bluuebunny/crossref_metadata_2025 huggingface dataset:
Skeletal Aging and Osteoporosis: Cellular Senescence and Beyond
Authors: Chandra Abhishek , Rajawat Jyotika
Published: February 2021

Bone is a dynamic organ maintained by tightly regulated mechanisms. With old age, bone homeostasis which is maintained by an intricate balance between bone formation and bone resorption, undergoes deregulation. Oxidative stress-induced DNA damage, cellular apoptosis, and cellular senescence are all responsible for this tissue dysfunction and the imbalance in bone homeostasis. These cellular mechanisms have become a target for therapeutics to treat age-related osteoporosis. Pharmacological and genetic mouse models have shown the importance of senescent cell clearance in alleviating age-related osteoporosis. Senescent cells have an altered secretome, which may have an autocrine, paracrine, or endocrine function. The current review discusses the current and potential pathways which lead to a senescence profile in an aged skeleton. The review was written following an extensive literature survey of published studies, mostly excluding articles published on pre-print servers. The review discusses potential therapeutics targeting cellular senescence and the senescent secretome as underlying pathogenesis of an aging bone.
Analisis Kinerja Lini Produksi Baju di PT Efrata Retailindo Menggunakan Metode Six-Sigma
Authors: Islaminudin Muhammad Imam Al , Hendarsjah Hidajat
Published: February 2021

This study purposed to analyze the performance of clothing production lines in PT Efrata Retailindo and give some advice of improvement to production management of PT Efrata Retailindo. the result of this analyze is expected to inform the production management abaout the factual performance of production line proccess and give some advice that can be use by the production management. this research uses secondary data that is the production flow, and number of inspected product and defect, which is obtained from the recording of production management with the permission of person in charge in production management PT Efrata Retailindo. Data analyze that used are six-sigma method in proccess approach. the result of this research are the level sigma of clothing production line, and the advice about improvement that can be applied on production line. based on the measure phase of six-sigma method there are three critical to quality that affect some amount of defect. so that, on the analyze phase of six-sigma method, the level sigma of the production line categorized as an average performance in six-sigma point of view.
Peningkatan Kapasitas Tata Laksana Kesehatan Ternak Sapi Potong di Pelemrejo, Andong, Boyolali
Authors: Nuraini Dian Meididewi , Sunarto Sunarto , Widyas Nuzul , Pramono Ahmad , Prastowo Sigit
Published: February 2021

Mayoritas masyarakat Desa Pelemrejo, Kecamatan Andong, Kabupaten Boyolali adalah petani yang memiliki usaha ternak sapi potong. Produksi ternak sapi sering kali terkendala masalah kesehatan ternak yang dapat menurunkan kualitas serta kuantitas daging sapi. Pengetahuan mengenai manajemen kesehatan sapi potong perlu diberikan kepada peternak untuk membantu meminimalisir kerugian yang terjadi akibat masalah kesehatan. Kegiatan ini bertujuan untuk memberikan pengetahuan kepada peternak mengenai manajemen kesehatan sapi potong. Metode kegiatan terdiri dari survei ke peternakan sapi potong, penyuluhan dan diskusi massal, serta pemberian bantuan obat-obatan dan desinfektan ke peternak. Kunjungan ke peternakan di desa tersebut menunjukkan bahwa terdapat sapi yang menunjukkan kekurusan, kondisi kandang kotor dengan area penyimpanan pakan yang tidak sesuai standar. Penyuluhan dan diskusi massal dengan cara penyampaian materi secara langsung mengenai identifikasi kondisi kesehatan sapi, program sanitasi kandang, program pemberian obat cacing teratur, penyakit yang sering ditemukan pada sapi potong, serta pengobatan yang dapat dilakukan oleh peternak. Obat-obatan dan desinfektan diberikan kepada peternak untuk membantu dalam mengaplikasikan manajemen kesehatan ternak yang telah dijelaskan melalui penyuluhan. Secara keseluruhan dapat disimpulkan bahwa peternak dapat mengikuti materi penyuluhan serta berperan aktif dalam proses diskusi yang dilakukan.
Psychological Issues and Treatment Strategies in Popular Musicians: A Review, Part 2
Authors: Raeburn Susan D
Published: February 2021

Part 1 of this review [MPPA 1999;14:171-9] described the overall goals of the paper as follows: to increase the reader’s understanding of what types of common psychological problems popular musicians face; how individual, family, and sociocultural factors interact in the development
and maintenance of these problems; and how interventions need to address all of these factors. The ecological transactional model developed by developmental psychologists Cicchetti and Toth was presented as the contextual background for understanding the development of an individual’s
psychological resiliency or vulnerability to symptoms. The model posits four interacting levels as crucial to an individual’s “ecology”: the self, the family, the community, and the culture. The first part of this review explored aspects of each of these levels, including
occupational risk factors as characteristic of the community and culture of popular musicians. Part 1 ended with a brief discussion of the creative process, similarly from an interactive systems perspective.
Sound Exposure Levels Experienced by a College Jazz Band Ensemble: Comparison with OSHA Risk Criteria
Authors: Henoch Miriam A , Chesky Kris
Published: February 2021

