: March 2021

Background

Protein synthesis is a cellular process that takes place through the successive translation events within the ribosome by the event-specific protein factors, namely, initiation, elongation, release, and recycling factors. In this regard, we asked the question about how similar are those translation factors to each other from a wide variety of bacteria? Hence, we did a thorough in silico study of the translation factors from 495 bacterial sp., and 4262 amino acid sequences by theoretically measuring their pI and MW values that are two determining factors for distinguishing individual proteins in 2D gel electrophoresis in experimental procedures. Then we analyzed the output from various angles.

Results

Our study revealed the fact that it’s not all same, or all random, but there are distinct orders and the pI values of translation factors are translation event specific. We found that the translation initiation factors are mainly basic, whereas, elongation and release factors that interact with the inter-subunit space of the intact 70S ribosome during translation are strictly acidic across bacterial sp. These acidic elongation factors and release factors contain higher frequencies of glutamic acids. However, among all the translation factors, the translation initiation factor 2 (IF2) and ribosome recycling factor (RRF) showed variable pI values that are linked to the order of phylogeny.

Conclusions

From the results of our study, we conclude that among all the bacterial translation factors, elongation and release factors are more conserved in terms of their pI values in comparison to initiation and recycling factors. Acidic properties of these factors are independent of habitat, nature, and phylogeny of the bacterial species. Furthermore, irrespective of the different shapes, sizes, and functions of the elongation and release factors, possession of the strictly acidic pI values of these translation factors all over the domain Bacteria indicates that the acidic nature of these factors is a necessary criterion, perhaps to interact into the partially enclosed rRNA rich inter-subunit space of the translating 70S ribosome.
The psychometric evaluation of the sense of belonging instrument (SOBI) with Iranian older adults
Authors: Allen Kelly-Ann , Arslan Gökmen , Craig Heather , Arefi Sedigheh , Yaghoobzadeh Ameneh , Sharif Nia Hamid
Published: March 2021

Background

A sense of belonging is a significant predictor of mental health and well-being in later life. A sense of belonging in childhood and adolescence contributes to a number of adult behavioural and psychological outcomes. A high sense of belonging has been associated with better health, longevity, psychological well-being, and disease recovery.

Methods

In this study, the Persian version of the Sense of Belonging Instrument (SOBI) for older adults in Iran was evaluated psychometrically to develop an accurate measure for belonging. Participants in the study were 302 older adults, 60 years old and above, living independently in Iran and chosen through convenience sampling.

Results

An exploratory factor analysis indicated that the four-factor structure, which included 16 items, accounted for 54.12% of the total variance, and was characterized by strong factor loadings, with values ranging from .50 to .87. Thereafter, a confirmatory factor analysis confirmed the four-factor latent structure of the SOBI, providing adequate data-model fit statistics. All latent structures were characterized by adequate-to-strong latent construct (H) internal reliability (α) coefficients.

Conclusions

The Persian version of the SOBI is a useful tool in understanding older adult patients’ sense of belonging when living independently within the community. The implications for practice and research are discussed.
Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies
Authors: Batmani Sedighe , Jalali Rostam , Mohammadi Masoud , Bokaee Shadi
Published: March 2021

Background

Urinary incontinence is a common condition in the general population and, in particular, the older adults population, which reduces the quality of life of these people, so this study aims to systematically examine and meta-analyse the overall prevalence of urinary incontinence in older women around the world and the related and influential factors.

Methods

This report is a comprehensive systematic review and meta-analysis of the findings of research on urinary incontinence in older adults people across the world through looking for MEDLINE, Cochrane Library Sciencedirect, Embase, Scopus, ProQuest and Persian databases, namely iranmedex, magiran, and SID from January 2000 to April 2020, the heterogeneity of the experiments was measured using the I2 index and the data processing was done in the Systematic Meta-Analysis programme.

