bluuebunny/crossref_metadata_2025 huggingface dataset:
Chromosomal characteristics of salt stress heritable gene expression in the rice genome
Authors: McGowan Matthew T. , Zhang Zhiwu , Ficklin Stephen P.
Published: May 2021

Background

Gene expression is potentially an important heritable quantitative trait that mediates between genetic variation and higher-level complex phenotypes through time and condition-dependent regulatory interactions. Therefore, we sought to explore both the genomic and condition-specific characteristics of gene expression heritability within the context of chromosomal structure.

Results

Heritability was estimated for biological gene expression using a diverse, 84-line, Oryza sativa (rice) population under optimal and salt-stressed conditions. Overall, 5936 genes were found to have heritable expression regardless of condition and 1377 genes were found to have heritable expression only during salt stress. These genes with salt-specific heritable expression are enriched for functional terms associated with response to stimulus and transcription factor activity. Additionally, we discovered that highly and lowly expressed genes, and genes with heritable expression are distributed differently along the chromosomes in patterns that follow previously identified high-throughput chromosomal conformation capture (Hi-C) A/B chromatin compartments. Furthermore, multiple genomic hot-spots enriched for genes with salt-specific heritability were identified on chromosomes 1, 4, 6, and 8. These hotspots were found to contain genes functionally enriched for transcriptional regulation and overlaps with a previously identified major QTL for salt-tolerance in rice.

Conclusions

Investigating the heritability of traits, and in-particular gene expression traits, is important towards developing a basic understanding of how regulatory networks behave across a population. This work provides insights into spatial patterns of heritable gene expression at the chromosomal level.
First case report of acute cholangitis secondary to Cronobacter sakazakii
Authors: Sahra Syeda , Jahangir Abdullah , Mobarakai Neville , Glaser Allison , Jahangir Ahmad , Sharif Muhammad Ans
Published: May 2021

Introduction

Cronobacter sakazakii is an opportunistic Gram-negative, rod-shaped bacterium which may be a causative agent of meningitis in premature infants and enterocolitis and bacteremia in neonates and adults. While there have been multiple cases of C. sakazakii infections, there have been no acute cholangitis cases reported in humans.

Case presentation

An 81-year-old male with a past medical history of basal cell carcinoma, alcoholic liver cirrhosis, transjugular intrahepatic portosystemic shunt procedure, complicated by staphylococcus bacteremia, pituitary tumor, glaucoma, and hypothyroidism presented to the emergency room with the complaint of diffuse and generalized 10/10 abdominal pain of 1 day’s duration. There was a concern for pancreatitis, acute cholangitis, and possible cholecystitis, and the patient underwent a percutaneous cholecystostomy tube placement. Blood cultures from admission and biliary fluid cultures both grew C. sakazakii. The patient was treated with a carbapenem and clinically improved.

Conclusions

The case study described a patient with multiple medical comorbidities that presented with C. sakazakii bacteremia and cholangitis. While this bacterium has been implicated in other infections, we believe this is the first time the bacteria is being documented to have caused acute cholangitis.
COVID – 19 related knowledge and preventive practices early in the outbreak among health care workers in selected public health facilities of Illu aba Bor and Buno Bedelle zones, Southwest Ethiopia
Authors: Tsegaye Dereje , Shuremu Muluneh , Oljira Dereje , Dubale Sileshi , Befekadu Getachew , Bidira Kebebe
Published: May 2021

Background

Novel-coronavirus 2019 (COVID-19) disease is currently a worldwide health risk and public health emergency concern. The virus is transmitted from an infected person to another person through close contact and droplets. Frontline health care workers are the most at risk of infection, and so a WHO interim guidance document was issued by the World Health Organization (WHO) which underscores the importance of proper sanitation and waste management practices for COVID- 19 in health-care settings. This study aimed at assessing knowledge and preventive practices towards Covid-19 among health care providers in selected health facilities of Illu Aba Bor and Buno Bedele zones, Southwest Ethiopia.

Methods

An institution-based cross-sectional study was conducted from April to May 2020 among 330 health workers in selected health facilities of Illu Aba Bor and Buno-Bedelle Zones, Southwest Ethiopia. Data were collected using a self-administered structured questionnaire. The collected data were entered into Epidata version 3.1 and exported to SPSS version 23 for analysis. Bivariate and multivariable logistic regression analysis was used to identify independent predictors of preventive practices towards Covid-19. Statistical significance was declared at a p-value of < 0.05.

Result

The majority of respondents (93.3%) demonstrated good knowledge of COVID-19, and the mean (SD) knowledge score was 9.04 ± 1.06. Nearly two-thirds (64.2%) of the study participants had good infection prevention practices. Being male (AOR = 3.65, 95% CI: (1.96, 6.80)), education level (AOR = 1.82, 95% CI (1.02, 3.22)), profession (AOR = 3.17, 95% CI (1.08, 9.33)), service year (5–10 years) (AOR = 2.00 (1.02, 3.92)) and more than 10 years (AOR = 3.14 (1.51, 6.52)), availability of personal protective equipment (AOR = 1.96 (1.06, 3.61)) and Knowledge level (AOR = 2.61 (1.48, 4.62)) were independent predictors of COVID-19 preventive practices.

