bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring capabilities in health and physical activity promotion: a systematic review.
Authors: Till Maike , Abu-Omar Karim , Ferschl Susanne , Reimers Anne Kerstin , Gelius Peter
Published: January 2021

Background: The capability approach by Amartya Sen and Martha Nussbaum has gained increasing attention in the field of public health. As it combines individual, social and structural factors and shifts the focus of attention from the actual behavior towards available options for health behaviors that people can actually choose from, it may help advance our understanding of complex health issues. Objectives: The aim of this article is to identify and describe tools available to measure capabilities within the context of health, with a specific focus on capabilities for health-enhancing physical activity.Method: We conducted a systematic literature review using 11 databases covering scientific journal articles published in English or German between the years 2000 and 2020 with a focus on capabilities for health or physical activity. Results: We found a total of 51 articles meeting our inclusion criteria. Four articles measured capabilities using qualitative methods, one combined qualitative and quantitative methods, while the rest used quantitative methods. We identified a total 11 different capabilitzy questionnaires, all showing moderate to good validity/reliability. Only one questionnaire and one interview-based tool specifically dealt with capabilities for health enhancing physical activity. Conclusion: Although we were able to identify measurement tools for capabilities in health, this review has shown that there is no generic tool available for the measurement across all population- and age-groups, and tools focusing on physical activity are scarce. However, our results can be used as guide for future projects that aim at measuring capabilities.
CERTL reduces C16 ceramide, amyloid-β levels and inflammation in a model of Alzheimer's disease
Authors: Crivelli Simone Mwenda , Luo Qian , Stevens Jo A.A. , Giovagnoni Caterina , Kruining Daan van , Bode Gerard , Hoedt Sandra den , Hobo Barbara , Scheithauer Anna-Lena , Walter Jochen , Mulder Monique T , Exley Christopher , Mold Matthew J. , Mielke Michelle M. , De Vries Helga E , Wouters Kristiaan , Hove Daniel L.A. van den , Berkes Dusan , Ledesma María Dolores , Verhaagen Joost , Losen Mario , Bieberich Erhard , Martinez-Martinez Pilar
Published: January 2021

Background: Dysregulation of ceramide and sphingomyelin levels have been suggested to contribute to the pathogenesis of Alzheimer’s disease (AD). Ceramide transfer proteins (CERTs) are ceramide carriers which are crucial for ceramide and sphingomyelin balance in cells. Extracellular forms of CERTs co-localize with amyloid-β (Aβ) plaques in AD brains. To date, the significance of these observations for the pathophysiology of AD remains uncertain.Methods: A plasmid expressing CERTL, the long isoform of CERTs, was used to study the interaction of CERTL with amyloid precursor protein (APP) by co-immunoprecipitation and immunofluorescence in HEK cells. The recombinant CERTL protein was employed to study interaction of CERTL with amyloid-β (Aβ), Aβ aggregation process in presence of CERTL, and the resulting changes in Aβ toxicity in neuroblastoma cells. CERTL was overexpressed in neurons by adeno associated virus (AAV) in a mouse model of familial AD (5xFAD). Ten weeks after transduction, animals were challenged with behavior tests for memory, anxiety and locomotion. At week twelve, brains were investigated for sphingolipid levels by mass spectrometry, plaques and neuroinflammation by immunohistochemistry, gene expression and/or immunoassay.Results: Here, we report that CERTL, binds to APP, modifies Aβ aggregation and reduces Aβ neurotoxicity in vitro. Furthermore, we show that intracortical injection of AAV, mediating the expression of CERTL, decreases levels of ceramide d18:1/16:0 and increases sphingomyelin levels in the brain of male 5xFAD mice. CERTL in vivo over-expression has a mild effect on animal locomotion, decreases Aβ formation and modulates microglia by decreasing their pro-inflammatory phenotype.Conclusion: Our results demonstrate a crucial role of CERTL in regulating ceramide levels in the brain, in amyloid plaque formation and neuroinflammation, thereby opening research avenues for therapeutic targets of AD and other neurodegenerative diseases.
Diet’s Cariogenicity and Healthfulness Index (DCHI) - A novel, comprehensive index for children
Authors: Shanbhog Raghavendra , HP Chanchala , KT Srilatha , B Madhushree , SN Manjunatha
Published: January 2021

Background:A realistic and tailored dietary advice plays a vital role in Preventive Dentistry. An appropriate diet analysis forms the bases for a precise dietary advice. Analysis of diet for its cariogenicity is a complex process thus performing a meaningful diet analysis is a challenge in routine clinical practice. Currently, very few tools are available for researchers or clinicians to assess children’s diet relating to caries risk. To the best of our knowledge an index that helps clinician to reduce composite diet diary information to a simple quantifiable interpretation is lacking. The current scientific paper presents a novel index that assesses the cariogenicity and healthfulness of child’s diet objectively and guides the professional to achieve pragmatic diet modification in the prevention of dental caries. Methods:A team comprised of specialist from division of Pediatric dentistry, Community medicine and Diet and Nutrition along with a pilot parent-child population of number 50 were involved in initial structuring of Diet’s Cariogenicity and Healthfulness Index.To obtain cut off values for cariogenicity of diet score a study was carried out with sample of 774 children correlating diet diary with caries status. A Receiver Operating Characteristic curve closest to the ideal of 100% sensitivity and 100% specificity was applied for statistical analysis.Results:Receiver Operating Characteristic curves plotted was 22.5 for diet scores for its cariogenicity. The sensitivity, specificity, and area under the curve of these cut‐off values were 70 and 95.Conclusions:The current scientific paper presents a novel Diet’s Cariogenicity and Healthfulness Index that assesses the cariogenicity and healthfulness of child’s diet objectively so as to guide the professional to achieve a pragmatic diet modification.
Lifestyle Exercise Attenuates Immunosenescence; Flow Cytometry Analysis
Authors: Tylutka Anna , Morawin Barbara , Gramacki Artur , Zembron-Lacny Agnieszka
Published: January 2021

