bluuebunny/crossref_metadata_2025 huggingface dataset:
Priority setting at the clinical level: the case of nusinersen and the Norwegian national expert group
Authors: Magelssen Morten , Rasmussen Magnhild , Wallace Sean , Førde Reidun
Published: May 2021

Background

Nusinersen is one of an increasing number of new, expensive orphan drugs to receive authorization. These drugs strain public healthcare budgets and challenge principles for resource allocation. Nusinersen was introduced in the Norwegian public healthcare system in 2018. A national expert group consisting of physicians was formed to oversee the introduction and continuation of treatment in light of specific start and stop criteria.

Methods

We have studied experiences within the expert group with a special emphasis on their application of the start and stop criteria, rationing of treatment, and experienced moral dilemmas. A research interview with six members of the national expert group was performed, then analysed with manifest content analysis. The analysis was supplemented with publically available sources on priority setting and the process leading up to the introduction of nusinersen and the establishment of the expert group.

Results

Sixty-six patients have received treatment within the first 25 months since the national expert group’s establishment. Treatment has not been discontinued for any patient. No patients under 18 years of age have been denied treatment, as those who were referred at this age were all deemed to fulfill the start criteria. The expert group has, however, increased geographical treatment equity and facilitated important cooperation at the national level. Furthermore, it has enhanced open and critical discussions of both medical issues and new ethical dilemmas.

Conclusion

Although facilitating equal access to treatment for SMA patients, the national expert group has not discontinued treatment for any patient. It is suggested that in order for clinicians to be able to ration care for individual patients, they require both adequate support and sufficient formal authority. Start and stop criteria need to be re-evaluated as more knowledge and experience are gained regarding the treatment.
Collecting specialty-related medical terms: Development and evaluation of a resource for Spanish
Authors: López-Úbeda Pilar , Pomares-Quimbaya Alexandra , Díaz-Galiano Manuel Carlos , Schulz Stefan
Published: May 2021

Background

Controlled vocabularies are fundamental resources for information extraction from clinical texts using natural language processing (NLP). Standard language resources available in the healthcare domain such as the UMLS metathesaurus or SNOMED CT are widely used for this purpose, but with limitations such as lexical ambiguity of clinical terms. However, most of them are unambiguous within text limited to a given clinical specialty. This is one rationale besides others to classify clinical text by the clinical specialty to which they belong.

Results

This paper addresses this limitation by proposing and applying a method that automatically extracts Spanish medical terms classified and weighted per sub-domain, using Spanish MEDLINE titles and abstracts as input. The hypothesis is biomedical NLP tasks benefit from collections of domain terms that are specific to clinical subdomains. We use PubMed queries that generate sub-domain specific corpora from Spanish titles and abstracts, from which token n-grams are collected and metrics of relevance, discriminatory power, and broadness per sub-domain are computed. The generated term set, called Spanish core vocabulary about clinical specialties (SCOVACLIS), was made available to the scientific community and used in a text classification problem obtaining improvements of 6 percentage points in the F-measure compared to the baseline using Multilayer Perceptron, thus demonstrating the hypothesis that a specialized term set improves NLP tasks.

Conclusion

The creation and validation of SCOVACLIS support the hypothesis that specific term sets reduce the level of ambiguity when compared to a specialty-independent and broad-scope vocabulary.
Whole-body vibration training versus conventional balance training in patients with severe COPD—a randomized, controlled trial
Authors: Gloeckl Rainer , Schneeberger Tessa , Leitl Daniela , Reinold Tobias , Nell Christoph , Jarosch Inga , Kenn Klaus , Koczulla Andreas R.
Published: May 2021

Background

Whole-body vibration training (WBV) performed on a vibration platform can significantly improve physical performance in patients with chronic obstructive pulmonary disease. It has been suggested that an important mechanism of this improvement is based on an improvement in balance. Therefore, the aim of this study was to investigate the effects of WBV compared to conventional balance training.

Methods

48 patients with severe COPD (FEV1: 37 ± 7%predicted) and low exercise performance (6 min walk distance (6MWD): 55 ± 10%predicted) were included in this randomized controlled trial during a 3 week inpatient pulmonary rehabilitation. All patients completed a standardized endurance and strength training program. Additionally, patients performed 4 different balance exercises 3x/week for 2 sets of 1 min each, either on a vibration platform (Galileo) at varying frequencies (5–26 Hz) (WBV) or on a conventional balance board (BAL). The primary outcome parameter was the change in balance performance during a semi tandem stance with closed eyes assessed on a force measurement platform. Muscular power during a countermovement jump, the 6MWD, and 4 m gait speed test (4MGST) were secondary outcomes. Non-parametric tests were used for statistical analyses.

Results

Static balance performance improved significantly more (p = 0.032) in favor of WBV (path length during semi-tandem stand: − 168 ± 231 mm vs. + 1 ± 234 mm). Muscular power also increased significantly more (p = 0.001) in the WBV group (+ 2.3 ± 2.5 W/kg vs. − 0.1 ± 2.0 W/kg). 6MWD improved to a similar extent in both groups (WBV: 48 ± 46 m, p < 0.001 vs. BAL: 38 ± 32 m; p < 0.001) whereas the 4MGST increased significantly only in the WBV-group (0.08 ± 0.14 m/s2, p = 0.018 vs. 0.01 ± 0.11 m/s2, p = 0.71).

