bluuebunny/crossref_metadata_2025 huggingface dataset:
Was it thickened Dua’s layer? Clinical, tomographical, and histopathological correlation: A case report
Authors: Sharma Vijay K , Sinha Rajesh , Sati Alok , Agarwal Manisha
Published: December 2020

A 62-year-old female developed pseudophakic bullous keratopathy after cataract surgery and underwent Descemet stripping automated endothelial keratoplasty (DSAEK). Intraoperatively, a white opacified pre-Descemet’s layer was noticed after scoring and removal of trypan blue stained Descemet’s membrane (DM), and endothelium complex. It was removed using internal limiting membrane peeling forceps and sent for histopathological evaluation along with DM-endothelium complex and epithelium. Preoperative, intraoperative, and postoperative clinical, tomographical, and histopathological data confirmed thickened PDL or Dua’s layer. This is a rare encounter with scarred PDL or Dua’s layer during DSAEK surgery.
A Systematic Review of the Cardiovascular Manifestations and Outcomes in the Setting of Coronavirus-19 Disease
Authors: Thakkar Samarthkumar , Arora Shilpkumar , Kumar Ashish , Jaswaney Rahul , Faisaluddin Mohammed , Ammad Ud Din Mohammad , Shariff Mariam , Barssoum Kirolos , Patel Harsh P , Nirav Arora , Jani Chinmay , Patel Kripa , Savani Sejal , DeSimone Christopher , Mulpuru Siva , Deshmukh Abhishek
Published: December 2020

The impact of coronavirus disease, 2019 (COVID-19), has been profound. Though COVID-19 primarily affects the respiratory system, it has also been associated with a wide range of cardiovascular (CV) manifestations portending extremely poor prognosis. The principal hypothesis for CV involvement is through direct myocardial infection and systemic inflammation. We conducted a systematic review of the current literature to provide a foundation for understanding the CV manifestations and outcomes of COVID-19. PubMed and EMBASE databases were electronically searched from the inception of the databases through 27 April 2020. A second literature review was conducted to include major trials and guidelines that were published after the initial search but before submission. The inclusion criteria for studies to be eligible were case reports, case series, and observation studies reporting CV outcomes among patients with COVID-19 infection. This review of the current COVID-19 disease and CV outcomes literature revealed a myriad of CV manifestations with potential avenues for treatment and prevention. Future studies are required to understand on a more mechanistic level the effect of COVID-19 on the myocardium and thus provide avenues to improve mortality and morbidity.
Polydactylous Squamous Cell Carcinoma of the Nail Unit: A Structured Review of the Literature
Authors: Jedlowski Patrick M. , Jedlowski Mahdieh F. , Segal Robert J.
Published: December 2020

Squamous cell carcinoma of the nail unit (SCCNU) is a rare neoplastic condition that involves multiple digits (polydactylous SCCNU) in only 3.9% of cases. Here, we report a case of polydactylous SCCNU and perform a comprehensive review of MEDLINE and Embase to collate 44 cases of polydactylous SCCNU reported to date. Polydactylous patients were younger on average (48 to 61-63 years) and had a longer diagnostic delay (44 vs 35.1 months) compared with reported monodactylous cases. Human papillomavirus (HPV) positivity was observed in 49% of cases, and the most common serotypes noted were 16 (25.8%), 73 (16.1%), 58 (9.7%), 18 (6.5%), and 33 (6.5%). Twenty percent of the cases were in immunosuppressed individuals who had a statistically significant lower age at diagnosis (39.33 years vs 51.12 years; P = .01) and diagnostic delay (2.50 months vs 132.46 months, P = .04). Patients with HPV positivity had a lower age at diagnosis (43.74 years vs 53.29 years, P = .04). Environmental exposures noted to be associated with polydactylous disease included X-rays, paint/solvents, soluble oils, and stagnant water. This comprehensive literature review serves to characterize polydactylous SCCNU and distinguish the differences in its characteristics to improve diagnosis and clinical recognition.
Analysis of ion current signal during negative valve overlap of HCCI combustion with high compression ratio
Authors: Wick Maximilian , Zhu Denghao , Deng Jun , Li Liguang , Andert Jakob
Published: December 2020

Homogenous charge compression ignition (HCCI) combustion is a low temperature combustion process which combines high combustion efficiency with ultra-low [Formula: see text] raw emissions. Steep increases of the in-cylinder pressure and unstable combustion sequences at the limits of the operating range can damage the engine and limit the use of HCCI to part load operation. This can be done using closed loop combustion control based on combustion parameters like the indicated mean effective pressure and the combustion phasing. Since in-cylinder pressure sensors are expensive components and therefore not suitable for series application, ion current sensors can be used as an additional source of information about the combustion. Combustion analysis using methods similar to those used in pressure based measurements can be implemented using an online analysis of the ion current signal. In this study, the ion current sensor will be examined for its suitability for combustion control under HCCI conditions with lean air/fuel ratios and high compression ratios. Research has found that the ion current signal is strongly depended on the boundary conditions. Especially the air/fuel ratio which plays an important role for signal strength during the combustion process. When using valve timings with negative valve overlap in combination with a fuel pre-injection, a further peak of the ion current signal close to the gas exchange top dead center can be found in addition to the one during combustion. At the same time, it is hard to extract information from the cylinder pressure signal during NVO. Under lean conditions this peak even exceeds the signal during combustion. This study analyzes the ion current signal during NVO and its potential to be used for future combustion control concepts. The ion current signal shows potential to stabilize HCCI combustion at high loads. However, the prediction of late combustion cycles is still challenging.
Alternation of EEG Characteristics During Transcutaneous Acupoint Electrical Stimulation–Induced Sedation
Authors: Yan Fei , Song Dawei , Dong Zhen , Zhang Yun , Wang Haidong , Huang Liyu , Wang Yubo , Wang Qiang
Published: December 2020

