bluuebunny/crossref_metadata_2025 huggingface dataset:
A practical method for oral administration of isotretinoin in pediatric oncology patient: A case study of neuroblastoma
Authors: Alwhaibi Abdulrahman , Alenazi Miteb , Almadi Bana , Alotaibi Abdulaziz , Alshehri Sultan M , Shakeel Faiyaz
Published: August 2022

Introduction

Isotretinoin is a synthetic vitamin A derivative, administered off-label as maintenance therapy for neuroblastoma. This report addresses the challenge of administering isotretinoin to children, given its availability as soft gelatin capsules only.

Case report

A 3-year-old boy diagnosed with stage IV neuroblastoma has undergone multimodal therapy, including six cycles of chemotherapy, followed by tumor resection and radiotherapy. Later, he was initiated on immunotherapy and prescribed isotretinoin 50 mg orally twice daily for two weeks, before each immunotherapy cycle. Isotretinoin is not available in liquid formulation and the patient could not swallow isotretinoin capsules. Therefore, pharmacist counseling was required to ensure appropriate administration of the drug.

Management and outcomes

The patient’s parents were instructed to pierce prescribed capsules, and empty and dilute their contents into a small glass containing olive oil after taking safety measures. Isotretinoin’s stability in olive oil for 72 h was compared using high-performance liquid chromatography to its stability in soybean oil. The recovery rates were 98.62% and 98.3%, respectively. Drug miscibility was not an issue as isotretinoin is lipophilic. Therefore, it could be administered easily without considerable remaining on the interior wall of the glass.

Discussion

To the best of our knowledge, this is the first report that suggests a practical method for administering isotretinoin in liquid form, particularly in pediatric oncology patients. Isotretinoin was noted to be stable in olive oil and its exposure to light and oxygen would not be an issue given the short time from preparation to administration and the low emphasis on exposure by the manufacturer when such a method is recommended.
The slow movements: Informetric mapping of the scholarship and implications for tourism and hospitality
Authors: Klarin Anton , Park Eerang , Kim Sangkyun
Published: August 2022

Slow food and the consequent slow movements are becoming more evident in research and media with the recognition of its implications for sustainability in many spheres of society. This study—the first systematic literature review of this topic—offers a comprehensive interdisciplinary investigation into slow movements which allows us to gain a systems view of the scholarship; stakeholder-oriented insights; and a holistic understanding of slowness while recognizing the various movements within and providing future research directions for tourism and hospitality researchers. This study identifies that slowness has extended to most aspects of our everyday life, such as the slow city, slow management, slow fashion, slow philosophy in general, and slow tourism; the latter offering COVID-19 post-pandemic recovery opportunities through sustainable tourism and hospitality. This study acts as a springboard for a better understanding of the slow(ness) movements to encourage more proactive interactions with key stakeholders and to develop the field further.
Implementation and evaluation of a pilot antenatal ultrasound imaging programme using tele-ultrasound in Ethiopia
Authors: Jemal Kemal , Ayana Dereje , Tadesse Felagot , Adefris Mulat , Awol Mukemil , Tesema Mengistu , Dagne Bewunetu , Abeje Sandra , Bantie Alehegn , Butler Megan , Nwoke Chikezirim , Kanyuka Zakhar , Adams Scott J , Mendez Ivar
Published: August 2022

Introduction

Ultrasound imaging is an important aspect of antenatal care, though access to antenatal ultrasound imaging is limited in many developing countries. The objective of this study was to evaluate a pilot programme which aimed to improve access to antenatal ultrasound for rural Ethiopians through enhanced training of healthcare providers (including midwives, nurses and clinical officers) with support remotely provided by obstetricians using a tele-ultrasound platform.

Methods

Thirteen healthcare providers in the North Shoa Zone in Ethiopia completed training to enable them to perform antenatal ultrasound with the remote supervision of an obstetrician via a tele-ultrasound platform. Pregnant women attending an antenatal appointment at two facilities were offered an antenatal ultrasound exam performed by one of the healthcare providers. Image interpretations between obstetricians and healthcare providers were compared. Participants and healthcare providers were invited to complete a questionnaire regarding their experience with tele-ultrasound, and participants, healthcare providers and obstetricians were interviewed regarding their experience with the tele-ultrasound pilot programme.

Results

2795 pregnant women had an antenatal ultrasound exam. Of 100 exams randomly selected to assess concordance between healthcare providers’ and obstetricians’ image interpretations, concordance ranged from 79% to 100% for each parameter assessed. 99.4% of participants surveyed indicated that they would recommend antenatal ultrasound using tele-ultrasound to friends and family. Themes relating to participants’ experiences of having a tele-ultrasound exam were reduced travel and cost, equivalence in quality of virtual care to in-person care and empowerment through diagnostic information.

Conclusion

Healthcare provider–performed antenatal ultrasound – supported by obstetricians via tele-ultrasound – showed high levels of concordance, was well-received by participants and provided rural Ethiopian women with enhanced access to antenatal imaging.
Association of D-dimer with short-term risk of venous thromboembolism in acutely ill medical patients: A systematic review and meta-analysis
Authors: Chi Gerald , Lee Jane J , Memar Montazerin Sahar , Marszalek Jolanta
Published: August 2022

Background:

D-dimer, a marker of ongoing procoagulant activity, has been widely used for the diagnosis of venous thromboembolism (VTE). The prognostic significance of D-dimer in stratifying VTE risk for acutely ill medical patients has not been well-established.