Conclusions

WBV can improve balance performance and muscular power significantly more compared to conventional balance training.

Trial registration: Clinical-Trials registration number: NCT03157986; date of registration: May 17, 2017. https://clinicaltrials.gov/ct2/results?cond=&term=NCT03157986&cntry=&state=&city=&dist =
FASE-CPHG Study: identification of asthma phenotypes in the French Severe Asthma Study using cluster analysis
Authors:   The CPHG (College of French Non-academic Hospitals), Raherison-Semjen Chantal , Parrat Eric , Nocent-Eijnani Cécilia , Mangiapan Gilles , Prudhomme Anne , Oster Jean-Philippe , Aperre de Vecchi Corinne , Maurer Cyril , Debieuvre Didier , Portel Laurent
Published: May 2021

Background

In France, data regarding epidemiology and management of severe asthma are scarce. The objective of this study was to describe asthma phenotypes using a cluster analysis in severe asthmatics recruited in a real world setting.

Methods

The study design was prospective, observational and multicentric. The patients included were adults with severe asthma (GINA 4–5) followed-up in French Non Academic Hospital between May 2016 and June 2017. One hundred and seven physicians included 1502 patients. Both sociodemographic and clinical variables were collected. Hierarchical cluster analysis was performed by the Ward method followed by k-means cluster analysis on a population of 1424 patients.

Results

Five clusters were identified: cluster 1 (n = 690, 47%) called early onset allergic asthma (47.5% with asthma before 12 years), cluster 2 (n = 153, 10.5%): obese asthma (63.5% with BMI > 30 kg/m2), cluster 3 (n = 299, 20.4%): late-onset asthma with severe obstructive syndrome (89% without atopy), cluster 4 (n = 143, 9.8%): eosinophilic asthma (51.7% had more than 500 eosinophils/mm3), and cluster 5 (n = 139, 9.5%): aspirin sensitivity asthma (63% had severe asthma attacks).

Conclusions

In our population of adults with severe asthma followed by pulmonologists, five distinct phenotypes were identified and are quite different from those mentioned in previous studies.
Transcranial sonographic assessment of the third ventricle in neuro-ICU patients to detect hydrocephalus: a diagnostic reliability pilot study
Authors: Widehem Rémy , Bory Paul , Greco Frédéric , Pavillard Frédérique , Chalard Kévin , Mas Alexandre , Djanikian Flora , Carr Julie , Molinari Nicolas , Jaber Samir , Perrigault Pierre-François , Chanques Gerald
Published: May 2021

Background

Transcranial sonography is a point-of-care tool recommended in intensive care units (ICU) to monitor brain injured patients. Objectives of the study was to assess feasibility and reliability of the third ventricle (V3) diameter measurement using transcranial sonography (TCS) compared to brain computed-tomography (CT), the gold standard measurement, and to measure the TCS learning curve. Design: prospective study, in a 16-bed neurological ICU in an academic hospital. Every consecutive brain injured adult patient, who required a brain CT and TCS monitoring were included. The V3 diameter was blindly measured by TCS and CT. Intraclass correlation coefficient (ICC) and Bland–Altman plot were used to assess the reliability and agreement between TCS and CT V3 measurements. Diagnosis performance of the V3 diameter using TCS to detect hydrocephalus was measured. Absolute difference between V3 measurement by residents and experts was measured consecutively to assess the learning curve.

Results

Among the 100 patients included in the study, V3 diameter could be assessed in 87 patients (87%) from at least one side of the skull. Both temporal windows were available in 70 patients (70%). The ICC between V3 diameter measured by TCS and CT was 0.90 [95% CI 0.84–0.93] on the right side, and 0.92 [0.88–0.95] on the left side. In Bland–Altman analysis, mean difference, standard deviation, 95% limits of agreement were 0.36, 1.52, − 2.7 to 3.3 mm, respectively, on the right side; 0.25, 1.47, − 2.7 to 3.1 mm, respectively, on the left side. Among the 35 patients with hydrocephalus, V3 diameters could be measured by TCS in 31 patients (89%) from at least one side. Hydrocephalus was, respectively, excluded, confirmed, or inconclusive using TCS in 35 (40%), 25 (29%) and 27 (31%) of the 87 assessable patients. After 5 measurements, every resident reached a satisfactory measurement compared to the expert operator.

Conclusion

TCS allows rapid, simple and reliable V3 diameter measurement compared with the gold standard in neuro-ICU patients. Aside from sparing irradiating procedures and transfers to the radiology department, it may especially increase close patient monitoring to detect clinically occult hydrocephalus earlier. Further studies are needed to measure the potential clinical benefit of this method.