Jazz education plays a prominent role in the music education of students in secondary and postsecondary schools. Although there is some research relative to health risks posed to professional musicians, little information is available as it relates to young musicians at the collegiate
and secondary levels. The primary purpose of this study was to assess the risk of music-induced hearing loss to members of a college jazz band using the currently defined damage risk criteria of the Occupational Safety and Health Administration (OSHA) (1983). Dosimeter measurements were made
over a 3-day period for five different positions within a University of North Texas jazz ensemble. Measurements obtained from each musician and each position were then compared with current OSHA standards. Findings indicated that when equivalent measures were derived for three hours of exposure,
allowable exposure limits were exceeded for ten of the 15 measures obtained. The lead musicians within the ensemble appeared to be at the highest risk for hearing loss. The findings lend further support for the inclusion of musicians in an occupational noise standard.
Application of Electromyography and Electromyographic Biofeedback in Music Performance Research: A Review of the Literature since 1985
Authors: Kjelland James M
Published: February 2021

The diagnostic application of electromyography (EMG) and the combination of EMG and clinical biofeedback (EMG-BF) have been shown to be effective in the assessment and management of muscle tension in a wide range of activities, including sports as well as music. However, not all applications
of EMG-BF have been found to be successful; indeed, some of the early reports of the benefits have been debated and disputed since the earliest applications of the technology. It is the purpose of this paper to glean a profile of research applying EMG and EMG-BF to music performance since
approximately 1985--the year of my own work in this area.
Knee Rotation in Classical Dancers during the Grand Plié
Authors: Barnes Margaret A , Krasnow Donna , Tupling Susan J , Thomas Martin
Published: February 2021

For the past two decades, dance researchers and educators have been concerned about the use of the grand plié and its potential impact on injury incidence. The purpose of this study was to investigate external longitudinal rotation (ELR) at the knee during grand pliés
performed in three classical ballet leg positions, 2nd, 3rd, and 4th, by professional female ballet dancers. Light reflective markers were placed on seven lower body segments of ten volunteer subjects. Subjects performed three trials of the grand plié and one demi-plié in each
of the three leg positions while being videotaped. Marker locations were digitized. Five “instants” were identified in the plié: begin, demi-plié lowering phase, grand plié, demi-plié rising phase, and finish. The ELRs at the knee joints for each instant
were analyzed using an analysis of variance (ANOVA) and custom matrix analysis. Results indicate that ELR values are highest at the bottom of the movement in all positions, and that 3rd and 4th position grand pliés present higher overall ELRs than 2nd position. Because ELR at the knee
has been named as one of the more serious predisposing factors to knee injury, the results of this study indicate that further investigation about the grand plié is needed, and educators should include grand pliés in the training process with caution.
Emerging Concepts of Posture and Alignment
Authors: Krasnow Donna , Monasterio Rita , Chatfield Steven J
Published: February 2021

Dance educators have been posing questions and theories about the alignment of the body for centuries. In The Life and Works of John Weaver, Ralph includes lectures by Weaver, written in 1721, in which he describes good posture for the dancer. Blasis first published An Elementary
Treatise Upon the Theory and Practice of the Art of Dancing in 1820, in which he expounds in detail about the correct placement of the segments of the dancer’s body. By the 1900s these concepts of alignment were becoming extended, and detailed discussions of the importance of teaching
proper alignment began to appear in the literature.
Effectiveness of a Prophylactic Course to Prevent Playing-related Health Problems of Music Students
Authors: Spahn Claudia , Hildebrandt Horst , Seidenglanz Karin
Published: February 2021

The goal of the present study was to investigate the effectiveness of a course offered to students at the Zürich Conservatory for the prevention of playing-related health problems. It was hypothesized that the course offered would have a positive effect (1) on the psychological
and physical health of the music students, and (2) on their work as musicians in training. Twenty-two musicians each in the test and control groups participated in an evaluation study with pre and post measurements. The students had to fill in questionnaires before the beginning and at the
end of the course. Throughout the semester, the test group was offered a weekly course in “Physiology of Music and Performing Arts Medicine,” consisting of a double hour combining lectures and practical exercises with preventive topics relevant to musicians. Based on the pre-to-post
measurements in the test group, playing-related symptoms, general symptom frequency, and emotional disturbances and anxiety level decreased; general coping with work as a musician and security in performance situations improved. The effects measured in this study need to be confirmed by further
studies with a randomized design.
An Orchestra Musician’s Perspective on 20 Years of Performing Arts Medicine
Authors: Horvath Janet
Published: February 2021

As the Associate Principal Cello of the Minnesota Orchestra since 1980 and the founder and director of the Playing (less) Hurt Conference and Lecture Series, I have seen the explosion of interest in and the establishment of the field of performing arts medicine from its very inception.
Over the years, I have encountered countless musicians in various stages of denial or shame concerning their very real pain. Admitting to a problem ultimately means reckoning with it, making changes to playing technique or habits, and oftentimes taking a hiatus from playing altogether.
Adolescent Development: How Dancers Compare with the Typical Teenager
Authors: Robson Bonnie E
Published: February 2021