Methods:

A literature search was performed to collect studies that compared the incidence of short-term VTE between acutely ill medical patients with elevated or nonelevated D-dimer levels. The cutoff of D-dimer was 0.5 μg/mL or otherwise defined by included studies. The study endpoint was any occurrence of VTE (inclusive of deep vein thrombosis [DVT], pulmonary embolism, or VTE-related death) within 90 days of hospital presentation. A meta-analytic approach was employed to estimate the odds ratio (OR) with 95% CI by fitting random-effects models using the generic inverse variance weighted approach.

Results:

A total of 10 studies representing 31,119 acutely ill medical patients were included. Compared to those with nonelevated D-dimer levels, patients with elevated D-dimer had approximately threefold greater odds for short-term VTE within 90 days (OR, 3.28; 95% CI, 2.44 to 4.40; p < 0.0001). The association of elevated D-dimer with VTE composite (OR, 3.33; 95% CI, 2.20 to 5.02) and with DVT (OR, 3.26; 95% CI, 2.32 to 4.58) was comparable. The association was significant among patients who presented various acute medical illness (OR, 2.68; 95% CI, 2.01 to 3.58) and those who presented with acute stroke (OR, 3.25; 95% CI, 2.31 to 4.58).

Conclusion:

Elevation of D-dimer was predictive of the occurrence of VTE within 90 days among acutely ill medical patients.
Making “Senses”: The qualia of Pu’er tea and sensorial encounters between tea producers and traders in southwest China
Authors: Ma Zhen
Published: August 2022

This article analyses how Han buyers’ perception of and desire for the qualia—sensuous qualities—of Pu’er tea affects how ethnic minority producers perceive and make the tea. As a defining aspect of the consumers' experiences with ancient Pu’er tea, these qualia were invented and emphasised as part of the elite Chinese tea culture by Han traders and consumers. While the Bulang people's traditional way of making and using Pu’er tea related more to its economic and symbolic values than to its perceived effects on the body, in response to China's rapid marketisation they had to learn to sense the qualia rooted in a Han lexicon and philosophy and then acquire new skills to produce them. The paper argues that sensorial experience as a cultural dimension of tea has created new layers within Bulang people's encounters with the modern market.
Medical professionals’ agency and pharmaceuticalization: Physician-industry relations in Russia
Authors: Borozdina Ekaterina , Zvonareva Olga
Published: August 2022

In the contemporary world pharmaceuticals have become a go-to answer to a growing number of questions. This process of pharmaceuticalization gives rise to a concern with the increasing influence of the pharmaceutical industry on physicians’ decision-making. Critics suggest that companies’ for-profit-interests might compromise the integrity of medical practice. This article employs qualitative research methodology to explore how Russian physicians deal with the industry’s efforts to expand and shape the use of pharmaceuticals. By bridging perspectives of social studies of science and sociology of professions, we offer a contextualized account of physicians’ daily practices and interpretations related to pharmaceuticalization. The findings question conventional assumptions of physician-industry relations and allow to delineate a new form of medical professionalism that emerges in the context of pharmaceuticalization and cannot be reduced to either “resisting” industry marketing activities or “giving in” to them and thus corrupting biomedical expertise. Instead, the ways in which physicians navigate abundant sources of knowledge and use industry resources to overcome constraints of their organizational environment attest to mundane forms of agency exercised by physicians in their relations with industry.
“Will the law not protect survivors who don’t weep”: Twitter as a platform of feminist deliberation and democracy in India
Authors: Pain Paromita
Published: August 2022

An analysis of 40,000 tweets that trended after the Tarun Tejpal acquittal in India showed that the nature of the debate around issues of molestation and rape exhibited attributes of deliberation and demonstrated that Twitter in India, in certain cases, has strong potential to emerge as a space for deliberative feminist activism. Discussions gave impetus to advocacy around sexual molestation. While the word “victim” was used in more instances rather than the human rights–based term “survivor,” Twitter debates were supportive toward survivors of assault. There was minimum trolling and patriarchy was called out as was a legal system that sided with the influential man of power. Although city-bred English-speaking voices dominated, conversations were intersectional in nature acknowledging how the horror of physical assault was perceived by different women belonging to disparate socio-economic strata and how legal systems exacerbated gender related crimes.
A conceptual competencies-based framework to enhance the innovation capacity of fourth industrial revolution entrepreneurs
Authors: Blignaut (Taljaard) Amorie , Botha Melodi
Published: August 2022

