bluuebunny/crossref_metadata_2025 huggingface dataset:
Mitigating Information Overload: An Experiential Exercise Using Role-Play to Illustrate and Differentiate Theories of Motivation
Authors: Afota Marie-Colombe , Robinson Melanie A.
Published: July 2020

Work motivation is a core component of many management courses. However, its effective teaching can be hampered by the fragmentation and seeming incoherence of the various theories of work motivation. To address this challenge, we describe an interactive role-play activity that induces students to synthesize, apply, and compare several theories of motivation. In the first part of the exercise, students work in small groups to prepare a role-play skit illustrating a specific theory of motivation. In the second part, groups present their role-play skits in front of the class, and the rest of the students try to determine which theories were performed. Next, the debriefing session encourages students to discuss, compare, and contrast the theories. Though the present exercise focuses on four theories—the hierarchy of needs, the two-factor theory, expectancy theory, and self-determination theory—the activity can be easily adapted to incorporate other models of motivation.
The Creatures Collective: Manifestings
Authors: Hernández KJ , Rubis June M , Theriault Noah , Todd Zoe , Mitchell Audra , Country Bawaka , Burarrwanga Laklak , Ganambarr Ritjilili , Ganambarr-Stubbs Merrkiyawuy , Ganambarr Banbapuy , Maymuru Djawundil , Suchet-Pearson Sandie , Lloyd Kate , Wright Sarah
Published: July 2020

This piece explores the work and entanglements of our research collective, formed in 2016. First, we collectively articulate the ethos and the motivations that inform the ways in which we labor to engage with complex, plural, multi-vocal experiences of extinction, “the Anthropocene,” and earth violence as they are felt and known across the diverse communities we represent. Then, drawing on more than three years of work across relations that tie us to Australia, Canada, Malaysian Borneo, the Philippines, and the United States of America, we share reflections on some of the vital relationships, methods, and “creatures” that animate our collaboration. This collection of “manifestings” aims to show how we work, very consciously, to foster more-than-human capacities for confronting the multi-scalar, cross-cosmological forms of violence that drive extinction and other forms of ecological harm in the world today.
Near-fault seismic risk assessment of simply supported bridges
Authors: Zhong Jian , Jiang Linwei , Pang Yutao , Yuan Wancheng
Published: July 2020

Bridges tend to sustain excessive seismic demand (e.g. displacement) under pulse-like ground motions attributing to the effect of forward directivity, which is of high likely to occur at locations near the fault rupture. This study tries to incorporate the pulse effect into the probabilistic seismic hazard analysis (PSHA) and probabilistic seismic demand analysis (PSDA) framework, which are combined to quantify the risk of earthquake-induced damage in the near-fault location. The near-fault PSDA and PSHA are established and connected conditioned on peak ground velocity (PGV). Four sets of typical simply supported bridge types with the varying heights, representing the range of the period, are simulated by taking account the strength and stiffness degradation associated with material and geometry nonlinearity. The detailed investigation of the near-fault seismic risk is performed for these bridge models located at representative near-fault sites namely 5, 10, 15, and 20 km, respectively. The results reveal that near-field directivity effect strongly impacts the bridge damage risk with the observation of higher risk at the closer site; the bridges with the period of approximately Tp/2(pulse period) tend to experience the highest seismic risk, and the relative vulnerability of four bridge types is also compared.
The effect of spectral shape on damping modification factors
Authors: Miranda Sebastián , Miranda Eduardo , Carlos de la Llera Juan
Published: July 2020

The main objective of this study is to investigate the effect of spectral shape on damping modification factors η used in equivalent static and response spectrum analyses of structures with damping ratios that are different from 5% critical damping. Record-to-record variability of η is also evaluated through a statistical analysis of 5270 ground motions records from 1137 interface earthquakes recorded in Chile. The effect of spectral shape is studied using recently developed spectral shape metrics SaRatio and epsilon [Formula: see text] and evaluating their use as possible predictors for η. Similarly to previous investigations, this article also examines the effect of oscillator period, earthquake magnitude, and earthquake duration for different levels of damping ratio. Results suggest that SaRatio is an effective predictor of η, particularly for highly damped structures. However, results also indicate that for rock and firm sites, earthquake faulting mechanism and site class do not have a significant influence on η. A simple period-independent regression model for η as a function of SaRatio and damping ratio is proposed. A comparison between median η from this study and those in current Chilean seismic codes shows that code factors are unconservative.
Development of an interactive curriculum and trainee-specific preparedness plan for emergency medicine residents
Authors: Walker Ayanna D. , Fusco Nicholas , Tsau Joshua , Ganti Latha
Published: July 2020

Objectives

To create an interactive mass casualty incident (MCI) curriculum for emergency medicine residents and to integrate them into the hospital disaster response, thereby creating a “trainee-specific emergency preparedness plan.”

Methods

We created an interactive MCI curriculum and “trainee-specific emergency preparedness plan” for emergency medicine residents. The curriculum consisted of lectures, a small focus group, a triage activity, and the designation of a resident disaster champion to collaborate with hospital leadership to implement a “trainee-specific emergency preparedness plan” for the upcoming hospital disaster drill.

