bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comprehensive Investigation on Potential Risk Factors for NSCL/P in a Rural District of Hebei Province, China
Authors: Chai Congna , Cheng Lei , Jiao Jianjun , Dang Juan , Jin Shubin
Published: November 2021

Non syndromic cleft lip with or without palate (NSCL/P), one of the most common birth defects, is closely related to various risk factors. However, information regarding risk factors for NSCL/P in rural districts in China is very limited thus far. The objective of this study was designed to identify the potential risk factors for NSCL/P in rural districts.

A comprehensive retrospective investigation including 435 NSCL/P patients and 402 healthy children was carried out in Hebei Province, China. Multiple logistic regression analysis and transmission disequilibrium test (TDT) were respectively used to identify non-genetic and genetic risk factors for NSCL/P, and then PLINK was used to explore the relationship between non-genetic and genetic risk factors.

The results showed that maternal periconceptional exposure to pesticides and herbicides, as well as low parental education level were involved in the increased risk of NSCL/P, whereas maternal folic acid and multivitamin supplementation use during preconception period were associated with the reduced risk of NSCL/P. TDT analysis identified 2 single nucleotide polymorphisms (SNPs) (rs7078160 and rs4752028) in VAX1 and one SNP (rs17563) in BMP4 as the genetic risk factors for NSCL/P. Further analysis showed that the genetic risk factors were closely related with the negative non-genetic risk factors.

Our study identified the potential risk factors for NSCL/P in rural districts, thus providing a theoretical basis for the prevention of NSCL/P occurrence.
Pre-Epiglottic Baton Plate in the Management of Upper Airway Obstruction in an Infant with Femoral Facial Syndrome: A Case Report
Authors: Pang Si Ling , Ho Cheuk Hin Angus , Law Chun Man Lorie , Yang Yanqi , Leung Yiu Yan
Published: November 2021

Femoral facial syndrome (FFS) is a rare condition which may present with hypoplasia or aplasia of the femora and unusual facies characterized by long philtrum, thin upper lip and micrognathia. We present the case of a ten-month old infant with FFS who had retroglossal obstruction and who was treated with a pre-epiglottic baton plate. The pre-epiglottic baton plate can be a simple, non-invasive and effective tool for the clinical management of syndromic patients with mild-to-moderate upper airway obstruction due to micrognathia.
Examining Relationship-Level Predictors of Individual-Level Health in Long Distance Relationships
Authors: Du Bois Steve N. , Woodward Honor , Manser Kelly , Saigal Seema , Santic Frane , Tully Timothy , Sher Tamara Goldman
Published: November 2021

Long distance relationships (LDR) are increasingly common, particularly among postsecondary students. The geographic separation inherent in LDR, and related relationship factors, may have implications for the health of individuals in LDR. However, little current work examines these potential associations. The current study examined associations between relationship-level predictors (satisfaction, stress, maintenance) and individual-level health (e.g., anxiety, depression, sleep disturbance, fatigue) and health behaviors (e.g., alcohol and cigarette use, sex) in LDR. Participants ( N  =  100) were postsecondary students and romantic partners of postsecondary students, recruited from October 2018–June 2019, who completed an online survey on relationships and health. Here, we report sample characteristics; correlations between key study variables; and, results of stepwise hierarchical regressions testing whether relationship-level variables predicted individual-level health. Results indicated that relationship satisfaction and relationship stress predicted self-reported health in multiple domains, in the expected directions; but, neither relationship satisfaction nor relationship stress predicted health behaviors. Relationship maintenance predicted neither self-reported health nor health behaviors. Overall, some, but not all, relationship-level variables influenced some, but not all, individual-level health variables among postsecondary students and partners of postsecondary students in LDR. Future work can clarify relationship-level predictors of individual-level health behaviors in postsecondary students, among whom LDR are prevalent.
Fulfilling the self through food in wellness blogs: Governing the healthy subject
Authors: Tiusanen Kaisa
Published: November 2021

In the world of wellness, food and eating are fundamentally important to one’s subjectivity: the self in this sphere is created and maintained through food consumption along a plant-based, ‘wholesome’ and healthy personal journey to well-being. This article focuses on the analysis of wellness food blogs run by women, aiming to map out the technologies of the self through which the ‘ideal wellness subject’ is created. The analysis examines technologies of subjectivity as they aspire towards (1) balance, (2) healing and (3) narrativization of the self. The article suggests that the subjectivities related to wellness culture draw from postfeminist and healthist ideologies and are based on a neoliberal discourse of individuality and self-control. The sociocultural indifference of wellness culture and its prerogative to police the self through culturally hegemonic pursuits based on (the right kind of) consumption makes the language of wellness a prominent neoliberal discourse.
Combining Photography and Duoethnography for Creating a Trioethnography Approach to Reflect Upon Educational Issues Amidst the COVID-19 Global Pandemic
Authors: Le Giang Nguyen H , Tran Vuong , Le Trang Thuy
Published: November 2021