Entrepreneurship scholars have focused their research on compiling a list of competencies that enhance entrepreneurial behaviour. Yet, these efforts might be redundant as new competencies are necessary in the Fourth Industrial Revolution (4IR). Furthermore, previous research investigated entrepreneurial competencies (ECs) from a developed country perspective. This paper follows two phases in identifying ECs for the 4IR in a developing country context. During phase 1, a Delphi study is employed, whereby 12 participants provide 108 ECs (round 1) and 87 ECs (round 2) required for the 4IR. Based on an extensive literature review, a concept matrix is conducted in phase 2, in which 136 competencies are listed. After phase 2 has been conducted, 87 ECs are identified, of which 33 have resulted as the most cited in the literature. By utilizing this multi-dimensional holistic approach, we can distinguish the ECs necessary to increase entrepreneurs’ capacity to innovate. The final analyses indicate 12 ECs, presented in a conceptual framework and categorized into four domains: cognitive (knowledge), functional (skills), social (attitudes and behaviours) and meta (facilitating learning). The findings illustrate the demand for specific ECs, although no additional ECs such as technology skills are identified for the 4IR within a developing country context.
Natural resources, authoritarian regimes, social services and the limits of cash transfers in Middle Africa
Authors: Künzler Daniel
Published: August 2022

The francophone and especially iberophone countries of the UN subregion Middle Africa are a gap in the literature on social policies in sub-Saharan Africa. A comparative analysis shows that there are differences in the provision of social services in the mainly authoritarian regimes in Middle Africa. Countries with a current or past form of authoritarianism that include elites from regions across the country are less underperforming regarding social services than the more exclusive authoritarian regimes based on one region or even one family. However, against parts of the literature, no Middle African country introduced a tax-financed age-based cash transfer, although most of them, having natural resources, are not low-income countries. Many have fragmented small short-term emergency cash transfers that the literature expects rather in low-income countries. The remarkable exceptions are the richest upper middle-income countries, namely Gabon and Equatorial Guinea, where research did not reveal any cash transfer programmes. Social policies are strikingly unimportant as electoral issues.
Multi-criteria sensor placement determination in prognostics and health management using combined fault diagnosis, fault detection, and risk indexes
Authors: Pourgol-Mohammad Mohammad , Salehpour-Oskouei Farzin
Published: August 2022

In framework of a prognostics and health management (PHM), a stochastic method is proposed for optimal sensor locations determination using three independent criteria indexes, reflecting the efficiency of sensor network: (i) the uncertainty of sensor information, the ability of fault diagnosis of a sensor network, (ii) the reliability of sensors, reflecting the fault detectability in sensor networks, (iii) risk of sensor failure including the consequence of sensor failure scenarios. The dynamic system failure model is developed and analyzed to consider the variation of environmental factors and their related failure threshold characterization along with statistical variance estimation as the information value that each possible sensor placement scenario provides through sensor information. A dynamic failure model is developed to incorporate the interaction of sensors and their corresponding components. It is demonstrated here that considering each criterion independently will not comprehensively determine the optimal placement scenario. An augmented index is formulated through Shannon Entropy theory, ranking all sensor placement scenarios based on proposed combined index. Optimization of sensor placement is demonstrated on a typical steam turbine. As shown in detail, the ranking based on each criterion provides different inconsistent rank for the location of the sensors. The combined index is found practically proper and recommended for rank and selection process.
Left-wing melancholia and activist memories of the Colombian conflict in Fabiola Calvo Ocampo’s Hablarán de mí
Authors: Elston Cherilyn
Published: August 2022

Dialoguing with recent memory studies scholarship that has questioned the field’s predominant focus on violence, victimhood and trauma, this article explores the emergence of forms of memory in Colombia that alongside commemorating the armed conflict also incorporate positive memories of the past and memories of left activism. To do so, it analyses Colombian journalist and academic, Fabiola Calvo Ocampo’s testimonial text Hablarán de mí as a key example of recent transitional justice and memory discourses emerging out of a new peacebuilding context in the country. Although detailing a history of trauma and a melancholic vision of the catastrophic destruction of the left in Colombia, the article reads Calvo Ocampo’s testimony through Enzo Traverso’s reading of left-wing melancholia to suggest that the text recovers a memory of the vanquished as part of an attempt to restore a left-activist memory of past historical struggles, which can be mobilised for the current peacebuilding scenario.
Laterally Based External Fixation for Pott’s Fractures
Authors: Vogt Jordan , Seligson David , Abushahin Imad , Poynter Thomas
Published: August 2022

In this article, we describe the construction and appropriate use of a lateral-based fixator for ankle fractures. This lateral-based frame is useful for treating Pott’s fractures. With lateral ankle dislocations, the lateral frame places the hindfoot in alignment with the leg. Soft tissue trauma has been recognized as an early limiting factor in patients with ankle fractures, in addition to the need for obtaining and maintaining anatomic position. A kickstand is added for heel and medial soft tissue offloading. The lateral frame is a quick and reproducible technique with satisfactory results.