Results

In 29 studies and the sample size of 518,465 people in the age range of 55–106 years, urinary incontinence in older adults’ women in the world based on a meta-analysis of 37.1% (95% CI: 29.6–45.4%) was obtained. The highest prevalence of urinary incontinence was reported in older adults’ women in Asia with 45.1% (95% CI: 36.9–53.5%). Meta-regression also showed that with increasing the sample size and year of the study, the overall prevalence of urinary incontinence in the older adults women of the world decreased and increased, respectively, which were statistically significant differences (P <  0.05). According to studies, the most important factors influencing the incidence of urinary incontinence in older women are women’s age (p <  0.001), obesity (p <  0.001), diabetes (p <  0.001), women’s education (p <  0.001), delivery rank (p <  0.001), hypertension (p <  0.001), smoking (p <  0.001). They also have urinary tract infections (p <  0.001).

Conclusion

Given the high prevalence of urinary incontinence in older women around the world, health policy makers must consider control and diagnostic measures in older women and prioritize treatment and rehabilitation activities.
Management of Comprehensive Care of multiple-birth infants from fetal to infancy period: challenges, training, strategies
Authors: Changiz Tahereh , Namnabati Mahboobeh
Published: March 2021

Background

Prematurity escalates the crisis of the infants a susceptible group of the society. Multiple delivery further intensifies the susceptibility of both family and health system. A comprehensive care is, thus, necessary to ensure the optimal growth and development of such multiple-births. Accompanied by trainings, challenges, and strategies, the present study was conducted based on a two-year report of comprehensive care management experience on two sets of multiple infants.

Methods

A qualitative case study approach was used to survey these two sets of premature infants (quadruplet and quintuplet) and their families. The data were collected through medical files, interviews, questionnaire, field presence, phone call and WhatsApp application, and continued follow-ups. Content analysis was performed based on survey and interventions during a period of two years in Isfahan, Iran (2018–2020).

Results

Case presentation and comprehensive care management are the main areas resulted from this study. The results of the study were categorized in eight challenging areas (categories) and strategies including sterility and infertility period, transition from the intrauterine to neonatal intensive care unit (NICU), discharge process, physical and developmental status, home visit and home care, development of care plan, socio-economic support, and coronavirus nightmare.

Conclusion

Based on challenges and strategies during these two years, the situation of the multiple-birth infants and their families’ needs should be identified as the first prerequisites in an inter-professional approach and in collaboration with the health providers. Isfahan University of Medical Sciences, Welfare Organization, and the charities were the parties involved with this process in our study. It was also found that developing a separate specific package of comprehensive care management plan for multiple-births is a necessity.
Socioeconomic, demographic and healthcare determinants of the COVID-19 pandemic: an ecological study of Spain
Authors: García Carlos Navarro
Published: March 2021

Background

The coronavirus disease 2019 (COVID-19) pandemic has posed a major challenge to health, economic and political systems around the world. Understanding the socioeconomic, demographic and health determinants affecting the pandemic is of interest to stakeholders. The purpose of this ecological study is to analyse the effect of the different socioeconomic, demographic and healthcare determinants on the mortality rate and estimated cumulative incidence of COVID-19 first wave in the Spanish regions.

Methods

From the available data of the 17 Spanish regions (Autonomous Communities), we have carried out an ecological study through multivariate linear regression using ordinary least squares. To do this, we conducted an analysis using two distinct dependent variables: the logarithm of mortality rate per 1,000,000 inhabitants and the estimated cumulative incidence. The study has 12 explanatory variables.

Results

After applying the backward stepwise multivariate analysis, we obtained a model with nine significant variables at different levels for mortality rate and a model with seven significant variables for estimated cumulative incidence. Among them, six variables are statistically significant and of the same sign in both models: “Nursing homes beds”, “Proportion of care homes over 100 beds”, “Log GDP per capita”, “Aeroplane passengers”, “Proportion of urban people”, and the dummy variable “Island region”.

Conclusions

The different socioeconomic, demographic and healthcare determinants of each region have a significant effect on the mortality rate and estimated cumulative incidence of COVID-19 in territories where the measures initially adopted to control the pandemic have been identical.
Early postoperative clinical recovery of robotic arm-assisted vs. image-based navigated Total hip Arthroplasty
Authors: Shibanuma Nao , Ishida Kazunari , Matsumoto Tomoyuki , Takayama Koji , Sanada Yutaro , Kurosaka Masahiro , Kuroda Ryosuke , Hayashi Shinya
Published: March 2021

Background

This study compared the early clinical recovery of total hip arthroplasty (THA) using computer navigation systems (nTHA) and robotic arm-assisted THA (rTHA).