Trial registration: ClinicalTrials.gov ID: NCT02830269.
Wireless management system of prefabricated construction materials based on BIM technology
Authors: Wu Xinhua
Published: May 2021

The primary goal of material management is to arrange the use of materials reasonably, which is particularly important for the construction industry. Wireless communication can transmit a lot of information in time in production, which can promote the management and arrangement of building materials. In order to explore the management method of prefabricated materials, this paper compares the prefabricated building materials management based on BIM with the traditional method and the management method combining BIM and wireless communication through sampling survey and sand table simulation. This paper compares the material procurement, storage and quality in the construction stage and analyzes the material management differences of different technical methods in different stages. The results show that the average inventory turnover rate of BIM-based management method is 6 times, and that of conventional method is 4 times. However, in the construction stage, the gap between the two methods is narrowed. The combination of wireless communication and BIM leads the whole process in inventory turnover rate. The turnover times of prefabricated building materials management method based on BIM Technology is reduced to 3 times, and that of conventional method is reduced to 2 times. However, the turnover times of BIM combined with wireless communication is more than 4 times. Therefore, BIM-based prefabricated building materials management can reduce the use of funds and the occupation of warehouse, and control the quality of materials better than the traditional methods. However, the combination of BIM and wireless communication can achieve better results.
Foraging conditions for breeding penguins improve with distance from colony and progression of the breeding season at the South Orkney Islands
Authors: Phillips Jessica Ann , Fayet Annette L. , Guilford Tim , Manco Fabrizio , Warwick-Evans Victoria , Trathan Phil
Published: May 2021

Background

According to central place foraging theory, animals will only increase the distance of their foraging trips if more distant prey patches offer better foraging opportunities. Thus, theory predicts that breeding seabirds in large colonies could create a zone of food depletion around the colony, known as “Ashmole’s halo”. However, seabirds’ decisions to forage at a particular distance are likely also complicated by their breeding stage. After chicks hatch, parents must return frequently to feed their offspring, so may be less likely to visit distant foraging patches, even if their quality is higher. However, the interaction between prey availability, intra-specific competition, and breeding stage on the foraging decisions of seabirds is not well understood. The aim of this study was to address this question in chinstrap penguinsPygoscelis antarcticusbreeding at a large colony. In particular, we aimed to investigate how breeding stage affects foraging strategy; whether birds foraging far from the colony visit higher quality patches than available locally; and whether there is evidence for intraspecific competition, indicated by prey depletions near the colony increasing over time, and longer foraging trips.

Methods

We used GPS and temperature-depth recorders to track the foraging movements of 221 chinstrap penguins from 4 sites at the South Orkney Islands during incubation and brood. We identified foraging dives and calculated the index of patch quality based on time allocation during the dive to assess the quality of the foraging patch.

Results

We found that chinstrap penguin foraging distance varied between stages, and that trips became shorter as incubation progressed. Although patch quality was lower near the colony than at more distant foraging patches, patch quality near the colony improved over the breeding season.

Conclusions

These results suggest chinstrap penguin foraging strategies are influenced by both breeding stage and prey distribution, and the low patch quality near the colony may be due to a combination of depletion by intraspecific competition but compensated by natural variation in prey. Reduced trip durations towards the end of the incubation period may be due to an increase in food availability, as seabirds time their reproduction so that the period of maximum energy demand in late chick-rearing coincides with maximum resource availability in the environment. This may also explain why patch quality around the colony improved over the breeding season. Overall, our study sheds light on drivers of foraging decisions in colonial seabirds, an important question in foraging ecology.
Neural correlates of treatment effect and prediction of treatment outcome in patients with PTSD and comorbid personality disorder: study design
Authors: Aarts Inga , Vriend Chris , Snoek Aishah , van den End Arne , Blankers Matthijs , Beekman Aartjan T. F. , Dekker Jack , van den Heuvel Odile A. , Thomaes Kathleen
Published: May 2021

Background

Neural alterations related to treatment outcome in patients with both post-traumatic stress disorder (PTSD) and comorbid personality disorder are unknown.

Here we describe the protocol for a neuroimaging study of treatment of patients with PTSD and comorbid borderline (BPD) or cluster C (CPD) personality disorder traits. Our specific aims are to 1) investigate treatment-induced neural alterations, 2) predict treatment outcome using structural and functional magnetic resonance imaging (MRI) and 3) study neural alterations associated with BPD and CPD in PTSD patients. We hypothesize that 1) all treatment conditions are associated with normalization of limbic and prefrontal brain activity and hyperconnectivity in resting-state brain networks, with additional normalization of task-related activation in emotion regulation brain areas in the patients who receive trauma-focused therapy and personality disorder treatment; 2) Baseline task-related activation, together with structural brain measures and clinical variables predict treatment outcome; 3) dysfunction in task-related activation and resting-state connectivity of emotion regulation areas is comparable in PTSD patients with BPD or CPD, with a hypoconnected central executive network in patients with PTSD+BPD.

Methods

We aim to include pre- and post-treatment 3 T-MRI scans in 40 patients with PTSD and (sub) clinical comorbid BPD or CPD. With an expected attrition rate of 50%, at least 80 patients will be scanned before treatment. MRI scans for 30 matched healthy controls will additionally be acquired. Patients with PTSD and BPD were randomized to either EMDR-only or EMDR combined with Dialectical Behaviour Therapy. Patients with PTSD and CPD were randomized to Imaginary Rescripting (ImRs) or to ImRs combined with Schema Focused Therapy. The scan protocol consists of a T1-weighted structural scan, resting state fMRI, task-based fMRI during an emotional face task and multi-shell diffusion weighted images. For data analysis, multivariate mixed-models, regression analyses and machine learning models will be used.

