bluuebunny/crossref_metadata_2025 huggingface dataset:
Shared care follow-up of patients with B-cell neoplasms based on nurse-led telephone consultations and PRO-data: a feasibility study from the North Denmark Region
Authors: Sommer Mia , Frandsen Lone , Jensen Paw , Nielsen Søren Ramme , Nielsen Lars Børty , Brøndum Rasmus Froberg , Bøgsted Martin , Madsen Jakob , Severinsen Marianne Tang , Sørensen Erik Elgaard , Grønkjær Mette , El-Galaly Tarec Christoffer
Published: November 2020

Background

Patients with B-cell neoplasms in remission are monitored with regular physician visits at the hospital. The current standard follow-up procedure is not evidence-based or individualized to patient needs. To improve and individualize the follow-up, we investigated the feasibility of a shared care follow-up initiative, with alternating physician visits and nurse-led telephone consultations and assessments based on patient-reported outcome (PRO) data.

Methods

Patients ≥18 years diagnosed with B-cell neoplasms were eligible for the study when they were in remission and stable without treatment for at least 6 months. Patients were assigned to alternating visits with physicians and nurse-led telephone consultations. The nurse-led telephone consultations were based on PROs, which were collected with the European Organization for Research and Treatment of Cancer questionnaire (EORTC-QLQ-C30), the Myeloproliferative Neoplasm – Symptom Assessment Form, and the Hospital Anxiety and Depression Scale. Patients completed questionnaires before every nurse-led consultation. We also applied the Patient Feedback Form to survey patient acceptance of the requirement of questionnaire completion. We applied descriptive statistics, in terms of counts (n) and proportions (%), to describe the study population and all endpoints.

Results

Between February 2017 and December 2018, 80 patients were enrolled. Adherence, measured as the recruitment rate, was 96% (80/83), and the drop-out rate was 6% (5/80). During the study period, 3/80 (4%) patients relapsed, and 5/80 (6%) patients returned to the standard follow-up, because they required closer medical observation. Relapses were diagnosed based on unscheduled visits requested by patients (n = 2) and patient-reported symptoms reviewed by the nurse (n = 1). The response rate to questionnaires was 98% (335/341). A total of 58/79 (74%) patients completed the Patient Feedback Form; 51/57 (89%) patients reported improved communication with health care professionals; and 50/57 (88%) patients reported improved recollection of symptoms as a result of completing questionnaires.

Conclusion

Based on patient adherence, a low relapse rate, and positive patient attitudes towards completing questionnaires, we concluded that a shared care follow-up, supported by PROs, was a feasible alternative to the standard follow-up for patients with B-cell disease in remission.
Screening and patient-tailored care for emotional and cognitive problems compared to care as usual in patients discharged home after ischemic stroke (ECO-stroke): a protocol for a multicenter, patient-blinded, cluster randomized controlled trial
Authors: Slenders J. P. L. , Van den Berg-Vos R. M. , van Heugten C. M. , Visser-Meily J. M. A. , Evers S. M. A. A. , de Haan R. J. , de Man-van Ginkel J. M. , Kwa V. I. H.
Published: November 2020

Background

Ischemic stroke patients with a good outcome in terms of motor functioning and communication are likely to be discharged home without further rehabilitation. A significant number of these patients experience cognitive and emotional problems resulting in lower quality of life and decreased participation in society. This paper presents the protocol of a study examining the clinical effectiveness, cost-effectiveness and implementation of an intervention focused on screening and patient-tailored care for cognitive and emotional problems as compared to usual care in patients discharged home after ischemic stroke.

Methods / design

A multicenter, patient-blinded, cluster randomized controlled trial will be performed. Centers will be randomized (1:1) to the intervention group or the usual care group. Patients (> 18 years old) with a neurological confirmed diagnosis of ischemic stroke who can be discharged home without follow-up treatment at an outpatient rehabilitation clinic will be included. In the intervention group, patients will receive a short, individualized, semi-structured consultation by specialized nurses in addition to usual care. This consultation includes 1) screening for cognitive and emotional problems, 2) screening for restrictions in participation, 3) promotion of self-management strategies and 4) a decision tool for referral to rehabilitation services. The intervention will be performed approximately 6 weeks after the stroke at the neurology outpatient clinics and will take approximately 60 min. The control group will receive care as usual. Both groups will be followed-up at 6 weeks, 3 months and 12 months after stroke. The primary outcome will be the level of participation measured with the Restriction subscale of the Utrecht Scale for Evaluation of Rehabilitation on the level of Participation (USER-Participation-R) at 12 months. A cost-effectiveness analysis and process evaluation will be performed alongside.

Discussion

This trial is the first to evaluate clinical effectiveness, cost-effectiveness and implementation of screening and patient-tailored care for cognitive and emotional problems compared to care as usual in patients discharged home after ischemic stroke. Potentially, this will improve the outcomes for patients with frequently occurring cognitive and emotional problems after stroke.

Trial registration

Netherlands Trial Register: NL7295, registered 25 September 2018
Beagle dog 90-day oral toxicity study of a novel coccidiostat – ethanamizuril
Authors: Zhang Keyu , Zheng Haihong , Wei Shuya , Wang Xiaoyang , Fei Chenzhong , Wang Chunmei , Liu Yingchun , Zhang Lifang , Xue Feiqun , Tang Shusheng
Published: November 2020

Background

Triazine coccidiostats are widely used in chickens and turkeys for coccidiosis control. Ethanamizuril is a novel triazine compound that exhibits anticoccidial activity in poultry. This study was designed to evaluate the subchronic toxicity of ethanamizuril in beagle dogs at doses of 12, 60 or 300 mg/kg/day in diet for 90 days.

