bluuebunny/crossref_metadata_2025 huggingface dataset:
A co-constructed picture of learning in play by teachers and parents
Authors: Wu Shu-chen
Published: December 2020

In discussions about how to implement learning through/in/at play, there is still not a commonly agreed view. This qualitative study investigated Chinese teachers’ and parents’ perspectives on learning in play to attain a co-constructed picture of learning in play through real classroom practices and perceptions using the Mosaic approach. Fourteen teachers and six parents took part in this study. Among the participants, six kindergarten teachers were interviewed to obtain their perspectives on learning in play. They assisted the researchers in the selection of exemplary play episodes, which were filmed in their own classrooms. Four three-minute videos containing the largest amount of learning elements based on the teachers’ views were selected for further in-depth focus group discussions. The selected multivocal video-cued interview clips were shown to eight other teachers and six parents in focus groups to elicit their perspectives on learning in play. The co-constructed picture of learning in play that emerged included discipline in the classroom, more difficult and complicated learning matters, more freedom to play, and teachers’ intervention to facilitate children’s learning in play. The findings revealed different social representations of learning in play in the Hong Kong context, the contributions of which are important and useful for professional education practices and curricular policy currently undergoing reform.
Supporting High Students Experiencing Homelessness Going to College: Perspectives of Local Liaisons
Authors: Havlik Stacey A. , Duckhorn Madeline
Published: December 2020

This qualitative study provides insight into the perceptions and experiences of local homeless liaisons supporting students experiencing homelessness who are preparing for and transitioning to college. Findings suggest that when it comes to preparing students experiencing homelessness for college, liaisons are very involved by addressing students’ three main areas of need. These include their basic needs (i.e., physiological, safety, and academic) and social-emotional needs (i.e., love and belonging and esteem), as well as needs related to college-going (i.e., students’ belief they can go to college) and expectations of college-going outcomes (i.e., students’ belief they can graduate from college). Findings suggest that liaisons play a particularly important role in supporting the college-going of students experiencing homelessness and do so primarily by working collaboratively with a system of stakeholders.
Modification of the cotton woven fabrics with Tancho® for using on the diabetic foot symptom
Authors: Ali Marwa A , Amr A
Published: December 2020

Diabetes is a chronic disease that is widely spread in this time. Diabetic foot is one of the most common symptoms, it starts when the dryness emerge after that the cracks appear on the back or outcrops of the foot. The primary treatment for these symptoms is considered the best choice to prevent diabetic foot diseases. The aim of this study is using treated fabric with Tancho® (based on olive oil) to give the cracked or pre-ulcer foot the sufficient hydration for skin cells during the rest periods to heal. The study was based on using 100% cotton woven fabrics with three structures that are treated with Tancho® petroleum jelly as emulsion using two techniques; Pad/Batch and Pad/Dry/Cure methods, to compare between them in the improvement of fabric for healing. Weight and thickness were conducted to evaluate the fabric functional performance before and after treatment with Tancho®. The antimicrobial activity was done for samples to determine the biological property. Roughness, SEM and TEM were done to study the morphological surface of samples produced. Finally, the best samples performances as a result from radar chart analysis were applied in vivo for rats, to determine the efficiency of the treated samples through clinical observation and histopathological changes. The results of the produced samples that weaved by three different structures and treated with Pad/Batch method were increased of the stimulation of skin cells to heal after surgical either in case of use for surface skin scratches or as scaffold for skin layers.
Periostin Secreted by Carcinoma-Associated Fibroblasts Promotes Ovarian Cancer Cell Platinum Resistance Through the PI3K/Akt Signaling Pathway
Authors: Chu Lei , Wang Fangce , Zhang Wenjun , Li Huai-fang , Xu Jun , Tong Xiao-wen
Published: December 2020

Periostin (POSTN) is a protein secreted by mesenchymal cells. Periostin is upregulated in several cancer types and overexpression is associated with poor prognosis. However, the functional role and molecular underpinnings of periostin in epithelial ovarian cancer (EOC) is unknown. In the present study, periostin was found to be significantly upregulated in EOC stroma. Functional studies revealed that periostin could decrease cisplatin (DDP)-induced apoptosis in EOC. Periostin led to DDP resistance in EOC cells, potentially through the PI3K/Akt signaling pathway. We generated periostin-overexpressing fibroblasts and found that EOC cells were resistant to DDP when co-cultured with periostin-overexpressing fibroblasts. The findings of the present study indicated that periostin secreted by cancer-associated stromal cells may be a potential therapeutic target for EOC.
Characterizing disease progression of nonalcoholic steatohepatitis in Leptin-deficient rats by integrated transcriptome analysis
Authors: Lu Ping , Yang Guang , Jiang Lichun , He Wen , Wu Wanwan , Qi Lingbin , Shen Shijun , Rao Junhua , Zhang Peng , Xue Zhigang , Jiang Cizhong , Fan Guoping , Zhu Xianmin
Published: December 2020