This study proposes a new research design, combining duoethnography and photography into a trioethnography that opens an artful lens through which educational changes, emerging and unfixed problems, and unexplored/unseen values and hopes were examined. Central to this trioethnography was voices of three Vietnamese doctoral students with transnational experiences in Canada and Australia, around three educational topics: researcher positionality, education inequity, and mindfulness in relation to the global crisis within and beyond higher education contexts. Living transnationally in these insecure and rocky times of a pandemic gives us a unique opportunity to contemplate the global educational shifts, moves, and changes in and after the crisis. We formed our discussions in the three circles of the Indigenous approach, in which we shared cultural artifacts, such as photographs, and used them as the catalysts for personal and interactive reflections. Taking up the spirit of duoethnography, we have seen that findings might be emerging from our dialogues and discussions; we gathered three different voices of contemplative educators to juxtapose our diverse perspectives and experiences of how education is changing, evolving, and shifting significantly amidst the COVID-19. In this process, we have shown efforts in progressing the traditional methodological practices of duoethnography through our trioethnographic conversations. Within the back-and-forth conversations, we have seen multiple facets of our narrative experiences through photographs, including personal sophisticated emotions, struggles, hopes, and losses.
Prevalence and predictors of hypertension among adults in Mbarara City, Western Uganda
Authors: Batte Anthony , Gyagenda Joseph Ogavu , Otwombe Kennedy , Muhindo Rose , Bagasha Peace , Kiggundu Daniel , Aujo Judith Caroline , Atuhe David Martin , Kansiime Grace , Hussein Reham , Namuyimbwa Lydia , Mukasa Sandra Luyima , Kabuye Amina , Mukasa Joseph , Sekasanvu Emmanuel , Kalyesubula Robert
Published: November 2021

Objective

The study aim was to evaluate the prevalence and predictors of hypertension among an urban adult population in Mbarara city, Western Uganda.

Methods

We evaluated blood pressure measurements, social demographic and clinical parameters of adults living in Mbarara city, Uganda. These parameters were extracted from medical records of adults who participated in the Uganda World Kidney Day 2020 health screening activities. A total of 302 adults were evaluated for hypertension using the American College of Cardiology/American Heart Association 2017 (blood pressure threshold 130/80 mmHg) and International Society of Hypertension 2020 guidelines (threshold 140/90 mmHg).

Results

The mean age of the participants was 42.5 years (standard deviation: 15.1) and majority were male 195/302 (64.6%). Using American College of Cardiology/American Heart Association 2017 guidelines, 156/302 (51.7%) adults were newly diagnosed with hypertension compared to 68/302 (22.5%) newly diagnosed with hypertension using International Society of Hypertension 2020 guidelines. Only 23/302 (7.6%) were on treatment. Based on American College of Cardiology/American Heart Association 2017 guidelines, age ≥40 years and overweight/obesity were statistically significant predictors of hypertension (p < 0.05 for all) at multivariate analysis. Using the International Society of Hypertension 2020 guidelines, age ≥40 years predicted hypertension.

Discussion

The prevalence of hypertension is high among this urban adult population irrespective of the guidelines used, highlighting the need for hypertension prevention interventions.
Saving EU digital constitutionalism through the proportionality principle and a transatlantic digital accord
Authors: Czarnocki Jan
Published: November 2021

The article explains the importance of the emerging movement for EU digital constitutionalism (EUDC), which reflects a Union-wide effort to address through regulation the challenges posed by digitalisation. The article outlines the core legislative acts that have been introduced by proponents of EUDC. It describes why EUDC is important for fundamental rights protection and European foreign policy, and how the ‘Brussels effect’ extends the impact of EUDC. It enquires into whether EUDC is sustainable, taking into consideration waning EU global influence and the need for economic growth. The EU needs to strike a balance between fundamental rights protection and economic growth. The proportionality principle is the right tool for this. A proportional approach should be followed in establishing a transatlantic digital accord with the US—an agreement on the basic principles governing the digital space. A more proportional approach will pave the way to such an agreement—giving EUDC a global scope.
Political Budget Cycles in Public Revenues: Evidence From Fines
Authors: Benito Bernardino , Guillamón María-Dolores , Ríos Ana-María
Published: November 2021

This article seeks to ascertain whether local governments make improper use of their discretion and use pecuniary sanctions for electoral purposes. To this end, a sample of Spanish municipalities with a population of more than 1,000 citizens during the period 2010 to 2016 has been used. Our results show that revenues from fines are influenced by the presence of elections. In particular, we find that local governments in an election year reduce the percentage of fines, measured either over total non-financial revenues or in per capita terms. This reduction, compared to the pre-election year, suggests that politicians use their discretionary power to issue fewer fines in election years, as they are aware that penalties are not well-regarded by citizens. In addition, we find that the most indebted municipalities, those governed by right-wing parties and the most fragmented municipalities tend to collect more revenues from fines in the pre-election year. Finally, other factors influencing revenues from fines are the number of inhabitants of the municipality, the sources of external funding that the local government has, the ideology of the rulers and their political strength.
Lavender Aromatherapy to Reduce Anxiety During Intrauterine Insemination: A Randomized Controlled Trial
Authors: Jones Tiffanny , Purdy MacKenzie , Stewart Elizabeth A. , Cutshall Susanne M. , Hathcock Matthew A. , Mahapatra Saswati , Bauer Brent A. , Ainsworth Alessandra J.
Published: November 2021

Background

Infertility is a global public health issue. Therapies such as intrauterine insemination (IUI) are effective but may be associated with considerable anxiety. Preliminary data suggest that decreasing this anxiety might lead to improved outcomes.