Results

Residents gave positive feedback on the new curriculum and retained information from the education. All resident teams accurately triaged at least 78% of the disaster scenarios. The residents also created a “trainee-specific emergency preparedness plan” for the upcoming hospital disaster drill, utilizing principles they learned from their MCI lessons. By allowing the residents to have an active role in the design and implementation of the new resident integrated disaster management plan, there was a general consensus of increased interest and retention of what was learned, as well as an increased comfort level in participating in MCI scenarios. Residents did not feel cursory to the planning; they became a part of the planning and felt more involved. Through this exercise, residents were able to give feedback to the hospital leadership that further shaped the disaster response plan. We also found that integration of the emergency medicine residents into the hospital response doubled the amount of active physicians available.

Conclusion

An interactive-based MCI curriculum is more engaging and may foster more retention than the traditional lecture approach. Resident involvement in the hospital disaster response is paramount as more hospitals are becoming teaching hospitals and mass casualty incidents are inevitable.
Ethical perceptions towards real-world use of companion robots with older people and people with dementia: survey opinions among younger adults
Authors: Bradwell Hannah L. , Winnington Rhona , Thill Serge , Jones Ray B.
Published: July 2020

Background

Use of companion robots may reduce older people’s depression, loneliness and agitation. This benefit has to be contrasted against possible ethical concerns raised by philosophers in the field around issues such as deceit, infantilisation, reduced human contact and accountability. Research directly assessing prevalence of such concerns among relevant stakeholders, however, remains limited, even though their views clearly have relevance in the debate. For example, any discrepancies between ethicists and stakeholders might in itself be a relevant ethical consideration while concerns perceived by stakeholders might identify immediate barriers to successful implementation.

Methods

We surveyed 67 younger adults after they had live interactions with companion robot pets while attending an exhibition on intimacy, including the context of intimacy for older people. We asked about their perceptions of ethical issues. Participants generally had older family members, some with dementia.

Results

Most participants (40/67, 60%) reported having no ethical concerns towards companion robot use when surveyed with an open question. Twenty (30%) had some concern, the most common being reduced human contact (10%), followed by deception (6%). However, when choosing from a list, the issue perceived as most concerning was equality of access to devices based on socioeconomic factors (m = 4.72 on a scale 1–7), exceeding more commonly hypothesized issues such as infantilising (m = 3.45), and deception (m = 3.44). The lowest-scoring issues were potential for injury or harm (m = 2.38) and privacy concerns (m = 2.17). Over half (39/67 (58%)) would have bought a device for an older relative. Cost was a common reason for choosing not to purchase a device.

Conclusions

Although a relatively small study, we demonstrated discrepancies between ethical concerns raised in the philosophical literature and those likely to make the decision to buy a companion robot. Such discrepancies, between philosophers and ‘end-users’ in care of older people, and in methods of ascertainment, are worthy of further empirical research and discussion. Our participants were more concerned about economic issues and equality of access, an important consideration for those involved with care of older people. On the other hand the concerns proposed by ethicists seem unlikely to be a barrier to use of companion robots.
Pre- and during-labour predictors of low birth satisfaction among Iranian women: a prospective analytical study
Authors: Nahaee Jila , Mohammad-Alizadeh-Charandabi Sakineh , Abbas-Alizadeh Fatemeh , Martin Colin R. , Hollins Martin Caroline J. , Mirghafourvand Mojgan , Hassankhani Hadi
Published: July 2020

Background

Maternal childbirth dissatisfaction has short- and long-term negative effects on the mothers’ health and life, as well as on relation with her child and family. Due to lack of studies in Iran and other counties, we aimed to determine pre- and during- labour predictors of low birth satisfaction.

Methods

Seven hundred women with low risk singleton pregnancy participated in this prospective analytical study. The participants were hospitalized for vaginal delivery with fetus in cephalic presentation and gestational age of 370–416at two teaching centers in Tabriz (Iran). Woman characteristics, anxiety state (using Spielberger inventory) and dehydration were assessed at cervical dilatation of 4–6 cm. Iranian (Persian) birth satisfaction scale-revised was applied 12–24 h after birth. Multiple linear regression was used to determine the predictors.

Results

Excluding 26 women who were outliers, 674 women were analyzed. The mean birth satisfaction score was 23.8 (SD 6.5) from an attainable score of 0–40. The during-labour predictors of low birth satisfaction score were severe and moderate anxiety, labour dystocia, insufficient support by staff, vaginal birth with episiotomy and tear, emergency cesarean section, labour induction and labour augmentation with oxytocin, and woman dehydration. The pre-labour predictors included being primiparous, sexual and emotional violence during pregnancy, gestational age of 400–416, preference for cesarean section, no attendance at pregnancy classes, and insufficient household income. The proportion of the variance explained by the during-labour variables was 75%, by pre-labour variables was 14% and by overall was 76%.

Conclusions

The controllable during-labour predictors explains most of the variance of the satisfaction score. It seems that responding to women’s physical and psychological needs during labour and applying less interventions could improve women’s childbirth satisfaction.
Protect MSM from HIV and other sexually transmitted diseases by providing mobile health services of partner notification: protocol for a pragmatic stepped wedge cluster randomized controlled trial
Authors: Yan Xiangyu , Li Yongjie , Su Hexuan , Xing Yi , Zhang Bo , Lu Zuhong , Jia Zhongwei
Published: July 2020

Background

Recently, more and more men who have sex with men (MSM) look for casual partners through online dating platforms in China. However, most are unable to know their partners’ HIV and other sexually transmitted diseases (STD) statuses, leading to the rapid increase in HIV infection among Chinese MSM. Effective partner notification is urgently needed to increase the risk awareness of MSM and prevent HIV and other STDs transmission. However, the traditional intervention mainly targets to the HIV-positive MSM and the effect is not promising. Our study aims to provide Internet-based partner notification, along with a series of health services for HIV-negative MSM to protect them from HIV and other STDs.