Discussion

This study is one of the first to use neuroimaging measures to predict and better understand treatment response in patients with PTSD and comorbid personality disorders. A heterogeneous, naturalistic sample will be included, ensuring generalizability to a broad group of treatment seeking PTSD patients.

Trial registration

Clinical Trials, NCT03833453 & NCT03833531. Retrospectively registered, February 2019.
Investigating the effects of two novel 4-MMPB analogs as potent lipoxygenase inhibitors for prostate cancer treatment
Authors: Iranpour Sonia , Al-Mosawi Aseel Kamil Mohammed , Bahrami Ahmad Reza , Sadeghian Hamid , Matin Maryam M.
Published: May 2021

Background

Lipoxygenases are one of the critical signaling mediators which can be targeted for human prostate cancer (PC) therapy. In this study, 4-methyl-2-(4-methylpiperazinyl)pyrimido[4,5-b]benzothiazine (4-MMPB) and its two analogs, 4-propyl-2-(4-methylpiperazinyl)pyrimido[4,5-b]benzothiazine (4-PMPB) and 4-ethyl-2-(4-methylpiperazinyl)pyrimido[4,5-b]benzothiazine (4-EMPB), were proposed to have anti-tumor properties in prostate cancer.

Methods

After synthesizing the compounds, cytotoxic effects of 4-MMPB and its two analogs against PC-3 cancerous and HDF normal cells were investigated by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay and then mechanism of cell death was assessed by flow cytometry. Finally, the anti-tumor effects of the mentioned compounds were investigated in an immunocompromised C57BL/6 mouse model.

Results

4-PMPB and 4-EMPB had similar anti-cancer effects on PC-3 cells as compared with 4-MMPB, while they were not effective on normal cells. Moreover, apoptosis and ferroptosis were the main mechanisms of induced cell death in these cancerous cells. Furthermore, in vivo results indicated that both analogs had similar anti-cancer effects as 4-MMPB, leading to delayed tumor growth without any noticeable side effects in weight loss and histological investigations.

Conclusion

Thus, our results suggest that specific targeting of lipoxygenases via 4-MMPB analogs can be considered as a treatment of choice for PC therapy, although it requires further investigations.
Cell structure formation in a two-dimensional density-based dislocation dynamics model
Authors: Wu Ronghai , Zaiser Michael
Published: May 2021

Cellular patterns formed by self-organization of dislocations are a most conspicuous feature of dislocation microstructure evolution during plastic deformation. To elucidate the physical mechanisms underlying dislocation cell structure formation, we use a minimal model for the evolution of dislocation densities under load. By considering only two slip systems in a plane strain setting, we arrive at a model which is amenable to analytical stability analysis and numerical simulation. We use this model to establish analytical stability criteria for cell structures to emerge, to investigate the dynamics of the patterning process and establish the mechanism of pattern wavelength selection. This analysis demonstrates an intimate relationship between hardening and cell structure formation, which appears as an almost inevitable corollary to dislocation dominated strain hardening. Specific mechanisms such as cross slip, by contrast, turn out to be incidental to the formation of cellular patterns.
Association of nasopharyngeal viruses and pathogenic bacteria in children and their parents with and without HIV
Authors: Khan Tila , Das Ranjan Saurav , Chaudhary Amrita , Chatterjee Jyotirmoy , Bhattacharya Sangeeta Das
Published: May 2021

Background

Bacteria and respiratory viruses co-occur in the nasopharynx, and their interactions may impact pathogenesis of invasive disease. Associations of viruses and bacteria in the nasopharynx may be affected by HIV.

Methods

We conducted a nested case-control study from a larger cohort study of banked nasopharyngeal swabs from families with and without HIV in West Bengal India, to look at the association of viruses and bacteria in the nasopharynx of parents and children when they are asymptomatic. Quantitative polymerase chain reaction for 4 bacteria and 21 respiratory viruses was run on 92 random nasopharyngeal swabs from children--49 from children living with HIV (CLH) and 43 from HIV uninfected children (HUC)-- and 77 swabs from their parents (44 parents of CLH and 33 parents of HUC).

Results

Bacteria was found in 67% of children, viruses in 45%, and both in 27% of child samples.Staphylococcus aureus(53%) was the most common bacteria, followed byStreptococcus pneumoniae(pneumococcus) (37%) in children and parents (53, 20%). Regardless of HIV status, viruses were detected in higher numbers (44%) in children than their parents (30%) (p = 0.049), particularly rhinovirus (p = 0.02). Human rhinovirus was the most frequently found virus in both CLH and HUC. Children with adenovirus were at six times increased risk of also having pneumococcus (Odds ratio OR 6, 95% CI 1.12–31.9) regardless of HIV status. In addition, the presence of rhinovirus in children was associated with increased pneumococcal density (Regression coeff 4.5, 1.14–7.9). In CLH the presence of rhinovirus increased the risk of pneumococcal colonization by nearly sixteen times (OR 15.6, 1.66–146.4), and, pneumococcus andS. aureusdual colonization by nearly nine times (OR 8.7).

