bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuous shared control in prosthetic hand grasp tasks by Deep Deterministic Policy Gradient with Hindsight Experience Replay
Authors: Gao Zhaolong , Tang Rongyu , Chen Luyao , Huang Qiang , He Jiping
Published: August 2020

Grasp using a prosthetic hand in real life can be a difficult task. The amputee users are often capable of planning the reaching trajectory and hand grasp location selection, however, failed in precise finger movements, such as adapting the fingers to the surface of the object without excessive force. It is much efficient to leave that part to the machine autonomy. In order to combine the intention and planning ability of users with robotic control, the shared control is introduced in which users’ inputs and robot control methods are combined to achieve a goal. The shared control problem can be formulated as a Partially Observable Markov Decision Process. To find the optimal control policy, we adopt an adaptive dynamic programming and reinforcement learning-based control algorithm-Deep Deterministic Policy Gradient combined with Hindsight Experience Replay. We proposed the algorithm with a prediction layer using the reparameterization technique. The system was tested in a modified simulation environment for the ability to follow the user’s intention and keep the contact force in boundary for safety.
Intent-to-treat analysis of cluster randomized trials when clusters report unidentifiable outcome proportions
Authors: DeSantis Stacia M , Li Ruosha , Zhang Yefei , Wang Xueying , Vernon Sally W , Tilley Barbara C , Koch Gary
Published: August 2020

Background

Cluster randomized trials are designed to evaluate interventions at the cluster or group level. When clusters are randomized but some clusters report no or non-analyzable data, intent-to-treat analysis, the gold standard for the analysis of randomized controlled trials, can be compromised. This article presents a very flexible statistical methodology for cluster randomized trials whose outcome is a cluster-level proportion (e.g. proportion from a cluster reporting an event) in the setting where clusters report non-analyzable data (which in general could be due to nonadherence, dropout, missingness, etc.). The approach is motivated by a previously published stratified randomized controlled trial called, “The Randomized Recruitment Intervention Trial (RECRUIT),” designed to examine the effectiveness of a trust-based continuous quality improvement intervention on increasing minority recruitment into clinical trials (ClinicalTrials.gov Identifier: NCT01911208).

Methods

The novel approach exploits the use of generalized estimating equations for cluster-level reports, such that all clusters randomized at baseline are able to be analyzed, and intervention effects are presented as risk ratios. Simulation studies under different outcome missingness scenarios and a variety of intra-cluster correlations are conducted. A comparative analysis of the method with imputation and per protocol approaches for RECRUIT is presented.

Results

Simulation results show the novel approach produces unbiased and efficient estimates of the intervention effect that maintain the nominal type I error rate. Application to RECRUIT shows similar effect sizes when compared to the imputation and per protocol approach.

Conclusion

The article demonstrates that an innovative bivariate generalized estimating equations framework allows one to implement an intent-to-treat analysis to obtain risk ratios or odds ratios, for a variety of cluster randomized designs.
Non-inferiority trials using a surrogate marker as the primary endpoint: An increasing phenotype in cardiovascular trials
Authors: Bikdeli Behnood , Caraballo César , Welsh John , Ross Joseph S , Kaul Sanjay , Stone Gregg W , Krumholz Harlan M
Published: August 2020

Background/aims

Non-inferiority trials are increasing in cardiovascular medicine, with approval of many drugs and devices on the basis of such studies. Surrogate markers as primary endpoints have been also more frequently used for efficient assessment of cardiovascular interventions. However, there is uncertainty about their concordance with clinical outcomes. Non-inferiority design using a surrogate marker as a primary endpoint may pose particular challenges in clinical interpretation. We sought to explore the publication trends, methodology, and reporting features of non-inferiority cardiovascular trials that used a primary surrogate marker as the primary endpoint.

Methods

We searched six high-impact journals ( The New England Journal of Medicine, The Journal of the American Medical Association, The Lancet, The Journal of the American College of Cardiology, Circulation, and European Heart Journal) from 1 January 1990 to 31 December 2018 and identified non-inferiority cardiovascular trials that used a surrogate marker as the primary endpoint. We assessed the non-inferiority margin reported in the manuscript and other publicly available platforms (e.g. protocol, clinicaltrials.gov). We also determined whether the included non-inferiority trials with surrogate markers as primary endpoints were followed by clinical outcome trials.

Results

We screened 15,553 publications and identified 247 cardiovascular trials that used a non-inferiority design. Of these, 37 had a surrogate marker as a primary endpoint (18 drug trials, 13 device trials, 6 others). All of these non-inferiority trials with surrogate outcomes were published after 2000, mostly in cardiology journals (13 in The Journal of the American College of Cardiology, 9 in European Heart Journal, 8 in Circulation, 6 in The Lancet, 1 in The New England Journal of Medicine), and their publication rate increased over time (p < 0.001 for linear trend). The median number of patients in the primary analysis was 300 (interquartile range: 202–465). The study protocol or a methods paper was publicly available for only 13 (35.1%) trials, of which the non-inferiority margin was not reported in 4 trials. In 16 studies (43.2%), the manuscript did not acknowledge the limitations of using a surrogate endpoint or the need for a definitive clinical outcome trial. Thirty-four trials (91.9%) concluded that the tested intervention met non-inferiority criteria. However, only five (13.5%) were followed by clinical outcomes trials the results of which did not always confirm non-inferiority.