Nonalcoholic steatohepatitis (NASH) is an aggressive liver disease threatening human health, yet no medicine is developed to treat this disease. In this study, we first discovered that Leptin mutant rats ( LepΔI14/ΔI14) exhibit characteristic NASH phenotypes including steatosis, lymphocyte infiltration, and ballooning after postnatal week 16. We then examined NASH progression by performing an integrated analysis of hepatic transcriptome in Leptin-deficient rats from postnatal 4 to 48 weeks. Initially, simple steatosis in LepΔI14/ΔI14 rats were observed with increased expression of the genes encoding for rate-limiting enzymes in lipid metabolism such as acetyl-CoA carboxylase and fatty acid synthase. When NASH phenotypes became well developed at postnatal week 16, we found gene expression changes in insulin resistance, inflammation, reactive oxygen species and endoplasmic reticulum stress. As NASH phenotypes further progressed with age, we observed elevated expression of cytokines and chemokines including C-C motif chemokine ligand 2, tumor necrosis factor ɑ, interleukin-6, and interleukin-1β together with activation of the c-Jun N-terminal kinase and nuclear factor-κB pathways. Histologically, livers in LepΔI14/ΔI14 rats exhibited increased cell infiltration of MPO+ neutrophils, CD8+ T cells, CD68+ hepatic macrophages, and CCR2+ inflammatory monocyte-derived macrophages associated with macrophage polarization from M2 to M1. Subsequent cross-species comparison of transcriptomes in human, rat, and mouse NASH models indicated that Leptin-deficient rats bear more similarities to human NASH patients than previously established mouse NASH models. Taken together, our study suggests that LepΔI14/ΔI14 rats are a valuable pre-clinical rodent model to evaluate NASH drug safety and efficacy.
The neurovascular extracellular matrix in health and disease
Authors: Logsdon Aric F , Rhea Elizabeth M , Reed May , Banks William A , Erickson Michelle A
Published: December 2020

The blood–brain barrier (BBB) is a vital interface that supports normal brain functions. Endothelial cells (ECs) are the main component of the BBB and are highly specialized to govern the transfer of substances into brain. The EC lumen is enmeshed with an extracellular matrix (ECM), known as the endothelial glycocalyx layer (EGL). The lumen-facing EGL is primarily comprised of proteoglycans (PGs) and glycosaminoglycans (GAGs), which function as the first line of defense for blood-to-brain transfer of substances. Circulating factors must first penetrate the EGL before interacting with the EC. The abundance and composition of the PG and GAGs can dictate EGL function, and determine which circulating substances communicate with the ECs. The EGL can interact with circulating factors through physio-chemical interactions with the EC. Some disease states reveal a “thinning” of the EGL that may increase EC interactions with components of the systemic circulation and alter BBB function. EGL changes may also contribute to the cognitive complications of systemic diseases, such as sepsis and diabetes. For decades, researchers have measured how genetic and environmental factors influence the peripheral EGL constituents; however, much less is known about the neurovascular EGL. In this mini-review, we introduce components of the EGL and innovative ways to measure their abundance and composition that may contribute to BBB dysfunction.
The Epidemiological Characteristics of Late-Onset Hypogonadism in Chinese Middle-Aged and Elderly Men: Two Cross-Sectional Studies in the Same Community
Authors: Zhou Shan-Jie , Zhao Ming-Jia , Yang Yi-Hong , Guan Di , Li Zhi-Guang , Ji Yu-Dang , Zhang Bao-Long , Shang Xue‑Jun , Xiong Cheng‑Liang , Gu Yi-Qun
Published: December 2020

The purpose of this study was to investigate the prevalence and epidemiological characteristics of late-onset hypogonadism (LOH) in middle-aged and elderly Chinese men. Two cross-sectional studies were conducted at 5-year intervals in community-dwelling men living in the same area. A total of 1472 (Study 1, S1) and 944 (Study 2, S2) men aged 40–69 years old were recruited as subjects. Subjects were evaluated through combining serum reproductive hormone levels with the Androgen Deficiency in Aging Males (ADAM) questionnaire and the Aging Males’ Symptoms (AMS) scale. A significant difference was found in mean testosterone deficiency (TD) prevalence between S1 and S2, using either serum total testosterone (TT; 14.02% vs. 6.36%) or serum calculated free testosterone (cFT; 43.69% vs. 16.53%) cutoff values. According to the S1 or S2 data, the mean prevalence of LOH was 37.85%/15.47% in the positive ADAM test and 15.42%/9.43% in the positive AMS test ( p < .01). According to classifications of TD based on gonadal status, the prevalence of secondary TD (27.34%) was higher than the primary (16.36%) and compensated (15.42%) TD in S1 ( p < .01). However, there were significant differences among the prevalence of primary (6.89%), secondary (9.64%), and compensated (27.65%) TD in S2 ( p < .05). Different types of testosterone levels, TD cutoff values, and questionnaires influenced the prevalence of TD and LOH. The serum FT cutoff value was an optimal threshold for evaluating and diagnosing TD and LOH, whose prevalence increased gradually with male aging.
Prostate Cancer Treatment and Work: A Scoping Review
Authors: Yu Ko Wellam F. , Oliffe John L. , Bottorff Joan L.
Published: December 2020