Objective

To determine whether lavender aromatherapy (LA) reduces anxiety during an IUI procedure.

Methods

A randomized controlled trial of women undergoing IUI at a hospital-based fertility clinic. The intervention and comparison were the use of LA vs water. Measurements were the change in anxiety level during an IUI procedure, with secondary assessment of pain scores, patient satisfaction, and pregnancy rates.

Results

In total, 67 women were screened, and 62 women randomly assigned to either placebo (n = 31) or LA (n = 31). No differences were observed in baseline demographic characteristics or visual analog scores for anxiety before IUI (mean [95% CI], 33.9 [25.2 to 45.6] mm vs 41.0 [33.0 to 49.0] mm) in the LA and placebo groups. However, a statistically significant change in anxiety was observed after LA inhalation during the procedure (mean [95% CI], −11.2 [−19.1 to −3.2]) compared with placebo (mean [95% CI], 1.3 [−5.6 to 8.2]; P = .02). No significant difference was observed in pain during IUI in the LA group vs placebo group. Patient satisfaction was high, with 93% of respondents in the LA group satisfied with the aromatherapy during their procedure. Additionally, 76% of participants who received placebo reported that they would prefer to use LA during their IUI. No statistically significant difference was detected in pregnancy rates between the 2 groups: 19.4% with LA vs 9.7% with placebo ( P = .47).

Conclusion

LA reduced anxiety and was preferred by women during IUI fertility treatments.
Is there difference and correlation between medial and lateral tibial plateau coronal obliquity in native knee? A radiographic study
Authors: Leung Thomas Ka Chun , Lau Will Wai Hong , Fung Wing Chiu , Chan Vincent Wai Kwan , Cheung Amy , Cheung Man Hong , Fu Henry , Yan Chun Hoi , Chan Ping Keung , Chiu Kwong Yuen
Published: November 2021

Background/Purpose

Knee joint line is commonly defined as a tangent to medial and lateral tibial plateaus in various radiographic measurements. We aim to investigate radiographic differences between medial and lateral knee joint line coronal obliquity. It has significant implication on radiographic analysis following unicompartmental knee arthroplasty.

Methods

We analysed the knee radiographs of 48 young patients (mean age 25.1 + /-5.6 years) with 50 anterior cruciate ligament-deficient knees. Medial and lateral tibial plateau coronal obliquity were defined as angles between femoral knee joint line and the tangent to articular surface of each tibial plateau. Mediolateral differences and linear correlation were analysed.

Results

Significant difference was found between medial (mean = -1.5, SD = 2.4 degrees) and lateral obliquity (mean =  + 0.6, SD = 3.0 degrees) ( p < 0.001). The mean mediolateral difference was 3.1 degrees (SD = 2.8, range 0–11.8 degrees), without significant correlation (r = 0.085, p = 0.56).

Conclusion

Mediolateral differences exist in knee joint line obliquity. Each compartment should be considered separately when measuring knee joint line obliquity.
Joint awareness after unicompartmental and total knee arthroplasty: Which feels more natural?
Authors: Güngör Reşit Harun , Bayrak Gökhan , Şavkın Raziye , Büker Nihal
Published: November 2021

Background/Purpose

The purpose of this study was to compare the joint awareness and knee function after unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) for the management of isolated medial compartment osteoarthritis.

Methods

Patients who underwent UKA or TKA at our institution for isolated medial compartment osteoarthritis from 2015 to 2020 with a minimum follow-up of 1 year were screened. 116 eligible patients were invited and 94 volunteer patients participated. All patients were evaluated with The Forgotten Joint Score-12 and Lysholm Knee Scale.

Results

Average follow-up period was 29.13±15.48 months for UKA and 31.66±2.91 months for TKA groups ( p=0.292). FJS-12 of the UKA group was significantly higher than that of the TKA group (79.74±15.06 and 63.25±19.86, respectively; p=0.024). The Lysholm Knee Scale score was also significantly higher in the UKA group compared with the TKA group (92.94±8.74 and 78.34±14.99, respectively; p = 0.002).

Conclusion

Our findings suggest that patients who underwent UKA were less aware of their artificial joints and had better knee function compared to patients who underwent TKA for medial osteoarthritis of the knee.
Hiking-related orthopaedic injuries: Another epidemic during the COVID-19 pandemic
Authors: Chu Wing Yiu Claudia , Chong Yau Chun , Mok Wing Yuk
Published: November 2021

Introduction

Coronavirus disease 2019 (COVID-19) had spread to over 200 countries and regions across the world since early 2020. Travel bans had been implemented in Hong Kong to control the spread of virus. Despite the burden to the healthcare system brought by COVID-19, there was also an increase in number of hiking-related injuries requiring inpatient care. The aim of this study is to report the incidence of hiking-related injuries admitted to the orthopaedic wards during the COVID-19 pandemic and comparison with statistics from the past years.

Methods

Data was retrieved from the admission books of the orthopaedic wards and Electronic Patient Records. The number of admissions, patients’ demographics and details of hospitalisation were compared between February to May 2020 (COVID-19 study period) and 2019. Secondary analysis was performed on admissions for tibia and/or fibula fractures with or without operation during the study period and compared with the past five years.

