bluuebunny/crossref_metadata_2025 huggingface dataset:
Working with authentic texts in English in teaching future doctors on a bilingual basis
Authors: Glushchenko Oksana A.
Published: October 2020

The work is prepared as part of a study aimed at finding effective ways of teaching English to medical programmes students. The subject of the research is the tendencies of linguodidactics in non-linguistic programmes in Russian higher education. We consider methods focusing on the development of academic language competence, based on approaches related to the integration of authentic texts in the specialty into the study of the English language, among which one can single out content and language integrated learning (hereinafter – CLIL) and English for special purposes (hereinafter – ESP). They help to improve not only the language competence of future doctors, but also academic and cognitive. The use of these approaches makes it possible to im-prove the skills of foreign language communication in the framework of professional education without breaking a single methodic continuum, which is important because it contributes to an im-provement in the ratio of time costs and results without reducing the quality of education. Scientific novelty lies in the consideration of the competence-based approach in higher education from the position of bilingualism. In the course of the work, fundamental patterns of ontogeny of artificial bilingualism were discovered, which are adapted to the conditions of modern medical discourse, which determines the methods of research – deduction, abstraction and analysis. As a result, it was concluded that in order to comply with the requirements for the preparation of medical programmes students, it is necessary to develop the interlanguage to the level of fluent bilitarity. The results obtained can be used in the development of specialized training programs.
Dental implant therapy in the Brazilian Public System
Authors: Kinalski Mateus de Azevedo , Pires Ana Luiza Cardoso , Saporiti Júlia Machado , Santos Mateus Bertolini Fernandes dos
Published: October 2020

Aim: This retrospective study aims to describe and analyze the number of dental implants and implant-retained prostheses performed by the Unified Health System (SUS) in the last decade. Methods: This study is based on secondary data from the official government database (DATASUS) performed from January 2010 to December 2019 and is reported following the STROBE. A descriptive analysis was performed of the total sample and the stratified sample divided by Brazilian states. Results: A total of 143,037 dental implants and 93,325 implant-retained prostheses were provided by SUS. It is possible to observe that some states played a massive role on the provision of dental implants and implant-retained prostheses (Parana state: 58.4% and 55.9% and Paraiba state: 21.1% and 25.2% of the total amount of dental implants and implant-retained prostheses, respectively) while some states did not provide a single implant-retained prosthesis. Also, inland cities were mostly responsible for the number of procedures compared to the state capitals. Conclusion: Although dental implant therapy is available in SUS across the country, the number of treatments provided in the last decade is still very limited and is also mainly concentrated in the southeastern region of Brazil.
Avaliação dos efeitos microclimáticos de diferentes zonas climáticas locais em cidade de clima temperado
Authors: Krüger Eduardo , Pereira Natasha Hansen Gapski
Published: October 2020

O clima urbano é influenciado por características morfológicas e de uso e ocupação do solo. Aspectos como grau de verticalização, presença de vegetação e adensamento urbano influenciam diretamente sobre variáveis climáticas, gerando microclimas diferenciados na área urbana. Em relação ao conforto ambiental humano, a possibilidade de se prever fenômenos do clima urbano orienta decisões projetuais arquitetônicas e urbanísticas. Esta pesquisa teve por objetivo analisar diferenças térmicas intraurbanas a partir de dados meteorológicos coletados em estações amadoras participantes da rede Weather Underground, localizadas em diferentes zonas climáticas locais (Local Climate Zones - LCZs) em Londres, Inglaterra. Utilizaram-se dados meteorológicos de dez estações distribuídas nos eixos leste-oeste e norte-sul. Avaliou-se se as variações nos microclimas são significativas o bastante para suprir a demanda de energia para aquecimento e resfriamento de edificações, por meio do somatório de graus-hora de aquecimento e resfriamento para cada ponto. Pela análise do perfil longitudinal das temperaturas, a pesquisa constatou a formação de ilhas de calor nos locais com maior intensidade de uso e ocupação e menor cobrimento vegetal. Com relação à demanda por climatização artificial, notaram-se diferenças consideráveis em função da LCZ de cada ponto.
Compatibility of a Security Policy for a Cloud-based Healthcare System with the EU General Data Protection Regulation (GDPR)
Authors: Georgiou Dimitra , Lambrinoudakis Costas
Published: October 2020

Currently, there are several challenges that Cloud-based health-care Systems, around the world, are facing. The most important issue is to ensure security and privacy or in other words to ensure the confidentiality, integrity and availability of the data. Although the main provisions for data security and privacy were present in the former legal framework for the protection of personal data, the General Data Protection Regulation (GDPR) introduces new concepts and new requirements. In this paper, we present the main changes and the key challenges of the General Data Protection Regulation, and also at the same time we present how the Cloud-based Security Policy methodology proposed in [1] could be modified in order to be compliant with the GDPR and how Cloud environments can assist developers to build secure and GDPR compliant Cloud-based health Systems. The major concept of this paper is, primarily, to facilitate Cloud Providers in comprehending the framework of the new General Data Protection Regulation and secondly, to identify security measures and security policy rules for the protection of sensitive data in a Cloud-based Health System, following our risk-based Security Policy Methodology that assesses the associated security risks and takes into account different requirements from patients, hospitals, and various other professional and organizational actors.
A Comparative Analysis of Verb Synonyms from the Perspective of Valency Structure in the Context of 'Provide and Offer'
Authors: Hongxia Mei
Published: October 2020

