bluuebunny/crossref_metadata_2025 huggingface dataset:
Sexual and reproductive health self-care interventions in the Eastern Mediterranean Region: findings from a cross-sectional values and preferences survey to inform WHO normative guidance on self-care interventions
Authors: Logie Carmen H. , Abela Heather , Turk Tarek , Parker Samantha , Gholbzouri Karima
Published: April 2021

Background

Self-care strategies for sexual and reproductive health (SRH) include practices, tools, and strategies for people to manage their health. Access to SRH services has increased in the Eastern Mediterranean Region (EMR) in the past decade. The objective of this manuscript is to provide a preliminary assessment of self-care SRH interventions focusing on access, knowledge, perceived challenges, and recommendations for the future. We aim to contribute to the evidence base on knowledge and uptake of self-care SRH strategies in the EMR.

Methods

We conducted an online cross-sectional Global Values and Preferences Survey (GVPS) to inform WHO guideline development on self-care interventions for SRH. Recruitment was web-based and included hosting the survey on the WHO Department of Reproductive Health and Research website, and sharing the survey link to diverse SRH websites. Analyses included the subsample of respondents living in EMR countries. We first conducted descriptive statistics of sociodemographic and self-care intervention responses. We then conducted bivariate analyses to examine statistically significant differences in knowledge for each intervention between EMR and non-EMR regions. We extracted open-text responses and applied thematic analysis techniques.

Results

There were 53 respondents from the EMR spanning 14 countries, including16 health care providers (HCP) and 37 laypersons. Qualitative responses (n = 16) suggest that (a) perceived benefits of self-care SRH strategies include enhanced SRH access, knowledge, and improved SRH outcomes; (b) perceived concerns include misuse and safety; (c) linkage to care following self-care SRH interventions can consider mobile phone apps, hotlines, health care liaisons, and community outreach; (d) HCP want additional training on strengthening therapeutic alliances with patients and practical information on interventions; and (e) future research can focus on reproductive health, condom use, service barriers, and implementation. EMR respondents reported lower knowledge levels than non-EMR respondents on the following strategies: diaphragm/cervical cap, contraceptive patch, web-based SRH information, post-exposure prophylaxis, re-exposure prophylaxis, and HIV treatment.

Conclusions

Knowledge of self-care SRH strategies varies by intervention type in the EMR. Future research with larger and more representative samples can inform regional self-care SRH implementation. Knowledge dissemination, stigma reduction, accessibility, and training of health care professionals are key domains for advancing access to self-care SRH strategies in the EMR.
Applying a framework to assess the impact of cardiovascular outcomes improvement research
Authors: Sarkies Mitchell N. , Robinson Suzanne , Briffa Tom , Duffy Stephen J. , Nelson Mark , Beltrame John , Cullen Louise , Chew Derek , Smith Julian , Brieger David , Macdonald Peter , Liew Danny , Reid Chris
Published: April 2021

Background

Health and medical research funding agencies are increasingly interested in measuring the impact of funded research. We present a research impact case study for the first four years of an Australian National Health and Medical Research Council funded Centre of Research Excellence in Cardiovascular Outcomes Improvement (2016–2020). The primary aim of this paper was to explore the application of a research impact matrix to assess the impact of cardiovascular outcomes improvement research.

Methods

We applied a research impact matrix developed from a systematic review of existing methodological frameworks used to measure research impact. This impact matrix was used as a bespoke tool to identify and understand various research impacts over different time frames. Data sources included a review of existing internal documentation from the research centre and publicly available information sources, informal iterative discussions with 10 centre investigators, and confirmation of information from centre grant and scholarship recipients.

Results

By July 2019, the impact on the short-term research domain category included over 41 direct publications, which were cited over 87 times (median journal impact factor of 2.84). There were over 61 conference presentations, seven PhD candidacies, five new academic collaborations, and six new database linkages conducted. The impact on the mid-term research domain category involved contributions towards the development of a national cardiac registry, cardiovascular guidelines, application for a Medicare Benefits Schedule reimbursement item number, introduction of patient-reported outcome measures into several databases, and the establishment of nine new industry collaborations. Evidence of long-term impacts were described as the development and use of contemporary management for aortic stenosis, a cardiovascular risk prediction model and prevention targets in several data registries, and the establishment of cost-effectiveness for stenting compared to surgery.

Conclusions

We considered the research impact matrix a feasible tool to identify evidence of academic and policy impact in the short- to midterm; however, we experienced challenges in capturing long-term impacts. Cost containment and broader economic impacts represented another difficult area of impact to measure.
Cigarette smoke-associated inflammation impairs bone remodeling through NFκB activation
Authors: Lu Yi , Di Yuanpu Peter , Chang Ming , Huang Xin , Chen Qiuyan , Hong Ni , Kahkonen Beth A. , Di Marissa E. , Yu Chunyan , Keller Evan T. , Zhang Jian
Published: April 2021

Background

Cigarette smoking constitutes a major lifestyle risk factor for osteoporosis and hip fracture. It is reported to impair the outcome of many clinical procedures, such as wound infection treatment and fracture healing. Importantly, although several studies have already demonstrated the negative correlation between cigarette consume and impaired bone homeostasis, there is still a poor understanding of how does smoking affect bone health, due to the lack of an adequately designed animal model. Our goal was to determine that cigarette smoke exposure impairs the dynamic bone remodeling process through induction of bone resorption and inhibition of bone formation.