Results

48 patients were admitted due to hiking-related conditions during the COVID-19 study period, which was 2.4 times more than 2019. 23 patients suffered from tibia and/or fibula fractures and was higher than the past five years (average 5.8, p = 0.0001). Among patients operated for tibia and/or fibula fractures, the percentage of hiking-related injuries was 41.9% in 2020 and 6.9% in the past five years (p = 0.0002).

Conclusions

An increase in incidence of hiking-related orthopaedic injuries was observed during the COVID-19 pandemic. Healthcare workers, public health experts and government officials should work together to raise awareness on safety in hiking for effective prevention of injury.
Guidelines for Authors and Reviewers of Plastic Surgery
Authors: Thoma Achilles , Murphy Jessica , Arneja Jugpal
Published: November 2021

Credible clinical research is a precondition of evidence-based surgery. If clinical research is not conducted and reported properly, such research can be unreliable, unclear, and misleading. Our journal, Plastic Surgery, aims to improve its quality and thus enhance interest, submissions, and readership. To do so, we must ensure that the articles published in our journal align with these goals. This article guides future clinical research contributors, how to design, conduct and report valuable and reliable research. Readers are informed how to choose a title and keywords that properly reflect the content of the article. The proper organization of a manuscript, and the information that goes into each section is described. Valuable tools like the EQUATOR Network Guidelines, the FINER Criteria and the PICOT Format are described for the reader. These resources help formulate a proper research question and ensure transparency in reporting. Commonly used study designs, and the research questions they answer are presented. This ensures that those engaged in research are choosing the right study design for their research. We outline the statistical information that should be presented in the Methods section and differentiate between the content that should be found in the Results and Discussion sections. As Plastic Surgery strives to publish high-quality, reliable research, it is by the standards presented in this article that we will judge all manuscripts submitted for publication.
Book review: Rakesh Batabyal, The Modern School (1920–2020): A Century of Schooling in India
Authors: Kumar Deepak
Published: November 2021

Rakesh Batabyal, The Modern School (1920–2020): A Century of Schooling in India (Chennai: Westland Publications), 2020, 411 pp., ₹594, (hb).
The Huns (‘Hūṇas’) in India: A Review
Authors: Kumar Ashish
Published: November 2021

Limited attention seems to have been paid in Indian historical work to the Hūṇas (Huns) except for the general assumption that they played a very destructive role in Indian history. There is need for a fresh appraisal of the Hūṇa polity in the light of the Schūyen copper scroll, and further work on the numismatic evidence, while the details of their conflict with the Guptas need to be properly worked out. Finally, the objective behind their deep intrusion into central India (especially Malwa) has to be located in a broader context.
Famine of 1943 in Bakarganj and British Colonial Policy
Authors: Islam Muhammad Saiful , Zisan Tasnuva Habib
Published: November 2021

In the vast literature of Bengal famine of 1943, it is hard to offer new insights about that vicious source of mass misery. Local history may mark a significant departure here, as it provides scope for an in-depth study of both the origin and course of the famine. Bakarganj was called the granary of Bengal, which used to supply rice to other regions even in the driest years due to its large production. But the famine of 1943 gravely affected this district. The present study shows how it was the colonial measures that played a vital role in intensifying the famine in Bakarganj. The government’s led to: hoarding of rice and serious shortage of food supply. The article concentrates on four aspects of the government failure: inappropriate warning system, callous purchase policy, lack of effective government inspection and a policy of disaster denial.
In the Footsteps of ‘Lenin’: Peace, Struggle and the Progressive Intelligentsia in Colonial Bengal
Authors: Bhattacharya Binayak
Published: November 2021

The article begins with an obscure Bengali poem ‘Lenin’ published in 1924. Tracing the publication and its consequences, it explores the transmission of progressive ideas from Europe to Bengal, following the First World War and the Russian Revolution. Subsequently, the rise of fascism in Europe, and the Second World War marked a significant juncture in this trajectory, where the rhetoric of ‘peace’, championed during the years after the First World War, developed into a new relationship with popular struggles in Bengali progressive cultural practice.
A Tetrameric Assembly of Saposin A: Increasing Structural Diversity in Lipid Transfer Proteins
Authors: Shamin Maria , Spratley Samantha J. , Graham Stephen C. , Deane Janet E.
Published: November 2021

Saposins are lipid transfer proteins required for the degradation of sphingolipids in the lysosome. These small proteins bind lipids by transitioning from a closed, monomeric state to an open conformation exposing a hydrophobic surface that binds and shields hydrophobic lipid tails from the aqueous environment. Saposins form a range of multimeric assemblies to encompass these bound lipids and present them to hydrolases in the lysosome. This lipid-binding property of human saposin A has been exploited to form lipoprotein nanodiscs suitable for structural studies of membrane proteins. Here we present the crystal structure of a unique tetrameric assembly of murine saposin A produced serendipitously, following modifications of published protocols for making lipoprotein nanodiscs. The structure of this new saposin oligomer highlights the diversity of tertiary arrangement that can be adopted by these important lipid transfer proteins.
How I treat frontline transplantation-eligible multiple myeloma
Authors: Perrot Aurore
Published: November 2021