Conclusion

Non-inferiority trials that use a surrogate marker as the primary endpoint are being increasingly performed. However, these trials pose particular challenges with design, reporting, and interpretation, which are not systematically and consistently addressed or reported.
Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG)
Authors: Altintas Ayse , Dargvainiene Justina , Schneider-Gold Christiane , Asgari Nasrin , Ayzenberg Ilya , Ciplea Andrea I. , Junker Ralf , Leypoldt Frank , Wandinger Klaus-Peter , Hellwig Kerstin
Published: August 2020

Neuromyelitis optica spectrum disorder (NMOSD), autoimmune encephalitis (AE), myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) are antibody-mediated neurological diseases. They have mostly female predominance, affecting many women during childbearing age. Interactions between the underlying disease (or necessary treatment) and pregnancy can occur in every of these illnesses. Herein, we present the characteristics of NMOSD, AE, MG and LEMS in general, and review published data regarding the influence of the different diseases on fertility, pregnancy, puerperium, treatment strategy during pregnancy and post-partum period, and menopause but also male factors. We summarise key elements that should be borne in mind when confronted with such cases.
Dramatic response to combination pembrolizumab and radiation in metastatic castration resistant prostate cancer
Authors: Han Harry J. , Li Yun Rose , Roach Mack , Aggarwal Rahul
Published: August 2020

Immune checkpoint inhibitors targeting PD-1 and PD-L1 have demonstrated anti-tumor activity in several advanced solid malignancies. In previously treated metastatic castration resistant prostate cancer (mCRPC), a small subset of patients have a therapeutic response to checkpoint inhibition. Those who do respond to anti-PD-1/PD-L1 therapy have a marked, durable response to treatment, suggesting some derive long-term benefit from immune checkpoint blockade. In other cancers, one strategy to increase the efficacy of immune checkpoint blockade is to combine it with a pro-immune stimulatory agent, such as radiation. Here we present a case of a patient with heavily treated mCRPC who had a significant tumor response to concurrent pembrolizumab and radiation therapy to the primary prostatic mass. We review the growing evidence supporting the use of this combination therapy in other cancers and its potential benefit and safety in mCRPC. Our report highlights a potential therapeutic approach that should be further investigated in previously treated mCRPC.
Molecular mechanisms and clinical implications of miRNAs in drug resistance of colorectal cancer
Authors: Duan Lili , Yang Wanli , Feng Weibo , Cao Lu , Wang Xiaoqian , Niu Liaoran , Li Yiding , Zhou Wei , Zhang Yujie , Liu Jinqiang , Zhang Hongwei , Zhao Qingchuan , Hong Liu , Fan Daiming
Published: August 2020

Systemic chemotherapy is identified as a curative approach to prolong the survival time of patients with colorectal cancer (CRC). Although great progress in therapeutic approaches has been achieved during the last decades, drug resistance still extensively persists and serves as a major hurdle to effective anticancer therapy for CRC. The mechanism of multidrug resistance remains unclear. Recently, mounting evidence suggests that a great number of microRNAs (miRNAs) may contribute to drug resistance in CRC. Certain of these miRNAs may thus be used as promising biomarkers for predicting drug response to chemotherapy or serve as potential targets to develop personalized therapy for patients with CRC. This review mainly summarizes recent advances in miRNAs and the molecular mechanisms underlying miRNA-mediated chemoresistance in CRC. We also discuss the potential role of drug resistance-related miRNAs as potential biomarkers (diagnostic and prognostic value) and envisage the future orientation and challenges in translating the findings on miRNA-mediated chemoresistance of CRC into clinical applications.
Systematic combination of Lean Management with digitalization to improve production systems on the example of Jidoka 4.0
Authors: Deuse Jochen , Dombrowski Uwe , Nöhring Fabian , Mazarov Jürgen , Dix Yannick
Published: August 2020

Lean Management builds the basis for efficient production systems for many industrial companies. However, lots of potentials of Lean Management have been lifted and information and communication technologies in the context of digitalization and cyber-physical production systems (CPPS) offer new possibilities to enhance the performance of companies. Even though surveys indicate that companies recognize these potentials, especially small and medium-sized companies still face challenges in selection and implementation of suitable solutions. Thus, the research project GaProSys 4.0 aims at supporting companies with a systematic approach to combine existing structures of Lean Management with potentials of digitalization in development of a new set of methods to enhance production systems. This paper presents the approach of the research project to develop a structured set of methods and provides an example to illustrate the potentials.
The potential role of mechanically sensitive ion channels in the physiology, injury, and repair of articular cartilage
Authors: Xu Bo-Yang , Jin Yu , Ma Xiao-Hui , Wang Chi-Yu , Guo Yi , Zhou Dan
Published: August 2020