Methods

We developed cigarette smoke exposure protocols exposing mice to environmental smoking for 10 days or 3 months to determine acute and chronic smoke exposure effects. We used these models, to demonstrate the effect of smoking exposure on the cellular and molecular changes of bone remodeling and correlate these early alterations with subsequent bone structure changes measured by microCT and pQCT. We examined the bone phenotype alterations in vivo and ex vivo in the acute and chronic smoke exposure mice by measuring bone mineral density and bone histomorphometry. Further, we measured osteoclast and osteoblast differentiation gene expression levels in each group. The function changes of osteoclast or osteoblast were evaluated.

Results

Smoke exposure caused a significant imbalance between bone resorption and bone formation. A 10-day exposure to cigarette smoke sufficiently and effectively induced osteoclast activity, leading to the inhibition of osteoblast differentiation, although it did not immediately alter bone structure as demonstrated in mice exposed to smoke for 3 months. Cigarette smoke exposure also induced DNA-binding activity of nuclear factor kappaB (NFκB) in osteoclasts, which subsequently gave rise to changes in bone remodeling-related gene expression.

Conclusions

Our findings suggest that smoke exposure induces RANKL activation-mediated by NFκB, which could be a “smoke sensor” for bone remodeling.
Health care professionals’ attitudes towards youth-friendly sexual and reproductive health services in Jordan: a cross-sectional study of physicians, midwives and nurses
Authors: Gausman Jewel , Othman Areej , Al-Qotob Raeda , Shaheen Abeer , Abu Sabbah Eman , Aldiqs Mohannad , Hamad Iqbal , Dabobe Maysoon , Langer Ana
Published: April 2021

Background

Youth-friendly sexual and reproductive health (SRH) services are thought to make such services for adolescents more accessible and acceptable; however, provider attitudes may still present an important barrier. Improving youth SRH service utilization has been recognized as a national priority in Jordan; however, existing services remain underutilized. Previous studies found that youth perceive SRH services to be inadequate and that providers are not supportive of their needs. The purpose of this study is measure provider attitudes towards youth-friendly SRH services and explore their variation according to individual characteristics among health care professionals in Jordan.

Methods

We measured provider attitudes towards youth-friendly SRH services using a scale that was developed and validated in Jordan. The scale consists of three subscales: (1) Attitudes towards SRH information and services offered to youth, (2) Norms and personal beliefs, and (3) Attitudes towards the policy and clinical environment. Possible scores range between 1 and 4, with higher scores reflecting more youth-friendly attitudes. Physicians, midwives and nurses working at either primary health centers, comprehensive care centers, or women’s and children’s health centers where services to adolescents are or should be offered were recruited from four governorates in Jordan using a two-stage, cluster sampling scheme. Differences in attitudes were assessed using simple and multivariable linear regression analysis.

Results

The sample consisted of 510 providers from four governorates in Jordan. The mean provider score on the full scale was 2.7, with a range of 2.0 to 3.8. On Subscales 1 and 2, physicians exhibited significantly more youth-friendly attitudes than nurses by scoring 0.17 points higher than nurses on Subscale 1 (95% CI: 0.02–0.32; p < 0.05) in adjusted analyses. Providers who had been previously trained in SRH issues scored 0.10 points higher (95% CI: 0.00—0.20; p < 0.05) than those who had not on Subscale 3. No differences were found according to provider characteristics on Subscale 2. Providers exhibited the lowest scores related to items referencing youth sexual behavior.

Conclusions

Provider attitudes towards youth-friendly SRH service delivery highlight context-specific, cultural concerns. The limited variation in attitudes related to norms and personal beliefs may be a reflection that such beliefs are deeply held across Jordanian society. Last, as past training on SRH was significantly associated with higher scores, our results suggest opportunity for intervention to improve providers’ confidence and knowledge.
A hSCARB2-transgenic mouse model for Coxsackievirus A16 pathogenesis
Authors: Chen Yanli , Li Heng , Yang Jinxi , Zheng Huiwen , Guo Lei , Li Weiyu , Yang Zening , Song Jie , Liu Longding
Published: April 2021

Background

Coxsackievirus A16 (CA16) is one of the neurotropic pathogen that has been associated with severe neurological forms of hand, foot, and mouth disease (HFMD), but its pathogenesis is not yet clear. The limited host range of CA16 make the establishment of a suitable animal model that can recapitulate the neurological pathology observed in human HFMD more difficult. Because the human scavenger receptor class B, member 2 (hSCARB2) is a cellular receptor for CA16, we used transgenic mice bearing human SCARB2 and nasally infected them with CA16 to study the pathogenicity of the virus.

Methods

Coxsackievirus A16 was administered by intranasal instillation to groups of hSCARB2 transgenic mice and clinical signs were observed. Sampled at different time-points to document and characterize the mode of viral dissemination, pathological change and immune response of CA16 infection.

Results

Weight loss and virus replication in lung and brain were observed in hSCARB2 mice infected with CA16, indicating that these animals could model the neural infection process. Viral antigens were observed in the alveolar epithelia and brainstem cells. The typical histopathology was interstitial pneumonia with infiltration of significant lymphocytes into the alveolar interstitial in lung and diffuse punctate hemorrhages in the capillaries of the brainstem. In addition, we detected the expression levels of inflammatory cytokines and detected high levels of interleukin IL-1β, IL-6, IL-18, and IFN-γ in nasal mucosa, lungs and brain tissues.

