bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of brief ICF-sleep disorders and obesity core set in obstructive sleep apnea patients
Authors: Xie Liang , Wu Qinhan , Hu Weiping , Li Wenjing , Xiang Guiling , Hao Shengyu , Guo Chengyao , Jiang Hong , Wu Xiaodan , Wu Xu , Li Shanqun
Published: June 2020

Background

Clinical questionnaires are mainly applied as screening tools for identification of the Obstructive sleep apnea (OSA) patients. Little attention has been paid to assess the body functions and health status of the patients. International Classification of Functioning, Disability and Health (ICF) was designed for better understanding and describing functioning and disability of patients. This study adopted the Brief ICF-Sleep Disorders and Obesity Core Set to evaluate the impairment of functioning and health status of OSA patients.

Methods

Five hundred ninety-two participants were enrolled in this cross-sectional study. Data were collected using Brief ICF-Sleep Disorders and Obesity Core Set Polysomnography was performed and basic characteristics of the patients were recorded.

Results

The scores for the component Body Functions and Code b130, b134, b140, b440, b530, s330, d160, d240, d450 of the two core sets were significantly different among the patients divided by apnea-hypopnea index (AHI) or oxygen saturation (SaO2) nadir, but the frequency of code s330, d160, d240, d450 was low. The Body Functions component of the both sets were closely related to neck circumference (NC), body mass index (BMI), apnea-hypopnea index (AHI) of the OSA patients. Body Functions of the Brief ICF-Sleep Disorders performed better with a threshold of 4 with sensitivity, specificity and area under the receiver operating characteristic curve (AUC) as 0.62, 0.74, 0.68(AHI ≥ 5), 0.69, 0.63, 0.66 (AHI ≥ 15), 0.75, 0.56, 0.66 (AHI ≥ 30), 0.56, 0.70, 0.63 (SaO2 nadir≤90%), 0.67, 0.66, 0.66 (SaO2 nadir<85%), 0.71, 0.59, 0.65 (SaO2 nadir<80%), separately.

Conclusion

The Body Functions component of both two sets could be an evaluation tool of impairment of body functions for OSA patients. The Brief ICF-Sleep Disorders Body Functions component performed better with a threshold of 4 and might provide a new insight for physicians to assess OSA patients.
Improving the evaluation of COPD exacerbation treatment effects by accounting for early treatment discontinuations: a post-hoc analysis of randomized clinical trials
Authors: Król Agnieszka , Palmér Robert , Rondeau Virginie , Rennard Stephen , Eriksson Ulf G. , Jauhiainen Alexandra
Published: June 2020

Background

Chronic obstructive pulmonary disease (COPD) clinical trials aimed at evaluating treatment effects on exacerbations often suffer from early discontinuations of randomized treatment. Treatment discontinuations imply a loss of information and should ideally be considered in the statistical analysis of trial results, particularly if the discontinuations are related to the disease or treatment itself. Here, we explore this issue by investigating (1) whether there exists an association between the risks of exacerbation and treatment discontinuation in COPD clinical trials and (2) whether disregarding this association can cause bias in exacerbation treatment effect estimates. We focus on the hypothetical estimand, i.e. the treatment effect that would have been observed had all subjects completed the trial as planned.

Methods

The association between exacerbation and discontinuation risks was analysed by applying a joint frailty (random effect) model – allowing for the simultaneous analysis of multiple types of correlated events – to data from five Phase III-IV COPD clinical trials. Specifically, the impact of the association on exacerbation treatment effect estimates was assessed by comparing the treatment hazard ratios of the joint frailty model to the rate/hazard ratios of two related statistical models (the negative binomial and shared frailty models), which both assume discontinuations to be unrelated to the trial outcome. The models were also compared using simulated data.

Results

A statistically significant (p < 0.0001), positive association between exacerbation and discontinuation risks was found in all trials. Importantly, simulations confirmed that – with such an association – models disregarding the association risk producing biased results (> 5 percentage point difference in hazard/rate ratio). For some treatment comparisons in the clinical trials, the difference in treatment effect estimates between the joint frailty and the other models was as high as 10–15 percentage points. The difference was affected by the strength of the exacerbation-discontinuation association, the population heterogeneity in exacerbation risk, and the difference in discontinuation rates between treatment arms.

Conclusions

We have identified an association between the risks of exacerbation and treatment discontinuation in five COPD clinical trials. We recommend using the joint frailty model to account for this association when estimating exacerbation treatment effects, particularly when targeting the hypothetical estimand.
Adoption of a dedicated multidisciplinary team is associated with improved survival in acute pulmonary embolism
Authors: Myc Lukasz A. , Solanki Jigna N. , Barros Andrew J. , Nuradin Nebil , Nevulis Matthew G. , Earasi Kranthikiran , Richardson Emily D. , Tsutsui Shawn C. , Enfield Kyle B. , Teman Nicholas R. , Haskal Ziv J. , Mazimba Sula , Kennedy Jamie L. W. , Mihalek Andrew D. , Sharma Aditya M. , Kadl Alexandra
Published: June 2020

Background

Acute pulmonary embolism remains a significant cause of mortality and morbidity worldwide. Benefit of recently developed multidisciplinary PE response teams (PERT) with higher utilization of advanced therapies has not been established.

