bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of a progressive protocol of high-intensity interval training for overweight/obese, sedentary African American women: a retrospective analysis
Authors: Arad Avigdor D. , Albu Jeanine B. , DiMenna Fred J.
Published: September 2020

Background

African American (AA) women have a higher prevalence of obesity and related metabolic dysfunction and lower level of physical activity compared to white counterparts. Determining feasible exercise alternatives for AA women is, therefore, paramount. Time-efficient high-intensity interval training (HIIT) might be particularly suited for AA women who cite time constraints as a frequent barrier to exercise adherence. The purpose of this study was to assess the feasibility of a 14-week progressive HIIT protocol for previously-sedentary overweight/obese AA women.

Methods

Twenty-eight healthy, premenopausal (age, 20–40 yr), sedentary, nondiabetic, overweight/obese AA women volunteered to participate in the randomized controlled clinical trial from which these data were retrospectively analysed. After assessment, participants were randomly allocated to a HIIT group (n = 14) or a no-exercise control group. The HIIT intervention consisted of 24-min sessions performed three times per week for 14 weeks during which work-interval intensity (75 to 90% of heart rate reserve; HRR) and duration (30 to 60 s) and work/recovery ratio (1:7 to 1:3) were progressed in four stages. Feasibility was assessed based on adherence (attrition rate), perceptual response (RPE) and success rate, which was calculated based on the degree to which target intensities for work intervals were achieved/maintained.

Results

Five of 14 participants (35%) in the HIIT group dropped out during the intervention. One-way repeated-measures ANOVA revealed a significant difference across stages for success rate (p = 0.018) with post-hoc analysis indicating a significant difference between stage 1 and the other stages and stage 4 and the other stages. There was no significant difference in RPE across stages (p = 0.057).

Conclusion

Albeit based on a limited number of participants, we found an attrition rate that was higher than what has been reported previously for HIIT (~ 17.6%) when previously-sedentary overweight/obese AA women performed a protocol with work-interval intensity progressed from 75 to 90% HRR during a 14-week intervention. With respect to intensity, the precipitous drop for achievement of the target HR during the fourth stage (weeks 8–14) for those who did complete the protocol implies that it might be advisable to restrict work-interval intensity to < 90% HRR.

Trial registration

ClinicalTrials.gov. (NCT04293367). Registered 03 March 2020 – Retrospectively registered.
DNA methylation of FKBP5 in South African women: associations with obesity and insulin resistance
Authors: Willmer Tarryn , Goedecke Julia H. , Dias Stephanie , Louw Johan , Pheiffer Carmen
Published: September 2020

Background

Disruption of the hypothalamic–pituitary–adrenal (HPA) axis, a neuroendocrine system associated with the stress response, has been hypothesized to contribute to obesity development. This may be mediated through epigenetic modulation of HPA axis-regulatory genes in response to metabolic stressors. The aim of this study was to investigate adipose tissue depot-specific DNA methylation differences in the glucocorticoid receptor (GR) and its co-chaperone, FK506-binding protein 51 kDa (FKBP5), both key modulators of the HPA axis.

Methods

Abdominal subcutaneous adipose tissue (ASAT) and gluteal subcutaneous adipose tissue (GSAT) biopsies were obtained from a sample of 27 obese and 27 normal weight urban-dwelling South African women. DNA methylation and gene expression were measured by pyrosequencing and quantitative real-time PCR, respectively. Spearman’s correlation coefficients, orthogonal partial least-squares discriminant analysis and multivariable linear regression were performed to evaluate the associations between DNA methylation, messenger RNA (mRNA) expression and key indices of obesity and metabolic dysfunction.

Results

Two CpG dinucleotides within intron 7 of FKBP5 were hypermethylated in both ASAT and GSAT in obese compared to normal weight women, while no differences in GR methylation were observed. Higher percentage methylation of the two FKBP5 CpG sites correlated with adiposity (body mass index and waist circumference), insulin resistance (homeostasis model for insulin resistance, fasting insulin and plasma adipokines) and systemic inflammation (c-reactive protein) in both adipose depots. GR and FKBP5 mRNA levels were lower in GSAT, but not ASAT, of obese compared to normal weight women. Moreover, FKBP5 mRNA levels were inversely correlated with DNA methylation and positively associated with adiposity, metabolic and inflammatory parameters.

Conclusions

These findings associate dysregulated FKBP5 methylation and mRNA expression with obesity and insulin resistance in South African women. Additional studies are required to assess the longitudinal association of FKBP5 with obesity and associated co-morbidities in large population-based samples.

Graphical abstract
Promoting patients’ rights through hospital accreditation
Authors: Sperling Daniel , Pikkel Rina B.
Published: September 2020

Background

Over the past decade, hospitals in many countries, including Israel, have undergone an accreditation process aimed at improving the quality of services provided. This process also refers to the protection and promotion of patients’ rights. However, reviewing the criteria and content included in this category in the Israeli context reveals definitions and implications that differ from those presented by the law – specifically the Patient’s Rights Act 1995. Moreover, the rights included in it are not necessarily equally represented in other legislation.

Methods

This study seeks to examine the question of whether and to what extent the scope, contents, and definitions of patients’ rights in the JCI Standards are similar to or different from patients’ rights as they are addressed and protected in national legislation.