Conclusions

The hSCARB2-transgenic mice can be productively infected with CA16 via respiratory route and exhibited a clear tropism to lung and brain tissues, which can serve as a model to investigate the pathogenesis of CA16 associated respiratory and neurological disease.
The role of protein hydrolysates for exercise-induced skeletal muscle recovery and adaptation: a current perspective
Authors: Morgan Paul T. , Breen Leigh
Published: April 2021

The protein supplement industry is expanding rapidly and estimated to have a multi-billion market worth. Recent research has centred on understanding how the manufacturing processes of protein supplements may impact muscle recovery and remodeling. The hydrolysed forms of protein undergo a further heating extraction process during production which may contribute to amino acids (AA) appearing in circulation at a slightly quicker rate, or greater amplitude, than the intact form. Whilst the relative significance of the rate of aminoacidemia to muscle protein synthesis is debated, it has been suggested that protein hydrolysates, potentially through the more rapid delivery and higher proportion of di-, tri- and smaller oligo-peptides into circulation, are superior to intact non-hydrolysed proteins and free AAs in promoting skeletal muscle protein remodeling and recovery. However, despite these claims, there is currently insufficient evidence to support superior muscle anabolic properties compared with intact non-hydrolysed proteins and/or free AA controls. Further research is warranted with appropriate protein controls, particularly in populations consuming insufficient amounts of protein, to support and/or refute an important muscle anabolic role of protein hydrolysates. The primary purpose of this review is to provide the reader with a current perspective on the potential anabolic effects of protein hydrolysates in individuals wishing to optimise recovery from, and maximise adaptation to, exercise training.
Correction to: Using organization theory to position middle-level managers as agents of evidence-based practice implementation
Authors: Birken Sarah A. , Currie Graeme
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Higher pedicle screw density does not improve curve correction in Lenke 2 adolescent idiopathic scoliosis
Authors: Skalak Timothy J. , Gagnier Joel , Caird Michelle S. , Farley Frances A. , Li Ying
Published: April 2021

Purpose

Higher pedicle screw density posterior spinal fusion (PSF) constructs have not been shown to result in improved curve correction in Lenke 1 and 5 adolescent idiopathic scoliosis (AIS) but do increase cost. The purpose of this study questioned whether higher screw density constructs improved curve correction and maintenance of correction in Lenke 2 AIS. Secondary goals were to identify predictive factors for correction and postoperative magnitude of curves in Lenke 2 AIS.

Methods

We identified patients 11 to 17 years old who underwent primary PSF for Lenke 2 AIS between 2007 and 2017 who had minimum follow-up of 2 years. Demographic and radiographic data were collected to perform regression and elimination analysis.

Results

Thirty patients (21 females, 9 males) were analyzed. Average age and SD at time of surgery was 14.0 ± 1.8 years (range, 11–17 years), and median follow-up was 2.8 years (IQR 2.1–4.0 years). Implant density did not predict final postoperative curve magnitude. Predictors of final postoperative curve magnitude were sex and preoperative curve magnitude. Predictors of percentage of correction of major curve were sex and age at the time of surgery. Predictors of final postoperative thoracic kyphosis were sex and percent flexibility preop. Females had lower final postoperative major curve magnitude, a higher percent curve correction, and lower postoperative thoracic kyphosis.

Conclusions

Increased implant density is not predictive of postoperative curve magnitude in Lenke 2 AIS. Predictors of postoperative curve magnitude are sex and preoperative curve magnitude.

Level of evidence

Level III, retrospective observational
The current state of anesthesia safety in a third world country: a cross-sectional survey among anesthesia providers in Ethiopia
Authors: Mihretu Fassil
Published: April 2021

Background

Improving patient safety during anesthesia and surgery becomes a major global public health issue due to the increasing in surgical burden. Anesthesia is delivered safely in developed countries, but its safety is hampered by complex problems in third world countries. This survey assesses the unmet anesthesia needs of one of a third world country, Ethiopia.

Methods

A cross-sectional survey was conducted in Amhara region of Ethiopia from 15/12/2019 to 30/1/2020. All 81 hospitals of the region were stratified by their level as district, general, and referral hospital. The study was conducted in 66 hospitals. The number of hospitals from each strata were calculated by proportional sampling technique resulting; five referral, three general, and fifty eight primary hospitals. Each hospital from each strata was selected by convenience. Each anesthesia provider for the survey was selected randomly from each hospital and questionnaires were distributed. The minimum expected safe anesthesia requirements were taken from World Health Organization-World Federation of Societies of Anesthesiologists International Standard and Ethiopian Hospitals Standard. Anesthesia practice was expected safe if the minimum requirements were practiced always (100%) in each hospital. P < 0.05 with 95% confidence interval were used to compare the safety of anesthesia between higher and lower level hospitals.

Results

Seventy eight (88.6%) anesthesia providers working in 62 hospitals responded to the survey. On aggregate, 36 (58%) hospitals from the total 62 hospitals have met the minimum expected safe anesthesia requirements. Among the different variables assessed; professional aspects 32 (52.45%), medication and intravenous fluid 33 (53.36%), equipment and facilities 33 (52.56%), patient monitoring 43(68.88%), and anesthesia conduct 38 (62.1%) of surveyed hospitals have met the minimum requirements. Anesthesia safety is relatively higher in higher level hospitals (general and referral) 6 (75%) when compared to district hospitals 30 (55.5%), P < 0.001.

