bluuebunny/crossref_metadata_2025 huggingface dataset:
Succeeding with prolonged usage of consumer-based activity trackers in clinical studies: a mixed methods approach
Authors: Henriksen André , Sand Anne-Sofie , Deraas Trygve , Grimsgaard Sameline , Hartvigsen Gunnar , Hopstock Laila
Published: August 2020

Background

Lack of physical activity (PA) is a risk factor for death and non-communicable disease. Despite this, more than one fourth of adults worldwide do not follow PA guidelines. As part of a feasibility study to test a complex intervention for increasing PA, we included a consumer-based activity tracker (AT) as a tool to measure PA outcomes and to track heart rate during exercise sessions. The aim of the present study was to identify factors that increase wear time when using a consumer-based AT for monitoring of participants in clinical research.

Methods

Sixteen participants aged 55–74 years, with obesity, sedentary lifestyle, and elevated cardiovascular risk were recruited to a 12-month feasibility study. Participants wore a Polar M430 AT to collect continuous PA data during a six-month intervention followed by 6 months of follow-up. We performed quantitative wear time analysis, tested the validity of the AT, and completed two rounds of qualitative interviews to investigate how individual wear-time was linked to participant responses.

Results

From 1 year of tracking, mean number of valid wear days were 292 (SD = 86), i.e. 80%. The Polar M430 provides acceptable measurements for total energy expenditure. Motivations for increased wear time were that participants were asked to wear it and the ability to track PA progress. Perceived usefulness included time keeping, heart rate- and sleep tracking, becoming more conscious about day-to-day activity, and improved understanding of which activity types were more effective for energy expenditure. Sources of AT annoyance were measurement inaccuracies and limited instruction for use. Suggestions for improvement were that the AT was big, unattractive, and complicated to use.

Conclusions

Adherence to wearing a consumer-based AT was high. Results indicate that it is feasible to use a consumer-based AT to measure PA over a longer period. Potential success factors for increased wear time includes adequate instruction for AT use, allowing participants to choose different AT designs, and using trackers with accurate measurements. To identify accurate trackers, AT validation studies in the target cohort may be needed.

Trial registration

U.S. National Library of Medicine, Clinical Trial registry: NCT03807323; Registered 16 September 2019 – Retrospectively registered.
Monitoring the decomposition of wealth-related inequality in the use of regular antenatal care in Egypt (1995–2014)
Authors: Khadr Zeinab
Published: August 2020

Background

Between 1995 and 2014 Egypt successfully increased the use of regular antenatal care (URAC) among women from 30.4 to 82.9%. The same period saw a decrease in the wealth-based inequality in URAC. This paper investigates the changes in the main determinants contributing to the wealth-based inequality in URAC for the 2 years of 1995 and 2014, and the determinants that underlined the declines in this inequality.

Methods

The secondary analysis was based on data from the 1995 and 2014 rounds of the Egypt Demographic and Health Survey. Logistic regression was implemented to model URAC for the 2 years and inequality was measured using the concentration index. Decomposition of the concentration index and Blinder -Oaxaca decomposition were implemented to assess the contribution of the URAC determinants to its inequality and the changes between 1995 and 2014.

Results

Decomposition of inequalities in URAC in 1995 and 2014 showed that social determinants were the main contributors to these inequalities. More than 90% of the inequalities were explained by the living in rural Upper Egypt, women and their husbands secondary and higher education, the household standard of living, and birth order. These same determinants were responsible for more than 76% of the decline in the inequality in URAC between 1995 and 2014. Wide spread of poverty in rural Upper Egypt was found to contribute significantly to the inequality in URAC. Women and their husbands who have secondary or higher education maintained their high odds of URAC.

Conclusion

Since poverty in rural Upper Egypt, and inequality in education and parity are crucial social determinants of URAC inequality and its change overtime, new policies and interventions need to focus not only on the health system but on social initiatives with an equity lens to tackle the structural causes underlying these factors and their inequalities.
Health beliefs and barriers related to HIV prevention and screening among students of the University of Vlora: a cross-sectional study
Authors: Lalo Rezarta , Theodhosi Gjergji , Breshanaj Alberta
Published: August 2020

Background

Previous researchers have found that young university students can have a high level of knowledge about HIV/AIDS infection, but they are still not utilizing the existing HIV prevention methods. As a result there is a need to determine which factors and barriers influence the use of existing HIV screening and prevention methods among students of the University of Vlora in Albania.