Adolescence is a developmental phase of tremendous physical, cognitive, and social-emotional growth. It is often thought of as a time of reworking of previous stages of development with the emergence of the individual’s identity. Some time in these years the adolescent is expected
to answer the existential question, “Who am I?” To better understand the specific psychological strengths and conflicts of the adolescent dance student, it may be useful to review the “normal” developmental course. Adolescence is commonly divided into three stages:
early, middle, and late.
The Effects of a Tinnitus Awareness Survey on College Music Majors’ Hearing Conservation Behaviors
Authors: Zeigler Mark C , Taylor Jack A
Published: February 2021

The purpose of the study was to investigate the effects of a tinnitus awareness survey on the hearing conservation behaviors of freshman music majors (as measured 30 weeks later with a follow-up survey). The surveys were distributed to students at a large school of music in a public
university (n = 200) and a small music department in a private university (n = 48). More than half the students (58.9%) claimed to have tinnitus at some level. The most frequent response to what caused their tinnitus was “not sure,” followed by “exposure to
noise over an extended period of time.” Most students (64.2% to 95%) did not wear hearing protection during rehearsals, concerts, or loud non-performance-related activities. In the follow-up survey, the majority (86.0%) said they did not change their use of hearing protection devices
(including those students with tinnitus), but the students in the small college claimed to use significantly more protection than the students in the large college. Since the students in the small college received additional specific examples of tinnitus problems when completing the preliminary
survey, it was concluded that more examples might be necessary to raise the awareness of factors leading to tinnitus. The result could be a positive change in the students’ use of hearing protection.
Psychosomatic Findings in Musician Patients at a Department of Hand Surgery
Authors: Spahn Claudia , Ell Nikolaus , Seidenglanz Karin
Published: February 2021

In the present study, the degree and frequency of symptoms of depression and anxiety as well as signs of somatoform disorders were ascertained in former musician patients of a department of hand surgery by means of standardized psychometric instruments. It was also the goal of the study
to find out to what extent musicians seeking somatically oriented therapy ascribe significance to psychosocial factors regarding the etiology and the course of their ailments, and to what extent they feel psychologically stressed by their somatic symptoms. Sixty-nine musicians were evaluated.
The results of the study showed a low frequency of significant ratings for depression and anxiety compared with clinical and nonclinical populations of nonmusicians, whereas there was a clear tendency toward somatization in the sample investigated. A fourth of the musicians had ratings compatible
with those of psychosomatic patients, and can be classified as an at-risk group for a somatoform disorder. Three fourths of the musicians evinced a somatically oriented subjective ailment model. This means that, from their point of view, psychosocial factors play but a minor role in the etiology
and the course of somatic symptoms. Three fourths of the musicians, however, stated in retrospective evaluation that they had felt psychologically stressed by their physical symptoms. All in all, the results suggest that psychosomatic aspects play a decisive role in somatic problems of musicians,
and that it would seem particularly important for hand surgeons to take note of psychosocial aspects in the etiology and the course of their symptoms.
Musculoskeletal Pain from Repetitive Strain in Musicians: Insights into an Alternative Approach
Authors: Davies Clair
Published: February 2021

In dealing with the symptoms of repetitive strain suffered by musicians, the focus has been primarily on assessing prevalence and developing means of prevention. While these are useful endeavors, the etiology of repetitive strain at the cellular level has not been well understood. As
a consequence, the well-established forms of therapy--drugs, exercise, stretching, splinting, and rest--have gone largely unquestioned, even though they fail to solve the problems of many musicians. Chronic pain continues to ruin musical careers, in spite of everything the medical community
has to offer. It may be worth questioning whether the medical community is overlooking something of value outside the boundaries of accepted practice. There is reason to believe that a significant proportion of the aches, pains, and other symptoms caused by repetitive strain are actually generated
by myofascial trigger points, or small contraction knots, in the muscles of the body. This article is an effort to acquaint the readers with the basic tenets of myofascial trigger points.
“But I Didn’t Ask to Be a Lawyer”: Dealing with Questions of Disability
Authors: Brandfonbrener Alice G
Published: February 2021

Everyone involved in the practice of medicine is acutely aware that the nature of their work has changed dramatically over the past one to two decades. For one thing, given the requisites of dealing with managed care, Medicare, Medicaid, HMOs, and PPOs, there is a new language to be
learned. The new systems often demand spending paperwork time in excess of that allowed for clinical work, filling out a myriad of constantly changing forms, and doing battle, not with one’s medical peers but with unseen gatekeepers trained in business not in medicine, in defense of
treatment plans. To add insult to injury, and perhaps even more in conflict with the practice of good medicine, are those cases involving (1) workman’s compensation (WC) and (2) personal injury (PI) litigation. Most physicians presumably elected medicine over other professions, including
business or law, and thus have reason to resent the proportion of their time taken from what they do best, taking care of patients, by the many administrative and legal aspects of practicing medicine.
Disability Studies and Performing Arts Medicine
Authors: Lubet Alex
Published: February 2021

My introduction to the emerging field of disability studies (DS) was not by accident, but by injury. A professor of music composition and theory who uses piano and computer keyboards extensively, performs on acoustic guitar, electric bass, and mandolin, and handwrites a great deal,
I have coped with pain and functional limitations from spinal and upper limb injuries for years. In 1999, on disability leave, recovering from neurosurgery for cervical disk herniation, I read a call for papers on disability and the performing arts. Intrigued, I immersed myself in DS literature,
and began to participate in the Society for Disability Studies and to engage in research, teaching, and creative projects on disability topics.
Cigarette Smoking in the Adolescent Dance Population
Authors: Wilmerding M Virginia , Robson Bonnie , Book Angela
Published: February 2021