Recent studies have shown that applying acupuncture during general anesthesia can reduce the dosage of anesthetics. Hence, it is speculated that acupuncture may have a sedative effect. However, existing studies employed acupuncture in combination with anesthetics, which makes determine acupuncture’s role in producing sedation difficult. In this work, we investigated the sedative effect of acupuncture by using transcutaneous acupoint electrical stimulation (TAES) at bilateral Zusanli (ST36), Shenmen (HT7) and Sanyinjiao (SP6). Using a cross-over design, 2 separate sessions, that are, the resting and TAES sessions, were conducted for each subject. The sedative effect was quantified by using the bispectral index (BIS). The difference in brain activities between resting and TAES sessions was investigated by analyzing the simultaneously recorded EEG signals. Our results showed that a statistically significant difference in BIS values existed between resting and TAES sessions, which suggested that TAES alone was capable of inducing observable sedation. Using power spectrum analysis, we showed that TAES-induced sedation was accompanied by a reduction in alpha band power and an increment in delta band power. Permutation entropy was lower during the TAES session, which suggested that TAES reduced the complexity of the EEG signal. Moreover, a significant reduction in the global strength of brain functional connections was observed during TAES. These findings suggest that TAES alone can induce observable sedative effects, and this sedation effect is accompanied by changes in brain activities that have shown to be correlated with consciousness.
Evaluation of Protein Content in the Diet of Amateur Male Bodybuilder
Authors: Karpik A , Machniak M , Chwałczynska A
Published: December 2020

Public gyms and fitness clubs promote active lifestyles. At the same time, numerous nutritional errors and the phenomenon of incorrect supplementation are being observed among the given study group. Behavior can lead to malaise, injury, or lack of progression. One of the most serious mistakes is the incorrect level of protein in the diet. The aim of the study is to assess the quantity and quality of protein consumed by men undertaking recreational strength training in Szczecin. The study involved 35 men aged 18–35, practicing amateur strength training, from Szczecin (Poland). The author’s questionnaire collected information on supplementation, physical activity, and subjective assessment of nutritional knowledge. The obtained test results were subjected to statistical analysis performed in the Statistica12 program. On average, respondents consumed 1.8 g of protein/kg, with the highest recorded conversion rate of 3.7 g of protein/kg of body weight, and the lowest of 0.9 g/kg of body weight. Total protein consumption ranged from 70.2 to 295.7 g, and the average value was 147.8 g (22%), which differs from the study group, that is, 129–133 g, which gives 14% energy proteins. It was found that the protein supplementation, on average, provided 31% of the total protein intake of the study group. The results show inappropriate dietary behavior regarding food supplementation among the examined group. Further education on the nutritional value of the food and a healthy and balanced diet is being recommended for the individuals practicing strength sports.
The Use of Delphi Method and Analytical Hierarchy Process in the Establishment of Assessment Tools in Premature Ejaculation: The Scoring System for Premature Ejaculation Treatment Outcomes
Authors: Zhang Jianzhong , Han Taoli , Cai Zhonglin , Wang Ying , Shang Xuejun , Yang Bin , Li Hongjun
Published: December 2020

There is a lack of objective tools to comprehensively evaluate premature ejaculation (PE) treatment results clinically. We aimed to describe the development of a novel scoring system for PE treatment results as an example of using the Delphi method and an analytical hierarchy process for complex decision-making in the field of sexual medicine. A Delphi question survey was adopted to collect expert opinions from 47 Chinese specialists in andrology/urology on the assessment of PE treatment outcomes based on four primary properties, that is, the improvement in intravaginal ejaculation latency time, a couple’s mental status, the ability to control ejaculation, and sexual intercourse satisfaction. Different weights on those primary properties were assigned to create a mathematical hierarchy matrix and then perform an analysis. The scores were assigned according to the calculated weights. The ratio among the combined weights of the four primary properties was 1:3:2:3. The total numerical score was 36. Scores above 27, between 26 and 18, and below 17 indicated significant improvement, moderate improvement, and no improvement in PE, respectively, with selected treatments. The scoring system with 36 points can be used by physicians, patients, and their sexual partners to comprehensively and objectively assess quantitative PE treatment results.
Chelation during sequential pregnancies: A case report with a twist
Authors: Markowitz Morri E , Mercedes Joann , Apt-Dudfield Olga
Published: December 2020