Background: Interaction of physical activity and overall immune profile is very complex and depends on the intensity, duration and frequency of undertaken physical activity, the exposure to cytomegalovirus (CMV) infection and the age-related changes in the immune system. Daily physical activity, which particularly influences immunity, declines dramatically with age. Therefore, the aim of the study was to explain whether physical activity sustained throughout life can attenuate or reverse immunosenescence. Methods: Ninety-nine older adults (60-90 years) were recruited for the study. According to the 6-min walk test (6WMT), the Åstrand-Ryhming bike test (VO2max) and Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire, the individuals were classified as physically active (n=34) and inactive (n=20) groups. The analysis of T lymphocytes between active vs. inactive participants was performed using eight-parameter flow cytometry.Results: Analysis of the baseline peripheral naïve and memory T lymphocytes showed a significant relationship of lifestyle exercise with CD4/CD8 ratio. Above 50% of physically active participants demonstrated the CD4/CD8 ratio ≥1 or ≤2.5 contrary to the inactive group who showed the ratio <1. The elderly with the result of 6WMT >1.3 m/s and VO2max >35 mL/kg/min had a significantly higher CD4+CD45RA+ T lymphocyte percentage and also a higher ratio of CD4+CD45RA+/CD4+CD45RO+.Interestingly, in active older adults with IgG CMV+ (n=30) the count of CD4+CD45RA+ T lymphocytes was higher than in the inactive group with IgG CMV+ (n=20). Conclusion: Based on the flow cytometry analysis, we concluded that lifestyle exercise could lead to rejuvenation of the immune system by increasing the percentage of naïve T lymphocytes or by reducing the tendency of the inverse CD4/CD8 ratio.
Risk Factors of Early Stage Residual Back Pain After Percutaneous Kyphoplasty or Vertebroplasty: A Retrospective Study of 853 Patients
Authors: Zhang Bo-bo , Yang Yi-min , Ren Zhi-wei , Yang Wei-zhou , Xiu Jin-tao , Zhang Yin-gang
Published: January 2021

Background: A small but significant proportion of patients experienced residual back pain after PVP or PKP treatment. The aim of the present study was to explore risk factors that may affect residual back pain after PKP or PVP. This study identified the risk factors of residual back pain after PKP or PVP, allowing proper intervention and improved clinical outcome.Methods: From January 2010 to January 2017, a total of 853 patients were treated by PVP or PKP at The First Affiliated Hospital of Xi’an Jiaotong University. We recorded the Visual Analog Scale (VAS) scores. Patients with a VAS score > 3 post-operatively and at the 1 month follow-up evaluation were grouped into the “residual back pain” group. The others were grouped into the control group. The following possible risk factors were collected: age; gender; weight; bone mineral density (BMD); surgical approach; surgical type; cement distribution; anesthesia; hypertension; diabetes; smoking; alcohol consumption; vertebral fracture type, and vertebral fracture location. Risk factors associated with residual back pain were evaluated using logistic regression analysis.Results: The incidence of residual back pain after PVP/PKP is 9.61%. Results showed that cement distribution, smoking, vertebral fracture type and vertebral fracture location were independently associated with residual back pain after PVP or PKP in the early post-operative stage. Conclusion: Unsatisfactory cement distribution, smoking history, osteogenic vertebral tumors, osteolytic vertebral tumors, and thoracic fractures were independently associated with residual back pain after PVP or PKP at the early post-operative stage.
Genome sequence analysis of the beneficial Bacillus subtilis PTA-271 isolated from a Vitis vinifera (cv. Chardonnay) rhizospheric soil: assets for sustainable biocontrol.
Authors: LEAL Catarina , Fontaine Florence , Aziz Aziz , Egas Conceiçao , Clement Christophe , Trotel-Aziz Patricia
Published: January 2021

Background: Bacillus subtilis strains have been widely studied for their numerous benefits in agriculture, including viticulture. Providing several assets, B. subtilis spp. are described as promising plant-protectors against many pathogens and as influencers to adaptations in a changing environment. This study reports the draft genome sequence of the beneficial Bacillus subtilis PTA-271, isolated from the rhizospheric soil of healthy Vitis vinifera cv. Chardonnay at Champagne Region in France, attempting to draw outlines of its full biocontrol capacity.Results: The PTA-271 genome has a size of 4,001,755 bp, with 43.78% of G + C content and 3,945 protein coding genes. The draft genome of PTA-271 putatively highlights a functional swarming motility system hypothesizing a colonizing capacity and a strong interacting capacity, strong survival capacities and a set of genes encoding for bioactive substances. Predicted bioactive compounds are known to: stimulate plant growth or defenses such as hormones and elicitors, influence beneficial microbiota, and counteract pathogen aggressiveness such as effectors and many kinds of detoxifying enzymes.Conclusions: Plurality of the putatively encoded biomolecules by Bacillus subtilis PTA-271 genome suggests environmentally robust biocontrol potential of PTA-271, protecting plants against a broad spectrum of pathogens.
The seal louse (Echinophthirius horridus) in the Dutch Wadden Sea: investigation of vector-borne pathogens
Authors: Hirzmann Jörg , Ebmer David , Contreras Guillermo J. Sánchez , Rubio-García Ana , Magdowski Gerd , Gärtner Ulrich , Taubert Anja , Hermosilla Carlos
Published: January 2021