The article provides a comparison and examination of the different regulatory frameworks of patients’ rights, especially those in the accreditation of healthcare institution and legislation, analyzes the gaps between such frameworks, and suggests possible implications on our understanding of the concept of patients’ rights.

Results

The patients’ right chapter in the accreditation process introduces and promotes the concepts of patient and family rights, increases the awareness and compliance of such concepts, and may create greater consistency in their introduction and application.

Conclusions

Discussion of the Israeli case not only demonstrates how regulatory frameworks are instrumental – for broader policy purposes, especially in the area of patients’ rights and the rights of patients’ families – but also calls for a more general examination of the concept of patients’ rights in health policies and its contribution to the quality of health services. Reference to patients’ rights in accreditation of healthcare institutions may promote and enhance this concept and contribute to the delivery of care, thereby complementing a lacuna in the law.
An active and verifiable trust evaluation approach for edge computing
Authors: Mo Wen , Wang Tian , Zhang Shaobo , Zhang Jinhuan
Published: September 2020

Billions of Internet of Thing (IoT) devices are deployed in edge network. They are used to monitor specific event, process and to collect huge data to control center with smart decision based on the collected data. However, some malicious IoT devices may interrupt and interfere with normal nodes in data collection, causing damage to edge network. Due to the open character of the edge network, how to identify the credibility of these nodes, thereby identifying malicious IoT devices, and ensure reliable data collection in the edge network is a great challenge. In this paper, an Active and Verifiable Trust Evaluation (AVTE) approach is proposed to identify the credibility of IoT devices, so to ensure reliable data collection for Edge Computing with low cost. The main innovations of the AVTE approach compared with the existing work are as follows: (1) In AVTE approach, the trust of the device is obtained by an actively initiated trusted detection routing method. It is fast, accurate and targeted. (2) The acquisition of trust in the AVTE approach is based on a verifiable method and it ensures that the trust degree has higher reliability. (3) The trust acquisition method proposed in this paper is low-cost. An encoding returned verification method is applied to obtain verification messages at a very low cost. This paper proposes an encoding returned verification method, which can obtain verification messages at a very low cost. In addition, the strategy of this paper adopts initiation and verification of adaptive active trust detection according to the different energy consumption of IoT devices, so as to reliably obtain the trust of device under the premise of ensuring network lifetime. Theoretical analysis shows that AVTE approach can improve the data collection rate by 0.5 ~ 23.16% while ensuring long network lifetime compared with the existing scheme.
The use of remdesivir outside of clinical trials during the COVID-19 pandemic
Authors: Halimi Vesa , Daci Armond , Ridova Nevenka , Panovska-Stavridis Irina , Stevanovic Milena , Filipce Venko , Dimovski Aleksandar , Grozdanova Aleksandra
Published: September 2020

With a scientific background from filoviruses, paramyxoviruses, SARS-CoV, and MERS-CoV, remdesivir entered into the COVID-19 battle to become one of the favorable therapeutic candidates with potential antiviral activity in the treatment of this disease. Globally, remdesivir was accessed and investigated through clinical research (clinical trials) and clinical practice (compassionate use, expanded access, early access scheme, and emergency use). Currently, remdesivir approval status differs between states. This paper aims to review and analyze regulatory approaches for accessing and investigating remdesivir, by communicating regulatory variability between countries in terms of terminology, modalities, and protocols.
Sagittal knee kinematics in relation with the posterior tibia slope during jump landing after an anterior cruciate ligament reconstruction
Authors: Keizer Michèle N. J. , Hijmans Juha M. , Gokeler Alli , Otten Egbert , Brouwer Reinoud W.
Published: September 2020

Purpose

An increased posterior tibia plateau angle is associated with increased risk for anterior cruciate ligament injury and re-rupture after reconstruction. The aims of this study were to determine whether the tibia plateau angle correlates with dynamic anterior tibia translation (ATT) after an anterior cruciate ligament reconstruction and whether the tibia plateau angle correlates with aspects of knee kinematics and kinetics during jump landing.

Methods

Thirty-seven patients after anterior cruciate ligament reconstruction with autograft hamstring tendon were included. Knee flexion angle and knee extension moment during single leg hops for distance were determined using a motion capture system and the dynamic ATT with its embedded method. The medial and lateral posterior tibia plateau angle were measured using MRI. Moreover, passive ATT was measured using the KT-1000 arthrometer.

Results

A weak negative correlation was found between the maximal dynamic ATT and the medial tibia plateau angle (p = 0.028, r = − 0.36) and between the maximal knee flexion angle and the lateral tibia plateau angle (p = 0.025, r = − 0.37) during landing. Patients with a smaller lateral tibia plateau angle show larger maximal knee flexion angle during landing than the patients with larger lateral tibia plateau angle. Also, the lateral tibia plateau angle is associated the amount of with muscle activity.

Conclusion

The posterior medical tibia plateau angle is associated with dynamic ATT. The maximal knee flexion angle and muscle activity are associated with the posterior lateral tibia plateau angle.

Level of evidence

III
High resolution diffusion-weighted imaging with readout segmentation of long variable echo-trains for determining myometrial invasion in endometrial carcinoma
Authors: Xie Mengnv , Ren Zhen , Bian Dujun , Li Dan , Yu Li , Zhu Fang , Huang Rui , Zhang Zhibang , Suye Suye , Fu Chun
Published: September 2020

Background

We assessed the image quality of endometrial cancer lesions by readout segmentation of long variable echo-trains (RESOLVE) diffusion-weighted imaging (DWI) compared with that by single-shot echo-planar imaging (SS-EPI) DWI, aimed to explore the value of RESOLVE DWI for determining myometrial invasion and clinical stage in endometrial cancer.