Methods

Thirty prospective subjects who underwent rTHA were clinically compared to 30 subjects who underwent nTHA. Clinical data (surgical time, intraoperative blood loss, pain severity, number of days to independent walking, and Harris Hip Score (HHS) at discharge), and radiographic parameters (inclination and anteversion angles) were statistically compared between the two groups.

Results

Follow-up times were 24.3 ± 6.0 and 27.0 ± 7.0 days in the rTHA and nTHA groups, respectively. The surgical time (135.1 ± 13.9 min vs. 146.2 ± 12.8 min, p = 0.002), number of days to independent walking (7.2 ± 2.0 vs. 11.5 ± 3.0 days, p < 0.001), and postoperative pain using a numeric rating scale on postoperative days 7, 10,, and 14 (1.4 ± 0.9 vs. 2.2 ± 1.2, p = 0.005; 1.0 ± 0.8 vs. 1.8 ± 1.1, p = 0.002; 0.3 ± 0.5 vs. 1.1 ± 0.9, p < 0.001; respectively) were significantly reduced in the rTHA group compared to the nTHA group. The rTHA group showed a significantly higher postoperative HHS compared to the nTHA group (85.3 ± .3.2 vs. 81.0 ± 8.5, p = 0.014). No statistically significant difference was observed in radiographic parameters between the groups; however, the incidence of intraoperative target angle changes was significantly lower in the rTHA group than in the nTHA group (0/30 subjects [0%] vs. 11/30 subjects [36.7%], p < 0.001).

Conclusion

The surgical time, postoperative pain, and number of days to independent walking were significantly shorter, and the HHS at discharge was significantly higher in the rTHA group than in the nTHA group. Thus, compared to the nTHA group, the rTHA group showed improved early clinical recovery.
Deep learning-based six-type classifier for lung cancer and mimics from histopathological whole slide images: a retrospective study
Authors: Yang Huan , Chen Lili , Cheng Zhiqiang , Yang Minglei , Wang Jianbo , Lin Chenghao , Wang Yuefeng , Huang Leilei , Chen Yangshan , Peng Sui , Ke Zunfu , Li Weizhong
Published: March 2021

Background

Targeted therapy and immunotherapy put forward higher demands for accurate lung cancer classification, as well as benign versus malignant disease discrimination. Digital whole slide images (WSIs) witnessed the transition from traditional histopathology to computational approaches, arousing a hype of deep learning methods for histopathological analysis. We aimed at exploring the potential of deep learning models in the identification of lung cancer subtypes and cancer mimics from WSIs.

Methods

We initially obtained 741 WSIs from the First Affiliated Hospital of Sun Yat-sen University (SYSUFH) for the deep learning model development, optimization, and verification. Additional 318 WSIs from SYSUFH, 212 from Shenzhen People’s Hospital, and 422 from The Cancer Genome Atlas were further collected for multi-centre verification. EfficientNet-B5- and ResNet-50-based deep learning methods were developed and compared using the metrics of recall, precision, F1-score, and areas under the curve (AUCs). A threshold-based tumour-first aggregation approach was proposed and implemented for the label inferencing of WSIs with complex tissue components. Four pathologists of different levels from SYSUFH reviewed all the testing slides blindly, and the diagnosing results were used for quantitative comparisons with the best performing deep learning model.

Results

We developed the first deep learning-based six-type classifier for histopathological WSI classification of lung adenocarcinoma, lung squamous cell carcinoma, small cell lung carcinoma, pulmonary tuberculosis, organizing pneumonia, and normal lung. The EfficientNet-B5-based model outperformed ResNet-50 and was selected as the backbone in the classifier. Tested on 1067 slides from four cohorts of different medical centres, AUCs of 0.970, 0.918, 0.963, and 0.978 were achieved, respectively. The classifier achieved high consistence to the ground truth and attending pathologists with high intraclass correlation coefficients over 0.873.