Conclusion

Anesthesia safety in Ethiopia appears challenged by substandard continuous medical education and continuous professional development practice, and limited availability of some essential equipment and medications. Patient monitoring and anesthesia conduct are relatively good, but World Health Organization surgical safety checklist application and postoperative pain management are very low, affecting the delivery of safe anesthesia conduct.
Targeting MCL-1 in cancer: current status and perspectives
Authors: Wang Haolan , Guo Ming , Wei Hudie , Chen Yongheng
Published: April 2021

Myeloid leukemia 1 (MCL-1) is an antiapoptotic protein of the BCL-2 family that prevents apoptosis by binding to the pro-apoptotic BCL-2 proteins. Overexpression of MCL-1 is frequently observed in many tumor types and is closely associated with tumorigenesis, poor prognosis and drug resistance. The central role of MCL-1 in regulating the mitochondrial apoptotic pathway makes it an attractive target for cancer therapy. Significant progress has been made with regard to MCL-1 inhibitors, some of which have entered clinical trials. Here, we discuss the mechanism by which MCL-1 regulates cancer cell apoptosis and review the progress related to MCL-1 small molecule inhibitors and their role in cancer therapy.
Child Caregiver’s healthcare seeking behavior and its determinants for common childhood illnesses in Addis Ababa, Ethiopia: a community-based study
Authors: Bellete Martha , Boke Moges Muluneh , Yenit Melaku Kindie
Published: April 2021

Background

Appropriate healthcare-seeking behavior and access to the health care facility is key to improving health service utilization. Although the accessibility of comprehensive childhood disease intervention services in Ethiopia has been modified at the community level, the use of such health care services has remained limited. Therefore, this study aimed to assess the healthcare-seeking behavior of common childhood illness and its determinants.

Methods

A community-based cross-sectional study design was used. A multi-stage sampling method was used to recruit eight hundred and thirty-four study participants. A pre-tested and standardized questionnaire was used to collect data. The collected data were visually checked for incompleteness and entered into the statistical software Epi-info version 7 and exported to SPSS version 20 software for descriptive and bi-variable analysis. To identify variables associated with the healthcare-seeking behavior. Logistic regression analysis was performed. Adjusted odds ratios with a 95% confidence interval were used to see the strength of association, and variables with P-values of < 0.05 were considered statistically significant.

Results

The proportion of health care seeking behavior of care-givers for childhood illness was 69.5% (95% CI, 66.4, 72.4%). The education level of caregiver (AOR: 1.61, 95% CI: 1.01–2.60), knowledge of childhood illness (AOR: 2.02, 95% CI: 1.46–2.79), cough (AOR: 1.94, 95% CI: 1.39–2.71) and diarrhea (AOR: 2.09, 95% CI: 1.46–2.99) as main symptoms of illness and perceived severity of illness (AOR:3.12, 95% CI: 2.22–4.40) were significantly associated with healthcare-seeking behaviors of caregivers.

Conclusion

Low healthcare-seeking behavior was observed for childhood illnesses. Educational level, knowledge of childhood illness, cough, and diarrhea as primary symptoms of illness, and perceived severity of caregiver illness were significant associated with healthcare-seeking behavior. Therefore, interventions that strengthen the caregiver’s awareness of childhood illness and danger signs need to be considered. Besides, addressing the identified associated variables to healthcare-seeking behavior is critically important to curb the problem.
Using behavioral theory and shared decision-making to understand clinical trial recruitment: interviews with trial recruiters
Authors: Brehaut Jamie C. , Lavin Venegas Carolina , Hudek Natasha , Presseau Justin , Carroll Kelly , Rodger Marc
Published: April 2021

Background

Clinical trial recruitment is a continuing challenge for medical researchers. Previous efforts to improve study recruitment have rarely been informed by theories of human decision making and behavior change. We investigate the trial recruitment strategies reported by study recruiters, guided by two influential theoretical frameworks: shared decision-making (SDM) and the Theoretical Domains Framework (TDF) in order to explore the utility of these frameworks in trial recruitment.

Methods

We interviewed all nine active study recruiters from a multi-site, open-label pilot trial assessing the feasibility of a large-scale randomized trial. Recruiters were primarily nurses or master's-level research assistants with a range of 3 to 30 years of experience. The semi-structured interviews included questions about the typical recruitment encounter, questions concerning the main components of SDM (e.g. verifying understanding, directive vs. non-directive style), and questions investigating the barriers to and drivers of their recruitment activities, based on the TDF. We used directed content analysis to code quotations into TDF domains, followed by inductive thematic analysis to code quotations into sub-themes within domains and overarching themes across TDF domains. Responses to questions related to SDM were aggregated according to level of endorsement and informed the thematic analysis.

Results

The analysis helped to identify 28 sub-themes across 11 domains. The sub-themes were organized into six overarching themes: coordinating between people, providing guidance to recruiters about challenges, providing resources to recruiters, optimizing study flow, guiding the recruitment decision, and emphasizing the benefits to participation. The SDM analysis revealed recruiters were able to view recruitment interactions as successful even when enrollment did not proceed, and most recruiters took a non-directive (i.e. providing patients with balanced information on available options) or mixed approach over a directive approach (i.e. focus on enrolling patient in study). Most of the core SDM constructs were frequently endorsed.