This article reported a study of verb synonym’s valency structure based on corpus data, which clearly shows the affiliation between the word item and its governing member. This study analyzed ‘provide’ and ‘offer’ in British National Corpus from the perspective of types and frequency distribution of valency structures, action elements, the relevance between valency structure and its meaning. The results indicate the valency structure is characteristic and closely interrelated with word’s meaning. Therefore, this can give us some enlightenment in h distinguishing verb synonyms effectively and promoting the English vocabulary teaching.
Surgical Management of Open Fractures: The Right Time to Operate
Authors: Stephenson Bradley
Published: October 2020

The objective of this article was to determine the appropriate time between open fracture and treatment with antibiotics and surgical debridement. This clinical review will address the well-debated question: what is the urgency for surgical management in open fractures? The review will also address the parameters to best minimize infection rates. The review will look at the best antimicrobials needed for an open fracture. The overall goal of this clinical review was to allow physician assistants working in settings who require open fracture triage and management to understand the time constraint to deliver the best treatment for patients. The review also looks to address potential complications for patients with open fractures even when management is up to date with the standard of care. This is important because the debate continues among facilities, even among services within the same facility, about how soon an open fracture needs to be addressed.
Restructuring of an Orthopaedic Surgery Residency Research Rotation Correlates with Increased Academic Productivity in Teaching Faculty
Authors: Granger Caroline J. , Rothy Alexander , Nigh Evan , Hernandez Victor H. , Baraga Michael , Conway Sheila Ann
Published: October 2020

Introduction:

Contribution toward clinical research is paramount to the education of physician trainees and is required by the Accreditation Council for Graduate Medical Education. From 1987 through 2015, our single institution orthopaedic surgery residency research experience included 2 dedicated research rotations. Because few resident projects were pursued to completion, feedback was used to restructure the curriculum, including the appointment of 2 clinical orthopaedic faculty to serve as codirectors, development of a revised curriculum, use of research teams, and a centralized research database. Our group previously displayed increased resident productivity within 2 years after the 2015 implementation. The aim of this study was to investigate the impact of orthopaedic residency curricular changes on scholarly activity of orthopaedic teaching faculty.

Methods:

The curriculum vitae (CVs) of a single institution's orthopaedic teaching faculty were collected and retrospectively reviewed from 2014 through 2018 to determine academic productivity of clinical faculty. Indicators of academic productivity included peer-reviewed publications (including journal impact factors) and podium or poster presentations.

Results:

Twenty-three of 27 faculty members responded to our request for CVs. One hundred three CVs were reviewed on 23 faculty. All academic indicators increased over 5 years. Multivariate analysis of variance (MANOVA) using a multivariate repeated measures analysis was completed. A sphericity χ2 test was violated for all measures, precluding us from using unadjusted univariate analysis. Univariate MANOVA with repeated measures displays significance regarding impact factor (f < 0.02, p < 0.05) and journal publications (f < 0.004, p < 0.05). Subsequent multivariate analysis shows similar results regarding impact factor (f < 0.0008), journal publications (0.0005), and poster presentations (f < 0.016).

Conclusions:

Improved structure of an established resident research rotation combined with enhanced faculty mentorship resulted in a significant increase in academic productivity for clinical teaching faculty of the department of orthopaedic surgery. This increase parallels that seen in orthopaedic resident research productivity; indicating a positive impact on teaching faculty scholarly activity.

Level of Evidence:

III.
The Content and Accessibility of Orthopaedic Residency Program Websites
Authors: Sherman Nathan C. , C. Sorenson Jacob , M. Khwaja Ansab , L. DeSilva Gregory
Published: October 2020

Background:

Applicants to orthopaedic surgery residency programs face a competitive match. Internet resources such as program websites allow prospective applicants to gauge interest in particular programs. This study evaluated the content and accessibility of orthopaedic surgery residency program websites.

Methods:

Existing orthopaedic surgery residency programs for the 2020 application cycle were identified on the Electronic Residency Application Service (ERAS) website. Individual program websites were accessed through links directly from the ERAS website, and a Google search for each program was performed to corroborate accessibility. Programs websites were then reviewed and evaluated on the presence of 20 criteria selected for their potential to influence resident recruitment (10) and education (10), respectively. The results were compared with the lone 2001 study and with orthopaedic fellowship website analyses.

Results:

One hundred eighty-nine orthopaedic surgery residency programs were accredited at the time of the study. Only 6 programs (3.2%) did not have a website identifiable through ERAS or Google searches, leaving a final sample size of 183 websites. Approximately 73.3% of all recruitment content and 44.9% of education content were present on the websites available. There was a significant increase in all available recruitment and education content (p < 0.05) when compared with the lone 2001 study. Orthopaedic residency program websites provide comparable recruitment content at a higher rate (71.1%) than orthopaedic fellowship websites (59.6%) but fall slightly below average in presentation of education content (44.9% vs 45.9%).

