bluuebunny/crossref_metadata_2025 huggingface dataset:
Two Threats to Precision Medicine Equity
Authors: Matthew Dayna Bowen
Published: December 2019

In January 2015, President Barack Obama unveiled the “Precision Medicine Initiative,” a nationwide research effort to help bring an effective, preventive, and therapeutic approach to medicine. The purpose of the initiative is to bring a precise understanding of the genetic and environmental determi­nants of disease into clinical settings across the United States.1 The announcement was coupled with $216 million provided in the President’s proposed budget for a million-person national research cohort including public and private partnerships with academic medical centers, research­ers, foundations, privacy experts, medical ethicists, and medical product innovators. The Initiative promises to expand the use of precision medicine in cancer research and modernize regulatory approval processes for genome sequencing technologies. In response, Congress passed the 21st Century Cures Act in December 2016, authorizing a total of $1.5 billion over 10 years for the program.2 Although the Precision Medicine Initiative heralds great promise for the future of disease treatment and eradication, its implementation and development must be carefully guided to ensure that the millions of federal dollars expended will be spent equitably. This commentary discusses two key threats to the Precision Medicine Initia­tive’s ability to proceed in a manner consis­tent with the United States Constitutional requirement that the federal government shall not “deny to any person . . . the equal protection of the laws.”3 In short, this com­mentary sounds two cautionary notes, in order to advance precision medicine equity. First, achieving precision medicine equity will require scientists and clinicians to fulfill their intellectual, moral, and indeed legal duty to work against abusive uses of preci­sion medicine science to advance distorted views of racial group variation.Precision medicine scientists must decisively denounce and distinguish this Initiative from the pseudo-science of eugenics – the im­moral and deadly pseudo-science that gave racist and nationalist ideologies what Troy Duster called a “halo of legitimacy” during the first half of the 20th century.4 Second, to combat the social threat to precision medicine, scientists must incorporate a comprehensive, ecological understanding of the fundamental social and environ­mental determinants of health outcomes in all research. Only then will the Precision Medicine Initiative live up to its potential to improve and indeed transform health care delivery for all patients, regardless of race, color, or national origin.Ethn Dis: 2019;29(Suppl 3):629-640; doi:10.18865/ed.29.S3.629
Access and Management: Indigenous Perspectives on Genomic Data Sharing
Authors: Garrison Nanibaa' A. , Barton Krysta S. , Porter Kathryn M. , Mai Thyvu , Burke Wylie , Carroll Stephanie Russo
Published: December 2019

As genomic researchers are encouraged to engage in broad genomic data shar­ing, American Indian/Alaska Native/Native Hawaiian (AI/AN/NH) leaders have raised questions about ownership of data and biospecimens and concerns over emerging challenges and potential threats to tribal sovereignty. Using a community-engaged research approach, we conducted 42 semi-structured interviews with tribal lead­ers, clinicians, researchers, policy makers, and tribal research review board members about their perspectives on ethical issues related to genetics in AI/AN/NH communi­ties. We report findings related to perspec­tives on genetic research, data sharing, and envisioning stronger oversight and manage­ment of data. In particular, participants voiced concerns about different models of data sharing, infrastructure and logistics for housing data, and who should have authority to grant access to data. The results will ultimately guide policy-making and the creation of guidelines and new strategies for tribes to drive the research agenda and promote ethically and culturally appropriate research.Ethn Dis.2019;29(Suppl 3):659-668;doi:10.18865/ed.29.S3.659
The National Democratic Revolution (NDR) in South Africa: An ideological journey
Authors: Venter Jan , Bain Eddie , Mosala Seshupo
Published: December 2019

Many people are familiar with South Africa’s political past – the prolonged periods of colonialism and oppression of the black majority, and the eventual dismantling of apartheid and the introduction of a new democratic order. Relatively few people, however, know what principles actually steered South Africa on its journey towards freedom and democracy.
It is not uncommon for oppressed people to rise up and institute change through violent revolution. While some groups of people threw their weight behind the idea of an armed struggle, South Africa’s revolution was largely an ideological one ‒ characterised by a succession of struggle leaders debating the merits of communism vs. socialism, forming resistance groups and alliances, and producing authoritative treatises on how to achieve political and economic liberation (not so much a revolution but a bloody evolution). With the desired political dispensation long since attained, South Africa now faces the formidable challenge of freeing the majority of the population from economic bondage – an outcome that few anticipated back in 1994.
This paper traces the history of the ‘National Democratic Revolution’ (NDR) as it applies to South Africa ‒ from its tentative beginnings, to its heyday, to the present time when overwhelming economic challenges are now threatening to eclipse much of the ideological fervour and progress of years gone by.
Influencia del envío de mensajes de texto al teléfono móvil en el control glucémico de la diabetes tipo 2 = Influence of sending messages to the mobile phone in the glycemic control of diabetes type 2
Authors: García-Viola Alba
Published: December 2019