Conclusions

Identified sub-themes can be linked to TDF domains for which effective behavior change interventions are known, yielding interventions that can be evaluated as to whether they improve recruitment. Despite having no formal training in shared decision-making, study recruiters reported practices consistent with many elements of SDM. The development of SDM training materials specific to trial recruitment could improve the informed decision-making process for patients.
Esophagus involvement in systemic sclerosis: ultrasound parameters and association with clinical manifestations
Authors: Ma Li , Zhu Qingli , Zhang Yan , Li Jianchu , Jiang Yuxin , Xu Dong , Zeng Xiaofeng , Hou Yong , Liu He
Published: April 2021

Background

The esophagus involvement in systemic sclerosis (SSc) is very common yet underestimated due to the lack of suitable screening tools. This study aims to explore the usefulness of ultrasound (US) in the assessment of esophagus involvement and to identify its relationship with clinical and CT manifestations.

Methods

We performed transabdominal esophageal US in 38 SSc patients and 38 controls. US parameters including the abdominal esophagus length, esophagus wall thickness, shear-wave elastography, gastro-esophageal (His) angle, and reflux were compared. Relationships between distinguishable US parameters and clinical/CT parameters, such as gastro-esophageal reflux disease questionnaire (GERDQ), modified Rodnan skin score (mRSS), interstitial lung disease (ILD) score, the largest esophagus diameter (Dmax), and esophagus dilation percentage (%Eop), were evaluated.

Results

Abdominal esophagus length was shorter in the SSc group than the control group (2.69 cm vs 3.06 cm, P = 0.018), whereas His angle and the angle change before and after drinking water were larger in the SSc group than the control group (121° vs 108°, P < 0.001; 7.97° vs 2.92°, P = 0.025). Reflux was more frequently seen in the SSc group than the control group (7/38 vs 0/38; P = 0.017). As for correlation with clinical and CT parameters, His angle was higher in patients with GERDQ ≥ 8 than GERDQ < 8 (116.5° vs 125.6°, P = 0.035). Patients with reflux showed higher ILD score than patients without (15.8 vs 9.6, P = 0.043). Furthermore, abdominal esophagus length was negatively correlated with %Eop and Dmax (r = − 0.573, P < 0.001; r = − 0.476, P = 0.003).

Conclusion

US parameters of the esophagus can distinguish SSc patients from controls, as well as have correlations with clinical and CT characteristics. Our pilot study first shows that US can be used as a noninvasive and convenient method to evaluate the esophagus involvement in SSc.
Burden of non-alcoholic steatohepatitis among children with type 2 diabetes mellitus
Authors: Parlett Lauren , Ma Qinli , Shi Qian , Crawford Geoffrey , Herrera Scott Laura , Willey Vincent , Agiro Abiy
Published: April 2021

This claims-based retrospective cohort study examined the prevalence and incremental impact of non-alcoholic steatohepatitis among children with type 2 diabetes mellitus in the United States. Although diagnoses of non-alcoholic steatohepatitis were not common among diabetic children, it was associated with significantly higher incremental healthcare cost and risk of hospitalization.
Data on the effects of fertilization on growth rates, biomass allocation, carbohydrates and nutrients of nitrogen-fixing and non-nitrogen-fixing tree legumes during tropical forest restoration
Authors: Jaquetti Roberto K. , Gonçalves José Francisco C.
Published: April 2021

Objectives

Tree legume species play an important role in forest restoration in the tropics. Understanding how different species adjust carbohydrate allocation and growth under distinct nutrient availability will enhance the success of restoring degraded areas.

Data description

A 2-year tropical forest plantation of the Forest Restoration Program of the Balbina Hydropower Dam was evaluated. Three non-N-fixing (Cenostigma tocantinum, Dipteryx odorata and Senna reticulata) and three N-fixing (Clitoria fairchildiana, Inga edulis and Acacia spp.) tree legume species were either fertilized or not fertilized. Growth rates and biomass allocation were calculated, and carbon (C) fractions and nitrogen (N), phosphorus (P) and nonstructural carbohydrate (NSC) concentrations were determined. Multiple nutrient additions increased the growth rates and aboveground biomass production of fertilized plants. According to the results presented, different species and N- fixers respond differently to fertilization regimes. The authors encourage the use of the presented data in meta-analysis studies that consider the fertilization or nutrient deficiency effects on growth, carbohydrate and nutrient responses. N-fixing species with high biomass growth and foliar N are important for restoring N and C cycles in nutrient-limited soils. Fertilization treatments are fundamental during the early stages of forest plantation development.
Diagnostic and prognostic value of plasma neurofilament light and total-tau in sporadic Creutzfeldt-Jakob disease
Authors: Zerr Inga , Villar-Piqué Anna , Hermann Peter , Schmitz Matthias , Varges Daniela , Ferrer Isidre , Riggert Joachim , Zetterberg Henrik , Blennow Kaj , Llorens Franc
Published: April 2021

Background

Blood neurofilament light (Nfl) and total-tau (t-tau) have been described to be increased in several neurological conditions, including prion diseases and other neurodegenerative dementias. Here, we aim to determine the accuracy of plasma Nfl and t-tau in the differential diagnosis of neurodegenerative dementias and their potential value as prognostic markers of disease severity.