Conclusion:

This is the first study in nearly 20 years to assess the content and accessibility of orthopaedic residency program websites. There is noticeable variability in the presentation of website content, but approximately 73.3% of recruitment content and 44.9% of the educational content were easily accessible through internet search. Orthopaedic surgery residency programs and their applicants may benefit from standardization of program websites and an increase in recruitment and education content.
Conversion from a failed proximal femoral nail anti-rotation to a cemented or uncemented total hip arthroplasty device: A retrospective review of 198 hips with previous intertrochanteric femur fractures
Authors: Yu Weiguang , Han Xiulan , Chen Wenli , Shuai Mao , Zhao Mingdong , Zhang Chao Xin , Han Guowei , Ye Junxing , Chen Meiji , Zhuang Jintao
Published: October 2020

Background: At present, it is unclear which device ( uncemented or cemented total hip arthroplasty [UTA or CTA, respectively]) is more suitable for the conversion of a failed proximal femoral nail anti-rotation (PFNA). The aim of this review was to assess the outcomes of failed PFNAs converted to a UTA or CTA device in elderly individuals with intertrochanteric femoral fractures (IFFs) . Methods: Two hundred fifty-eight elderly individuals (258 hips) with IFFs who underwent a conversion to a UTA or CTA device following failed PFNAs during 2007-2017 were retrospectively identified from the China Southern Medical Centre (CSMC) database. The primary endpoint was the Harris Hip Score (HHS); secondary endpoint was the key orthopaedic complication rate. Results: The median follow-up was 65 months (60-69 months). Significant distinctions were observed (87.26±16.62 for UTA vs. 89.32±16.08 for CTA, p=0.021; 86.61±12.24 for symptomatic UTA vs. 88.68±13.30 for symptomatic CTA, p=0.026). A significant difference in the overall key orthopaedic complication rate was detected (40.8% [40/98] vs. 19.0% [19/100], p =0.001). Apparent distinctions were detected in terms of the rate of revision, loosening, and periprosthetic fracture (11.2% for UTA vs 3.0% for CTA, p = 0.025; 13.2% for UTA vs 5.0% for CTA, p = 0.043; 10.2% for UTA vs 3.0% for CTA, p = 0.041, respectively). Conclusion: For elderly individuals with IFFs who suffered a failed PFNA , CTA devices may have a noteworthy advantage in regard to functional scores and the rate of key orthopaedic complications compared with UTA devices, and CTA revision should be performed as soon as possible, regardless of whether these individuals have symptoms.
Missed opportunities for diagnosis and treatment in patients with tuberculosis symptoms: a systematic review
Authors: Divala Titus Henry , Lewis Joe , Bulterys Michelle , Lutje Vittoria , Corbett Elizabeth , Schumacher Samuel , MacPherson Peter
Published: October 2020

Background Identification of symptomatic patients followed by prompt on-site investigation form the foundation of facility-based tuberculosis (TB) screening and diagnosis. However, underdiagnosis is common, contributing to ongoing transmission and adverse health outcomes. We conducted this systematic review with the hypothesis that underdiagnosis is largely secondary to to failure of the symptom-screen-based approach to efficiently identify patients at risk of TB. Methods We searched (to 22 January 2019) MEDLINE, Embase, and Cinahl for studies investigating the pathway of care for patients (and standardised patients) presenting to health facilities or pharmacies with TB symptoms. We used QUADAS-2 to assess risk of bias. We reported the proportions of symptomatic patients at each stage of the diagnostic and care pathway from symptom screening to treatment initiation. We adhered to the PRISMA statement throughout this work. Results After screening 3,184 titles and abstracts, we identified 14 eligible studies. None provided data addressing the full cascade of care from clinical presentation to treatment initiation in the same patient population. Symptom-screening, the critical entry point for diagnosis of TB, was not done for 40%, 50%, and 96% of symptomatic participants in the three studies that reported this outcome. The proportion of symptomatic attendees offered a diagnostic investigation (data available for 13 studies), was very low with a study level median of 38% (IQR: 22% to 45%, range 5% to 84%).Conclusions Inefficiencies of the TB symptom screen-based patient pathway are a major contributor to underdiagnosis of TB in health facilities, and reflect inconsistent implementation of longstanding guidelines to ask all patients attending health facilities about respiratory symptoms and to offer diagnostic tests to all patients promptly once TB symptoms are identified. Screening tools and interventions with better diagnostic performance than symptoms, are urgently needed to improve the efficiency of TB care pathways in health facilities.
Methodologies and Procedures Employed in the Identification and Quantitation of Lipid Mediators via LC-MS/MS
Authors: Colas Roman A. , Gomez Esteban A , Dalli Jesmond
Published: October 2020

Liquid chromatography tandem mass spectrometry (LC-MS/MS) is a sensitive and robust approach for the identification and quantitation of lipid mediators including the specialized pro-resolving mediators (resolvins, maresins, protectins and lipoxins), and the classic eicosanoids. Due to the relatively low concentration of these molecules in biological samples, this methodology is classically coupled with solid phase extraction (SPE) techniques that enhance the sensitivity of the assay. Herein, we provide a step-by-step description of instrumentation employed in the both SPE and LC-MS/MS and detailed methodologies employed in the extraction of these lipid mediators and their identification and quantitation using LC-MS/MS.
Satisfaction with malaria care among pregnant women and mothers of under-five years children in Ibadan, Southwest Nigeria
Authors: Oladimeji Kelechi Elizabeth , Tsoka-Gwegweni Joyce Mahlako , Yaya Sanni , Nutor Jerry John , Adeola Abiodun M , Cumber Samuel Nambile , Hyera Francis Leonard Mpotte , Goon Ter Daniel
Published: October 2020