High-dose melphalan supported by autologous transplantation has been the standard of care for eligible patients with newly diagnosed multiple myeloma (MM) for >25 years. Several randomized clinical trials have recently reaffirmed the strong position of transplantation in the era of proteasome inhibitors and immunomodulatory drugs combinations, demonstrating a significant reduction of progression or death in comparison with strategies without transplantation. Immunotherapy is currently changing the paradigm of MM management, and daratumumab is the first-in-class human monoclonal antibody targeting CD38 approved in the setting of newly diagnosed MM. Quadruplets have become the new standard in transplantation programs, but outcomes remain heterogeneous, with various response depth and duration. The development of sensitive and specific tools for disease prognostication allows the consideration of strategies adaptive to dynamic risk. This review discusses the different options available for the treatment of transplantation-eligible patients with MM in frontline setting.
PP2A is a therapeutically targetable driver of cell fate decisions via a c-Myc/p21 axis in human and murine acute myeloid leukemia
Authors: Goswami Swagata , Mani Rajeswaran , Nunes Jessica , Chiang Chi-Ling , Zapolnik Kevan , Hu Eileen , Frissora Frank , Mo Xiaokui , Walker Logan A. , Yan Pearlly , Bundschuh Ralf , Beaver Larry , Devine Raymond , Tsai Yo-Ting , Ventura Ann , Xie Zhiliang , Chen Min , Lapalombella Rosa , Walker Alison , Mims Alice , Larkin Karilyn , Grieselhuber Nicole , Bennett Chad , Phelps Mitch , Hertlein Erin , Behbehani Gregory , Vasu Sumithira , Byrd John C. , Muthusamy Natarajan
Published: November 2021

Dysregulated cellular differentiation is a hallmark of acute leukemogenesis. Phosphatases are widely suppressed in cancers but have not been traditionally associated with differentiation. In this study, we found that the silencing of protein phosphatase 2A (PP2A) directly blocks differentiation in acute myeloid leukemia (AML). Gene expression and mass cytometric profiling revealed that PP2A activation modulates cell cycle and transcriptional regulators that program terminal myeloid differentiation. Using a novel pharmacological agent, OSU-2S, in parallel with genetic approaches, we discovered that PP2A enforced c-Myc and p21 dependent terminal differentiation, proliferation arrest, and apoptosis in AML. Finally, we demonstrated that PP2A activation decreased leukemia-initiating stem cells, increased leukemic blast maturation, and improved overall survival in murine Tet2−/−Flt3ITD/WT and human cell-line derived xenograft AML models in vivo. Our findings identify the PP2A/c-Myc/p21 axis as a critical regulator of the differentiation/proliferation switch in AML that can be therapeutically targeted in malignancies with dysregulated maturation fate.
Venetoclax plus dose-adjusted R-EPOCH for Richter syndrome
Authors: Davids Matthew S. , Rogers Kerry A. , Tyekucheva Svitlana , Wang Zixu , Pazienza Samantha , Renner Sarah K. , Montegaard Josie , Ihuoma Udochukwu , Lehmberg Timothy Z. , Parry Erin M. , Wu Catherine J. , Jacobson Caron A. , Fisher David C. , Thompson Philip A. , Brown Jennifer R.
Published: November 2021

Richter syndrome (RS) of chronic lymphocytic leukemia (CLL) is typically chemoresistant, with a poor prognosis. We hypothesized that the oral Bcl-2 inhibitor venetoclax could sensitize RS to chemoimmunotherapy and improve outcomes. We conducted a single-arm, investigator-sponsored, phase 2 trial of venetoclax plus dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (VR-EPOCH) to determine the rate of complete response (CR). Patients received R-EPOCH for 1 cycle, then after count recovery, accelerated daily venetoclax ramp-up to 400 mg, then VR-EPOCH for up to 5 more 21-day cycles. Responders received venetoclax maintenance or cellular therapy off-study. Twenty-six patients were treated, and 13 of 26 (50%) achieved CR, with 11 achieving undetectable bone marrow minimal residual disease for CLL. Three additional patients achieved partial response (overall response rate, 62%). Median progression-free survival was 10.1 months, and median overall survival was 19.6 months. Hematologic toxicity included grade ≥3 neutropenia (65%) and thrombocytopenia (50%), with febrile neutropenia in 38%. No patients experienced tumor lysis syndrome with daily venetoclax ramp-up. VR-EPOCH is active in RS, with deeper, more durable responses than historical regimens. Toxicities from intensive chemoimmunotherapy and venetoclax were observed. Our data suggest that studies comparing venetoclax with chemoimmunotherapy to chemoimmunotherapy alone are warranted. This trial was registered at www.clinicaltrials.gov as #NCT03054896.
Drug–target interaction prediction using unifying of graph regularized nuclear norm with bilinear factorization
Authors: Sorkhi Ali Ghanbari , Abbasi Zahra , Mobarakeh Majid Iranpour , Pirgazi Jamshid
Published: November 2021

Background

Wet-lab experiments for identification of interactions between drugs and target proteins are time-consuming, costly and labor-intensive. The use of computational prediction of drug–target interactions (DTIs), which is one of the significant points in drug discovery, has been considered by many researchers in recent years. It also reduces the search space of interactions by proposing potential interaction candidates.