Conclusions

Multi-cohort testing demonstrated our six-type classifier achieved consistent and comparable performance to experienced pathologists and gained advantages over other existing computational methods. The visualization of prediction heatmap improved the model interpretability intuitively. The classifier with the threshold-based tumour-first label inferencing method exhibited excellent accuracy and feasibility in classifying lung cancers and confused nonneoplastic tissues, indicating that deep learning can resolve complex multi-class tissue classification that conforms to real-world histopathological scenarios.
New classifications of axillary lymph nodes and their anatomical-clinical correlations in breast surgery
Authors: Cirocchi Roberto , Amabile Maria Ida , De Luca Alessandro , Frusone Federico , Tripodi Domenico , Gentile Patrizia , Tabola Renata , Pironi Daniele , Forte Flavio , Monti Massimo , D’Andrea Vito , Sorrenti Salvatore
Published: March 2021

Background

In the last decade, two research groups, the French group by Clough et al. (Br J Surg. 97:1659–65, 2010) and the Chinese one by Li et al. (ISRN Oncol 2013:279013, 2013), proposed two types of classification of axillary lymph nodes in breast cancer, identifying novel anatomic landmarks for dividing the axillary space in lymph node dissection.

Main body

Knowledge of the exact location of the sentinel node helps to focus the surgical dissection and to reduce the morbidity of sentinel lymph node biopsy procedures, in particular the risk of arm lymphedema, without compromising sensitivity.

Conclusion

In this article, we aimed at focusing on the clinical impact that the most recent classifications of axillary lymph nodes have obtained in literature, highlighting the importance of defining new demarcations to preserve the axillary lymph nodes as much as possible in breast surgery.
Aquaporin 3 promotes human extravillous trophoblast migration and invasion
Authors: Nong Yingqi , Li Shifen , Liu Wenjuan , Zhang Xiqian , Fan Lin , Chen Ye , Huang Qianwen , Zhang Qianyu , Liu Fenghua
Published: March 2021

Problem

Does aquaporin 3 (AQP3) affect the migration and invasion of human extravillous trophoblast (HTR8/Svneo) cells?

Method of study

A lentivirus infection system was used to construct stable cell lines with either AQP3 knockdown or overexpression. RT-PCR and western blotting were used to verify the efficiencies of AQP3 knockdown or overexpression in HTR8/Svneo cells at mRNA and protein levels, respectively. Cell Counting Kit-8 and flow cytometry assays were used to detect the influence of AQP3 knockdown or overexpression on proliferation and apoptosis of HTR8/Svneo cells. In addition, wound healing and Transwell invasion assays were used to detect the effects of AQP3 knockdown or overexpression on migration and invasion capabilities of HTR8/Svneo cells. An Agilent gene chip was used to screen for significant differentially expressed genes after AQP3 knockdown. Finally, mechanisms by which AQP3 influences the migration and invasion of HTR8/Svneo cells were explored using bioinformatic analysis.

Results

Compared with controls, migration and invasion capabilities of HTR8/Svneo cells were significantly reduced after AQP3 knockdown, and significantly increased after AQP3 overexpression. Subsequent bioinformatic analysis of gene chip expression profiles indicated downregulation of genes related to adhesion such as PDGF-B, as well as signaling pathways (such as PIK3/AKT, NF-κB, and TNF) after AQP3 knockdown.

Conclusions

AQP3 could significantly promote migration and invasion capabilities of human extravillous trophoblasts, it may mediate embryo invasion and adhesion to endometrium by regulating PDGF-B, PIK3/AKT signaling pathways, although this requires further verification.
Human DNA decays faster with time than viral dsDNA: an analysis on HPV16 using pathology archive samples spanning 85 years
Authors:   the RIS HPV TT study groups, Nicolás-Párraga Sara , Torres Montserrat , Alemany Laia , Félix Ana , Cruz Eugenia , de Sanjosé Silvia , Bosch Francesc Xavier , Bravo Ignacio G.
Published: March 2021

Background

Quality of the nucleic acids extracted from Formalin Fixed Paraffin Embedded (FFPE) samples largely depends on pre-analytic, fixation and storage conditions. We assessed the differential sensitivity of viral and human double stranded DNA (dsDNA) to degradation with storage time.