Prostate cancer is the most common malignancy diagnosed in North American men. Although medical advances have improved survival rates, men treated for prostate cancer experience side-effects that can reduce their work capacity, increase financial stress, and affect their career and/or retirement plans. Working-age males comprise a significant proportion of new prostate cancer diagnoses. It is important, therefore, to understand the connections between prostate cancer and men’s work lives. This scoping review aimed to summarize and disseminate current research evidence about the impact of prostate cancer treatment on men’s work lives. Electronic databases were searched to identify peer-reviewed articles published between 2006 and 2020 that reported on the impact of prostate cancer treatment on men’s work. Following scoping review guidelines, 21 articles that met inclusion criteria were identified and analyzed. Evidence related to the impact of prostate cancer on work was grouped under three themes: (1) work outcomes after prostate cancer treatment; (2) return to work considerations, and (3) impact of prostate cancer treatment on men’s finances. Findings indicate that men’s return to work may be more gradual than expected after prostate cancer treatment. Some men may feel pressured by financial stressors and masculine ideals to resume work. Diverse factors including older age and social benefits appear to play a role in shaping men’s work-related plans after prostate cancer treatment. The findings provide direction for future research and offer clinicians a synthesis of current knowledge about the challenges men face in resuming work in the aftermath of prostate cancer treatment.
Community-based health care providers as research participant recruitment gatekeepers: ethical and legal issues in a real-world case example
Authors: Celedonia Karen L , Valenti Michael W , Corrales Compagnucci Marcelo , Lowery Wilson Michael
Published: December 2020

Community-based mental health care providers (CBMHCPs) are increasingly contacted by external researchers for research study recruitment. Unfortunately, many do not possess the resources or personnel with the skills required to successfully evaluate research proposals for risks. Providing access to clients and client health information can result in harmful personal and legal consequences if the proper safeguards do not exist. This article discusses the legal requirements and practical implications for CBMHCPs when acting as gatekeepers. A case study from a large CBMHCP is presented as an illustration of steps that can be taken to protect clients and avoid risk. Additional recommendations for establishing protective safeguards and research evaluation protocols are discussed.
Theoretical and experimental studies on the fluorescence properties of aluminum(III), cadmium(II), zinc(II), and copper(II) complexes of substituted 8-hydroxyquinoline
Authors: Yuanyuan Zhang , Hongrui Cheng , Qingrong Sun , Hongli Chen , Weiqing Yang , Menglin Ma
Published: December 2020

Fifty-five 8-hydroxyquinoline (8-HQ) derivatives are synthesized and the corresponding aluminum(III), cadmium(II), copper(II), and zinc(II) metal complexes are prepared and their fluorescent activities are evaluated. The results indicate that the aluminum complexes have the best fluorescence properties, followed by zinc and cadmium complexes, while almost no fluorescence is observed with the copper complexes. The relationship between the fluorescence properties and complex structure is summarized and a predictive three-dimensional quantitative structure–property relationship model is established using the multifit molecular alignment rule of Sybyl program. With the introduction of groups at the C-2 position or electron-withdrawing groups to the 8-hydroxyquinoline framework, fluorescence wavelength blue shifts are observed with the zinc, aluminum, and cadmium complexes. At the same time, a red shift of the fluorescence emission wavelength is detected for the aluminum and zinc complexes when C-5 of 8-hydroxyquinoline was substituted with halogens or a methyl group. Moreover, the zinc, cadmium, and aluminum complexes with 2,4-dimethyl substituents on the 8-hydroxyquinoline all show good fluorescence properties. The highest occupied molecular orbital and lowest unoccupied molecular orbital energies of the complexes are also calculated and the fluorescence properties of the metal complexes are analyzed from the viewpoint of molecular orbitals.
Anti-carbamylated protein antibody isotype pattern differs between palindromic rheumatism and rheumatoid arthritis
Authors: Castellanos-Moreira Raul , Rodriguez-Garcia Sebastian C. , Cabrera-Villalba Sonia , Gomara María José , Salvador Georgina , Ruiz-Esquide Virginia , Ramirez Julio , Inciarte-Mundo Jose , Morla Rosa , Garcia-Moreno Cristina , Cuervo Andrea , Gómez-Puerta Jose A. , Cañete Juan D. , Haro Isabel , Sanmarti Raimon
Published: December 2020

Background:

A restricted response against citrullinated peptides/proteins, with less isotype usage, has been found in palindromic rheumatism (PR) in comparison with rheumatoid arthritis (RA). We hypothesized that this different antibody response may be observed for other post-translational modified proteins. We compared the prevalence and isotype usage of two specificities of anti-carbamylated peptide/protein antibodies (Anti-CarP) in patients with PR and RA.

Methods:

Cross-sectional study including 54 patients with pure PR and 53 patients with RA, matched by sex, age, disease duration and ACPA. Anti-CarP specificities were determined by home-made enzyme-linked immunosorbent assay tests using a synthetic chimeric fibrin/filaggrin homocitrullinated peptide (CFFHP) and fetal calf serum (FCS) homocitrullinated protein as antigens. IgG, IgA and IgM isotypes were measured.