Results

In this paper, a new approach based on unifying matrix factorization and nuclear norm minimization is proposed to find a low-rank interaction. In this combined method, to solve the low-rank matrix approximation, the terms in the DTI problem are used in such a way that the nuclear norm regularized problem is optimized by a bilinear factorization based on Rank-Restricted Soft Singular Value Decomposition (RRSSVD). In the proposed method, adjacencies between drugs and targets are encoded by graphs. Drug–target interaction, drug-drug similarity, target-target, and combination of similarities have also been used as input.

Conclusions

The proposed method is evaluated on four benchmark datasets known as Enzymes (E), Ion channels (ICs), G protein-coupled receptors (GPCRs) and nuclear receptors (NRs) based on AUC, AUPR, and time measure. The results show an improvement in the performance of the proposed method compared to the state-of-the-art techniques.
Prenatal diagnosis of auriculocondylar syndrome with a novel missense variant of GNAI3: a case report
Authors: Liu Xiaoliang , Sun Wei , Wang Jun , Chu Guoming , He Rong , Zhang Bijun , Zhao Yanyan
Published: November 2021

Background

Auriculocondylar syndrome (ACS) is a rare disorder characterized by micrognathia, mandibular condyle hypoplasia, and auricular abnormalities. Only 6 pathogenic variants of GNAI3 have been identified associated with ACS so far. Here, we report a case of prenatal genetic diagnosis of ACS carrying a novel GNAI3 variant.

Case presentation

A woman with 30 weeks of gestation was referred to genetic counseling for polyhydramnios and fetal craniofacial anomaly. Severe micrognathia and mandibular hypoplasia were identified on ultrasonography. The mandibular length was 2.4 cm, which was markedly smaller than the 95th percentile. The ears were low-set with no cleft or notching between the lobe and helix. The face was round with prominent cheeks. Whole-exome sequencing identified a novel de novo missense variant of c.140G > A in the GNAI3 gene. This mutation caused an amino acid substitution of p.Ser47Asn in the highly conserved G1 motif, which was predicted to impair the guanine nucleotide-binding function. All ACS cases with GNAI3 mutations were literature reviewed, revealing female-dominated severe cases and right-side-prone deformities.

Conclusion

Severe micrognathia and mandibular hypoplasia accompanied by polyhydramnios are prenatal indicators of ACS. We expanded the mutation spectrum of GNAI3 and summarized clinical features to promote awareness of ACS.
nPTD classification: an updated classification of gastric cancer location for function preserving gastrectomy based on physiological lymphatic flow
Authors: Kinami Shinichi , Nakamura Naohiko , Miyashita Tomoharu , Kitakata Hidekazu , Fushida Sachio , Fujimura Takashi , Itoh Tohru , Takamura Hiroyuki
Published: November 2021

Background

The correlation between tumor location and lymphatic flow distribution in gastric cancer has been previously reported, and PTD (Proximal – Transitional – Distal) classification was proposed. Our group updated and developed the nPTD classification.

Method

We retrospectively studied gastric cancer patients who underwent the dye method sentinel node biopsy from 1993 to 2020. The inclusion criteria were a single lesion type 0 cancer of ≤5 cm in the long axis, clinically node-negative, and invasion within the proper muscle layer pathologically. In this study, the distribution of dyed lymphatic flow was evaluated for each occupied area of the tumor.

Results

We included 416 patients in this study. The tumors located in the watershed of the right and left gastroepiploic arteries near greater curvature had extensive lymphatic flow; therefore, a newly circular region with a diameter of 5 cm is set on the watershed of the greater curvature between P and T zone as the ‘n’ zone. In addition, for cancers located in the lesser P curvature, lymphatic flow to the greater curvature was not observed. Therefore, the P zone was divided into two: the lesser curvature side (PL) and the greater curvature side (PG).

Conclusions

The advantage of the nPTD classification is that it provides not only proper nodal dissection but also adequate function-preserving gastrectomy. If the tumor is localized within the PL, the proximal gastrectomy resection area can be further reduced. In contrast, for cancers located in the ‘n’ zone, near-total gastrectomy is required because of the extensive lymphatic flow.
Decreased sphingomyelin (t34:1) is a candidate predictor for lung squamous cell carcinoma recurrence after radical surgery: a case-control study
Authors: Takanashi Yusuke , Funai Kazuhito , Eto Fumihiro , Mizuno Kiyomichi , Kawase Akikazu , Tao Hong , Kitamoto Takuya , Takahashi Yutaka , Sugimura Haruhiko , Setou Mitsutoshi , Kahyo Tomoaki , Shiiya Norihiko
Published: November 2021

Background

To reduce disease recurrence after radical surgery for lung squamous cell carcinomas (SQCCs), accurate prediction of recurrent high-risk patients is required for efficient patient selection for adjuvant chemotherapy. Because treatment modalities for recurrent lung SQCCs are scarce compared to lung adenocarcinomas (ADCs), accurately selecting lung SQCC patients for adjuvant chemotherapy after radical surgery is highly important. Predicting lung cancer recurrence with high objectivity is difficult with conventional histopathological prognostic factors; therefore, identification of a novel predictor is expected to be highly beneficial. Lipid metabolism alterations in cancers are known to contribute to cancer progression. Previously, we found that increased sphingomyelin (SM)(d35:1) in lung ADCs is a candidate for an objective recurrence predictor. However, no lipid predictors for lung SQCC recurrence have been identified to date. This study aims to identify candidate lipid predictors for lung SQCC recurrence after radical surgery.

