bluuebunny/crossref_metadata_2025 huggingface dataset:
Gait improvements by assisting hip movements with the robot in children with cerebral palsy: a pilot randomized controlled trial
Authors: Kawasaki Shihomi , Ohata Koji , Yoshida Takeshi , Yokoyama Atsushi , Yamada Shigehito
Published: July 2020

Background

Recently, rehabilitation robots are expected to improve the gait of cerebral palsy (CP) children. However, only few previous studies have reported the kinematic and kinetic changes by using wearable exoskeleton robots. The aim of this study was to investigate the change in gait parameters in CP children by training with the wearable robot-assisted gait training.

Methods

10 spastic CP children with Gross Motor Function Classification Scale levels I-III completed a sham-controlled crossover randomized trial. Robot-assisted gait training (RAGT) and non-assisted gait training (NAGT) were performed on the treadmill with the Honda Walking Assist (HWA) in two different days. To examine the carry-over effect from treadmill walking to overground walking, participants also performed 5.5 m overground-walks without the HWA before and after treadmill training (pre- and post-trial). During treadmill walking, peak of both hip and knee angles were measured. Also, we calculated the limb symmetry of hip range of motion. In addition, gait speed and ground reaction force were measured in overground trials.

Results

The maximum hip angle on the limb with fewer hip movements, which was defined as the affected limb, showed a significant interaction between ASSIST (RAGT and NAGT) and TIME (pre- and post-trial) (p < 0.05). Limb symmetry significantly improved after RAGT (p < 0.05), but not in NAGT. Furthermore, the affected limb showed a significant increase in the positive peak of the anterior-posterior ground reaction force during 70–100% of the gait cycle (p < 0.05). However, there was no change in gait speed.

Conclusion

By assisting the both hip movements with the HWA, maximum hip flexion and extension angle of the affected limb improved. Also, limb symmetry and propulsion force of the affected limb improved. Our results suggest that assisting both hip movements with the HWA might be an effective method for improving gait in CP children.

Trial registration

UMIN-CTR, UMIN000030667. Registered 3 January 2018,https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000033737
Building knowledge translation competency in a community-based hospital: a practice-informed curriculum for healthcare providers, researchers, and leadership
Authors: Provvidenza Christine , Townley Ashleigh , Wincentak Joanne , Peacocke Sean , Kingsnorth Shauna
Published: July 2020

Background

Enacting knowledge translation (KT) in healthcare settings is a complex process that requires organizational facilitation. In addition to addressing organizational-level barriers, targeting individual-level factors such as KT competencies are a necessary component of this aim. While literature on KT competency training is rapidly growing, there has been little exploration of the potential benefits of training initiatives delivered from an intra-organizational perspective. Addressing this gap, we developed the Knowledge Translation Facilitator Network (KTFN) to meet the KT needs of individuals expected to use and produce knowledge (e.g., healthcare providers, research staff, managers, family advisors) within an academic health sciences center. The aim of this study is to describe the development, implementation, and evaluation of the KTFN curriculum.

Methods

An educational framework was used to guide creation of the KTFN curriculum. Stakeholder interviews, a literature review of KT competency, and environmental scan of capacity building initiatives plus adult learning principles were combined with in-house experience of KT practitioners to inform content and delivery. An evaluation strategy consisting of pre/post-test curriculum and post-session satisfaction surveys, as well as post-curriculum interviews assessed impact on participant knowledge and skills and captured perceived value of KFTN.

Results

The curriculum has been delivered three times over 3 years, with 30 individuals trained, representing healthcare providers, graduate level research trainees, managers, and family advisors. Using the New World Kirkpatrick Model as an analysis framework, we found that the KTFN curriculum was highly valued and shifted learners’ perceptions of KT. Participants identified enhanced knowledge and skills that could be applied to different facets of their work; increased confidence in their ability to execute KT tasks; and intention to use the content in future projects. Barriers to future use included time to plan and conduct KT activities.

Conclusion

KTFN was developed to enhance KT competency among organizational members. This initiative shows promise as a highly valued training program that meets both individual and organizational KT needs and speaks to the importance of investing in tailored KT competency initiatives as an essential building block to support moving evidence into practice.
An epistatic interaction between pre-natal smoke exposure and socioeconomic status has a significant impact on bronchodilator drug response in African American youth with asthma
Authors: Magaña J. , Contreras M. G. , Keys K. L. , Risse-Adams O. , Goddard P. C. , Zeiger A. M. , Mak A. C. Y. , Elhawary J. R. , Samedy-Bates L. A. , Lee E. , Thakur N. , Hu D. , Eng C. , Salazar S. , Huntsman S. , Hu T. , Burchard E. G. , White M. J.
Published: July 2020

Background

Asthma is one of the leading chronic illnesses among children in the United States. Asthma prevalence is higher among African Americans (11.2%) compared to European Americans (7.7%). Bronchodilator medications are part of the first-line therapy, and the rescue medication, for acute asthma symptoms. Bronchodilator drug response (BDR) varies substantially among different racial/ethnic groups. Asthma prevalence in African Americans is only 3.5% higher than that of European Americans, however, asthma mortality among African Americans is four times that of European Americans; variation in BDR may play an important role in explaining this health disparity. To improve our understanding of disparate health outcomes in complex phenotypes such as BDR, it is important to consider interactions between environmental and biological variables.