Results:

Anti-CarP were positive (CFFHP or FCS) in 24% and 64% of patients with PR and RA, respectively ( p < 0.005). All Anti-CarP isotype proportions were significantly lower in PR than in RA: Anti-CarP-IgG (24% versus 51%), Anti-CarP-IgA (7% versus 34%) and Anti-CarP-IgM (7% versus 36%). Mean titers of Anti-CarP isotypes were also lower in PR. In Anti-CarP positive patients, the isotype distribution differed between PR and RA: IgG Anti-CarP was used in all PR patients and in 79% of RA patients. By contrast, a significantly lower isotype usage of both IgA (31% versus 53%) and IgM (31% versus 56%) was observed in PR patients. No significant differences in clinical or demographic characteristics were observed according to Anti-CarP status in PR patients, except for a higher prevalence of ACPA and higher mean titers of ACPA and rheumatoid factor in Anti-CarP positive patients.

Conclusion:

Anti-CarP are found in patients with PR but in a lower proportion and with a different isotype usage from in RA, suggesting a distinct B cell response to homocitrullinated antigens in PR.
A Local Dental Network Approach to the COVID-19 Pandemic: Innovation Through Collaboration
Authors: Hearnshaw Simon , Serban Stefan , Mohammed Imran , Zubair Ajmal , Jaswal Deksha , Grant Siobhán
Published: December 2020

The coronavirus pandemic has had significant effects on individuals, healthcare systems and governments. In the UK, whilst routine dentistry was suspended, an urgent dental care system was required to support urgent patient need. Using an adapted model of Donabedians’ framework, a critical evaluation of the services developed and implemented is provided and the various innovative approaches involved in this work are discussed. The three domains of the framework are structure, process and outcome.

Structure:

We present the principles for selecting and initiating hubs, the integration with secondary care services and the supply of personal protective equipment.

Process:

The main elements are communication, the development of referral processes to manage complex cases and data collection.

Outcome:

Through work with local dental stakeholders, 23 clusters and 36 hubs were set up covering a large geographical area. The integrated network of hubs and clusters has strengthened collaboration between providers and policy makers. Various leadership approaches facilitated the readiness for the transition to recovery. The new local collaborative structures could be used to support local programmes such as flexible commissioning, peer-led learning and integration with primary care networks.
Disparity in biomedical publication trends in the CARICOM countries: Is there a need for a more vibrant research culture in the region?
Authors: Singh Keerti , Majumder Md Anwarul Azim , Gupta Subir , Gaur Uma , Sa Bidyadhar , Adams Oswald P
Published: December 2020

Background:

Biomedical research and publications provide evidence-based information about the extent and burden of health-related problems of a country and help to formulate strategic and operational plans to tackle the problems.

Purpose:

To determine the biomedical publication rates of CARICOM full member countries.

Methods:

Biomedical publications of full member CARICOM countries were retrieved using PubMed (1990–2015) and SCImago Journal & Country Rank (1996–2015) databases. CARICOM countries having >50 publications in the PubMed (1990–2015) database were subject to further analysis, whereby publications of each country were adjusted by total population (million population), gross domestic product (billion-dollar), and Internet usage rate (hundred thousand population).

Results:

Total publications by all countries were 7281 and 8378 in PubMed and SCImago Journal & Country Rank, respectively. Jamaica produced highest number of publications (PubMed: 3928 (53.9%); SCImago Journal & Country Rank: 2850 (34.0%)). In both databases, Grenada had the highest research publications when adjusted with per million population (4721 and 10,633), per billion gross domestic product (803 and 1651), and per hundred thousand Internet users (1487 and 3387). Trend analysis revealed Jamaica produced the highest number of additional PubMed listed publications each year, averaging 4.8/year, followed by Trinidad and Tobago (4.4). According to SCImago Journal & Country Rank, Jamaica also had the highest number of citations (42,311) and h-index (76), followed by Trinidad and Tobago (29,152 and 71). Barbados had the highest number of citations per document (24.9), followed by Haiti (18.4). The publication rates determined by PubMed and SCImago Journal & Country Rank databases were significantly correlated (p < 0.001). Most publications (68% SCImago Journal & Country Rank and 85% PubMed) can be attributed to authors affiliated with Barbados, Jamaica, and Trinidad.

Conclusion:

Publication and citation rates varied markedly between CARICOM countries and were in general low. Most publications could be attributed to researchers affiliated with The University of the West Indies. More universities valuing biomedical research are needed in the region, and more resources needed to improve publication rates.
High-Energy Proximal Humerus Fractures in Geriatric Patients: A Review
Authors: Walters Jordan M. , Ahmadi Shahryar
Published: December 2020

High-energy proximal humerus fractures in elderly patients can occur through a variety of mechanisms, with falls and MVCs being common mechanisms of injury in this age group. Even classically low-energy mechanisms can result in elevated ISS scores, which are associated with higher mortality in both falls and MVCs. These injuries result in proximal humerus fractures which are commonly communicated via Neer’s classification scheme. There are many treatment options in the armamentarium of the treating surgeon. Nonoperative management is widely supported by systematic review as compared to almost all other treatment methods. ORIF is particularly useful for complex patterns and fracture dislocations in healthy patients. Hemiarthroplasty can be of utility in patients with fracture patterns with high risk of AVN and poor bone quality risking screw cut-out. Reverse total shoulder arthroplasty is a popular method of treatment for geriatric patients also, with literature now showing that even late conversion from nonoperative management or ORIF to rTSA can lead to good clinical outcomes. Prevention is possible and important for geriatric patients. Optimizing medical care including hearing, vision, strength, and bone quality, in coordination with primary care and geriatricians, is of great importance in preventing fractures and decreasing injury when falls do occur. Involving geriatricians on dedicated trauma teams will also likely be of benefit.
Understanding the Secondary Exposure to Trauma and Professional Quality of Life of School Counselors
Authors: Rumsey Amanda D. , McCullough Rafe , Chang Catharine Y.
Published: December 2020