Methods

Recurrent (n = 5) and non-recurrent (n = 6) cases of lung SQCC patients who underwent radical surgery were assigned to recurrent and non-recurrent groups, respectively. Extracted lipids from frozen tissue samples of primary lung SQCC were analyzed by liquid chromatography-tandem mass spectrometry. Candidate lipid predictors were screened by comparing the relative expression levels between the recurrent and non-recurrent groups. To compare lipidomic characteristics associated with recurrent SQCCs and ADCs, a meta-analysis combining SQCC (n = 11) and ADC (n = 20) cohorts was conducted.

Results

Among 1745 screened lipid species, five species were decreased (≤ 0.5 fold change; P < 0.05) and one was increased (≥ 2 fold change; P < 0.05) in the recurrent group. Among the six candidates, the top three final candidates (selected by AUC assessment) were all decreased SM(t34:1) species, showing strong performance in recurrence prediction that is equivalent to that of histopathological prognostic factors. Meta-analysis indicated that decreases in a limited number of SM species were observed in the SQCC cohort as a lipidomic characteristic associated with recurrence, in contrast, significant increases in a broad range of lipids (including SM species) were observed in the ADC cohort.

Conclusion

We identified decreased SM(t34:1) as a novel candidate predictor for lung SQCC recurrence. Lung SQCCs and ADCs have opposite lipidomic characteristics concerning for recurrence risk.

Trial registration

This retrospective study was registered at the UMIN Clinical Trial Registry (UMIN000039202) on January 21, 2020.
A case analysis of a mass treatment approach to control GI and water-related conditions in Sudan
Authors: Salih Alaaddin , Mohamed Mohamed
Published: November 2021

Background

The efficiency of mass chlorination in controlling diarrheal diseases during acute emergencies has been extensively reported in literature. However, long-term crises received unparallel attention. Researchers have previously carried out a trial that investigated the impact of using chemical means to treat water reservoirs of Um-Baddah Nevachah, a refugee camp located in the western outskirts of Khartoum, Sudan.

A double-blind community experimental trial was carried out by randomly adding either chlorine or a placebo to the major water tanks in the area. Data were collected using a mixed-methods study design. The primary input was the quantitative data derived from total coliforms lab tests and records of the local primary healthcare center, while the embedded (nested) portion generated most of the qualitative data from direct face-to-face interviews.

As a case analysis, this study aims to critically appraise the original trial. In the Background the authors discussed the context of the trial, approach used, and outcomes. Discussion section included three issues related to the trial: scientific importance, challenges and strategies.

Discussion

Importance: There are two factors that contribute to the importance of this study: First, the integrated and systematic approach followed to resolve associated challenges. The study swiftly moved from investigating potential water contamination, to test whether it is related to an endogenous focus that auto-taints drinking water, and finally it explored the impact of tanks chlorination on public health. Second, the longstanding humanitarian context which remains largely underreported in literature. Challenges: funding limitations were among the first obstacles faced. During the fieldwork preparation phase, a lot of work was required to resolve logistical and security challenges. Keeping volunteers motivated was the biggest concern during the last phase of data collection. Strategies: The “Matrix Solutions Strategy” was developed and used to optimize scarce resources to simultaneously target multiple problems through a single intervention.

Conclusion

Key lessons learned from the whole experience were: persistence is paramount for the success of studies in precarious situations; lateral thinking generates alternative solutions that are novel, feasibility and practical in resources-limited settings; and finally respecting local culture and regulations is essential for building trust with both authorities and vulnerable societies.
Mortality differences between migrants and Italians residing in Rome before, during, and in the aftermath of the great recession. A longitudinal cohort study from 2001 to 2015
Authors: Trappolini Eleonora , Marino Claudia , Agabiti Nera , Giudici Cristina , Davoli Marina , Cacciani Laura
Published: November 2021

Background

In Europe, one of the most consistent findings is that of migrant mortality advantage in high-income countries. Furthermore, the literature shows that economic shocks, which bring worse health outcomes, can severely affect the most disadvantaged individuals. We analyse differences and changes in all-cause mortality between Italians and migrants residing in Rome before, during, and in the aftermath of the Great Recession (2001–2015) by birth-cohort.

Methods

The analysis is a longitudinal open cohort study. Mortality data come from the Register of the Causes of Death (58,637 deaths) and the population denominator (n = 2,454,410) comes from the Municipal Register of Rome. By comparing three time-periods (2001–2005, 2006–2010, and 2011–2015), we analyse all-cause mortality of Rome residents born, respectively, in the intervals 1937–1976, 1942–1981, 1947–1986 (aged 25–64 years at entry into observation). Computing birth-cohort-specific death rates and applying parametric survival models with age as the time-scale, we compare mortality differences between migrants and Italians by gender, area of origin, and time-period.