Results

Ethanamizuril was well tolerated at low and middle dosages in beagle dogs, and no drug-related toxical effects were observaed in terms of survival, clinical observations, organs weight and damage in these dose groups. However, in high dose administration group, food consumption and histologic changes in kidneys were noticed in both sexes of beagle dog, although the renal lesions were finally resolved at the end of 4 weeks exposure of ethanamizuril.

Conclusions

No-observed-adverse-effect level (NOAEL) was considered for ethanamizuril at dose of 60 mg/kg/day in Beagle dog. This result added toxicity effects of ethanamizuril to the safety database, which might guide safely using of ethanamizuril as a novel coccidiostat.
Applying systems thinking to knowledge mobilisation in public health
Authors: Haynes Abby , Rychetnik Lucie , Finegood Diane , Irving Michelle , Freebairn Louise , Hawe Penelope
Published: November 2020

Context

Knowledge mobilisation (KM) is a vital strategy in efforts to improve public health policy and practice. Linear models describing knowledge transfer and translation have moved towards multi-directional and complexity-attuned approaches where knowledge is produced and becomes meaningful through social processes. There are calls for systems approaches to KM but little guidance on how this can be operationalised. This paper describes the contribution that systems thinking can make to KM and provides guidance about how to put it into action.

Methods

We apply a model of systems thinking (which focuses on leveraging change in complex systems) to eight KM practices empirically identified by others. We describe how these models interact and draw out some key learnings for applying systems thinking practically to KM in public health policy and practice. Examples of empirical studies, tools and targeted strategies are provided.

Findings

Systems thinking can enhance and fundamentally transform KM. It upholds a pluralistic view of knowledge as informed by multiple parts of the system and reconstituted through use. Mobilisation is conceived as a situated, non-prescriptive and potentially destabilising practice, no longer conceptualised as a discrete piece of work within wider efforts to strengthen public health but as integral to and in continual dialogue with those efforts. A systems approach to KM relies on contextual understanding, collaborative practices, addressing power imbalances and adaptive learning that responds to changing interactions between mobilisation activities and context.

Conclusion

Systems thinking offers valuable perspectives, tools and strategies to better understand complex problems in their settings and for strengthening KM practice. We make four suggestions for further developing empirical evidence and debate about how systems thinking can enhance our capacity to mobilise knowledge for solving complex problems – (1) be specific about what is meant by ‘systems thinking’, (2) describe counterfactual KM scenarios so the added value of systems thinking is clearer, (3) widen conceptualisations of impact when evaluating KM, and (4) use methods that can track how and where knowledge is mobilised in complex systems.
Correction to: Osteopontin/secreted phosphoprotein-1 behaves as a molecular brake regulating the neuroinflammatory response to chronic viral infection
Authors: Mahmud Farina J. , Du Yong , Greif Elizabeth , Boucher Thomas , Dannals Robert F. , Mathews William B. , Pomper Martin G. , Sysa-Shah Polina , Metcalf Pate Kelly A. , Lyons Claire , Carlson Bess , Chacona Maria , Brown Amanda M.
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
Guided endodontic treatment of multiple teeth with dentin dysplasia: a case report
Authors: Krug Ralf , Volland Julian , Reich Sebastian , Soliman Sebastian , Connert Thomas , Krastl Gabriel
Published: November 2020

Background

To report the outcome of guided endodontic treatment (GET) of a case of dentin dysplasia with pulp canal calcification (PCC) and apical periodontitis based on the use of a 3D-printed template designed by merging cone-beam computed tomography (CBCT) and surface scan data.

Case presentation

A 12-year old female with radicular dentin dysplasia type I (DD-1) presented for endodontic treatment. Radiography revealed PCC in all teeth and apical radiolucency in seven teeth (12, 15, 26, 31, 32, 36 and 46). Tooth 36 had the most acute symptoms and was thus treated first by conventional access cavity preparation and root canal detection. Despite meticulous technique, the distal and mesiolingual canals were perforated. The perforations were immediately repaired with mineral trioxide aggregate, and the decision was made to switch to guided endodontic treatment for the remaining 6 teeth. CBCT and intraoral surface scans were acquired and matched using coDiagnostix planning software (Dental Wings Inc.), the respective drill positions for root canal location were determined, and templates were virtually designed and 3D-printed. The template was positioned on the respective tooth, and a customized drill was used to penetrate the calcified part of the root canal and perform minimally invasive access cavity preparation up to the apical region. All root canals were rapidly and successfully located with the templates. At 1-year follow-up, clear signs of apical healing were present in all treated teeth.

Conclusions

In patients with dentin dysplasia, conventional endodontic therapy is challenging. GET considerably facilitates the root canal treatment of teeth affected by dentin dysplasia.
Augmented reality-guided periacetabular osteotomy—proof of concept
Authors: Kiarostami Pascal , Dennler Cyrill , Roner Simon , Sutter Reto , Fürnstahl Philipp , Farshad Mazda , Rahm Stefan , Zingg Patrick O.
Published: November 2020

Background

The Ganz’ periacetabular osteotomy (PAO) consists of four technically challenging osteotomies (OT), namely, supraacetabular (saOT), pubic (pOT), ischial (iOT), and retroacetabular OT (raOT).