Results

We evaluated the impact of pairwise and three-variable interactions between environmental, social, and biological variables on BDR in 233 African American youth with asthma using Visualization of Statistical Epistasis Networks (ViSEN). ViSEN is a non-parametric entropy-based approach able to quantify interaction effects using an information-theory metric known as Information Gain (IG). We performed analyses in the full dataset and in sex-stratified subsets. Our analyses identified several interaction models significantly, and suggestively, associated with BDR. The strongest interaction significantly associated with BDR was a pairwise interaction between pre-natal smoke exposure and socioeconomic status (full dataset IG: 2.78%, p = 0.001; female IG: 7.27%, p = 0.004)). Sex-stratified analyses yielded divergent results for females and males, indicating the presence of sex-specific effects.

Conclusions

Our study identified novel interaction effects significantly, and suggestively, associated with BDR in African American children with asthma. Notably, we found that all of the interactions identified by ViSEN were “pure” interaction effects, in that they were not the result of strong main effects on BDR, highlighting the complexity of the network of biological and environmental factors impacting this phenotype. Several associations uncovered by ViSEN would not have been detected using regression-based methods, thus emphasizing the importance of employing statistical methods optimized to detect both additive and non-additive interaction effects when studying complex phenotypes such as BDR. The information gained in this study increases our understanding and appreciation of the complex nature of the interactions between environmental and health-related factors that influence BDR and will be invaluable to biomedical researchers designing future studies.
CagA orchestrates eEF1A1 and PKCδ to induce interleukin-6 expression in Helicobacter pylori-infected gastric epithelial cells
Authors: Xu Shaohan , Wu Xiaoqian , Zhang Xiaoyan , Chen Chu , Chen Hao , She Feifei
Published: July 2020

Background

Helicobacter pylori colonises the stomach of approximately 50% of the global population. Cytotoxin-associated gene A protein (CagA) is one of the important virulent factors responsible for the increased inflammation and increases the risk of developing peptic ulcers and gastric carcinoma. The cytokine interleukin-6 (IL-6) has particularly important roles in the malignant transformation of gastric and intestinal epithelial cells as it is upregulated in H. pylori-infected gastric mucosa. In this study, we investigated the underlying mechanisms of CagA-induced IL-6 up-regulation during H. pylori infection. AGS cells, a human gastric adenocarcinoma cell line, lacking eEF1A1 were infected with CagA+H. pylori (NCTC11637), CagA−H. pylori (NCTC11637ΔcagA), or transduced by Ad-cagA/Ad-GFP. The expression and production of IL-6 were measured by quantitative real-time reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay, respectively. The interactions among CagA, eukaryotic translation elongation factor 1-alpha 1 (eEF1A1), protein kinase Cδ (PKCδ), and signal transducer and activator of transcription 3 (STAT3) were determined by western blot or co-immunoprecipitation.

Results

During H. pylori infection, CagA-M (residues 256‒871aa) was found to interact with eEF1A1-I (residues 1‒240aa). NCTC11637 increased the expression of IL-6 in AGS cells compared with NCTC11637ΔcagA whereas knockdown of eEF1A1 in AGS cells completely abrogated these effects. Moreover, the CagA-eEF1A1 complex promoted the expression of IL-6 in AGS cells. CagA and eEF1A1 cooperated to mediate the expression of IL-6 by affecting the activity of p-STATS727 in the nucleus. Further, CagA-eEF1A1 affected the activity of STAT3 by recruiting PKCδ. However, blocking PKCδ inhibited the phosphorylation of STAT3S727 and induction of IL-6 by CagA.

Conclusions

CagA promotes the expression of IL-6 in AGS cells by recruiting PKCδ through eEF1A1 in the cytoplasm to increase the phosphorylation of STAT3S727 in the nucleus. These findings provide new insights into the function of CagA-eEF1A1 interaction in gastric adenocarcinoma.
Nucleo–cytoplasmic transport defects and protein aggregates in neurodegeneration
Authors: Bitetto Giacomo , Di Fonzo Alessio
Published: July 2020

In the ongoing process of uncovering molecular abnormalities in neurodegenerative diseases characterized by toxic protein aggregates, nucleo-cytoplasmic transport defects have an emerging role. Several pieces of evidence suggest a link between neuronal protein inclusions and nuclear pore complex (NPC) damage. These processes lead to oxidative stress, inefficient transcription, and aberrant DNA/RNA maintenance. The clinical and neuropathological spectrum of NPC defects is broad, ranging from physiological aging to a suite of neurodegenerative diseases. A better understanding of the shared pathways among these conditions may represent a significant step toward dissecting their underlying molecular mechanisms, opening the way to a real possibility of identifying common therapeutic targets.
Syntrophic acetate oxidation replaces acetoclastic methanogenesis during thermophilic digestion of biowaste
Authors: Dyksma Stefan , Jansen Lukas , Gallert Claudia
Published: July 2020

Background

Anaerobic digestion (AD) is a globally important technology for effective waste and wastewater management. In AD, microorganisms interact in a complex food web for the production of biogas. Here, acetoclastic methanogens and syntrophic acetate-oxidizing bacteria (SAOB) compete for acetate, a major intermediate in the mineralization of organic matter. Although evidence is emerging that syntrophic acetate oxidation is an important pathway for methane production, knowledge about the SAOB is still very limited.