This quasi-experimental study examined secondary exposure to trauma and factors of professional quality of life among a national sample of 361 school counselors. Results indicate that major upheaval between parents, death of a close friend or family member, and emotional abuse are the most common traumatic events that school counselors are exposed to and that school counselors in Title I schools report significantly more exposure. Hierarchical multiple regression results revealed that secondary exposure to trauma predicted secondary traumatic stress. We discuss recommendations for research and school counseling practice.
Interdisciplinary Team-Based Learning: An Integrated Opportunity Recognition and Evaluation Model for Teaching Business, Engineering and Design Students
Authors: Bailey Jennifer , Read James , Linder Benjamin , Neeley Lawrence
Published: December 2020

This paper describes a pedagogical framework and a set of team-based learning (TBL) activities which can be applied to an interdisciplinary course comprised of a mix of engineering, design, and business students. The goal of the team-based learning (TBL) activities is to help students to appreciate both the benefits and the challenges of working in interdisciplinary teams. To enhance their interdisciplinary collaboration skills, students engage in a series of knowledge sharing and knowledge integration activities, based on the Jigsaw technique, a team-based learning methodology. These activities enable the students to recognize and reconcile their disciplinary differences and biases, which arise because of the cognitive diversity of the team. Students are assigned to interdisciplinary teams to identify and prototype an entrepreneurial opportunity. By the end of these activities, students are able to incorporate the perspectives of all three disciplines to develop an integrated team mental model (TMM) of the opportunity recognition and opportunity evaluation process.
Deep learning for sensitive detection of Helicobacter Pylori in gastric biopsies
Authors: Klein Sebastian , Gildenblat Jacob , Ihle Michaele Angelika , Merkelbach-Bruse Sabine , Noh Ka-Won , Peifer Martin , Quaas Alexander , Büttner Reinhard
Published: December 2020

Background

Helicobacter pylori, a 2 × 1 μm spiral-shaped bacterium, is the most common risk factor for gastric cancer worldwide. Clinically, patients presenting with symptoms of gastritis, routinely undergo gastric biopsies. The following histo-morphological evaluation dictates therapeutic decisions, where antibiotics are used for H. pylori eradication. There is a strong rational to accelerate the detection process of H. pylori on histological specimens, using novel technologies, such as deep learning.

Methods

We designed a deep-learning-based decision support algorithm that can be applied on regular whole slide images of gastric biopsies. In detail, we can detect H. pylori both on Giemsa- and regular H&E stained whole slide images.

Results

With the help of our decision support algorithm, we show an increased sensitivity in a subset of 87 cases that underwent additional PCR- and immunohistochemical testing to define a sensitive ground truth of HP presence. For Giemsa stained sections, the decision support algorithm achieved a sensitivity of 100% compared to 68.4% (microscopic diagnosis), with a tolerable specificity of 66.2% for the decision support algorithm compared to 92.6 (microscopic diagnosis).

Conclusion

Together, we provide the first evidence of a decision support algorithm proving as a sensitive screening option for H. pylori that can potentially aid pathologists to accurately diagnose H. pylori presence on gastric biopsies.
Sex difference in the incidence of cardia and non-cardia gastric cancer in the United States, 1992–2014
Authors: Yao Qiang , Qi Xiaona , Xie Shao-Hua
Published: December 2020

Background

Gastric cancer is more common in men than in women, but underlying reasons have not been completely understood. This study aimed to assess patterns of the sex difference in the incidence of gastric cancer in the United States.

Methods

Using data from 13 cancer registries in the Surveillance, Epidemiology, and End Results Program, we analyzed the age-specific sex difference in the incidence of gastric cancer by ethnicity, anatomic site and histological type in the United States during 1992–2014. We assessed the temporal trends in the sex differences in the incidence of gastric cancer during the study period.

Results

The male-to-female incidence ratio of cardia cancer increased with age until peaking at ages 55–69 years and decreased thereafter, while the ratio for non-cardia gastric cancer increased with age before ages < 60 years and remained stable onwards. The age-specific patterns in the sex difference of gastric cancer incidence varied between intestinal and diffuse histological types. The sex difference in the incidence of cardia cancer remained relatively stable except for that the absolute difference between the sexes in whites decreased on average by 0.8% per year from 1992 to 2014. The absolute incidence difference between the sexes in non-cardia gastric cancer decreased over time in whites, blacks, and Asian and Pacific islanders by approximately 4% per year. The male-to-female incidence ratio of non-cardia gastric cancer decreased over time in whites and blacks, but remained relatively stable in Asian and Pacific islanders.