Purpose

We performed a proof of concept study to test (1) the feasibility of augmented reality (AR) guidance for PAO, (2) precision of the OTs guided by AR compared to the freehand technique performed by an experienced PAO surgeon, and (3) the effect of AR on performance depending on experience.

Methods

A 3D preoperative plan of a PAO was created from segmented computed tomography (CT) data of an anatomic plastic pelvis model (PPM). The plan was then embedded in a software application for an AR head-mounted device. Soft tissue coverage was imitated using foam rubber. The 3D plan was then registered onto the PPM using an anatomical landmark registration. Two surgeons (one experienced and one novice PAO surgeon) each performed 15 freehand (FH) and 15 AR-guided PAOs. The starting point distances and angulation between the planned and executed OT planes for the FH and the AR-guided PAOs were compared in post-intervention CTs.

Results

AR guidance did not affect the performance of the expert surgeon in terms of the mean differences between the planned and executed starting points, but the raOT angle was more accurate as compared to FH PAO (p = 0.0027). AR guidance increased the accuracy of the performance of the novice surgeon for iOT (p = 0.03). An intraarticular osteotomy performed by the novice surgeon with the FH technique could be observed only once.

Conclusion

AR guidance of osteotomies for PAOs is feasible and seems to increase accuracy. The effect is more accentuated for less-experienced surgeons.

Clinical relevance

This is the first proof of concept study documenting the feasibility of AR guidance for PAO. Based on these findings, further studies are essential for elaborating on the potential merits of AR guidance to increase the accuracy of complex surgical procedures.
MeCP2 gates spatial learning-induced alternative splicing events in the mouse hippocampus
Authors: Brito David V. C. , Gulmez Karaca Kubra , Kupke Janina , Frank Lukas , Oliveira Ana M. M.
Published: November 2020

Long-term memory formation is supported by functional and structural changes of neuronal networks, which rely on de novo gene transcription and protein synthesis. The modulation of the neuronal transcriptome in response to learning depends on transcriptional and post-transcriptional mechanisms. DNA methylation writers and readers regulate the activity-dependent genomic program required for memory consolidation. The most abundant DNA methylation reader, the Methyl CpG binding domain protein 2 (MeCP2), has been shown to regulate alternative splicing, but whether it establishes splicing events important for memory consolidation has not been investigated. In this study, we identified the alternative splicing profile of the mouse hippocampus in basal conditions and after a spatial learning experience, and investigated the requirement of MeCP2 for these processes. We observed that spatial learning triggers a wide-range of alternative splicing events in transcripts associated with structural and functional remodeling and that virus-mediated knockdown of MeCP2 impairs learning-dependent post-transcriptional responses of mature hippocampal neurons. Furthermore, we found that MeCP2 preferentially affected the splicing modalities intron retention and exon skipping and guided the alternative splicing of distinct set of genes in baseline conditions and after learning. Lastly, comparative analysis of the MeCP2-regulated transcriptome with the alternatively spliced mRNA pool, revealed that MeCP2 disruption alters the relative abundance of alternatively spliced isoforms without affecting the overall mRNA levels. Taken together, our findings reveal that adult hippocampal MeCP2 is required to finetune alternative splicing events in basal conditions, as well as in response to spatial learning. This study provides new insight into how MeCP2 regulates brain function, particularly cognitive abilities, and sheds light onto the pathophysiological mechanisms of Rett syndrome, that is characterized by intellectual disability and caused by mutations in the Mecp2 gene.
Circular RNA MCTP2 inhibits cisplatin resistance in gastric cancer by miR-99a-5p-mediated induction of MTMR3 expression
Authors: Sun Guangli , Li Zheng , He Zhongyuan , Wang Weizhi , Wang Sen , Zhang Xing , Cao Jiacheng , Xu Penghui , Wang Haixiao , Huang Xiaoxu , Xia Yiwen , Lv Jialun , Xuan Zhe , Jiang Tianlu , Fang Lang , Yang Jing , Zhang Diancai , Xu Hao , Xu Zekuan
Published: November 2020

Background

Cisplatin (CDDP) is the first-line chemotherapy for gastric cancer (GC). The poor prognosis of GC patients is partially due to the development of CDDP resistance. Circular RNAs (circRNAs) are a subclass of noncoding RNAs that function as microRNA (miRNA) sponges. The role of circRNAs in CDDP resistance in GC has not been evaluated.

Methods

RNA sequencing was used to identify the differentially expressed circRNAs between CDDP-resistant and CDDP-sensitive GC cells. qRT-PCR was used to detect the expression of circMCTP2 in GC tissues. The effects of circMCTP2 on CDDP resistance were investigated in vitro and in vivo. Pull-down assays and luciferase reporter assays were performed to confirm the interactions among circMCTP2, miR-99a-5p, and myotubularin-related protein 3 (MTMR3). The protein expression levels of MTMR3 were detected by western blotting. Autophagy was evaluated by confocal microscopy and transmission electron microscopy (TEM).