Results

A metabolic reconstruction of metagenome-assembled genomes (MAGs) from a thermophilic solid state biowaste digester covered the basic functions of the biogas microbial community. Firmicutes was the most abundant phylum in the metagenome (53%) harboring species that take place in various functions ranging from the hydrolysis of polymers to syntrophic acetate oxidation. The Wood-Ljungdahl pathway for syntrophic acetate oxidation and corresponding genes for energy conservation were identified in a Dethiobacteraceae MAG that is phylogenetically related to known SAOB. 16S rRNA gene amplicon sequencing and enrichment cultivation consistently identified the uncultured Dethiobacteraceae together with Syntrophaceticus, Tepidanaerobacter, and unclassified Clostridia as members of a potential acetate-oxidizing core community in nine full-scare digesters, whereas acetoclastic methanogens were barely detected.

Conclusions

Results presented here provide new insights into a remarkable anaerobic digestion ecosystem where acetate catabolism is mainly realized by Bacteria. Metagenomics and enrichment cultivation revealed a core community of diverse and novel uncultured acetate-oxidizing bacteria and point to a particular niche for them in dry fermentation of biowaste. Their genomic repertoire suggests metabolic plasticity besides the potential for syntrophic acetate oxidation.
Fine-scale succession patterns and assembly mechanisms of bacterial community of Litopenaeus vannamei larvae across the developmental cycle
Authors: Wang Yanting , Wang Kai , Huang Lei , Dong Pengsheng , Wang Sipeng , Chen Heping , Lu Zheng , Hou Dandi , Zhang Demin
Published: July 2020

Background

Microbiome assembly in early life may have a long-term impact on host health. Larval nursery is a crucial period that determines the success in culture of Litopenaeus vannamei, the most productive shrimp species in world aquaculture industry. However, the succession patterns and assembly mechanisms of larval shrimp bacterial community still lack characterization at a fine temporal scale. Here, using a high-frequency sampling strategy and 16S rRNA gene amplicon sequencing, we investigated dynamics of larval shrimp bacterial community and its relationship with bacterioplankton in the rearing water across the whole developmental cycle in a realistic aquaculture practice.

Results

Alpha-diversity of larval shrimp bacteria showed a U-shaped pattern across the developmental cycle with the stages zoea and mysis as the valley. Correspondingly, the compositions of dominant bacterial taxa at the stages nauplius and early postlarvae were more complex than other stages. Remarkably, Rhodobacteraceae maintained the overwhelming dominance after the mouth opening of larvae (zoea I~early postlarvae). The taxonomic and phylogenetic compositions of larval bacterial community both showed stage-dependent patterns with higher rate of taxonomic turnover, suggesting that taxonomic turnover was mainly driven by temporal switching among closely related taxa (such as Rhodobacteraceae taxa). The assembly of larval bacteria was overall governed by neutral processes (dispersal among individuals and ecological drift) at all the stages, but bacterioplankton also had certain contribution during three sub-stages of zoea, when larval and water bacterial communities were most associated. Furthermore, the positive host selection for Rhodobacteraceae taxa from the rearing water during the zoea stage and its persistent dominance and large predicted contribution to metabolic potentials of organic matters at post-mouth opening stages suggest a crucial role of this family in larval microbiome and thus a potential source of probiotic candidates for shrimp larval nursery.

Conclusions

Our results reveal pronounced succession patterns and dynamic assembly processes of larval shrimp bacterial communities during the developmental cycle, highlighting the importance of the mouth opening stage from the perspective of microbial ecology. We also suggest the possibility and potential timing in microbial management of the rearing water for achieving the beneficial larval microbiota in the nursery practice.
Outcomes of inpatient psychological treatments for children and adolescents with eating disorders at time of discharge: a systematic review
Authors: Isserlin Leanna , Spettigue Wendy , Norris Mark , Couturier Jennifer
Published: July 2020

Background

Recommended first line treatment for children and adolescent eating disorders is outpatient therapy. However, a significant number of children and adolescents with eating disorders continue to require inpatient treatment during the course of their illness. The effect of psychological treatments in an inpatient setting on outcomes at the time of discharge remains unclear. This paper presents the results of a review of the literature on outcomes at the time of discharge following inpatient psychological treatment for children and adolescents with eating disorders.

Main body

The majority of studies found were observational and of low quality. The most consistently reported positive outcome of inpatient treatment is weight gain. Results related to symptom change and motivation vary between studies. Within the inpatient setting, there is considerable heterogeneity in the types of treatments offered, goals of treatment, length of stay and outcomes measured.