Cigarette smoking continues to be a major international health problem that affects adolescents. Most adult smokers report their first contact with smoking occurring before the age of 18 years. Research has established figures of initiation rates to be as low as 5% and as high as 31%,
with the male samples consistently smoking at a slightly higher rate than the female samples. This was a prospective study using a questionnaire to sample 397 preprofessional dance students. Participants averaged 16 years of age, and 90% were female. Nearly one third of the dancers who responded
identified that they were occasional or regular smokers. Dancers who smoked even occasionally had a higher injury rate and lower overall health. They displayed a higher rate of comorbid behaviors associated with eating disorders, such as laxative use, diet pill use, and vomiting. Their rates
of alcohol and illegal drug use were statistically higher than those of their non-smoking cohorts. Finally, nearly two thirds of the smokers reported that they trained with a teacher who was also a smoker. This study suggests that smoking has adverse effects on dancers, including increased
injury rate, increased comorbid behaviors, and other health issues. In the world of dance, the teacher, choreographer, or director acts as a role model to students and, as such, has a particularly sensitive position in the choices the adolescent dancer makes. Effective prevention must go beyond
informing dancers of health risks and must include the experience of a healthy role model.
Surgery on the Hands of Musicians with Rheumatoid Arthritis
Authors: Ell Nikolaus
Published: February 2021

The essential requisites for successful operative treatment of hands affected by rheumatoid arthritis are a thorough knowledge of the disease and experience in the applicable specialized hand surgical techniques. In musicians, decisions about the indications for surgery, the particular
technique to be used, and the disadvantages of each possible procedure require additional basic knowledge about musical instruments and how they are played. This paper provides an overview of the changes in the hand and their effects on musicians in the early stages and late stages of rheumatoid
arthritis as well as the special considerations that must be taken into account for operative therapy in both the early and late stages of the disease. The choice of operative procedure is often dependent on the instrument played and may vary between the right and left hands, or even from
one finger to the next. If at all possible, the anticipated results of an operation should be simulated and checked preoperatively by using static or dynamic testsplints.
Hand Pain Attributed to Overuse among Professional Pianists: A Study of 200 Cases
Authors: Sakai Naotaka
Published: February 2021

Two hundred professional pianists and students with hand pain (35 men and 165 women; 102 right, 62 left, and 36 bilateral; with a mean age of 26.3 years) attributed to overuse while playing the piano were investigated. The diagnoses were divided into six groups: tenosynovitis or tendinitis
(56 cases), enthesopathy (49), muscle pain (38), neurological disturbance (28), joint pain (24), and neck or scapular pain (5). Tenosynovitis or tendinitis included de Quervain’s disease (29), flexor tenosynovitis (17), and tendinitis of the extensor digitorum communis (6). The enthesopathy
group consisted of lateral epicondylitis (27), medial epicondylitis (7), olecranon pain (4), and distal pain of the flexor carpi radialis or ulnaris (8). Muscle pain was seen in the digital extensors (12) and flexors (5) of the forearm, the thenar muscle (8), the hypothenar muscle (6), and
the interossei (6). Finger joint pain was noted in the proximal interphalangeal joint (15), metacarpophalangeal joint (6), and first carpometacarpal joint (1). Neurological disturbance included focal dystonia (18), cubital tunnel syndrome (8), and carpal tunnel syndrome (2). Seventy subjects
stated that they were practicing some specific keyboard techniques at the onset of their overuse trouble; octaves (30 cases) and chords (22), which require hyperabduction of both the thumb and the little finger, accounted for 74% of these techniques.
Crowdsourcing to Develop Open-Access Learning Resources on Antimicrobial Resistance
Authors: Kpokiri Eneyi , John Randall , Wu Dan , Fongwen Noah , Budak Jehan , Chang Christina , Ong Jason , Tucker Joseph
Published: February 2021

ObjectivesAntimicrobial resistance (AMR) is a significant threat to global public health. Many medical curricula have limited clinical cases and materials focused on AMR. Enhanced AMR education and training are needed to support antimicrobial stewardship programmes. We used crowdsourcing methods to develop open-access, learner-centred AMR resources. Crowdsourcing is the process of having a large group, including experts and non-experts, solve a problem and then share solutions with the public.MethodsWe organised a global crowdsourcing contest soliciting AMR-related multiple-choice questions, infographics, and images. First, we convened a diverse steering committee group to finalise a call for entries. Second, we launched the contest and disseminated the call for entries using social media, blog posts, email, and an in-person event. Partner institutions included two digital healthcare platforms: Fig. 1® and Ding Xiang Yuan. Both organizations serve as online communities for healthcare specialists and professionals to report and comment on clinical information. At the end of the call, solicited entries were screened for eligibility and judged on merit and relevance to AMR learning and education. Exceptional entries were recognised, awarded prizes, and further reviewed for sharing with the public via open-access platforms.ResultsWe received 59 entries from nine countries. These included 54 multiple-choice questions, four infographics, and one image. Eligible entries (n = 56) were reviewed and assigned a score on a 1–10 scale. Eight entries received mean scores greater than 6.0 and were selected as finalists. The eight finalist entries consisted of three infographics and five multiple-choice questions. They were disseminated through open-access publications and online medical communities.ConclusionsWe demonstrate that crowdsourcing challenge contests can be used to identify infectious disease teaching materials. Medical educators and curriculum developers can adapt this method to solicit additional teaching content for medical students.
Development of an Immunochromatographic Strip for Rapid Detection of H7 Subtype Avian Influenza Viruses
Authors: Li Ge , Wang Xun , Li Qingmei , Yang Jifei , Liu Xiao , Qi Wenbao , Guo Junqing , Deng Ruiguang , Zhang Gaiping
Published: February 2021