Biomechanical factors play an extremely important role in regulating the function of articular chondrocytes. Understanding the mechanical factors that drive chondrocyte biological responses is at the heart of our interpretation of cascade events leading to changes in articular cartilage osteoarthritis. The mechanism by which mechanical load is transduced into intracellular signals that can regulate chondrocyte gene expression remains largely unknown. The mechanically sensitive ion channel (MSC) may be one of its specific mechanisms. This review focuses on four ion channels involved in the mechanotransduction of chondrocytes, exploring their properties and the main factors that activate the associated pathways. The upstream and downstream potential relationships between the protein pathways were also explored. The specific biophysical mechanism of the chondrocyte mechanical microenvironment is becoming the focus of research. Elucidating the mechanotransduction mechanism of MSC is essential for the research of biophysical pathogenesis and targeted drugs in cartilage injury-related diseases.
Transbronchial Needle Aspiration Cytology and Purulent Pericarditis
Authors: Vallabhaneni Srilakshmi , Kichloo Asim , Rawan Amir , Aljadah Michael , Albosta Michael , Singh Jagmeet , Cutitta Christopher
Published: August 2020

Endobronchial ultrasound with transbronchial needle aspiration (TBNA) is commonly performed for the evaluation of mediastinal lymphadenopathy. Purulent pericarditis is a rare, yet potentially fatal complication of TBNA. It commonly presents with nonspecific symptoms such as chest pain, shortness of breath, palpitations, or vague abdominal discomfort. Additionally, more severe symptoms such as cardiac tamponade and even death have been reported. In this article, we present the case of a 58-year-old male who developed purulent pericardial effusion with tamponade thought to be caused by TBNA cytology. This case raises an important question regarding the current guidelines for prophylactic antibiotic treatment for patients at high risk of developing purulent pericarditis as a complication of TBNA.
Effect of ACL Reconstruction on Range of Tibial Rotation: A Systematic Review of Current Literature and a Recommendation for a Standard Measuring Protocol
Authors: Zee Mark J.M. , Robben Bart J. , Zuurmond Rutger G. , Bulstra Sjoerd K. , Diercks Ronald L.
Published: August 2020

Background:

Tibial rotation is an important topic in anterior cruciate ligament (ACL) surgery, and many efforts are being made to address rotational stability. The exact role of the ACL in controlling tibial rotation in clinical studies is unknown.

Purpose:

To quantify the effect of ACL reconstruction on the amount of tibial rotation based on the current available literature.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A literature search of the PubMed and EMBASE databases was performed in August 2019. Two independent reviewers reviewed titles and abstracts as well as full-text articles. A total of 2383 studies were screened for eligibility. After screening of titles and abstracts, 178 articles remained for full-text assessment. Ultimately, 13 studies were included for analysis. A quality assessment was performed by means of the RoB 2.0 (revised tool for Risk of Bias in randomized trials) and the ROBINS-I (Risk Of Bias In Non-randomized Studies–of Interventions) tools.

Results:

According to the studies using computer-assisted surgery that were included in this review, ACL reconstruction resulted in an average reduction in tibial rotation of 17% to 32% compared with preoperatively; whether the range of tibial rotation returned to preinjury levels remained unclear. In the current literature, a gold standard for measuring tibial rotation is lacking. Major differences between the study protocols were found. Several techniques for measuring tibial rotation were used, each with its own limitations. Most studies lacked proper description of accompanying injuries.

Conclusion:

ACL reconstruction reduced the range of tibial rotation by 17% to 32%. Normal values for the range of tibial rotation in patients with ACL deficiency and those who undergo ACL reconstruction could not be provided based on the current available literature owing to a lack of uniform measuring techniques and protocols. Therefore, we advocate uniformity in measuring tibial rotation.
Understanding the Difference Between Healthcare Informatics and Healthcare Data Analytics in the Present State of Health Care Management
Authors: Wan Thomas , Gurupur Varadraj
Published: August 2020

The purpose of this article is to perform a scientific analysis of the definitions associated with healthcare informatics and healthcare data analytics. Additionally, the authors attempt to redefine the scientific pursuit of healthcare informatics and healthcare data analytics. This commentary can assist the thinking of informaticians and data analysts working in healthcare management and practice. The authors also provide a brief insight on the possible future direction of informatics and analytics associated with healthcare.
Evaluating pedestrian perceptions of street design with a 3D stated preference survey
Authors: Kasraian Dena , Adhikari Sneha , Kossowsky David , Luubert Michael , Hall G Brent , Hawkins Jason , Nurul Habib Khandker , Roorda Matthew J
Published: August 2020

In many places, streets are still primarily designed for the convenience of motorists, considering mobility function as the principal design goal. There is a scarcity of empirical evidence on the relationship between the design of a street and how it is experienced by pedestrians who use it. This work focuses on quantifying pedestrians’ perception of walkability through a stated preference survey using a dynamic 3D representation of various street designs in Toronto, Canada. The stated preference scenarios are generated through a rule-based 3D environment (Esri’s CityEngine) and animated using a gaming engine (Unity). A random sample of 600 Torontonians is used for the empirical investigation by estimating a mixed multinomial logit model. The results indicate that there is a high preference for (i) streets that include transit lanes as opposed to car-exclusive lanes, (ii) the presence of trees on the sidewalk, and (iii) two-way cycle paths on the curb lane. Furthermore, pedestrians are willing to trade sidewalk width for the presence of trees and outdoor dining. The survey’s innovative presentation mode and its findings can contribute to the development of much-needed evidence-based design tools to assess the trade-offs required between the many possible uses of roadway space, while focusing on the overlooked role of the pedestrian experience.
Subdividing the sprawl: Endogenous segmentation of housing submarkets in expansion areas of Santiago, Chile
Authors: Cox Tomás , Hurtubia Ricardo
Published: August 2020