This report summarizes chelation management of lead poisoning occurring during sequential pregnancies. Several aspects make this case unusual; firstly recurrent lead poisoning, secondly treatment with succimer, the use of which is very rarely reported in pregnancy, and thirdly the presence of co-existent vitamin D deficiency and hyperparathyroidism, both potential contributors to bone lead release.
Diffracting relationalities in early years pedagogies of care
Authors: Arndt Sonja
Published: December 2020

This diffractive disruption of care in early years settings and pedagogies opens up to a provocation that perhaps we don’t know care at all. Driven by Puig de la Bellacasa’s questioning of the notion of care as not solely a human-only matter and applying that in relation to the early years, it explores what it might mean when we cannot know all that cares or is cared for when we include more-than-human elements and factors, and when what is care remains to a large extent uncertain. Explicating the complexity of care in the early years assemblage, the paper uses a philosophical diffractive reading as a method of turning and re-turning to emphasise the non-linearity and fluidity between the doing, receiving and thinking about care in a human and more-than-human world. It urges a push beyond expected understandings of care and thus also pedagogies, culminating in potentialities that re-view a world in which things and beings are increasingly recognised as crucial, influential and potentially care-ing.
Chronic pain, functionality and quality of life in cancer survivors
Authors: Poço Gonçalves João , Veiga Dalila , Araújo António
Published: December 2020

The increasing number of cancer survivors associated to a longer average life-span after diagnosis of an oncological disease facilitates the observation of deleterious long-term effects of both oncological disease and its treatment. Among these effects, chronic pain emerges as one of the most prevalent and, with its onset, there is a decrease in these patients’ functionality and quality of life. The main focus in oncological disease treatment has been tumour eradication and average life expectancy extension after diagnosis, neglecting these deleterious long-term effects. This study aims at assessing the prevalence and characteristics of chronic pain in cancer survivors as well as pain interference in their quality of life and functionality. The study selected cancer survivors (n = 85) after dismissal from oncology service to assess the presence and characteristics of chronic pain, their health-related quality of life (HRQoL) and pain-related disability through a combination of different questionnaires. Chronic pain prevalence was 23.5%. In total, 85% of patients reported neuropathic pain descriptors and 45% presented diagnostic criteria for neuropathic pain. Of these patients, 45% were followed-up for pain surveillance and 35% underwent analgesic medication. There was a median pain disability index of 20.50 (14.50–35.00) and an average HRQoL of 0.5338 in chronic pain patients and 0.8872 in patients without pain. We found that chronic pain was the main negative predictor of HRQoL and was associated with decreased functionality. This study also concluded that these patients often were not offered the appropriate long-term medical follow-up. These findings highlight a need to raise awareness among health professionals to the importance of timely diagnosis and treatment of pain and its impact on HRQoL and functionality of long-term cancer survivors as well as the need to change clinical practice in order to improve healthcare provided to these patients.
Making a Microaggression: Using Big Data and Qualitative Analysis to Map the Reproduction and Disruption of Microaggressions through Social Media
Authors: Eschmann Rob , Groshek Jacob , Chanderdatt Rachel , Chang Khea , Whyte Maysa
Published: December 2020

Racial microaggressions are defined as subtle racial slights that can be offensive or hurtful. One of the defining characteristics of racial microaggressions is how difficult they can be to respond to, and the literature reports that not responding may be the most common response to microaggressions. This study addresses a vital gap in the existing literature by examining the extent to which the silence that characterizes face-to-face experiences with microaggressions extends into online social media spaces. Drawing on a dataset of 254,964 tweets over an 8-year period, we present and examine trends in the usage of the term “microaggressions” over time. Furthermore, we then generate a purposive sample of 1,038 of the most influential tweets to explore discussions and content themes through an in-depth qualitative analysis of these messages. Here, we find both a drastic increase in the usage of the term microaggression on Twitter over time and an intense contestation over its meaning and repercussions for both individuals and society. Implications of these findings in understanding the role of online social media discourse in challenging or reproducing hegemonic racial structures is discussed.
Social capital: The forgotten responsivity factor
Authors: Koetzle Deborah , Matthews Betsy
Published: December 2020

The Risk-Need-Responsivity model of correctional intervention has become the cornerstone of correctional practice in the United States. With a primary focus on building human capital through interventions aimed at developing knowledge and skills needed for prosocial behavior, the model enjoys widespread empirical support. This approach, however, has been criticized by desistance-focused scholars for its failure to recognize social capital and the importance of social networks for facilitating behavior change. The current article examines the concept of individual-level social capital and describes how its development can be integrated into the Risk-Need-Responsivity model of correctional interventions as an important responsivity factor. Recommendations include assessing for social capital and strategies for enhancing both bonding and bridging social capital.
Keeping women under subjection: Laws and norms in Mughal India
Authors: Bano Shadab
Published: December 2020

Domestic (and public) violence against women has a long history in India. The present article offers evidence of the perpetration of such violence in medieval times including the norms by which this was justified or partly constrained. The argument is that both Muslim and Hindu laws, as elaborated and interpreted, justified the violence and physical constraints put on women. Note is also taken of attempts at modifying the range of such violence, for example, in respect of sati.
Book review: Irfan Habib, The National Movement, Part 2: The Struggle for Freedom 1919–1947
Authors: Mukherjee Mridula
Published: December 2020