Materials and methods

From April 2017 to March 2018, a total of 30 endometrial cancer patients (mean age 52.8 ± 9.0 years), who had undergone RESOLVE DWI and SS-EPI DWI, were included in the study. The image quality of endometrial carcinoma by two kinds of DWI scanning methods was compared qualitatively and quantitatively. The Spearman rank correlation test was used to assess the correlation of qualitative image quality scores between two readers. The accuracy of two DWI methods in detecting myometrial invasion and staging of endometrial carcinoma was calculated according to postoperative pathological results. The indexes were analyzed including sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV).

Results

The qualitative score of RESOLVE DWI group was superior to SS-EPI DWI group in every aspect of five aspects (all P < 0.001). Interobserver agreement of depiction was good or excellent in two DWI sequences. Signal to noise ratio and contrast to noise ratio values in RESOLVE DWI group were both higher than those in SS-EPI DWI group (P<0.001). No statistical difference of apparent diffusion coefficient value was observed between two DWI groups (P = 0.261). The specificity, accuracy, PPV, and NPV of estimating myometrial invasion by RESOLVE DWI in three cases (intramucosal lesion, <50% superficial invasion and ≥ 50% deep invasion) were all higher than those by SS-EPI DWI for endometrial carcinoma. Especially RESOLVE DWI was valuable in judging <50% superficial invasion (95%CI:0.586, 0.970). No significant difference in accuracy staging was between the two DWI groups (P = 0.125).

Conclusion

RESOLVE DWI can provide higher quality images of endometrial carcinoma than SS-EPI DWI. The high-quality images are helpful for precise assessment of myometrial invasion in endometrial cancer.
Creation of an optic nerve sheath diameter ultrasound model for NeuroICU education
Authors: Felix Heidi M. , Rosenbush Kristin A. , Lannen Amy M. , Pooley Robert A. , Siegel Jason L. , Brown Benjamin L. , McMullan Melissa L. , Collins Christina I. , Freeman William D.
Published: September 2020

Background

Using ultrasound to measure optic nerve sheath diameter (ONSD) is an emerging bedside technique to noninvasively assess intracranial pressure (ICP) in patients with brain injury. This technique is unique among bedside ultrasonography and is often performed by providers who have no formal ultrasound training. We sought to create a low-cost, 3D, reusable ONSD model to train neurology, neurosurgery, and critical care providers in measuring ICP.

Results

We identified 253 articles, of which 15 were associated with models and 2 with simulation. One gelatin model was reported, upon which we based our initial design. We could not validate the visual findings of this model; however, after constructing multiple beta models, the design most representative of human eye anatomy was a globe made of ballistics gel and either a 3 mm, 5 mm, or 7 mm × 50 mm 3D-printed optic nerve inserted into a platform composed of ballistics gel, all of which sat inside a 3D-printed skull. This model was used to teach ONSD measurements with ultrasound at a continuing medical education event prior to training on a live human model.

Conclusion

A simple 3D ballistic ONSD model allows learners to practice proper hand placement and pressure, basic landmarks, and ONSD measurement prior to operating on a human eye. This model is replicable and sustainable given that the globe and platform are composed of ballistics gel.
Exploring patient and public involvement (PPI) and co-production approaches in mental health research: learning from the PARTNERS2 research programme
Authors:   The PARTNERS2 writing collective, Allen Dawn , Cree Lindsey , Dawson Paul , El Naggar Shaimma , Gibbons Bliss , Gibson John , Gill Laura , Gwernan-Jones Ruth , Hobson-Merrett Charley , Jones Beverly , Khan Hameed , McCabe Catherine , Mancini Mary , McLellan Dougie , Nettle Mary , Pinfold Vanessa , Rawcliffe Tim , Sanders Angela , Sayers Ruth , Smith Deb , Wright Diane
Published: September 2020

Background

Patient and Public Involvement (PPI) in research is a growing field of work, incorporating experiential knowledge within research processes. Co-production is a more recent PPI approach that emphasises the importance of power-sharing to promote inclusive research practices, valuing and respecting knowledge from different sources, and relationship building. Applying co-production principles in research trials can be difficult, and there are few detailed worked examples or toolkits. This paper explores the successes and challenges encountered by one research team.

Methods

Our paper is written by a team of 21 people working on PARTNERS2, led by a smaller co-ordinating group. Using a co-operative style inquiry, the authors have reflected on and written about their experiences; analysis of the resulting 15 accounts provided examples of how PPI and co-production were delivered in practice.

Results

We reveal varied and complicated experiences as we developed our collaborative approach across the entire research programme. Four main themes emerge from reflective accounts which describe aspects of this process: (1) recognising the importance of ‘emotional work’; (2) developing safe spaces to create and share knowledge; (3) some challenges of using our personal identities in research work; and (4) acknowledging power-sharing within the research hierarchy. We also found continual relationship building, how different forms of expertise were valued, and stigma were central to shaping what work was possible together. Other important practices were transparency, particularly over decision making, and clear communication.