Conclusions

Children more frequently carried viruses regardless of HIV status. In CLH the presence of rhinovirus, the most frequently detected virus, significantly increased co-colonization with pneumococcus andS. aureus.
Responses of the predatory species, Coccinella undecimpunctata L. (Coleoptera: Coccinellidae), to the volatiles from its prey, Aphis craccivora Koch. and Vicia faba plant
Authors: Fouad Hany Ahmed
Published: May 2021

Background

Plants after infestation emit specific volatiles, which can influence foraging behavior of insect predators of herbivores. This work aimed to evaluate the responses of the predatory species, Coccinella undecimpunctata L. (Coleoptera: Coccinellidae), adults to volatiles emitted from its cowpea aphid prey, Aphis craccivora (Koch.), and from Vicia faba plant to improve the efficiency of searching for its prey. An olfactometer bioassay was used for this investigation.

Results

The results revealed that both male and female of C. undecimpunctata significantly used olfactory cues from infested plant + aphids, but the mated females exhibited a complete response (47.50%). The mated male was attracted to aphids (30.0%) more than other tested predatory types, indicating the capacity to exploit volatiles induced by aphids.

Conclusions

The results supported that C. undecimpunctata adult uses plant volatiles induced by A. craccivora infestation, which might act as reliable indicators to find its prey.
Exploring the heterogeneity of factors that may influence implementation of PrEP in family planning clinics: a latent profile analysis
Authors: Piper Kaitlin N. , Haardörfer Regine , Escoffery Cam , Sheth Anandi N. , Sales Jessica
Published: May 2021

Background

Title X-funded family planning clinics have been identified as optimal sites for delivery of pre-exposure prophylaxis (PrEP) for HIV prevention. However, PrEP has not been widely integrated into family planning services, especially in the Southern US, and data suggest there may be significant implementation challenges in this setting. Because Title X clinics vary greatly in provider-, organizational-, and systems-level characteristics, there is likely variation in capacity to implement PrEP across clinics.

Methods

We conducted a survey from February to June 2018 among providers and administrators of non-PrEP-providing Title X-funded clinics across 18 southern states. Survey items were designed using the Consolidated Framework for Implementation Research (CFIR) to assess constructs relevant to PrEP implementation. To explore the heterogeneity of CFIR-related implementation determinants and identify distinct sub-groups of Title X clinics, a latent profile analysis was conducted using nine CFIR constructs: complexity, relative advantage, cost, attitudes, implementation climate, compatibility, leadership engagement, available resources, and cosmopolitanism. We then conducted a multi-level analysis (accounting for nesting of participants within clinics) to test whether group membership was associated with readiness for implementation of PrEP, controlling for key sociodemographic characteristics.

Results

Four hundred and fourteen healthcare providers/administrators from 227 non-PrEP-providing Title X clinics participated in the study. We identified six sub-groups of clinics that each had distinct patterns of PrEP implementation determinants. Clinic sub-groups included “Highest Capacity for Implementation”, “Favorable Conditions for Implementation”, “Mixed Implementation Context”, “Neutral Implementation Context”, “Incompatible Setting for Implementation”, and “Resource-Strained Setting”. Group membership was related to numerous provider-level (i.e., ability to prescribe medication) and clinic-level (i.e., provision of primary care) characteristics. In comparison to the “Neutral” group (which held neutral perceptions across the implementation determinants), the “Highest Capacity” and “Favorable Conditions” groups had significantly higher levels of implementation readiness, and the “Resource-Strained” group had a significantly lower level of implementation readiness.

Conclusions

Latent profile analyses can help researchers understand how implementation readiness varies across healthcare settings, promoting tailoring of implementation strategies to unique contexts.
A pharmacognostic approach for mitigating pancreatic cancer: emphasis on herbal extracts and phytoconstituents
Authors: Gupta Shruti , Kumar Atul , Tejavath Kiran Kumar
Published: May 2021

Background

Pancreatic cancer is studied as one of the most lethal cancers with currently no control of its lethality, mainly due to its late diagnosis and lack of foolproof treatment processes. Despite continuous efforts being made in looking for therapies to deal with cancer, it keeps on being a labyrinth for the researchers. Efforts like discovering new treatment options, repurposing existing drugs, are continuously made to deal with this cancer.

Main body

With the urge to get answers and the fact that nature has all roots of therapeutics, efforts are made in the direction of finding those answers for providing ministrations for pancreatic cancer from plant products. Plant products are used as treatment options either directly in the form of extracts or an alternative to them is individual phytochemicals that are either isolated from the plants or are commercially synthesized for various purposes. In this review, we put forward such pharmacognostic initiatives made in combating pancreatic cancer, focusing mainly on plant extracts and various phytochemicals; along with the mechanisms which they triggered to fulfill the need for cytotoxicity to pancreatic cancer cells (in vitro and in vivo).

Conclusion

This study will thus provide insights into new combination therapy that can be used and also give a clue on which plant product and phytoconstituent can be used in dealing with pancreatic cancer.