Methods

A pragmatic stepped wedge cluster randomized controlled trial design is used to evaluate the effectiveness of a new intervention paradigm, which aims to reduce HIV and other STDs incidences among MSM in China. Through integrating a mobile health (mHealth) service application (app) to the current HIV and other STDs prevention and control methods, the new paradigm provides partner notification of HIV, syphilis, hepatitis B, and hepatitis C statuses. A total of 6172 MSM in 16 districts of Beijing, China will be recruited and randomized to sequentially receive partner notification intervention through the app at 6-month intervals. The primary outcomes are HIV incidence and the additional cost of the intervention. The secondary outcomes include incidences of syphilis, hepatitis B, and hepatitis C, disease transmission social networks, testing adherence, knowledge of HIV and STDs control, health self-responsibility awareness, changes of high risk behaviors and other related outcomes. The generalized linear mixed models (GLMM) will be used to analyze the differences of outcomes in the control period and in the intervention period.

Discussion

We expect that the HIV incidence will be significantly lower and the secondary outcomes will also be improved with providing health service of partner notification through mhealth intervention. The feasible and affordable public health intervention paradigm will have implications for HIV and STDs prevention and control among MSM and other key populations.

Trial registration

ClinicalTrials.gov, NCT04349748. Registered on 16 April 2020.
Barriers to childhood immunization in sub-Saharan Africa: A systematic review
Authors: Bangura Joseph Benjamin , Xiao Shuiyuan , Qiu Dan , Ouyang Feiyun , Chen Lei
Published: July 2020

Background

Immunization to prevent infectious diseases is a core strategy to improve childhood health as well as survival. It remains a challenge for some African countries to attain the required childhood immunization coverage. We aim at identifying individual barriers confronting parents/caretakers, providers, and health systems that hinder childhood immunization coverage in Sub-Saharan Africa.

Method

This systematic review searched PubMed/MEDLINE, Web of Science and EMBASE. We restricted to published articles in English that focused on childhood immunization barriers in sub-Saharan Africa from January 1988 to December 2019. We excluded studies if: focused on barriers to immunization for children in other regions of the world, studied adult immunization barriers; studies not available on the university library, they were editorial, reports, reviews, supplement, and bulletins. Study designs included were cross-sectional, second-hand data analysis; and case control.

Results

Of the 2652 items identified, 48 met inclusion criteria. Parents/caretakers were the most common subjects. Nine articles were of moderate and 39 were of high methodological quality. Nine studies analyzed secondary data; 36 used cross-sectional designs and three employed case control method. Thirty studies reported national immunization coverage of key vaccines for children under one, eighteen did not. When reported, national immunization coverage of childhood vaccines is reported to be low. Parents/caretaker’ barriers included lack of knowledge of immunization, distance to access point, financial deprivation, lack of partners support, and distrust in vaccines and immunization programs. Other associated factors for low vaccine rates included the number of off-springs, lifestyle, migration, occupation and parent’s forgetfulness, inconvenient time and language barrier. Barriers at health system level cited by healthcare providers included limited human resources and inadequate infrastructures to maintain the cold chain and adequate supply of vaccines.

Conclusion

In this review we identified more thoroughly the parents/caretakers’ barriers than those of providers and health systems. Factors that influenced decisions to get children vaccinated were mainly their gender, beliefs, socio-culture factors in the communities in which they live. Thus it is vital that immunization programs consider these barriers and address the people and societies in their communities across sub-Saharan Africa.
A circRNA-miRNA-mRNA network plays a role in the protective effect of diosgenin on alveolar bone loss in ovariectomized rats
Authors: Zhang Zhiguo , Yue Lifeng , Wang Yuhan , Jiang Yanhua , Xiang Lihua , Cheng Yin , Ju Dahong , Chen Yanjing
Published: July 2020

Background

The present study aimed to assess the perturbation in circular RNA (circRNA)/mRNA expression profiles and a circRNA-miRNA-mRNA coexpression network involved in the potential protective effect of diosgenin (DIO) on alveolar bone loss in rats subjected to ovariectomy (OVX).

Methods

The Wistar rats (female) manipulated with sham operation were classified as the SHAM group and the grouping of OVX rats administered with DIO, estradiol valerate or vehicle for 12 weeks was DIO group, EV group and OVX group respectively. Following treatments, the plasmatic levels of osteocalcin and tumor necrosis factor-alpha and the microstructure of alveolar bone were assayed. Based on microarray analyses, we identified differentially expressed (DE) circRNAs and mRNAs in alveolar bone of rats in both OVX and DIO group. The DE circRNAs and DE mRNAs involved in the bone metabolism pathway validated by RT-qPCR were considered key circRNAs/mRNAs. On the basis of these key circRNAs/mRNAs, we predicted the overlapping relative miRNAs of key circRNAs/mRNAs, and a circRNA-miRNA-mRNA network was built.