Conclusions

Both extrinsic and intrinsic factors may have contributed to the sex difference in gastric cancer. Sex hormones may play a role in the development of cardia cancer and intestinal type of gastric cancer.
Macrolide and fluoroquinolone associated mutations in Mycoplasma genitalium in a retrospective study of male and female patients seeking care at a STI Clinic in Guangzhou, China, 2016-2018
Authors: Ke Wujian , Li Dongling , Tso Lai Sze , Wei Ran , Lan Yinyuan , Chen Zhengyu , Zhang Xiaohui , Wang Liuyuan , Liang Chunmei , Liao Yuying , Chen Huiru , Liu Yahui , Zheng Heping , Yang Ligang
Published: December 2020

Background

Antimicrobial resistance in M. genitalium is a growing clinical problem. We investigated the mutations associated with macrolide and fluoroquinolone resistance, two commonly used medical regimens for treatment in China. Our aim is to analyze the prevalence and diversity of mutations among M. genitalium-positive clinical specimens in Guangzhou, south China.

Methods

A total of 154 stored M. genitalium positive specimens from men and women attending a STI clinic were tested for macrolide and fluoroquinolone mutations. M. genitalium was detected via TaqMan MGB real-time PCR. Mutations associated with macrolide resistance were detected using primers targeting region V of the 23S rRNA gene. Fluoroquinolone resistant mutations were screened via primers targeting topoisomerase IV (parC) and DNA gyrase (gyrA).

Results

98.7% (152/154), 95.5% (147/154) and 90.3% (139/154) of M. genitalium positive samples produced sufficient amplicon for detecting resistance mutations in 23S rRNA, gyrA and parC genes, respectively. 66.4% (101/152), 0.7% (1/147) and 77.7% (108/139) samples manifested mutations in 23S rRNA, gyrA and parC genes, respectively. A2072G (59/101, 58.4%) and S83I (79/108, 73.1%) were highly predominating in 23S rRNA and parC genes, respectively. Two samples had amino acid substitutions in gyrA (M95I and A96T, respectively). Two samples had two amino acid substitutions in parC (S83I + D87Y). 48.6% (67/138) of samples harbored both macrolide and fluoroquinolone resistance-associated mutations. The most common combination of mutations was A2072G (23S rRNA) and S83I (parC) (40/67, 59.7%). One sample had three amino acid changes in 23S rRNA, gyrA and parC genes (A2072G + A96T + S83I).

Conclusions

The high antimicrobial resistance rate of M. genitalium in Guangzhou is a very worrying problem and suggests that antimicrobial resistance testing and the development of new antibiotic regimens are crucially needed.
The timing of initiation of pharmacotherapy for women with gestational diabetes mellitus
Authors: Harrison Rachel K. , Cruz Meredith , Wong Ashley , Davitt Caroline , Palatnik Anna
Published: December 2020

Background

The decision to initiate pharmacotherapy is integral in the care for pregnant women with gestational diabetes mellitus (GDM). We sought to compare pregnancy outcomes between two threshold percentages of elevated glucose values prior to initiation of pharmacotherapy for GDM. We hypothesized that a lower threshold at pharmacotherapy initiation will be associated with lower rates of adverse perinatal outcomes.

Methods

This was a retrospective cohort study of women with GDM delivering in a single tertiary care center. Pregnancy outcomes were compared using bivariable and multivariable analyses between women who started pharmacotherapy (insulin or oral hypoglycemic agent) after a failed trial of dietary modifications at two different ranges of elevated capillary blood glucose (CBG) values: Group 1 when 20–39% CBG values were above goal; Group 2 when ≥40% CBG values were above goal. The primary outcome was a composite GDM-associated neonatal adverse outcome that included: macrosomia, large for gestational age (LGA), shoulder dystocia, hypoglycemia, hyperbilirubinemia requiring phototherapy, respiratory distress syndrome, stillbirth, and neonatal demise. Secondary outcomes included cesarean delivery, preterm birth (< 37 weeks), neonatal intensive care unit (NICU) admission, and small for gestational age (SGA).

Results

A total of 417 women were included in the study. In univariable analysis, the composite neonatal outcome was statistically significantly higher in Group 2 compared to Group 1 (47.9% vs. 31.4%, p = 0.001). In addition, rates of preterm birth (15.7% vs 7.4%, p = 0.011), NICU admission (11.7% vs 4.0%, p = 0.006), and LGA (21.2% vs 9.1% p = 0.001) were higher in Group 2. In contrast, higher rates of SGA were noted in Group 1 (8.0% vs. 2.9%, p = 0.019). There was no difference in cesarean section rates. These findings persisted in multivariable analysis after adjusting for confounding factors (composite neonatal outcome aOR = 0.50, 95%CI [0.31–0.78]).