Conclusions

Our work provides one example of the ‘messy’ nature of collaborative research in practice. The learning we surface was contextual, generated within a large-scale research programme, but applicable to other studies. We found for success there needs to be an acknowledgement of the importance of emotional work, creating safe spaces to co-produce, transparency in decision making and reflection on the difficulties of using personal identities in research work including for service user researchers. These elements are more important than existing guidelines suggest. Implementation of actions to support emotional work, will require changes within individual teams as well as institutions. Introducing reflective practice in teams may be helpful in identifying further improvements to inclusive research practice.
Pedicle internal limiting membrane flap technique for very large macular holes: a preliminary report
Authors: Tavares Neto José Edísio da Silva , Coelho Igor Neves , Jorge Rodrigo , Isaac David Leonardo Cruvinel , de Ávila Marcos Pereira
Published: September 2020

Background

Conventional vitrectomy technique for macular hole surgery has a good outcome in small and medium macular holes, but for very large macular holes (minimum linear diameter higher than 700 μm) other techniques were developed aiming to achieve greater rates of closure and visual acuity gain. The purpose of this article is to report the anatomical and functional outcomes of four very large macular hole (MH) cases which have undergone vitrectomy with the pedicle internal limiting membrane (ILM) flap technique.

Methods

This is a retrospective series of four patients with large MH who were treated with vitrectomy and the pedicle ILM flap technique. Comprehensive ophthalmologic evaluation was performed before surgery and included ETDRS best-corrected visual acuity (BCVA) and spectral domain optical coherence tomography (SD-OCT) for MH measures: height, minimum linear diameter (MLD) and external base diameter. The particular detail of this technique is related to ILM flap creation. During the peeling, the ILM was not removed completely from the retina but was left attached to the edges of the macular hole and subsequently trimmed with the vitrectomy probe using the scissors mode.

Results

Four patients with very large MH underwent PPV and the pedicle ILM flap technique was used to pursue macular closure. Median preoperative BCVA was 20/400 (range: 20/320 to 20/400) and median postoperative BCVA was 20/200 (range: 20/320 to 20/200). Of the 4 cases reported, 3 obtained anatomical closure (75%), and also presented BCVA improvement after surgery, considering the last follow-up visit of each case. No additional procedures were performed in either case. One patient demonstrated no anatomic and functional improvement.

Conclusion

The present study describes the first Brazilian case series of very large MH treated by the inverted pedicle ILM flap technique. This technique was associated with anatomic and visual improvement in most cases, and represents an alternative therapeutic approach for large macular holes.

Trial Registration Project registered in Plataforma Brasil with CAAE number 30163520.0.0000.5440 and approved in ethics committee   from  Ribeirão Preto Medical School Clinics Hospital, University of São Paulo—Ribeirão Preto, São Paulo, Brazil (appreciation number 3.948.426 gave the approval).
Mortality and its association with CD4 cell count and hemoglobin level among children on antiretroviral therapy in Ethiopia: a systematic review and meta-analysis
Authors: Wubneh Chalachew Adugna , Belay Getaneh Mulualem
Published: September 2020

Background

Even though there are advancements in HIV/AIDS prevention and treatment approach, HIV continues to be a global challenge. Pediatrics HIV is one of the challenges in the reduction of child mortality particularly in less developed countries like Ethiopia. Therefore, this study aims to estimate the pooled proportion of child mortality and the effect of hemoglobin level and CD4 cell count among children on antiretroviral therapy in Ethiopia.

Method

All published were articles searched using PubMed, EMBASE, Google Scholar, and Web of Science database. Besides, Ethiopian institutional research repositories and reference lists of included studies were used.We limited the searching to studies conducted in Ethiopia and written in the English language. Studies that were done in a cohort, cross-sectional, and case-control study design were considered for the review. The weighted inverse variance random effects model was applied, and the overall variations between studies were checked by using heterogeneity test Higgins’s (I2). Subgroup analysis by region and year of publication was conducted.All of the included articles were assessed using the Joanna Briggs Institute (JBI) quality appraisal criteria. In addition, publication bias was also checked with Egger’s regression test and the funnel plot. Based on the results, trim and fill analysis was performed to manage the publication bias.

Result

A total of 16 studies with 7047 participants were included in this systematic review and meta-analysis. The overall pooled proportion of mortality among children on antiretroviral therapy (ART) was found to be 11.78% (95% CI 9.34, 14.23). In subgroup analysis, the highest child mortality was observed in the Amhara region 16.76 % (95% CI 9.63, 23.90) and the lowest is in the Tigray region 4.81% (95% CI 2.75, 6.87). Besides, the proportion of mortality among children with low CD4 count and hemoglobin level was 2.42 (AOR = 2.42, 95% CI 1.65, 3.56) and 3.24 (AOR = 3.24, 95% CI 1.51, 6.93) times higher compared to their counterparts, respectively.

Conclusion

The proportion of mortality among children on ART was high in Ethiopia. Those children who had low CD4 cell count and low hemoglobin levels at baseline need special attention, treatment, and care.

Trial registration

The protocol of this systematic review and meta-analysis has been registered in PROSPERO with the registration numberCRD42018113077.
Culture-dependent analysis of seed bacterial endophyte, Pseudomonas spp. EGN 1 against the stem rot disease (Sclerotium rolfsii Sacc.) in groundnut
Authors: Archana T. , Rajendran L. , Manoranjitham S. K. , Santhana Krishnan V. P. , Paramasivan M. , Karthikeyan G.
Published: September 2020

Background

Groundnut, Arachis hypogaea L., crop is an important oil seed crop in India and is prone to attack by numerous fungal and viral diseases, among the soil-borne diseases, stem rot caused by Sclerotium rolfsii Sacc. is economically important.