Urban sprawl is a phenomenon observed in most cities around the globe and especially in Latin America, where it is associated to socioeconomic segregation. In the case of Chile, sprawl has been generally based on large real estate projects. Developers target their projects to different types of consumers, which translates into submarkets with a broad range of housing-unit’s characteristics, but also different location strategies. This heterogeneity has been analyzed and measured in the literature, but quantitative studies have used exogenous or sequential methods to identify submarkets, leading to potential bias in the segmentation. In this paper, we propose an econometric model to measure location drivers for different types of real estate projects that fills this gap. The modeling framework is based on discrete-choice and latent-class models, allowing us to simultaneously identify market segmentations, and their particular location choice preferences, without the need of arbitrary or ex-ante definitions of submarkets. The model is applied to the city of Santiago, Chile. The results reveal two clearly different approaches taken by developers to produce housing, with one submarket of “exclusive” and more sprawling projects, and another submarket of “massive” and more density driven projects. Location strategies are very different between submarkets, reproducing the socio-spatial segregation already observed in the consolidated city.
Cellular automata for simulating land-use change with a constrained irregular space representation: A case study in Nanjing city, China
Authors: Zhu Jie , Sun Yizhong , Song Shuyin , Yang Jing , Ding Hu
Published: August 2020

Traditional cell-based cellular automata (CA) models use a regular cellular grid to represent geographic space, and new approaches to CA models have explored the use of a vector representation of space instead of a regular grid to characterize urban space more realistically. However, less attention has been paid to modeling the interaction between the geospatial information and the irregular cells. To date, the majority of spatial boundaries have been created by individual agencies in an uncoordinated manner. As a consequence, the potential uses of the data collected for land-use change models are limited. In this paper, we propose a new vector-based CA model based on a new constrained irregular space representation using the theory of hierarchical spatial reasoning. For dividing the geographic space considering different items, first land patches are considered as the minimum division unit; then aggregation rules, including attribute, geometric and boundary barrier constraints, are defined; and finally different levels of spatial units are formed through land patches based on aggregation rules. The proposed model is used to simulate the land-use changes in Nanjing, Jiangsu Province, China. The performance validation and comparison illustrate the feasibility of the proposed space representation in a CA model. By using this model, it is expected that the use of the real spatial boundaries that are employed in urban planning could help provide a flexible paradigm to consider various drivers or constraints for realistically simulating land-use changes.
VEGF-C protects the integrity of the bone marrow perivascular niche in mice
Authors: Fang Shentong , Chen Shuo , Nurmi Harri , Leppänen Veli-Matti , Jeltsch Michael , Scadden David , Silberstein Lev , Mikkola Hanna , Alitalo Kari
Published: August 2020

Hematopoietic stem cells (HSCs) reside in the bone marrow (BM) stem cell niche, which provides a vital source of HSC regulatory signals. Radiation and chemotherapy disrupt the HSC niche, including its sinusoidal vessels and perivascular cells, contributing to delayed hematopoietic recovery. Thus, identification of factors that can protect the HSC niche during an injury could offer a significant therapeutic opportunity to improve hematopoietic regeneration. In this study, we identified a critical function for vascular endothelial growth factor-C (VEGF-C), that of maintaining the integrity of the BM perivascular niche and improving BM niche recovery after irradiation-induced injury. Both global and conditional deletion of Vegfc in endothelial or leptin receptor–positive (LepR+) cells led to a disruption of the BM perivascular niche. Furthermore, deletion of Vegfc from the microenvironment delayed hematopoietic recovery after transplantation by decreasing endothelial proliferation and LepR+ cell regeneration. Exogenous administration of VEGF-C via an adenoassociated viral vector improved hematopoietic recovery after irradiation by accelerating endothelial and LepR+ cell regeneration and by increasing the expression of hematopoietic regenerative factors. Our results suggest that preservation of the integrity of the perivascular niche via VEGF-C signaling could be exploited therapeutically to enhance hematopoietic regeneration.
Concomitant benzodiazepine and opioids decrease sleep apnoea risk in chronic pain patients
Authors: Mir Soodaba , Wong Jean , Ryan Clodagh M. , Bellingham Geoff , Singh Mandeep , Waseem Rida , Eckert Danny J. , Chung Frances
Published: August 2020

Background

The concurrent use of sedating centrally acting drugs and opioids by chronic pain patients occurs routinely despite concerns of negative impacts on respiration during sleep. The effects of centrally acting drugs and opioids on sleep apnoea have not been well characterised. The objective of this study was to assess the effect of concomitant centrally acting drugs and opioids on the prevalence and severity of sleep apnoea in chronic pain patients.