Methods

To evaluate patient-centered outcomes and cost-effectiveness of a multidisciplinary PERT we performed a retrospective analysis of 554 patients with acute PE at the university of Virginia between July 2014 and June 2015 (pre-PERT era) and between April 2017 through October 2018 (PERT era). Six-month survival, hospital length-of-stay (LOS), type of PE therapy, and in-hospital bleeding were assessed upon collected data.

Results

317 consecutive patients were treated for acute PE during an 18-month period following institution of a multidisciplinary PE program; for 120 patients PERT was activated (PA), the remaining 197 patients with acute PE were considered as a separate, contemporary group (NPA). The historical, comparator cohort (PP) was composed of 237 patients. These 3 groups were similar in terms of baseline demographics, comorbidities and risk, as assessed by the Pulmonary Embolism Severity Index (PESI). Patients in the historical cohort demonstrated worsened survival when compared with patients treated during the PERT era. During the PERT era no statistically significant difference in survival was observed in the PA group when compared to the NPA group despite significantly higher severity of illness among PA patients. Hospital LOS was not different in the PA group when compared to either the NPA or PP group. Hospital costs did not differ among the 3 cohorts. 30-day re-admission rates were significantly lower during the PERT era. Rates of advanced therapies were significantly higher during the PERT era (9.1% vs. 2%) and were concentrated in the PA group (21.7% vs. 1.5%) without any significant rise in in-hospital bleeding complications.

Conclusions

At our institution, all-cause mortality in patients with acute PE has significantly and durably decreased with the adoption of a PERT program without incurring additional hospital costs or protracting hospital LOS. Our data suggest that the adoption of a multidisciplinary approach at some institutions may provide benefit to select patients with acute PE.
Decreased detection of ESBL- or pAmpC-producing Escherichia coli in broiler breeders imported into Sweden
Authors: Nilsson Oskar , Börjesson Stefan , Landén Annica , Greko Christina , Bengtsson Björn
Published: June 2020

In the spring of 2010, it was discovered that a large proportion of broilers in Sweden were colonized with Escherichia coli producing extended-spectrum beta-lactamases (ESBL) or plasmid mediated AmpC (pAmpC). It was hypothesized that the high prevalence was due to transfer from an upper level in the production pyramid and sampling upwards in the production pyramid was initiated. From 2010 to 2019, all shipments (n = 122) of broiler breeders were screened on arrival to Sweden for the occurrence of ESBL- or pAmpC-producing E. coli using selective methods. Samples of paper linings from shipments of breeders were cultured on MacConkey agar supplemented with cefotaxime (1 mg/L) after pre-enrichment in either MacConkey broth with cefotaxime (1 mg/L), or from late June 2015 in buffered peptone water without antibiotics. ESBL- or pAmpC-producing E. coli was isolated from 43 (35%) of these. Over the years, the proportion of positive imports have decreased and during 2018 and 2019 all imports were negative. In conclusion, the occurrence of ESBL- or pAmpC-producing E. coli in broiler breeders on arrival to Sweden has decreased. Such bacteria have not been detected in any shipments since 2017.
Modifiable environmental exposure and risk of rheumatoid arthritis—current evidence from genetic studies
Authors: Jiang Xia , Alfredsson Lars
Published: June 2020

Rheumatoid arthritis (RA) is a multifactorial chronic autoimmune disease, which involves a complex interplay of environmental triggers and genetic components in its etiology. It has been shown that genetics only explain about half of the liability to develop RA, leaving a large room for non-genetic factors. Indeed, several environmental exposures including smoking, drinking, obesity, and dietary patterns (and more) have been identified to be associated with RA risk, yet the observational nature of conventional epidemiological investigation hampers causal inference, as the validity of results could be plagued by measurement error, confounding, and/or reverse causality. Mendelian randomization (MR) is a novel statistical approach that uses genetic variants as instrumental variables (IV) to make causal inferences from observational data. The current genetic discoveries in the many heritable and modifiable human complex traits have provided an exceptional opportunity to evaluate a putative causal relationship between exposure and outcome in the absence of high-quality experimental or intervention studies, through a MR design. In the current review, we detail the contribution of MR studies hitherto conducted for modifiable environmental exposures with the risk of RA to understand the role of these factors in RA pathogenesis. We start with a brief introduction of each study, follow by a summarization of shortcomings and conclude by highlighting future directions. The application of MR design in the field of rheumatology remains limited. Only a few MR studies have examined the causal roles of vitamin D, cigarette smoking, alcohol consumption, coffee consumption, and levels of education in RA, where, no consistent evidence for a causal relationship has been found. Most studies lacked sensitivity analyses to verify MR model assumptions and to guarantee the validity of results. Almost all studies are likely to bias the strength of association towards a null value, since they used IVs from earlier GWAS(s) of exposures with a small sample size (i.e., few genetic markers). As the magnitudes of GWAS expand rapidly, additional trait-associated loci have been discovered. Incorporating these loci would greatly improve the strength of genetic instruments, as well as both the accuracy and precision of MR estimates. To conclude, there is a need for an update and a huge space for improvement of future MR studies in RA.
Comprehensive evaluation of targeted multiplex bisulphite PCR sequencing for validation of DNA methylation biomarker panels
Authors: Lam Dilys , Luu Phuc-Loi , Song Jenny Z. , Qu Wenjia , Risbridger Gail P. , Lawrence Mitchell G. , Lu Jennifer , Trau Matt , Korbie Darren , Clark Susan J. , Pidsley Ruth , Stirzaker Clare
Published: June 2020

Background

DNA methylation is a well-studied epigenetic mark that is frequently altered in diseases such as cancer, where specific changes are known to reflect the type and severity of the disease. Therefore, there is a growing interest in assessing the clinical utility of DNA methylation as a biomarker for diagnosing disease and guiding treatment. The development of an accurate loci-specific methylation assay, suitable for use on low-input clinical material, is crucial for advancing DNA methylation biomarkers into a clinical setting. A targeted multiplex bisulphite PCR sequencing approach meets these needs by allowing multiple DNA methylated regions to be interrogated simultaneously in one experiment on limited clinical material.