Methods

Plasma Nfl and t-tau were measured in healthy controls (HC, n = 70), non-neurodegenerative neurological disease with (NND-Dem, n = 17) and without dementia syndrome (NND, n = 26), Alzheimer’s disease (AD, n = 44), Creutzfeldt-Jakob disease (CJD, n = 83), dementia with Lewy bodies/Parkinson’s disease with dementia (DLB/PDD, n = 35), frontotemporal dementia (FTD, n = 12), and vascular dementia (VaD, n = 22). Biomarker diagnostic accuracies and cutoff points for the diagnosis of CJD were calculated, and associations between Nfl and t-tau concentrations with other fluid biomarkers, demographic, genetic, and clinical data in CJD cases were assessed. Additionally, the value of Nfl and t-tau predicting disease survival in CJD was evaluated.

Results

Among diagnostic groups, highest plasma Nfl and t-tau concentrations were detected in CJD (fold changes of 38 and 18, respectively, compared to HC). Elevated t-tau was able to differentiate CJD from all other groups, whereas elevated Nfl concentrations were also detected in NND-Dem, AD, DLB/PDD, FTD, and VaD compared to HC. Both biomarkers discriminated CJD from non-CJD dementias with an AUC of 0.93. In CJD, plasma t-tau, but not Nfl, was associated with PRNP codon 129 genotype and CJD subtype. Positive correlations were observed between plasma Nfl and t-tau concentrations, as well as between plasma and CSF concentrations of both biomarkers (p < 0.001). Nfl was increased in rapidly progressive AD (rpAD) compared to slow progressive AD (spAD) and associated to Mini-Mental State Examination results. However, Nfl displayed higher accuracy than t-tau discriminating CJD from rpAD and spAD. Finally, plasma t-tau, but not plasma Nfl, was significantly associated with disease duration, offering a moderate survival prediction capacity.

Conclusions

Plasma Nfl and t-tau are useful complementary biomarkers for the differential diagnosis of CJD. Additionally, plasma t-tau emerges as a potential prognostic marker of disease duration.
Severe acute myopathy following SARS-CoV-2 infection: a case report and review of recent literature
Authors: Islam Badrul , Ahmed Mohiuddin , Islam Zhahirul , Begum S. M.
Published: April 2021

Background

SARS-CoV2 virus could be potentially myopathic. Serum creatinine phosphokinase (CPK) is frequently found elevated in severe SARS-CoV2 infection, which indicates skeletal muscle damage precipitating limb weakness or even ventilatory failure.

Case presentation

We addressed such a patient in his forties presented with features of severe SARS-CoV2 pneumonia and high serum CPK. He developed severe sepsis and acute respiratory distress syndrome (ARDS) and received intravenous high dose corticosteroid and tocilizumab to counter SARS-CoV2 associated cytokine surge. After 10 days of mechanical ventilation (MV), weaning was unsuccessful albeit apparently clear lung fields, having additionally severe and symmetric limb muscle weakness. Ancillary investigations in addition with serum CPK, including electromyogram, muscle biopsy, and muscle magnetic resonance imaging (MRI) suggested acute myopathy possibly due to skeletal myositis.

Conclusion

We wish to stress that myopathogenic medication in SARS-CoV2 pneumonia should be used with caution. Additionally, serum CPK could be a potential marker to predict respiratory failure in SARS-CoV2 pneumonia as skeletal myopathy affecting chest muscles may contribute ventilatory failure on top of oxygenation failure due to SARS-CoV2 pneumonia.
An endophytic Schizophyllum commune Fr. exhibits in-vitro and in-vivo antidiabetic activity in streptozotocin induced diabetic rats
Authors: Sharma Avinash , Kaur Rajvir , Kaur Jasleen , Garg Saweta , Bhatti Rajbir , Kaur Amarjeet
Published: April 2021

The present study aimed at isolation of endophytic basidiomycetous fungi and evaluation of their in-vitro and in-vivo antidiabetic potential. Preliminary screening for in-vitro activity was carried out using α-glucosidase inhibition assay. An endophytic isolate Sch1 (isolated from Aloe vera), identified to be Schizophyllum commune Fr. on molecular basis, exhibiting more than 90% α-glucosidase inhibitiory activity was selected for further studies. Detailed in-vivo investigations for antidiabetic potential of ethyl acetate extract of S. commune (Sch1), at two different doses, were carried out in streptozotocin induced diabetic Wistar rats. Treatment of diabetic rats with S. commune extract caused significant decrease in blood glucose level and increase in body weight after 14 days experimental period. It significantly restored renal parameters including creatinine, blood urea nitrogen, fractional excretion of sodium, and potassium level in diabetic rats. Improvement in lipid profile and level of antioxidant parameters viz. reduced glutathione, thiobarbituric acid reactive species, and superoxide anion generation was also observed after treatment. Liver enzymes (serum glutamic pyruvic transaminase, serum glutamic-oxaloacetic transaminases, and alkaline phosphatase) homeostasis was found to be markedly improved in diabetic rats administered with S. commune extract. The effects were more pronounced at higher concentration and comparable to acarbose which was used as positive control. Phytochemical analysis revealed the presence of phenolics and terpenoids in the ethyl acetate extract. This is the first report highlighting the therapeutic potential of an endophytic S. commune in the management of diabetes.
Investigation of the neutral fractional differential inclusions of Katugampola-type involving both retarded and advanced arguments via Kuratowski MNC technique
Authors: Etemad Sina , Souid Mohammed Said , Telli Benoumran , Kaabar Mohammed K. A. , Rezapour Shahram
Published: April 2021