Results

DIO showed an anti-osteopenic effect on the rat alveolar bone loss induced by OVX. In total, we found 10 DE circRNAs (6 downregulated and 4 upregulated) and 614 DE mRNAs (314 downregulated and 300 upregulated) in samples of the DIO group compared with those of the OVX group. However, only one circRNA (rno_circRNA_016717) and seven mRNAs (Sfrp1,Csf1,Il1rl1,Nfatc4,Tnfrsf1a,Pik3c2g, andWnt9b) were validated by qRT-PCR and therefore considered key circRNA/mRNAs. According to these key circRNA/mRNAs and overlapping predicted miRNAs, a coexpression network was constructed. After network analysis, one circRNA-miRNA-mRNA axis (circRNA_016717/miR-501-5p/Sfrp1) was identified.

Conclusion

The mechanism of DIO inhibiting alveolar bone loss after OVX is possibly relevant to the simultaneous inhibition of osteogenesis and osteoclastogenesis by mediating the expression of important molecules in the Wnt, PI3K, RANK/RANKL or osteoclastogenic cytokine pathways. The circRNA_016717/miR-501-5p/Sfrp1axis may play important roles in these processes.
Repeatedly heated mix vegetable oils-induced atherosclerosis and effects of Murraya koenigii
Authors: Ambreen Gul , Siddiq Afshan , Hussain Kashif , Hussain Abdul Saboor , Naz Zara
Published: July 2020

Background

Statins are considered as standard drugs to control cholesterol levels, but their use is also associated with renal hypertrophy, hemorrhagic stroke, hepatomegaly, and myopathy. Murraya koenigii is an herb that is used in traditional cuisine and as a medicine in South Asia. Here we assessed the antidyslipidemic and antiatherosclerotic effects of this spice in repeated heated mix vegetable oils (RHMVO)-induced atherosclerotic models.

Methods

Aqueous extract of M. koenigii leaves (Mk LE) was prepared and its phytoconstituents were determined. Rabbits were divided into 5 groups (n = 10). Except for the control group, all the other four groups were treated with RHMVO for 16 weeks (dose = 2 ml/kg/day) to induce dyslipidemia and atherosclerosis. These groups were further treated for 10 weeks either with 300 and 500 mg/kg/day Mk LE, lovastatin, RHMVO, or left untreated. Body and organ weights were measured along with oxidative stress and tissue damage parameters. Lipid profile and hepatic function markers were studied. Atheroma measurement and histopathological examination were also performed in control and treated groups.

Results

Mk LE significantly (p < 0.05) attenuated RHMVO-induced dyslipidemia and atheroma formation. Furthermore, fat accumulation and lipid peroxidation in hepatic tissues were reduced by Mk LE in a dose-dependent manner. Our results indicated that the antidyslipidemic effects of Mk LE in 500 mg/kg/day dose were comparable to lovastatin. Additionally, oxidative stress markers were reduced much more significantly in Mk LE-500 than in the statin group (p < 0.05).

Conclusions

This study recommends Mk LE as a potent antioxidant and lipid-lowering natural medicine that can attenuate the RHMVO-induced atherosclerotic in optimal doses and duration. Therefore, Mk LE can be accessible, cheap, and free of adverse effects alternate to statins.
Breast Cancer knowledge and perceived barriers to help seeking among pre-clinical and clinical female medical students of King Edward Medical University, Lahore: a cross-sectional study
Authors: Qasim Saleha , Tayyab Hamnah , Zulqadar Kainat , Masood Somer , Qasim Tahira Bano , Zubair Zainab
Published: July 2020

Background

Breast cancer is the most common form of cancer in women and second most common cancer after lung cancer. The prognosis of breast cancer depends on early detection and intervention which in turn relies upon awareness. Health workers in all communities are responsible for educating the population at risk. This study evaluates the knowledge regarding breast cancer, personal judgment of confidence, perceived barriers to help seeking and breast self-examination practices among Pakistani female medical students and studies the impact of clinical training on the studied variables.

Methods

Descriptive cross-sectional study design using self-administered validated questionnaires (BCAM-Breast Cancer Awareness Measure designed by Cancer Research UK) was employed. Female medical students enrolled in clinical and pre-clinical classes of King Edward Medical University, Lahore were targeted and questioned regarding symptoms, risk factors and their practices regarding breast cancer. Possible barriers to seeking help were also studied.

Result

The mean number of symptoms correctly identified was 6.7 ± 3.2 (5.5 ± 3.2 for pre-clinical and 7.8 ± 2.9 for clinical students) and for risk factors it was 4.3 ± 2.1 (3.7 ± 2.1 for pre-clinical and 4.7 ± 2.2 for clinical students). The difference in the level of perception of two groups was found to be significant (p < 0.001 for symptoms and p < 0.001 for risk factors). 38.7% of the subjects responded that they check their breasts rarely, 33.1% were fairly confident while 8.6% were very confident about detecting a change in their breast, 50.0% never noticed a change in their breast, and 77.4% will contact a doctor within a week or less of finding a change in their breast. Confidence about detecting a change significantly improved (p < 0.001) after the start of clinical training.