Results

Here, we provide an updated protocol and recommendations for multiplex bisulphite PCR sequencing (MBPS) assays for target DNA methylation analysis. We describe additional steps to improve performance and reliability: (1) pre-sequencing PCR optimisation which includes assessing the optimal PCR cycling temperature and primer concentration and (2) post-sequencing PCR optimisation to achieve uniform coverage of each amplicon. We use a gradient of methylated controls to demonstrate how PCR bias can be assessed and corrected. Methylated controls also allow assessment of the sensitivity of methylation detection for each amplicon. Here, we show that the MBPS assay can amplify as little as 0.625 ng starting DNA and can detect methylation differences of 1% with a sequencing coverage of 1000 reads. Furthermore, the multiplex bisulphite PCR assay can comprehensively interrogate multiple regions on 1–5 ng of formalin-fixed paraffin-embedded DNA or circulating cell-free DNA.

Conclusions

The MBPS assay is a valuable approach for assessing methylated DNA regions in clinical samples with limited material. The optimisation and additional quality control steps described here improve the performance and reliability of this method, advancing it towards potential clinical applications in biomarker studies.
An update on long intergenic noncoding RNA p21: a regulatory molecule with various significant functions in cancer
Authors: Amirinejad Roya , Rezaei Mina , Shirvani-Farsani Zeinab
Published: June 2020

Long intergenic noncoding RNA p21 was mapped on the human chromosome 6p21.2. Accordingly, it was firstly described by promoting the p53-dependent apoptosis in the mouse. Also, it is a new lncRNA playing some vital roles in the cell cycle, apoptosis, cell proliferation, tumorigenesis, invasion, metastasis, and angiogenesis. In this regard, it was shown that,lincRNA-p21regulates these biological processes involved in carcinogenesis through various signaling pathways including Notch signaling, JAK2/STAT3, and AKT/mTOR pathways. Another mechanism by thatlincRNA-p21can affect these processes is a cross-talk with different miRNAs. In vitro and in vivo studies revealed dysregulation oflincRNA-p21in various human cancers. In addition, emerging evidence demonstrated that,lincRNA-p21can be considered as a potential prognostic and therapeutic biomarker in cancers. Also,lincRNA-p21enhances the response to radiotherapy for colorectal cancer. However, the molecular mechanisms oflincRNA-p21in carcinogenesis have not been fully elucidated so far. So, this review summarizes the function oflincRNA-p21,as a tumor suppressor factor in different biological processes implicated in cancers.
Differences in alexithymia, emotional awareness, and facial emotion recognition under conditions of self-focused attention among women with high and low eating disorder symptoms: a 2 x 2 experimental study
Authors: Vander Wal Jillon S. , Kauffman Alicia A. , Soulliard Zachary A.
Published: June 2020

Background

Women with eating disorders generally perform more poorly on measures of alexithymia, defined as difficulty identifying and describing emotions, and theory of mind, or the ability to infer what others are thinking and feeling. The extent to which these abilities may be influenced by variables such as self-focused attention, or directing attention toward internally generated information, has yet to be investigated. Thus, the purpose of the present study was to examine differences between women high and low in disordered eating symptoms on measures of emotional awareness and facial affect recognition under conditions of high and low self-focused attention.

Methods

University women scoring high or low on a measure of disordered eating (n = 79) were randomly assigned to a condition of high or low self-focused attention. Outcomes included alexithymia (self-rated ability to identify and describe emotions), emotional awareness (ability to describe the emotions of oneself and others), and facial affect recognition. Scores on a measure of negative affect were statistically controlled.

Results

Women with high disordered eating symptom scores rated themselves as having more difficulties identifying, but not describing emotions after controlling for negative affect, but demonstrated greater difficulties describing their own and others’ emotions on a measure of emotional awareness. In the self-focused attention condition, women scored lower on self emotional awareness and were quicker to identify expressions of negative facial affect regardless of eating disorder symptom status than women in the non-self-focused attention condition. There were no significant interactions between eating disorder status and self-focused attention.