Conclusion

There remains a paucity of high-quality studies examining the effect of psychological treatments provided to children and adolescents in an inpatient setting. The significant heterogeneity between studies makes it not possible to compare across studies. Future research should aim to resolve these deficiencies in order to better determine the specific factors that contribute to positive outcomes of inpatient treatment for children and adolescents with eating disorders.
Degradation of emerald green: scientific studies on multi-polychrome Vairocana Statue in Dazu Rock Carvings, Chongqing, China
Authors: Li Zhimin , Wang Lele , Chen Huili , Ma Qinglin
Published: July 2020

The spontaneous degradation of pigments in painting may occur depending on environment, especially the surrounding condition of high humidity and soluble salts. Even some of these are well studied, more investigations are still in need for heritage science. Paint cross sections from Vairocana Statue in Dazu Rock Carvings, one of World Cultural Heritage, Chongqing, China are studied by optical microscopy (OM), Raman spectroscopy (Raman) and mapping, and scanning electron microscopy coupled with energy dispersive X-ray analysis (SEM–EDS). Ultramarine blue, emerald green, synthetic atacamite, vermilion, red lead, gold foil, orpiment, cerussite, gypsum and barite are identified as pigments. Moreover, lavendulan (NaCaCu5(AsO4)4Cl·5H2O) and mimetite (Pb5(AsO4)3Cl) are degradation products of emerald green (Cu(C2H3O2)2·3Cu(AsO2)2) and cerussite(PbCO3) originally used as green pigment with mixture. These secondary products are formed via multistep progresses as degradation of emerald green and cerussite, oxidation of arsenite ((AsO2)−), migration of arsenate ((AsO4)3−) and precipitation reaction of these ions with other necessary ions from environmental conditions. Based on the pigment and paint layer stratigraphy analysis, the paintings of the statue have been executed at least four times and the most recent may be after 1850s. The formation of lavendulan give rise to a highlight for identification of green copper-arsenic containing pigments and characterization of degradation in complex conditions.
Mapping aboveground biomass and its prediction uncertainty using LiDAR and field data, accounting for tree-level allometric and LiDAR model errors
Authors: Saarela Svetlana , Wästlund André , Holmström Emma , Mensah Alex Appiah , Holm Sören , Nilsson Mats , Fridman Jonas , Ståhl Göran
Published: July 2020

Background

The increasing availability of remotely sensed data has recently challenged the traditional way of performing forest inventories, and induced an interest in model-based inference. Like traditional design-based inference, model-based inference allows for regional estimates of totals and means, but in addition for wall-to-wall mapping of forest characteristics. Recently Light Detection and Ranging (LiDAR)-based maps of forest attributes have been developed in many countries and been well received by users due to their accurate spatial representation of forest resources. However, the correspondence between such mapping and model-based inference is seldom appreciated. In this study we applied hierarchical model-based inference to produce aboveground biomass maps as well as maps of the corresponding prediction uncertainties with the same spatial resolution. Further, an estimator of mean biomass at regional level, and its uncertainty, was developed to demonstrate how mapping and regional level assessment can be combined within the framework of model-based inference.

Results

Through a new version of hierarchical model-based estimation, allowing models to be nonlinear, we accounted for uncertainties in both the individual tree-level biomass models and the models linking plot level biomass predictions with LiDAR metrics. In a 5005 km2large study area in south-central Sweden the predicted aboveground biomass at the level of 18 m ×18 m map units was found to range between 9 and 447 Mg ·ha−1. The corresponding root mean square errors ranged between 10 and 162 Mg ·ha−1. For the entire study region, the mean aboveground biomass was 55 Mg ·ha−1and the corresponding relative root mean square error 8%. At this level 75% of the mean square error was due to the uncertainty associated with tree-level models.

Conclusions

Through the proposed method it is possible to link mapping and estimation within the framework of model-based inference. Uncertainties in both tree-level biomass models and models linking plot level biomass with LiDAR data are accounted for, both for the uncertainty maps and the overall estimates. The development of hierarchical model-based inference to handle nonlinear models was an important prerequisite for the study.
Antithrombin III treatment for portal vein thrombosis after living donor liver transplantation: a case report
Authors: Hirata Yuta , Sanada Yukihiro , Omameuda Takahiko , Katano Takumi , Miyahara Go , Yamada Naoya , Okada Noriki , Onishi Yasuharu , Sakuma Yasunaru , Sata Naohiro
Published: July 2020

Background

There have been no reports on the effectiveness of the administration of antithrombin III (AT III) for post-transplant portal vein thrombosis (PVT). We herein report a case of post-transplant PVT that was resolved by AT III treatment after living donor liver transplantation (LDLT).

Case presentation

The patient was a 57-year-old man who had been diagnosed with decompensate liver cirrhosis by hepatitis C virus infection. He presented with repeated hepatic coma and refractory ascites. Computed tomography (CT) revealed PVT of Yerdel classification grade II before LDLT. He underwent ABO-identical LDLT using a right lobe graft. A liver function test revealed elevated liver enzyme levels on post-operative day (POD) 14. The CT examination on POD 15 revealed PVT in the left side of the main portal vein at the side of left gastric vein ligation. AT III treatment from POD 15 to POD 24 was performed. Magnetic resonance imaging revealed that the PVT had decreased 10% on POD 27. Furthermore, AT III treatment from POD 28 to POD 32 was performed. The CT examination demonstrated the disappearance of PVT on POD 69 and thereafter, he had no recurrence of PVT on 10 post-operative month (POM).