Background: Belonging to the anopluran family Echinophthiriidae, Echinophthirius horridus, the seal louse, has been reported to parasitize a broad range of representatives of phocid seals. So far, only few studies focused on vector function of echinophthiriid lice and knowledge on their role in pathogen transmission is still scarce. The current study aims to investigate the possible vector role of E. horridus parasitizing seals in the Dutch Wadden Sea.Methods: E. horridus seal lice were collected from 54 harbour seals (Phoca vitulina) and one grey seal (Halichoerus grypus) during their rehabilitation period at the Sealcentre Pieterburen, the Netherlands. DNA was extracted from pooled seal lice of individual seals for molecular detection of the seal heartworm Acanthocheilonema spirocauda, the rickettsial intracellular bacterium Anaplasma phagocytophilum, and the cell wall-less bacteria Mycoplasma spp. using PCR assays.Results: Seal lice from 35% of the harbour seals (19/54) and from the grey seal proved positive for A. spirocauda. The seal heartworm was molecularly characterised and phylogenetically analysed (rDNA, cox1). A nested PCR was developed for the cox1 gene to detect A. spirocauda stages in seal lice. A. phagocytophilum and a Mycoplasma species previously identified from a patient with disseminated ‘seal finger’ mycoplasmosis were detected the first time in seal lice. Conclusions: Our findings support the potential vector role of seal lice in transmission of A. spirocauda, and reveal new insights into the spectrum of pathogens occurring in seal lice. Studies on vector competence of E. horridus, especially for bacterial pathogens, are essentially needed in the future as these pathogens might have detrimental effects on the health of seal populations. Further, studies on the vector role of different echinophthiriid species infecting a wide range of pinniped hosts should be conducted to extend the knowledge of vector borne pathogens in seal lice.
SNX10 and PTGDS are Associated with the Progression and Prognosis of Cervical Squamous Cell Carcinoma
Authors: Jiang Pinping , Cao Ying , Gao Feng , Sun Wei , Liu Jinhui , Ma Ziyan , Xie Manxin , Fu Shilong
Published: January 2021

Background: Cervical cancer (CC) is the primary cause of death in women. This study sought to investigate the potential mechanism and prognostic genes of CC. Methods: We downloaded four gene expression profiles from GEO. The RRA method was used to integrate and screen differentially expressed genes (DEGs) between CC and normal samples. Functional analysis was performed by clusterprofiler. We built PPI network by Search Tool for the Retrieval of Interacting Genes Database (STRING) and selected hub modules via Molecular COmplex Detection (MCODE). CMap database was used to find molecules with therapeutic potential for CC. The hub genes were validated in GEO datasets, Gene Expession Profiling Interactive Analysis (GEPIA), immunohistochemistry, Cox regression analysis, TCGA methylation analysis and ONCOMINE were carried out. ROC curve analysis and GSEA were also performed to describe the prognostic significance of hub genes. Results: Functional analysis revealed that 147 DEGs were significantly enriched in binding, cell proliferation, transcriptional activity and cell cycle regulation. PPI network screened 30 hub genes, with CDK1 having the strongest connectivity with CC. Cmap showed that apigenin, thioguanine and trichostatin A might be used to treat CC(P<0.05). Eight genes (APOD, CXCL8, MMP1, MMP3, PLOD2, PTGDS, SNX10 and SPP1) were screened out through GEPIA. Of them, only PTGDS and SNX10 had not appeared in previous studies about CC. The validation in GEO showed that PTGDS showed low expression in tumor tissues while SNX10 showed high expression in tumor tissues. Their expression profiles were consistent with the results in immunohistochemistry. ROC curve analysis indicated that the model had a good diagnostic efficiency(AUC=0.738). GSEA showed that the two genes were associated with the chemokine signaling pathway(P<0.05). TCGA methylation analysis showed that patients with lowly-expressed and highly-methylated PTGDS had a worse prognosis than those with highly-expressed and lowly-methylated PTGDS (p=0.037). Cox regression analysis showed that SNX10 and PTGDS were independent prognostic indicators for OS among CC patients(P=0.007 and 0.003). Conclusions: PTGDS and SNX10 showed abnormal expression and methylation in CC. Both genes might have high prognostic value of CC patients.
Morphological study of the vastus medialis oblique in recurrent patellar dislocation based on magnetic resonance images
Authors: Shu Lei , Yang Xu , He Hangyuan , Chen Biao , Chen Liaobin , Ni Qubo
Published: January 2021