Conclusion

This study suggests that clinical training may have improved knowledge of female medical students regarding breast cancer; yet the knowledge related to the symptoms and risk factors of breast cancer and frequency of breast self-examination of female medical students is less than anticipated.
Data mining application to healthcare fraud detection: a two-step unsupervised clustering method for outlier detection with administrative databases
Authors: Massi Michela Carlotta , Ieva Francesca , Lettieri Emanuele
Published: July 2020

Background

The healthcare sector is an interesting target for fraudsters. The availability of a great amount of data makes it possible to tackle this issue with the adoption of data mining techniques, making the auditing process more efficient and effective. This research has the objective of developing a novel data mining model devoted to fraud detection among hospitals using Hospital Discharge Charts (HDC) in Administrative Databases. In particular, it is focused on the DRG upcoding practice, i.e., the tendency of registering codes for provided services and inpatients health status so to make the hospitalization fall within a more remunerative DRG class.

Methods

We propose a two-step algorithm: the first step entails kmeans clustering of providers to identify locally consistent and locally similar groups of hospitals, according to their characteristics and behavior treating a specific disease, in order to spot outliers within this groups of peers. An initial grid search for the best number of features to be selected (through Principal Feature Analysis) and the best number of local groups makes the algorithm extremely flexible. In the second step, we propose a human-decision support system that helps auditors cross-validating the identified outliers, analyzing them w.r.t. fraud-related variables, and the complexity of patients’ casemix they treated. The proposed algorithm was tested on a database relative to HDC collected by Regione Lombardia (Italy) in a time period of three years (2013-2015), focusing on the treatment of Heart Failure.

Results

The model identified 6 clusters of hospitals and 10 outliers among the 183 units. Out of those providers, we report the in depth the application of Step Two on three Hospitals (two private and one public). Cross-validating with the patients’ population and the hospitals’ characteristics, the public hospital seemed justified in its outlierness, while the two private providers were deemed interesting for a further investigation by auditors.

Conclusions

The proposed model is promising in identifying anomalous DRG coding behavior and it is easily transferrable to all diseases and contexts of interest. Our proposal contributes to the limited literature regarding behavioral models for fraud detection, identifying the most ’cautious’ fraudsters. The results of the first and the second Steps together represent a valuable set of information for auditors in their preliminary investigation.
Epidemiology and short-term outcomes of acute kidney injury among patients in the intensive care unit in Laos: a nationwide multicenter, prospective, and observational study
Authors: Sengthavisouk Noot , Lumlertgul Nuttha , Keomany Chanmaly , Banouvong Phonepadith , Senavong Phetvilay , Sayyaphet Sidavone , Binbundith Sakountala , Kulvichit Win , Peerapornratana Sadudee , Praditpornsilpa Kearkiat , Tungsanga Kriang , Eiam-Ong Somchai , Srisawat Nattachai
Published: July 2020

Background

Acute kidney injury (AKI) has become a global health issue. Little is known about the disease burden in Laos. We aimed to evaluate the burden and outcomes of AKI as well as assess the availability of AKI treatment in Laos.

Methods

We performed a multicentric prospective observational study in adult patients who had been admitted to 5 intensive care units (ICU) in Laos. The data was serially collected on the first 28 days of ICU admission. Patients were diagnosed by the KDIGO 2012 criteria for AKI. We used AKI occurrence as the primary outcome and explored risk factors on the development and outcomes of AKI.

Results

We enrolled 1480 patients from 5 ICU centers across Laos from January to December 2016. After excluding patients with end-stage renal disease and those with incomplete data, AKI occurred in 508 of the 1460 enrolled patients (34.8%). Overall, the rates of maximum AKI staging were 4% for stage 1, 10.3% for stage 2, and 20.5% for stage 3. Risk factors for AKI were older age, obesity, cardiovascular diseases, respiratory diseases, renal diseases, oncologic diseases, and chronic kidney diseases. Only 1.8% of all participants received RRT. The mortality rate was 28.4% in non-AKI patients compared to 44.5% in AKI patients, which increased according to the stage of AKI (stage 1, 4.9%; stage 2, 28.3%; stage 3 66.8%;P < 0.001). There were 13.6% who were discharged against medical advice.

Conclusions

AKI is a huge burden in Laos with under-recognition and poor outcomes.
Evaluation of buccal damage associated with acute inhalation exposure to 2,4-dichlorophenoxyacetic acid (2,4-D) in mice
Authors: Parizi José Luiz Santos , Tolardo Amanda Jodas , Lisboa Ana Carolina Gomes , Barravieira Bruna , de Azevedo Mello Fabíola , Rossi Renata Calciolari , Nai Gisele Alborghetti
Published: July 2020

Background

The herbicide dichlorophenoxyacetic acid (2,4-D) is one of the most widely used crop spraying products in the world. Some pesticides induce the degranulation of mast cells and increase allergic responses. This is the first study to evaluate the damage to the oral mucosa after an experimental simulation of environmental inhalation exposure to the 2,4-D herbicide. The aim of this study was evaluate the possible oral damage caused by acute inhalation exposure to the herbicide 2,4-D.

Results

There was a difference between the exposure concentrations in relation to tissue congestion intensity (p = 0.002) and mast cell counts (p = 0.002), a difference in the evaluation of the interaction between the exposure concentrations and nebulization time in the dorsum epithelium thickness (p = 0.013), and a significant correlation between the epithelial thickness and the number of nucleoli organizing regions on the dorsum of the tongue (p = 0.048).