Conclusions

The present case suggests that the administration of AT III is safe and suitable for the treatment of post-transplant PVT.
Convergence of the deep BSDE method for coupled FBSDEs
Authors: Han Jiequn , Long Jihao
Published: July 2020

The recently proposed numerical algorithm, deep BSDE method, has shown remarkable performance in solving high-dimensional forward-backward stochastic differential equations (FBSDEs) and parabolic partial differential equations (PDEs). This article lays a theoretical foundation for the deep BSDE method in the general case of coupled FBSDEs. In particular, a posteriori error estimation of the solution is provided and it is proved that the error converges to zero given the universal approximation capability of neural networks. Numerical results are presented to demonstrate the accuracy of the analyzed algorithm in solving high-dimensional coupled FBSDEs.
EQ-5D: a plea for accurate nomenclature
Authors: Brooks Richard , Boye Kristina S. , Slaap Bernhard
Published: July 2020

Between 1987 and 1990, the EuroQol Group developed a 5-dimension health-related quality of life instrument, originally known as ‘the EuroQol instrument’, which since 1995 has been called the ‘EQ-5D’. For several years, ‘the EuroQol instrument’ and ‘EQ-5D’ were both deployed in published materials. In order to standardise nomenclature, the EuroQol Group agreed in 2001 on a terminology glossary containing 12 items; this was recently revised and augmented to include 22 items and can be found on the Group’s website (www.euroqol.org). Since 2009, EQ-5D has been available in three versions: EQ-5D-3L, EQ-5D-5L, and EQ-5D-Y, where 3L stands for three levels, 5L for five levels, and Y for youth. Yet, almost 20 years after the original glossary was published, the instrument and its components continue to be inaccurately named in published materials. Two surveys – of arthritis applications, and 82 recent publications – found a variety of terms used to describe the instrument. Despite the instrument being named ‘EQ-5D’ for 25 years, and the terms ‘EQ-5D-3L’ and ‘EQ-5D-5L’ being established for a decade, variations of ‘the EuroQol instrument’ continue to be used as descriptors. The EuroQol Group’s website contains advice on how to use EQ-5D, including nomenclature, and potential users are urged to consult the site. Since standardising nomenclature is crucial in the compilation of systematic reviews, the EuroQol Group would like to emphasise that ‘EQ-5D’ is not an abbreviation and is the correct term to use when referring to the instrument in general. In the interests of accuracy and good practice, users of the EuroQol family of instruments should employ the standard EQ-5D nomenclature when reporting and discussing their findings.
Demise of the Jabłonna Reef (Zechstein Limestone) and the onset of gypsum deposition (Wuchiapingian, west Poland): carbonate-to-evaporite transition in a saline giant
Authors: Peryt Tadeusz Marek , Jasionowski Marek , Raczyński Paweł , Chłódek Krzysztof
Published: July 2020

Microbial deposits commonly occur at the transition between carbonate and sulphate facies, and they also abound in the uppermost part of the middle Wuchiapingian Zechstein Limestone in west Poland. These deposits occur as isolated reefs of the basinal zone and in the condensed sequences in most parts of the study area. The deposits of the latter category reflect evaporative drawdown, and the abrupt boundary between the carbonate and sulphate deposits in the basin suggests the nature of evaporites that start to precipitate as soon as they reach the saturation level. A few-metre-thick unit of mostly brecciated microbial deposits at the top, reefal portion of the Zechstein Limestone records extreme palaeoenvironmental events that occurred at the transition from carbonate to sulphate deposition. These events are related first to subaerial exposure of the reef, which lasted several 105 years and then to the Lower Anhydrite transgression.
Utilization of waste wool fibers for fabrication of wool powders and keratin: a review
Authors: Zhang Chunhua , Xia Liangjun , Zhang Jiajing , Liu Xin , Xu Weilin
Published: July 2020

Wool fiber contains approximately 95% keratinous proteins, which is one of the most abundant sources of structural protein. However, a large amount of wool waste is underutilized. Developing appropriate approaches to recycle wool waste and produce value-added products is vital for sustainable development and reducing environmental burden. Thus, this paper reviews the mechanical methods of fabricating wool powder, including pan milling, combined wet and air-jet milling, steam explosion, freeze milling, and three-stage milling. The influencing factors of shape and size, structure, and properties are highlighted to overview of the possible controlling methods. Then, this review summarizes various chemical methods for the extraction of wool keratin, underlining the dissolution efficiency and the structure of wool keratin. Furthermore, the application of reused wool particles in textile, biosorbent, and biomaterials are also reported. Finally, several perspectives in terms of future research on the fabrication and application of wool particles are highlighted.

Graphical abstract
Machine Learning Applied to Registry Data: Development of a Patient-Specific Prediction Model for Blood Transfusion Requirements During Craniofacial Surgery Using the Pediatric Craniofacial Perioperative Registry Dataset
Authors: Jalali Ali , Lonsdale Hannah , Zamora Lillian V. , Ahumada Luis , Nguyen Anh Thy H. , Rehman Mohamed , Fackler James , Stricker Paul A. , Fernandez Allison M. ,   Pediatric Craniofacial Collaborative Group
Published: July 2020

Background:

Craniosynostosis is the premature fusion of ≥1 cranial sutures and often requires surgical intervention. Surgery may involve extensive osteotomies, which can lead to substantial blood loss. Currently, there are no consensus recommendations for guiding blood conservation or transfusion in this patient population. The aim of this study is to develop a machine-learning model to predict blood product transfusion requirements for individual pediatric patients undergoing craniofacial surgery.

METHODS:

Using data from 2143 patients in the Pediatric Craniofacial Surgery Perioperative Registry, we assessed 6 machine-learning classification and regression models based on random forest, adaptive boosting (AdaBoost), neural network, gradient boosting machine (GBM), support vector machine, and elastic net methods with inputs from 22 demographic and preoperative features. We developed classification models to predict an individual’s overall need for transfusion and regression models to predict the number of blood product units to be ordered preoperatively. The study is reported according to the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) checklist for prediction model development.