Methods

This was a cross-sectional study conducted among university students in the district of Vlora, Albania from April to June 2018. Stratified, multi-stage sampling technique was used to select randomly study subjects. A structured, self-administered questionnaire was used for data collection. Bivariate and multivariate logistic regression analysis was employed to reflect the relationship between variables.

Results

The mean age of the participants (710) was 20.85 ± 2.1 years. 38% of them believe that chances of getting HIV would not stop them to have sexual intercourse with more than one partner, 69% report that using a condom seems like an insult to their partner. 78% of the students with sexual experience didn’t used Voluntary Counseling and Testing services. The students from the rural area (AOR = 0.50, 95% CI [0.30–0.82]) and those of first academic year (AOR second/first year =2.31, 95% CI [1.33–3.99], AOR third/first year =1.18, 95% CI [0.65–2.13]) were less likely to use HIV service.

Conclusions

The findings reveal that health beliefs and barriers are good predictors of the preventive behaviours toward HIV infection. The survey has provided evidence to suggest that creating awareness about HIV prevention among student community, especially those from non-health sciences and rural areas could contribute to increased uptake of the VCT services, the condom use and to reduce the identified stigmatizing barriers.
Oncology education for family medicine residents: a national needs assessment survey
Authors: Yip Steven M. , Meyers Daniel E. , Sisler Jeff , Wycliffe-Jones Keith , Kucharski Edward , Elser Christine , Temple-Oberle Claire , Spadafora Silvana , Ingledew Paris-Ann , Giuliani Meredith , Kuruvilla Sara , Sumar Nureen , Tam Vincent C.
Published: August 2020

Background

This study aimed to determine the current state of oncology education in Canadian family medicine postgraduate medical education programs (FM PGME) and examine opinions regarding optimal oncology education in these programs.

Methods

A survey was designed to evaluate ideal and current oncology teaching, educational topics, objectives, and competencies in FM PGMEs. The survey was sent to Canadian family medicine (FM) residents and program directors (PDs).

Results

In total, 150 residents and 17 PDs affiliated with 16 of 17 Canadian medical schools completed the survey. The majority indicated their programs do not have a mandatory clinical rotation in oncology (79% residents, 88% PDs). Low rates of residents (7%) and PDs (13%) reported FM residents being adequately prepared for their role in caring for cancer patients (p = 0.03). Residents and PDs believed the most optimal method of teaching oncology is through clinical exposure (65% residents, 80% PDs). Residents and PDs agreed the most important topics to learn (rated ≥4.7 on 5-point Likert scale) were: performing pap smears, cancer screening/prevention, breaking bad news, and approach to patient with increased cancer risk. According to residents, other important topics such as appropriate cancer patient referrals, managing cancer complications and post-treatment surveillance were only taught at frequencies of 52, 40 and 36%, respectively.

Conclusions

Current FM PGME oncology education is suboptimal, although the degree differs in the opinion of residents and PDs. This study identified topics and methods of education which could be focussed upon to improve FM oncology education.
Particulate matter and emergency visits for asthma: a time-series study of their association in the presence and absence of wildfire smoke in Reno, Nevada, 2013–2018
Authors: Kiser Daniel , Metcalf William J. , Elhanan Gai , Schnieder Brendan , Schlauch Karen , Joros Andrew , Petersen Craig , Grzymski Joseph
Published: August 2020

Background

Health risks due to particulate matter (PM) from wildfires may differ from risk due to PM from other sources. In places frequently subjected to wildfire smoke, such as Reno, Nevada, it is critical to determine whether wildfire PM poses unique risks. Our goal was to quantify the difference in the association of adverse asthma events with PM on days when wildfire smoke was present versus days when wildfire smoke was not present.

Methods

We obtained counts of visits for asthma at emergency departments and urgent care centers from a large regional healthcare system in Reno for the years 2013–2018. We also obtained dates when wildfire smoke was present from the Washoe County Health District Air Quality Management Division. We then examined whether the presence of wildfire smoke modified the association of PM2.5, PM10–2.5, and PM10 with asthma visits using generalized additive models. We improved on previous studies by excluding wildfire-smoke days where the PM concentration exceeded the maximum PM concentration on other days, thus accounting for possible nonlinearity in the association between PM concentration and asthma visits.