Resumen: Introducción: La prevalencia de diabetes mellitus tipo 2 en adultos se ha incrementado significativamente en la última década, considerándose un problema de salud pública. Los nuevos avances tecnológicos pueden resultar de gran utilidad en el manejo de la enfermedad. Objetivos: Evaluar la evidencia científica disponible sobre el aviso mediante mensajes de texto al teléfono móvil de los pacientes diabéticos tipo 2, y determinar cómo influye en el control glucémico, en la adhesión al tratamiento, así como en los niveles de hemoglobina glicosilada (HbA1c). Metodología: Se realizó una revisión bibliográfica en la que se encontraron 12 artículos, los cuales, cumplían con los criterios de inclusión. Se consultaron las siguientes bases de datos: Pubmed, Scopus, Lilacs, Dialnet Plus y Cuiden Plus. Resultados: De acuerdo con los textos revisados, el uso de las nuevas tecnologías se asocia con una disminución de los niveles de HbA1c, una mejora de los controles glucémicos, una mayor adquisición de conocimientos sobre la enfermedad y estilo de vida, y una mayor adherencia al tratamiento terapéutico. Además, los pacientes identificaron estas intervenciones como una herramienta muy útil y motivadora. Conclusión: El envío de mensajes de texto a los pacientes con diabetes tipo 2 tiene un papel muy importante en el cuidado y manejo de la enfermedad.Palabras clave: Medios de Comunicación; Diabetes Mellitus Tipo 2; Teléfono inteligente; Mensaje de Texto; Autocontrol; Hemoglobina glicosilada.Abstract: Introduction: The prevalence of type 2 diabetes mellitus in adults has increased significantly in the last decade, being considered a public health problem. New technological advances can be very useful in the management of the disease. Objectives: To evaluate the available evidence about the warning by means of text messages to the mobile phone of the diabetic patients Type 2 and to determine how it influences in the glycemic control, in the adherence to the treatment, as well as in the levels of glycosylated hemoglobin. Methodology: A literature review was conducted where 12 articles, which met the previous established inclusion criteria, were found. The following databases were consulted for the literature review: Pubmed, Scopus, Lilacs, Dialnet Plus and Cuiden Plus. Results: According to the revised texts, the use of new technologies is associated with a decrease in HbA1c levels, improvement of glycemic controls, a greater acquisition of knowledge about the disease and lifestyle, and greater adherence to therapeutic treatment. In addition, patients identified these interventions as a very useful and motivating tool. Conclusions: Sending text messages to patients with type 2 diabetes plays a very important role in the care and management of the disease.Keywords: Communications Medium; Diabetes Mellitus Type 2; Smartphone; Text Messaging; Selfmanagement; Glycosylated hemoglobin.
Zimbabwe Language Policy: Continuity or Radical Change?
Authors: Sibanda Lovemore
Published: December 2019

The Zimbabwe government introduced a new language policy in education to change the colonial language policy seven years after attaining independence. So much was expected from the postcolonial language.  The use of English as the media of instruction during the colonial era was problematic. It denied Africans to describe the world in their languages. Native languages were marginalized and neglected. Africans were robbed of their self-worth and identity. It is against this background that the Zimbabwean government African states after attaining independence and sovereignty pursued an agenda of linguistic decolonization. This paper evaluates the implementation of Zimbabwe's language policy after it gained independence from Britain in 1980. We argue that despite the claim by the Zimbabwe government that it is a revolutionary government which would completely overhaul all colonial structures, institutions, and policies, the implementation of the language policy is a continuity, rather a radical change. Colonial language policy fundamentals are intact and present in the current language policy. English is still the dominant language of instruction. Indigenous languages are considered inferior and on the verge of extinction. The policy failed where it matters most—decolonizing the mind. Zimbabwe needs a sound language policy in education to shake off vestiges of a colonial legacy, and allow children to go to school in their languages to achieve the overall goal of education for all. The language policy must be developed through a broad-based consultative process with specific implementation strategies and commitment by government and non-governmental agencies for funding its implementation.
The Lived Experience of Cervical Cancer Screening as Perceived by Indigenous Maya Women in Guatemala
Authors: Goodman Rhonda Lynn
Published: December 2019

Indigenous Maya women in Guatemala have little or no access to cervical cancer screening or follow-up care. Healthcare groups initiated a program to address this situation. This study collected the women's stories before and after screening. Screening was conducted by a licensed Guatemalan medical doctor. The participants had never experienced cervical cancer screening. They were given an opportunity to tell how they felt about the screening. The stories provide an opportunity to learn of the experience of cervical cancer screening as perceived by the indigenous Maya women and could assist to develop culturally appropriate approaches to this population.
Simulation of Navigation Receiver for Ultra-Small Satellite
Authors: Spiridonov A. A. , Ushakov D. V. , Saechnikov V. A.
Published: December 2019

Currently, ultra-small satellite aresubjectstostringentrequirementsintermsoftheaccuracyof determining the position of the satellite in orbit, while the satellite is the subject to restrictions on mass, size and power consumption. The aim of this work is to simulate of navigation receiver operation for the ultra-small satellite with restrictions on energy consumption and computational resources.

The operating conditions are considered and the requirements to the onboard navigation receiver for the ultra-small satellite are determined. The navigation receiver operation at the initial stage, performance testing, error detection, analysis of the reliability of the solution of the navigation-time determination problem are described.

The structure of the design ballistics problems for orbit prediction of ultra-small spacecraft and navigation satellites, radio visibility intervals for GLONASS and GPS systems, parameters of navigation signals have been developed.