RESULTS:

The GBM performed best in both domains, with an area under receiver operating characteristic curve of 0.87 ± 0.03 (95% confidence interval) and F-score of 0.91 ± 0.04 for classification, and a mean squared error of 1.15 ± 0.12, R-squared (R
2) of 0.73 ± 0.02, and root mean squared error of 1.05 ± 0.06 for regression. GBM feature ranking determined that the following variables held the most information for prediction: platelet count, weight, preoperative hematocrit, surgical volume per institution, age, and preoperative hemoglobin. We then produced a calculator to show the number of units of blood that should be ordered preoperatively for an individual patient.

CONCLUSIONS:

Anesthesiologists and surgeons can use this continually evolving predictive model to improve clinical care of patients presenting for craniosynostosis surgery.
The Effect of High-Flow Nasal Oxygen on Carbon Dioxide Accumulation in Apneic or Spontaneously Breathing Adults During Airway Surgery: A Randomized-Controlled Trial
Authors: Booth Anton W. G. , Vidhani Kim , Lee Phil K. , Coman Scott H. , Pelecanos Anita M. , Dimeski Goce , Sturgess David J.
Published: July 2020

BACKGROUND:

High-flow nasal oxygen (HFNO) is an emerging technology that has generated interest in tubeless anesthesia for airway surgery. HFNO has been shown to maintain oxygenation and CO2 clearance in spontaneously breathing patients and is an effective approach to apneic oxygenation. Although it has been suggested that HFNO can enhance CO2 clearance during apnea, this has not been established. The true extent of CO2 accumulation and resulting acidosis using HFNO during prolonged tubeless anesthesia remains undefined.

METHODS:

In a single-center trial, we randomly assigned 20 adults undergoing microlaryngoscopy to apnea or spontaneous ventilation (SV) using HFNO during 30 minutes of tubeless anesthesia. Serial arterial blood gas analysis was performed during preoxygenation and general anesthesia. The primary outcome was the partial pressure of CO2 (Paco
2) after 30 minutes of general anesthesia, with each group compared using a Student t test.

RESULTS:

Nineteen patients completed the study protocol (9 in the SV group and 10 in the apnea group). The mean (standard deviation [SD]) Paco
2 was 89.0 mm Hg (16.5 mm Hg) in the apnea group and 55.2 mm Hg (7.2 mm Hg) in the SV group (difference in means, 33.8; 95% confidence interval [CI], 20.6–47.0) after 30 minutes of general anesthesia (P < .001). The average rate of Paco
2 rise during 30 minutes of general anesthesia was 1.8 mm Hg/min (SD = 0.5 mm Hg/min) in the apnea group and 0.8 mm Hg/min (SD = 0.3 mm Hg/min) in the SV group. The mean (SD) pH was 7.11 (0.04) in the apnea group and 7.29 (0.06) in the SV group (P < .001) at 30 minutes. Five (55%) of the apneic patients had a pH <7.10, of which the lowest measurement was 7.057. No significant difference in partial pressure of arterial O2 (Pao
2) was observed after 30 minutes of general anesthesia.

CONCLUSIONS:

CO2 accumulation during apnea was more than double that of SV after 30 minutes of tubeless anesthesia using HFNO. The use of robust measurement confirms that apnea with HFNO is limited by CO2 accumulation and the concomitant severe respiratory acidosis, in contrast to SV. This extends previous knowledge and has implications for the safe application of HFNO during prolonged procedures.
Remodeling the epigenome and (epi)cytoskeleton: a new paradigm for co-regulation by methylation
Authors: Walker Cheryl , Burggren Warren
Published: July 2020

The epigenome determines heritable patterns of gene expression in the absence of changes in DNA sequence. The result is programming of different cellular-, tissue- and organ-specific phenotypes from a single organismic genome. Epigenetic marks that comprise the epigenome (e.g. methylation) are placed upon or removed from chromatin (histones and DNA) to direct the activity of effectors that regulate gene expression and chromatin structure. Recently, the cytoskeleton has been identified as a second target for the cell's epigenetic machinery. Several epigenetic ‘readers, writers and erasers’ that remodel chromatin have been discovered to also remodel the cytoskeleton, regulating structure and function of microtubules and actin filaments. This points to an emerging paradigm for dual-function remodelers with ‘chromatocytoskeletal’ activity that can integrate cytoplasmic and nuclear functions. For example, the SET domain-containing 2 methyltransferase (SETD2) has chromatocytoskeletal activity, methylating both histones and microtubules. The SETD2 methyl mark on chromatin is required for efficient DNA repair, and its microtubule methyl mark is required for proper chromosome segregation during mitosis. This unexpected convergence of SETD2 activity on histones and microtubules to maintain genomic stability suggests the intriguing possibility of an expanded role in the cell for chromatocytoskeletal proteins that read, write and erase methyl marks on the cytoskeleton as well as chromatin. Coordinated use of methyl marks to remodel both the epigenome and the (epi)cytoskeleton opens the possibility for integrated regulation (which we refer to as ‘epiregulation’) of other higher-level functions, such as muscle contraction or learning and memory, and could even have evolutionary implications.
Differential dynamics of early stages of platelet adhesion and spreading on collagen IV- and fibrinogen-coated surfaces
Authors: Horev Melanie B. , Zabary Yishaia , Zarka Revital , Sorrentino Simona , Medalia Ohad , Zaritsky Assaf , Geiger Benjamin
Published: July 2020

Background:Upon wound formation, platelets adhere to the neighboring extracellular matrix and spread on it, a process which is critical for physiological wound healing. Multiple external factors, such as the molecular composition of the environment and its mechanical properties, play a key role in this process and direct its speed and outcome.