Conclusion

The overall level of knowledge of HCWs was good. However, the practice was relatively low. Gender, educational status, profession, year of service, knowledge towards COVID-19, and availability of personal protective equipment were independent predictors of good infection prevention practices. Optimizing the infection prevention and control loop of the health facilities is recommended.
Prophylactic pegfilgrastim to prevent febrile neutropenia among patients receiving biweekly (Q2W) chemotherapy regimens: a systematic review of efficacy, effectiveness and safety
Authors: Mahtani Reshma , Crawford Jeffrey , Flannery Sinéad M. , Lawrence Tatiana , Schenfeld Jennifer , Gawade Prasad L.
Published: May 2021

Background

Pegfilgrastim, a long-acting granulocyte colony-stimulating factor (G-CSF), is commonly used to prevent febrile neutropenia (FN), a potentially life-threatening complication, following myelosuppressive chemotherapy. The FDA label for pegfilgrastim specifies that it should not be administered 14 days before or within 24 h of administration of myelosuppressive chemotherapy, precluding the use of pegfilgrastim in biweekly (Q2W) regimens. The National Comprehensive Cancer Network and the European Organisation for Research and Treatment of Cancer guidelines support the use of prophylactic pegfilgrastim in patients receiving Q2W regimens. The objective of this study was to systematically review evidence from randomized clinical trials (RCTs) and observational studies that describe the effectiveness and safety of prophylactic pegfilgrastim in preventing FN among patients receiving Q2W regimens.

Methods

An Ovid MEDLINE, Embase, and Cochrane Library literature search was conducted to evaluate the evidence regarding efficacy, effectiveness, and safety of prophylactic pegfilgrastim versus no prophylactic pegfilgrastim or prophylaxis with other G-CSF in patients who were receiving Q2W chemotherapy regimens with high (> 20%) or intermediate (10–20%) risk of FN for a non-myeloid malignancy. Studies that addressed absolute or relative risk of FN, grade 1–4 neutropenia, all-cause or any hospitalization, dose delays or dose reductions, adverse events, or mortality were included. Studies where the comparator was a Q3W chemotherapy regimen with primary prophylactic pegfilgrastim were also included.

Results

The initial literature search identified 2258 publications. Thirteen publications met the eligibility criteria, including eight retrospective, one prospective, one phase 1 dose escalation study, and three RCTs. In nine of the 13 studies reporting incidence of FN, and in seven of the nine studies reporting incidence of neutropenia, administration of prophylactic pegfilgrastim in patients receiving Q2W regimens resulted in decreased or comparable rates of FN or neutropenia compared with patients receiving filgrastim, no G-CSF, lipefilgrastim or pegfilgrastim in Q3W regimens. In six of the nine studies reporting safety data, lower or comparable safety profiles were observed between pegfilgrastim and comparators.

Conclusions

In a variety of non-myeloid malignancies, administration of prophylactic pegfilgrastim was efficacious in reducing the risk of FN in patients receiving high- or intermediate-risk Q2W regimens, with an acceptable safety profile.

Trial registration

PROSPERO registration no: CRD42019155572.
Attitudes of Lebanese adults regarding COVID-19 vaccination
Authors: Kasrine Al Halabi Carina , Obeid Sahar , Sacre Hala , Akel Marwan , Hallit Rabih , Salameh Pascale , Hallit Souheil
Published: May 2021

Background

COVID-19 was first detected in Lebanon on February 21, 2020; it reached its peak in January 2021, with a total number of 418,448 confirmed cases and 5380 deaths (until March 15, 2021). Gaining insight into factors regarding willingness or refusal for vaccination might guide our goals in raising the awareness and target efforts to increase acceptance of the COVID-19 vaccine and maximize the uptake. Therefore, this study aims to assess the intent to receive the COVID-19 vaccine among Lebanese adults and the factors associated with vaccine refusal.

Methods

We conducted a cross-sectional study during November–December 2020 among Lebanese adults from all Lebanese regions using a survey tool with closed-ended questions that included sociodemographic data and questions about vaccine hesitancy, knowledge, attitude, practice, and fear of COVID-19. We used the snowball technique to collect the data because of the COVID-19 imposed lockdown.

Results

Of the 579 participants, 21.4% were willing to receive the vaccine, 40.9% refused, and the remainder were unsure of their response. More vaccine hesitancy (adjusted odds ratio (aOR) = 1.06; 95% CI 1.03–1.09) was significantly associated with more odds of disagreeing/ strongly disagreeing on receiving the COVID-19 vaccine compared to being neutral. More vaccine hesitancy (aOR = 0.95; 95% CI 0.91–0.99), female gender compared to males (aOR = 0.53; 95% CI 0.32–0.87), and being married compared to single (aOR = 0.53; 95% CI 0.29–0.98) were significantly associated with lower odds of agreeing/strongly agreeing on receiving the COVID-19 vaccine compared to being neutral.