Results

CircMCTP2 was downregulated in CDDP-resistant GC cells and tissues compared to CDDP-sensitive GC cells and tissues. A high level of circMCTP2 was found to be a favorable factor for the prognosis of patients with GC. CircMCTP2 inhibited proliferation while promoting apoptosis of CDDP-resistant GC cells in response to CDDP treatment. CircMCTP2 was also found to reduce autophagy in CDDP-resistant GC cells. MiR-99a-5p was verified to be sponged by circMCTP2. Inhibition of miR-99a-5p could sensitize GC cells to CDDP. MTMR3 was confirmed to be a direct target of miR-99a-5p. Knockdown of MTMR3 reversed the effects of circMCTP2 on the proliferation, apoptosis and autophagy of CDDP-resistant GC cells. CircMCTP2 was also confirmed to inhibit CDDP resistance in vivo in a nude mouse xenograft model.

Conclusions

CircMCTP2 sensitizes GC to CDDP through the upregulation of MTMR3 by sponging miR-99a-5p. Overexpression of CircMCTP2 could be a new therapeutic strategy for counteracting CDDP resistance in GC.
A versatile toolkit for CRISPR-Cas13-based RNA manipulation in Drosophila
Authors: Huynh Nhan , Depner Noah , Larson Raegan , King-Jones Kirst
Published: November 2020

Advances in CRISPR technology have immensely improved our ability to manipulate nucleic acids, and the recent discovery of the RNA-targeting endonuclease Cas13 adds even further functionality. Here, we show that Cas13 works efficiently in Drosophila, both ex vivo and in vivo. We test 44 different Cas13 variants to identify enzymes with the best overall performance and show that Cas13 could target endogenous Drosophila transcripts in vivo with high efficiency and specificity. We also develop Cas13 applications to edit mRNAs and target mitochondrial transcripts. Our vector collection represents a versatile tool collection to manipulate gene expression at the post-transcriptional level.
Cohort profile: why do people keep hurting their back?
Authors: Klyne David M. , van den Hoorn Wolbert , Barbe Mary F. , Cholewicki Jacek , M. Hall Leanne , Khan Asaduzzaman , Meroni Roberto , Moseley G. Lorimer , Nicholas Michael , O’Sullivan Lee , Park Rachel , Russell Glen , Sterling Michele , Hodges Paul W.
Published: November 2020

Objective

Low back pain (LBP) is one of the most disabling and costly conditions worldwide. It remains unclear why many individuals experience persistent and recurrent symptoms after an acute episode whereas others do not. A longitudinal cohort study was established to address this problem. We aimed to; (1) evaluate whether promising and potentially modifiable biological, psychological, social and behavioural factors, along with their possible interactions, predict LBP outcome after an acute episode; (2) compare these factors between individuals with and without acute LBP; and (3) evaluate the time-course of changes in these factors from LBP onset. This paper outlines the methodology and compares baseline characteristics between acute LBP and control, and LBP participants with and without follow-up.

Results

133 individuals with acute LBP and 74 pain-free individuals participated. Bio-psycho-social and behavioural measures were collected at baseline and 3-monthly for 12 months (LBP) or 3 months (control). Pain and disability were recorded fortnightly. Baseline characteristics were mostly similar between those who did and did not return for follow-up. Initial analyses of this cohort have revealed important insights into the pathways involved in acute-to-chronic LBP. These and future findings will provide new targets for treatment and prevention of persistent and recurrent LBP.
Genetic counselling and testing for inherited dementia: single-centre evaluation of the consensus Italian DIAfN protocol
Authors: Mega Anna , Galluzzi Samantha , Bonvicini Cristian , Fostinelli Silvia , Gennarelli Massimo , Geroldi Cristina , Zanetti Orazio , Benussi Luisa , Di Maria Emilio , Frisoni Giovanni B.
Published: November 2020

Background

A consensus protocol for genetic counselling and testing of familial dementia, the Italian Dominantly Inherited Alzheimer’s and Frontotemporal Network (IT-DIAfN) protocol, has been developed in Italy by a network of expert dementia centres. The aim of this study is to evaluate feasibility and acceptability of the genetic counselling and testing process, as undertaken according to the IT-DIAfN protocol in one of the IT-DIAfN dementia research centres.

Methods

The protocol was tested by a multidisciplinary team at the IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy, on affected individuals with suspected inherited forms of Alzheimer’s disease (AD) or frontotemporal dementia (FTD), and to healthy at-risk relatives. The genetic counselling and testing process consisted of (i) pre-test consultation and psychological assessment (ii) genetic testing, (iii) genetic test result disclosure and (iv) follow-up consultation and psychological assessment.

Results

Twenty affected individuals from 17 families fulfilled the family history criteria of the IT-DIAfN protocol for suspected inherited dementia (17 for AD, 2 for FTD, 1 for inclusion body myopathy with Paget disease of bone and frontotemporal dementia) and were included in the protocol. Nineteen out of 20 affected individuals received the genetic test result (one left after the pre-test consultation being not ready to cope with an unfavourable outcome). A pathogenic mutation was found in 6 affected individuals (1 in PSEN1, 2 in PSEN2, 1 in GRN, 1 in MAPT, 1 in VCP). Eleven healthy at-risk relatives asked to undergo predictive testing and were included in the protocol. Three completed the protocol, including follow-up; one did not ask for the genetic test result after genetic testing; and eight withdrew before the genetic testing, mainly due to an increased awareness about the possible consequences of an unfavourable test result. To date, no catastrophic reactions were reported at the follow-up.