Graphical abstract
Production Processes for Creating Educational Videos
Authors: Castillo Stephanie , Calvitti Karisa , Shoup Jeffery , Rice Madison , Lubbock Helen , Oliver Kendra H.
Published: May 2021

A "how-to" guide for producing videos, bridging multimedia learning theory with a production pipeline. Three steps in contemporary video-making for educational purposes are outlined: preproduction, production, and postproduction. Overall, the article encourages educators to become producers by engaging in this creative medium.
Lenvatinib in Patients With Advanced Grade 1/2 Pancreatic and Gastrointestinal Neuroendocrine Tumors: Results of the Phase II TALENT Trial (GETNE1509)
Authors: Capdevila Jaume , Fazio Nicola , Lopez Carlos , Teulé Alexandre , Valle Juan W. , Tafuto Salvatore , Custodio Ana , Reed Nicholas , Raderer Markus , Grande Enrique , Garcia-Carbonero Rocio , Jimenez-Fonseca Paula , Hernando Jorge , Bongiovanni Alberto , Spada Francesca , Alonso Vicente , Antonuzzo Lorenzo , Spallanzani Andrea , Berruti Alfredo , La Casta Adelaida , Sevilla Isabel , Kump Patrizia , Giuffrida Dario , Merino Xavier , Trejo Lorena , Gajate Pablo , Matos Ignacio , Lamarca Angela , Ibrahim Toni
Published: May 2021

PURPOSE

Approved systemic therapies for advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have shown limited capacity to reduce tumor burden and no antitumor activity after progression to targeted agents (TAs). We investigated the efficacy and safety of lenvatinib in patients with previously treated advanced GEP-NETs.

PATIENTS AND METHODS

This was a multicenter, single-arm, open-label, phase II trial with two parallel cohorts (ClinicalTrials.gov identifier: NCT02678780 ) involving 21 institutions in 4 European countries. Eligible patients had histologically confirmed advanced grade 1-2 pancreatic (panNET) or GI (GI-NET) NETs with documented tumor progression after treatment with a TA (panNET) or somatostatin analogs (GI-NET). Patients were treated with lenvatinib 24 mg once daily until disease progression or treatment intolerance. The primary end point was overall response rate by central radiology review. Secondary end points included progression-free survival, overall survival, duration of response, and safety.

RESULTS

Between September 2015 and March 2017, a total of 111 patients were enrolled, with 55 (panNET) and 56 (GI-NET) patients in each cohort. The median follow-up was 23 months. The overall response rate was 29.9% (95% CI, 21.6 to 39.6): 44.2% (panNET) and 16.4% (GI-NET). The median (range) duration of response was 19.9 (8.4-30.8) and 33.9 (10.6-38.3) months in the panNET and GI-NET groups, respectively. The median progression-free survival was 15.7 months (95% CI, 14.1 to 19.5). The most common adverse events were fatigue, hypertension, and diarrhea; 93.7% of patients required dose reductions or interruptions.

CONCLUSION

We report the highest centrally confirmed response reported to date with a multikinase inhibitor in advanced GEP-NETs, with a particularly strong response in the panNET cohort. This study provides novel evidence for the efficacy of lenvatinib in patients with disease progression following treatment with other TAs, suggesting the potential value of lenvatinib in the treatment of advanced GEP-NETs.
Goldenhar Syndrome With Ankylosis of the Temporomandibular Joint: A Case Report
Authors: Partyka Lauren M.
Published: May 2021

Goldenhar syndrome, or oculoauriculovertebral dysplasia, represents approximately 10% of craniofacial microsomia anomalies. These patients have a variety of clinical features that are relevant to anesthesia providers, including a high-arched palate, mandibular hypoplasia, micrognathia, and temporomandibular joint (TMJ) malformation. The oral manifestations of Goldenhar syndrome range from malocclusion to complex TMJ involvement. Outside of the dental and oral surgery literature, the potential for TMJ ankylosis in Goldenhar patients is seldom emphasized. TMJ ankylosis impacts airway management, and anesthesia providers must be aware of this clinical phenotype when planning the anesthetic care of patients with Goldenhar syndrome.
Digital Footprint Management as an Effective Tool for Creating University Positive Image
Authors: Miheenkova T. , Morozova K. , Lobacheva A.
Published: May 2021

The article reveals the essence of the concepts of " active digital footprint", "passive digital footprint" and "digital shadow" of a person and organization, as well as their components and interconnection. In the essay, the authors substantiated the importance of a conscious approach to the formation of a digital footprint of an organization and its employees. It also describes how an employee’s digital footprint affects a company's digital footprint and it’s brand. We mentioned organizations that create or track the digital footprint of other organizations and described the principles of their actions. We gave recommendations that are aimed at creating a positive digital footprint of educational organizations through the management of the digital footprint of employees. The recommendations were developed based on the analysis of the digital footprint and digital shadow of the State University of Management, which is actively working on its image.
Impacts of home-based physical exercises on the health of people with spinal cord injury: a systematic review
Authors: Oliveira José Igor Vasconcelos de , Lúcia Inês Guedes Leite de Oliveira  , Costa Manoel da Cunha , Perrier-Melo Raphael José , Simim Mário Antônio de Moura , Oliveira Saulo Fernandes Melo de
Published: May 2021