Methods

We randomly selected forty-four HPV16-positive invasive cervical cancer (ICC) FFPE samples collected between 1930 and 1935 and between 2000 and 2004. We evaluated through qPCR the amplification within the same sample of two targets of the HPV16 L1 gene (69 bp, 134 bp) compared with two targets of the human tubulin-β gene (65 bp, 149 bp).

Results

Both viral and human, short and long targets were amplified from all samples stored for 15 years. In samples archived for 85 years, we observed a significant decrease in the ability to amplify longer targets and this difference was larger in human than in viral DNA: longer fragments were nine times (CI 95% 2.6–35.2) less likely to be recovered from human DNA compared with 1.6 times (CI 95% 1.1–2.2) for viral DNA.

Conclusions

We conclude that human and viral DNA show a differential decay kinetics in FFPE samples. The faster degradation of human DNA should be considered when assessing viral DNA prevalence in long stored samples, as HPV DNA detection remains a key biomarker of viral-associated transformation.
The rise and fall of global health issues: an arenas model applied to the COVID-19 pandemic shock
Authors: Smith Stephanie L. , Shiffman Jeremy , Shawar Yusra Ribhi , Shroff Zubin Cyrus
Published: March 2021

Background

The global health agenda is ill-defined as an analytical construct, complicating attempts by scholars and proponents to make claims about the agenda status of issues. We draw on Kingdon’s definition of the agenda and Hilgartner and Bosk’s public arenas model to conceptualize the global health agenda as those subjects or problems to which collectivities of actors operating nationally and globally are paying serious attention at any given time. We propose an arenas model for global health agenda setting and illustrate its potential utility by assessing priority indicators in five arenas, including international aid, pharmaceutical industry, scientific research, news media and civil society. We then apply the model to illustrate how the status of established (HIV/AIDS), emergent (diabetes) and rising (Alzheimer’s disease) issues might be measured, compared and change in light of a pandemic shock (COVID-19).

Results

Coronavirus priority indicators rose precipitously in all five arenas in 2020, reflecting the kind of punctuation often caused by focusing events. The magnitude of change varied somewhat by arena, with the most pronounced shift in the global news media arena. Priority indicators for the other issues showed decreases of up to 21% and increases of up to 41% between 2019 and 2020, with increases suggesting that the agenda for global health issues expanded in some arenas in 2020— COVID-19 did not consistently displace priority for HIV/AIDS, diabetes or Alzheimer’s disease, though it might have for other issues.

Conclusions

We advance an arenas model as a novel means of addressing conceptual and measurement challenges that often undermine the validity of claims concerning the global health agenda status of problems and contributing causal factors. Our presentation of the model and illustrative analysis lays the groundwork for more systematic investigation of trends in global health agenda setting. Further specification of the model is needed to ensure accurate representation of vital national and transnational arenas and their interactions, applicability to a range of disease-specific, health systems, governance and policy issues, and sensitivity to subtler influences on global health agenda setting than pandemic shocks.
Comprehensive identification of somatic nucleotide variants in human brain tissue
Authors:   Brain Somatic Mosaicism Network, Wang Yifan , Bae Taejeong , Thorpe Jeremy , Sherman Maxwell A. , Jones Attila G. , Cho Sean , Daily Kenneth , Dou Yanmei , Ganz Javier , Galor Alon , Lobon Irene , Pattni Reenal , Rosenbluh Chaggai , Tomasi Simone , Tomasini Livia , Yang Xiaoxu , Zhou Bo , Akbarian Schahram , Ball Laurel L. , Bizzotto Sara , Emery Sarah B. , Doan Ryan , Fasching Liana , Jang Yeongjun , Juan David , Lizano Esther , Luquette Lovelace J. , Moldovan John B. , Narurkar Rujuta , Oetjens Matthew T. , Rodin Rachel E. , Sekar Shobana , Shin Joo Heon , Soriano Eduardo , Straub Richard E. , Zhou Weichen , Chess Andrew , Gleeson Joseph G. , Marquès-Bonet Tomas , Park Peter J. , Peters Mette A. , Pevsner Jonathan , Walsh Christopher A. , Weinberger Daniel R. , Vaccarino Flora M. , Moran John V. , Urban Alexander E. , Kidd Jeffrey M. , Mills Ryan E. , Abyzov Alexej
Published: March 2021

Background

Post-zygotic mutations incurred during DNA replication, DNA repair, and other cellular processes lead to somatic mosaicism. Somatic mosaicism is an established cause of various diseases, including cancers. However, detecting mosaic variants in DNA from non-cancerous somatic tissues poses significant challenges, particularly if the variants only are present in a small fraction of cells.