Level of Evidence: Level V: Surgical Technique
Reconstruction Using Perforator Propeller Flaps After Malignant Melanoma Resection of the Lower Extremity
Authors: Alvarez Rio Adela , Roca Mas Josep Oriol , Soroa Moreno Gonzalo Joaquin , Navarro Sanchez Daniel , Monge Castresana Ivan , Estrada Cuxart Jaime
Published: August 2022

Introduction: Surgical excision with margin of 2 cm is the treatment of choice in malignant cutaneous melanoma when Breslow index is >1 mm. When located on the lower limb, these resections can lead to large defects that require complex reconstruction in order to salvage the limb. The use of propeller-perforator flaps has multiple advantages such as the preservation of adjacent muscles, decrease in morbidity in the donor site, and good aesthetic and functional results. Our objective is to expose our experience and results with the use of propeller-perforator flaps for coverage of this kind of defects. Materials and Methods: Patients with malignant cutaneous melanoma of the lower limb who required reconstruction with a propeller-perforator flap between the years 2015 and 2021 in our plastic surgery department were included in this retrospective research. Demographic, reconstructive, oncologic, and functional data were collected and analyzed. Results: The cohort of 22 patients showed 100% of successful reconstructive outcomes. Only 2 patients experienced distal necrosis of the flap that was resolved with local dressings. Fast recovery and early capacity to walk were achieved in the majority of the patients with an average of 10.1 days until weight-baring walking. The 2-year overall and progression-free survival rates were 86.37% and 81.82%, respectively. Conclusion: The use of propeller perforator flaps for oncological defects coverage in the lower limb location has to be considered as a reliable choice as it takes less surgical time and a faster recovery. It allows limb salvage with an adequate length and functionality, with minimal donor site morbidity and a lower index of complications, contributing to improve patient’s quality of life and not delaying other oncological treatments.
Trade Facilitation in Customs Environment: Measuring the Impact on Economic Integration in South Asia
Authors: Gandhi Tanya , Ahmed Shahid
Published: August 2022

Customs is a complex arena in the domain of international trade facilitation in developing regions of the world like South Asia. Despite the establishment of a free trade area in South Asia, the countries in the region still uphold a significant level of customs barriers for each other. South Asia’s intra-regional trade is just 6.1% of its total trade, making it the least unified region of the world. This study measures the impact of trade facilitation in the customs environment on regional economic integration in South Asia through intra-regional trade. The study developed its index for customs environment and incorporated it into an augmented panel gravity model to conclude that an improved customs environment significantly increases trade flows within the region. The estimates of simulation analysis illustrate that South Asia has immense potential for expanding intra-regional trade if collective regional efforts are made in trade facilitation in the customs environment. By doing so, trade flows could increase by 41–143% in various scenarios, which could not be achieved otherwise, even by completely phasing out tariffs. India is the largest country in South Asia and therefore has a detrimental part to play in achieving this.

JEL Codes: C23, F10, F15, F17
Electronically monitored medication adherence in idiopathic pulmonary fibrosis: prevalence, predictors and outcomes
Authors: Delameillieure Anouk , Wuyts Wim A. , Pironet Antoine , Dobbels Fabienne
Published: August 2022

Medication adherence studies in idiopathic pulmonary fibrosis (IPF) are limited, use cross-sectional designs and report discontinuation rates.

We prospectively investigated adherence to pirfenidone in IPF patients using electronic monitoring, which provides insights on whether and when the medication was taken on a day-by-day basis. We investigated the impact of nonadherence on lung function and selected predictors for nonadherence based on the COM-B behavioural model. The longitudinal statistical analyses included generalised estimation equations and linear mixed effects models.

55 patients initiating pirfenidone were followed-up for 2 years after diagnosis (76.4% men, mean age 71.1 years (range 50–87 years), mean forced vital capacity (FVC) 88% predicted (sd18.3), mean diffusing capacity of the lung for carbon monoxide (DLCO) 58.1% predicted (sd14.7)). Our data showed an association (p=0.03) between the proportion of days with three pirfenidone intakes (i.e.dosing adherence) and FVC % predicted, whereby a high dosing adherence seemed necessary to maintain stable or improving FVC % predicted values. 58.2% of the participants were able to implement at least 90% correct dosing days, yet adherence significantly decreased over time. Too short dosing intervals had negative effects on lung function outcomes. Knowledge on IPF and self-reported adherence were significantly associated with electronically measured adherence.

In conclusion, nonadherence is prevalent and might negatively affect lung function. Further research is needed on the impact of nonadherence on outcomes and its predictors, so that tailored interventions can be developed. Meanwhile, a self-report questionnaire could be used to identify adherence issues and teams should equip patients with knowledge about their treatment and how to take it.
Identification of OSCA gene family in Solanum habrochaites and its function analysis under stress
Authors: Miao Shuang , Li Fengshuo , Han Yang , Yao Zhongtong , Xu Zeqian , Chen Xiuling , Liu Jiayin , Zhang Yao , Wang Aoxue
Published: August 2022

Background

OSCA (hyperosmolality-gated calcium-permeable channel) is a calcium permeable cation channel protein that plays an important role in regulating plant signal transduction. It is involved in sensing changes in extracellular osmotic potential and an increase in Ca2+ concentration. S. habrochaites is a good genetic material for crop improvement against cold, late blight, planthopper and other diseases. Till date, there is no report on OSCA in S. habrochaites. Thus, in this study, we performed a genome-wide screen to identify OSCA genes in S. habrochaites and characterized their responses to biotic and abiotic stresses.

Results

A total of 11 ShOSCA genes distributed on 8 chromosomes were identified. Subcellular localization analysis showed that all members of ShOSCA localized on the plasma membrane and contained multiple stress-related cis acting elements. We observed that genome-wide duplication (WGD) occurred in the genetic evolution of ShOSCA5 (Solhab04g250600) and ShOSCA11 (Solhab12g051500). In addition, repeat events play an important role in the expansion of OSCA gene family. OSCA gene family of S. habrochaites used the time lines of expression studies by qRT-PCR, do indicate OSCAs responded to biotic stress (Botrytis cinerea) and abiotic stress (drought, low temperature and abscisic acid (ABA)). Among them, the expression of ShOSCAs changed significantly under four stresses. The resistance of silencing ShOSCA3 plants to the four stresses was reduced.