Background: To investigate the morphological parameters of the vastus medialis obliquus (VMO) muscle and delineate its importance in the maintenance of patellofemoral joint stability.Methods: The magnetic resonance imaging (MRI) data of seventy-five knees (fifty-four patients) with recurrent lateral patella dislocation (LPD) and seventy-five knees (seventy patients) without recurrent LPD were retrospectively analysed. Five morphological parameters related to the VMO (elevation in the sagittal plane and coronal plane, craniocaudal extent, muscle-fibre angulation, cross-sectional area ratio) and two patella tilt parameters (patella tilt angle, bisect offset ratio) were measured in MR images. The independent-samples t test or chi-square test was used for statistical comparisons.Results: The mean ages of the patients in the recurrent LPD group and control group were 22.1 ± 9.9 years and 24.0 ± 6.5 years, respectively. Eighteen out of seventy-five (24%) patients MRI showed VMO injuries. Compared with the control group, the patients with recurrent LPD showed significantly higher sagittal VMO elevation (10.4 ± 2.3 mm vs 4.1 ± 1.9 mm), coronal VMO elevation (15.9 ± 5.7 mm vs 3.9 ± 3.7 mm), muscle-fibre angulation (35.4 ± 8.0° vs 27.9 ± 6.3°), patella tilt angle (25.9 ± 10.7° vs 9.1 ± 5.2°), and bisect offset ratio values (0.9 ± 0.3 vs 0.5 ± 0.1) and significantly lower craniocaudal extent (13.7 ± 5.3 mm vs 16.7 ± 5.1 mm) and cross-sectional area ratio values (0.05 ± 0.02 vs 0.07 ± 0.02).Conclusions: The results showed that abnormalities in the VMO and patella tilt were clearly present in recurrent LPD patients compared with normal people.
Differences on Pyrexia Related Immune Responses between SARS-CoV-2 and Influenza-A-infected Children: A Retrospective Study
Authors: Kou Shanglong , Zhan Senlin , Li Xiaohe , Zhang Mingxia , Deng Guofang , Pan Yanchao , Yuan Jing
Published: January 2021

Background: The ongoing pandemic of COVID‐19 has led to an unprecedented global crisis with problems of fragmentation in healthcare services in many severely affected countries. A key issue is distinguishing the clinical manifestations of COVID-19 from other respiratory infectious disease, especially in children and teens.Methods: To provide precise and comprehensive information on SARS-CoV-2 infected children, a total 62 hospitalized patients, aged from 1 to 14 years old and confirmed with the infection of either SARS-CoV-2 or influenza A virus, were enrolled from September 2019 to February 2020. The epidemiological, clinical and laboratory characteristics, as well as the outcomes of these pediatric patients were collected, followed by comparisons and regression analysis on clinical features and hematological parameters among the COVID-19 patients and the flu patients.Results: We reported that SARS-CoV-2 infected children showed less fever (43.33% vs 100%, p<0.001) with mild elevation of the body temperature (p<0.001), as well as attenuated inflammatory responses in comparison with patients with influenza A infection. We further showed the significant correlations between initial body temperature and multiple immune parameters (white blood cell counts and inflammatory markers) among SARS-CoV-2 infected children. Conclusions: Children with SARS-CoV-2 infection were more likely to have mild symptoms and relatively slow progression with a hypo-inflammatory response. Furthermore, the correlation results suggested that distinct immune responses were involved during SARS-CoV-2 infection.
Dietary Intakes of Total Polyphenol and Its Subclasses in Association with the Incidence of Chronic Kidney Diseases: A Prospective Population-based Cohort Study
Authors: Mirmiran Parvin , Yuzbashian Emad , Rahbarinejad Pegah , Asghari Golaleh , Azizi Fereidoun
Published: January 2021

Background: As chronic kidney disease (CKD) is amongst the current global health challenges, this study is aiming to evaluate the long-term intake of total polyphenol and its subclasses in association with CKD incidence. Methods: For the purpose of this study, a sample of 3021 Iranian adults (47% men, aged 20-79 years) with no CKD diagnosis at baseline, were selected from the Tehran Lipid and Glucose Study population. The total intake of polyphenol and its major subclasses were assessed by a validated food frequency questionnaire and categorized as flavonoids, phenolic acids, stilbenes, and lignans. Although the morphological abnormalities of the kidneys or 3-month persistent urinalysis can distinctively define CKD, the glomerular filtration rate (eGFR) reduction is accepted as a more precise index of renal function. Therefore, eGFR <60 mL/min/1.73m2 was the exclusive index of CKD diagnosis in the current study. The eGFR was calculated by the Modification of Diet in Renal Disease Study equation. Cox-regression analysis was used to assess the hazard ratio and 95% confidence intervals of CKD in quartiles of the total polyphenols.Results: In this study, 355 CKD cases over 11,058.464 person-years was reported. The median (IQR) age of participants was 36 years (27-46) at baseline. Moderate intake of lignans (≤6.8 mg) was negatively associated with the incidence of CKD in the adjusted model. No significant associations were detected between higher amounts of lignin and total polyphenols (HR: 0.97, 95% CI 0.67-1.40) and CKD incidence. Conclusions: Based on the current findings, moderate intake of lignin possess CKD-protective properties by approximately 32%. No independent associations were observed between higher amounts of lignins and CKD incidence.
An exploratory study to estimate cost-effectiveness threshold value for life saving treatments in western Iran
Authors: Moradi Najmeh , Woldemichael Abraha , Malekian Parisa , Rotavandi Delnia Moradi , Rezaei Satar
Published: January 2021