Conclusion

Overall, our findings revealed a high percentage of people (40%) who strongly disagreed with receiving the vaccine, mainly females, married participants, and those who have a general vaccine hesitancy. Moreover, no significant association was found with knowledge, attitude, or prevention practice regarding COVID-19. Targeted efforts are necessary to increase acceptance of a COVID-19 vaccine among the Lebanese population to control the COVID-19 pandemic. Further studies with a larger sample size are warranted to validate our results and provide better insights into the underlying reasons for refusing vaccination.
Motivating antibiotic stewardship in Bangladesh: identifying audiences and target behaviours using the behaviour change wheel
Authors: Unicomb Leanne E. , Nizame Fosiul Alam , Uddin Mohammad Rofi , Nahar Papreen , Lucas Patricia J. , Khisa Nirnita , Akter S. M. Salim , Islam Mohammad Aminul , Rahman Mahbubur , Rousham Emily K.
Published: May 2021

Background

South Asia is a hotspot for antimicrobial resistance due largely to over-the-counter antibiotic sales for humans and animals and from a lack of policy compliance among healthcare providers. Additionally, there is high population density and high infectious disease burden. This paper describes the development of social and behavioural change communication (SBCC) to increase the appropriate use of antibiotics.

Methods

We used formative research to explore contextual drivers of antibiotic sales, purchase, consumption/use and promotion among four groups: 1) households, 2) drug shop staff, 3) registered physicians and 4) pharmaceutical companies/medical sales representatives. We used formative research findings and an intervention design workshop with stakeholders to select target behaviours, prioritise audiences and develop SBCC messages, in consultation with a creative agency, and through pilots and feedback. The behaviour change wheel was used to summarise findings.

Results

Workshop participants identified behaviours considered amenable to change for all four groups. Household members and drug shop staff were prioritised as target audiences, both of which could be reached at drug shops. Among household members, there were two behaviours to change: suboptimal health seeking and ceasing antibiotic courses early. Thus, SBCC target behaviours included: seek registered physician consultations; ask whether the medicine provided is an antibiotic; ask for instructions on use and timing. Among drug shop staff, important antibiotic dispensing practices needed to change. SBCC target behaviours included: asking customers for prescriptions, referring them to registered physicians and increasing customer awareness by instructing that they were receiving antibiotics to take as a full course.

Conclusions

We prioritised drug shops for intervention delivery to all drug shop staff and their customers to improve antibiotic stewardship. Knowledge deficits among these groups were notable and considered amenable to change using a SBCC intervention addressing improved health seeking behaviours, improved health literacy on antibiotic use, and provision of information on policy governing shops. Further intervention refinement should consider using participatory methods and address the impact on profit and livelihoods for drug shop staff for optimal compliance.
Development and validation of an instrument to measure physician awareness of bioethics and medical law in Oman
Authors: Al-Busaidi Ahmed S. , Ganesh Anuradha , Al-Adawi Samir , Al-Farsi Yahya M. , Al-Rawahi Maryam K. , Al-Mawali Nusaiba A. , Al-Kharousi Nadiya S. , Al-Alawi Mohammed , Al-Mujaini Abdullah S.
Published: May 2021

Background

A different ethos with respect to the perception of medical ethics prevails in societies in transition such as those in the Arabian Peninsula, which makes it difficult to apply international principles of bioethics in medical practice. This study aimed to develop and psychometrically test an instrument that measures physicians’ awareness of bioethics and medical law and their attitudes towards the practice of medical ethics. Additionally, it examined physician correlates influencing the awareness of bioethics.

Methods

Following a rigorous review of relevant literature by a panel of experts, a 13-item instrument, the Omani physicians’ bioethics and medical law awareness (OBMLA) questionnaire was developed with the aim of assessing physicians’ awareness of bioethics and medical law. The study tool’s construct validity and internal consistency reliability were examined by exploratory factor analysis (EFA) and Cronbach’s alpha. In a cross-sectional study, the questionnaire was distributed among a random sample of 200 physicians at a tertiary hospital in Muscat, Oman. Participant characteristics that may influence awareness of bioethics and medical law were explored.

Results

The EFA of the OBMLA questionnaire resulted in three well-loading factors: (1) Physicians’ bioethics practice subscale (2) incentive related bioethics subscale and (3) medical law awareness subscale. Internal consistency reliability ranged between Cronbach’s α: 0.73–0.8. Of the total 200 participants, 52% reported that teaching medical ethics during medical school was inadequate. The overall mean (standard deviation, SD) of the bioethics awareness score and Omani medical law awareness were 27.6 (3.5) and 10.1 (2.1) respectively. The majority of physicians (73%) reported that they frequently encountered ethical dilemmas in their practice and 24.5% endorsed the view that unethical decisions tended to occur in their practice.

Conclusion

The study provides an insight into the practice of bioethics, and the awareness of bioethics and medical law among physicians in a teaching hospital in Oman. The OBMLA questionnaire appears to be a valid and reliable tool to assess a physician’s awareness of bioethics and medical law. In this preliminary study, it appears that participants have suboptimal scores on the indices which measure practice and awareness of bioethics and medical law.
Maintaining proper health records improves machine learning predictions for novel 2019-nCoV
Authors: Khan Koffka , Ramsahai Emilie
Published: May 2021

Background

An ongoing outbreak of a novel coronavirus (2019-nCoV) pneumonia continues to affect the whole world including major countries such as China, USA, Italy, France and the United Kingdom. We present outcome (‘recovered’, ‘isolated’ or ‘death’) risk estimates of 2019-nCoV over ‘early’ datasets. A major consideration is the likelihood of death for patients with 2019-nCoV.