The motion relative to the satellite systems GPS and GLONASS for a preliminary orbit of СubeBel-1 have been simulated. The Doppler dynamics of the GPS satellite signals in the receiver without restrictions on the relative speed for one day has been calculated. Radio visibility intervals for GPS and GLONASS satellites were calculated and optimal conditions for the cold start of the navigation receiver with a relative speed limit (Vr < 500 m/s) for 1 hour of operation both in separate and in joint operation on both systems were determined.

To test the verification methods of the experimental data of the СubeBel-1 satellite, the operation of the navigation receiver of the Nsight satellite was studied according to the received telemetry from the beginning of its flight until the moment it entered stable operation.It is shown that the telemetry data of the navigation receiver at the testing stage had a significant error. After software correction, the navigation receiver worked steadily throughout the week of observation, the error of longitude and latitude measurements did not exceed 0.2 degrees.
Scattering of Elastic Waves by an Inhomogeneous Boundary in the Acoustic Testing of Permanent Joints
Authors: Baev A. R. , Levkovich N. V. , Mayorov A. L. , Asadchaya M. V.
Published: December 2019

Improving the reliability and testing performance of permanent joints оf different materials made by welding, spraying, gluing, soldering and other methods is an important production task, for which the ultrasonic method is the simplest and most effective. The purpose of this work was to expand the technical possibilities and increase the sensitivity of ultrasonic testing of adhesion defects of materials joints based on the establishment of laws governing the formation of a scattering field of elastic waves from an inhomogeneous boundary in three-dimensional space and issuing recommendations for the development of suggested method.

For the first time, in the framework of classical concepts, the scattering fields of elastic waves of an acoustic beam with a circular cross section moving across the boundary of a semi-infinite defect are calculated. It is proposed to use a phase shift between the waves reflected from the indicated surfaces, which varies in the range of π/4–π, as an important parameter of the material joint's defect. It has a significant effect on the field pattern and its angular amplitude extrema — minima and maxima of different orders when the defect boundary is moved relative to the center of the acoustic beam spot.

The features of the evolution of the structure of the scattering field are established, which make it possible to identify optimal conditions for the detection of weakly reflective defects in sound. It is shown that it is possible in principle to estimate the defect's area by measuring a change in the amplitude of the primary maximum of the radiation pattern of the scattered waves.

Specific examples show the effectiveness of using the proposed method for a number of practical applications.
Urban-Rural Disparities in Treatment Outcomes Among Recurrent TB Cases in Zambia
Authors: Mutembo Simon , Mutanga Jane Namangolwa , Musokotwane Kebby , Kanene Cuthbert , Dobbin Kevin , Yao Xiaobai , Li Changwe , Marconi Vincent , Whalen Christopher
Published: December 2019

Background
At least 13 – 20% of all Tuberculosis (TB) cases are recurrent TB. Recurrent TB has critical public health importance because recurrent TB patients have high risk of Multi-Drug Resistant TB (MDR-TB). It is critical to understand variations in the prevalence and treatment outcomes of recurrent TB between different geographical settings.
The objective of our study was to estimate the prevalence of recurrent TB among TB cases and compare risk of unfavorable treatment outcomes between rural and urban settings.
Methods
In a retrospective cohort study conducted in southern province of Zambia, we used mixed effects logistic regression to asses associations between explanatory and outcome variables. Primary outcome was all-cause mortality and exposure was setting (rural/urban). Data was abstracted from the facility TB registers.
Results
Overall 3,566 recurrent TB cases were diagnosed among 25,533 TB patients. The prevalence of recurrent TB was 15.3% (95% CI: 14.8 15.9) in urban and 11.3% (95% CI: 10.7 12.0) in rural areas. Death occurred in 197 (5.5%), 103 (2.9%) were lost to follow-up, and 113 (3.2%) failed treatment. Rural settings had 70% higher risk of death (adjusted OR: 1.7; 95% CI: 1.2 2.7). Risk of lost to follow-up was twice higher in rural than urban (adjusted OR: 2.0 95% CI: 1.3 3.0). Compared to HIV-uninfected, HIV-infected individuals on Anti-retroviral Treatment (ART) were 70% more likely to die (adjusted OR: 1.7; 95% CI: 1.2 3.1).
Conclusion
Recurrent TB prevalence was generally high in both urban and rural settings. The risk of mortality and lost to follow-up was higher among rural patients. We recommend a well-organized Directly Observed Therapy strategy adapted to setting where heightened TB control activities are focused on areas with poor treatment outcomes.
Effect of arsenic stress on 5-methylcytosine, photosynthetic parameters and nutrient content in arsenic hyperaccumulator Pteris cretica (L.) var. Albo-lineata
Authors: Zemanová Veronika , Popov Marek , Pavlíková Daniela , Kotrba Pavel , Hnilička František , Česká Jana , Pavlík Milan
Published: December 2019