Conclusions

Our case series shows that a structured genetic counselling and testing protocol for inherited dementia can be implemented in both affected individuals and at-risk relatives in a research setting. The procedure was shown to be safe in terms of occurrence of catastrophic events. A formal validation in larger cohorts is needed.
Correction to: Vilnius Declaration on chronic respiratory diseases: multisectoral care pathways embedding guided self-management, mHealth and air pollution in chronic respiratory diseases
Authors: Valiulis Arunas , Bousquet J. , Veryga A. , Suprun U. , Sergeenko D. , Cebotari S. , Borelli D. , Pietikainen S. , Banys J. , Agache I. , Billo N. E. , Bush A. , Chkhaidze I. , Dubey L. , Fokkens W. J. , Grigg J. , Haahtela T. , Julge K. , Katilov O. , Khaltaev N. , Odemyr M. , Palkonen S. , Savli R. , Utkus A. , Vilc V. , Alasevicius T. , Bedbrook A. , Bewick M. , Chorostowska-Wynimko J. , Danila E. , Hadjipanayis A. , Karseladze R. , Kvedariene V. , Lesinskas E. , Münter L. , Samolinski B. , Sargsyan S. , Sitkauskiene B. , Somekh D. , Vaideliene L. , Valiulis Algirdas , Hellings P. W.
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
Automatic LIDAR building segmentation based on DGCNN and euclidean clustering
Authors: Gamal Ahmad , Wibisono Ari , Wicaksono Satrio Bagus , Abyan Muhammad Alvin , Hamid Nur , Wisesa Hanif Arif , Jatmiko Wisnu , Ardhianto Ronny
Published: November 2020

There has been growing demand for 3D modeling from earth observations, especially for purposes of urban and regional planning and management. The results of 3D observations has slowly become the primary source of data in terms of policy determination and infrastructure planning. In this research, we presented an automatic building segmentation method that directly uses LIDAR data. Previous works have utilized the CNN method to automatically segment buildings. However, the existing body of works have relied heavily on the conversion of LIDAR data into Digital Terrain Model (DTM), Digital Surface Model (DSM), or Digital Elevation Model (DEM) formats. Those formats required conversion of LIDAR data into raster images, which poses challenges to the evaluation of building volumes. In this paper, we collected LIDAR data with unmanned aerial vehicle and directly segmented buildings utilizing the said LIDAR data. We utilized a Dynamic Graph Convolutional Neural Network (DGCNN) algorithm to separate buildings and vegetation. We then utilized Euclidean Clustering to segment each building. We found that the combination of these methods are superior to prior works in the field, with accuracy up to 95.57% and an Intersection Over Union (IOU) score of 0.85.
Correction to: Half-graben inversion tectonics revealed by gravity modeling in the Mikawa Bay region, Central Japan
Authors: Miyakawa Ayumu , Abe Tomoya , Sumita Tatsuya , Otsubo Makoto
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
Evaluation of a multidisciplinary global health online course in Mexico
Authors: Carrasco Héctor , Fuentes Patricia , Eguiluz Itzel , Lucio-Ramírez Cesar , Cárdenas Sandra , Leyva Barrera Ilse Mariana , Pérez-Jiménez Manuel
Published: November 2020

Background

Global Health Education (GHE) focuses on training proactive global citizens to tackle health challenges in an increasingly interconnected and interdependent world. Studies show that health professionals in training have reported that GHE has improved their teamwork, responsiveness to contextual factors that impact health, and understanding of health systems; however, there is little research on the impact of GHE courses in undergraduate settings, especially in low and middle-income countries (LMICs).

Methods

Our study analyzes a multidisciplinary online global health course at Tecnologico de Monterrey, México. We conducted a cross-sectional study with pre- and post-design. Students who took the multidisciplinary course of Global Health for Leaders in the Fall of 2019 (n = 153) and Spring of 2020 (n = 348) were selected for this study. Using a five-point Likert scale (strongly agree to strongly disagree), the survey assessed seven competencies as well as questions about course expectations, takeaways, and recommendations to improve the course. We performed descriptive statistical analyses comparing the combined pre-tests (from Fall and Spring cohorts) to the combined post-tests. Fisher’s exact test was used to compare the samples.

Results

Of the 501 pre-course surveys administered, 456 responses were completed in the pre-course and 435 in the post-course (91% overall response rate). Only 8.7% of the respondents in the pre-course survey strongly agreed that they could describe fundamental aspects of global health such as the Millennium Development Goals or Sustainable Development Goals, in contrast to a 56% of the students who strongly agreed in the post-course survey (p < 0.001). Similar differences were captured in understanding the global burden of disease, social determinants of health, the effects of globalization in health, health systems’ goals and functions, and human rights. 38% felt that the course helped them develop a more empathetic perception of the suffering of others experiencing global health-related issues.