Background: Cost-effectiveness analysis provides a crucial means for evidence-informed decision-making on resource allocation. This study aims to elicit individuals' willingness to pay (WTP) for one additional quality-adjusted life-year (QALY) gained from life-saving treatment and associated factors in Kermanshah city, western Iran.Methods: We conducted a cross-sectional study on a total of 847 adults aged 18 years and above to elicit their WTP for one additional QALY gained by oneself and a family member using a hypothetical life-saving treatment. We used a multistage sampling technique to select the samples, and the Iranian version of EQ-5D-3L, and visual analogue scale (VAS) measures to obtain the participants’ health utility value. The Tobit regression model was used to identify the factors affecting WTP per QALY values.Results: The mean WTP value and standard deviation (SD) was US$ 862 (3,224) for the respondents. The mean utility values using EQ-5D-3L and VAS methods for respondents were 0.779 and 0.800, respectively. Besides, the WTP for the additional QALY gained by the individual participants using the EQ-5D-3L and VAS methods were respectively US$ 1,202 and US$ 1,101, while the estimated value of the family members was US$ 1,355 (SD= 3,993). The Tobit regression models indicated that monthly income, education level, sex, and birthplace were statistically significantly associated (p < 0.05) with both the WTP for the extra QALY values using the EQ-5D-3L and the VAS methods. Educational level and monthly income also showed statistically significant relationships with the WTP for the additional QALY gained by the family members (p < 0.05). Conclusion: Our findings indicated that the participants' WTP value of the additional QALY gained from the hypothetical life-saving treatment was in the range of 0.20 to 0.24 of the gross domestic product (GDP) per capita of Iran. This value is far lower than the World Health Organization (WHO) recommended CE threshold value of one. This wide gap reflects the challenges the health system is facing and requires further research for defining the most appropriate CE threshold at the local level.
Nanomaterials induce different levels of oxidative stress, depending on the used model system: Comparison of in vitro and in vivo effects
Authors: Karkossa Isabel , Bannuscher Anne , Hellack Bryan , Wohlleben Wendel , Laloy Julie , Stan Miruna S. , Dinischiotu Anca , Wiemann Martin , Luch Andreas , Haase Andrea , von Bergen Martin , Schubert Kristin
Published: January 2021

Background: The immense variety and constant development of nanomaterials (NMs) raise the demand for a facilitated risk assessment, for which knowledge on NMs mode of actions (MoAs) is required. For this purpose, a comprehensive data basis is of paramountcy that can be obtained using omics. Furthermore, the establishment of suitable in vitro test systems is indispensable to follow the 3R concept and to master the high number of NMs. In the present study, we aimed at comparing NM effects in vitro and in vivo using a multi-omics approach. We applied an integrated data evaluation strategy based on proteomics and metabolomics to four silica NMs and one titanium dioxide-based NM. For in vitro investigations, rat alveolar epithelial cells (RLE-6TN) and rat alveolar macrophages (NR8383) were treated with different doses of NMs, and the results were compared to effects on rat lungs after short-term inhalations and instillations at varying doses with and without a recovery period.Results: Since the production of reactive oxygen species (ROS) is described to be a critical biological effect of NMs, and enrichment analyses confirmed oxidative stress as a significant effect upon NM treatment in vitro in the present study, we focused on different levels of oxidative stress. Thus, we found opposite changes for proteins and metabolites that are related to the production of reduced glutathione in alveolar epithelial cells and alveolar macrophages, illustrating that NMs MoAs depend on the used model system. Interestingly, in vivo, pathways related to inflammation were affected to a greater extent than oxidative stress responses. Hence, the assignment of the observed effects to the levels of oxidative stress was different in vitro and in vivo as well. However, the overall classification of “active” and “passive” NMs was consistent in vitro and in vivo.Conclusions: The consistent classification indicates both tested cell lines to be suitable for NM toxicity assessment even though the induced levels of oxidative stress strongly depend on the used model systems. Thus, the here presented results highlight that model systems need to be carefully revised to decipher the extent to which they can replace in vivo testing.
What is the impact of the Rashomon Approach in primary care education? : An educational case report of Implementing Dialogue and Improvisation into Medical Education
Authors: Takamura Akiteru , Imafuku Rintaro
Published: January 2021

Background:The excessive sub-divided or concrete pre-determined objectives found in the technological approach in contemporary medical education curricula may hinder the students’ spontaneous learning about diverse needs and values in care. However, medical professionals must learn the diversity for care or a variety of social factors of the patients influencing decision making in daily practice.Methods:We introduced a new method of curriculum development called the Rashomon approach. For testing the Rashomon approach, educational activities to teach the diversity in primary care were developed in four modules: 1) explication of the competency without specifying sub-objectives; 2) dialogue among multiple professional students; 3) visits and interviews of the patients; 4) dialogue with teachers' improvisation. The students’ outcomes and responses were quantitatively and qualitatively analyzed.Results:A total of 135 medical students joined this study in 2017. The descriptive data suggested that the key concepts of diversity in primary care were fully recognized and that the pre-determined general goals were achieved. Scores on the understanding of social factors in medicine, respect for other professionals, professional identity, and satisfaction with the course were very high.Conclusion:Instead of the technological approach, the Rashomon approach, in which only a general goal guides educational activities was used in this research. Improvisation and dialogue fit the approach and were potentially effective activities to learn the multifaceted practice of medicine. In an era of competency-based education, the Rashomon approach could be a very useful framework in primary care education.
The assessment of general movements in term and late-preterm infants diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by two years of age - A scoping review.
Authors: Seesahai Judy , Rotter Thomas , Luther Maureen , Maddalena Patricia , Church Paige Terrien , Asztalos Elizabeth , Banihani Rudaina
Published: January 2021