Background Arsenic toxicity induces a range of metabolic responses in plants, including DNA methylation. The focus of this paper was on the relationship between As-induced stress and plant senescence in the hyperaccumulator Pteris cretica var. Albo-lineata (Pc-Al). We assume difference in physiological parameters and level of DNA methylation in young and old fronds as first symptoms of As low toxicity. Results The As accumulation of Pc-Al fronds, grown in pots of haplic chernozem contaminated with 100 mg As kg-1 for 122 days, decreased with age. Content of As was higher in young than old fronds (2800 and 2000 mg As kg-1 dry matter, respectively). Opposite trend – increase with age, was confirmed for determined nutrients – Cu, Mg, Mn, S and Zn. A significant elevation of all analysed nutrients was showed in old fronds. Arsenic accumulation affected DNA methylation status in fronds, but content of 5-methylcytosine (5mC) decreased only in old fronds of Pc-Al (from 25% to 15%). Determined photosynthetic processes showed a decrease of fluorescence, photosynthetic rate and chlorophylls of As treatment in young and old fronds. Water potential was decreased by As in both fronds. Thinning of the sclerenchymatous inner cortex and a reduction in average tracheid metaxylem in the vascular cylinder was showed in roots of As treatment. Irrespective to fronds age, physiological parameters correlated more significantly with a 5mC than with direct As toxicity. Similar trend was found for contents of Cu, Mg, Mn, S and Zn. Conclusions The results of this paper point to first changes in the metabolism of the hyperaccumulator plant Pc-Al, upon exposure to As contamination. The significant impact of As on DNA methylation was found in old fronds. Irrespective to fronds age, the most significant correlations were confirmed for 5mC, in contrast to direct As toxicity. Our analysis of the very low water potential values and lignification of cell walls in roots showed that transports of assimilated metabolites and water between roots and fronds were reduced. As was showed by our results, epigenetic changes could affect studied parameters of the As hyperaccumulator plant Pc-Al, especially in old fronds.
Multilocus phylogeny and cryptic diversity of white-toothed shrews (Mammalia, Eulipotyphla, Crocidura) in China
Authors: Author) shunde Chen(Former Corresponding , Qing Jiao , Liu Zhu , Liu Yang , Tang Mingkun , Murphy Robert W , Pu Yingting , Wang Xuming , Tang Keyi , Guo Keji , Jiang xuelong , Author) shaoying Liu(New Corresponding
Published: December 2019

Background: Crocidura , the most speciose mammalian genus, occurs across much of Asia, Europe and Africa. The taxonomy of Chinese representatives has been studied primarily based on cursory morphological comparisons and their molecular phylogenetic analyses remain unexplored. In order to understand the phylogeny of this group in China, we estimated the first multilocus phylogeny and conducted species delimitation, including taxon sampling throughout their distribution range. Results: We obtained one mitochondrial gene ( cytb ) (~ 1, 134 bp) and three nuclear genes ( ApoB , BRCA1 , RAG1 ) (~ 2, 170 bp) for 132 samples from 57 localities. Molecular analyses identified at least 14 putative species that occur within two major well-supported groups in China. Polyphyletic C. wuchihensis appears to be composed of two putative species. Two subspecies, C. rapax rapax and C. rapax kurodai should be elevated to full species status. A phylogenetic tree based on mitochondrial gene from Asian Crocidura species showed that the C. rapax rapax is embedded within C. attenuata , making the latter a paraphyletic group. Three strongly supported undescribed species ( C. sp.1, C. sp.2 and C. sp.3) are revealed from Zada County of Tibet (Western China), Hongjiang County of Hunan Province (Central China) and Dongyang County of Zhejiang Province (Eastern China), Motuo County of Tibet, respectively. The divergence time estimation suggested that China’s Crocidura species began to diversify during the late Pliocene (3.66 Ma) and the Early Pleistocene (2.29 Ma), followed by a series of diversifications through the Pleistocene. Conclusions: The cryptic diversity found in this study indicated that the number of species is strongly underestimated under the current taxonomy. We propose that the three undescribed species should be evaluated using extensive taxon sampling and comprehensive morphological and morphometric approaches. Climate change since the late Pliocene and the uplift of the Qinghai-Tibet Plateau may result in the diversification and speciation of China’s Crocidura species. In short, the underestimated diversity underlines the need for a taxonomic revision of Chinese Crocidura species.
Cytological evidence of BSD2 functioning in both chloroplast division and dimorphic chloroplast formation in maize leaves
Authors: Li Heying , Bai Mei , Jiang Xingshan , Shen Rongxin , Wang Huina , Wang Haiyang , Wu Hong
Published: December 2019

Background: Maize bsd2 ( bundle sheath defective2 ) is a classical C 4 mutant with defective C 4 photosynthesis, accompanied with reduced accumulation of Rubisco (ribulose bisphosphate carboxylase oxygenase) and aberrant mature chloroplast morphology in the bundle sheath (BS) cells. However, as a hypothetical chloroplast chaperone, the effects of BSD2 on C 4 chloroplast development have not been fully examined yet, which precludes a full appreciation of BSD2 function in C 4 photosynthesis. The aims of our study are to find out the role of BSD2 in regulating chloroplasts development in maize leaves, and to add new insights into our understanding of C 4 biology. Results: We found that at the chloroplast maturation stage, the thylakoid membranes of chloroplasts in the BS and mesophyll (M) cells became significantly looser, and the grana of chloroplasts in the M cells became thinner stacking in the bsd2 mutant when compared with the wild type plant. Moreover, at the early chloroplast development stage, the number of dividing chloroplasts and the chloroplast division rate are both reduced in the bsd2 mutant, compared with wild type. Quantitative reverse transcriptase-PCR analysis revealed that the expression of both thylakoid formation-related genes and chloroplast division-related genes is significantly reduced in the bsd2 mutants. Further, we showed that BSD2 interacts physically with the large submit of Rubisco (LS) in Bimolecular Fluorescence Complementation assay. Conclusions: Our combined results suggest that BSD2 plays an essential role in regulating the division and differentiation of the dimorphic BS and M chloroplasts, and that it acts at a post-transcriptional level to regulate LS stability or assembly of Rubisco.
Acupuncture of fascia points to relieve hand spasm after stroke: a study protocol for a multicenter randomized controlled trial
Authors: zhang zengqiao , Feng Wei , Li Kun-Peng , He Jing , Jiang Li-Ming , Wang Wu , Hu Xiao-Shen
Published: December 2019