Conclusions

Initiation of pharmacotherapy for GDM when 20–39% of CBG values are above goal, compared to ≥40%, was associated with decreased rates of adverse neonatal outcomes attributable to GDM. This was accompanied by higher rates of SGA among women receiving pharmacotherapy at the lower threshold. Additional studies are required to identify the optimal threshold of abnormal CBG values to initiate pharmacotherapy for GDM.
Zone-specific reference ranges of fetal adrenal artery Doppler indices: a longitudinal study
Authors: Xu Ran , Zhu Ziling , Tang Wenjuan , Zhou Qichang , Zeng Shi
Published: December 2020

Background

The fetal adrenal gland is a highly vascularized organs and develops two recognizable distinct zones in uetro, inner fetal zone (FZ) and outer definitive zone (DZ). Based on the region supplied, middle adrenal artery (MAA) mainly contribute to FZ while inferior adrenal artery (IAA) mainly to the inferior part of DZ. The purpose of this study was to establish reference ranges of adrenal artery Doppler indices of IAA and MAA, and assess zonal difference of blood supply to fetal adrenal gland.

Methods

The pulsatility index (PI), resistance index (RI), and systolic:diastolic ratio (S/D) of the IAA and MAA were obtained serially at 4-week intervals in normal fetuses. The MAA and IAA were referred based on the course and location in the gland: IAA referring the artery that mainly branches from the renal artery and walks along the renal upper pole, distributing the inferoposterior part of DZ in the adrenal gland while MAA as arterial blood flowing along the single central adrenal vein in the medial part of the gland. Multilevel modeling was performed to establish the gestational age-associated reference ranges for IAA and MAA. Differences in Doppler indices between the IAA and MAA were assessed.

Results

One hundred sixty-eight fetuses with 843 observations were included. The IAA had a higher detection rate than the MAA (100% vs 89.2%, p < 0.05). The resistance of IAA had a reduction around 35 weeks of gestation and that of MAA remained unchanged throughout the second half of pregnancy. Lower PI, RI and S/D were observed in the MAA than in the IAA (p < 0.05) from 752 paired measurements.

Conclusion

There is a zonal difference in blood supply in favor of the fetal zone, which may correspond to its unique function. Reference ranges of Doppler parameters in adrenal artery maybe beneficial for further evaluation of fetal hemodynamics.
New PTEN mutation identified in a patient with rare bilateral choroidal ganglioneuroma
Authors: Jiang Zhaoxin , Zhang Ting , Chen Chonglin , Sun Limei , Li Songshan , Ding Xiaoyan
Published: December 2020

Background

Choroidal ganglioneuroma is an extremely rare tumor, and there is little knowledge regarding its pathogenesis. We aimed to investigate the phenotypic and genetic alterations in one sporadic patient with a rare case of bilateral choroidal ganglioneuroma.

Methods

A 6-year-old boy with histological diagnosis of bilateral ganglioneuroma was recruited for the study. Comprehensive ophthalmic examinations were performed. Genomic DNA was extracted from the peripheral blood samples collected from the patient, his unaffected family members, and 200 unrelated control subjects from the same population. Whole exome sequencing was performed and raw reads were aligned to the human genome reference (hg19) using Burrows-Wheeler Aligner. DNA from all available family members was Sanger sequenced for segregation analysis.

Results

Extensive bilateral retinal detachments were observed via optical coherence tomography. Diffuse thickening of choroid was identified with ultrasound B scan and magnetic resonance imaging. Genetic analysis revealed the presence of a novel heterozygous PTEN frameshift mutation, c.498delA (p.Thr167LeufsTer16), in exon 6. It was present in the affected individual, but not in any of the family members. Genetic analysis revealed that there was no mutation in neurofibromatosis-related genes in the family. Upon performing comprehensive systemic examinations, no obvious abnormalities in other organs were observed.

Conclusions

A novel de novo PTEN mutation was identified in a patient with bilateral choroidal ganglioneuroma. Although PTEN mutations are known to induce multiple abnormalities, choroidal ganglioneuroma can be the first manifestation without abnormalities in other organs. Further studies are needed to confirm the association between choroidal ganglioneuroma and PTEN mutation.
Experiences of psychotherapists working with refugees in Germany: a qualitative study
Authors: Asfaw Baye Berihun , Beiersmann Claudia , Keck Verena , Nikendei Christoph , Benson-Martin Janine , Schütt Inken , Lohmann Julia
Published: December 2020

Background

Despite a high burden of mental health problems among refugees, there is limited knowledge about effective mental health care provision for this group. Although substantial efforts in understanding the complexity of cross-cultural psychotherapy – which in the context of this study we use to refer to therapy with client and therapist of different cultural backgrounds – have been made, there remains a dearth of research exploring barriers for effective cross-cultural psychotherapy. This study aimed at narrowing this gap in knowledge by exploring major challenges encountered by psychotherapists in cross-cultural psychotherapy and strategies which have proven useful in overcoming such challenges.

Methods

We employed a qualitative study design, conducting semi-structured in-depth interviews with 10 purposely selected psychotherapists working with refugees in Germany. Respondents were from varying theoretical background and had varying levels of experience. Data were analyzed using a thematic approach, following a mix of deductive and inductive coding.

Results

Respondents reported three main challenges in their cross-cultural practice: different or unrealistic expectations of clients towards what psychotherapy would offer them; challenges grounded in different illness explanatory models; and communication challenges. In dealing with these challenges, respondents recommended psychoeducation to overcome issues related to problematic expectations towards psychotherapy; “imagining the real”, identifying “counter magic” and other client-appropriate resources to deal with issues related to clients’ foreign illness attributions; and translators in dealing with communication barriers, though the latter not univocally.