BACKGROUND The General Movements Assessment is a non-invasive and cost-effective tool with demonstrated reliability for identifying infants at risk for cerebral palsy. Early detection of cerebral palsy allows for implementation of early intervention, and is associated with better functional outcomes. No review to date has summarized the utility of the General Movements Assessment to predict cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy.METHODS We conducted a scoping review involving infants born greater than or equal to 34 weeks gestational age to identify all available evidence and delineate research gaps. We extracted data on sensitivity, specificity, positive and negative predictive value and described the strengths and limitations of the results. We searched five databases (MEDLINE, Embase, PsychINFO, Scopus and CINAHL). Two reviewers conducted all screening and data extraction independently. The articles were categorized according to key findings and a critical appraisal performed.RESULTS From the electronic database search, only two studies, case series, met all of the inclusion criteria. The total number of participants were 60. Neither of the final eligible studies included late-preterm neonates. Both studies reported on sensitivity, specificity, positive predictive and negative predictive value. The newer study reported that in the time period between term and 4-5 months post-term, that any cramped synchronized movements in this time period had results of 100% sensitivity and variable results for specificity, positive predictive value and negative predictive value. Neither of the studies had infants that received therapeutic hypothermia for Neonatal Encephalopathy.CONCLUSIONS The finding of cramped synchronized General Movements is a strong predictor for the diagnosis of cerebral palsy by two years of age in the term population with neonatal encephalopathy. The deficit of high quality research limits the applicability and so the general movements assessment should not be used in isolation when assessing this population.Systematic review registrationTitle registration with Joanna Briggs Institute. URL: http://joannabriggswebdev.org/research/registered_titles.aspx
The semi-dwarfing gene Rht-dp from dwarf Polish wheat (Triticum polonicum L.) is the “Green Revolution” gene Rht-B1b
Authors: Chai Songyue , Yao Qin , Zhang Xu , Xiao Xue , Fan Xing , Zeng Jian , Sha Lina , Kang Houyang , Zhang Haiqin , Li Jun , Zhou Yonghong , Wang Yi
Published: January 2021

Background: The wheat dwarfing gene increases lodging resistance, the grain number per spike and harvest index. Dwarf Polish wheat (Triticum polonicum L., 2n = 4x = 28, AABB, DPW), initially collected from Tulufan, Xinjiang, China, carries a semi-dwarfing gene Rht-dp on chromosome 4BS. However, Rht-dp and its dwarfing mechanism are unknown.Results: Homologous cloning and mapping revealed that Rht-dp is the ‘Green Revolution’ gene Rht-B1b. A haplotype analysis in 59 tetraploid wheat accessions showed that Rht-B1b was only present in T. polonicum. Transcriptomic analysis of two pairs of near-isogenic lines (NILs) of DPW×Tall Polish wheat (Triticum polonicum L., 2n = 4x = 28, AABB, TPW) revealed 41 differentially expressed genes (DEGs) as potential dwarfism-related genes. Among them, 28 functionally annotated DEGs were classed into five sub-groups: hormone-related signalling transduction genes, transcription factor genes, cell wall structure-related genes, reactive oxygen-related genes, and nitrogen regulation-related genes. Conclusions: These results indicated that Rht-dp is Rht-B1b, which regulates pathways related to hormones, reactive oxygen species, and nitrogen assimilation to modify the cell wall structure, and then limits cell wall loosening and inhibits cell elongation, thereby causing dwarfism in DPW.
Bayesian Network Models with Decision Tree Analysis for Management of Childhood Malaria in Malawi
Authors: Taneja Sanya B. , Douglas Gerald P. , Cooper Gregory F. , Michaels Marian G. , Druzdzel Marek J. , Visweswaran Shyam
Published: January 2021

Background: Malaria is a major cause of death in children under five years old in low- and middle-income countries such as Malawi. Accurate diagnosis and management of malaria can help reduce the global burden of childhood morbidity and mortality. Trained healthcare workers in rural health centers manage malaria with limited supplies of malarial diagnostic tests and drugs for treatment. A clinical decision support system that integrates predictive models to provide an accurate prediction of malaria based on clinical features could aid healthcare workers in the judicious use of testing and treatment. We developed Bayesian network (BN) models to predict the probability of malaria from clinical features and an illustrative decision tree to model the decision to use or not use a malaria rapid diagnostic test (mRDT).Methods: We developed two BN models to predict malaria from a dataset of outpatient encounters of children in Malawi. The first BN model was created manually with expert knowledge, and the second model was derived using an automated method. The performance of the BN models was compared to other statistical models on a range of performance metrics at multiple thresholds. We developed a decision tree that integrates predictions with the costs of mRDT and a course of recommended treatment. Results: The manually created BN model achieved an area under the ROC curve (AUC) equal to 0.60 that was statistically significantly higher than the other models. The BN models had high sensitivity and specificity values (0.74 and 0.42 respectively for the manual BN model, 0.45 and 0.68 respectively for the automated BN model) at the optimal threshold for classification. The balanced accuracy values were similar across all the models. Sensitivity analysis of the decision tree showed that at low (below 0.04) and high (above 0.40) probabilities of malaria in a child, the preferred decision that minimizes expected costs is not to perform mRDT.Conclusion: In resource-constrained settings, judicious use of mRDT is important. Predictive models in combination with decision analysis can provide personalized guidance on when to use mRDT in the management of childhood malaria. BN models can be efficiently derived from data to support such clinical decision making.
Triple Threat; pancreatic cystic lesion presenting with spontaneous hemorrhage is found to harbor three distinct neoplasms.
Authors: Cha Da Eun , Horn Callie , Passeri Michael
Published: January 2021