BackgroundPatient satisfaction is as an important measure of program assessment and health system performance. In our study, we assessed patient’s satisfaction with malaria care among pregnant women (PW) and mothers of children less than five years of age (MU5) in Ibadan, Nigeria. MethodsA cross-sectional design, patient satisfaction with malaria care was assessed among 1,373 participants (818 PW and 555 MU5) with the anti-malarial care they received in a comprehensive hospital in Ibadan, Nigeria. Data on patient satisfaction was obtained using a validated eighteen-item questionnaire (PSQ-18) and analysed using the standard satisfaction scales and quantitative scores. ResultsMajority of the study respondents were married and within the age group 25-34years. Overall, indecisive satisfaction (mean range of 3.0-3.99) was observed for items 4, 7, 9, 10, 12, 13, and 16 in the PSQ-18 tool. From the satisfaction sub-scales derived, lowest mean score reflecting poor satisfaction (mean 2.96) was observed for the domain ‘time spent with doctor’ among the pregnant women, while in mothers of children aged under five years, poor satisfaction (mean 2.95) was observed for the general satisfaction sub-scale. Results of the multivariate analysis showed that pregnant women in the upper socioeconomic class had statistically significant lower odds of satisfaction (OR: 0.29, 95% CI: 0.10 – 0.84) with the interpersonal way malaria care was provided. Among mothers of children less than five years old, education and socioeconomic status were significant predictors of higher odds of satisfaction with financial aspects of malaria care.ConclusionSocio economic status and one of its indicators, education plays significant roles in mothers’ satisfaction with health care access, level of care received and most importantly their prospective health seeking behaviour. Important aspect, such as patient’s perception of being well treated by the health care provider should be a key consideration for formulate a patients’ centred strategy to improve health care for malaria in malaria endemic settings.
The Physical Activity Wearables in the Police Force (PAW-Force) study: Acceptability and impact 
Authors: Buckingham Sarah Ann , Morrissey Karyn , Williams Andrew James , Price Lisa , Harrison John
Published: October 2020

Background: Policing is a highly stressful and increasingly sedentary occupation. The study aim was to assess the acceptability and impact of a mobile health (mHealth) technology intervention (Fitbit® activity monitor and ‘Bupa Boost’ smartphone app) to promote physical activity (PA) and reduce sedentary time in the police force.Methods: Single-group, pre-post, mixed methods pilot study. Police officers and staff (n=180) were recruited from two police forces in South West England. Participants used the technology for 12 weeks (an ‘individual’ then ‘social’ phase) followed by five months of optional use. Data sources included Fitbit®-recorded objective step count, questionnaire surveys and semi-structured interviews (n=32). Outcome assessment points were baseline (week 0), mid-intervention (week 6), post-intervention (week 12) and follow-up (month 8). Paired t-tests were used to investigate changes in quantitative outcomes. Qualitative analysis involved framework and thematic analysis.Results: Changes in mean daily step count were non-significant (p>0.05), but self-reported PA increased in the short term (e.g. +465.4 MET-minutes/week total PA baseline to week 12, p=0.011) and longer term (e.g. +420.5 MET-minutes/week moderate-to-vigorous PA baseline to month 8, p=0.024). The greatest impact on behaviour was perceived by less active officers and staff. There were no significant changes in sedentary time; the qualitative findings highlighted the importance of context and external influences on behaviour. There were no statistically significant changes (all p-values >0.05) in any secondary outcomes (physical and mental health-related quality of life, perceived stress and perceived productivity), with the exception of an improvement in mental health-related quality of life (SF-12 mental component score +1.75 points, p=0.020) from baseline to month 8. Engagement with and perceived acceptability of the intervention was high overall, but a small number of participants reported negative physical (skin irritation) and psychological (feelings of guilt and anxiety) consequences of technology use. Individual app features (such as goal-setting and self-monitoring) were generally preferred to social components (social comparison, competitions and support). Conclusions: mHealth technology is an acceptable and potentially impactful intervention for increasing PA in the police force. The intervention was less useful for reducing sedentary time and the impact on secondary outcomes is unclear.
Effects of Propofol on Intracranial Pressure and Prognosis in Patients with Severe Brain Diseases Undergoing Endotracheal Suctioning
Authors: Wu Menghang , Yin Xiaorong , Chen Maojun , Liu Yan , Zhang Xia , Li Tingting , Long Yujuan , Wu Xiaomei , Pu Lihui , Zhang Maojie , Hu Zhi , ye ling
Published: October 2020