Conclusions

Further examination of different types of emotion recognition and description in oneself and others as well as processes that may influence these abilities is warranted.
Correction to: Association among dispositional mindfulness, self-compassion, and leukocyte telomere length in Chinese adults
Authors: Keng Shian-Ling , Yim Onn Siong , Lai Poh San , Chew Soo Hong , Ebstein Richard P.
Published: June 2020

An amendment to this paper has been published and can be accessed via the original article.
Designing and integrating a quality management program for patients undergoing head and neck resection with free-flap reconstruction
Authors: Dort Joseph C. , Sauro Khara M. , Schrag Christiaan , Chandarana Shamir , Matthews Jennifer , Nakoneshny Steven , Manoloto Vida , Miller Tanya , McKenzie C. David , Hart Robert D. , Matthews T. Wayne
Published: June 2020

Background

Care pathways (CPs) offer a proven method of systematically improving patient care. CPs are particularly helpful in complex clinical conditions where variation in care is a problem such as patients undergoing major head and neck resection with free flap reconstruction. Although CPs have been used to manage this patient group, most CPs are implemented as part of relatively short-term quality improvement projects. This paper outlines a detailed methodology for designing and delivering a quality management program sustained for 9 years.

Methods

We describe a change management approach informed by Kotter's “8 Step Process” that provided a useful framework to guide program development and implementation. We then provide a detailed, step by step description of how such a program can be implemented as well as a detailed summary of time and costs for design, implementation and sustainability phases. An approach to design and delivery of a measurement, audit and feedback system is also provided.

Results

We present a summary of resources needed to design and implement a head and neck surgery quality management program. The primary result of this study is a design for a sustainable quality management program that can be used to guide and improve care for patients undergoing major head and neck resection with free flap reconstruction.

Conclusions

A change management approach to design and delivery of a head and neck quality management program is practical and feasible.
Telephone consultations with otolaryngology – head and neck surgery reduced emergency visits and specialty consultations in northern Alberta
Authors: Tian Peter George Jaminal , Eurich Dean , Seikaly Hadi , Boisvert Douglas , Montpetit John , Harris Jeffrey
Published: June 2020

Background

RAAPID (Referral, Access, Advice, Placement, Information, and Destination) is a 24-h call center in Alberta, Canada, facilitating urgent telephone consultations between physicians and specialists. We evaluated the extent to which RAAPID calls to Otolaryngology-Head and Neck Surgery (OHNS) reduced visits to the emergency department and specialty clinics.

Methods

This was a cross-sectional study evaluating all telephone consultations to OHNS from physicians in northern Alberta between 2013 and 2014 (T1) (where consultations by residents occurred) and 2015 to 2017 (T2) (where consultations were done by consultants during office hours and residents during after hours). Outcomes of the calls included medical advice, specialty clinic referrals, and emergency department (ED) referrals. Differences in the reduction of ED visits and costs, overall as well as in T1 and T2, were assessed using multivariate logistic regression.

Results

Overall, 62.3% (1064/1709) of telephone consultations reduced ED visits consisting of advice being provided ( n = 884; 83.1%) and referral to specialty clinics ( n = 180; 16.9%). The adjusted odds ratio of calls reducing emergency visits in T2 as compared to T1 was 2.47 (95% CI 1.99 to 3.08). The adjusted odds ratio of reducing ED visits during office hours compared to after-hours 2.54 (95% CI 1.77–3.64). The estimated direct costs avoided from ED visits in T1 and T2 were $42,224.22 and $114,393.86, respectively.

Conclusion

RAAPID telephone consultations to OHNS were effective in reducing ED visits and healthcare costs. This model should be considered in other areas to improve efficiencies within the health system.
Tau Ser208 phosphorylation promotes aggregation and reveals neuropathologic diversity in Alzheimer’s disease and other tauopathies
Authors: Xia Yuxing , Prokop Stefan , Gorion Kimberly-Marie M. , Kim Justin D. , Sorrentino Zachary A. , Bell Brach M. , Manaois Alyssa N. , Chakrabarty Paramita , Davies Peter , Giasson Benoit I.
Published: June 2020

Tau protein abnormally aggregates in tauopathies, a diverse group of neurologic diseases that includes Alzheimer’s disease (AD). In early stages of disease, tau becomes hyperphosphorylated and mislocalized, which can contribute to its aggregation and toxicity. We demonstrate that tau phosphorylation at Ser208 (pSer208) promotes microtubule dysfunction and tau aggregation in cultured cells. Comparative assessment of the epitopes recognized by antibodies AT8, CP13, and 7F2 demonstrates that CP13 and 7F2 are specific for tau phosphorylation at Ser202 and Thr205, respectively, independently of the phosphorylation state of adjacent phosphorylation sites. Supporting the involvement of pSer208 in tau pathology, a novel monoclonal antibody 3G12 specific for tau phosphorylation at Ser208 revealed strong reactivity of tau inclusions in the brains of PS19 and rTg4510 transgenic mouse models of tauopathy. 3G12 also labelled neurofibrillary tangles in brains of patients with AD but revealed differential staining compared to CP13 and 7F2 for other types of tau pathologies such as in neuropil threads and neuritic plaques in AD, tufted astrocytes in progressive supranuclear palsy and astrocytic plaques in corticobasal degeneration. These results support the hypothesis that tau phosphorylation at Ser208 strongly contributes to unique types of tau aggregation and may be a reliable marker for the presence of mature neurofibrillary tangles.
Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: do not dismiss confounders!
Authors: Jouffroy Romain , Vivien Benoît
Published: June 2020

Recently, Okada et al. reported an association between low pH value before the implementation of extracorporeal cardiopulmonary resuscitation (ECPR) and 1-month unfavorable neurological outcome among out-of-hospital cardiac arrest (OHCA) patients treated with ECPR.