Methods

We conducted a prospective cohort study at five chronic pain clinics. Each participant underwent an in-laboratory polysomnography and daily morphine milligram equivalents were calculated. Participants were grouped into centrally acting drugs and opioid users
versus
sole opioid users.

Results

Of the 332 consented participants, 204 underwent polysomnography and 120 (58.8%) had sleep apnoea (72% obstructive, 20% central, and 8% indeterminate sleep apnoea). Overall, 35% (71 of 204) were taking opioids alone, and 65% (133 of 204) were taking centrally acting drugs and opioids. There was a 69% decrease in the odds of having sleep apnoea (apnoea�hypopnoea index =5 events�h
-1
) in participants taking benzodiazepine/opioids
versus
sole opioid users (OR 0.31, 95% CI:0.12�0.80, p=0.015). Additionally, concomitant benzodiazepine/opioids
versus
sole opioid use was associated with a decrease in respiratory arousal index scores (p=0.03). Mean overnight
S
pO
2

was approximately 1% lower in the concomitant benzodiazepine/opioids group
versus
sole opioid users (93.1�2.5
versus
94.4�2.1%, p=0.01).

Conclusion

In chronic pain patients on opioids, administration of certain benzodiazepine sedatives induced a mild respiratory depression but paradoxically reduced sleep apnoea risk and severity by increasing the respiratory arousal threshold.
Longitudinal monitoring of sinonasal and oral bacterial reservoirs to prevent chronic lung infection in people with cystic fibrosis
Authors: Passarelli Mantovani Rebeca , Sandri Angela , Boaretti Marzia , Burlacchini Gloria , Li Vigni Veronica , Scarazzai Mattia , Melotti Paola , Signoretto Caterina , Lleo Maria M.
Published: August 2020

Background

Paranasal sinuses act as bacterial reservoirs and contribute to transmitting bacteria to the lower airway of patients with cystic fibrosis (CF). Also, passage of bacteria from the oral cavity to the lungs may occur.

Methods

We evaluated the presence ofPseudomonas aeruginosa,Staphylococcus aureus,Stenotrophomonas maltophilia,Achromobacter xylosoxidansandSerratia marcescensin sputum and nasal lavage of 59 patients with CF, and also collected saliva and used toothbrushes from 38 of them. We assessed the clonal identity of the strains isolated from the different samples by pulsed-field gel electrophoresis.

Results

About 80% of the patients were positive for at least one of the bacterial species examined in nasal lavage and sputum. Among the subjects with positive sputum, 74% presented the same species in the nasal lavage and saliva, and 26% on their toothbrush.S. aureuswas the most abundant species in all samples. Clonal identity (≥80% similarity) of the strains isolated among the different samples from each patient was confirmed in almost all cases. Longitudinal observation helped to identify five patients who were colonised in the lower airways after an initial period of nasal or oral colonisation.

Conclusion

Nasal and oral sites act as bacterial reservoirs, favouring the transmission of potentially pathogenic microorganisms to the lower airway. The lack of eradication from these sites might undermine the antibiotic therapy applied to treat the lung infection, allowing the persistence of the bacteria within the patient if colonisation of these sites is not assessed, and no specific therapy is performed.
HPC-REDItools: a novel HPC-aware tool for improved large scale RNA-editing analysis
Authors: Flati Tiziano , Gioiosa Silvia , Spallanzani Nicola , Tagliaferri Ilario , Diroma Maria Angela , Pesole Graziano , Chillemi Giovanni , Picardi Ernesto , Castrignanò Tiziana
Published: August 2020

Background

RNA editing is a widespread co-/post-transcriptional mechanism that alters primary RNA sequences through the modification of specific nucleotides and it can increase both the transcriptome and proteome diversity. The automatic detection of RNA-editing from RNA-seq data is computational intensive and limited to small data sets, thus preventing a reliable genome-wide characterisation of such process.

Results

In this work we introduce HPC-REDItools, an upgraded tool for accurate RNA-editing events discovery from large dataset repositories. Availability: https://github.com/BioinfoUNIBA/REDItools2.

Conclusions

HPC-REDItools is dramatically faster than the previous version, REDItools, enabling big-data analysis by means of a MPI-based implementation and scaling almost linearly with the number of available cores.
Screening and identification of miRNAs related to sexual differentiation of strobili in Ginkgo biloba by integration analysis of small RNA, RNA, and degradome sequencing
Authors: Liu Xiao-Meng , Cheng Shui-Yuan , Ye Jia-Bao , Chen Ze-Xiong , Liao Yong-Ling , Zhang Wei-Wei , Kim Soo-Un , Xu Feng
Published: August 2020

Background

Ginkgo biloba, a typical dioecious plant, is a traditional medicinal plant widely planted. However, it has a long juvenile period, which severely affected the breeding and cultivation of superior ginkgo varieties.