Background: H7N9 avian influenza virus (AIV) including highly and low pathogenic viruses have been detected in China since 2013. H7N9 AIV has a high mortality rate after infection in humans, and most human cases have close contacted with poultry in the live poultry market. Therefore, it is necessary to develop a rapid point-of-care testing (POCT) technique for H7N9 AIV detection.Methods: The H7N9 AIV was inactivated and purified, and was used as the antigen to immunize BALB/c. Twelve H7-HA specific monoclonal antibodies (McAbs) were produced through the hybridoma technique. The McAb 10A8 was conjugated with colloid gold as detecting antibody; McAb 9B6 was dispensed on the nitrocellulose membran as the capture test line and the Goat-anti mouse IgG antibody was dispensed as control line respectively. The immunochromatographic strip was prepared.Results: The analysis of ELISA and virus neutralization test showed that the obtained McAbs specifically recognized H7 HA. Based on the prepared strip, the detection of H7 AIV was achieved within 10 min. No cross-reaction occurred between H7 AIVs and other tested viruses. The detection limit of the strip for H7 was 2.4 log10EID50/0.1 mL for chicken swab samples.Conclusion: The McAbs were specific for H7 and the immunochromatographic strip developed in this study was convenient, rapid and reliable for the detection of H7 AIV. The strip could provide an effective method for the rapid and early detection of H7 AIV.
Knockdown of miR-423-5p simultaneously upgrades the eNOS and VEGFa pathways in ADSCs and improves erectile function in diabetic rats
Authors: ZHOU JUN , Yin Yinghao , Yang Yuan , Peng Dongyi , Wei Jingchao , Tang Yuxin
Published: February 2021

Background Erectile dysfunction (ED) is both physical and psychological problem to men. The treatment is still unsatisfied. Modified adipose derived stem cells (ADSCs) may be a good therapy. This study aim to investigate if knockout of miR-423-5p in ADSCs alleviates damage to endothelial cells in high glucose conditions and improves erectile function in diabetic rats. Methods MiR-423-5p was knocked down in ADSCs. Then, ADSCs, NC-miR-ADSCs, and miR-ADSCs were co-cultured with human umbilical vein endothelial cells (HUVECs). Normal glucose and high glucose media were supplemented. Afterwards, the supernatant and HUVECs were collected for assessment of eNOS and VEGFa expression, cell proliferation, and apoptosis. Fifteen male Sprague-Dawley (SD) rats aged 12 weeks were induced to develop diabetes mellitus by intraperitoneal injection with streptozocin (STZ), and five healthy SD rats were used as normal controls. Eight weeks after developing diabetes, the rats received ADSCs and miR-ADSCs via injection into the corpora cavernosa, whereas normal controls and DM controls were injected with saline. Erectile function and histological assessment of penile tissues were performed eight weeks after injection. Results MiR-423-5p was successfully inhibited in ADSCs, and HUVECs co-cultured with ADSCs or miR-ADSCs exhibited higher eNOS and VEGFa protein expression levels compared to DM groups (P<0.05). MiR-ADSCs enhanced HUVEC proliferation compared to the ADSCs and NC-miR-ADSCs in both normal and high glucose conditions (P<0.01). Lower apoptotic rates were observed when HUVECs were co-cultured with miR-ADSCs, compared to ADSCs and NC-miR-ADSCs (P<0.05). The ICP/MAP indicated that erectile function was severely impaired in the DM rats compared with the normal group. Injection of ADSCs and miR-ADSCs improved erectile function (P<0.01) significantly and was associated with the overexpression of eNOS and VEGFa. Masson trichrome stain showed less fibrosis formation in the miR-ADSC group than the DM group. Conclusions MiR-423-5p knockdown in ADSCs ameliorated high glucose-mediated damage to HUVECs and improved erectile function in DM rats by inducing eNOS and VEGFa overexpression, indicating that miR-423-5p may be a potential target in the treatment of DM erectile dysfunction (DMED).
The Inflammatory Markers of Multisystem Inflammatory Syndrome in children (MIS-C) and Adolescents During the COVID-19 Pandemic: A Meta-Analysis
Authors: Zhao Yan , Yin Li-juan , Patel Jenil , Tang Lei , Huang Ying
Published: February 2021