Main body of abstract

Incidence (86.6%) of the stem rot disease was recorded in Coimbatore district, Tamil Nadu, India, during the roving survey. For its management, an attempt was made to isolate bacterial endophyte from peanut seeds of different groundnut cultivars by culture-dependent analysis. Totally, 16 bacterial endophytes (endophytes groundnut (EGN) 1 to EGN 16 along with standards TNAU-Pf1 and EPC 5) were obtained and characterized through morphological, biochemical and molecular studies and also phytostimulation activities were performed. Among the isolates, EGN 1 and EGN 4 showed positive results for indole acetic acid (IAA), siderophore, phosphate solubilization and protease tests in vitro. The dual culture analysis showed inhibition rates of 60.1% (dual plate assay), 68.23% (filter paper disc assay) and 100% (triangle method of streaking and culture filtrate assay) for EGN 1 against S. rolfsii. Further, the crude metabolite assay showed 97.7% inhibition in EGN 1, followed by 87.7% in EGN 4. The roll towel study showed a high vigour index of 4286.7 in EGN 1; hence, this isolate was chosen. Further, thin-layer chromatography (TLC) analysis showed various bands at 0.72 Rf, whereas GC-MS analysis indicated the prominent peaks of hexadecanoic acid and cis-vaccenic acid that may responsible for antifungal activity. In a molecular approach, the genomic DNA of EGN 1 strain was used to amplify a 1200 bp PCR-fragment and sequenced.

Short conclusion

The overall outcome of this study showed that Pseudomonas spp. EGN 1 had a great potential as a bio-stimulant and biocontrol agent to manage effectively the stem rot in peanut.
Neurosurgery in paediatric strokes
Authors: Ganapathy S. , Pandey P.
Published: September 2020

Paediatric strokes are a different entity owing to the difference in pathological entity causing the stroke as well as difficulty in treatment and management due to the presence of a growing brain and small vascular volume making surgery and endovascular intervention dangerous. Yet, the high neuronal plasticity coupled with unique surgical and endovascular procedures makes surgery in these conditions rewarding with improving morbidity and mortality statistics. The field is young and dynamic leading to constant change and updating. We attempt to review the current recommendations with our own experience in paediatric neurosurgery for paediatric strokes and present an overview of common conditions causing paediatric strokes. A brief review of the literature is also supplied for reference.
Trans-septal course of anomalous left main coronary artery originating from single right coronary ostium presenting with atrial fibrillation in a severely obese patient: a case report
Authors: Cavallo Armando Ugo , Muscogiuri Emanuele , Forcina Marco , Colombo Antonio , Fiore Flavio , Sperandio Massimiliano
Published: September 2020

Background

To present a case of anomalous origin of the left coronary artery evaluated with invasive coronary angiography (ICA) and ECG-gated coronary computed tomography (CCT).

Case presentation

A patient (55 years old, male) with a past medical history of respiratory failure and atrial fibrillation underwent ICA to rule out coronary artery disease. Subsequently, the patient underwent ECG-gated CCT to evaluate a suspected anomalous aortic origin of the left coronary artery, since the interventional cardiologist was not able to properly identify the left coronary artery and its distal branches. CCT showed left coronary artery originating from the right coronary Valsalva sinus, coursing within the interventricular septum and emerging at the middle segment of the interventricular sulcus, where the left anterior descending and circumflex arteries originated.

Conclusion

The case we presented highlights the value of ECG-gated CCT in the evaluation of coronary anomaly anatomy and thus risk stratification derived by proper coronary anatomy assessment. Although ICA was not helpful in the diagnosis, it also has a pivotal role regarding the therapeutic management of this condition.
Implementing social distancing policy measures in the battle against the coronavirus: protocol of a comparative study of Denmark and Sweden
Authors: Nilsen Per , Seing Ida , Ericsson Carin , Andersen Ove , Stefánsdóttir Nina Thórný , Tjørnhøj-Thomsen Tine , Kallemose Thomas , Kirk Jeanette Wassar
Published: September 2020

Background

Social distancing policies to ensure physical distance between people have become a crucial strategy in the battle against the spread of the coronavirus. The aim of this project is to analyze and compare social distancing policies implemented in Denmark and Sweden in 2020. Despite many similarities between the two countries, their response to the coronavirus pandemic differed markedly. Whereas authorities in Denmark initiated mandatory regulations and many severe restrictions, Swedish authorities predominantly promoted voluntary recommendations.

Methods

The project is an interdisciplinary collaboration between researchers in Denmark and Sweden with different disciplinary backgrounds. The project is based on a comparative analysis, an approach that attempts to reach conclusions beyond single cases and to explain differences and similarities between objects of analysis and relations between objects against the backdrop of their contextual conditions. Data will be gathered by means of document analysis, qualitative interviews, and a questionnaire survey to address three research questions: (1) What social distancing policies regarding the coronavirus have been formulated and implemented, who are the policymakers behind the policy measures, which implementers are expected to implement the measures, and who are the targets that the measures ultimately seek to influence? (2) How have the social distancing policies and policy measures been justified, and what types of knowledge form the basis for the measures? and (3) What are the differences and similarities in citizens’ perceptions of acceptability and compliance with social distancing policy measures in relation to the coronavirus?