Results

Here, the Brain Somatic Mosaicism Network conducts a coordinated, multi-institutional study to examine the ability of existing methods to detect simulated somatic single-nucleotide variants (SNVs) in DNA mixing experiments, generate multiple replicates of whole-genome sequencing data from the dorsolateral prefrontal cortex, other brain regions, dura mater, and dural fibroblasts of a single neurotypical individual, devise strategies to discover somatic SNVs, and apply various approaches to validate somatic SNVs. These efforts lead to the identification of 43 bona fide somatic SNVs that range in variant allele fractions from ~ 0.005 to ~ 0.28. Guided by these results, we devise best practices for calling mosaic SNVs from 250× whole-genome sequencing data in the accessible portion of the human genome that achieve 90% specificity and sensitivity. Finally, we demonstrate that analysis of multiple bulk DNA samples from a single individual allows the reconstruction of early developmental cell lineage trees.

Conclusions

This study provides a unified set of best practices to detect somatic SNVs in non-cancerous tissues. The data and methods are freely available to the scientific community and should serve as a guide to assess the contributions of somatic SNVs to neuropsychiatric diseases.
COVID-19: underpowered randomised trials, or no randomised trials?
Authors: Fretheim Atle
Published: March 2021

A recently published trial of face mask use to protect against COVID-19 demonstrated a key barrier to carrying out randomised trials in public health: the need for unattainably large sample sizes. For many public health interventions, the choice is not between sufficiently powered trials and underpowered trials, but between underpowered trials and no trials at all. Underpowered trials should be viewed as contributions to the larger body of evidence, alongside other studies of various sizes and designs, collectively assessed and synthesized in systematic reviews. Overemphasis on sample size calculation is probably more of a hindrance than a help to scientific progress.
Priming with a gonadotropin-releasing hormone agonist before immature oocyte retrieval may improve maturity of oocytes and outcome in in vitro maturation (IVM) cycle: a case report
Authors: Smirnova A. , Anshina M. , Paz E. Shalom , Ellenbogen A.
Published: March 2021

Background

The concept of using a gonadotropin-releasing hormone agonist (GnRH-a) instead of human chorionic gonadotropin for triggering ovulation in patients treated with an antagonist protocol for in vitro fertilization (IVF) has become a routine clinical practice. It may promote oocyte nuclear maturation, resumption of meiosis and cumulus expansion. It seems that this attempt could be beneficial in an in vitro maturation (IVM) oocyte cycle performed for polycystic ovarian syndrome as well as for other indications such as urgent fertility preservation in patients with malignancies or unusual indications.

Case presentation

We present the case of a Caucasian patient who needed fertility preservation when routine natural IVF treatment did not yield oocyte retrieval, followed by three IVM cycles, priming ovulation with a GnRH-a. In total, 12 oocytes were obtained, all matured 4.5 hours after incubation in maturation media. The fertilization rate after intracytoplasmic sperm injection was 83%. Six good-quality embryos were vitrified.

Conclusions

It seems that triggering with a GnRH-a in selected cases may replace human chorionic gonadotropin in IVM of oocytes and could be highly beneficial in terms of obtaining high-grade embryos and possible pregnancy.
Any closer to successful therapy of multiple myeloma? CAR-T cell is a good reason for optimism
Authors: Marofi Faroogh , Tahmasebi Safa , Rahman Heshu Sulaiman , Kaigorodov Denis , Markov Alexander , Yumashev Alexei Valerievich , Shomali Navid , Chartrand Max Stanley , Pathak Yashwant , Mohammed Rebar N. , Jarahian Mostafa , Motavalli Roza , Motavalli Khiavi Farhad
Published: March 2021