Nevertheless, we believe that some methodological flaws deserve their conclusions.

The time duration between OHCA occurrence and blood gas analysis (BGA), a major confounder for misinterpretation, was not taken into account. It is not reported whether the result of BGA analysis was considered and/or treated, and if ECPR implementation decision had been influenced by the results analysis. Furthermore, the no-flow duration and the in-hospital phase confounders for neurological outcome are not included as covariates in the logistic regression. Therefore, we believe that causes and consequences should not be confused: the longer is the no-flow duration, the greater are the metabolic consequences.
Orange peel as low-cost adsorbent in the elimination of Cd(II) ion: kinetics, isotherm, thermodynamic and optimization evaluations
Authors: Akinhanmi Temilade Fola , Ofudje Edwin Andrew , Adeogun Abideen Idowu , Aina Peter , Joseph Ilo Mayowa
Published: June 2020

The presence of heavy metals in polluted water is known not only to cause severe harm to marine organisms, but also to terrestrial plants and animals including human beings. This research applied low-cost and environmentally benign adsorbent primed from waste orange peel (OP) for the removal of Cd(II) ions from aqueous solution via batch adsorption process. The surface properties of the orange peel powder were studied using scanning electron microscopy (SEM), X-ray spectroscopy (XRD) and Fourier transform infrared spectroscopy (FT-IR). Operational conditions like temperature, contact time, sorbent dosage, solution pH and initial adsorbate concentration were investigated. The utmost uptake of Cd(II) ion was obtained at a contact time of 120 min, initial metal concentration of 240 mg/L, adsorbent dosage of 0.04 g/L, temperature of 45 °C and solution pH of 5.5. Equilibrium results showed that the orange peel adsorbent has an adsorption capacity of 128.23 mg/g as obtained from the Langmuir isotherm. The adsorption kinetics data followed a pseudo-first-order kinetic model with correlation coefficient (R2) > 0.9 and low standard % error values. The adsorption process was found to be endothermic in nature with enthalpy of 0.0046 kJ mol−1 and entropy of-636.865 Jmol−1K−1. Results from the optimization study indicated that higher adsorbent dosage and lower Cd(II) ion concentration increased the percentage of Cd(II) ion removal. Thus, orange peel could be used in the removal of Cd(II) ion from aqueous solutions.
Proposal for a layer-based IoT construction method and its implementation and evaluation on a rolling stand-up walker
Authors: Ogawa Katsushi , Uegami Kenji , Chiba Itaru , Uno Kyono , Aoyama Hiroki , Yonenobu Kazuo , Jeong Seonghee
Published: June 2020

It is a problem that the poor gait function of many elderly people affects their activities of daily living (ADL), and deteriorates their quality of life (QoL). To enhance rehabilitation of the gait function, it is desirable to increase the amount of training received. In this research, we develop a measurement system for a gait training device that enables effective rehabilitation using the internet of things (IoT) and measurement technology proactively, which aims to realize gconstant rehabilitation h by considering ADL (except training time) as rehabilitation. We propose an IoT measurement system model that classifies each function of the IoT system in a hierarchical structure to promote systematic development more efficiently. Based on this model, we (1) modularize a device for measuring the upper limb load, acceleration, and gait distance, (2) develop a device for presenting the target value of rehabilitation visually to the user using the internet, and (3) implement the model on a commercial rolling stand-up walker and gait training device. We confirm that we can obtain excellent measurements using each mounted module.
Parathyroid carcinoma in a 13-year-old girl with a long-term survival
Authors: Omi Yoko , Yamamoto Tomoko , Nagashima Yoji , Abe Koichiro , Karasawa Kumiko , Tanaka Yukichi , Okamoto Takahiro
Published: June 2020

Background

Parathyroid carcinoma as a cause of primary hyperparathyroidism in children is extremely rare. We report a case of parathyroid carcinoma which occurred in a 13-year-old girl who survived for more than 45 years after the first operation.

Case presentation

A woman was admitted to our hospital for the treatment of recurrent parathyroid carcinoma in the neck. She had been diagnosed with primary hyperparathyroidism from a fibula fracture and underwent parathyroidectomy at 13 years old. She had no family history of multiple endocrine neoplasia or jaw tumor syndrome. Genetic testing was not performed, and the histopathological diagnosis of the tumor had been parathyroid adenoma at the time. At 22 years old, she showed hypercalcemia after a femur fracture. Pulmonary metastases of parathyroid carcinoma in the bilateral lungs were found and surgically removed. Regarding the clinical course, her diagnosis was corrected from parathyroid adenoma to parathyroid carcinoma. At 33 years old, re-resection of the lung metastases was performed. For 10 years, her serum calcium level stayed within the normal range. However, her serum calcium level and intact parathyroid hormone eventually began to increase. Two masses suspected of being parathyroid carcinoma recurrence were found in the neck when she was 57 years old. En bloc resection was performed. Pathologically, the tumors were diagnosed as parathyroid adenoma. The serum calcium level and intact parathyroid hormone did not decrease after the operation. A99mTc-methoxy-isobutyl-isonitrile- and18F-fluorodeoxyglucose-negative,11C-methionine-positive tumor was detected at the right side of the trachea in the neck. The tumor was removed, along with the thyroid, muscle, and trachea that were involved. The pathological diagnosis was parathyroid carcinoma recurrence. The serum calcium level and intact parathyroid hormone decreased temporarily but had increased again 8 months later. Methionine-positive tumors were found at the right side of the trachea and suspected of being a recurrence. Denosumab reduced her serum calcium level, and radiation successfully suppressed the growth of the recurrent tumors.