Conclusion

In this study, we have presented our experience in teaching an online global health course for multidisciplinary undergraduates in a LMIC. The competencies reported by our students indicate that the course prepared them to confront complex global health issues.
PET/CT imaging for tumour response assessment to immunotherapy: current status and future directions
Authors: Unterrainer Marcus , Ruzicka Michael , Fabritius Matthias P. , Mittlmeier Lena M. , Winkelmann Michael , Rübenthaler Johannes , Brendel Matthias , Subklewe Marion , von Bergwelt-Baildon Michael , Ricke Jens , Kunz Wolfgang G. , Cyran Clemens C.
Published: November 2020

Recent immunotherapeutic approaches have evolved as powerful treatment options with high anti-tumour responses involving the patient’s own immune system. Passive immunotherapy applies agents that enhance existing anti-tumour responses, such as antibodies against immune checkpoints. Active immunotherapy uses agents that direct the immune system to attack tumour cells by targeting tumour antigens. Active cellular-based therapies are on the rise, most notably chimeric antigen receptor T cell therapy, which redirects patient-derived T cells against tumour antigens. Approved treatments are available for a variety of solid malignancies including melanoma, lung cancer and haematologic diseases. These novel immune-related therapeutic approaches can be accompanied by new patterns of response and progression and immune-related side-effects that challenge established imaging-based response assessment criteria, such as Response Evaluation Criteria in Solid tumours (RECIST) 1.1. Hence, new criteria have been developed. Beyond morphological information of computed tomography (CT) and magnetic resonance imaging, positron emission tomography (PET) emerges as a comprehensive imaging modality by assessing (patho-)physiological processes such as glucose metabolism, which enables more comprehensive response assessment in oncological patients. We review the current concepts of response assessment to immunotherapy with particular emphasis on hybrid imaging with 18F-FDG-PET/CT and aims at describing future trends of immunotherapy and additional aspects of molecular imaging within the field of immunotherapy.
German guidelines on the diagnosis and treatment of neurosyphilis
Authors: Klein Matthias , Angstwurm Klemens , Esser Stefan , Hahn Kathrin , Maschke Matthias , Scheithauer Simone , Schoefer Helmut , Sturzenegger Matthias , Wildemann Brigitte , Weber Jörg
Published: November 2020

Introduction

In view of the importance of neurosyphilis and the difficulties encountered in diagnosing it, the S1 guideline “Neurosyphilis” has been published by the German Society for Neurology (DGN) in accordance with the stipulations of the Association of the Scientific Medical Societies in Germany (AWMF). The present article is an abridged translation of that German guideline.

Main recommendations

(a) Neurosyphilis can manifest as early neurosyphilis (meningitis, meningovascular neurosyphilis or syphilitic gummas) or late neurosyphilis (tabes dorsalis, general paresis). (b) The following diagnostic criteria help to establish the presence of probable neurosyphilis (always point iv, accompanied by any two of points i to iii): (i) subacute or chronic neuro-psychiatric symptoms; (ii) increased cerebrospinal fluid (CSF) cell count or signs of blood–CSF barrier disruption; (iii) positive effect of anti-neurosyphilis antibiotic therapy on clinical course and CSF findings; (iv) positive TPHA/TPPA or FTA test in serum. (c) The diagnosis of neurosyphilis is confirmed by the subsequent detection of intrathecal production of antibodies againstTreponema pallidum. (d) In neurosyphilis, treatment with intravenous penicillin or ceftriaxone for 14 days is recommended. (e) The following parameters can be used to assess a therapeutic effect: clinical findings, serum VDRL, and CSF cell count.

Conclusion

The German guideline on the diagnosis and treatment of neurosyphilis is a practical tool to support clinicians in diagnosing and treating patients with neurosyphilis. This article is an abridged translation of this guideline (Klein MW, J.; Angstwurm, K.; Esser, S.; Hahn, K.; Matschke, M.; Scheithauer, S.; Schoefer, H.; Sturzenegger, M.; Wildemann, B. Neurosyphilis, S1-Leitlinie. Deutsche Gesellschaft für Neurologie, Leitlinien für Diagnostik und Thearpie in der Neurologie 2020).
A systematic review of the prevalence of mental and neurocognitive disorders amongst older adults’ populace in Egypt
Authors: Odejimi Opeyemi , Tadros George , Sabry Noha
Published: November 2020

Background

Mental and neurocognitive disorders are the leading cause of disabilities amongst the older adult populace worldwide. The population of the older adult in Egypt is fast growing. The national census in 2017 revealed a 2.56% increase in the older adult population from the 2006 census, and these figures are expected to double by year 2031. This study aims to review current evidence about the prevalence of mental and neurocognitive disorders amongst older adult population in Egypt.

Results

A systematic review was carried out, and 16 studies met the inclusion criteria outlined in this study. Four main mental and neurocognitive disorders were identified: depression, anxiety, cognitive impairment and dementia. The reported prevalence of depression, anxiety, dementia and cognitive impairment are 23.7–74.5%, 14.2–72%, 3.66–39.2% and 1.74–51.4%, respectively. Anxiety and depression were positively correlated with the female gender, increasing age and lower educational status. Also, cognitive impairment and dementia were positively correlated with age, illiteracy or low education. However, there appears to be inconsistencies in the diagnostic tools used.

Conclusion

Egypt aging population is growing, and this research brings to forefront the scale of mental and neurocognitive disorders amongst the older adult population. This may help ensure evidence-based initiatives are put in place and priority is given to resource allocation for geriatric mental and neurocognitive disorders in Egypt.

Systematic review registration

PROSPERO CRD42018114831
Omental Metastasis from ALK-positive Lung Cancer — A Case Report
Authors: Khalid Taha , Phelan Brendan , Yousif Ala
Published: November 2020

Background

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related deaths worldwide. In Ireland alone, there are over 2500 new cases of lung cancer diagnosed each year. It ranks fourth among the most common cancers and causes 21% of all cancer-related deaths.