Background: The loss of life ability of patients after stroke is mostly caused by the dysfunction of upper limbs, especially hands. Hand functional exercise is the premise of alleviating hand dysfunction, and the relief of hand spasm is the basis of timely and effective hand functional exercise. Previous clinical observation showed that fascial point needling could effectively alleviate hand spasm immediately after stroke, but further evidence from large sample studies is needed. The overall objective of this trial is to further evaluate the clinical efficacy of fascial point acupuncture on hand spasm after stroke. Methods/design: This multicenter randomized controlled trial will compare the efficacy of fascial point acupuncture versus sham acupuncture and routine rehabilitation therapy in stroke patients with hand spasm. Patients will be randomized to undergo either the fascial point acupuncture or the sham acupuncture or the control (routine rehabilitation therapy). We will recruit 210 stroke inpatients who meet the trial criteria and observe the remission of hand spasm and improvement of limb function after 4 weeks of intervention. The first evaluation indexes are the remission of hand spasm and the duration of spasm remission. The second evaluation indexes are the hand function of affected limbs and the ability of daily living. When the accumulative total number of cases included reaches 120, a mid-term analysis will be conducted to determine any evidence that experimental intervention does have an advantage. Discussion: Our aim is to evaluate the efficacy of fascial point acupuncture in relieving hand spasm after stroke. The results will provide more evidences for the clinical application of this therapy in the future. Trial registration: The trial has been registered at the Chinese Clinical Trial Registry（ChiCTR）on April 9, 2019. Registration number: ChiCTR1900022379 Keywords: Fascia points, Acupuncture, Spasm, Stroke
Loosening and revision rates after total shoulder arthroplasty: a systematic review of cemented all-polyethylene glenoid and design of the modern metal-backed glenoid
Authors: Kim Dong Min , Aldeghaither Mohammed , Alabdullatif Fahad , Shin Myung Jin , Kholinne Erica , Kim Hyojune , Jeon In-Ho , Koh Kyoung-Hwan
Published: December 2019

Background: Modern designs of metal-backed glenoids (MBG) have been devised to overcome flaws such as loosening and a high failure rate.This review aimed to compare rates of complications and revision surgeries between the modern metal-backed glenoid (MBG) and the cemented polyethylene glenoid (PEG).Methods: Literature search was carried out using PubMed, Cochrane Library, EMBASE, and Google Scholar using MeSH terms and natural keywords. A total of 1186 articles were screened. We descriptively analyzed numerical data between the groups and statistically analyzed the categorical data, such as the presence of radiolucent line, loosening, and revision surgery (failure). Articles were divided into 3 groups based on follow-up duration: short-term < 36 months, midterm 36–72 months, and long-term > 72 months.Results: This study included 35 articles (3769 shoulders); 25 on cemented PEG and ten on the modern MBG. Mean age was 66.4 (21–93) and 66.5 years (31–88). The mean duration of follow-up was 73.1 (12–211) and 56.1 months (24–100). Overall, the rate of the radiolucent line was 354/1302 (27%) and 47/282 (17%), the loosening rate was 465/3185 (15 %) and 22/449 (5%), and the failure rate was 189/3316 (6%) and 11/457 (2%), for PEG and MBG, respectively. The results of short- and mid-term FU studies showed lower rates of radiolucency and loosening in the cemented PEG group, but there was no significant difference in failure rate (P=0.754 and 0.829, respectively). In long-term FU, MBG was better in terms of loosening (P <0.001) and failure rates (P = 0.006).Conclusions: The modern MBG component, especially TM glenoid, seems to be a promising alternative to cemented PEGs, based on subgroup revision rates according to the follow-up duration and overall results of ROM and clinical scores. All polyethylene glenoids tend to increase loosening and failure over time. The modern MBG seems to have no difference in failure, at least in the short- and mid-term compared to the cemented PEG. More long-term follow-up studies on modern MBG should be ultimately conducted.
Playing sport injured is associated with osteoarthritis, joint pain and worse health related quality of life: A cross sectional study
Authors: Bullock Garrett Scott , Collins Gary S , Peirce Nick , Arden Nigel K , Filbay Stephanie R
Published: December 2019