Conclusion

We have reported a rare case of parathyroid carcinoma in a child who has survived for over 40 years. Positron emission tomography of11C-methionine was useful for detecting local recurrence. This patient’s long-term survival has been attributed to multimodality treatment including repeated surgery, medication, and radiation.
Premarital sex and pregnancy in Greater Jakarta
Authors: O’Donnell James , Utomo Iwu Dwisetyani , McDonald Peter
Published: June 2020

Social taboos and stigmas around sexuality and non-marital sex in Indonesia have led to substantial underreporting of the prevalence of premarital sex. In this study, we explore underreporting amongst young adults in Greater Jakarta. We use the 2010 Greater Jakarta Transition to Adulthood Survey (GJTAS), a survey of more than 3000 people aged 20–34 years, to derive estimates of underreporting based on discrepancies reported in the timing of marriage, first child birth and first sexual intercourse and sexual activities. Survival and life table analyses are utilised to identify individual and societal predictors of premarital sex and its reporting and to estimate cumulative incidence across young adulthood. The results reveal substantial evidence of underreporting, particularly amongst women, arising from premarital pregnancies. We estimate that the proportion of the female cohort who will engage in premarital sex by the age of 35 years increases from 4.4 to 22% after taking into account evidence of underreporting. Premarital pregnancies and unreported premarital sex is found to be particularly common amongst lower educated people. This raises important questions for policy and research in terms of the provision of information and support for young couples and the methodological implications of substantial underreporting.
Wolbachia: a possible weapon for controlling dengue in Nepal
Authors: Khadka Sujan , Proshad Ram , Thapa Alina , Acharya Krishna Prasad , Kormoker Tapos
Published: June 2020

Dengue, a mosquito-borne viral infectious disease, causes a high morbidity and mortality in tropical and subtropical areas of the world. In Nepal, the first case of dengue was reported in 2004 followed by frequent outbreaks in subsequent years, with the largest being in 2019 taking the death toll of six. It is reported that the number of dengue fever cases are soaring in Nepal spreading from the plains to more hilly regions. This might have serious public health implications in the future when combined with other factors, such as: global warming, lack of early detection and treatment of dengue, lack of diagnostic facilities, poor healthcare systems and mosquito control strategies. Nepal, thus, needs a cost-effective mosquito control strategy for the prevention and control of dengue. The Wolbachia-mediated biological method of the dengue control strategy is novel, economic, and environment-friendly. It has been successfully trialed in several areas of dengue-prone countries of the world, including Australia, Malaysia, Vietnam etc. resulting in significant reductions in dengue incidence. Given the lack of effective vector control strategy and weak economic condition of the country along with the persistence of climate and environment conditions that favors the host (Aedes mosquito) for Wolbachia, this approach can be a promising option to control dengue in Nepal.
Chinese cultural view, the inner idea of Confucianism and the intuitionism of the Taoist school—comments on The Silver Wings: a scholarly sequel to the Golden Wing
Authors: Jing Du
Published: June 2020

The Silver Wings: Local Society and Cultural Changes in China (1920s–1980s) is a representative ethnographic work since the reconstruction of Chinese anthropology in the late 1970s. It used the perspective of cultural change to make a return visit to the field sites described in the book “The Golden Wing”. What is most academic valuable about the book is its methodological implications. To be specific, the book refers to the concept of “culture” in Chinese historical documents, putting the issues examined into the framework of the relationship between state and local society in the long course of Chinese history. In the field work, the author’s use of intuitive research methods and the look-back method is also commendable. If we want to understand this book exactly, it is best to combine the two films the author made, Dragon Boat Festival and winter solstice, because they form a semantic chain. In short, The Silver Wings is an excellent work of anthropology, it had lead Chinese cultural anthropology into a new historical period.
DGAT1 polymorphism in Egyptian Zaraibi goat breed and their association with milk yield and composition
Authors: Eid Jehane I. , Teleb Doaa F. , Mohamed Shaimaa A. , El-Ghor Akmal A.
Published: June 2020

Background

The triacylglycerols in milk fat determine the physical and functional properties of dairy products rich in milk fat. Therefore, understanding the variability of genes related to fat synthesis is important for food production. We investigated the effect of diacylglycerol O-acyltransferase 1 (DGAT1) gene polymorphism on milk production parameters of the Zaraibi goat. Milk components were estimated by infrared spectroscopy. Moreover, Restriction Fragment Length Polymorphisms (RFLP) were used to detect genetic variants in DGAT1 genes. The amplified products were sequenced and aligned to the caprine reference sequence of this gene.

Results

Two alleles (T and C) were identified in Zaraibi goats. The T allele resulted in one silent mutation while the C allele specified two-point mutations: one was located within a non-coding region (T703C) and the other (T713C) causing a Ile → Thr substitution in the deduced amino acid sequence. Moreover, the DGAT1 polymorphism significantly (p< 0.05) affected total solid content of milk, wherein harboring CC genotype had significantly higher amount of total solid than those with TC genotype. Milk contents and yields did not differ significantly between goats with CC and TC genotype.