Results

In order to clarify the complex mechanism of sexual differentiation in G. biloba strobili. Here, a total of 3293 miRNAs were identified in buds and strobili of G. biloba, including 1085 known miRNAs and 2208 novel miRNAs using the three sequencing approaches of transcriptome, small RNA, and degradome. Comparative transcriptome analysis screened 4346 and 7087 differentially expressed genes (DEGs) in male buds (MB) _vs_ female buds (FB) and microstrobilus (MS) _vs_ ovulate strobilus (OS), respectively. A total of 6032 target genes were predicted for differentially expressed miRNA. The combined analysis of both small RNA and transcriptome datasets identified 51 miRNA-mRNA interaction pairs that may be involved in the process of G. biloba strobili sexual differentiation, of which 15 pairs were verified in the analysis of degradome sequencing.

Conclusions

The comprehensive analysis of the small RNA, RNA and degradome sequencing data in this study provided candidate genes and clarified the regulatory mechanism of sexual differentiation of G. biloba strobili from multiple perspectives.
Protocol registration issues of systematic review and meta-analysis studies: a survey of global researchers
Authors: Tawfik Gehad Mohamed , Giang Hoang Thi Nam , Ghozy Sherief , Altibi Ahmed M. , Kandil Hend , Le Huu-Hoai , Eid Peter Samuel , Radwan Ibrahim , Makram Omar Mohamed , Hien Tong Thi Thu , Sherif Mahmoud , Hossain As-Saba , Thang Tai Luu Lam , Puljak Livia , Salem Hosni , Numair Tarek , Moji Kazuhiko , Huy Nguyen Tien
Published: August 2020

Background

Although protocol registration of systematic reviews/meta-analysis (SR/MA) is still not mandatory, it is highly recommended that authors publish their SR/MA protocols prior to submitting their manuscripts for publication as recommended by the Cochrane guidelines for conducting SR/MAs. our aim was to assess the awareness, obstacles, and opinions of SR/MA authors about the protocol registration process.

Methods

A cross-sectional survey study included the authors who published SR/MAs during the period from 2010 to 2016, and they were contacted for participation in our survey study. They were identified through the literature search of SR/MAs in Scopus database. An online questionnaire was sent to each participant via e-mail after receiving their approval to join the study. We have sent 6650 emails and received 275 responses.

Results

A total of 270 authors responses were complete and included in the final analysis. Our results has shown that PROSPERO was the most common database used for protocol registration (71.3%). The registration-to-acceptance time interval in PROSPERO was less than 1 month (99.1%). Almost half of the authors (44.2%) did not register their protocols prior to publishing their SR/MAs and according to their opinion that the other authors lack knowledge of protocol importance and mandance to be registered, was the most commonly reported reason (44.9%). A significant percenatge of respondents (37.4%) believed that people would steal their ideas from protocol databases, while only 5.3% reported that their SR/MA had been stolen. However, the majority (72.9%) of participants have agreed that protocol registries play a role in preventing unnecessary duplication of reviews. Finally, 37.4% of participants agree that SR/MA protocol registration should be mandatory.

Conclusion

About half of the participants believes that the main reason for not registering protocols, is that the other authors lack knowledge concerning obligation and importance to register the SR/MA protocols in advance. Therefore, tools should be available to mandate protocol registration of any SRs beforehand and increasing awareness about the benefits of protocol registration among researchers.
The influence of care home managers on the implementation of a complex intervention: findings from the process evaluation of a randomised controlled trial of dementia care mapping
Authors: Kelley R. , Griffiths A. W. , Shoesmith E. , McDermid J. , Couch E. , Robinson O. , Perfect D. , Surr C. A.
Published: August 2020

Background

Many people with dementia live in care homes, where staff can struggle to meet their complex needs. Successful practice improvement interventions in these settings require strong managerial support, but little is known about how managers can support implementation in practice, or what factors support or hinder care home managers in providing this support. Using Dementia Care Mapping™ (DCM) as an example, this study explored how care home managers can support the implementation of complex interventions, and identified factors affecting their ability to provide this support.

Methods

We undertook interviews with 48 staff members (managers and intervention leads) from care homes participating in the intervention arm of the DCM EPIC trial of DCM implementation.

Results

Managerial support played a key role in facilitating the implementation of a complex intervention in care home settings. Managers could provide practical and financial support in many forms. However, managerial support and leadership approaches towards implementation were highly variable in practice, and implementation was easily de-stabilised by management changes or competing managerial priorities. How well managers understood, valued and engaged with the intervention, alongside the leadership style they adopted to support implementation, were key influences on implementation success.

Conclusions

For care home managers to effectively support interventions they must fully understand the proposed intervention and its potential value. This is especially important during times of managerial or practice changes, when managers lack the skills required to effectively support implementation, or when the intervention is complex. It may be unfeasible to successfully implement new interventions during times of managerial or practice instability.

Trial registration

Current Controlled Trials ISRCTN82288852, registered 16/01/2014.
Sex differences in campylobacteriosis incidence rates at different ages - a seven country, multi-year, meta-analysis. A potential mechanism for the infection
Authors: Green Manfred S. , Schwartz Naama , Peer Victoria
Published: August 2020

Background

There is evidence that males have higher incidence rates (IR) of campylobacteriois than females. The objectives of this study were to determine whether these observations differ between age groups and are consistent over different countries and during different time periods.