Conclusion

This study identified the OSCA gene family of S. habrochaites for the first time and analyzed ShOSCA3 has stronger resistance to low temperature, ABA and Botrytis cinerea stress. This study provides a theoretical basis for clarifying the biological function of OSCA, and lays a foundation for tomato crop improvement.
Antibacterial efficacy of lytic phages against multidrug-resistant Pseudomonas aeruginosa infections in bacteraemia mice models
Authors: Arumugam Shri Natrajan , Manohar Prasanth , Sukumaran Sunilkumar , Sadagopan Sathish , Loh Belinda , Leptihn Sebastian , Nachimuthu Ramesh
Published: August 2022

Background

Pseudomonas aeruginosa is an opportunistic pathogen that can cause a variety of infections in humans, such as burn wound infections and infections of the lungs, the bloodstream and surgical site infections. Nosocomial spread is often concurrent with high degrees of antibiotic resistance. Such resistant strains are difficult to treat, and in some cases, even reserved antibiotics are ineffective. A particularly promising therapy to combat infections of resistant bacteria is the deployment of bacteriophages, known as phage therapy. In this work, we evaluated the in vivo efficacy of two Pseudomonas phages in bacteremia mice models. For this study, non-neutropenic mice (BalB/C) were infected with P. aeruginosa AB030 strain and treated using two bacteriophages, AP025 and AP006.

Results

The results showed that a single dose of phages at higher concentrations, bacteria: phage at 1:10 and 1:100 were effective in eliminating the bloodstream infection and achieving 100% mice survival.

Conclusion

This study highlights the efficacy of using a single dose of phages to restore mice from bacteremia.
TG/HDL-C ratio predicts in-hospital mortality in patients with acute type A aortic dissection
Authors: Lin Yan-Juan , Lin Jian-Long , Peng Yan-Chun , Li Sai-Lan , Chen Liang-Wan
Published: August 2022

Background

In recent years, abnormalities in serum lipids and lipoproteins have been shown to be associated with cardiovascular disease risk. However, their prognostic value for acute type A aortic dissection is unclear. This study analyzed the correlation between triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and in-hospital mortality in patients with AAAD, and aimed to investigate the clinical significance of preoperative blood lipids and lipoproteins on the prognosis of acute type A aortic dissection.

Methods

A total of 361 patients who underwent type A aortic dissection surgery in Fujian Cardiac Medical Center from June 2018 to March 2020 were retrospectively collected. According to the baseline TG/HDL-C ratio, the patients were divided into 3 groups according to the tertile method, the low TG/HDL-C ratio T1 group (< 1.18) and the middle TG/HDL-C ratio T2 group (1.18–1.70). T3 group with high TG/HDL-C ratio (> 1.70). Kaplan–Meier was used for survival analysis, and Cox proportional hazards regression model was used to analyze the factors affecting the prognosis of patients. The receiver operating characteristic (ROC) curve was used for the diagnostic efficacy.

Results

Among the 361 patients in this study, the mean age was 52.4 ± 11.3 years, 73 (20.2%) were female, and 82 (22.7%) died in hospital. Kaplan–Meier curve showed that with the increase of TG/HDL-C ratio, the risk of in-hospital death gradually increased (P < 0.001). Multivariate Cox regression analysis showed that age (HR = 1.031), body mass index (HR = 1.052), hypertension (HR = 3.491), white blood cells (HR = 1.073), TG/HDL-C ratio (HR = 1.604), MODS (HR = 1.652) was positively correlated with in-hospital mortality (P < 0.05). After adjusting for age, sex, and other risk factors, a significant association was found between the TG/HDL-C ratio and in-hospital mortality for acute type A aortic dissection (HR = 1.472, 95% CI, 1.354–3.451, P = 0.019).

Conclusion

Patients with type A aortic dissection have obvious abnormal blood lipid metabolism, and serum TG/HDL-C levels are positively correlated with in-hospital mortality in patients with AAAD.
Trend in the incidence of hepatitis A in mainland China from 2004 to 2017: a joinpoint regression analysis
Authors: Li Yuan-Sheng , Zhang Bei-Bei , Zhang Xi , Fan Song , Fei Li-Ping , Yang Chao , Ren Ning-Jun , Li Xiang , Luo Ya-Mei , Zhang Jun-Hui
Published: August 2022

Background

China has experienced a continuous decreasing trend in the incidence of hepatitis A in recent years. Temporal trend analyses are helpful in exploring the reasons for the changing trend. Thus, this study aims to analyse the incidence trend of viral hepatitis A by region and age group in mainland China from 2004 to 2017 to evaluate the effectiveness of prevention and control measures.

Methods

Data on hepatitis A and population information were collected and analysed with a joinpoint regression model. Annual percentage changes (APCs) and average annual percentage changes (AAPCs) were estimated for the whole country and for each region and age group.