As per the indicated need in literature, we conducted a systematic review and meta-analysis to characterize inflammatory markers of MIS-C patients with COVID-19, Kawasaki disease (KD), and coronary artery abnormalities. We searched nine databases for studies on inflammatory markers of MIS-C. After quality check, data were pooled using a fixed- or random-effects model. Inflammatory markers included white blood cell count (WBC) or leukocytes, absolute lymphocyte count (ALC), absolute neutrophil count (ANC), platelet count (PLT), C-reactive protein (CRP), procalcitonin (PCT), ferritin, D-dimer, lactate dehydrogenase (LDH), fibrinogen and erythrocyte sedimentation rate (ESR) for comparisons by severity and age. Twenty studies with 2,990 participants yielded 684 MIS-C patients. Compared to non-severe COVID-19 patients, MIS-C patients had lower ALC and higher ANC, CRP and D-dimer levels. Compared to severe COVID-19 patients, MIS-C patients had lower LDH and PLT counts and higher ESR levels. Compared to KD patients, MIS-C patients had lower ALC and PLT, and higher CRP and ferritin levels. Severe MIS-C patients had higher levels of WBC, CRP, D-dimer and ferritin. For MIS-C, younger children had lower CRP and ferritin levels than medium-aged/older children. Measurement of inflammatory markers might assist clinicians in accurate evaluation and diagnosis of MIS-C and the associated disorders.
Effect of sterilization on 3-point dynamic response to in vitro bending of an Mg implant.
Authors: Becerra Luis Humberto Campos , Rodríguez Marco Antonio Loudovic Hernández , Arroyo Raúl Lesso , S Hugo Esquivel , Castro Alejandro Torres
Published: February 2021

Background: The aim of the study is to characterize a biomedical magnesium alloy and highlighting the loss of mechanical integrity due to the sterilization method. Ideally, when using these alloys is to delay the onset of degradation so that the implant can support body loads and avoid toxicological effects due to the release of metal ions into the body. Methods: Standardized procedures according to ASTM F-1264 and ISO-10993-5 were used, respecting detailed methodological controls to ensure accuracy and reproducibility of the results, this testing methodology is carried out in accordance with the monographs of the Pharmacopoeia for the approval of medical devices and obtaining a health registration. An intramedullary implant (IIM) manufactured in magnesium (Mg) WE43 can support loads of the body in the initial period of bone consolidation without compromising the integrity of the fractured area. A system with these characteristics would improve morbidity and health costs by avoiding secondary surgical interventions. Results: As a property, the fatigue resistance of Mg in aggressive environments such as the body environment undergoes progressive degradation, however, the autoclave sterilization method drastically affects fatigue resistance, as demonstrated in tests carried out under in vitro conditions. Coupled with this phenomenon, the relatively poor biocompatibility of Mg WE43 alloys has limited applications where they can be used due to low acceptance rates from agencies such as the FDA. However, Mg alloy with elements such as yttrium and rare earth elements (REEs) have been shown to delay biodegradation depending on the method of sterilization and the physiological solution used. With different sterilization techniques, it may be possible to keep toxicological effects to a minimum while still ensuring a balance between the integrity of fractured bone and implant degradation time. Therefore, the evaluation of fatigue resistance of WE43 specimens sterilized and tested in immersion conditions (enriched Hank's solution) and according to ASTM F-1264, along with the morphological, crystallinity, and biocompatibility characterization of the WE43 alloy allows for a comprehensive evaluation of the mechanical and biological properties of WE43. Conclusions: These results will support decision-making to generate a change in the current perspective of biomaterials utilized in medical devices (MDs), to be considered by manufacturers and health regulatory agencies. An implant manufactured in WE43 alloy can be used as an intramedullary implant, considering keeping elements such as yttrium-REEs below as specified in its designation and with the help of a coating that allows increasing the life of the implant in vivo.Trial registration: N/A
Incidence and Mortality of Eye Cancer in Shandong, China: A Population-based Study During 2013-2017
Authors: Li Yingmei , Wang Hongtao , Lu Zilong , Sun Jiandong , Zhang Jiyu , Jiang Fan , Fu Zhentao , Guo Xiaolei , Xu Aiqiang
Published: February 2021

Background: Eye cancer is relatively rare. Current prevalence and disease burden of eye cancer are unlcear.The purpose of this study was to understand the epidemiology in the incidence and mortality of eye cancer in Shandong Province, and to provide reference for the prevention and control of eye cancer.Methods: Population-based cancer incidence and death data from cancer registries in 2013-2017 was collected by Shandong Center for Disease Control and Prevention (SDCDC). Extracted data were firstly assessed for data quality and then were aggregated by area (urban/rural), gender, and age group [0, 1-4, 5-9, 10-14, …, 85+]. Crude and age-adjusted incidence and mortality rates were calculated.Results: The reported numbers of eye cancer incident cases and deaths in Shandong cancer registry from 2013 to 2017 were 169 and 43, respectively. The crude incidence rate, age-standardized rate of incidence by Chinese population (ASRIC, 2000) and world population (ASRIW) were 11.12/107, 8.92/107 and 12.44/107, respectively. The crude mortality rate, age-standardized rate of mortality by Chinese population (ASRMC, 2000) and world population (ASRMW) were 2.83/107, 1.89/107 and 2.58/107, respectively. There were no marked differences in the incidence and mortality rates between male and female. The incidence rates were similar between rural and urban areas. The mortality rate in rural areas was higher than that in urban areas. The mortality-to-incidence (M/I) ratio in rural areas (0.30) was considerably higher than that in urban areas (0.18). The highest incidence was observed in children aged 0-4 years old, which was true for both urban and rural areas, and for both genders,Conclusion: Eye cancer is not a common malignant tumor in this population. Prevention and control measures should be tailored according to the epidemiological characteristics and risk factors of eye cancer.
Prognostic Significance of Functional Dependency in Older Patients Hospitalized for COVID-19: An Observational Cross-Sectional Study
Authors: Plotnikov Galina , Waizman Efraim , Tzur Irma , Yusupov Alexander , Shapira Yonatan , Gorelik Oleg
Published: February 2021