Conclusions

Even after acute exposure, the herbicide 2,4-D had the potential to damage the oral epithelium, especially at higher doses.
Relationship of chest CT score with clinical characteristics of 108 patients hospitalized with COVID-19 in Wuhan, China
Authors: Zhang Jie , Meng Guangping , Li Wei , Shi Bingqing , Dong Hongna , Su Zhenzhong , Huang Qian , Gao Peng
Published: July 2020

Background

In December 2019, the outbreak of a disease subsequently termed COVID-19 occurred in Wuhan, China. The number of cases increased rapidly and spread to six continents. However, there is limited information on the chest computed tomography (CT) results of affected patients. Chest CT can assess the severity of COVID-19 and has sufficient sensitivity to assess changes in response to glucocorticoid therapy.

Objective

Analyze COVID-19 patients to determine the relationships of clinical characteristics, chest CT score, and levels of inflammatory mediators.

Methods

This retrospective, single-center case series of 108 consecutive hospitalized patients with confirmed COVID-19 at Tongji Hospital, Tongji Medical College of HUST (Wuhan, China) examined patients admitted from January 28 to February 20, 2020. Patient demographics, comorbidities, clinical findings, chest CT results, and CT scores of affected lung parenchyma were recorded. The relationships between chest CT score with levels of systemic inflammatory mediators were determined.

Results

All patients exhibited signs of significant systemic inflammation, including increased levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin, chest CT score, and a decreased lymphocyte (LY) count. Chest CT score had positive associations with white blood cell (WBC) count, CRP, ESR, procalcitonin, and abnormal coagulation function, and a negative association with LY count. Treatment with a glucocorticoid increased the LY count, reduced the CT score and CRP level, and improved coagulation function.

Conclusions

COVID-19 infection is characterized by a systemic inflammatory response that affects the lungs, blood, digestive system, and circulatory systems. The chest CT score is a good indicator of the extent of systemic inflammation. Glucocorticoid treatment appears to reduce systemic inflammation in these patients.
Nasal microbiota dominated by Moraxella spp. is associated with respiratory health in the elderly population: a case control study
Authors: van den Munckhof Ellen H. A. , Hafkamp Harriet C. , de Kluijver Josephine , Kuijper Ed J. , de Koning Maurits N. C. , Quint Wim G. V. , Knetsch Cornelis W.
Published: July 2020

Background

The elderly (≥65 years) are one of the populations most at risk for respiratory tract infections (RTIs). The aim of this study was to determine whether nasal and/or oropharyngeal microbiota profiles are associated with age and RTIs.

Methods

Nasal and oropharyngeal swabs of 152 controls and 152 patients with an RTI were included. The latter group consisted of 72 patients with an upper respiratory tract infection (URTI) and 80 with a lower respiratory tract infection (LRTI). Both nasal and oropharyngeal swabs were subjected to microbiota profiling using amplicon sequencing of the 16S rRNA gene. Moraxella species were determined using quantitative real-time PCR and culture.

Results

Based on the microbiota profiles of the controls and the patients with an RTI, eight nasal and nine oropharyngeal microbiota clusters were defined. Nasal microbiota dominated by either Moraxella catarrhalis or Moraxella nonliquefaciens was significantly more prevalent in elderly compared to mid-aged adults in the control group (p = 0.002). Dominance by M. catarrhalis/nonliquefaciens was significantly less prevalent in elderly with an LRTI (p = 0.001) compared to controls with similar age.

Conclusions

Nasal microbiota dominated by M. catarrhalis/nonliquefaciens is associated with respiratory health in the elderly population.
Mutations in fibroblast growth factor (FGF8) and FGF10 identified in patients with conotruncal defects
Authors: Zhou Shuang , Wang Qingjie , Meng Zhuo , Peng Jiayu , Zhou Yue , Song Wenting , Wang Jian , Chen Sun , Sun Kun
Published: July 2020

Background

Conotruncal defects (CTDs) are a type of heterogeneous congenital heart diseases (CHDs), but little is known about their etiology. Increasing evidence has demonstrated that fibroblast growth factor (FGF) 8 and FGF10 may be involved in the pathogenesis of CTDs.

Methods

The variants of FGF8 and FGF10 in unrelated Chinese Han patients with CHDs (n = 585), and healthy controls (n = 319) were investigated. The expression and function of these patient-identified variants were detected to confirm the potential pathogenicity of the non-synonymous variants. The expression of FGF8 and FGF10 during the differentiation of human embryonic stem cells (hESCs) to cardiomyocytes and in Carnegie stage 13 human embryo was also identified.

Results

Two probable deleterious variants (p.C10Y, p.R184H) of FGF8 and one deletion mutant (p.23_24del) of FGF10 were identified in three patients with CTD. Immunofluorescence suggested that variants did not affect the intracellular localization, whereas ELISA showed that the p.C10Y and p.23_24del variants reduced the amount of secreted FGF8 and FGF10, respectively. Quantitative RT-PCR and western blotting showed that the expression of FGF8 and FGF10 variants was increased compared with wild-type; however, their functions were reduced. And we found that FGF8 and FGF10 were expressed in the outflow tract (OFT) during human embryonic development, and were dynamically expressed during the differentiation of hESCs into cardiomyocytes.