Irfan Habib, The National Movement, Part 2: The Struggle for Freedom 1919–1947 (New Delhi: Tulika Books), 2019, ix + 168 pp., ₹350.
Neurophysiological coding of space and time in the hippocampus, entorhinal cortex, and retrosplenial cortex
Authors: Alexander Andrew S. , Robinson Jennifer C. , Dannenberg Holger , Kinsky Nathaniel R. , Levy Samuel J. , Mau William , Chapman G. William , Sullivan David W. , Hasselmo Michael E.
Published: December 2020

Neurophysiological recordings in behaving rodents demonstrate neuronal response properties that may code space and time for episodic memory and goal-directed behaviour. Here, we review recordings from hippocampus, entorhinal cortex, and retrosplenial cortex to address the problem of how neurons encode multiple overlapping spatiotemporal trajectories and disambiguate these for accurate memory-guided behaviour. The solution could involve neurons in the entorhinal cortex and hippocampus that show mixed selectivity, coding both time and location. Some grid cells and place cells that code space also respond selectively as time cells, allowing differentiation of time intervals when a rat runs in the same location during a delay period. Cells in these regions also develop new representations that differentially code the context of prior or future behaviour allowing disambiguation of overlapping trajectories. Spiking activity is also modulated by running speed and head direction, supporting the coding of episodic memory not as a series of snapshots but as a trajectory that can also be distinguished on the basis of speed and direction. Recent data also address the mechanisms by which sensory input could distinguish different spatial locations. Changes in firing rate reflect running speed on long but not short time intervals, and few cells code movement direction, arguing against path integration for coding location. Instead, new evidence for neural coding of environmental boundaries in egocentric coordinates fits with a modelling framework in which egocentric coding of barriers combined with head direction generates distinct allocentric coding of location. The egocentric input can be used both for coding the location of spatiotemporal trajectories and for retrieving specific viewpoints of the environment. Overall, these different patterns of neural activity can be used for encoding and disambiguation of prior episodic spatiotemporal trajectories or for planning of future goal-directed spatiotemporal trajectories.
Five-Year Follow-up of Microincisional Vitrectomy Surgery, Endolaser Tumor Ablation, and Gene-Expression Profiling in Small Uveal Melanoma
Authors: Murray Timothy G. , Villegas Victor M. , Bach Austin , Gold Aaron S.
Published: December 2020

Purpose:

This work evaluates a microincisional vitrectomy surgical (MIVS) approach to endolaser ablation of small uveal malignant melanoma by incorporating genetic tumor classification as a means to avoid radiotherapy while maintaining local tumor control without compromising visual acuity (VA).

Methods:

An institutional review board–approved, single-surgeon, retrospective analysis was conducted of a consecutive case series of all patients with tumors less than 2.5 mm in apical thickness who underwent MIVS, endolaser tumor ablation, fine-needle aspiration biopsy (FNAB), and intravitreal triamcinolone acetonide for small uveal melanoma between 2012 and 2015.

Results:

A total of 226 patients underwent FNAB from January 2012 to January 2015 for uveal melanoma. All 58 patients treated for a small uveal melanoma were included. This group of patients had a minimum follow-up of 60 months (range, 60-93 months). At initial diagnosis, subretinal fluid was present in 52 eyes (89.1%), macular edema was present in 24 eyes (41.4%), and epiretinal membrane was present in 11 eyes (20.1%). Fifty-six specimens (96.5%) received a molecular classification of either class 2 (4 of 56, 7.1%) or class 1 (52 of 56, 92.8%). Initial VA was 20/40 or better in 26 eyes (44.8%), and final VA was 20/40 or better in 48 of 58 eyes (82.8%).

Conclusions:

Endolaser tumor ablation delivered at MIVS surgery enables excellent tumor control (98.3%) and improves VA to better than 20/40 in more than 80% of treated eyes. FNAB achieves molecular classification in 96.5% of all patients undergoing treatment for small choroidal melanoma independent of tumor size.
A Likert-Type scale for evaluating the “bottom line” of patient safety
Authors: Rashkovits Sarit
Published: December 2020

The formally reported number of adverse events may be open to ambivalent interpretation – actual higher prevalence of adverse events versus a patient safety culture supporting reporting and learning. Many methods appearing in the literature that are not based on reporting systems struggle for adequately assess the precise level of prevalence of adverse events. Confronting this challenge in patient safety research, we suggest evaluating the perceived state of “almost no adverse events” in the ward, by using a short Likert- type scale we developed for this purpose. Some evidence for its reliability and validity are presented using two samples (99 head nurses, and 383 nurses). As was expected, leadership had a significant direct effect on the measured state of “almost no adverse events” as well as an indirect effect mediated successively by psychological safety, and safety behavior.
Intelligent recognition of acoustic emission signals from damage of glass fiber-reinforced plastics
Authors: Li Qiufeng , Qi Tiantian , Shi Lihua , Chen Yao , Huang Lixia , Lu Chao
Published: December 2020