Background
Coronavirus disease 2019 (COVID-19) is a pandemic infection with substantial risk of death, especially in elderly persons. Information about the prognostic significance of functional status in older patients with COVID-19 is scarce.
Methods
Demographic, clinical, laboratory and short-term mortality data were collected of 186 consecutive patients aged ≥ 65 years hospitalized with COVID-19. Data were compared between 4 groups: 1) age 65–79 years without severe functional dependency (n = 69); 2) age ≥ 80 years without severe functional dependency (n = 28); 3) age 65–79 years with severe functional dependency (n = 32); and 4) age ≥ 80 years with severe functional dependency (n = 57).
Results
Statistically significant differences were observed between the groups in the proportions of patients with hypertension, diabetes mellitus, cerebrovascular disease, renal failure, dementia, heart failure, pressure sores and malignant disorders; and of the proportions that resided in nursing homes. Compared to groups 1 and 2, patients in groups 3 and 4 presented with lower mean serum albumin levels on admission; and were treated more often with antibiotics and less often with convalescent plasma, tocilizumab and remdesivir. The mortality rate was higher in group 4 than in groups 1 − 3: 45.6% vs. 8.7%, 17.9% and 18.3%, respectively (p < 0.001). On multivariate analysis, age ≥ 80 years with severe functional dependency remained one of the variables most significantly associated with mortality (odds ratio 10.42 and 95% confidence interval 3.27–33.24).
Conclusions
Among patients with COVID-19, the association of severe functional dependency with mortality is stronger among those aged ≥ 80 years than aged 65–79 years. Assessment of functional status may contribute to decision making for care of older inpatients with COVID-19.
Assessment of Animal Health and Production Constraints: The Case of Three Districts
Authors: Dugassa Jiregna , Kebede Abraham , Tamiru Yobsan
Published: February 2021

Background
Animal production is an important tool for improving the standard of living of humans and is the backbone of Ethiopia's agricultural development. The country is known for its high reproductive potential, but it is not consumed by various factors.
Objectives
The overall objective of the study is to assess the key issues related to animal health and performance.
Methods
In addition to case-observation studies at the District Veterinary Clinic, cross-sectional study design using well-designed and structured questionnaire surveys.
Results
The evaluation was carried out in three intentionally selected districts, namely: Gidda Ayana, Sibu Sire and Jimma Arjo. As a result, 200, 145 and 165 respondents were sampled among the animal owners in the districts of Gidda Ayana, Sibu Sire and Jimma Arjo, respectively. In all districts, infectious and non-infectious diseases common in the regions were also assessed and classified. In addition, feeds, management systems, water sources, and reproductive status of animals were also assessed. According to the majority of respondents, natural pastures and breeding are the main sources of food and livestock genetic improvement systems, which they rely on to improve their animal production.
Conclusion and Recommendations:
In the present study, the barriers to livestock health and productivity in districts are high in quality and their number. These include animal feeding, poor animal management, limited ability to use genetics, high prevalence of infectious diseases, and animal husbandry systems. Thus, it is important to increase the veterinary services, extension services and alternative sources of animal feed besides provision of training and capacity building on rational use, reproduction, prevention and control of animal diseases for local farmers.
COVID-19 Mortality in Malaria Endemic Countries: An Ecological Study
Authors: Michael U. Anyanwu
Published: February 2021

IntroductionThe number of persons infected with COVID-19 continue to increase with deaths reported daily across the globe. High income countries such as the US, the UK, Italy and Belgium have reported high COVID-19 related deaths but low-and-middle-income countries have recorded fewer deaths despite having poor healthcare system. This study aimed to investigate the association between malaria prevalence and COVID-19 mortality.MethodsThis is an ecological study with data from 195 countries. Spearman’s correlation was used to test the association between the population variables and COVID-19 mortality. Generalized linear model with Poisson distribution was used to determine the significant predictors of COVID-19 mortality. ResultsThere was a significant positive correlation between median age, life expectancy, 65+ mortality and COVID-19 mortality while malaria prevalence, sex ratio and cardiovascular mortality were negatively correlated with COVID-19 mortality. Malaria prevalence, life expectancy and mortality rate were significant on multivariate regression analysis.ConclusionThe results of this study support the hypotheses that there is reduced COVID-19 deaths in malaria endemic countries, although the results need to be proved further by clinical trials.
The Effect of an Electronic Medical Record Intervention on Hydroxychloroquine Prescribing Habits and Surveyed Providers’ Opinions of the 2016 American Academy of Ophthalmology Guidelines in the Rheumatology and Dermatology Practices of an Academic Institution
Authors: Overbury Rebecca , Pupaibool Jakrapun , Hansen Christopher , Lebiedz-Odrobina Dorota
Published: February 2021