BackgroundTo investigate whether the administration of intravenous propofol before endotracheal suctioning (ES) in patients with severe brain disease can reduce the sputum suction response, improve prognosis, and accelerate recovery.MethodsA total of 208 severe brain disease patients after craniocerebral surgery were enrolled in the study. The subjects were randomly assigned to the experimental group (n=104) and the control group (n=104). The experimental group was given intravenous propofol (10ml propofol with 1ml 2% lidocaine), 0.5-1 mg/kg, before ES, while the control group was subjected to ES only. Changes in vital signs, sputum suction effect, the fluctuation range of intracranial pressure (ICP) before and after ES, choking cough response, short-term complications, length of stay, and hospitalization cost were evaluated. Additionally, the Glasgow Outcome Scale (GOS) prognosis score was obtained at six months after the operation.ResultsAt the baseline, the characteristics of the two groups were comparable (P>0.05). The increase of systolic blood pressure after ES was higher in the control group than in the experimental group (P < 0.05). The average peak value of ICP in the experimental group during the suctioning (15.57 ± 12.31 mmHg) was lower than in the control group (18.24 ± 8.99 mmHg; P < 0.05). The percentage of patients experiencing cough reaction- during suctioning in the experimental group was lower than in the control group (P < 0.05), and the fluctuation range of ICP was increased (P < 0.0001). The effect of ES was achieved in both groups. The incidence of short-term complications in the two groups was comparable (P > 0.05). At 6 months after the surgery, the GOS scores were significantly higher in the experimental than in the control group (4-5 points, 51.54% vs. 32.64%; 1-3 points, 48.46% vs. 67.36%; P<0.05). There was no significant difference in the length of stay and hospitalization cost between the two groups.ConclusionsPropofol sedation before ES could reduce choking cough response and intracranial hypertension response. The use of propofol was safe and improved the long-term prognosis.The study was registered in the Chinese Clinical Trial Registry on May 16, 2015 (ChiCTR-IOR-15006441).
Reversibility of hAT-MSCs phenotypic and metabolic changes after exposure to and withdrawal form HCC-conditioned medium through regulation of the ROS/MAPK/HIF-1α signalling pathway
Authors: Wang Chenyang , Hu Jie , Chen Zheng , Wang Yifan , Lu Sinan , Zhang Yuan , Li Yufeng , Xiang Yucheng , Ji Yutian , Zeng Cheng , Ding Yuan , Wang Weilin
Published: October 2020

Background: Mesenchymal stem cells (MSCs) play an important role in tumor progression; concomitantly, MSCs also undergo profound changes in the tumor microenvironment (TME). These changes can directly impact the application and efficacy of MSC-based anti-tumor therapy. However, few studies have focused on the regulation of MSC fate in TME, which will limit the progress of MSC-based anti-tumor therapy. Herein, we investigated the effects of conditioned medium from human hepatocellular carcinoma cells (HCC-CM) on the phenotype and glucose metabolism of human adipose tissue-derived MSCs (hAT-MSCs). Methods: The passage 2 (P2) to passage 3 (P3) hAT-MSCs were exposed to conditioned medium from Hep3B, Huh7 and HCCLM3 cells for 4-8 weeks in vitro. Then, immunofluorescent, CCK-8 assay, EdU assay, Transwell assay, and flow cytometry were used to assess the alterations in cell phenotype in terms of cell morphology, secretory profiles, proliferation, migration, invasion, cell cycle, and apoptosis. In addition, glucose metabolism was evaluated by related kits. Next, the treated hAT-MSCs were subjected to withdrawal from HCC-CM for 2-4 weeks, and alterations in phenotype and glucose metabolism were reevaluated. Finally, the molecular mechanism was clarified by Western blotting. Results: The results revealed that after exposure to HCC-CM, hAT-MSCs developed a stellate-shaped morphology. In association with cytoskeleton remodelling, hAT-MSCs showed enhanced capacities for migration and invasion, while cell proliferation was inhibited by regulating the cell cycle by downregulating cyclins and cyclin-dependent kinases and activating the mitochondrial apoptosis pathway. In terms of glucose metabolism, our results showed mitochondrial dysfunction and elevated glycolysis of hAT-MSCs. However, interestingly, when the treated hAT-MSCs were subjected to withdrawal from HCC-CM, the alterations in phenotype and glucose metabolism could be reversed, but secretory phenotype and tumor-promoting properties appear to be permanent. Further studies showed that these changes in hAT-MSCs may be regulated by the ROS/MAPK/HIF-1α signalling pathway. Conclusion: Taken together, the effects of long-term HCC-CM treatment on phenotype and glucose metabolism in hAT-MSCs are modest and largely reversible after withdrawal, but HCC-CM endow hAT-MSCs with permanent secretory phenotype and tumor-promoting properties. This is the first report on the reversal of phenotype and glucose metabolism in tumor-associated MSCs (TA-MSCs), it is anticipated that new insights into TA-MSCs will lead to the development of novel strategies for MSC-based anti-tumor therapy.
Cerebrospinal fluid α-synuclein predicts neurodegeneration and clinical progression in non-demented elders
Authors: Li Jie-Qiong , Bi Yan-Lin , Shen Xue-Ning , Wang Hui-Fu , Xu Wei , Tan Chen-Chen , Dong Qiang , Wang Yan-Jiang , Tan Lan , Yu Jin-Tai
Published: October 2020