Glass fiber-reinforced plastics (GFRP) is widely used in many industrial fields. When acoustic emission (AE) technology is applied for dynamic monitoring, the interfering signals often affect the damage evaluation results, which significantly influences industrial production safety. In this work, an effective intelligent recognition method for AE signals from the GFRP damage is proposed. Firstly, the wavelet packet analysis method is used to study the characteristic difference in frequency domain between the interfering and AE signals, which can be characterized by feature vector. Then, the model of back-propagation neural network (BPNN) is constructed. The number of nodes in the input layer is determined according to the feature vector, and the feature vectors from different types of signals are input into the BPNN for training. Finally, the wavelet packet feature vectors of the signals collected from the experiment are input into the trained BPNN for intelligent recognition. The accuracy rate of the proposed method reaches to 97.5%, which implies that the proposed method can be used for dynamic and accurate monitoring of GFRP structures.
Filling the Void: Use of the Interpositional Buccal Fat Pad to Decrease Palatal Contraction and Fistula Formation
Authors: Thurston Todd E. , Vargo James , Bennett Katelyn , Vercler Christian , Kasten Steven , Buchman Steve
Published: December 2020

Objective: The objective of this study was to evaluate the ability of the buccal fat pad flap (BFPF) to fill the void remaining after muscle transposition and study its effect on durability, fistula rate, palatal shortening/contraction, and relapse of muscle positioning in wide and challenging cleft repairs. Design: A retrospective chart review was performed. Charts were abstracted for standard demographics, reason for BFPF utilization, palatal length, palatal fistula, co-morbidities, and speech outcomes. Patients, Participants: Patients under age 3 who underwent primary palatoplasty between October 2007 and September 2015 which utilized a medially placed BFPF were identified. Results: Fifty-three patients were identified. Mean age at palatoplasty was 1.4 (0.78-2.55) years. Mean follow-up was 2.52 (0.02-7.26) years. Twenty-four (45.3%) patients had concerning intraoperative findings warranting flap utilization. Twenty-nine (54.7%) patients underwent BFPF for large dead-space volume. Four patients (7.55%) experienced a fistula. Thirty-nine patients had comments on their palatal length. Of these, 28 (71.8%) were of average length, and 8 (20.5%) were long. Thirty-three patients have undergone formal speech evaluation. Of these, 20 (60.6%) were of normal resonance, and 12 (36.4%) demonstrated nominal hypernasality. No patients have yet to require a secondary speech operation. Conclusion: Use of the BFPF has become more common in our practice particularly in challenging cleft palate repairs. It is a versatile technique addressing large interpositional dead space and thin outer and inner lamellae in the anterior soft palate after posterior muscle transposition. Early results, in difficult repairs, demonstrate excellent durability and that palatal length appears to be maintained, potentially lessening the need for secondary speech surgery.
Acute effect of ambient fine particulate matter on heart rate variability: an updated systematic review and meta-analysis of panel studies
Authors: Niu Zhiping , Liu Feifei , Li Baojing , Li Na , Yu Hongmei , Wang Yongbo , Tang Hong , Chen Xiaolu , Lu Yuanan , Cheng Zilu , Liu Suyang , Chen Gongbo , Zhang Yuxiao , Xiang Hao
Published: December 2020

Background

Decreased heart rate variability (HRV) is a predictor of autonomic system dysfunction, and is considered as a potential mechanism of increased risk of cardiovascular disease (CVD) induced by exposure to particulate matter less than 2.5 μm in diameter (PM2.5). Previous studies have suggested that exposure to PM2.5 may lead to decreased HRV levels, but the results remain inconsistent.

Methods

An updated systematic review and meta-analysis of panel studies till November 1, 2019 was conducted to evaluate the acute effect of exposure to ambient PM2.5 on HRV. We searched electronic databases (PubMed, Web of Science, and Embase) to identify panel studies reporting the associations between exposure to PM2.5 and the four indicators of HRV (standard deviation of all normal-to-normal intervals (SDNN), root mean square of successive differences in adjacent normal-to-normal intervals (rMSSD), high frequency power (HF), and low frequency power (LF)). Random-effects model was used to calculate the pooled effect estimates.

Results

A total of 33 panel studies were included in our meta-analysis, with 16 studies conducted in North America, 12 studies in Asia, and 5 studies in Europe. The pooled results showed a 10 μg/m3 increase in PM2.5 exposure which was significantly associated with a − 0.92% change in SDNN (95% confidence intervals (95%CI) − 1.26%, − 0.59%), − 1.47% change in rMSSD (95%CI − 2.17%, − 0.77%), − 2.17% change in HF (95%CI − 3.24%, − 1.10%), and − 1.52% change in LF (95%CI − 2.50%, − 0.54%), respectively. Overall, subgroup analysis suggested that short-term exposure to PM2.5 was associated with lower HRV levels in Asians, healthy population, and those aged ≥ 40 years.