Background

Retinal toxicity is a rare adverse event related to the use of hydroxychloroquine (HCQ). To address this, in 2016, the American Academy of Ophthalmology (AAO) issued guidelines recommending that HCQ not exceed 5 mg/kg/day. We analyzed HCQ prescribing habits at our institution, compared to these guidelines, and used surveys to determine the opinions on these guidelines. We then introduced, in a prospective and non-controlled study, an electronic medical record (EMR) tool to study how this intervention might affect compliance with or opinions on these guidelines.
Methods

Data were collected pre-intervention (June 2017 - January 2019) and post-intervention (March 2019 - April 2020). In January 2019 we released our EMR tool. Results were analyzed using descriptive statistics for demographic data and Fisher’s exact tests for comparisons of proportions between groups.
Results

Pre-intervention, we reviewed 1,128 rheumatology charts and 282 dermatology charts. 31.0% and 39.7% respectively (32.8% combined) were prescribed HCQ > 5 .0 mg/kg/day. Post-intervention, we reviewed 1,158 rheumatology charts and 106 dermatology charts. 23.1% and 26.4% respectively (23.3% combined) were prescribed HCQ > 5.0 mg/kg/day. Post-intervention, fewer patients (9.5%) were prescribed HCQ > 5 mg/kg/day (p < 0.00001). Pre-intervention, we compiled 18 rheumatology surveys and 12 dermatology surveys. Post-intervention, we compiled 16 rheumatology surveys and 12 dermatology surveys. Post-intervention, fewer rheumatologists incorrectly described the AAO weight-based guidelines. Combined, there was an overall reduction but not of statistical significance (p = 0.47).
Conclusions

At our academic institution, there remains unfamiliarity of and hesitation to comply with the 2016 AAO guidelines. Prescribed doses often exceed what is recommended in these guidelines. An EMR tool can improve compliance with these guidelines and might improve providers’ familiarity with these guidelines.
Comparative Study on the Esophageal Microflora of Different Tissue Types in Patients With Esophageal Squamous Cell Carcinoma
Authors: liu Xiaobo , Gao Ziye , Xu Wen , Meng JianChao , Sun Chuantao , Wen Hui , Tong Qiang , He Shuixiang
Published: February 2021

Objective: This study aimed to compare the differences in microbiota between the postoperative tissues and esophageal mucosa tissues of patients with esophageal squamous cell carcinoma (ESCC). Methods: Seventy-two patients who had ESCC and diagnosed in Taihe Hospital were selected from July 2018 to July 2019 to participate in this work. Then, 27 postoperative tissues and 45 mucosa samples of ESCC were collected. The sequence V4 hypervariable region was amplified, and Illumina MiSeq sequencing was performed to analyze the differences between the two groups. Results: Results revealed that the Shannon and Chao1 indices of the postoperative esophageal cancer tissue group (Group A) were significantly higher (P<0.05) than those of the esophageal mucosa group (Group B). The Simpson index of Group A was higher than that of Group B, but the difference was not significant (P>0.05). The beta diversity of the two groups was also not significantly different (P>0.05). LEfSe analysis showed that the abundance of Megasphaera, Actinobacteria, Enterobacteriaceae, and Enterobacteriales in Group A was significantly higher than that in Group B, but the abundance of Mogibacteriaceae in Group B was significantly higher than that in Group A (P<0.05). At the phylum level, Actinobacteria and Verrucomicrobiae were more abundant in the postoperative tissue group than in the esophageal mucosa group. The abundance of Fusobacteriia, SR1, and Spirochaetes in the postoperative tissue group was significantly lower than that of the esophageal mucosa group(P<0.05). Conclusion: The source of the sample should be considered in studies on the esophageal flora. More relevant findings were obtained from postoperative tissues than from the normal mucosa.
Clinical Outcomes and Predicted Model of Surgical Patients With Enhanced Recovery After Surgery (ERAS): A Multicenter Prospective Clinical Study
Authors: Ren Li , Lv Feng , Min Su , Jin Juying , Wang Wenjian , Qin Peipei
Published: February 2021

Enhanced recovery after surgery (ERAS) has been accepted widely in the whole world. However, clinical effects of ERAS in China have not been systematically reported, and it is still unclear whether there is key component with the present ERAS program to secure enhanced recovery. Patients who were undergoing operations with ERAS program were included. All the perioperative information were collected via a website and a nomogram to predict postoperative complication was conducted. 950 subjects from 59 hospitals were included in this study. Illness of cardiovascular (22.6%) and endocrine system (11.1%) were the top two coexisted diseases preoperatively. The recovery time of ability of drinking water after surgery was 6 (4-8) h, and almost half of patients could do active exercises in bed within 6 h postoperatively. The overall incidence of complications within 1 month postoperatively was 11.1%. Preoperative creatinine and bilirubin, intraoperative maximum systolic blood pressure and NRS scores at rest at postoperative 3 days were independent risk factors for complications within 1 month postoperatively. However, minimally invasive surgery was associated with a decrease probability of the complications. This study firstly indicates preoperative hepatorenal function, intraoperative systolic blood pressure, minimally invasive surgery and postoperative pain control can independently influence the prognosis of surgical patients.