BackgroundPancreatic serous cystadenoma (SCA) is a benign, cystic lesion with an indolent growth pattern. Complications such as spontaneous hemorrhage or malignant transformation from SCA are extremely rare. Our case report describes an unusual presentation of a patient with a previously diagnosed SCA, made unique by the presence of three separate neoplasms in the final specimen. Case PresentationA 74-year-old male with a previous diagnosis of SCA presented emergently with epigastric pain and non-bilious vomiting. Laboratory results were notable for a hemoglobin of 8.3 g/dl. CT scan of the abdomen demonstrated a complex, solid-cystic mass in the pancreatic head with a large hematoma and questionable focus of active hemorrhage. Surgical resection was recommended due to the risk of malignancy, possibility of re-bleeding, and symptoms of severe duodenal compression. Pancreaticoduodenectomy was performed, and final pathology demonstrated three separate neoplasms: serous cystadenoma, intraductal papillary mucinous neoplasm, and neuroendocrine tumor.Conclusion: While pancreatic SCA are benign tumors that can be observed safely in the majority of cases, surgical intervention is often indicated in patients with large, symptomatic cysts or when diagnosis is unclear. When undergoing surveillance, it is crucial for both the patient and the care team to be aware of the possibility of rare, but life-threatening complications, such as hemorrhage. Likewise, the possibility of misdiagnosis or concurrent neoplasia should be considered.
Comparison and Interpretation of Characteristics of Rhizosphere Microbial Communities in Three Blueberry Varieties
Authors: zhang Yan , Wang Wei , Shen Zhangjun , Wang Jingjing , Chen Yajun , Wang Dong , Liu Gang , Han Maozhen
Published: January 2021

Background: Studies on the rhizosphere microbiome of various plants proved that rhizosphere microbiota carries out various vital functions and can regulate the growth and improve the yield of plants. However, the rhizosphere microbiome of commercial blueberry was only reported by a few studies and remains elusive. Comparison and interpretation of the characteristics of the rhizosphere microbiome of blueberry are critical important to maintain its health. Methods: In this study, we collected 15 rhizosphere soil samples from three different blueberry varieties and five bulk soil samples, which were sequenced with a high-throughput sequencing strategy. Based on these sequencing datasets, we profiled the taxonomical, functional, and phenotypic compositions of rhizosphere microbial communities for three different blueberry varieties and compared our results with a previous study focused on the rhizosphere microbiome of blueberry varieties.Results: Our results demonstrated significant differences in alpha diversity and beta diversity of rhizosphere microbial communities of different blueberry varieties and bulk soil. The distribution patterns of taxonomical, functional, and phenotypic compositions of rhizosphere microbiome differ across the blueberry varieties. The rhizosphere microbial communities of three different blueberry varieties could be distinctly separated, and 28 discriminative biomarkers were selected to distinguish these three blueberry varieties. Core rhizosphere microbiota for blueberry was identified, and it contained 201 OTUs, which were mainly affiliated with Proteobacteria, Actinobacteria, and Acidobacteria. Moreover, the interactions between OTUs of blueberry rhizosphere microbial communities were explored by a co-occurrence network of OTUs from an ecological perspective. Conclusions: This pilot study explored the characteristics of blueberry’s rhizosphere microbial community, such as the beneficial microorganisms and core microbiome, and provided an integrative perspective on blueberry’s rhizosphere microbiome, which beneficial to blueberry health and production.
The -172A>G polymorphism in ADAM17 promoter region enhances its binding to EGR1 and confers susceptibility to sepsis progression
Authors: Shao Yiming , Zhang Wenying , Zhao Tian , Lu Furong , Hong Yuan , Liu Lizhen , Cai Yujie , Wei Ning , Cheng HongXiao , Chen Feng , He Junbing , Cui Lili
Published: January 2021

Background: A disintegrin and metalloproteinase 17 (ADAM17) is a proteolytic cleaving protein with a crucial function in inflammatory responses, especially sepsis. But the clear role of ADAM17 in sepsis and the underlying mechanism remained unknown. In this study, we aim to determine the clinical relevance of the ADAM17 rs12692386 (-172A>G) promoter polymorphism in sepsis progression and to further explore the effect and mechanism of the early growth response 1 (EGR1) /ADAM17 pathway in the inflammatory process following sepsis. Methods: A case-control study with a total of 903 sepsis patients and 1150 controls were enrolled to determine the association of ADAM17 -172A>G polymorphism with sepsis. The transcription factor binding to the promoter region of ADAM17 gene was predicted by bioinformatics analysis and verified by Chromatin Immunoprecipitation (ChIP) and luciferase assays. Quantitative real-time PCR and Western blot were performed to detect EGR1 and ADAM17 expression. Cytokine production was detected by enzyme-linked immunosorbent assay. The effect of EGR1/ADAM17 pathway on sepsis-induced inflammatory responses was evaluated in EGR1-silenced cells and endotoxemia mouse model.Results: Patients with sepsis subtype exhibited significantly lower frequencies of the -172AG/GG genotypes compared to those with severe sepsis (29.3% vs. 45.9%, P=0.0002) or septic shock (29.3% vs. 42.4%, P=0.0032). The frequency of -172G allele in the 28-day non-surviving patients was significantly higher than that in the surviving patients (29.3% vs. 21.8%, P=0.0188). The results of in vitro lipopolysaccharide-stimulated and luciferase assays indicated that the −172 A-to-G variation could functionally upregulate promoter activity and transcription of ADAM17 gene via enhancing the binding affinity of its promoter region with the EGR1. The ChIP assay identified the direct interaction. Further studies demonstrated that the EGR1/ADAM17 intervention could significantly decrease the pro-inflammatory cytokine secretion in vitro and improve the survival and inflammatory response of sepsis mouse model.Conclusions: These results provide evidence that the ADAM17 -172A>G polymorphism can functionally enhance ADAM17 expression and promote sepsis-induced inflammatory responses via the EGR1/ADAM17 pathway, which ultimately promote sepsis progression and poor prognosis.
Memory seeds enable high structural phase purity in 2D perovskite films for high-efficiency devices
Authors: Sidhik Siraj , Li Wenbin , Samani Mohammad H. K. , Zhang Hao , Wang Yafei , Hoffman Justin , Fehr Austin K. , Wong Michael , Katan Claudine , Even Jacky , Marciel Amanda B. , Kanatzidis Mercouri , Blancon Jean-Christophe , Mohite Aditya
Published: January 2021