Conclusion

Short-term exposure to PM2.5 was associated with decreased HRV levels. Future studies are warranted to clarity the exact mechanism of exposure to PM2.5 on the cardiovascular system through disturbance of autonomic nervous function.
Comparative transcriptome analysis of male and female flowers in Spinacia oleracea L
Authors: Li Ning , Meng Ziwei , Tao Minjie , Wang Yueyuan , Zhang Yulan , Li Shufen , Gao Wujun , Deng Chuanliang
Published: December 2020

Background

Dioecious spinach (Spinacia oleracea L.), a commercial and nutritional vegetable crop, serves as a model for studying the mechanisms of sex determination and differentiation in plants. However, this mechanism is still unclear. Herein, based on PacBio Iso-seq and Illumina RNA-seq data, comparative transcriptome analysis of male and female flowers were performed to explore the sex differentiation mechanism in spinach.

Results

Compared with published genome of spinach, 10,800 transcripts were newly annotated; alternative splicing, alternative polyadenylation and lncRNA were analyzed for the first time, increasing the diversity of spinach transcriptome. A total of 2965 differentially expressed genes were identified between female and male flowers at three early development stages. The differential expression of RNA splicing-related genes, polyadenylation-related genes and lncRNAs suggested the involvement of alternative splicing, alternative polyadenylation and lncRNA in sex differentiation. Moreover, 1946 male-biased genes and 961 female-biased genes were found and several candidate genes related to gender development were identified, providing new clues to reveal the mechanism of sex differentiation. In addition, weighted gene co-expression network analysis showed that auxin and gibberellin were the common crucial factors in regulating female or male flower development; however, the closely co-expressed genes of these two factors were different between male and female flower, which may result in spinach sex differentiation.

Conclusions

In this study, 10,800 transcripts were newly annotated, and the alternative splicing, alternative polyadenylation and long-noncoding RNA were comprehensively analyzed for the first time in spinach, providing valuable information for functional genome study. Moreover, candidate genes related to gender development were identified, shedding new insight on studying the mechanism of sex determination and differentiation in plant.
Correction to: Impact of a combined multimodal-aerobic and multimodal intervention compared to standard aerobic treatment in breast cancer survivors with chronic cancer-related fatigue - results of a three-armed pragmatic trial in a comprehensive cohort design
Authors:   On behalf of the CRF-2 study group, Kröz Matthias , Reif Marcus , Glinz Augustina , Berger Bettina , Nikolaou Andreas , Zerm Roland , Brinkhaus Benno , Girke Matthias , Büssing Arndt , Gutenbrunner Christoph
Published: December 2020

An amendment to this paper has been published and can be accessed via the original article.
A genomic-clinicopathologic nomogram for predicting overall survival of hepatocellular carcinoma
Authors: Zhou Kena , Zhou Qiang , Cai Congbo
Published: December 2020

Background

Hepatocellular carcinoma (HCC) is a common digestive tumor with great heterogeneity and different overall survival (OS) time, causing stern problems for selecting optimal treatment. Here we aim to establish a nomogram to predict the OS in HCC patients.

Methods

International Cancer Genome Consortium (ICGC) database was searched for the target information in our study. Lasso regression, univariate and multivariate cox analysis were applied during the analysis process. And a nomogram integrating model scoring and clinical characteristic was drawn.

Results

Six mRNAs were screened out by Lasso regression to make a model for predicting the OS of HCC patients. And this model was proved to be an independent prognostic model predicting OS in HCC patients. The area under the ROC curve (AUC) of this model was 0.803. TCGA database validated the significant value of this 6-mRNA model. Eventually a nomogram including 6-mRNA risk score, gender, age, tumor stage and prior malignancy was set up to predict the OS in HCC patients.

Conclusions

We established an independent prognostic model of predicting OS for 1–3 years in HCC patients, which is available to all populations. And we developed a nomogram on the basis of this model, which could be of great help to precisely individual treatment measures.
Evaluation of the uptake of tuberculosis preventative therapy for people living with HIV in Namibia: a multiple methods analysis
Authors: Roscoe Clay , Lockhart Chris , de Klerk Michael , Baughman Andrew , Agolory Simon , Gawanab Michael , Menzies Heather , Jonas Anna , Salomo Natanael , Taffa Negussie , Lowrance David , Robsky Katherine , Tollefson Deanna , Pevzner Eric , Hamunime Ndapewa , Mavhunga Farai , Mungunda Helena
Published: December 2020

Background

In 2016, Namibia had ~ 230,000 people living with HIV (PLHIV) and 9154 new tuberculosis (TB) cases, including 3410 (38%) co-infected cases. TB preventative therapy (TPT), consisting of intensive case finding and isoniazid preventative therapy, is critical to reducing TB disease and mortality.

Methods

Between November 2014 and February 2015, data was abstracted from charts of PLHIV enrolled in HIV treatment. Fifty-five facilities were purposively selected based on patient volume, type and location. Charts were randomly sampled. The primary outcome was to estimate baseline TPT in PLHIV, using nationally weighted proportions. Qualitative surveys were conducted and summarized to evaluate TPT practices and quantify challenges encountered by health care workers (HCW).