Conclusion

These results advance our understanding of the genetic architecture of Zaraibi milk composition and will help to improve the management and breeding program of the Egyptian dairy goat.

Graphical Abstract
Molecular identification of a Heterorhabditis entomopathogenic nematode isolated from the northernmost region of South Africa
Authors: Lulamba Tshikala Eddie , Serepa-Dlamini Mahloro Hope
Published: June 2020

Entomopathogenic nematodes (EPNs) are among the frequently used and commercialized bio-pesticides. However, they are restricted in their infectivity, persistence, storage, and cost of production. One of the methods used to improve this is a continuous search for new isolates with significant behavioral and physiological characteristics. A novel EPN isolate, Heterorhabditis zealandica strain ETL, isolated from South Africa (GPS co-ordinates − 24.849721 and 28.336980) is described and studied against late-instar of Galleria mellonella (L.) and Tenebrio mollitor (L.) larvae. The morphological and molecular studies indicated this isolate as a Heterorhabditis strain. The comparison of sequences of the internal transcribed spacer (ITS) region, the 18S rRNA gene, and the D2-D3 region of the 28S rRNA gene with available sequences of other described species within the genus indicate the isolate as a new Heterorhabditis zealandica strain. The phylogenetic analysis of the sequence data places strain ETL, closest to H. zealandica strain Bartow (GU174009) in the Heterorhabditis group. This EPN was lethal to G. mellonella and T. mollitor; as infections occurred within 24–96 h. Fifty percent of the larvae population were killed within 24 h and 100% after 96 h.
The green economy transition: the challenges of technological change for sustainability
Authors: Söderholm Patrik
Published: June 2020

The Green Economy is an alternative vision for growth and development; one that can generate economic development and improvements in people’s lives in ways consistent with advancing also environmental and social well-being. One significant component of a green economy strategy is to promote the development and adoption of sustainable technologies. The overall objective of this article is to discuss a number of challenges encountered when pursuing sustainable technological change, and that need to be properly understood by policy makers and professionals at different levels in society. We also identify some avenues for future research. The discussions center on five challenges: (a) dealing with diffuse – and ever more global – environmental risks; (b) achieving radical and not just incremental sustainable technological change; (c) green capitalism and the uncertain business-as-usual scenario; (d) the role of the state and designing appropriate policy mixes; and (e) dealing with distributional concerns and impacts. The article argues that sustainable technological change will require a re-assessment of the roles of the private industry and the state, respectively, and that future research should increasingly address the challenges of identifying and implementing novel policy instrument combinations in various institutional contexts.
How well do elderly patients do after total knee arthroplasty in the era of fast-track surgery?
Authors: Cheung Amy , Fu Henry , Cheung Man Hong , Chan Wai Kwan Vincent , Chan Ping Keung , Yan Chun Hoi , Chiu Kwong Yuen
Published: June 2020

Introduction

Total knee arthroplasty (TKA) in the elderly population is becoming increasingly prevalent. This study aimed to compare outcomes of patients aged ≥80 years with those aged < 80 years at time of TKA and to assess the effect of fast track peri-operative care on outcomes in the elderly.

Materials and methods

422 TKAs were performed in aged ≥80 at the time of surgery between 2009 and 2018. A control group aged < 80 years (37–79 +/− 7.6) was established. Peri-operative mortality, complications, 30-day re-admission, length of stay (LOS) and rehabilitation parameters were recorded.

Results

Mean age at operation for the ≥80’s group and control group was 82.7 (80–93+/− 2.5) and 69.3 (37–79+/− 7.6) years respectively. Post-operative Knee Society Functional Assessment (KSFA) scores were higher in the control group (49 vs. 57, p = 0.003). Average LOS was longer in the ≥80’s group (17.2 vs. 12.4 days respectively, p < 0.01). Mortality within 3 months of operation was 0.7% in the ≥80 group and 0% in the control group. Incidence of complications was comparable between the two groups at 12.8 and 12.9% for the group ≥80’s and control groups respectively (p = 0.962). Patients ≥80 years, receiving fast track peri-operative care had significantly shorter LOS and higher post-operative KSFA scores at all time points post-operation and shorter LOS (p < 0.01) compared to those who received conventional rehabilitation. LOS was longer in the ≥80’s group, which was likely related to higher levels of comorbidities. Complications were comparable in the two groups but were more severe in the elderly. Mortality rate after TKA was very low even in those over the age of 80. Younger patients benefited more in terms of functional improvement after TKA.

Conclusion

TKA is a safe and efficacious procedure for the elderly. More severe complications, longer length of stay and smaller gains in functional improvement can be expected in the elderly compared to younger patients. Fast track peri-operative care is useful in improving outcomes after TKA for elderly patients.
Hesperetin alleviates doxorubicin-induced migration in 4T1 breast cancer cells
Authors: Yunita Erma , Muflikhasari Haruma Anggraini , Ilmawati Gagas Pradani Nur , Meiyanto Edy , Hermawan Adam
Published: June 2020

Background

Hesperetin (Hst), a citrus flavanone, is widely distributed among citrus fruits, including lemons. Hst has been shown to possess bioactivity as an antioxidant, anti-inflammatory, anti-allergic, hypolipidemic, vasoprotector, and anticancer agent. This study aimed to identify potential combinations of Hst and the chemotherapeutic agent doxorubicin (Dox) as co-chemotherapy agents against 4T1 murine metastatic breast cancer cells.