The confinement period caused by the SARS-COV2 pandemic is another barrier to the practice of physical exercise by people with spinal cord injury (SCI). In view of the countless therapies targeted at this public, it is necessary to highlight the benefits of exercises performed at home. Thus, our objective was to determine the main characteristics of physical exercise training modes performed at home and their effects on people with SCI. We searched for intervention studies in five databases (PubMed, ScienceDirect, SPORTDiscus, Scopus and Cochrane CENTRAL) by including the terms and descriptors: “spinal cord injury”, “home-based”, exercise”, “video game”, “home-based physical activity”. The selected studies were described by means of a narrative synthesis. Of 69,843 studies, only 10 met the eligibility criteria, totaling 153 investigated individuals (25 women and 128 men). Regarding the type of injury, 118 participants were paraplegic and 33 tetraplegic. The studies addressed functional electrical stimulation (n = 4), electronic assistive devices (n = 5) and stretching exercises (n = 1). We observed that the focus of the interventions was the morphological, motor neuron, quality of life and functional aspects. The studies showed improvements in muscle strength andmorphology, in the ability to perform daily activities, in quality of life and in functional capacities, with no reported adverse situations. Although our review included a low number of randomized studies, we can conclude that several modes of exercise in the home environment promote benefits for people with SCI and can be options for maintaining or developing the health of this population.
Mesotherapy for skin rejuvenation: a brief and practical insight for aesthetic practitioners
Authors: Hamida-Pisal Philippe
Published: May 2021

Smooth and even skin possesses a form of magnetism, and people understand it as the external manifestation of a healthy lifestyle. New studies reveal the efficacy of mesotherapy in reducing external signs of ageing, such as wrinkles, large pores, sun damage and loss of glow, elasticity and firmness. The capacity of mesotherapy to stimulate and repair the mechanisms of the skin, creating a suitable environment for the fibroblasts to produce elastin and collagen, offers an effective long-lasting answer to most age-related skin concerns. The full practical aspects needed to perform mesotherapy treatments must be covered in training sessions in person, as the accuracy of mesotherapy depends on many considerations. To practice mesotherapy, practitioners need to have a deep theoretical understanding of the ageing process and of the techniques and materials that are used in mesotherapy.
Uncemented total hip arthroplasty can be used safely in the elderly population
Authors: Lewis Peter M. , Khan Faiz J. , Feathers Jacob R. , Lewis Michael H. , Morris Keith H. , Waddell James P.
Published: May 2021

Aims

“Get It Right First Time” (GIRFT) and NHS England’s Best Practice Tariff (BPT) have published directives advising that patients over the ages of 65 (GIRFT) and 69 years (BPT) receiving total hip arthroplasty (THA) should receive cemented implants and have brought in financial penalties if this policy is not observed. Despite this, worldwide, uncemented component use has increased, a situation described as a ‘paradox’. GIRFT and BPT do, however, acknowledge more data are required to support this edict with current policies based on the National Joint Registry survivorship and implant costs.

Methods

This study compares THA outcomes for over 1,000 uncemented Corail/Pinnacle constructs used in all age groups/patient frailty, under one surgeon, with identical pre- and postoperative pathways over a nine-year period with mean follow-up of five years and two months (range: nine months to nine years and nine months). Implant information, survivorship, and regular postoperative Oxford Hip Scores (OHS) were collected and two comparisons undertaken: a comparison of those aged over 65 years with those 65 and under and a second comparison of those aged 70 years and over with those aged under 70.

Results

Overall revision rate was 1.3% (13/1,004). A greater number of revisions were undertaken in those aged over 65 years, but numbers were small and did not reach significance. The majority of revisions were implant-independent. Single component analysis revealed a 99.9% and 99.6% survival for the uncemented cup and femoral component, respectively. Mean patient-reported outcome measures (PROMs) improvement for all ages outperformed the national PROMs and a significantly greater proportion of those aged over 65/69 years reached and maintained a meaningful improvement in their OHS earlier than their younger counterparts (p < 0.05/0.01 respectively).

Conclusion

This study confirms that this uncemented THA system can be used safely and effectively in patient groups aged over 65 years and those over 69 years, with low complication and revision rates. Cite this article: Bone Jt Open 2021;2(5):293–300.
DNA barcode of Enggano hill myna, Gracula religiosa enganensis (Aves: Sturnidae) based on mitochondrial DNA cytochrome oxidase subunit I
Authors: JARULIS JARULIS , MUSLIM CHOIRUL , KAMILAH SANTI NURUL , UTAMA AHMAT FAKHRI , PERMANA DEBY , SARI MELISA MAYANG , PRAYITNO ALEX HADI , JANNAH IZUL MIFTAKHUL
Published: May 2021