Results

Among 861 PLHIV sampled, 96% were eligible for TPT services, of which 87.1% were screened for TB at least once. For PLHIV eligible for preventative therapy (646/810; 82.6%), 45.4% (294/646) initiated therapy and 45.7% (139/294) of those completed therapy. The proportion of eligible PLHIV completing TB screening, initiating preventative therapy and then completing preventative therapy was 20.7%. Qualitative surveys with 271 HCW identified barriers to TPT implementation including: lack of training (61.3% reported receiving training on TPT); misunderstandings about timing of TPT initiation (46.7% correctly reported TPT should be started with antiretroviral therapy); and variable screening practices and responsibilities (66.1% of HCWs screened for TB at every encounter). Though barriers were evident, 72.2% HCWs surveyed described their clinical performance as very good, often placing responsibility of difficulties on patients and downplaying challenges like staff shortages and medication stock outs.

Conclusions

In this study, only 1 in 5 eligible PLHIV completed the TPT cascade in Namibia. Lack of training, irregularities with TB screening and timing of TPT, unclear prescribing and recording responsibilities, and a clinical misperception may have contributed to suboptimal programmatic implementation. Addressing these challenges will be critical with continued TPT scale-up.
Trends in contraceptive use, unmet need and associated factors of modern contraceptive use among urban adolescents and young women in Guinea
Authors: Sidibé Sidikiba , Delamou Alexandre , Camara Bienvenu Salim , Dioubaté Nafissatou , Manet Hawa , El Ayadi Alison M. , Benova Lenka , Kouanda Seni
Published: December 2020

Background

In Guinea, high fertility among adolescents and young women in urban areas remains a public health concern. This study describes trends in contraceptive use, unmet need, and factors associated with the use of modern family planning (FP) methods among urban adolescents and young women in Guinea.

Methods

We used four Guinea Demographic and Health Surveys (DHS) conducted in 1999, 2005, 2012, and 2018. Among urban adolescents and young women (15–24 years), we examined trends over time in three key indicators: 1. Modern Contraceptive use, 2. Unmet need for FP and 3. Modern contraceptive use among those in need of FP (demand satisfied). We used multivariable logistic regression to examine association between socio-demographic factors and modern FP use on the most recent DHS dataset (2018).

Results

We found statistically significant changes over the time period examined with an increase in modern contraceptive use (8.4% in 1999, 12.8% in 2018, p < 0.01) and demand satisfied (29.0% in 1999, 54.1% in 2018, p < 0.001), and a decrease in unmet need for FP (15.8% in 1999, 8.6% in 2018, p < 0.001). Factors significantly associated with modern FP use were; young women aged 20–24 years (AOR 2.8, 95% CI: 1.9–4.1), living in urban areas of Faranah (AOR: 2.6, 95% CI: 1.1–6.5) and Kankan (AOR: 3.6, 95% CI: 1.7–7.8), living in households in the middle (AOR: 7.7, 95% CI: 1.4–42.2) and richer wealth quintiles (AOR: 6.3, 95% CI: 1.0–38.1). Ever-married women (AOR: 0.5, 95% CI: 0.3–0.9) were less likely to use modern FP methods than never married as were those from the Peulh (0.3, 95% CI: 0.2–0.4) and Malinke (0.5, 95% CI: 0.3–0.8) ethnic groups compared to Soussou ethnic group.

Conclusion

Despite some progress, efforts are still needed to improve FP method use among urban adolescent and young women. Age, administrative region, wealth index, marital status, and ethnic group are significantly associated with modern FP use. Future policies and interventions should place emphasis on improving adolescents’ reproductive health knowledge, increasing FP availability and strengthening provision. Efforts should target adolescents aged 15–19 years in particular, and address disparities between administrative regions and ethnic groups, and health-related inequalities.
Association between social trust and the risk of cardiovascular disease in older adults in Korea: a nationwide retrospective cohort study
Authors: Hwang Seo Eun , Choi Seulggie , Kim Kyuwoong , Lee Jong-Koo , Oh Juhwan , Park Sang Min
Published: December 2020

Background

Although social capital has been shown to be one of the important social determinants of health, the association between social trust and the risk of cardiovascular disease (CVD) is not clear yet. We aimed to investigate the association of social trust with CVD risk using a large Korean population based data.

Methods

The data of this study was derived from the Korean National Health Insurance Service database. Community-level social trust was determined from the Korean Community Health Survey. The study population consisted of 2,156,829 participants. According to social trust index measured in the area of residence during 2011, participants were followed-up from 1 January 2012 to 31 December 2016. Multivariate Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD risk according to quintiles of social trust.

Results

Compared to participants with the lowest quintile of social trust, those within the highest quintile had lower risk for CVD (aHR 0.91, 95% CI = 0.89 to 0.93), CHD (aHR 0.92, 95% CI = 0.89 to 0.95), and stroke (aHR 0.90, 95% CI = 0.87 to 0.93). The risk-reducing association of high social trust on CVD risk was preserved after additional adjustments for lifestyle behaviors including smoking, alcohol consumption, and physical activity.

Conclusion

Higher social trust was associated with reduced risk of CVD even after considering lifestyle behaviors. Social trust in a community level is an important determinant of CVD and enhancing social trust may lead to reduced risk of CVD.
Epidemiology of pediatric femur fractures in children: the Swedish Fracture Register
Authors: Engström Zandra , Wolf Olof , Hailer Yasmin D.
Published: December 2020

Background

Although femur fractures in children are rare, they are the most common fractures in need of hospitalization. We sought to describe the epidemiology and treatment of pediatric femur fractures recorded in the Swedish Fracture Register (SFR). We also studied the relationship between femur fractures, age, sex, fracture pattern, injury mechanism, seasonal variation and treatment.