Methods

We obtained data on IRs of campylobacteriosis by sex and age group over a period of 11–26 years from seven countries. Male to female incidence rate ratios (IRR) were computed by age group, country and time period. For each age group, we used meta-analytic methods to combine the IRRs. Sensitivity analysis was used to test whether the results are robust to differences between countries and time periods. Meta-regression was conducted to estimate the different effects of age, country, and time period on the IRR.

Results

In the age groups < 1, 1–4, 5–9, 10–14, 15–44, 45–64 and 65+ years old, the pooled IRRs (with 95% CI) were 1.31 (1.26–1.37), 1.34 (1.31–1.37), 1.35 (1.32–1.38), 1.73 (1.68–1.79), 1.10 (1.08–1.12), 1.19(1.17–1.21) and 1.27 (1.24–1.30), respectively. For each age group, the excess campylobacteriosis IRs in males differed at different age groups. However, despite some quantitative differences between countries, the excess was consistently present over long time-periods. In meta-regression analysis, age group was responsible for almost all the variation in the IRRs.

Conclusions

The male predominance in campylobacteriosis IRs starts in infancy. This suggests that this is due, at least in part, to physiological or genetic differences and not just behavioural factors. These findings can provide clues to the mechanisms of the infection and could lead to more targeted treatments and vaccine development.
Improving mental wellbeing of forensic psychiatric outpatients through the addition of an informal social network intervention to treatment as usual: a randomized controlled trial
Authors: Swinkels L. T. A. , van der Pol T. M. , Popma A. , ter Harmsel J. F. , Dekker J. J. M.
Published: August 2020

Background

Forensic psychiatric patients often suffer from a multitude of severe psychiatric and social problems. Meanwhile multimodal evidence-based interventions are scarce and treatment effectiveness is in need of improvement. The main goal of forensic psychiatric treatment is to address psychiatric and social factors and thereby mitigate criminal behaviour. Notably, a supportive social network is an important protective factor for criminal behaviour. As such, improving a poor social network may decrease the risk of criminal recidivism. This study aims to examine the effectiveness of the addition of an informal social network intervention (FNC) to treatment as usual (TAU) among forensic psychiatric outpatients.

Methods

In a mono-center randomized controlled clinical trial with two parallel groups, forensic psychiatric outpatients with social network-related problems (N = 105) will be allocated to either TAU + FNC or TAU alone. The informal social network intervention consists of a 12-month coaching intervention, performed by the forensic network coach (a volunteer trained by an informal care institute). Assessments will be conducted at baseline and 3 months, 6 months, 9 months, 12 months, and 18 months after baseline. The primary outcome variable is mental wellbeing. Psychiatric functioning, criminal recidivism, substance abuse, quality of life, social network, social support, loneliness and self-sufficiency are included as secondary outcomes. A variety of potential mediators and moderators of effectiveness will be explored. Additionally, a qualitative evaluation of effectiveness will be performed.

Discussion

This study will contribute to the existing literature of forensic treatment effectiveness as it is the first RCT examining the effectiveness of adding a social network intervention in a forensic outpatient population. If effectiveness is shown, forensic mental health care could be optimized by collaborating with informal care or community initiatives aimed at improving a positive social network. In addition, results will provide insight regarding mediators and moderators of treatment effectiveness.

Trial registration

This study is registered at the Netherlands Trial Register (NTR7163). Date of registration: 16 april 2018.
Gorham-Stout disease successfully treated with sirolimus (rapamycin): a case report and review of the literature
Authors: Liang Yu , Tian Ruicheng , Wang Jing , Shan Yuhua , Gao Hongxiang , Xie Chenjie , Li Jingjing , Xu Min , Gu Song
Published: August 2020

Background

Gorham-Stout disease (GSD) is a rare disease characterized by bone lesions and osteolysis. Therapy usually involves surgical resection. Sirolimus (Rapamycin) is used in some patients with GSD but the efficacy and safety of Sirolimus remains unclear. We propose that Sirolimus may be a novel therapeutic for GSD and present a case and review of literature that supports this.

Case presentation

We presented a 1-year-old boy with GSD involving osteolysis of the right humerus with fracture of the left femur complicated by an effusion in the right pleural cavity. X-rays showed osteolysis in the right clavicle. A large pleural effusion was observed on the right-side, and the left lung was significantly compressed. X-rays also showed a fracture of the left femur. A femoral biopsy was performed that showed necrotic tissue in the cortical bone and a large number of irregularly shaped capillaries that proliferated within the necrotic tissue. Dilated lymphatic vessels were seen adjacent to the cortex, with fibrous tissue hyperplasia. We prescribed sirolimus, which is an oral mTOR inhibitor, for two consecutive years. The boy recovered well without other progressive bone lesions and participates in normal daily activities. His growth and development are the same as that of his peers.