Abstract. Jarulis, Muslim C, Kamilah SN, Utama AF, Permana D, Sari MM, Prayitno AH, Jannah IM. 2021. DNA barcode of Enggano hill myna, Gracula religiosa enganensis (Aves: Sturnidae) based on mitochondrial DNA cytochrome oxidase subunit I. Biodiversitas 22: 1635-1643. The sharp decline of the Enggano hill myna population due to illegal trading and habitat degradation needs to be our concern to prevent this bird from extinction. Taxonomically, Enggano hill myna is referred to as a sub-species, but this has not been confirmed by genetic data. We have sequenced seventeen Enggano hill myna mitochondrial DNA COI genes to describe their genetic identity (barcode), genetic distances, and phylogeny. DNA genome from seventeen blood samples was isolated with DNeasy® Blood and Tissue Kit Qiagen, while PCR amplification was performed using a pair primers, namely COIGRF (5'-TTCTGATTCTTTGGCCATCC-3') and COIGRR (5'-GTTGGAAGGCTTTGCGTTTA-3'). We used Clustal W alignment in MEGA 10.2.2 software to search single nucleotide polymorphisms. Genetic distance was analyzed by using the Kimura 2-parameter, and the phylogenetic tree was reconstructed with Neighbor-Joining models. We found 98.60% conservative sites, 0.69% parsimony sites, and 0.83% singleton sites from the 716 bp sequence. The highest nucleotide composition was cytosine (32.20%), and the lowest was guanine (16.80%), followed by 49% GC content. Seven SNP sites were found in 716 bp COI gene sequences of seventeen individuals. The genetic distance between Enggano hill myna individuals was ranged from 0.0-0.8%, and all Enggano hill myna individuals separated from Chinese and Indian populations in the phylogenetic tree with a genetic distance of 0.9% and 1.1%. Our data suggest that the Enggano hill myna population is still classified as a sub-species. The COI gene sequences that we found can be used to quickly identify this species and are also important to prevent illegal trading in Indonesia.
Implementation of species protection act for the conservation of Tanimbar corella, Cacatua goffiniana (Roselaar & Michels, 2004)
Authors: Haryoko Tri , O’Hara Mark , Mioduszewska Berenika , Sutrisno Hari , Budi Prasetyo Lilik , Mardiastuti Ani
Published: May 2021

Abstract. Haryoko T, O’Hara M, Mioduszewska B, Sutrisno H, Prasetyo LB, Mardiastuti A. 2021. Implementation of species protection act for the conservation of Tanimbar corella, Cacatua goffiniana (Roselaar & Michels, 2004). Biodiversitas 22: 1733-1740. Birds are among the most favored pet animals and are nurtured because of their melodious voice, intelligence, and beautiful feathers. Therefore, these animals are usually traded in both local and international markets. Wild bird trades are dominated by species from the order Passeriformes/songbirds and Psittaciformes/parrots. Furthermore, one of the Psittaciformes groups that are in high demand as a pet is the cockatoos. The Goffin’s cockatoo or Tanimbar corella/Cacatua goffiniana (Roselaar & Michels,2004)is one of seven species of parrots native to Indonesia and has been traded for decades. This endemic bird from the Tanimbar Islands (Maluku Province) has been protected by the Indonesian government since 1990 and has been on the CITES Appendix I since 1992. Therefore, this study aims to review the harvesting of C. goffiniana and the effect the bird's protection status has on its trade. It was conducted by investigating the legal trade data for 1981-2018, information on illegal trade, and ex-situ conservation of this species. The review on the trade of C. goffiniana was assessed using descriptive analysis. Furthermore, Independent Samples T-Test was used to determine the differences between the number of C. goffiniana traded before and after the bird was listed in Appendix I CITES and protected by Indonesia's law. The results showed that the number of exported Cacatua goffiniana for 38 years to 34 countries was 151,684. Furthermore, the United States of America was the largest importer with a total of 118,356/78.03%. It was discovered that the number of birds legally exported by Indonesia has decreased dramatically since 1990 because these animals are protected by Indonesian law. Consequently, there was a significant difference between the number traded before and after their designation as protected species. The nonparametric correlation between protection status and Appendix I CITES listing to the number of these animals traded was statistically significant. Finally, existing conservation practices involve efforts to restock the population by means of captive breeding programs. However, as conservation agencies have shown little success in breeding these species, the efforts are not sufficient to fulfill the demand. Therefore, illegal trade is still a major threat to the natural populations.
DNA barcoding of lamp shells (Brachiopoda: Lingula anatina) from Probolinggo, East Java, Indonesia
Authors: Ambarwati Reni , Rahayu Dwi Anggorowati , Rachmadiarti Fida , Khaleyla Firas
Published: May 2021

Abstract. Ambarwati R, Rahayu DA, Rachmadiarti F, Khaleyla F. 2021. DNA barcoding of lamp shells (Brachiopoda: Lingula anatina) from Probolinggo, East Java, Indonesia. Biodiversitas 22: 1764-1774. Lingula anatina is one of brachiopods found in tropical regions, however, the reports on this species from South East Asia is currently limited. This study, therefore, aims to identify the Cytochrome Oxidase subunit I (COI) sequence and phylogenetic of lamp shells from Probolinggo, Indonesia. A total of five samples of lamp shells were collected from Probolinggo, Indonesia, then identified based on morphological characters, and the identification was confirmed using molecular data. Subsequently, molecular characterization and identification were conducted based on 657 bp of COI gene similarity, sequence variation, genetic distance, phylogenetic topology, and BOLD System. According to the results, the Lingula species found in Probolinggo Indonesia was Lingula anatina. The median-joining network and Automatic Barcode Gap Discovery (ABGD) analysis showed this Lingula anatina population from Probolinggo had relatives of 22 haplotypes and divided into six haplogroups. Furthermore, the population belonged to the same haplogroup but had different haplotypes. Thus, this study provides more information for Lingula anatina phylogenetic and haplotype studies.