Methods:We combined live cell imaging, quantitative interference reflection microscopy and cryo-electron tomography to characterize, at a single platelet level, the differential spatiotemporal dynamics of the adhesion process to fibrinogen- and collagen IV-functionalized surfaces.

Results:Initially, platelets sense both substrates by transient rapid extensions of filopodia. On collagen IV, a short-term phase of filopodial extension is followed by lamellipodia-based spreading. This transition is preceded by the extension of a single or couple of microtubules into the platelet’s periphery and their apparent insertion into the core of the filopodia. On fibrinogen surfaces, the filopodia-to-lamellipodia transition was partial and microtubule extension was not observed leading to limited spreading, which could be restored by manganese or thrombin.

Conclusions:Based on these results, we propose that interaction with collagen IV stimulate platelets to extend microtubules to peripheral filopodia, which in turn, enhances filopodial-to-lamellipodial transition and overall lamellipodia-based spreading. Fibrinogen, on the other hand, fails to induce these early microtubule extensions, leading to full lamellipodia spreading in only a fraction of the seeded platelets. We further suggest that activation of integrin αIIbβ3 is essential for filopodial-to-lamellipodial transition, based on the capacity of integrin activators to enhance lamellipodia spreading on fibrinogen.
Factors influencing the utilization of dental services in East Java, Indonesia
Authors: Hariyani Ninuk , Setyowati Dini , Sari Multia Ranum , Maharani Diah Ayu , Nair Rahul , Sengupta Kaushik
Published: July 2020

Background: Despite high levels dental issues and insurance coverage in the East Java province Indonesia, the utilization of dental services is still low. This research aims to test some indicators for dental service utilization among East Java residents.

Methods: A secondary analysis was undertaken using data on the East Java province from the Indonesian Basic Health Research 2013, which included 90,551 randomly selected respondents aged 5–100 years old. Socio-demographic characteristics (age, sex, education and residential location), dental behavior (tooth brushing habit), and clinical (dental) condition were self-reported through a questionnaire. Multivariable models were generated to estimate prevalence ratios (PR), and 95% confidence intervals (95%CI).

Results: Prevalence of dental service utilization during the last 12 months in East Java province is only 9 %. Respondents 25–50 years old showed the highest utilization of dental services. Being male, having lower education and living in a district (as opposed to municipalities) were indicators for having lower utilization of dental treatment (PR [95% CI] = 0.81 [0.79–0.84], PR [95% CI] = 0.89 [0.86–0.93] and PR [95% CI] = 0.91 [0.88–0.95], respectively). Respondents with poor tooth brushing habit showed lower utilization of dental services. Having teeth was associated with higher utilization of dental treatment (PR [95% CI] = 1.39 [1.16–1.66).

Conclusions: Age, sex, education and residential location influence the utilization of dental services among Indonesia’s East Java residents. Poor tooth brushing habits and being edentulous are also indicators of lesser utilization. These results call for urgent public health interventions to increase equitable dental care services utilization.
An equation for the biological transmembrane potential from basic biophysical principles
Authors: Herrera-Valdez Marco Arieli
Published: July 2020

Biological membranes mediate different physiological processes necessary for life, many of which depend on ion movement. In turn, the difference between the electrical potentials around a biological membrane, called transmembrane potential, or membrane potential for short, is one of the key biophysical variables affecting ion movement. Most of the existing equations that describe the change in membrane potential are based on analogies with resistive-capacitive electrical circuits. These equivalent circuit models assume resistance and capacitance as measures of the permeable and the impermeable properties of the membrane, respectively. These models have increased our understanding of bioelectricity, and were particularly useful at times when the basic structure, biochemistry, and biophysics of biological membrane systems were not well known. However, the parts in the ohmic circuits from which equations are derived, are not quite like the biological elements present in the spaces around and within biological membranes. Using current, basic knowledge about the structure, biophysics, and biochemical properties of biological membrane systems, it is shown here that it is possible to derive a simple equation for the transmembrane potential. Of note, the resulting equation is not based on electrical circuit analogies. Nevertheless, the classical model for the membrane potential based on an equivalent RC-circuit is recovered as a particular case, thus providing a mathematical justification for the classical models. Examples are presented showing the effects of the voltage dependence of charge aggregation around the membrane, on the timing and shape of neuronal action potentials.
Post-traumatic stress in the wake of the COVID-19 pandemic: a scoping review
Authors: Rajkumar Ravi Philip
Published: July 2020

Background: Post-traumatic stress symptoms (PTSS), as well as post-traumatic stress disorder (PTSD) itself, are common sequelae of disasters, including disease outbreaks such as the COVID-19 pandemic. Understanding their frequency and correlates is essential to developing preventive, therapeutic and supportive measures in a time of crisis.