Background: Sports participants are faced with the decision to continue or cease play when injured. The implications of playing sport while injured on joint health and health-related quality of life (HRQoL) has not been investigated. The purpose of this study was to investigate the relationship between having played sport while injured and HRQoL, osteoarthritis, and persistent joint pain; and compare findings in elite and recreational athletes. Methods: The Cricket Health and Wellbeing Study cohort was used for this study. Inclusion criteria were: age ≥18 years, played ≥1 cricket season. Questionnaire data collected included a history of playing sport injured, SF-8 (physical (PCS) and mental (MCS) component scores), physician-diagnosed osteoarthritis, and persistent joint pain (most days of the last month). Multivariable linear regressions and logistic regressions were performed. Continuous covariates were handled using fractional polynomials. Models were adjusted for age, sex, cricket-seasons played, playing status, joint injury, and orthopaedic surgery. All participants (n=2,233) were included in HRQoL analyses, only participants aged ≥30 years (n=2,071) were included in osteoarthritis/pain analyses. Results: Of the 2,233 current and former cricketers (mean age: 51.7 SD 14.7, played 30 IQR 24 cricket seasons, 60% were current cricketers, 62% played recreationally; median PCS: 51.4 IQR 9.0; MCS: 54.3 IQR 8.6) 1719 (77%) had played sport while injured. People who had played sport injured reported worse adjusted PCS (Effect(95% CI): -1.78(-2.62, -0.93) and MCS (-1.40(-2.25, -0.54), had greater odds of osteoarthritis (adjusted OR(95% CI): 1.86(1.39, 2.51) and persistent joint pain (2.34(1.85, 2.96)), compared to people who had not played sport injured. Similar relationships were observed regarding PCS, osteoarthritis and pain in elite and recreational subgroups. Playing injured was only related to worse MCS scores for elite cricketers (-2.07(-3.52, -0.63)); no relationship was observed in recreational cricketers (-0.70(-1.79, 0.39)). Conclusion: Athletes that had played sport injured had impaired HRQoL, increased odds of osteoarthritis and persistent joint pain, compared to those who had not played sport injured. Playing sport injured was only related to impaired mental-components of HRQoL in elite athletes. Recreational and elite athletes should be informed of the potential long-term health implications of playing sport while injured.
A New Modification of Bosworth’s Technique to Repair Infectious Achilles Tendon Rupture
Authors: Wu Qipeng , Xiong Yuan , Fang Zhenhua , Wang Junwen , Liu Guohui , Lu Lin
Published: December 2019

Background The aim of this study was to assess radiographic and clinical outcomes of a new modified approach on the basis of Bosworth’s technique in the treatment of infectious Achilles tendon rupture (IATR). Materials and methods 15 patients (9 males and 6 females; 15 feet; average age of 38.3 years) were included in the study. After infection, the wounds were transferred to our department for treatment (Figure 1).Radiographic and clinical outcome in terms of the American Orthopaedic Foot&Ankle Society score (AOFAS), the Victorian institute of sports assessment Achilles (VISA-A), and the Achilles tendon total rupture score (ATRS) were investigated at 6 months, 12 months, and 24 months postoperatively. Results Preoperative AOFAS, VISA-A, and ATRS showed statistically significant improvement (p≤0.05) from35.03±6.81 (25-45), 21.04±8.17 (5-45), and 20.08±8.93 (6-55) to 90.04±5.32 (82-97), 95.11±3.09 (79-99), and 96.34±3.61 (89-97) at the last follow-up, respectively. All patients could lift heel on one foot and return to work at 12 to 16 weeks after operation (average 14.2 weeks). Overall, No complications such as infection, skin necrosis, sural nerve injury, deep vein thrombosis, and re-rupture of Achilles tendon occurred at last follow-up. Conclusion The new modified approach of Bosworth’s technique provided powerful curative efficacy of infectious Achilles tendon rupture, without severe complications in terms of infection, skin necrosis, sural nerve injury, deep vein thrombosis, and re-rupture of Achilles tendon. Level of Evidence: Level IV, case series.
Wnt5a-induced M2 polarization of tumor-associated macrophages via IL-10 promotes colorectal cancer progression
Authors: Liu Qing , Yang Chaogang , Wang Shuyi , Shi Dongdong , Wei Chen , Song Jialin , Lin Xiaobin , Dou Rongzhang , Bai Jian , Xiang Zhenxian , Huang Sihao , Liu Keshu , Xiong Bin
Published: December 2019

Background: Tumor-associated macrophages (TAMs) in the tumor microenvironment influence tumor initiation, invasion and metastasis. Several studies have shown that Wnt5a is mainly expressed in the tumor stroma, especially in TAMs. However, whether Wnt5a regulates the polarization and biological function of TAMs in colorectal cancer (CRC) is incompletely understood. Methods: Immunofluorescence staining was performed to detect CD68 and Wnt5a expression in colorectal tissues from patients (63 CRC specimens VS 20 normal tissues). RT-qPCR, flow cytometry, ELISA and inhibitors were carried out to explore the role of Wnt5a in the polarization of TAMs. Clone formation and transwell assays were performed to determine the effects of Wnt5a–treated macrophages on tumor proliferation, migration and invasion in vitro. Finally, a xenograft model was applied to confirm the effects of Wnt5a+ TAMs on CRC tumorigenesis. Results: We found that high Wnt5a+CD68+/CD68+ TAMs ratio was significantly associated with poor prognosis in CRC patients and Wnt5a+ TAM was an M2-like TAM subtype. Subsequently, we found that Wnt5a induced macrophages to secrete IL-10, which then acted as an autocrine cytokine to induce M2 polarization of these macrophages. IL-10 neutralizing antibody completely reversed the pro-M2 effect of Wnt5a. Mechanistically, the CaKMII-ERK1/2-STAT3 pathway was required for Wnt5a-mediated IL-10 expression in macrophages. Furthermore, Wnt5a-induced M2 macrophages promoted CRC cells proliferation, migration and invasion; knockdown of Wnt5a in TAMs significantly impaired the pro-tumor functions of TAMs. Conclusions: Our data indicate that Wnt5a could induce M2 polarization of TAMs by regulating CaKMII-ERK1/2-STAT3 pathway–mediated IL-10 secretion, ultimately promoting tumor growth and metastasis of CRC.
Can the DREEM scale be adapted to the medical simulation environment?
Authors: Mamcarz Izabela , Torres Anna , Mamcarz Piotr , Torres Kamil
Published: December 2019