Results

Overall, we find a lower risk of dying for migrants than Italians regardless of gender (Women: HR = 0.61, 95% CI 0.56–0.66; Men: HR = 0.49, 95% CI 0.45–0.53), and a lower death risk over time for the total population. Nevertheless, such a pattern changes according to gender and migrants’ area of origin.

Conclusion

Given the relevance of international migrations in Europe, studying migrants’ health has proved increasingly important. The deterioration in migrant health and the gradual weakening of migrants’ mortality advantage is likely to become a public health issue with important consequences for the healthcare system of all European countries.
Can a virtual microbiology simulation be as effective as the traditional Wetlab for pharmacy student education?
Authors: Baumann-Birkbeck L. , Anoopkumar-Dukie S. , Khan S. A. , Cheesman M. J. , O’Donoghue M. , Grant G. D.
Published: November 2021

Background

Pharmacy practice education requires the development of proficiencies and an understanding of clinical microbiology. Learning in this area could be delivered using practical laboratory exercises, or potentially, simulation-based education. Simulation has previously successfully enhanced learning in health professional education. The current global climate due to COVID-19 has further highlighted the important role of technology-enhanced learning in delivering outcomes that meet the requisite learning objectives of a course. The aim of the present study was to compare the impact of a commercially available virtual microbiology simulation (VUMIE™) with a traditional wet laboratory (wetlab) on learner knowledge, skills and confidence in a second-year integrated pharmacotherapeutics course for Bachelor of Pharmacy students.

Methods

A randomised, crossover study was employed to determine whether the simulation intervention (VUMIE™) improves learning outcomes (knowledge, skills and confidence) of pharmacy students, when compared to a traditional wetlab intervention. Each student completed three 1–2 h length sessions, for both the wetlab and VUMIE™ interventions (6 sessions total). Data was collected using surveys deployed at baseline (pre-interventions), post-intervention 1 or 2 (VUMIE™ or wetlab) and endpoint (post-interventions 1 and 2). Statistical analysis was conducted using SPSS Statistics 25 and Instat™ software.

Results

Response rates were approximately 50% at initial survey and approximately 25% at endpoint survey. VUMIE™ produced higher post-intervention knowledge scores for the multiple-choice questions compared to the wetlab, however, the highest score was achieved at endpoint. Both interventions produced statistically significant differences for mean scores compared to baseline (pre-VUMIE™ and wetlab) across the domains of knowledge, skills and confidence. VUMIE™ produced higher post-intervention mean scores for knowledge, skills and confidence compared to post-intervention mean scores for the wetlab, however there was no statistical significance between the mean score for the two interventions, thus the VUMIE™ activity produced learning outcomes comparable to the wetlab activity.

Conclusion

These findings suggest VUMIE™ provides similar effects on students’ knowledge, skills, and confidence as a wetlab. The simulation’s implementation was not cost-prohibitive, provided students with a physically and psychologically safe learning environment, and the benefit of being able to repeat activities, supporting deliberate practice.
Automatic RadLex coding of Chinese structured radiology reports based on text similarity ensemble
Authors: Chen Yani , Nan Shan , Tian Qi , Cai Hailing , Duan Huilong , Lu Xudong
Published: November 2021

Background

Standardized coding of plays an important role in radiology reports’ secondary use such as data analytics, data-driven decision support, and personalized medicine. RadLex, a standard radiological lexicon, can reduce subjective variability and improve clarity in radiology reports. RadLex coding of radiology reports is widely used in many countries, but translation and localization of RadLex in China are far from being established. Although automatic RadLex coding is a common way for non-standard radiology reports, the high-accuracy cross-language RadLex coding is hardly achieved due to the limitation of up-to-date auto-translation and text similarity algorithms and still requires further research.

Methods

We present an effective approach that combines a hybrid translation and a Multilayer Perceptron weighting text similarity ensemble algorithm for automatic RadLex coding of Chinese structured radiology reports. Firstly, a hybrid way to integrate Google neural machine translation and dictionary translation helps to optimize the translation of Chinese radiology phrases to English. The dictionary is made up of 21,863 Chinese–English radiological term pairs extracted from several free medical dictionaries. Secondly, four typical text similarity algorithms are introduced, which are Levenshtein distance, Jaccard similarity coefficient, Word2vec Continuous bag-of-words model, and WordNet Wup similarity algorithms. Lastly, the Multilayer Perceptron model has been used to synthesize the contextual, lexical, character and syntactical information of four text similarity algorithms to promote precision, in which four similarity scores of two terms are taken as input and the output presents whether the two terms are synonyms.

Results

The results show the effectiveness of the approach with an F1-score of 90.15%, a precision of 91.78% and a recall of 88.59%. The hybrid translation algorithm has no negative effect on the final coding, F1-score has increased by 21.44% and 8.12% compared with the GNMT algorithm and dictionary translation. Compared with the single similarity, the result of the MLP weighting similarity algorithm is satisfactory that has a 4.48% increase compared with the best single similarity algorithm, WordNet Wup.

Conclusions

The paper proposed an innovative automatic cross-language RadLex coding approach to solve the standardization of Chinese structured radiology reports, that can be taken as a reference to automatic cross-language coding.