Discussion and conclusion

Gorham-Stout disease is a rare and enigmatic disease characterized by the presentation of an intraosseous lymphatic anomaly (LM), which results in progressive bone resorption. Based on this case report and a literature review, we conclude that sirolimus may be an effective alternative medication for GSD.
Utilization of epinephrine-soaked gauzes to address bleeding from osteotomy sites in non-tourniquet total knee arthroplasty: a retrospective cohort study
Authors: Liu Hongzhi , Liu Zhaohui , Zhang Qidong , Guo Wanshou
Published: August 2020

Background

Reducing tourniquet inflation time is important because of the complications of tourniquet extensively used for the control of hemorrhage in total knee arthroplasty (TKA). Bleeding management is critical to acquire a relative bloodless arthrotomy interface for maximize cement fixation in non-tourniquet TKA. The purpose of this study was to investigate hemostatic and hemodynamic effects of epinephrine-soaked gauzes in cemented TKAs.

Methods

A retrospective cohort study of 101 patients in two groups was performed. The first group (n = 51) underwent unilateral TKA with our procedures of epinephrine use, the second group (n = 50) had the same protocol with tourniquet and no epinephrine utilization. Surgical field visualization was assessed by grading scale for difficulty of intraoperative visualization due to blood and number of surgical field clearances. Perioperative blood loss was recorded. Hemodynamic parameters were observed in the epinephrine group.

Results

There was statistically significant difference (p < 0.01) on surgeon-rated difficulty in visualization in the epinephrine group between before and after use of epinephrine, and no statistically significant difference (p = 0.96) between two groups before cementing. No statistically significant result on numbers of surgical field clearances between two groups (p = 0.25) was found. Epinephrine group showed significant difference in hidden blood loss compared with no epinephrine group (576.6 ± 229.3 vs 693.2 ± 302.9, respectively, p = 0.04). The hemodynamic effects of epinephrine may be under control.

Conclusion

The procedure of epinephrine soaked gauzes, as a prudent adjunct, may be effective to reduce blood loss and obtain bloodless bone sections in non-tourniquet TKAs, regardless of hemodynamics.
Starch composition, glycemic indices, antioxidant properties and carbohydrate hydrolyzing enzymes activities of African star apple fruit parts
Authors: Ajayi Olubunmi B. , Oyetayo Folake L. , Akomolafe Seun F.
Published: August 2020

Background

African star apple (Chrysophyllum albidum) is a traditonal fruit, which is predominant in tropical regions with the fruit parts consumed by the populace and used in folklore to manage diabetes. However, the likely activity mechanism is still undetermined. The current study examined and compared the inhibitory abilities of African star apple fruit parts on selected key enzymes related to diabetes mellitus in the pancreas tissue of rat.

Methods

Inhibitory effect of aqueous extract (1:10 w/v) of African star apple fruit parts (pulp, cotyledon, seed coat and pulp coat) on the activities of α-amylase, α-glucosidase, as well as their starch composition, phenolic constituents, estimated glycemic index, and antioxidant properties were assessed.

Results

The fruit parts showed low sugar, eGI, amylose, and amylopectin contents. The analysis also showed that the fruit parts inhibited α-glucosidase and α-amylase activities and exhibited antioxidant properties. Furthermore, the fruit parts contain high concentrations of beta-amyrin acetate, eleagine, epicatechin, epigallocatechin, skatole, stigmasterol and tetrahydro − 2- methylharman as revealed by HPLC-DAD.

Conclusion

The fruit part low estimated glycemic indices, strong antioxidant properties, inhibition of α-amylase and α-glucosidase activities exhibited might be related to the bioactive compounds contained in the extract. This could also be a potential mechanism for the use in the prevention and management of type-2 diabetes. Nevertheless, the African star apple pulp coat displayed the highest property in comparison to other parts of the fruit.
Anti-inflammation effects of the total saponin fraction from Dioscorea nipponica Makino on rats with gouty arthritis by influencing MAPK signalling pathway
Authors: Zhou Qi , Sun Hui Juan , Liu Shu Min , Jiang Xi Hong , Wang Qiu Yue , Zhang Shuang , Yu Dong Hua
Published: August 2020

Background

Dioscorea nipponica Makino is widely used in traditional Chinese medicine to treat gouty arthritis.

Methods

Sixty male Wistar rats were divided into six groups: the normal group, model group, colchicine group (COL) and three total saponin groups (RDN) (high dose [160 mg/kg], middle dose [80 mg/kg] and low dose [40 mg/kg]). HE staining was used to detect the histopathologic changes of the synovial tissue of joint. Immunohistochemical method was used to detect the protein expressions of P-38, p-P38, JNK, p-JNK, ERK1/2, p-ERK1/2, MEK1/2, p-MEK1/2, MKK4, p-MKK4, ICAM1, VCAM1, and PPARγ in the synovial tissue of joint. Realtime PCR and WB methods were used to detect the mRNA and protein expressions of PPARγ and AdipoR2 in the synovial tissue of joint. The contents of CXCL1 and ADP in the blood serum were measured by Elisa method.

Results

Our study showed that RDN could improve the situation of the synovial tissue, reduce the protein expressions of MKK4, p-MEK1/2, p-JNK, p-ERK1/2, ICAM1. They could also decrease the content of CXCL1 and increase the content of ADP in the blood serum.

Conclusion

RDN has good effect of anti-inflammation. This is in part realized by influencing MAPK signalling pathway. It provides a new visual angle to reveal the mechanism of RDN to treat GA.