Background The environment of medical simulation is a specific educational environment for teaching medicine. Medical universities are obliged to ensure appropriate conditions for conducting classes in medical simulation. In order to improve the quality of courses in simulation, it is necessary to get to know the educational environment and the medical simulation environment. It will be possible thanks to appropriately selected methods, which include important variables shaping these environments.MethodsAmong 312 medical students who had classes in medical simulation, the DREEM method (Roff et al.) and the QuESST method (Mamcarz et al.) were applied.Results The process of adapting the DREEM tool to Polish conditions and the construction stages of the QuESST tool were presented. The overall results of the QuESST and DREEM questionnaires correlated significantly. Also the overall result of QuESST correlated significantly with the results of individual DREEM scales.Conclusions The presented tools may be helpful in determining the educational conditions and conditions of medical simulation as a specific educational environment for teaching and learning medicine.
Challenges in the cultural adaptation of the German Myeloma Patient Outcome Scale (MyPOS): an outcome measure to support routine symptom assessment in myeloma care
Authors: Gerlach Christina , Taylor Kathy , Ferner Marion , Munder Markus , Weber Martin , Ramsenthaler Christina
Published: December 2019

Background Patients with multiple myeloma report more problems with quality of life (QoL) than other haematological malignancies over the course of their incurable illness. The patient-centred Myeloma Patient Outcome Scale (MyPOS) was developed to assess and monitor symptoms and supportive care factors in routine care. Our aim was to translate and culturally adapt the outcome measure to the German context, and to explore its face and content validity. Methods Translation and cultural adaptation following established guidelines used an exploratory, sequential mixed method study design. Steps included: (1) forward translation to German; (2) backward translation to English; (3) expert review; (4) focus groups with the target population (patients, family members, health care professionals) to achieve conceptual equivalence; (5) cognitive interviews using Tourangeau’s model with think-aloud technique to evaluate comprehension and acceptability; (6) final review. Results were analysed using thematic analysis. Results Cultural and linguistic differences were noted between the German and English original version. The focus groups (n = 11) and cognitive interviews (n = 9) both highlighted the need for adapting individual items and their answer options to the German health care context. Greater individuality regarding need for information with the right to not be informed was elaborated by patients. While the comprehensive nature of the tool was appreciated, item wording regarding satisfaction with health care was deemed not appropriate in the German context. For implementation into routine care, careful handling of data was addressed as a barrier, whereas the MyPOS itself was perceived as a facilitator/prompt for a patient-centred discussion of QoL issues. Conclusion With adaptations to answer options and certain items, the German version of the MyPOS can help monitor symptoms and problems afflicting myeloma patients over the course of the disease trajectory. It can help promote a model of comprehensive supportive and patient-centred care for these patients.
Genome-wide analysis of OVATE family proteins in cucumber (Cucumis sativus L.)
Authors: Han Lijie , Song Xiaofei , Wang Zhongyi , Liu Xiaofeng , Yan Liying , Zhou Zhaoyang , Zhang Xiaolan
Published: December 2019

Background: OVATE family proteins (OFPs) are plant-specific proteins with the conserved OVATE domain that regulating plant growth and development. Although these OFPs have been studied in several species, the biological functions of this OFP gene family remain largely unknown in cucumber (Cucumis sativus L.).
Results: In this study, we identified 19 CsOFPs in cucumber. This CsOFPs are distributed on seven chromosomes and can be divided into four subgroups. Most CsOFP genes are expressed in reproductive organs although have different expression patterns. Cis-elements analysis showed that there are six kinds of hormone response elements in CsOFPs and exogenous gibberellin treatment leads to a ‘first increase then decrease’ expression pattern of CsOFP7, CsOFP11 and CsOFP12. Ectopic expression of CsOFP11 in Arabidopsis resulted in shorter and blunt siliques.
Conclusions: Together, these results indicated that CsOFPs may play important roles in cucumber fruit development.
Factors influencing cognitive reactivity among young adults at high risk for depression in China: a cross-sectional study
Authors: Huang Fei Fei , Wen Zhi Peng , Li Qi , Chen Bin , Weng Wen Jie
Published: December 2019