Results

From 2004 to 2017, the seasonality and periodicity of hepatitis A case numbers were obvious before 2008 but gradually diminished from 2008 to 2011 and disappeared from 2012–2017. The national incidence of hepatitis A (AAPC =  − 12.1%) and the incidence rates for regions and age groups showed decreasing trends, with differences in the joinpoints and segments. Regarding regions, the hepatitis A incidence in the western region was always the highest among all regions, while a nonsignificant rebound was observed in the northeastern region from 2011 to 2017 (APC = 14.2%). Regarding age groups, the hepatitis A incidence showed the fastest decrease among children (AAPC =  − 15.3%) and the slowest decrease among elderly individuals (AAPC =  − 6.6%). Among all segments, the hepatitis A incidence among children had the largest APC value in 2007–2017, at − 20.4%.

Conclusion

The national annual incidence of hepatitis A continually declined from 2004 to 2017 and the gaps in hepatitis A incidence rates across different regions and age groups were greatly narrowed. Comprehensive hepatitis A prevention and control strategies, including the use of routine vaccination during childhood in mainland China, especially the implementation of the national Expanded Program on Immunization (EPI) in 2008, resulted in substantial progress from 2004 to 2017. However, gaps remain. Regular monitoring and analysis of hepatitis A epidemic data and prompt adjustment of hepatitis A prevention and control strategies focusing on children, elderly individuals and those living in certain regions are recommended.
Experiences of women awaiting cervical CANCER screening results from selected hospitals in Accra, Ghana
Authors: Osei Evans Appiah , Appiah Stella , Oti-Boadi Ezekiel , Hammond Dorothy , Awuah Dorothy Baffour , Menlah Awube , Garti Isabella , Baidoo Michael
Published: August 2022

Background

The rate at which cervical cancer is diagnosed among women worldwide is alarming, nevertheless, millions of women have never undergone cervical cancer screening, and many more with cervical cancer die prematurely without accessibility to quality healthcare or effective treatment. Women’s experiences following cervical cancer screening have not been extensively studied especially in advancing countries like Ghana. Hence, the researchers aim to explore the experiences of women awaiting cervical cancer results at selected hospitals in Accra.

Methods

An exploratory-descriptive qualitative design was adopted to purposively sample 48 participants engaged in face-face in-depth interviews, which were audio-taped and transcribed verbatim after. The interviews were guided by semi-structured interviews.

Findings

The findings revealed 3 themes and 10 subthemes. The themes were pre-screening experience, intra-screening experience, and post-screening experience. Participants narrated the challenges they face before the screening, during the screening, and as they waited for their results to get ready. Despite some challenges reported, most of the participants indicated that they were willing to come for a retesting if recommended.

Conclusion

In conclusion, participants who have undergone CCS have several experiences that may either motivate or discourage them from subsequent screening. Being aware of such experiences could help the nurses address them in order to increase the interest of the women in CCS.
Person-centred care on the move – an interview study with programme directors in Swedish higher education
Authors: Björkman I. , Feldthusen C. , Forsgren E. , Jonnergård A. , Lindström Kjellberg I. , Wallengren Gustafsson C. , Lundberg M.
Published: August 2022

Background

There is an increasing trend towards person-centred care (PCC) worldwide, suggesting that PCC should be mastered by future health care professionals. This study aims to explore programme directors’ views on facilitators and barriers to implementing PCC in four of the largest national study programmes in Sweden training future health care professionals.

Methods

A qualitative design was applied and interviews were conducted with 19 programme directors of Swedish national study programmes in medicine, nursing, occupational therapy and physiotherapy. The interviews were analysed using qualitative content analysis. Themes were sorted according to the Consolidated Framework for Implementation Research (CFIR) in an abductive approach. COREQ guidelines were applied.

Results

The overarching theme, as interpreted from the programme directors’ experiences, was ‘Person-centred care is on the move at different paces.’ The theme relates to the domains identified by the CFIR as outer setting, innovation, inner setting and process. PCC was understood as something familiar but yet new, and the higher education institutions were in a state of understanding and adapting PCC to their own contexts. The movement in the outer setting consists of numerous stakeholders advocating for increased patient influence, which has stirred a movement in the inner setting where the higher educational institutions are trying to accommodate these new demands. Different meanings and values are ascribed to PCC, and the concept is thus also ‘on the move’, being adapted to traditions at each educational setting.

Conclusion

Implementation of PCC in Swedish higher education is ongoing but fragmented and driven by individuals with a specific interest. There is uncertainty and ambiguity around the meaning and value of PCC and how to implement it. More knowledge is needed about the core of PCC as a subject for teaching and learning and also didactic strategies suitable to support students in becoming person-centred practitioners.
Identifying genetic markers enriched by brain imaging endophenotypes in Alzheimer’s disease
Authors: Kim Mansu , Wu Ruiming , Yao Xiaohui , Saykin Andrew J. , Moore Jason H. , Shen Li ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: August 2022

Background

Alzheimer’s disease (AD) is a complex neurodegenerative disorder and the most common type of dementia. AD is characterized by a decline of cognitive function and brain atrophy, and is highly heritable with estimated heritability ranging from 60 to 80$$\%$$
%
. The most straightforward and widely used strategy to identify AD genetic basis is to perform genome-wide association study (GWAS) of the case-control diagnostic status. These GWAS studies have identified over 50 AD related susceptibility loci. Recently, imaging genetics has emerged as a new field where brain imaging measures are studied as quantitative traits to detect genetic factors. Given that many imaging genetics studies did not involve the diagnostic outcome in the analysis, the identified imaging or genetic markers may not be related or specific to the disease outcome.