Results

MTT assay results showed that Hst exhibited cytotoxic effect in 4T1 cells, and its combination with Dox showed a synergistic effect based on the CI value. The combination of Hst and Dox increased G2/M phase cell cycle arrest and apoptosis induction. The combination of Hst and Dox inhibited migration and decreased MMP-9 expression in 4T1 cells.

Conclusion

In conclusion, the results of this study show that Hst has potential as a Dox co-chemotherapy against 4T1 cells by inducing G2/M phase cell cycle arrest and apoptosis. More importantly, Hst reduces Dox-induced migration and decreases MMP-9 expression.
Development of electrospun keratin/coenzyme Q10/poly vinyl alcohol nanofibrous scaffold containing mupirocin as potential dressing for infected wounds
Authors: Amajuoyi Joyce N. , Ilomuanya Margaret O. , Asantewaa-Osei Yaa , Azubuike Chukwuemeka P. , Adeosun Samson O. , Igwilo Cecilia I.
Published: June 2020

Background

Nanostructured wound dressings produced by electrospinning biocompatible polymers possess great potential because they resemble the natural extracellular matrix and support cell adhesion, proliferation, and differentiation. This study seeks to fabricate mupirocin, keratin, and coenzyme Q10 (Co Q10)-loaded PVA electrospun scaffolds intended for wound healing application and to characterize their morphology, physical properties, antibacterial activity, and biocompatibility. Polyvinyl alcohol (PVA) (10% w/v), various concentrations of keratin/Co Q10 fibrous scaffolds (electrospun at a voltage of 50 kV, flow rate of 4 mL/h), and 2% mupirocin was designed and fabricated to activate keratinocytes in the wound bed, stimulate cell proliferation, and increase antimicrobial penetration.

Results

The diameters of the scaffolds were observed to be in the nanoparticulate range 2.11 ± 0.20 to 3.27 ± 0.10 nm. By 30 min, all the scaffolds had more than 50% of the cumulative concentration of mupirocin released with 51.06 ± 2.104% to 74.66 ± 1.72% of mupirocin released. At 1 h, 80% of the mupirocin in the scaffold was seen to have diffused out of the scaffold. Release of mupirocin was modulated; an initial burst release was followed by sustained release over 2 h. Electrospun keratin/Co Q10/PVA scaffold containing mupirocin showed excellent antimicrobial activity against all the clinical isolates of 2586, Staphylococcus aureus 2590, 2583, 2587, 2555. All the electrospun scaffolds showed higher cell viability values than the control at 48 and 72 h, with the optimized CoQ10 scaffold concentration being 0.05% w/w.

Conclusion

Electrospun nanofibers combining the biocompatibility potential of PVA with the bioactive nature of keratin (0.01% w/w) and CoQ10 (0.5% w/w) and the antibacterial property of mupirocin as a new potential for proper wound care was successfully developed. The cell line studies on this electrospun scaffold (PKCM 3) showed their ability to support the growth of keratinocytes hence the potential of developed scaffolds as a wound dressing. In vivo studies to further investigate the applications of the electrospun keratin/Co Q10/PVA nanofibrous scaffold as a wound dressing is however required.
Strengthening mycology research through coordinated access to microbial culture collection strains
Authors: Smith D. , Kermode A. , Cafà G. , Buddie A. G. , Caine T. S. , Ryan M. J.
Published: June 2020

Well-managed genetic resources and associated metadata are essential to
underpin research addressing the challenges to food security, healthcare, climate
change, biodiversity, environment, education and our bio-based economy. Culture
collections have supported microbiology research for over 100 years, whether they are
collections belonging to individual scientists or institutional repositories. The 790
collections registered with the World Data Centre for Microorganisms (WDCM) together
hold over three million strains representing a wide range of microbial diversity. This
review provides an overview of the uses and outputs of collections that support work in
mycology, agriculture and the environment. Further, it focusses on the advantages of
coordinating efforts and establishes recommendations to improve resource provisions for
research and the development of the necessary infrastructure. The CABI living resource
collection provides an example that holds over 28,000 strains of fungi from 100 years of
research in mycology. In the modern era, microbial interventions and solutions require
knowledge not only of those microorganisms that can be grown and preserved axenically
but also whole microbial communities: i.e. ‘microbiomes’. Current technologies enable us
to access this latter, hidden resource, thereby facilitating a better understanding of
how to harness and manipulate microbial communities to improve crop yields and allow
successful interventions such as biocontrol of pests, diseases and invasive species. The
WDCM Analyzer of Bio-resource Citations reports that 79,224 strains from 131 collections
from 50 countries have been cited in 145,133 papers published in 50,307 journals from
January, 1953 until April, 2020. These organisms have a multitude of uses, for example
as sources of antibiotics, therapeutic drugs and other active agents. They have been
applied widely including in the biodegradation, bioremediation, biotransformation and
biotreatment of wastes. Further uses include interventions in agriculture for soil and
plant health or biological control of pests and diseases. All of the above may be
achieved by individual institutions but, by working together, collections can form a
critical mass to focus on key global issues and can achieve much more. Mechanisms are
suggested for coordinating collections in order to deliver a more comprehensive support
system in the advancement of science and innovation.