Background Accumulating reports have suggested that α-synuclein is involved in the pathogenesis of Alzheimer’s disease (AD). As the cerebrospinal fluid (CSF) α-synuclein has been suggested as a potential biomarker of AD, this study was set out to test whether CSF α-synuclein is associated with other AD biomarkers and could predict neurodegeneration and clinical progression in non-demented elders. Methods The associations between CSF α-synuclein and other AD biomarkers were investigated at baseline in non-demented Chinese elders. The predictive values of CSF α-synuclein for longitudinal neuroimaging change and the conversion risk of non-demented elders were assessed using linear mixed effects models and multivariate Cox proportional hazard models, respectively, in the Alzheimer's disease Neuroimaging Initiative (ADNI) database.Results The CSF α-synuclein levels correlated with AD-specific biomarkers, CSF total tau and phosphorylated tau levels, in 651 Chinese Han participants (training set). These positive correlations were replicated in the ADNI database (validation set). Using a longitudinal cohort from ADNI, the CSF α-synuclein concentrations were found to increase with disease severity. The CSF α-synuclein had high diagnostic accuracy for AD based on the “ATN” (amyloid, tau, neurodegeneration) system (A+T+ versus A−T−control) (area under the receiver operating characteristic curve, 0.84). Moreover, CSF α-synuclein predicted longitudinal hippocampus atrophy and conversion from MCI to AD dementia.Conclusions CSF α-synuclein is associated with CSF tau levels and could predict neurodegeneration and clinical progression in non-demented elders. This finding indicates that CSF α-synuclein is a potentially useful early biomarker for AD.
Medical students’ self-reported gender discrimination and sexual harassment over time
Authors: Kisiel Marta Alina , Kühner Sofia , Stolare Karin , Lampa Erik , Wohlin Martin , Johnston Nina , Rask-Andersen Anna
Published: October 2020

Background Gender discrimination (GD) and sexual harassment (SH) occur at all academic institutions worldwide. Medical students seem particularly affected, which may negatively affect their education and health. There are indications that policies and reforms on reducing GD/SH are insufficient. Swedish medical students’ experiences of GD/SH are monitored by course-evaluations and bi-annual student union evaluations; however, the response rate is usually low. The aim of this study was to compare the exposure to and context of self-reported GD/SH over an 11-year period amongst medical students at a Swedish university. Methods In 2002, a questionnaire (n=622) was mailed to medical students’ home addresses. It was repeated in 2013 and then distributed during mandatory lectures (n=856). The questions used a behavioristic approach and asked about specific GH/SH experiences. Participation was voluntary and anonymous. The changes in prevalence over time were calculated by sampling weights in order to obtain comparable estimates, representative of both cohorts. Results The response frequency was 55% (62% women) in 2002 and 81% (59% women) in 2013. The prevalence of GD tended to decrease for male and clinical students in comparison to female and pre-clinical peers. However, the prevalence of SH increased for female compared to male students. The ratio of SH for female pre-clinical students doubled in many instances; most often, the mistreatment occurred in the clinic. Medical doctors were indicated as perpetrators up to five times more often by all students in 2013. Conclusion Our results show a disproportional change in exposure to GD/SH between female and male medical students, resulting in a widening of the gender gap regarding prevalence of GD and SH between 2002 and 2013. In particular, personal experiences of SH increased for both sexes. It is proof that institutional efforts to fight mistreatment might be ineffective.
Evaluation of a training program for soft skill education and financial literacy to community health workers in India: a quasi-experimental study
Authors: Sharma Shantanu , Arora Kanishtha , Shekhar Chandra , Sinha Rajesh Kumar , Akhtar Faiyaz , Mehra Sunil
Published: October 2020

Background: Accredited Social Health Activists (ASHA) are community health workers responsible for improving the health status of people by facilitating their access to healthcare services. The life skills of ASHA are known to be effective in negotiating behaviour change in the community; however, there has been a meagre focus towards improving them. Considering this gap, we adopted a comprehensive training program, known as Personal Advancement and Career Enhancement (P.A.C.E.), to empower ASHAs on life skills and financial literacy. The present study intends to assess the training program in two districts of Uttar Pradesh, India, by examining changes in knowledge, perceptions, and practices of ASHAs about life skills and financial literacy.Methods: We conducted a quasi-experimental, non-randomized, controlled study with pre- and post-test assessments. Data were collected on socio-demographic characteristics, knowledge, and practices related to life skills (communication skills, self-confidence, problem–solving and decision-making skills, time and stress management skills) and financial literacy. Additionally, perceptions regarding changes in practices related to gender issues, life skills, and savings at the personal, community, and workplace levels were obtained from the intervention group. Factor analysis was performed to obtain the change patterns by assessing the degree to which the four domains of life skills, financial literacy, and domains of perceptions of change in practices were correlated to each other. A general linear regression model was performed to assess associations among change pattern scores and socio-demographic variables.Results: The data of 171 ASHA were analyzed (intervention group:86 and control group:85). There was a significant improvement in the average post-test scores of all the life skills and financial literacy in the intervention group (p<0.001). Three distinct change patterns were found post-training in the intervention group. Factor 1 (high loadings for perceptions related to change in practices) was positively associated with ASHAs aged 38 and above and with experience of ≤12 years. On the contrary, the change in financial literacy and self-confidence scores was common among ASHAs with more than 12 years of experience.Conclusions: The P.A.C.E training program was found effective in improving the life skills and financial literacy of ASHAs in India.
Perturbation of PI3K/Akt Signaling affected Autophagy Modulation in Dystrophin-Deficient Myoblasts
Authors: Yazid Muhammad Dain , Chen Hung-Chih
Published: October 2020