Conclusion

Our results provided evidence that damaging variants of FGF8 and FGF10 were likely contribute to the etiology of CTD. This discovery expanded the spectrum of FGF mutations and underscored the pathogenic correlation between FGF mutations and CTD.
Neurological involvement in Kawasaki disease: a retrospective study
Authors: Liu Xiaoliang , Zhou Kaiyu , Hua Yimin , Wu Mei , Liu Lei , Shao Shuran , Wang Chuan
Published: July 2020

Background

Kawasaki disease (KD) is an acute, self-limiting systemic vasculitis that predominately affects children. Neurological involvement is a known complication of KD, however, its association with KD severity remains elusive. We aimed to systematically describe the general manifestations of neurological involvement in KD, determine whether neurological involvement is a marker of disease severity in patients with KD, and assess the relationship of such involvement with intravenous immunoglobulin (IVIG) resistance and coronary artery lesions (CALs).

Methods

We retrospectively reviewed data from 1582 patients with KD between January 2013 and December 2017. Profiles of patients with neurological symptoms (group A, n = 80) were compared to those of gender- and admission date-matched patients without neurological involvement (group B, n = 512). Multivariate logistic regression analyses were performed to determine whether neurological involvement was significantly associated with IVIG resistance.

Results

Neurological involvement was observed in 5.1% (80/1582) of patients with KD. The neurological manifestations were diffuse, presenting as headache (13/80, 16.3%), convulsions (14/80, 17.5%), somnolence (40/80, 50.1%), extreme irritability (21/80, 26.3%), signs of meningeal irritation (15/80, 18.8%), bulging fontanelles (7/80, 8.8%), and facial palsy (1/80, 1.3%). Neurological symptoms represented the initial and/or predominant manifestation in 47.5% (38/80) of patients with KD. The incidence of IVIG resistance and levels of inflammatory markers were higher in group A than in group B. However, neurological involvement was not an independent risk factor for IVIG resistance or CALs.

Conclusion

Rates of neurological involvement were relatively low in patients with KD. Neurological involvement was associated with an increased risk of IVIG resistance and severe inflammatory burden. Our results highlight the need for pediatricians to recognize KD with neurological involvement and the importance of standard IVIG therapy.

Trial registration

Retrospectively registered.
CX3CL1/CX3CR1 axis attenuates early brain injury via promoting the delivery of exosomal microRNA-124 from neuron to microglia after subarachnoid hemorrhage
Authors: Chen Xiao , Jiang Ming , Li Haiying , Wang Yang , Shen Haitao , Li Xiang , Zhang Yunhai , Wu Jiang , Yu Zhengquan , Chen Gang
Published: July 2020

Background

Microglial activation-mediated neuroinflammation is a major contributor to early brain injury (EBI) after subarachnoid hemorrhage (SAH). MicroRNA-124 (miR-124) is the most abundant miRNAs in the central nervous system (CNS) and plays a vital role in microglial activation by targeting protein CCAAT-enhancer-binding protein α (C/EBPα). It has been reported that the CX3CL1/CX3CR1 axis is involved in the delivery of miR-124 from neurons to microglia.

Methods

An experimental rat SAH model was established by injecting autologous arterial blood into the prechiasmatic cistern, and cultured primary neurons and microglia were exposed to oxyhemoglobin to mimic SAH in vitro. We additionally exploited specific expression plasmids encoding CX3CL1 and CX3CR1.

Results

We observed significant decreases in CX3CL1 and CX3CR1 in the brain tissues of SAH patients. We also observed decreases in the levels of CX3CL1 in neurons and CX3CR1 in microglia after SAH in rats. Moreover, microglia exhibited an activated phenotype with macrophage-like morphology and high levels of CD45 and major histocompatibility complex (MHC) class II after SAH. After overexpression of CX3CL1/CX3CR1, the level of CD45 and MHC class II and the release of inflammatory factors tumor necrosis factor α, interleukin 1α and complement 1q were significantly decreased. There was also increased neuronal degeneration and behavior dysfunction after SAH, both of which were inhibited by CX3CL1/CX3CR1 overexpression. Additionally, we found that the delivery of exosomal miR-124 from neurons to microglia was significantly reduced after SAH, accompanied by an increase in C/EBPα expression, and was inhibited by CX3CL1/CX3CR1 overexpression. In conclusion, the CX3CL1/CX3CR1 axis may play protective roles after SAH by promoting the delivery of exosomal miR-124 to microglia and attenuate microglial activation and neuroinflammation.

Conclusions

CX3CL1/CX3CR1 axis may be a potential intervention target for the inhibition of SAH-induced EBI by promoting exosome transport of miR-124 to microglia.
Technology for monitoring everyday prosthesis use: a systematic review
Authors: Chadwell Alix , Diment Laura , Micó-Amigo M. , Morgado Ramírez Dafne Z. , Dickinson Alex , Granat Malcolm , Kenney Laurence , Kheng Sisary , Sobuh Mohammad , Ssekitoleko Robert , Worsley Peter
Published: July 2020

Background

Understanding how prostheses are used in everyday life is central to the design, provision and evaluation of prosthetic devices and associated services. This paper reviews the scientific literature on methodologies and technologies that have been used to assess the daily use of both upper- and lower-limb prostheses. It discusses the types of studies that have been undertaken, the technologies used to monitor physical activity, the benefits of monitoring daily living and the barriers to long-term monitoring, with particular focus on low-resource settings.