Method

Accounting for the impact of the variations in the reporting rate of 2019-nCoV, we used machine learning techniques (AdaBoost, bagging, extra-trees, decision trees and k-nearest neighbour classifiers) on two 2019-nCoV datasets obtained from Kaggle on March 30, 2020. We used ‘country’, ‘age’ and ‘gender’ as features to predict outcome for both datasets. We included the patient’s ‘disease’ history (only present in the second dataset) to predict the outcome for the second dataset.

Results

The use of a patient’s ‘disease’ history improves the prediction of ‘death’ by more than sevenfold. The models ignoring a patent’s ‘disease’ history performed poorly in test predictions.

Conclusion

Our findings indicate the potential of using a patient’s ‘disease’ history as part of the feature set in machine learning techniques to improve 2019-nCoV predictions. This development can have a positive effect on predictive patient treatment and can result in easing currently overburdened healthcare systems worldwide, especially with the increasing prevalence of second and third wave re-infections in some countries.
Care plus study: a multi-site implementation of early palliative care in routine practice to improve health outcomes and reduce hospital admissions for people with advanced cancer: a study protocol
Authors: Philip Jennifer , Le Gautier Roslyn , Collins Anna , Nowak Anna K. , Le Brian , Crawford Gregory B. , Rankin Nicole , Krishnasamy Meinir , Mitchell Geoff , McLachlan Sue-Anne , IJzerman Maarten , Hudson Robyn , Rischin Danny , Sousa Tanara Vieira , Sundararajan Vijaya
Published: May 2021

Background

Current international consensus is that ‘early’ referral to palliative care services improves cancer patient and family carer outcomes. In practice, however, these referrals are not routine. An approach which directly addresses identified barriers to early integration of palliative care is required. This protocol details a trial of a standardized model of early palliative care (Care Plus) introduced at key defined, disease-specific times or transition points in the illness for people with cancer. Introduced as a ‘whole of system’ practice change for identified advanced cancers, the key outcomes of interest are population health service use change.

The aims of the study are to examine the effect of Care Plus implementation on (1) acute hospitalisation days in the last 3 months of life; (2) timeliness of access to palliative care; (3) quality and (4) costs of end of life care; and (5) the acceptability of services for people with advanced cancer.

Methods

Multi-site stepped wedge implementation trial testing usual care (control) versus Care Plus (practice change). The design stipulates ‘control’ periods when usual care is observed, and the process of implementing Care Plus which includes phases of planning, engagement, practice change and evaluation. During the practice change phase, all patients with targeted advanced cancers reaching the transition point will, by default, receive Care Plus.

Health service utilization and unit costs before and after implementation will be collated from hospital records, and state and national health service administrative datasets. Qualitative data from patients, consumers and clinicians before and after practice change will be gathered through interviews and focus groups.

Discussion

The study outcomes will detail the impact and acceptability of the standardized integration of palliative care as a practice change, including recommendations for ongoing sustainability and broader implementation.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN 12619001703190. Registered 04 December 2019.
Gestational diabetes mellitus is associated with the neonatal gut microbiota and metabolome
Authors: Chen Ting , Qin Yufeng , Chen Minjian , Zhang Yuqing , Wang Xu , Dong Tianyu , Chen Guanglin , Sun Xian , Lu Ting , White Richard Allen , Ye Peng , Tun Hein M. , Xia Yankai
Published: May 2021

Background

Gestational diabetes mellitus (GDM) is a metabolic disease that occurs in pregnant women and increases the risk for the development of diabetes. The relationship between GDM and meconium microbiota and metabolome remains incompletely understood.

Methods

Four hundred eighteen mothers (147 women with GDM and 271 normal pregnant women) and their neonates from the GDM Mother and Child Study were included in this study. Meconium microbiota were profiled by 16S rRNA gene sequencing. Meconium and maternal serum metabolome were examined by UPLC-QE.

Results

Microbial communities in meconium were significantly altered in neonates from the GDM mothers. A reduction in alpha diversity was observed in neonates of GDM mothers. At the phylum level, the abundance of Firmicutes and Proteobacteria changed significantly in neonates of GDM mothers. Metabolomic analysis of meconium showed that metabolic pathways including taurine and hypotaurine metabolism, pyrimidine metabolism, beta-alanine metabolism, and bile acid biosynthesis were altered in GDM subjects. Several changed metabolites varying by the similar trend across the maternal serum and neonatal meconium were observed.