Discussion

To create a structure for addressing the three research questions, the project applies a theoretical framework informed by the policy and implementation science literatures. The framework consists of five interdependent domains that have an impact on policy implementation: (1) policymakers, (2) policy characteristics, (3) implementers, (4) targets, and (5) policy environment. Details of the framework are provided in the article.
Follow-Up Care for Breast and Colorectal Cancer Across the Globe: Survey Findings From 27 Countries
Authors: Mollica Michelle A. , Mayer Deborah K. , Oeffinger Kevin C. , Kim Youngmee , Buckenmaier Susan S. , Sivaram Sudha , Muha Catherine , Taib Nur Aishah , Andritsch Elisabeth , Asuzu Chioma C. , Bochis Ovidiu V. , Diaz Sheila , Trill Maria Die , Garcia Patricia J. , Grassi Luigi , Uchitomi Yosuke , Shaikh Asim Jamal , Jefford Michael , Lee Hyun Jeong , Johansen Christoffer , Luyirika Emmanuel , Maher Elizabeth Jane , Mallillin Maria Madeline B. , Maniragaba Theoneste , Mehnert-Theuerkauf Anja , Pramesh C. S. , Siesling Sabine , Spira Orit , Sussman Jonathan , Tang Lili , Hai Nguyen V. , Yalcin Suayib , Jacobsen Paul B.
Published: September 2020

PURPOSE

The purpose of this study was to describe follow-up care for breast and colorectal cancer survivors in countries with varying levels of resources and highlight challenges regarding posttreatment survivorship care.

METHODS

We surveyed one key stakeholder from each of 27 countries with expertise in survivorship care on questions including the components/structure of follow-up care, delivery of treatment summaries and survivorship care plans, and involvement of primary care in survivorship. Descriptive analyses were performed to characterize results across countries and variations between the WHO income categories (low, middle, high). We also performed a qualitative content analysis of narratives related to survivorship care challenges to identify major themes.

RESULTS

Seven low- or /lower-middle-income countries (LIC/LMIC), seven upper-middle-income countries (UMIC), and 13 high-income countries (HICs) were included in this study. Results indicate that 44.4% of countries with a National Cancer Control Plan currently address survivorship care. Additional findings indicate that HICs use guidelines more often than those in LICs/LMICs and UMICs. There was great variation among countries regardless of income level. Common challenges include issues with workforce, communication and care coordination, distance/transportation issues, psychosocial support, and lack of focus on follow-up care.

CONCLUSION

This information can guide researchers, providers, and policy makers in efforts to improve the quality of survivorship care on a national and global basis. As the number of cancer survivors increases globally, countries will need to prioritize their long-term needs. Future efforts should focus on efforts to bridge oncology and primary care, building international partnerships, and implementation of guidelines.
Fear of Cancer Recurrence in Patients With Localized Renal Cell Carcinoma
Authors: Bergerot Cristiane Decat , Battle Dena , Philip Errol J. , Bergerot Paulo Gustavo , Msaouel Pavlos , Smith Allan ‘Ben’ , Bamgboje Adeola Esther , Shuch Brian , Derweesh Ithaar H. , Jonasch Eric , Stern Adam P. , Pal Sumanta K. , Staehler Michael
Published: September 2020

PURPOSE:

Patients with cancer commonly report distress and fear of cancer recurrence (FCR) impacting quality of life and clinical outcomes. This study aims to test the association between emotional well-being and clinical characteristics of survivors with localized renal cell carcinoma (RCC).

MATERIALS AND METHODS:

Survivors with localized RCC were invited to participate in this study through social media by the Kidney Cancer Research Alliance. Participants self-reported clinical characteristics, distress (Distress Thermometer), and FCR (Fear of Cancer Recurrence-7). Ordinal regression was used to test the association between emotional well-being and patient characteristics.

RESULTS:

A total of 412 survivors were included in this analysis. Participants were mostly female (79.4%) and well educated (58.3%), with a median age of 54 years (range, 30-80 years) and median time since diagnosis of 17.5 months. More than one half were diagnosed with stage I disease (56.1%). Most patients (62.3%) had a clear understanding of their diagnosis. A high prevalence of moderate to severe distress (67.0%) and FCR (54.9%) was reported across all survivors of RCC. Higher FCR was associated with female gender, younger age, and lack of understanding of their diagnosis ( P = .001), whereas more recent diagnosis was associated with higher distress levels ( P = .01).

CONCLUSION:

Our findings suggest that FCR is a common problem that is persistent after therapy and that certain individuals, including female and younger patients, may be at particular risk of experiencing clinically relevant FCR.
Applying the ASCO and European Society for Medical Oncology Value Frameworks to Nasopharyngeal Cancer Treatments: Is Adding Induction Chemotherapy or Adjuvant Chemotherapy to Concurrent Chemoradiotherapy Worthwhile?
Authors: Tan Teng Hwee , Soon Yu Yang , Cheo Timothy , Wong Lea Choung , Leong Yiat Horng , Tey Jeremy C.S. , Ho Francis
Published: September 2020

PURPOSE:

To determine and compare the incremental clinical benefit (ICB) and costs of induction chemotherapy (IC) when added to concurrent chemoradiotherapy (CCRT), concurrent chemotherapy (CC) when added to radiotherapy (RT), and CC plus adjuvant chemotherapy (AC) when added to RT for locally advanced nasopharyngeal cancer (LA-NPC).