Methods

A systematic literature search was conducted in PubMed, Web of Science, Scopus, CINAHL and EMBASE of studies that monitored the activity of prosthesis users during daily-living.

Results

Sixty lower-limb studies and 9 upper-limb studies were identified for inclusion in the review. The first studies in the lower-limb field date from the 1990s and the number has increased steadily since the early 2000s. In contrast, the studies in the upper-limb field have only begun to emerge over the past few years. The early lower-limb studies focused on the development or validation of actimeters, algorithms and/or scores for activity classification. However, most of the recent lower-limb studies used activity monitoring to compare prosthetic components. The lower-limb studies mainly used step-counts as their only measure of activity, focusing on the amount of activity, not the type and quality of movements. In comparison, the small number of upper-limb studies were fairly evenly spread between development of algorithms, comparison of everyday activity to clinical scores, and comparison of different prosthesis user populations. Most upper-limb papers reported the degree of symmetry in activity levels between the arm with the prosthesis and the intact arm.

Conclusions

Activity monitoring technology used in conjunction with clinical scores and user feedback, offers significant insights into how prostheses are used and whether they meet the user’s requirements. However, the cost, limited battery-life and lack of availability in many countries mean that using sensors to understand the daily use of prostheses and the types of activity being performed has not yet become a feasible standard clinical practice. This review provides recommendations for the research and clinical communities to advance this area for the benefit of prosthesis users.
Robotic assessment of rapid motor decision making in children with perinatal stroke
Authors: Hawe Rachel L. , Kuczynski Andrea M. , Kirton Adam , Dukelow Sean P.
Published: July 2020

Background

Activities of daily living frequently require children to make rapid decisions and execute desired motor actions while inhibiting unwanted actions. Children with hemiparetic cerebral palsy due to perinatal stroke may have deficits in executive functioning in addition to motor impairments. The objective of this study was to use a robotic object hit and avoid task to assess the ability of children with hemiparetic cerebral palsy to make rapid motor decisions.

Methods

Forty-five children with hemiparetic cerebral palsy due to perinatal stroke and 146 typically developing children (both groups ages 6–19 years) completed a robotic object hit and avoid task using the Kinarm Exoskeleton. Objects of different shapes fell from the top of the screen with increasing speed and frequency. Children were instructed to hit two specific target shapes with either hand, while avoiding six distractor shapes. The number of targets and distractors hit were compared between children with hemiparetic cerebral palsy and typically developing children, accounting for age effects. We also compared performance to a simpler object hit task where there were no distractors.

Results

We found that children with hemiparetic cerebral palsy hit a greater proportion of total distractors compared to typically developing children, demonstrating impairments in inhibitory control. Performance for all children improved with age. Children with hemiparetic cerebral palsy hit a greater percentage of targets with each arm on the more complex object hit and avoid task compared to the simpler object hit task, which was not found in typically developing children.

Conclusions

Children with hemiparetic cerebral palsy due to perinatal stroke demonstrated impairments in rapid motor decision making including inhibitory control, which can impede their ability to perform real-world tasks. Therapies that address both motor performance and executive functions are necessary to maximize function in children with hemiparetic cerebral palsy.
Chronic nerve health following implantation of femoral nerve cuff electrodes
Authors: Freeberg Max J. , Pinault Gilles C. J. , Tyler Dustin J. , Triolo Ronald J. , Ansari Rahila
Published: July 2020

Background

Peripheral nerve stimulation with implanted nerve cuff electrodes can restore standing, stepping and other functions to individuals with spinal cord injury (SCI). We performed the first study to evaluate the clinical electrodiagnostic changes due to electrode implantation acutely, chronic presence on the nerve peri- and post-operatively, and long-term delivery of electrical stimulation.

Methods

A man with bilateral lower extremity paralysis secondary to cervical SCI sustained 5 years prior to enrollment received an implanted standing neuroprosthesis including composite flat interface nerve electrodes (C-FINEs) electrodes implanted around the proximal femoral nerves near the inguinal ligaments. Electromyography quantified neurophysiology preoperatively, intraoperatively, and through 1 year postoperatively. Stimulation charge thresholds, evoked knee extension moments, and weight distribution during standing quantified neuroprosthesis function over the same interval.

Results

Femoral compound motor unit action potentials increased 31% in amplitude and 34% in area while evoked knee extension moments increased significantly (p < 0.01) by 79% over 1 year of rehabilitation with standing and quadriceps exercises. Charge thresholds were low and stable, averaging 19.7 nC ± 6.2 (SEM). Changes in saphenous nerve action potentials and needle electromyography suggested minor nerve irritation perioperatively.

Conclusions

This is the first human trial reporting acute and chronic neurophysiologic changes due to application of and stimulation through nerve cuff electrodes. Electrodiagnostics indicated preserved nerve health with strengthened responses following stimulated exercise. Temporary electrodiagnostic changes suggest minor nerve irritation only intra- and peri-operatively, not continuing chronically nor impacting function. These outcomes follow implantation of a neuroprosthesis enabling standing and demonstrate the ability to safely implant electrodes on the proximal femoral nerve close to the inguinal ligament. We demonstrate the electrodiagnostic findings that can be expected from implanting nerve cuff electrodes and their time-course for resolution, potentially applicable to prostheses modulating other peripheral nerves and functions.

Trial registration

ClinicalTrials.govNCT01923662, retrospectively registered August 15, 2013.