Conclusion

Altogether, these findings suggest that GDM could alter the serum metabolome and is associated with the neonatal meconium microbiota and metabolome, highlighting the importance of maternal factors on early-life metabolism.
The m6A epitranscriptome on neural development and degeneration
Authors: Yen Ya-Ping , Chen Jun-An
Published: May 2021

N6-methyladenosine (m6A) is the most prevalent, conserved, and abundant RNA modification of the mRNAs of most eukaryotes, including mammals. Similar to epigenetic DNA modifications, m6A has been proposed to function as a critical regulator for gene expression. This modification is installed by m6A methylation “writers” (Mettl3/Mettl14 methyltransferase complex), and it can be reversed by demethylase “erasers” (Fto and Alkbh5). Furthermore, m6A can be recognized by “readers” (Ythdf and Ythdc families), which may be interpreted to affect mRNA splicing, stability, translation or localization. Levels of m6A methylation appear to be highest in the brain, where it plays important functions during embryonic stem cell differentiation, brain development, and neurodevelopmental disorders. Depletion of the m6A methylation writer Mettl14 from mouse embryonic nervous systems prolongs cell cycle progression of radial glia and extends cortical neurogenesis into postnatal stages. Recent studies further imply that dysregulated m6A methylation may be significantly correlated with neurodegenerative diseases. In this review, we give an overview of m6A modifications during neural development and associated disorders, and provide perspectives for studying m6A methylation.
Downregulation of CD151 restricts VCAM-1 mediated leukocyte infiltration to reduce neurobiological injuries after experimental stroke
Authors: Gao Ceshu , Jia Wangyue , Xu Wendeng , Wu Qiong , Wu Jian
Published: May 2021

Background

Translational failures in anti-adhesion molecule therapies after stroke reveal the necessity of developing new strategies that not only interrupt leukocyte recruitment but also consider the inhibition of endothelial cell inflammation, verification of therapeutic time window, and normal function maintenance of circulating leukocytes. Our study focused on the potential therapeutic value of CD151 downregulation in improving current anti-adhesion molecule therapies.

Methods

Lentivirus intracerebroventricular administration was conducted to inhibit the CD151 expression and observe its functional influence on neurological injuries and outcomes. Then, immunohistochemistry and myeloperoxidase activity assessment were performed to explore the effects of CD151 expression on neutrophil and monocyte recruitment after rat cerebral ischemia. Primary rat brain microvascular endothelial cells were subjected to oxygen glucose deprivation and reoxygenation to elucidate the underlying working mechanisms between CD151 and VCAM-1.

Results

The CD151 downregulation remarkably reduced neurological injuries and improved neurological outcomes, which were accompanied with reduced neutrophil and monocyte infiltration after the CD151 downregulation. The VCAM-1 expression was remarkably decreased among the adhesion molecules on the endothelial cell responsible for neutrophil and monocyte infiltration. The activation of p38 MAPK and NF-κB pathways was restricted after the CD151 downregulation. p38 MAPK and NF-κB inhibitors decreased the VCAM-1 expression, and p38 acted as an upstream regulator of NF-κB. However, CD151 downregulation did not directly influence the neutrophil and monocyte activation.

Conclusions

Overall, CD151 regulated the expression of adhesion molecules. It also played a critical role in suppressing VCAM-1-mediated neutrophil and monocyte infiltration via the p38/NF-κB pathway. This study possibly provided a new basis for improving current anti-adhesion molecule therapies.
Transfer of mode switching performance: from training to upper-limb prosthesis use
Authors: Heerschop Anniek , van der Sluis Corry K. , Bongers Raoul M.
Published: May 2021

Background

Current myoelectric prostheses are multi-articulated and offer multiple modes. Switching between modes is often done through pre-defined myosignals, so-called triggers, of which the training hardly is studied. We evaluated if switching skills trained without using a prosthesis transfer to actual prosthesis use and whether the available feedback during training influences this transfer. Furthermore we examined which clinically relevant performance measures and which myosignal features were adapted during training.

Methods

Two experimental groups and one control group participated in a five day pre-test—post-test design study. Both experimental groups used their myosignals to perform a task. One group performed a serious game without seeing their myosignals, the second group was presented their myosignal on a screen. The control group played the serious game using the touchpad of the laptop. Each training session lasted 15 min. The pre- and post-test were identical for all groups and consisted of performing a task with an actual prosthesis, where switches had to be produced to change grip mode to relocate clothespins. Both clinically relevant performance measures and myosignal features were analysed.

Results

10 participants trained using the serious game, 10 participants trained with the visual myosignal and 8 the control task. All participants were unimpaired. Both experimental groups showed significant transfer of skill from training to prosthesis use, the control group did not. The degree of transfer did not differ between the two training groups. Clinically relevant measure ‘accuracy’ and feature of the myosignals ‘variation in phasing’ changed during training.

Conclusions

Training switching skills appeared to be successful. The skills trained in the game transferred to performance in a functional task. Learning switching skills is independent of the type of feedback used during training. Outcome measures hardly changed during training and further research is needed to explain this. It should be noted that five training sessions did not result in a level of performance needed for actual prosthesis use.

Trial registration The study was approved by the local ethics committee (ECB 2014.02.28_1) and was included in the Dutch trial registry (NTR5876).
Defining and characterizing task-shifting medical devices
Authors: Sabet Sarvestani Amir , Coulentianos Marianna , Sienko Kathleen H.
Published: May 2021

Background

Task shifting could help address limited human resources available for the delivery of quality health care services in low-resource settings. However, the role of medical devices in supporting task shifting is not fully understood. This study aimed to 1) define “task-shifting medical devices” and 2) identify product characteristics to guide the design and development of task-shifting medical devices.

A three-part survey questionnaire comprising open-ended, rank-ordering, and multiple-choice questions was disseminated to healthcare professionals worldwide. The survey included questions to capture stakeholders’ general understanding of and preferences for task shifting in medicine and public health, and questions to define task-shifting medical devices and identify desirable product characteristics of task-shifting medical devices.