Despite many recent advances on cancer novel therapies, researchers have yet a long way to cure cancer. They have to deal with tough challenges before they can reach success. Nonetheless, it seems that recently developed immunotherapy-based therapy approaches such as adoptive cell transfer (ACT) have emerged as a promising therapeutic strategy against various kinds of tumors even the cancers in the blood (liquid cancers). The hematological (liquid) cancers are hard to be targeted by usual cancer therapies, for they do not form localized solid tumors. Until recently, two types of ACTs have been developed and introduced; tumor-infiltrating lymphocytes (TILs) and chimeric antigen receptor (CAR)-T cells which the latter is the subject of our discussion. It is interesting about engineered CAR-T cells that they are genetically endowed with unique cancer-specific characteristics, so they can use the potency of the host immune system to fight against either solid or liquid cancers. Multiple myeloma (MM) or simply referred to as myeloma is a type of hematological malignancy that affects the plasma cells. The cancerous plasma cells produce immunoglobulins (antibodies) uncontrollably which consequently damage the tissues and organs and break the immune system function. Although the last few years have seen significant progressions in the treatment of MM, still a complete remission remains unconvincing. MM is a medically challenging and stubborn disease with a disappointingly low rate of survival rate. When comparing the three most occurring blood cancers (i.e., lymphoma, leukemia, and myeloma), myeloma has the lowest 5-year survival rate (around 40%). A low survival rate indicates a high mortality rate with difficulty in treatment. Therefore, novel CAR-T cell-based therapies or combination therapies along with CAT-T cells may bring new hope for multiple myeloma patients. CAR-T cell therapy has a high potential to improve the remission success rate in patients with MM. To date, many preclinical and clinical trial studies have been conducted to investigate the ability and capacity of CAR T cells in targeting the antigens on myeloma cells. Despite the problems and obstacles, CAR-T cell experiments in MM patients revealed a robust therapeutic potential. However, several factors might be considered during CAR-T cell therapy for better response and reduced side effects. Also, incorporating the CAT-T cell method into a combinational treatment schedule may be a promising approach. In this paper, with a greater emphasis on CAR-T cell application in the treatment of MM, we will discuss and introduce CAR-T cell’s history and functions, their limitations, and the solutions to defeat the limitations and different types of modifications on CAR-T cells.
A wireless caching helper system with heterogeneous traffic and random availability
Authors: Avgouleas Ioannis , Pappas Nikolaos , Angelakis Vangelis
Published: March 2021

Multimedia content streaming from Internet-based sources emerges as one of the most demanded services by wireless users. In order to alleviate excessive traffic due to multimedia content transmission, many architectures (e.g., small cells, femtocells, etc.) have been proposed to offload such traffic to the nearest (or strongest) access point also called “helper”. However, the deployment of more helpers is not necessarily beneficial due to their potential of increasing interference. In this work, we evaluate a wireless system which can serve both cacheable and non-cacheable traffic. More specifically, we consider a general system in which a wireless user with limited cache storage requests cacheable content from a data center that can be directly accessed through a base station. The user can be assisted by a pair of wireless helpers that exchange non-cacheable content as well. Files not available from the helpers are transmitted by the base station. We analyze the system throughput and the delay experienced by the cached user and show how these performance metrics are affected by the packet arrival rate at the source helper, the availability of caching helpers, the caches’ parameters, and the user’s request rate by means of numerical results.
Evaluating effects of focal length and viewing angle in a comparison of recent face landmark and alignment methods
Authors: Li Xiang , Liu Jianzheng , Baron Jessica , Luu Khoa , Patterson Eric
Published: March 2021

Recent attention to facial alignment and landmark detection methods, particularly with application of deep convolutional neural networks, have yielded notable improvements. Neither these neural-network nor more traditional methods, though, have been tested directly regarding performance differences due to camera-lens focal length nor camera viewing angle of subjects systematically across the viewing hemisphere. This work uses photo-realistic, synthesized facial images with varying parameters and corresponding ground-truth landmarks to enable comparison of alignment and landmark detection techniques relative to general performance, performance across focal length, and performance across viewing angle. Recently published high-performing methods along with traditional techniques are compared in regards to these aspects.
Interventions for adolescent alcohol consumption in Africa: protocol for a scoping review including an overview of reviews
Authors: Biggane Alice M. , Briegal Eleanor , Obasi Angela
Published: March 2021

Background

Harmful alcohol use is a leading risk to the health of populations worldwide. Within Africa, where most consumers are adolescents, alcohol use represents a key public health challenge. Interventions to prevent or substantially delay alcohol uptake and decrease alcohol consumption in adolescence could significantly decrease morbidity and mortality, through both immediate effects and future improved adult outcomes. In Africa, these interventions are urgently needed; however, key data necessary to develop them are lacking as most evidence to date relates to high-income countries. The purpose of this review is to examine and map the range of interventions in use and create an evidence base for future research in this area.