Methods: A scoping review of the literature pertaining to PTSS and PTSD in relation to COVID-19 was carried out with the primary objective of assessing the frequency of PTSS/PTSD and the factors associated with it, and the secondary objective of summarizing expert recommendations in this field. For this purpose, PubMed and Embase literature databases were searched using the terms “COVID-19”, “nCoV-2”, “post-traumatic stress disorder”, “PTSS”, “PTSD” and “traumatization” in various combinations. A total of 10 relevant publications were found, which were tabulated and organized into original research on PTSS/PTSD (n = 7) and expert opinions or reviews (n = 3).

Results: The frequency of PTSS ranged from 7-34%, depending on study population and methodology. Gender, marital status, physical symptoms, and a prior psychiatric diagnosis were associated with the severity of PTSS. Expert opinions highlighted the prolonged nature of the impact of COVID-19, the need for long-term preventive and treatment strategies, and the need for innovation and collaboration in research and dissemination of information.

Conclusions: The COVID-19 outbreak is likely to leave a large number of persons suffering from PTSD in its wake. The above results may help us to identify those at risk in order to deliver preventive or early therapeutic interventions.
Evaluation of a behavior-centered design strategy for creating demand for oral PrEP among young women in Cape Town, South Africa
Authors: Morton Jennifer F. , Myers Laura , Gill Katherine , Bekker Linda-Gail , Stein Gabrielle , Thomas Katherine K. , Duyver Menna , van der Straten Ariane , McConnell Margaret , Aunger Robert , Curtis Valerie , de Witt Huberts Jessie , Van Damme Lut , Baeten Jared M. , Celum Connie
Published: July 2020

Background: There is an urgent need to find effective interventions that reduce young South African women’s vulnerability to HIV, and pre-exposure prophylaxis (PrEP) is highly effective when taken consistently. As national programs in Africa launch PrEP programs for young women, it is critical to understand how to effectively create awareness, stimulate interest, and increase uptake of PrEP.

Methods: Behavior-centered design (BCD) guided the development of a PrEP social marketing campaign for young women. Ethnographic observations, in-depth interviews, and focus-group discussions with young South African women informed the content and design of a 90-second PrEP demand creation video and two informational brochures. A short survey was administered to young women at their homes after watching a video to evaluate PrEP interest. Of 800 households with a 16-25-year-old female identified from a Cape Town township census, 320 women in these households viewed the video and completed a survey about the video and their interest in PrEP.

Results: In focus groups, young women from the township preferred local characters and messaging that was empowering, simple, and motivational. From the household survey of young women who viewed the video, most reported interest in learning more about PrEP (67.7% ‘definitely interested’ and 9.4% ‘somewhat interested’) and taking PrEP (56.4% ‘definitely interested’ and 12.5% ‘somewhat interested’). Factors significantly associated with interest in taking PrEP were having a primary partner with whom they regularly have sex (80.0% vs. 65.2% without a primary partner; adjusted odds ratio (AOR)=3.1, 95% CI: 1.3, 7.0) and being in a sexual partnership for <6 months (86.8% vs. 68.5% for >12 months; AOR=3.0, 95% CI: 1.2, 7.3).

Conclusions: A positively framed PrEP demand creation video generated high interest in PrEP among young South African women, particularly among women with a primary partner and a shorter-term relationship.

Registration: NCT03142256; registered on 5 May 2017.
Skew compressions of positive definite operators and matrices
Authors: Polettini Matteo , Böttcher Albrecht
Published: July 2020

The paper is devoted to results connecting the eigenvalues and singular values of operators composed by $P^\ast G P$ with those composed in the same way by $QG^{−1}Q^\ast$. Here $P +Q = I$ are skew complementary projections on a finite-dimensional Hilbert space and $G$ is a positive definite linear operator on this space. Also discussed are graph theoretic interpretations of one of the results.
Implicações do uso de estratégias de ensino ativas na formação de discentes em uma disciplina de bacharelado em hotelaria
Authors: Lima Thales Batista de
Published: July 2020

Esse trabalho objetiva analisar as implicações do uso de estratégias de ensino ativas, a partir de sua aplicação em uma disciplina de cunho teórico-prática, na formação de discentes do curso de graduação em Hotelaria de uma instituição federal de ensino superior. Baliza-se por uma perspectiva interpretativista e de cunho qualitativo. Ademais, caracteriza-se como um estudo de caso exploratório por investigar o uso de estratégias de ensino ativas por um docente na disciplina de Introdução à Administração em um curso de Hotelaria. Para tanto, realizou-se um grupo focal com 20 alunos matriculados nessa disciplina, abordando questões em torno de seu aprendizado com relação às estratégias de ensino ativas aplicadas, sendo analisados pelo método de análise de conteúdo. Os resultados indicam que os estudantes condescenderam das atividades desenvolvidas por dinamizar a aula e aprimorar suas competências, pois fomentam a criatividade, a reflexão e a capacidade de trabalhar em equipe. Entretanto, isso implica em domínio do docente para que a turma sinta confiança nas atividades, engajamento e maturidade dos grupos de trabalho e mudanças nos ambientes estruturais e institucionais para criar uma cultura de ensino voltado às estratégias de ensino ativas como forma de potencializar o processo formativo do aluno condizente com sua atuação profissional.