BackgroundUnderstanding the factors influencing cognitive reactivity (CR) may help identify individuals at risk for first episode depression and relapse, and facilitate routine access to preventative treatments. However, few studies have examined CR to depression in Asian countries. This study was performed to ascertain the current status of CR among Chinese young adults and explore the factors that influence their CR. MethodsA national cross-sectional online study using convenience sampling was conducted among 1637 healthy young adults in China (96.29%). ResultsThe mean CR score was 1.73±0.64. Binary logistic regression showed that a low level of CR was associated with the following factors: high self-compassion, high social support, high resilience, high monthly household income, and living in a rural area, with odds ratios (ORs) ranging from 0.14 to 0.70. Young adults in full-time employment, experiencing poor sleep, with high neuroticism, who reported frequent sad mood, and who had a high intensity of negative life events had increased CR to depression, with ORs ranging from 1.18 to 6.66. The prediction probability of these factors was 75.40%. Any causal relationships among the influencing factors and CR cannot be established. ConclusionsThe self-reported CR levels among Chinese young adults were moderate. Enhancing self-compassion, resilience, and social support for young adults and reducing negative life events, neuroticism, and poor sleep may facilitate reducing CR. These findings may help healthcare providers or researchers determine how to cultivate and improve the CR of young adults by establishing documented policies and/or improving intervention efficacies.
Identification of novel rice blast resistance alleles through sequence-based allele mining
Authors: Zhou Ying , Lei Fang , Wang Qiong , He Weicong , Bin Yuan , Yuan Wenya
Published: December 2019

Background: As rice ( Oryza sativa ) is the staple food of more than half the world’s population, rice production contributes greatly to global food security. Rice blast caused by the fungus M agnaporthe oryzae is a devastating fungal disease of rice, affecting yield and grain quality and resulting in substantial annual economic losses. Because the fungus evolves rapidly,, resistance conferred by most of the single blast race resistance genes is often broken after a few years of intensive agricultural use. Effective resistance breeding in rice therefore requires continual enrichment of the reservoir of resistance genes and alleles. Seed banks represent a rich source of genetic diversity; however, they have not been extensively used to identify novel genes and alleles. Results: We carried out a large-scale screen for novel blast resistance alleles in 1883 rice varieties from major rice producing areas across China. Of these, 107 varieties showed at least moderate resistance to natural infection by rice blast at rice blast nurseries in Enshi and Yichang, Hubei Province. Using sequence-based allele mining to amplify and clone the allelic variants of major rice blast resistance genes at the Pi2/9/gm/zt locus of chromosome 6 from the 107 blast-resistant varieties, we identified 13 novel blast resistance alleles. We then used controlled infections to assess the resistance of rice varieties carrying the novel alleles to 34 single rice blast isolates from Hubei, Guangdong, Jiangsu, Hunan, Jangxi, Sichuan, Heilongjiang, and Fujin Provinces. The varieties identified as being resistant in the nursery trials showed varied disease responses when infected with the single blast isolates, suggesting that the novel Pi2/9/gm/zt alleles vary in their blast resistance spectra. Some of the newly identified alleles have unique single nucleotide polymorphisms (SNPs), insertions, or deletions, in addition to polymorphic residues that are shared between the different alleles. Conclusions: These alleles expand the allelic series of blast resistance genes, enriching the genetic resource for rice blast resistance breeding programs and for studies aimed at deciphering rice–rice blast molecular interactions. Key words : Pi9 , R-genes, Nucleotide diversity, Gene conversion, Resistance gene alleles, Rice blast
Awareness of national malaria management guidelines among house officers in Khartoum state teaching hospitals. Sudan 2018
Authors: Aboshanab Mohammed Altyb Alshykh
Published: December 2019

Background: Malaria is a protozoan disease which can lead to serious complications if not treated early and correctly. The aim of this study to assess the knowledge about malaria management guidelines among house officers.Methods: this is the cross sectional observational study conducted at 6 of Khartoum teaching hospitalsResults: The study showed that among the 115 participants evaluated there were 70.4% females and 29.6% were males. 94.8% of participants knew there is malaria management guidelines and 5.2% didn't knew about presence of this guidelines, 58.3% have some information and 10.4% just hear about this guidelines. 89.6% knew the management of simple malaria is an outpatient management. 65.2% of the participants were aware about where to manage the cases of complicated malaria (inpatient or in Intensive Care Unit). 27.8% of the participants were aware about the management of simple malaria in the second and third trimester.Conclusion: Different levels of awareness about malaria management guidelines as whole: 4.3% had an overall poor level of awareness, and 74.8% had an overall average level of awareness and 20.9% had an overall good level of awareness.
Geographic availability and accessibility of day care services for people with dementia in Ireland
Authors: Pierse Tom , Keogh Fiona , O’Shea Eamon , Cullinan John
Published: December 2019

Background Day care is an important service for many people with dementia and their carers. In Ireland, day care services for people with dementia are delivered by a mix of dementia-specific day care centres as well as generic day care centres that cater for people with dementia to various degrees. In this paper we examine the geographic distribution of day care services for people with dementia relative to potential need.MethodsUsing a national survey of day care centres, we estimate the current availability of day care services for people with dementia in the country. We use geographic information systems (GIS) to map day care provision at regional and sub-regional levels and compare this to the estimated number of people with dementia in local areas.Results There is significant variation across the country in the existing capacity of day care centres to cater for people with dementia. The number of places per 100 persons with dementia in the community varies from 14.2 to 21.3 across Community Health Organisation areas. We also show that 18 per cent of people with dementia do not live within 15kms of their nearest day care centre.Conclusion Currently, day care centres, in many parts of the country, have limited capacity to provide a service for people with dementia who live in their catchment area. As the number of people with dementia increases, investment in day care centres should be targeted to areas where need is greatest. Our GIS approach provides valuable evidence that can help inform decisions on future resource allocation and service provision in relation to day care.