The absence of dystrophin has gave a massive impact on myotube development in Muscular Dystrophy pathogenesis. One of the conserved signaling pathways involved in skeletal muscle differentiation is the PI3K/Akt/mTOR pathway that plays a vital role in autophagy regulation. To further understand and establish targeted therapy in dystrophin-deficient myoblasts, protein expression profiling has been determined which provides information on perturbed autophagy modulation and activation. In this study, a dystrophin-deficient myoblast cell line established from the skeletal muscle of a dystrophic (mdx) mouse was used as a model. The dfd13 (dystrophin-deficient) and C2C12 (non-dystrophic) myoblasts were cultured in low mitogen conditions for 10 days to induce differentiation. The cells were subjected to total protein extraction prior to Western blotting assay technique. Protein sub-fractionation has been conducted to determine protein localization. The live-cell analysis of autophagy assay was done using a flow cytometer. As result, in our culture system, the dfd13 myoblasts did not achieve terminal differentiation. PTEN expression was profoundly increased in dfd13 myoblasts throughout the differentiation day subsequently indicates perturbation of PI3K/Akt/mTOR regulation. In addition, rictor-mTORC2 was also found inactivated in this event. This occurrence has caused FoxO3 misregulation leads to higher activation of autophagy-related genes in dfd13 myoblasts. Autophagosome formation was increased as LC3B-I/II showed accumulation upon differentiation. However, the ratio of LC3B lipidation and autophagic flux were shown decreased which exhibited dystrophic features. As a conclusion, perturbation of the PTEN-PI3K/Akt pathway triggers excessive autophagosome formation and subsequently reduced autophagic flux within dystrophin-deficient myoblasts where these findings are of importance to understand Duchenne Muscular Dystrophy (DMD) patients. We believe that some manipulation within its regulatory signaling reported in this study could help restore muscle homeostasis and attenuate disease progression.
Autopsy and Informatics Analysis Evidence Disturbed Haemostasis Progress in COVID-19: Medical Records from 407 Patients
Authors: Jiang Tiebin , Lv Bo , Liu Hongxia , He Shiwen , Zhang Guogang , Li Chanyi , Li Wanqiong , Li Weilin , He Yaqi , Zhang Tong , Wang Yunyun , Mo Wu , yi ning , Peng Luying , Li Ying , Ruan Chunhong , Li Chengyuan , Liu Yaqi , Luo Peipei , Jiang Huan , xue zhigang , Liu Liang , Wang Wenjun
Published: October 2020

Background: The progress of coagulation in COVID-19 patients with confirmed discharge status (decease or discharge) and the combination of the autopsy with the complete coagulation parameters were not well studied.Objective: To clarify the thrombotic phenomena with coagulation progress in COVID-19 patients based on epidemiological statistics combining the autopsy and informatics analysis.Methods: Using 9 autopsy results with COVID-19 pneumonia and the medical records of 407 patients including 39 deceased ones whose discharge status was certain, time-sequential changes of 11 relevant indices within mild, severe and critical infection throughout hospitalization according to the Chinese National Health Commission (NHC) guidelines were evaluated. Informatics tools were applied to calculate the importance of 11 indices and the correlation between those indices and the severities of COVID-19.Results: At the beginning of the hospitalization, platelet (PLT) had a significant decrease in critically ill patients. Blood glucose (GLU), prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer in critical patients were higher than those in mild and severe during the whole admission period. The International Society on Thrombosis and Haemostasis (ISTH) disseminated intravascular coagulation (DIC) score also showed the high DIC level in critical patients. At the relatively late stage of non-survivors, the temporal changes of PLT count, PT, and D-dimer were significantly different from survivors. A random forest model indicated that the most important feature was PT, followed by D-dimer, indicating their positive associations for the severities of disease. Autopsy data from 9 deceased patients also showed the DIC phenomena with prolonged PT, APTT, less PLT count and thrombosis in multiple organs.Conclusions: Combining autopsy data, time-sequential changes and informatics methods to explore the coagulation relevant indices among the different severities of the disease, helps guide the therapy and detect the prognosis in COVID-19 infection.
Dissecting Molecular Mechanisms Underlying H2O2-induced Apoptosis of Mouse Bone Marrow Mesenchymal Stem Cell: Role of Mst1 Inhibition.
Authors: Zhang Qian , Cheng Xianfeng , Zhang Haizhou , Zhang Tao , Wang Zhengjun , Zhang Wenlong , Yu Wancheng
Published: October 2020