Results

We propose a novel method to identify disease-related genetic variants enriched by imaging endophenotypes, which are the imaging traits associated with both genetic factors and disease status. Our analysis consists of three steps: (1) map the effects of a genetic variant (e.g., single nucleotide polymorphism or SNP) onto imaging traits across the brain using a linear regression model, (2) map the effects of a diagnosis phenotype onto imaging traits across the brain using a linear regression model, and (3) detect SNP-diagnosis association via correlating the SNP effects with the diagnostic effects on the brain-wide imaging traits. We demonstrate the promise of our approach by applying it to the Alzheimer’s Disease Neuroimaging Initiative database. Among 54 AD related susceptibility loci reported in prior large-scale AD GWAS, our approach identifies 41 of those from a much smaller study cohort while the standard association approaches identify only two of those. Clearly, the proposed imaging endophenotype enriched approach can reveal promising AD genetic variants undetectable using the traditional method.

Conclusion

We have proposed a novel method to identify AD genetic variants enriched by brain-wide imaging endophenotypes. This approach can not only boost detection power, but also reveal interesting biological pathways from genetic determinants to intermediate brain traits and to phenotypic AD outcomes.
Feature extraction from MRI ADC images for brain tumor classification using machine learning techniques
Authors: Vijithananda Sahan M. , Jayatilake Mohan L. , Hewavithana Badra , Gonçalves Teresa , Rato Luis M. , Weerakoon Bimali S. , Kalupahana Tharindu D. , Silva Anil D. , Dissanayake Karuna D.
Published: August 2022

Background

Diffusion-weighted (DW) imaging is a well-recognized magnetic resonance imaging (MRI) technique that is being routinely used in brain examinations in modern clinical radiology practices. This study focuses on extracting demographic and texture features from MRI Apparent Diffusion Coefficient (ADC) images of human brain tumors, identifying the distribution patterns of each feature and applying Machine Learning (ML) techniques to differentiate malignant from benign brain tumors.

Methods

This prospective study was carried out using 1599 labeled MRI brain ADC image slices, 995 malignant, 604 benign from 195 patients who were radiologically diagnosed and histopathologically confirmed as brain tumor patients. The demographics, mean pixel values, skewness, kurtosis, features of Grey Level Co-occurrence Matrix (GLCM), mean, variance, energy, entropy, contrast, homogeneity, correlation, prominence and shade, were extracted from MRI ADC images of each patient. At the feature selection phase, the validity of the extracted features were measured using ANOVA f-test. Then, these features were used as input to several Machine Learning classification algorithms and the respective models were assessed.

Results

According to the results of ANOVA f-test feature selection process, two attributes: skewness (3.34) and GLCM homogeneity (3.45) scored the lowest ANOVA f-test scores. Therefore, both features were excluded in continuation of the experiment. From the different tested ML algorithms, the Random Forest classifier was chosen to build the final ML model, since it presented the highest accuracy. The final model was able to predict malignant and benign neoplasms with an 90.41% accuracy after the hyper parameter tuning process.

Conclusions

This study concludes that the above mentioned features (except skewness and GLCM homogeneity) are informative to identify and differentiate malignant from benign brain tumors. Moreover, they enable the development of a high-performance ML model that has the ability to assist in the decision-making steps of brain tumor diagnosis process, prior to attempting invasive diagnostic procedures, such as brain biopsies.
First report of haemosporidia and associated risk factors in red junglefowl (Gallus gallus) in China
Authors: Li Zhao , Ren Xiao-Xia , Zhao Yin-Jiao , Yang Lian-Tao , Duan Bo-fang , Hu Na-Ying , Zou Feng-Cai , Zhu Xing-Quan , He Jun-Jun , Liu Qi-Shuai
Published: August 2022

Background

Avian haemosporidia infect both domestic and wild birds, causing anemia, acute tissue degeneration, and depopulation in wild birds. Poultry and wild birds have been reported as common reservoirs of haemosporidia, but limited information is available for red junglefowl (Gallus gallus) in China. The present study investigated the prevalence and molecular characterization of haemosporidia in red junglefowl.

Methods

Blood samples were collected from 234 red junglefowl from Jinghong City of Yunnan Province, and genomic DNA was extracted from these samples. The prevalence of haemosporidia was determined by nested PCR targeting the mitochondrial cytochromeb(cytb) gene. Molecular characterization was investigated based on phylogenetic analysis ofcytbsequences, and associated risk factors were analyzed using the Chi-square (χ2) test.

Results

The overall prevalence of haemosporidia was 74.8% (175/234), and three species were identified, namelyHaemoproteus enucleator,Leucocytozoon californicus, andPlasmodium juxtanucleare. The prevalence of haemosporidia in adult fowl (81.1%, 107/132) was significantly higher (χ2 = 6.32,df = 1,P = 0.012) than that in juveniles (66.7%, 68/102). Three novel haemosporidian lineages were revealed.