MATERIALS AND METHODS:

We searched phase III randomized controlled trials (RCTs) that reported overall survival benefit with the use of IC, CC, and CC + AC in LA-NPC. We quantified the ICB using the ASCO and European Society for Medical Oncology (ESMO) value frameworks. We calculated the incremental drug costs in US dollars using the lowest average wholesale price reported in the Lexicomp drug database.

RESULTS:

We identified three RCTs on IC, three RCTs on CC, and four RCTs on CC + AC. The ICB was judged to be grade A based on the ESMO framework. The ASCO Net Health Benefit score ranged from 17.43 to 57.39. The incremental drug costs ranged from $133.46 to $626.14. There were no statistically significant differences in the mean Net Health Benefit scores (39.37 for IC v 37.61 for CC v 33.98 for CC + AC; P = .89) and costs ($383 for IC v $253 for CC v $460 for CC + AC; P = .27) between the three approaches. There was no statistically significant correlation between ICB and costs.

CONCLUSION:

The magnitudes of ICB and incremental drug costs of adding of IC to CCRT, CC to RT, and CC + AC to RT for LA-NPC are not significantly different.
Pandemic Politics: Timing State-Level Social Distancing Responses to COVID-19
Authors: Adolph Christopher , Amano Kenya , Bang-Jensen Bree , Fullman Nancy , Wilkerson John
Published: September 2020

Context: Social distancing is an essential but economically painful measure to flatten the curve of emergent infectious diseases. As the novel coronavirus that causes COVID-19 spread throughout the United States in early 2020, the federal government left to the states the difficult and consequential decisions about when to cancel events, close schools and businesses, and issue stay-at-home orders.

Methods: The authors present an original, detailed dataset of state-level social distancing policy responses to the epidemic; they then apply event history analysis to study the timing of implementation of five social distancing policies across all 50 states.

Results: The most important predictor of when states adopted social distancing policies is political: all else equal, states led by Republican governors were slower to implement such policies during a critical window of early COVID-19 response.

Conclusions: Continuing actions driven by partisanship rather than by public health expertise and scientific recommendations may exact greater tolls on health and broader society.
FaceBase 3: analytical tools and FAIR resources for craniofacial and dental research
Authors: Samuels Bridget D. , Aho Robert , Brinkley James F. , Bugacov Alejandro , Feingold Eleanor , Fisher Shannon , Gonzalez-Reiche Ana S. , Hacia Joseph G. , Hallgrimsson Benedikt , Hansen Karissa , Harris Matthew P. , Ho Thach-Vu , Holmes Greg , Hooper Joan E. , Jabs Ethylin Wang , Jones Kenneth L. , Kesselman Carl , Klein Ophir D. , Leslie Elizabeth J. , Li Hong , Liao Eric C. , Long Hannah , Lu Na , Maas Richard L. , Marazita Mary L. , Mohammed Jaaved , Prescott Sara , Schuler Robert , Selleri Licia , Spritz Richard A. , Swigut Tomek , van Bakel Harm , Visel Axel , Welsh Ian , Williams Cristina , Williams Trevor J. , Wysocka Joanna , Yuan Yuan , Chai Yang
Published: September 2020

The FaceBase Consortium was established by the National Institute of Dental and Craniofacial Research in 2009 as a ‘big data’ resource for the craniofacial research community. Over the past decade, researchers have deposited hundreds of annotated and curated datasets on both normal and disordered craniofacial development in FaceBase, all freely available to the research community on the FaceBase Hub website. The Hub has developed numerous visualization and analysis tools designed to promote integration of multidisciplinary data while remaining dedicated to the FAIR principles of data management (findability, accessibility, interoperability and reusability) and providing a faceted search infrastructure for locating desired data efficiently. Summaries of the datasets generated by the FaceBase projects from 2014 to 2019 are provided here. FaceBase 3 now welcomes contributions of data on craniofacial and dental development in humans, model organisms and cell lines. Collectively, the FaceBase Consortium, along with other NIH-supported data resources, provide a continuously growing, dynamic and current resource for the scientific community while improving data reproducibility and fulfilling data sharing requirements.
Stbd1 promotes glycogen clustering during endoplasmic reticulum stress and supports survival of mouse myoblasts
Authors: Lytridou Andria A. , Demetriadou Anthi , Christou Melina , Potamiti Louiza , Mastroyiannopoulos Nikolas P. , Kyriacou Kyriacos , Phylactou Leonidas A. , Drousiotou Anthi , Petrou Petros P.
Published: September 2020

Imbalances in endoplasmic reticulum (ER) homeostasis provoke a condition known as ER stress and activate the unfolded protein response (UPR) pathway, an evolutionarily conserved cell survival mechanism. Here, we show that mouse myoblasts respond to UPR activation by stimulating glycogenesis and the formation of α-amylase-degradable, glycogen-containing ER structures. We demonstrate that the glycogen-binding protein Stbd1 is markedly upregulated through the PERK signalling branch of the UPR pathway and is required for the build-up of glycogen structures in response to ER stress activation. In the absence of ER stress, Stbd1 overexpression is sufficient to induce glycogen clustering but does not stimulate glycogenesis. Glycogen structures induced by ER stress are degraded under conditions of glucose restriction through a process that does not depend on autophagosome–lysosome fusion. Furthermore, we provide evidence that failure to induce glycogen clustering during ER stress is associated with enhanced activation of the apoptotic pathway. Our results reveal a so far unknown response of mouse myoblasts to ER stress and uncover a novel specific function of Stbd1 in this process, which may have physiological implications during myogenic differentiation.