Methods

In the first instance, we will conduct a review of systematic reviews relevant to global adolescent alcohol interventions. We will search the Cochrane Database of Systematic Reviews, MEDLINE (Ovid), CINAHL, Web of Science, Global Health and PubMed using a broad search. In the second instance we will conduct a scoping review by drawing on the methodological framework proposed by Arksey and O’Malley. We will search for all study designs and grey literature using the Cochrane Database of Systematic Reviews, MEDLINE (Ovid), CINAHL, Web of Science and Global Health, Google searches and searches in websites of relevant professional bodies and charities. An iterative approach to charting, collating, summarising and reporting the data will be taken, with the development of charting forms and the final presentation of results led by the extracted data. In both instances, the inclusion and exclusion criteria have been pre-defined, and two reviewers will independently screen abstracts and full text to determine eligibility of articles.

Discussion

It is anticipated that our findings will map intervention strategies aiming to reduce adolescent alcohol consumption in Africa. These findings are likely to be useful in informing future research, policy and public health strategies. Findings will be disseminated widely through peer-reviewed publication and in various media, for example, conferences, congresses or symposia.

Protocol Registration

This protocol was submitted to the Open Science Framework on May 03, 2021. www.osf.io/qnvba
Patient and provider knowledge of and attitudes toward medical conditions and medication during pregnancy
Authors: Shadowen Caroline , Wheeler Rachel , Terplan Mishka
Published: March 2021

Background

Knowledge of medical conditions and their evidence-based medications varies among individuals. This range of knowledge may affect attitudes and influence medical decision-making of both patients and providers. Perceptions may be even more impactful in pregnancy, a timeframe subject to bias, and in diseases that include behavioral symptoms and often carry significant societal stigma, such as opioid use disorder (OUD). We present our findings from a survey assessing participants’ knowledge of three distinct medical conditions (diabetes mellitus, bipolar disorder, and OUD) and how this knowledge affects perceptions of these disease states during pregnancy.

Methods

Using existing surveys in the literature as a guideline, we designed a cross-sectional survey including multiple-choice questions to evaluate our hypothesis that less knowledge about a medical condition would result in more negative opinions towards that condition and its treatment throughout pregnancy. Participants responded to perception statements using a 5-point Likert scale (1 = “strongly disagree,” 5 = “strongly agree”). Surveys were administered to patients in prenatal care, patients in OUD treatment, medical students, and medical residents within a single institution. Response means were generated and compared using t tests and ANOVA.

Results

A total of 323 participants completed the survey. There were differences in knowledge between respondent groups and by disease state, with prenatal patients having the least knowledge of all groups about OUD diagnosis (88.5% of prenatal patients answered correctly) and its treatment (91.8% answered correctly). Overall Likert means of all responses demonstrated that participants agreed that new mothers with OUD (mean 4.27, 5 = “strongly agree”) and their babies (4.12) would have challenges that others would not, compared to mothers with bipolar disorder (4.03) and their babies (3.60) as well as mothers with diabetes (3.87) and their babies (3.47), p < .001. Overall, respondents were likely to agree that women with OUD should not try to get pregnant (3.47), whereas they overall disagreed with that statement when it pertained to women with bipolar disorder (2.69, 2 = “disagree”) or diabetes (2.12), p = 0.03.

Conclusions

With this single-center study, we found that, though there were gaps in knowledge regarding disease and disease treatment during pregnancy, less knowledge was not associated with more negative perceptions of disease and disease treatment during pregnancy. Perceptions were especially negative toward pregnant women with OUD. Increasing awareness of lived experiences of patients with disease, as well as the biases carried by both patients and providers, could improve treatment of chronic diseases and outcomes for patients.