Lung cancers usually metastasize to the liver, brain, bone, and adrenal glands—rarely affecting the abdomen. To our knowledge, there are 8 previous studies in the literature to date which involve omental metastasis from NSCLC.

Case presentation

A 73-year-old lady presented with a history of productive cough for 18 months. A chest X-ray showed a suspicious 6 cm mass in the right lower zone. She went on to have an endobronchial biopsy which confirmed a moderately differentiated adenocarcinoma of the lung which was ALK positive. She went on to have staging PET and CT scans and was staged as cT3N2M0. She was not a suitable candidate for surgery so she had radical chemo-radiotherapy with 4 cycles of cisplatin pemetrexed followed by radical dose sequential radiotherapy. Post treatment CT showed the tumor to be more spiculated in appearance. She was ineligible for Durvalumab maintenance therapy due to the extensive pneumonitis following her radiotherapy which required a prolonged course of steroids. Interval scans every 3 months did not show any progression of disease.

She presented to the hospital 13 months post her diagnosis with progressive abdominal swelling. Restaging CT scans showed extensive omental infiltration, the presence of multiple peritoneal nodules, and progression of her pulmonary disease with new brain metastasis. Cytological analysis of the ascitic fluid confirmed metastasis followed by omental biopsy which confirmed metastatic ALK-positive NSCLC. She went on to have targeted treatment with alectinib. She tolerated the treatment well. Restaging scans done 3 months later showed good partial response to therapy.

Conclusion

In conclusion, ALK-positive NSCLC with metastasis to the omentum is very rare. However, in patients with atypical symptoms like ascites, the possibility of a metastasis must be considered and repeat biopsy is always recommended. A targeted therapy in the selected patients has shown a more durable response than chemotherapy.
Correction to: Review of annual progress of bridge engineering in 2019
Authors: Zhao Renda , Yuan Yuan , Wei Xing , Shen Ruili , Zheng Kaifeng , Qian Yongjiu , Pu Qianhui , Zhang Qinghua , Liao Haili , Li Xiaozhen , Zhao Canhui , Xu Guoji , Gou Hongye , Zhang Ziyang , Yu Chuanjin
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
Walking a Tightrope: Dosage Modifications and Treatment Outcomes of All-Trans-Retinoic Acid, Arsenic Trioxide, and Daunorubicin for High-Risk Acute Promyelocytic Leukemia
Authors: Danthala Madhav , Golamari Krishna Reddy , Seshachalam Arun , Mikkilineni Anupama , Chappidi Sitalata , Mekala Mahesh Babu , Elangovan Vidhubala , Chinnakali Palanivel
Published: November 2020

PURPOSE

The use of all- trans-retinoic acid (ATRA) and arsenic trioxide (ATO) in the treatment of low- and intermediate-risk acute promyelocytic leukemia (APL) is the standard of care. We report the combined use of ATRA, ATO, and daunorubicin (DNR) in patients newly diagnosed with high-risk APL. The primary focus was to describe the drug dosage modifications made in the real-world scenario.

METHODS

In this descriptive study, we included 16 out of 28 patients with high-risk APL from two tertiary care centers in South India (Vijayawada and Trichy) between January 2015 and December 2018. A unique approach of initiating ATRA at a dose of 25 mg/m2 on day 1 and escalation to 45 mg/m2 after cytoreduction with DNR and hydroxyurea was followed in all patients to avert differentiation syndrome, in the setting of hyperleukocytosis at presentation.

RESULTS

All patients who survived the first 3 days of admission achieved complete remission after a median duration of 29 days. There were no deaths during induction or consolidation, and the regimen was well tolerated; two patients developed grade 3/4 peripheral neuropathy requiring treatment modification. After a median follow-up duration of 1.9 years, there were no hematologic or molecular relapses.

CONCLUSION

The study sheds light on the modifications made to recommended dosages of ATRA, ATO, and DNR to optimize outcomes in high-risk APL and reaffirms the importance of ATO use in the front-line setting to achieve durable responses with minimal toxicity.
Measuring Tumor Epichaperome Expression Using [124I] PU-H71 Positron Emission Tomography as a Biomarker of Response for PU-H71 Plus Nab-Paclitaxel in HER2-Negative Metastatic Breast Cancer
Authors: Jhaveri Komal L. , dos Anjos Carlos H. , Taldone Tony , Wang Rui , Comen Elizabeth , Fornier Monica , Bromberg Jacqueline F. , Ma Weining , Patil Sujata , Rodina Anna , Pillarsetty Nagavarakishore , Duggan Susan , Khoshi Sarhe , Kadija Nathan , Chiosis Gabriela , Dunphy Mark P. , Modi Shanu
Published: November 2020

PURPOSE

Epichaperome network maintenance is vital to survival of tumors that express it. PU-H71 is an epichaperome inhibitor that binds to the ATP-binding site of HSP90 and has demonstrated antitumor activity in breast cancer xenograft models and clinical safety in patients. PU–positron emission tomography (PET) is a theragnostic imaging tool that allows visualization of the epichaperome target. In this phase Ib trial, we present safety and tolerability for PU-H71 plus nab-paclitaxel in HER2-negative patients with metastatic breast cancer (MBC) and the utility of PU-PET as a noninvasive predictive biomarker.