A class of the boundary value problem is investigated in this research work to prove the existence of solutions for the neutral fractional differential inclusions of Katugampola fractional derivative which involves retarded and advanced arguments. New results are obtained in this paper based on the Kuratowski measure of noncompactness for the suggested inclusion neutral system for the first time. On the one hand, this research concerns the set-valued analogue of Mönch fixed point theorem combined with the measure of noncompactness technique in which the right-hand side is convex valued. On the other hand, the nonconvex case is discussed via Covitz and Nadler fixed point theorem. An illustrative example is provided to apply and validate our obtained results.
The effects of stump size and within-gap position on sprout non-structural carbohydrates concentrations and regeneration in forest gaps vary among species with different shade tolerances
Authors: Zhang Ting , Yan Qiaoling , Wang G. Geoff , Zhu Jiaojun
Published: April 2021

Background

To restore secondary forests (major forest resources worldwide), it is essential to accelerate the natural regeneration of dominant trees by altering micro-environments. Forest gaps are products of various disturbances, ranging from natural storms or wildfires to anthropogenic events like logging and slashing-and-burning, and sprouts of most tree species with non-structural carbohydrates (NSCs) storage can regenerate from stumps after gap formation. However, how the stump sprouts with diverse NSCs storages and stump sizes (i.e., diameters) adapt to various micro-environments of within-gap positions remains unclear. Therefore in this study, we monitored the stump sprout regeneration (density, survival, and growth) and NSCs concentrations of three dominant tree species with different shade tolerances and varying stump diameters at five within-gap positions for the first two consecutive years after gap formation.

Results

Stump diameter was positively correlated with sprout density, growth, and survival of all three tree species, but insignificantly related with sprout NSCs concentrations at the early stage after gap formation. The effect of within-gap position on sprout NSCs concentrations was different among species. After an environmental adaptation of two growing seasons, the north of gap (higher light availability and lower soil moisture habitat) was the least conducive for shade-intolerant Quercus mongolica to accumulate leaf NSCs, and the east of gap (shadier and drier habitat) was conducive to increasing the leaf NSCs concentrations of shade-tolerant Tilia mandshurica.

Conclusions

Within-gap position significantly affected leaf NSCs concentrations of all three tree species, but most of the sprout growth, survival, and stem NSCs concentrations were independent of the various within-gap positions. Besides stump diameter, the NSCs stored in stump and root systems and the interspecific differences in shade tolerance also contributed more in sprout regeneration at the early stage (2 years) of gap formation. A prolonged monitoring (> 10 years) is needed to further examine the long-term effects of stump diameter and within-gap position on sprout regeneration. All of these findings could be applied to gap-based silviculture by promoting sprout regeneration of dominant tree species with different shade tolerances, which would help accelerate the restoration of temperate secondary forests.
Preserving inferior right hepatic vein enabled bisegmentectomy 7 and 8 without venous congestion: a case report
Authors: Terayama Masayoshi , Ito Kyoji , Takemura Nobuyuki , Inagaki Fuyuki , Mihara Fuminori , Kokudo Norihiro
Published: April 2021

Background

In hepatectomy, the preservation of portal perfusion and venous drainage in the remnant liver is important for securing postoperative hepatic function. Right hepatectomy is generally indicated when a hepatic tumor involves the right hepatic vein (RHV). However, if a sizable inferior RHV (IRHV) exists, hepatectomy with preservation of the IRHV territory may be another option. In this case, we verified the clinical feasibility of anatomical bisegmentectomy 7 and 8 with RHV ligation, averting the right hepatic parenchyma from venous congestion, utilizing the presence of the IRHV.

Case presentation

A 70-year-old man was presented with a large hepatic tumor infiltrating the RHV on computed tomography during a medical checkup. The patient was diagnosed with hepatocellular carcinoma (HCC), T2N0M0, stage III. Right hepatectomy was first considered, but multi-detector computed tomography (MDCT) also revealed a large IRHV draining almost all of segments 5 and 6, suggesting that IRHV-preserving liver resection may be another option. The calculated future remnant liver volumes were 382 mL (26.1% of the total volume) after right hepatectomy and 755 mL (51.7% of the total volume) after anatomical bisegmentectomy 7 and 8; therefore, we scheduled IRHV-preserving anatomical bisegmentectomy 7 and 8 considering the prevention of postoperative liver failure and increased chance of performing repeat resections in cases of recurrence. Preoperative three-dimensional simulation using MDCT clearly revealed the portal perfusion area and venous drainage territories by the RHV and IRHV. There was an issue with invisibility of the anatomical resection line of segments 7 and 8, which was completely dissolved by intraoperative ultrasonography using Sonazoid and the portal dye injection technique with counter staining. The postoperative course in the patient was uneventful, without recurrence of HCC, for 30 months after hepatectomy.