Two-dimensional (2D) perovskites are a class of halide perovskites offering a pathway for realizing efficient and durable optoelectronic devices. However, the broad chemical phase space and lack of understanding of film formation have led to quasi-2D perovskite films with polydispersity in perovskite layer thicknesses, which have hindered devices performance and stability. Here, we demonstrate a scalable approach involving dissolution of single-phase crystalline powders with homogeneous perovskite layer thickness in desired solvents, to fabricate 2D perovskite thin-films with high phase purity. In-situ characterizations reveal the presence of sub-micron-sized seeds in solution that preserve the memory of the dissolved single-crystals and dictate the nucleation and growth of grains with identical thickness of the perovskite layers in thin-films. Photovoltaic devices fabricated with such films, yields an efficiency of 17.1% and 1.20V open-circuit voltage, while preserving 97.5% of their peak-performance after 800 hours under illumination without any external thermal management.
A Comparative Study of Dexmedetomidine and Clonidine for Attenuation of Hemodynamic Response during Laryngoscopy and Intubation
Authors: Gupta Sanjay Kumar , Singhal Saurabh
Published: January 2021

Background: The present study was conducted to compare dexmedetomidine and clonidine for attenuation of hemodynamic response during laryngoscopy and intubation. Subjects and Methods: Group I patients received 0.9% normal saline (placebo), group II patients received 0.5 µg/kg of dexmedetomidine and group III patients received 3 µg/kg of or clonidine. Each group had 15 patients. Results: The mean age in group I was 28.2 years, in group II was 32.1 years and in group III was 33.2 years, mean weight was 61.2 years, in group II was 60.4 years and in group III was 62.1 years, height was 156.2 cm, in group II was 157.1 cm and in group III was 152.8 cm. There were 8 males and 7 females in group I, 6 males and 9 females in group II and 7 males and 8 females in group III. The mean SBP (mm Hg) in group I was 121.4 and in group II was 122.6, and in group III was 127.4, DBP (mm Hg) was 76.2 in group I, 78.4 in group II and 78.2 in group III. MAP (mm Hg) was 86.7 in group I, 93.2 in group II and 92.5 in group III. HR (bpm) was 74.2 in group I, 78.4 in group II and 77.3 in group III. % oxygen saturation was 98.2in group I, 98.5 in group II and 97.9 in group III. The difference was non- significant (P> 0.05). Conclusion: Authors found that both groups were equally effective in causing attenuation of hemodynamic response to endotracheal intubation.
Evaluation of Eﬃcacy of Transversus Abdominis Plane Block and Systemic Analgesia for Post-Operative Pain in Total Abdominal Hysterectomy: A Comparative Study
Authors: Viswanath Menaka , Kalathur Ravikrishna , K. Shanthini
Published: January 2021

Introduction: Management of post-operative Pain is gaining considerable attention with pain being recognized as the fifth vital sign. Post- operative pain management remains unresolved as pain is individualized and varies with surgery. The aim is to evaluate the analgesic efficacy of transverses abdominis plane block by continuous catheter technique and systemic analgesia for post-operative pain in total abdominal hysterectomy. Subjects and Methods: This randomized controlled trial was done in patients undergoing total abdominal hysterectomy via Pfannenstiel incision. Patients were assigned into 2 groups, systemic analgesics group (n=25) and TAP block group (n=25) randomly. Results: Out of 50 patients, 25 patients had systemic analgesics and 25 patients had TAP block. Demographics and surgical procedure times were comparable. Mean VAS pain score with coughing on day 1 and 2 in systemic analgesics group was 3.96 and 2.07 and in TAP block group were

0.7 and 0.3. Meantime taken to mobilize the patient after the surgery in the systemic analgesics group was 30.7 hours and in TAP block group was 22.4 hour. 18 patients needed rescue medication in the systemic analgesics group, and 9 patients required rescue medication in the TAP block group. In group 16 patients with systemic analgesics had post-operative nausea and vomiting, and 5 patients in group block TAP. Conclusion: Continuous TAP block provides better pain relief, denoted by lower visual analogue scores and better recovery profile enhancing recovery in patients undergoing abdominal hysterectomy.