METHODS

We performed a 3 + 3 dose-escalation study with escalating PU-H71 doses and standard nab-paclitaxel. The primary objective was to establish safety and determine maximum tolerated dose (MTD)/recommended phase 2 dose. Secondary objectives were to assess pharmacokinetics and clinical efficacy. Patients could enroll in a companion PU-PET protocol to measure epichaperome expression before treatment initiation to allow exploratory correlation with treatment benefit.

RESULTS

Of the 12 patients enrolled, dose-limiting toxicity occurred in one patient (G3 neutropenic fever) at dose level 1; MTD of PU-H71 was 300 mg/m2 plus nab-paclitaxel 260 mg/m2 administered every 3 weeks. Common toxicities included diarrhea, fatigue, peripheral neuropathy, and nausea. PU-H71 systemic exposure was not altered by nab-paclitaxel administration. Two of 12 patients had partial response (overall response rate, 17%) and the clinical benefit rate was 42% (5 of 12). Time to progression was associated with baseline epichaperome positivity and PU-H71 peak standard uptake value (SUV), with more durable disease control observed with high epichaperome levels.

CONCLUSION

The combination of PU-H71 and nab-paclitaxel was well tolerated, with evidence of clinical activity. More durable disease control without progression was observed in patients with high baseline epichaperome expression. A phase II trial of this combination with PU-PET as a companion diagnostic for patient selection is currently planned.
The Effect of Cycling-specific Vibration on Neuromuscular Performance
Authors: VIELLEHNER JOSEF , POTTHAST WOLFGANG
Published: November 2020

Purpose

This study aimed to provide an understanding of how surface-induced vibrations in cycling interfere with short-term neuromuscular performance.

Methods

The study was conducted as a cross-sectional single cohort trial. Thirty trained cyclists participated (mass = 75.9 ± 8.9 kg, body height = 1.82 ± 0.05 m, V˙O2max = 63 ± 6.8 mL·kg−1⋅min−1). The experimental intervention included a systematic variation of the two independent variables: vibration (Vib: front dropout, 44 Hz, 4.1 mm; rear dropout, 38Hz, 3.5 mm; NoVib) and cranking power (LOW, 137 ± 14 W; MED, 221 ± 18 W; HIGH, 331 ± 65 W) from individual low to submaximal intensity. Dependent variables were transmitted accelerations to the body, muscular activation (gastrocnemius medialis, gastrocnemius lateralis, soleus, vastus lateralis, vastus medialis, rectus femoris, triceps brachii, flexor carpi ulnaris, and lumbar erector spinae), heart rate, and oxygen consumption.

Results

The main findings show that the root-mean-square of local accelerations increased with vibration at the lower extremities, the torso, and the arms–shoulder system. The activation of gastrocnemius medialis, gastrocnemius lateralis, soleus, triceps brachii, and flexor carpi ulnaris increased significantly with vibration. The activation of vastus lateralis increased significantly with vibration only at HIGH cranking power. Oxygen consumption (+2.7%) and heart rate (+5%–7%) increased significantly in the presence of vibration.

Conclusions

Vibration is a full-body phenomenon. However, the impact of vibration on propulsion is limited as the main propulsive muscles at the thigh are not majorly affected. The demands on the cardiopulmonary and respiratory system increased slightly in the presence of vibration.
Working back to the future: strengthening radical social work with children and young people, and their perspectives on resilience, capabilities and overcoming adversity
Authors: Larkins Cath , Satchwell Candice , Davidge Gail , Carter Bernie , Crook Deborah
Published: November 2020

Using data from participatory storytelling research with 65 young people, this article provides a co-created theoretical grounding for radical social work with children and young people. The problems and solutions social work should be seeking are explored in the light of resilience theories and the capability approach. The young people’s perspectives echo but extend existing resilience interventions and definitions of the capability approach, highlighting structural and historical patterns of inequality. They call for a collective response to adverse experiences, which become obvious in one zone of experience but have consequences and roots in other places. Social work could usefully employ expanded understandings of socio-ecological resilience and the capability approach to focus interventions more clearly on the root causes of adversities and shape interventions that highlight capability sustainability and co-created solutions. This would involve professionals working alongside children and young people, as well as their families and allies, to confront enduring patterns of disadvantage.
The Reconceptualisation of social work in Chile and Argentina: the centrality of the profession’s relationship with social struggles1
Authors: Marro Katia , Duriguetto María Lucia , Panez Alexander , Orellana Víctor
Published: November 2020

This article addresses the relationship of social work with the movements and processes of popular organisation in Chile and Argentina in the context of the Latin American Reconceptualisation movement in the 1960s and 1970s. We will analyse the current context of the class struggle in these countries and the relationship that was established between social work and the social organisations and movements of the subaltern classes. Our hypothesis is that the relationship between the profession and the struggles developed by the subaltern classes, in their peculiarities in Chile and Argentina, was the central mediation for social work to question its social function in the reproduction of social relations and, as a result, erode its traditionalist and conservative bases.
Categorical and gradational: alternative survey measures of sex and gender
Authors: Saperstein Aliya , Westbrook Laurel
Published: November 2020

Demands for recognition of gender diversity and transgender people are growing. We tested non-binary sex and gender measures using nationally representative samples of US adults to assess feasibility for general population surveys. We find more support for a two-step categorical approach, with separate questions about natal sex and gender identity, than for a single question assessing transgender status as the latter was less reliable within our online surveys and over time. We also consider the challenge of determining measurement reliability for fluid characteristics and argue that using categorical and gradational gender measures in combination should become standard practice.