Methods

This nationwide observational register study was based on the pediatric part of the SFR. We included all patients < 16 years of age who were registered in the SFR from 2015 to 2018.

Results

Of the 709 femur fractures, 454 (64%) occurred in boys. Sixty-two of these fractures were proximal (9%), 453 shaft (64%) and 194 distal (27%). A bimodal age distribution peak was observed in boys aged 2–3 and 16–19 years. In contrast, the age distribution among girls was evenly distributed. Younger children were mainly injured by a fall, whereas older children sustained their fracture because of traffic accidents. Non-surgical treatment prevailed among younger children; however, prevalence of surgical treatment increased with age.

Conclusions

We found a lower ratio between boys and girls (1.8:1) compared to earlier studies. The bimodal age distribution was seen only in boys. Falls were the most common injury in younger children, whereas traffic-related accidents were the most common in adolescents. With age, there was a corresponding increase in surgical treatment.
Higher aggrecan 1-F21 epitope concentration in synovial fluid early after anterior cruciate ligament injury is associated with worse knee cartilage quality assessed by gadolinium enhanced magnetic resonance imaging 20 years later
Authors: Neuman Paul , Larsson Staffan , Lohmander L. Stefan , Struglics André
Published: December 2020

Background

To investigate if cartilage related biomarkers in synovial fluid are associated with knee cartilage status 20 years after an anterior cruciate ligament (ACL) injury.

Methods

We studied 25 patients with a complete ACL rupture without subsequent ACL reconstruction or radiographic knee OA. All had a delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) 20 years after the ACL injury, using the T1 transverse relaxation time in the presence of gadolinium (T1Gd) which estimates the concentration of glycosaminoglycans in hyaline cartilage. Synovial fluid samples were aspirated acutely (between 0 and 18 days) and during 1 to 5 follow up visits between 0.5 and 7.5 years after injury. We quantified synovial fluid concentrations of aggrecan (epitopes 1-F21 and ARGS), cartilage oligomeric matrix protein, matrix metalloproteinase-3 and tissue inhibitor of metalloproteinase-1 by immunoassays, and sulfated glycosaminoglycans by Alcian blue precipitation. Western blot was used for qualitative analyses of aggrecan fragments in synovial fluid and cartilage samples.

Results

Western blot indicated that the 1-F21 epitope was located within the chondroitin sulfate 2 region of aggrecan. Linear regression analyses (adjusted for age, sex, body mass index and time between injury and sampling) showed that acute higher synovial fluid 1-F21-aggrecan concentrations were associated with shorter T1Gd values 20 years after injury, i.e. inferior cartilage quality (standardized effects between − 0.67 and − 1.0). No other statistically significant association was found between molecular biomarkers and T1Gd values.

Conclusion

Higher acute synovial fluid 1-F21-aggrecan concentrations in ACL injured patients, who managed to cope without ACL reconstruction and were without radiographic knee OA, were associated with inferior knee cartilage quality assessed by dGEMRIC 20 years after injury.
Digital tools as promoters for person-centered care practices in chronic care? Healthcare professionals’ experiences from rheumatology care
Authors: Granström Emma , Wannheden Carolina , Brommels Mats , Hvitfeldt Helena , Nyström Monica E.
Published: December 2020

Background

Person-centered care (PCC) emphasize the importance of supporting individuals’ involvement in care provided and self-care. PCC has become more important in chronic care as the number of people living with chronic conditions is increasing due to the demographic changes. Digital tools have potential to support interaction between patients and healthcare providers, but empirical examples of how to achieve PCC in chronic care and the role of digital tools in this process is limited. The aim of this study was to investigate strategies to achieve PCC used by the healthcare professionals at an outpatient Rheumatology clinic (RC), the strategies’ relation to digital tools, and the perceived impact of the strategies on healthcare professionals and patients.

Methods

A single case study design was used. The qualitative data consisted of 14 semi-structured interviews and staff meeting minutes, covering the time period 2017–2019. The data were analyzed using conventional content analysis, complemented with document analyses.

Results

Ten strategies on two levels to operationalize PCC, and three categories of perceived impact were identified. On the individual patient level strategies involved several digital tools focusing on flexible access to care, mutual information sharing and the distribution of initiatives, tasks, and responsibilities from provider to patients. On the unit level, strategies concerned involving patient representatives and individual patients in development of digital services and work practices. The roles of both professionals and patients were affected and the importance of behavioral and cultural change became clear.

Conclusions

By providing an empirical example from chronic care the study contributes to the knowledge on strategies for achieving PCC, how digital tools and work practices interact, and how they can affect healthcare staff, patients and the unit. A conclusion is that the use of the digital tools, spanning over different dimensions of engagement, facilitated the healthcare professionals’ interaction with patients and the patients’ involvement in their own care. Digital tools complemented, rather than replaced, care practices.