Conclusions

This study examined the prevalence and identified species of avian haemosporidians in red junglefowl, providing new information on the molecular epidemiology and geographical distribution of haemosporidian parasites. Our results indicated high prevalence and diverse species distribution of these haemosporidians in red junglefowl. To the best of our knowledge, this is the first record of haemosporidian infection in red junglefowl in China.

Graphical Abstract
Neospora caninum infection induced mitochondrial dysfunction in caprine endometrial epithelial cells via downregulating SIRT1
Authors: Tao De-Liang , Zhao Shan-Shan , Chen Jin-Ming , Chen Xi , Yang Xin , Song Jun-Ke , Liu Qun , Zhao Guang-Hui
Published: August 2022

Background

Infection of Neospora caninum, an important obligate intracellular protozoan parasite, causes reproductive dysfunctions (e.g. abortions) in ruminants (e.g. cattle, sheep and goats), leading to serious economic losses of livestock worldwide, but the pathogenic mechanisms of N. caninum are poorly understood. Mitochondrial dysfunction has been reported to be closely associated with pathogenesis of many infectious diseases. However, the effect of N. caninum infection on the mitochondrial function of hosts remains unclear.

Methods

The effects of N. caninum infection on mitochondrial dysfunction in caprine endometrial epithelial cells (EECs), including intracellular reactive oxygen species (ROS), mitochondrial membrane potential (MMP), adenosine triphosphate (ATP) contents, mitochondrial DNA (mtDNA) copy numbers and ultrastructure of mitochondria, were studied by using JC-1, DCFH-DA, ATP assay kits, quantitative real-time polymerase chain reaction (RT-qPCR) and transmission electron microscopy, respectively, and the regulatory roles of sirtuin 1 (SIRT1) on mitochondrial dysfunction, autophagy and N. caninum propagation in caprine EECs were investigated by using two drugs, namely resveratrol (an activator of SIRT1) and Ex 527 (an inhibitor of SIRT1).

Results

The current study found that N. caninum infection induced mitochondrial dysfunction of caprine EECs, including accumulation of intracellular ROS, significant reductions of MMP, ATP contents, mtDNA copy numbers and damaged ultrastructure of mitochondria. Downregulated expression of SIRT1 was also detected in caprine EECs infected with N. caninum. Treatments using resveratrol and Ex 527 to caprine EECs showed that dysregulation of SIRT1 significantly reversed mitochondrial dysfunction of cells caused by N. caninum infection. Furthermore, using resveratrol and Ex 527, SIRT1 expression was found to be negatively associated with autophagy induced by N. caninum infection in caprine EECs, and the intracellular propagation of N. caninum tachyzoites in caprine EECs was negatively affected by SIRT1 expression.

Conclusions

These results indicated that N. caninum infection induced mitochondrial dysfunction by downregulating SIRT1, and downregulation of SIRT1 promoted cell autophagy and intracellular proliferation of N. caninum tachyzoites in caprine EECs. The findings suggested a potential role of SIRT1 as a target to develop control strategies against N. caninum infection.

Graphical abstract
Subscapular elastofibrolipoma treated with marginal resection: two case reports
Authors: Mardani Parviz , Kamran Hooman , Ayare Nazanin , Shahriarirad Reza , Shahabinejad Pardis , Geramizadeh Bita , Vafabin Masoud
Published: August 2022

Background

Elastofibroma dorsi is a rare benign tumor of soft tissue, typically under the lower angle of the scapula. Its specific location and distinctive clinical symptoms can provide enough information for diagnosis. Nevertheless, pathological confirmation by biopsy may be needed to rule out other malignancies.

Case presentation

Here, we present two cases of 63-year-old and 49-year-old female Asian patients who came to us with the chief complaint of pain and bulging in their shoulders. Both patients had rubbery and mobile masses. Also, shoulder movements were not restricted in the examination; however, the patients expressed pain during movements. Computed tomography scans were compatible with the diagnosis of elastofibroma dorsi. Surgical excision was performed for both cases owing to the symptomatic nature of the masses, and histopathological findings confirmed the diagnosis.

Conclusion

Elastofibroma dorsi is a benign pseudotumor presenting with an uncomfortable feeling in the shoulder with movement in older females. In typical symptom-free cases of elastofibroma dorsi, observation is sufficient, while in symptomatic patients or if there is suspicion of malignancy, complete resection with marginal resection is the treatment of choice.
Stepwise differentiation of functional pancreatic β cells from human pluripotent stem cells
Authors: Jin Wenwen , Jiang Wei
Published: August 2022

Pancreatic β cells differentiated from stem cells provide promise for cell replacement therapy of diabetes. Human pluripotent stem cells could be differentiated into definitive endoderm, followed by pancreatic progenitors, and then subjected to endocrinal differentiation and maturation in a stepwise fashion. Many achievements have been made in making pancreatic β cells from human pluripotent stem cells in last two decades, and a couple of phase I/II clinical trials have just been initiated. Here, we overview the major progresses in differentiating pancreatic β cells from human pluripotent stem cells with the focus on recent technical advances in each differentiation stage, and briefly discuss the current limitations as well.