This article has an associated First Person interview with the first author of the paper.
Mitofusin 2 but not mitofusin 1 mediates Bcl-XL-induced mitochondrial aggregation
Authors: Du Mengyan , Yu Si , Su Wenhua , Zhao Mengxin , Yang Fangfang , Liu Yangpei , Mai Zihao , Wang Yong , Wang Xiaoping , Chen Tongsheng
Published: September 2020

Bcl-2 family proteins, as central players of the apoptotic program, participate in regulation of the mitochondrial network. Here, a quantitative live-cell fluorescence resonance energy transfer (FRET) two-hybrid assay was used to confirm the homo-/hetero-oligomerization of mitofusins 2 and 1 (MFN2 and MFN1), and also demonstrate the binding of MFN2 to MFN1 with 1:1 stoichiometry. A FRET two-hybrid assay for living cells co-expressing CFP-labeled Bcl-XL (an anti-apoptotic Bcl-2 family protein encoded by BCL2L1) and YFP-labeled MFN2 or MFN1 demonstrated the binding of MFN2 or MFN1 to Bcl-XL with 1:1 stoichiometry. Neither MFN2 nor MFN1 bound with monomeric Bax in healthy cells, but both MFN2 and MFN1 bind to punctate Bax (pro-apoptotic Bcl-2 family protein) during apoptosis. Oligomerized Bak (also known as BAK1; a pro-apoptotic Bcl-2 family protein) only associated with MFN1 but not MFN2. Moreover, co-expression of Bcl-XL with MFN2 or MFN1 had the same anti-apoptotic effect as the expression of Bcl-XL alone to staurosporine-induced apoptosis, indicating the Bcl-XL has its full anti-apoptotic ability when complexed with MFN2 or MFN1. However, knockdown of MFN2 but not MFN1 reduced mitochondrial aggregation induced by overexpression of Bcl-XL, indicating that MFN2 but not MFN1 mediates Bcl-XL-induced mitochondrial aggregation.
Balancing Conscience: A Response to Fernandes & Ecret
Authors: Wolfe Ian , Guiahi Maryam
Published: September 2020

There are many lessons that bioethics can learn from the Holocaust. Forefront are the lessons from the Nuremberg trials and the formation of research ethics. An often-overlooked lesson is how the Nazi regime was able to construct a hierarchy in such a way that influenced people to act in horrendous ways. Fernandes & Ecret, writing in Conatus – Journal of Philosophy 4, no. 2 (2019), highlight the influence of hierarchy on the moral silence of nurses and physicians within the Nazi regime. While we greatly enjoyed the paper, and think it is an important contribution, we find several misrepresentations of current bioethical discourse. There is not a global acceptance of euthanasia or medical aid in dying, the contemporary position in bioethics does not favor removal of conscience-based protections, and the lack of personal conscience-based protections was not the main factor in the analysis of Nazi medical hierarchy. The authors’ overall conclusion that their analysis suggests the importance of strengthening personal conscience-based objections to prevent medical hierarchy from influencing immoral behavior misses the more significant issue of institutional behavior. Instead, we argue, that the lessons from the analysis of Nazi nurses and physicians speak to the importance of protecting patients from institutional conscience-based objections that violate patient rights of access to legal medical services. This paper will respond to the misrepresentations. We highlight the growing threats to health care access from religious affiliated institutions, the threats to professional ethics and physician and nurse scope of practice. We conclude that the analysis by Fernandes & Ecret does point out an important lesson, but rather than showing the importance of individual conscience protections, it speaks to the importance of protecting patient rights.
Pneumococcal carriage and antibiotic susceptibility patterns in mother-baby pairs in a rural community in Eastern Uganda: a cross-sectional study
Authors: Madut Akech Gabriel , Naloli Mercy , Sebwami Paul , Kazibwe Patrick , Atwikiriize Maureen , Onyait Julius , Oboth Paul , Nteziyaremye Julius , Nekaka Rebecca , Iramiot Jacob Stanley
Published: September 2020

Background: Pneumonia poses a significant threat to the lives of children below five years old worldwide, contributing to a high number of hospitalizations and death. Morbidity and morbidity are especially common in children under five and the elderly, although any age group can be affected. This study aimed to estimate pneumococcal carriage and determine antibiotic susceptibility patterns of the pneumococci isolated from mother-baby pairs in Ngora district after the rollout of the pneumococcal vaccine. We hypothesized that high carriage of Streptococcus pneumoniae in mothers leads to carriage in their babies and hence a greater chance of contracting pneumonia.

Methods: Consecutive sampling was used to select 152 mother-baby pairs from community visits and those seeking care at the health facility. We collected nasal swabs from both baby and mother for culture and sensitivity testing using the Kirby-Bauer’s agar disc diffusion method.

Results: This study found that there was a low prevalence of pneumococcal carriage in the mother-baby pair in Ngora district. We also observed high rates of microbial resistance to penicillin, which is the first-line drug for the management of pneumonia in Uganda.

Conclusions: The relationship between pneumococcal carriage and immunization status suggests that the pneumococcal vaccine is protective against pneumococcal carriage. Resistance of S. pneumoniae to commonly used antibiotics was high.