Results

Task-shifting medical devices were defined by respondents as “devices that can be used by a less specialized health worker”. Aside from safe and effective, both essential characteristics for medical devices, easy to use was the most cited product characteristic for a task-shifting medical device. Responses also emphasized the importance of task-shifting medical devices to enable local agency, such as peer-to-peer training and local maintenance. Several additional frequently mentioned attributes included low cost, contextually appropriate, maintainable, capable of using an alternative power source, easy to understand, easy to learn, reusable, and easy to manage throughout its use cycle.

Conclusion

This study defines and characterizes task-shifting medical devices based on healthcare professionals’ responses. Ease of use was identified as the most important characteristic that defines a task-shifting medical device, alongside safe and effective, and was strongly associated with enabling peer-to-peer training and maintainability. The findings from this study can be used to inform technology product profiles for medical devices used by lower-level cadres of healthcare workers in low-resource settings.
Coronary artery bypass graft surgery in patients on ticagrelor therapy is not associated with adverse perioperative outcomes
Authors: Diab Sammer , Arazi Mattan , Sternik Leonid , Raanani Ehud , Kachel Erez , Grosman-Rimon Liza , Shalabi Amjad , Amir Offer , Carasso Shemy
Published: May 2021

Background

Management of patients treated with Ticagrelor is challenging, as stopping Ticagrelor prior to coronary bypass graft surgery (CABG) may increase the risk of acute stent thrombosis. The aim of the study was to compare bleeding complications in patients treated with ticagrelor combined with acetylsalicylic acid (ASA) versus ASA alone until 1 day before surgery.

Methods

Bleeding complications, defined as the composite of red blood cell transfusion ≥1000 ml, chest drainage ≥2000 ml, and bleeding requiring surgical re-exploration, were compared in 161 patients, with 101 on preoperative acetylsalicylic acid (ASA) alone (group A) and 65 on ticagrelor + ASA (group B).

Results

There were no differences in bleeding complications between the two groups (26% vs. 27% in group A and B, respectively), with similar chest drainage in the first 24 h (569 ± 393 ml and 649 ± 427 ml, respectively).

Conclusions

Continuing ticagrelor until coronary artery bypass surgery was not associated with increased bleeding complications, suggesting that continued management with ticagrelor until surgery may be safe.
Fasciola gigantica tegumental calcium-binding EF-hand protein 4 exerts immunomodulatory effects on goat monocytes
Authors: Ehsan Muhammad , Hu Rui-Si , Hou Jun-Ling , Elsheikha Hany M. , Li Xiao-Dong , Liang Pan-Hong , Zhu Xing-Quan
Published: May 2021

Background

The liver flukeFasciola giganticasecretes excretory-secretory proteins during infection to mediate its interaction with the host. In this study, we investigated the immunomodulatory effects of a recombinant tegumental calcium-binding EF-hand protein 4 ofF. gigantica(rFg-CaBP4) on goat monocytes.

Methods

The rFg-CaBP4 protein was induced and purified by affinity chromatography. The immunogenic reaction of rFg-CaBP4 against specific antibodies was detected through western blot analysis. The binding of rFg-CaBP4 on surface of goat monocytes was visualized by immunofluorescence assay. The localization of CaBP4 within adult fluke structure was detected by immunohistochemical analysis. The cytokine transcription levels in response to rFg-CaBP4 were examined using ABI 7500 real-time PCR system. The expression of the major histocompatibility complex (MHC) class-II molecule (MHC-II) in response to rFg-CaBP4 protein was analyzed using Flow cytometry.

Results

The isopropyl-ß-D-thiogalactopyranoside-induced rFg-CaBP4 protein reacted with rat sera containing anti-rFg-CaBP4 polyclonal antibodies in a western blot analysis. The adhesion of rFg-CaBP4 to monocytes was visualized by immunofluorescence and laser scanning confocal microscopy. Immunohistochemical analysis localized native CaBP4 to the oral sucker, pharynx, genital pore, acetabulum and tegument of adultF. gigantica. Co-incubation of rFg-CaBP4 with concanavalin A-stimulated monocytes increased the transcription levels of interleukin (IL)-2, IL-4, interferon gamma and transforming growth factor-β. However, a reduction in the expression of IL-10 and no change in the expression of tumor necrosis factor-α were detected. Additionally, rFg-CaBP4-treated monocytes exhibited a marked increase in the expression of the major histocompatibility complex (MHC) class-II molecule (MHC-II) and a decrease in MHC-I expression, in a dose-dependent manner.

Conclusions

These findings provide additional evidence that calcium-binding EF-hand proteins play roles in host-parasite interaction. Further characterization of the immunomodulatory role of rFg-CaBP4 should expand our understanding of the strategies used byF. giganticato evade the host immune responses.