Background: Bone marrow mesenchymal stem cell (BM-MSC) has been shown to treat pulmonary arterial hypertension (PAH). However, excessive reactive oxygen species (ROS) increases the apoptosis of BM-MSCs, leading to poor survival and engraft efficiency. Thus, improving the ability of BM-MSCs to scavenge ROS may considerably enhance the effectiveness of transplantation therapy. Mammalian Ste20-like kinase 1 (Mst1) is a pro-apoptotic molecule which increases ROS production. The aim of this study is to uncover whether Mst1 inhibition enhanced the tolerance of BM-MSCs under H2O2 condition and the underlying mechanisms. Methods: Mst1 expression in BM-MSCs was inhibited via transfection with adenoviruses expressing a short hairpin (sh) RNA directed against Mst1 (Ad-sh-Mst1) and exposure to H 2 O 2 . Cell viability was detected by Cell counting Kit 8 (CCK-8) assay, and cell apoptosis was analyzed by Annexin V-FITC/PI, Caspase 3 Activity Assay kits, and pro caspase 3 expression. ROS level was evaluated by the ROS probe DCFH-DA, mitochondrial membrane potential (ΔΨm) assay, SOD1/2, CAT, and GPx expression. Autophagy was assessed using transmission electron microscopy, stubRFP-sensGFP-LC3 lentivirus and autophagy-related protein expression. The autophagy/Keap1/Nrf2 signal in H 2 O 2 -treated BM-MSC/sh-Mst1 was also measured. Results: Mst1 inhibition reduced ROS production, increased antioxidant enzyme SOD1/2, CAT, GPx expression, maintained ΔΨm, and alleviated cell apoptosis in H 2 O 2 -treated BM-MSCs. In addition, this phenomenon was closely correlated with the autophagy/Keap1/Nrf2 signal pathway. The autophagy inhibitor, the antioxidant pathway Keap1/Nrf2, was also blocked when autophagy was inhibited by 3-MA. However, Keap1 or Nrf2 knockout via siRNA had no effect on autophagy activation or suppression. Conclusion: Mst1 inhibition mediates the cytoprotective benefit of mBM-MSCs against H 2 O 2 oxidative stress injury. The underlying mechanisms involve autophagy activation and the Keap1/Nrf2 signal pathway.
The yellow perch (Perca flavescens) microbiome revealed resistance to colonisation mostly associated with neutralism driven by rare taxa under cadmium disturbance
Authors: Cheaib Bachar , Seghouani Hamza , Llewellyn Martin Stephen , Vandal-Lenghan Katherine , Mercier Pierre-Luc , Derome Nicolas
Published: October 2020

Background: Disentangling the dynamics of microbial interactions within communities improves our comprehension of metacommunity assembly of microbiota during host development and under perturbations. To assess the impact of stochastic variation of neutral processes on microbiota structure and composition under disturbance, two types of microbial habitats, free-living (water), and host-associated (skin and gut) were experimentally exposed to either a constant or gradual selection regime exerted by two sublethal cadmium chloride dosages (CdCl2). Yellow Perch (Perca flavescens) was used as a piscivorous ecotoxicological model. Using 16S rDNA gene based metataxonomics, quantitative diversity metrics of water, skin and gut microbial communities were characterized along with development and across experimental conditions. Results: After 30 days, constant and gradual selection regimes drove a significant alpha diversity increase for both skin and gut microbiota. In the skin, pervasive negative correlations between taxa in both selection regimes in addition to the taxonomic convergence with the environmental bacterial community, suggest a loss of colonisation resistance resulting in the dysbiosis of yellow perch microbiota. Furthermore, the network connectivity in gut microbiome was exclusively maintained by rare (low abundance) OTUs, while most abundant OTUs were mainly composed of opportunistic invaders such as Mycoplasma and other genera related to fish pathogens such as Flavobacterium. Finally, the mathematical modelling of community assembly using both non-linear least squares models (NLS) based estimates of migration rates and normalized stochasticity ratios (NST) based beta-diversity distances suggested neutral processes drove by taxonomic drift in host and water communities for almost all treatments. The NLS models predicted higher demographic stochasticity in the cadmium-free host and water microbiomes, however, NST models suggested higher ecological stochasticity under perturbations. Conclusions: Neutral models agree that water and host-microbiota assembly promoted by rare taxa have evolved predominantly under neutral processes with potential involvement of deterministic forces sourced from host filtering and cadmium selection. The early signals of perturbations in the skin microbiome revealed antagonistic interactions by a preponderance of negative correlations in the co-abundance networks. Our findings enhance our understanding of community assembly host-associated and free-living under anthropogenic selective pressure.
Acupuncture protects against cerebral ischemia-reperfusion injury via suppressing endoplasmic reticulum stress-mediated autophagy and apoptosis
Authors: Sun Xiaowei , Liu Hao , Sun Zhongren , Zhang Beng , Wang Xinyu , Liu Tingting , Pan Tingting , Gao Ying , Jiang Xicheng , Li Hongtao
Published: October 2020

Background: Acupuncture treatment possesses the neuroprotection potential to attenuate cerebral ischemia-reperfusion (I/R) injury. Endoplasmic reticulum (ER) stress has been suggested to be involved in the pathogenic mechanism of cerebral I/R injury. Whether acupuncture protects against cerebral I/R injury via regulating ER stress remains unclear. This study aimed to evaluate the role of ER stress in the neuroprotection of acupuncture against cerebral I/R injury and its underlying mechanisms. Methods: Cerebral I/R injury was induced by middle cerebral artery occlusion (MCAO) in rats. Acupuncture was carried out at Baihui (GV 20), Hegu (L14), and Taichong (Liv3) acupoints in rats immediately after reperfusion. The infarct volumes, neurological score, ER stress, autophagy and apoptosis were determined. Results: Acupuncture treatment decreased infarct volume, neurological score and suppressed ER stress via inactivation of ATF-6, PERK, and IRE1 pathways in MCAO rats. Attributing to ER stress suppression, 4-PBA (ER stress inhibitor) promoted the beneficial effect of acupuncture against cerebral I/R injury. Whereas, ER stress activator tunicamycin significantly counteracted the neuroprotective effects of acupuncture. In addition, acupuncture restrained autophagy via regulating ER stress in MCAO rats. Finally, ER stress took part in the neuroprotective effect of acupuncture against apoptosis in cerebral I/R injury. Conclusions: Our findings suggest that acupuncture offers neuroprotection against cerebral I/R injury, which is attributed to repressing ER stress-mediated autophagy and apoptosis.