Conclusions

Results show that psychotherapy with refugees can be very successful, at least from the psychotherapist perspective, but also poses significant challenges. Our findings underline the importance of developing, testing, and institutionalizing structured and structural approaches to training psychotherapists in cross-cultural therapy at scale, to accommodate the rising mental health care need of refugees as a client group.
ILDGDB: a manually curated database of genomics, transcriptomics, proteomics and drug information for interstitial lung diseases
Authors: Li Yupeng , Wu Gangao , Shang Yu , Qi Yue , Wang Xue , Ning Shangwei , Chen Hong
Published: December 2020

Background

Interstitial lung diseases (ILDs), a diverse group of diffuse lung diseases, mainly affect the lung parenchyma. The low-throughput ‘omics’ technologies (genomics, transcriptomics, proteomics) and relative drug information have begun to reshaped our understanding of ILDs, whereas, these data are scattered among massive references and are difficult to be fully exploited. Therefore, we manually mined and summarized these data at a database (ILDGDB, http://ildgdb.org/) and will continue to update it in the future.

Main body

The current version of ILDGDB incorporates 2018 entries representing 20 ILDs and over 600 genes obtained from over 3000 articles in four species. Each entry contains detailed information, including species, disease type, detailed description of gene (e.g. official symbol of gene), and the original reference etc. ILDGDB is free, and provides a user-friendly web page. Users can easily search for genes of interest, view their expression pattern and detailed information, manage genes sets and submit novel ILDs-gene association.

Conclusion

The main principle behind ILDGDB’s design is to provide an exploratory platform, with minimum filtering and interpretation, while making the presentation of the data very accessible, which will provide great help for researchers to decipher gene mechanisms and improve the prevention, diagnosis and therapy of ILDs.
Total knee arthroplasty according to the original knee phenotypes with kinematic alignment surgical technique—early clinical and functional outcomes
Authors: Hsu Cheng-En , Huang Jen-Ting , Tong Kwok-Man , Huang Kui-Chou
Published: December 2020

Background

The kinematic alignment (KA) technique in total knee arthroplasty (TKA) aims to restore the native alignment of pre-disease knee joint anatomy. Determining the individualized alignment targets is crucial for pre-operative planning, which can be set according to different original knee phenotypes. Five most common knee phenotypes have been categorized for KA-TKA alignment target setting in our previous study. The purpose of this study was to investigate the distribution of the five phenotypes in advanced OA knee patients and evaluate the clinical outcomes of this phenotype-oriented KA-TKA using the generic instrument, with particular emphasis on alignment strategy, surgical technique, survivorship, radiographic and functional outcomes.

Methods

The clinical data of 123 patients (88 women, 35 men) who had undergone 140 TKAs in our hospital were reviewed. All the TKAs were performed with alignment targets set according to the original phenotypes of the knee, with the KA method, using the generic total knee instrument. The patients’ demographics, preoperative and postoperative knee alignment angles, one-year postoperative range of motion (ROM), Oxford knee scores (OKS), Combined knee society score (CKSS) were collected and analyzed.

Results

The 3 years survivorship was 99.3% for all cause of revision, and 100% with revision other than infection as the endpoint. The preoperative phenotypes of the knee were as follows: neutral alignment 20.1% (type 1: 3.6%, type 2: 16.5%), varus alignment 71.2% (type 3: 46.0%, type 4: 25.2%), and valgus alignment (type 5: 8.6%). Using our protocol, patients with different knee phenotypes could get similar great functional improvement though the postoperative alignment parameters were significantly different between the knee phenotypes (P < 0.05).

Conclusion

The early outcomes of this phenotype-oriented KA-TKA using generic total knee instruments are promising. Setting individualized alignment target according to original knee phenotype is rational and practical. The residual varus alignment did not cause any aseptic loosening in the 3 years follow-up. Long-term survivorship and functional outcomes need to be evaluated in future studies.
Invasive raccoon management systems and challenges in regions with active control
Authors: Suzuki Takaaki , Ikeda Tohru
Published: December 2020

Background

The raccoon (Procyon lotor) is an invasive, non-native species in Japan. Throughout the country, it causes significant agricultural damage and negatively affects native biodiversity. Most of the responsibility for raccoon management lies with local government, and there are still many challenges to be overcome. Although raccoon populations have not been eradicated, intensive control campaigns such as focus on the early stages of invasion have controlled raccoons in some regions. To improve the national management of raccoons, we conducted a survey on raccoon management systems in local government departments considered to solve the challenges recognized in many areas. During 2014 and 2015, we surveyed three different municipal departments about raccoon management measures. The semi-structured interview survey covered two topics: (1) the situation leading up to the current management system; (2) the current management system.

Results

Our results describe the scope and methods used in raccoon management. The government staff managed raccoons using monitoring, employing a variety of methods, a range of budgets, and various role divisions. The management practices are similar in that they share a sense of taking precautions, collaborating with stakeholders, understanding that adequate methods must be used, and obtaining support from experts.

Conclusions

Our case studies reveal the challenges in raccoon management faced by local government officers in regions with active control. The management systems and methods that we surveyed seemed to be effective in solving problems in both developed and undeveloped areas.