Graphical abstract
MHD Powell–Eyring dusty nanofluid flow due to stretching surface with heat flux boundary condition
Authors: Abo-zaid Omima A. , Mohamed R. A. , Hady F. M. , Mahdy A.
Published: May 2021

A steady MHD boundary layer flow of Powell–Eyring dusty nanofluid over a stretching surface with heat flux condition is studied numerically. It is assumed that the fluid is incompressible and the impacts of thermophoresis and Brownian motion are taken into regard. In addition, the Powell–Eyring terms are considered in the momentum boundary layer and thermal boundary layer. The dust particles are seen as to be having the same size and conform to the nanoparticles in a spherical shape. We obtain a system of ordinary differential equations that are suitable for analyzed numerically using the fourth-order Runge–Kutta method via software algebraic MATLAB by applying appropriate transformations to the system of the governing partial differential equations in our problem. There is perfect compatibility between the bygone and current results when comparing our numerical solutions with the available data for values of the selected parameters. This confirms the validity of the method used here and thus the validity of the results. The influence of some parameters on the boundary layer profiles (the velocity and temperature for the particle phase and fluid phase, and nanoparticle concentration) is discussed. The results of this study display that the profiles of the velocity for particle and fluid phases increase with increasing Powell–Eyring fluid parameter, but reduce with height in magnetic field values. Mass concentration of the dust particles decreases the temperature of both the particle and fluid phases. The results also indicate the concentration of nanoparticle contraction as Schmidt number increases.
Clamping Cortisol and Testosterone Mitigates the Development of Insulin Resistance during Sleep Restriction in Men
Authors: Liu Peter Y , Lawrence-Sidebottom Darian , Piotrowska Katarzyna , Zhang Wenyi , Iranmanesh Ali , Auchus Richard J , Veldhuis Johannes D , Van Dongen Hans P A
Published: May 2021

Context

Sleep loss in men increases cortisol and decreases testosterone, and sleep restriction by 3 to 4 hours/night induces insulin resistance.

Objective

We clamped cortisol and testosterone and determined the effect on insulin resistance.

Methods

This was a randomized double-blind, in-laboratory crossover study in which 34 healthy young men underwent 4 nights of sleep restriction of 4 hours/night under 2 treatment conditions in random order: dual hormone clamp (cortisol and testosterone fixed), or matching placebo (cortisol and testosterone not fixed). Fasting blood samples, and an additional 23 samples for a 3-hour oral glucose tolerance test (OGTT), were collected before and after sleep restriction under both treatment conditions. Cytokines and hormones were measured from the fasting samples. Overall insulin sensitivity was determined from the OGTT by combining complementary measures: homeostasis model assessment of insulin resistance of the fasting state; Matsuda index of the absorptive state; and minimal model of both fasting and absorptive states.

Results

Sleep restriction alone induced hyperinsulinemia, hyperglycemia, and overall insulin resistance (P < 0.001 for each). Clamping cortisol and testosterone alleviated the development of overall insulin resistance (P = 0.046) and hyperinsulinemia (P = 0.014) by 50%. Interleukin-6, high-sensitivity C-reactive protein, peptide YY, and ghrelin did not change, whereas tumor necrosis factor-α and leptin changed in directions that would have mitigated insulin resistance with sleep restriction alone.

Conclusion

Fixing cortisol-testosterone exposure mitigates the development of insulin resistance and hyperinsulinemia, but not hyperglycemia, from sustained sleep restriction in men. The interplay between cortisol and testosterone may be important as a mechanism by which sleep restriction impairs metabolic health.
Overcoming Stress, Hunger, and Pain: Cocaine- and Amphetamine-Regulated Transcript Peptide’s Promise
Authors: Samson Willis K , Salvemini Daniela , Yosten Gina L C
Published: May 2021

Cocaine- and amphetamine-regulated transcript encodes an eponymous peptide, CARTp, which exerts diverse pharmacologic actions in the central and peripheral nervous systems, as well as in several endocrine organs, including pancreas. Here we review those diverse actions, the physiological relevance of which had remained unestablished until recently. With the identification of a CARTp receptor, GPR160, the physiologic importance and therapeutic potential of CARTp or analogs are being revealed. Not only is the CARTp-GPR160 interaction essential for the circadian regulation of appetite and thirst but also for the transmission of nerve injury-induced pain. Molecular approaches now are uncovering additional physiologically relevant actions and the development of acute tissue-specific gene compromise approaches may reveal even more physiologically relevant actions of this pluripotent ligand/receptor pair.
Dynamic mutation enhanced particle swarm optimization for optical wavefront shaping
Authors: Woo Chi Man , Li Huanhao , Zhao Qi , Lai Puxiang
Published: May 2021

Particle swarm optimization (PSO) is a well-known iterative algorithm commonly adopted in wavefront shaping for focusing light through or inside scattering media. The performance is, however, limited by premature convergence in an unstable environment. Therefore, we aim to solve this problem and enhance the focusing performance by adding a dynamic mutation operation into the plain PSO. With dynamic mutation, the “particles,” or the optimized masks, are mutated with quantifiable discrepancy between the current and theoretical optimal solution, i.e., the “error rate.” Gauged by that, the diversity of the “particles” is effectively expanded, and the adaptability of the algorithm to noise and instability is significantly promoted, yielding optimization approaching the theoretical optimum. The simulation and experimental results show that PSO with dynamic mutation demonstrates considerably better performance than PSO without mutation or with a constant mutation, especially under a noisy environment.
Polarization dynamics of ultrafast solitons
Authors: Klein Avi , Meir Sara , Duadi Hamootal , Govindarajan Arjunan , Fridman Moti
Published: May 2021