Conclusions

IRHV-preserving anatomical bisegmentectomy 7 and 8 is a safe and feasible procedure utilizing the three-dimensional simulation of the portal perfusion area and venous drainage territories and the portal dye injection technique.
Protocol for a feasibility study incorporating a randomised pilot trial with an embedded process evaluation and feasibility economic analysis of ThinkCancer!: a primary care intervention to expedite cancer diagnosis in Wales
Authors: Disbeschl Stefanie , Surgey Alun , Roberts Jessica L. , Hendry Annie , Lewis Ruth , Goulden Nia , Hoare Zoe , Williams Nefyn , Anthony Bethany Fern , Edwards Rhiannon Tudor , Law Rebecca-Jane , Hiscock Julia , Carson-Stevens Andrew , Neal Richard D. , Wilkinson Clare
Published: April 2021

Background

Compared to the rest of Europe, the UK has relatively poor cancer outcomes, with late diagnosis and a slow referral process being major contributors. General practitioners (GPs) are often faced with patients presenting with a multitude of non-specific symptoms that could be cancer. Safety netting can be used to manage diagnostic uncertainty by ensuring patients with vague symptoms are appropriately monitored, which is now even more crucial due to the ongoing COVID-19 pandemic and its major impact on cancer referrals. The ThinkCancer! workshop is an educational behaviour change intervention aimed at the whole general practice team, designed to improve primary care approaches to ensure timely diagnosis of cancer. The workshop will consist of teaching and awareness sessions, the appointment of a Safety Netting Champion and the development of a bespoke Safety Netting Plan and has been adapted so it can be delivered remotely. This study aims to assess the feasibility of the ThinkCancer! intervention for a future definitive randomised controlled trial.

Methods

The ThinkCancer! study is a randomised, multisite feasibility trial, with an embedded process evaluation and feasibility economic analysis. Twenty-three to 30 general practices will be recruited across Wales, randomised in a ratio of 2:1 of intervention versus control who will follow usual care. The workshop will be delivered by a GP educator and will be adapted iteratively throughout the trial period. Baseline practice characteristics will be collected via questionnaire. We will also collect primary care intervals (PCI), 2-week wait (2WW) referral rates, conversion rates and detection rates at baseline and 6 months post-randomisation. Participant feedback, researcher reflections and economic costings will be collected following each workshop. A process evaluation will assess implementation using an adapted Normalisation Measure Development (NoMAD) questionnaire and qualitative interviews. An economic feasibility analysis will inform a future economic evaluation.

Discussion

This study will allow us to test and further develop a novel evidenced-based complex intervention aimed at general practice teams to expedite the diagnosis of cancer in primary care. The results from this study will inform the future design of a full-scale definitive phase III trial.

Trial registration

ClinicalTrials.gov NCT04823559.
Phenotypic and haplotypic profiles of insecticide resistance in populations of Aedes aegypti larvae (Diptera: Culicidae) from central Lao PDR
Authors: Shimono Takaki , Kanda Seiji , Lamaningao Pheophet , Murakami Yuki , Darcy Andrew Waleluma , Mishima Nobuyuki , Inthavongsack Somchit , Soprasert Odai , Xaypangna Thonelakhanh , Nishiyama Toshimasa
Published: April 2021

Background

Aedes aegypti, which is widely distributed in the Lao People’s Democratic Republic (PDR), is the primary vector of arboviral diseases. Chemical insecticides have been intensively used to eliminate mosquito-borne diseases, resulting in the development of insecticide resistance. However, little is known about the insecticide resistance of mosquito populations in Lao PDR and the mechanisms responsible for it, which have important implications for vector management programs. Here, we examined the phenotypic and haplotypic profiles of insecticide resistance in populations of Ae. aegypti larvae from central Lao PDR.

Methods

Ae. aegypti larvae were collected from four sites in Lao PDR, and their susceptibility to temephos, deltamethrin, permethrin, and Bacillus thuringiensis israelensis (Bti) was tested using larval bioassays. Synergistic tests were also conducted to evaluate the activity of insecticide-metabolizing enzymes in the larvae. Deltamethrin-resistant and Deltamethrin-susceptible larvae were then genotyped for knockdown resistance (kdr) mutations to determine the associations between each genotype and resistance.

Results

Ae. aegypti larvae from central Lao PDR were considered to be “resistant” (<98% mortality) to organophosphates and pyrethroids. The bio-insecticide Bti remains effective against such larvae. The resistance mechanisms of Ae. aegypti larvae were found to vary among populations, especially for pyrethroid resistance. Kdr mutations were significantly associated with deltamethrin resistance in Ae. aegypti from the Xaythany population. In contrast, synergist assays with piperonyl butoxide suggested that cytochrome P450 monooxygenases played an important role in the resistance seen in the Khounkham and Thakhek populations.

Conclusion

This study obtained information that will aid the design and implementation of insecticide-based vector management of Ae. aegypti in central Lao PDR. Ae. aegypti larvae from central Lao PDR were highly susceptible to Bti, while they were resistant to temephos at a diagnostic dose of 0.0286 mg/L. Given the limited number of insecticides that are approved for vector control, it is important to alternate between temephos and other larvicides, such as Bti and pyriproxyfen. The differences in pyrethroid resistance mechanisms seen among the Ae. aegypti populations highlight the need to tailor vector-control strategies to each region to increase the success of dengue control in Lao PDR.