We study the polarization dynamics of ultrafast solitons in mode-locked fiber lasers. We find that when a stable soliton is generated, its state of polarization shifts toward a stable state, and when the soliton is generated with excess power levels it experiences relaxation oscillations in its intensity and timing. On the other hand, when a soliton is generated in an unstable state of polarization, it either decays in intensity until it disappears, or its temporal width decreases until it explodes into several solitons, and then it disappears. We also found that when two solitons are simultaneously generated close to each other, they attract each other until they collide and merge into a single soliton. Although these two solitons are generated with different states-of-polarization, they shift their state of polarization closer to each other until the polarization coincides when they collide. We support our findings by numerical calculations of a non-Lagrangian approach by simulating the Ginzburg-Landau equation governing the dynamics of solitons in a laser cavity. Our model also predicts the relaxation oscillations of stable solitons and the two types of unstable solitons observed in the experimental measurements.
Patient-reported outcomes after primary or revision total hip arthroplasty: A propensity score-matched Asian cohort study
Authors: Harada Satoru , Hamai Satoshi , Shiomoto Kyohei , Hara Daisuke , Fujii Masanori , Ikemura Satoshi , Motomura Goro , Nakashima Yasuharu
Published: May 2021

Background

Few studies have compared patient-reported outcome measures (PROMs) between primary and revision total hip arthroplasty (THA). We investigated and compared PROMs between propensity score-matched primary and revision THA in an Asian cohort.

Methods

The Oxford Hip Score (OHS) and University of California-Los Angeles (UCLA) activity score, satisfaction score, and Short Form-12 Health Survey (SF-12) were compared between 110 primary and 110 revision THAs after propensity score matching. Multivariate analyses were performed to determine which factors, including patients’ demographics, indication for revision, and pre-operative PROMs, were associated with post-operative PROMs in the revision THA cohort.

Results

The revision THA cohort demonstrated significantly lower post-operative OHS, UCLA activity score, and satisfaction score (10% decrease on average) than those in the primary THA cohort (P < .05). The difference in SF-12 mental component summary measure (MCS) between the two cohorts was statistically insignificant (P = .24). In multivariate analysis for the revision THA cohort, lower post-operative UCLA activity score was significantly associated with higher BMI and lower pre-operative UCLA activity score (P < .05).

Conclusion

Revision THA was associated with a modest but significant decrease in physical PROMs as compared with primary THA. Pre-operative UCLA activity score significantly affected the post-operative physical outcome measures in the revision THA cohort. However, post-operative SF-12 MCS was comparable between the primary and revision THA cohorts.
The Perception of Dietary Supplements Among Consumers Engaged in Sports on a Regular Basis
Authors: Szűcs Róbert Sándor , Szakály Zoltán
Published: May 2021

The inaccurate perception of their own body image can be observed not only among physically inactive people, but also among those doing sports on a regular basis. Corporate marketing communication further increases these uncertainties and doubts in people doing sport on a regular basis, and thus they can easily become actual consumers of dietary supplements. The results of our primary research (n=737) show the sport-related activities, attitudes and segmentation of those engaged in sports regularly, including details about the dietary supplements market. Our results indicate that the group of people engaged in sports on a regular basis is far from being a homogeneous segment. 56.4% of them in general show a positive attitude towards dietary supplements and they constitute the potential consumers of the product range. Opinion leaders (coaches), reference groups and word of mouth advertising (fellow sportsmen) were found to play the key role in choosing particular dietary supplements.
Re-Cording Lives
Authors: Pörtner Ephraim
Published: May 2021

Administrative asylum procedures are permeated by tensions between rationalities of legality, efficiency, and deterrence in asylum casework and their various effects on cases. Based on ethnographic research in the Swiss asylum administration, this book unveils the pragmatics and politics of rendering asylum cases resolvable by re-cording the lives of applicants in terms of asylum. With his reading of power and agency in administrations, Ephraim Pörtner offers a critical view of the intricate relationship between practices of asylum casework and the governmental need to resolve claims of people seeking protection.
Testing the Omnivore Hypothesis in Russia
Authors: Папушина Юлия Олеговна
Published: May 2021

In the last thirty years, a significant shift from the homology to omnivore argument has occurred in musical preference studies. Studies on the omnivore argument mainly come from North and South America, Western and sometimes Eastern Europe. To the best of our knowledge, there are no empirical tests of musical omnivorousness in Russia. The aim of this paper is to reveal omnivore musical preferences in Russia, and analyzes the links between musical preferences, social-demographic profiles, and tolerance. Our research also emphasizes the territory dimension.
The research setting is the Perm Region. A survey of 2,400 Perm Region citizens is analyzed using principal component analysis and linear regression provides evidence for the research. Our findings do not indicate omnivore musical tastes in Russia that contradicts the conclusions of the research in other cultures. Instead of finding the omnivore pattern, we found Bourdieu-like patterns of classical versus pop music taste and nostalgic taste versus contemporary taste. Representatives of each taste pattern have a specific social-demographic profile. The urbanization factor influences musical preferences as well. The paper discusses the limitations of the research and directions for further work.
Acknowledgements. The publication was prepared within the framework of the project “Intergenerational cultural dynamics” No 18-011-00548А supported by Russian Fundamental Research Fund.