Results

Air quality was affected by wildfire smoke on 188 days between 2013 and 2018. We found that the presence of wildfire smoke increased the association of a 5 μg/m3 increase in daily and three-day averages of PM2.5 with asthma visits by 6.1% (95% confidence interval (CI): 2.1–10.3%) and 6.8% (CI: 1.2–12.7%), respectively. Similarly, the presence of wildfire smoke increased the association of a 5 μg/m3 increase in daily and three-day averages of PM10 with asthma visits by 5.5% (CI: 2.5–8.6%) and 7.2% (CI: 2.6–12.0%), respectively. We did not observe any significant increases in association for PM10–2.5 or for seven-day averages of PM2.5 and PM10.

Conclusions

Since we found significantly stronger associations of PM2.5 and PM10 with asthma visits when wildfire smoke was present, our results suggest that wildfire PM is more hazardous than non-wildfire PM for patients with asthma.
Humanized bispecific antibody (mPEG × HER2) rapidly confers PEGylated nanoparticles tumor specificity for multimodality imaging in breast cancer
Authors: Cheng Yi-An , Wu Tung-Ho , Wang Yun-Ming , Cheng Tian-Lu , Chen I-Ju , Lu Yun-Chi , Chuang Kuo-Hsiang , Wang Chih-Kuang , Chen Chiao-Yun , Lin Rui-An , Chen Huei-Jen , Liao Tzu-Yi , Liu En-Shuo , Chen Fang-Ming
Published: August 2020

Background

Developing a universal strategy to improve the specificity and sensitivity of PEGylated nanoaparticles (PEG-NPs) for assisting in the diagnosis of tumors is important in multimodality imaging. Here, we developed the anti-methoxypolyethylene glycol (mPEG) bispecific antibody (BsAb; mPEG × HER2), which has dual specificity for mPEG and human epidermal growth factor receptor 2 (HER2), with a diverse array of PEG-NPs to confer nanoparticles with HER2 specificity and stronger intensity.

Result

We used a one-step formulation to rapidly modify the nanoprobes with mPEG × HER2 and optimized the modified ratio of BsAbs on several PEG-NPs (Lipo-DiR, SPIO, Qdot and AuNP). The αHER2/PEG-NPs could specifically target MCF7/HER2 cells (HER2++) but not MCF7/neo1 cells (HER2+/−). The αHER2/Lipo-DiR and αHER2/SPIO could enhance the sensitivity of untargeted PEG-NPs on MCF7/HER2 (HER2++). In in vivo imaging, αHER2/Lipo-DiR and αHER2/SPIO increased the specific targeting and enhanced PEG-NPs accumulation at 175% and 187% on 24 h, respectively, in HER2-overexpressing tumors.

Conclusion

mPEG × HER2, therefore, provided a simple one-step formulation to confer HER2-specific targeting and enhanced sensitivity and contrast intensity on HER2 positive tumors for multimodality imaging.
Results following surgical resection of recurrent chordoma of the spine: experience in a single institution
Authors: Chanplakorn Pongsthorn , Lertudomphonwanit Thamrong , Homcharoen Wittawat , Suwanpramote Prakrit , Laohacharoensombat Wichien
Published: August 2020

Background

Chordoma of the spine is a low-grade malignant tumor with vague and indolent symptoms; thus, large tumor mass is encountered at the time of diagnosis in almost cases and makes it difficult for en-bloc free-margin resection. Salvage therapy for recurrent chordoma is very challenging due to its relentless nature and refractory to adjuvant therapies. The aim of this present study was to report the oncologic outcome following surgical resection of chordoma of the spine.

Materials and methods

Retrospective review of 10 consecutive cases of recurrent chordoma patients who underwent surgical treatment between 2003 and 2018 at one tertiary-care center was conducted.

Results

There were 10 patients; 4 females and 6 males were included in this study. Eight patients had local recurrence. The recurrence was encountered at the muscle, surrounding soft tissue, and remaining bony structure. Distant metastases were found in 2 patients. The median time to recurrence or metastasis was 30 months after first surgery.

Conclusion

En-bloc free-margin resection is mandatory to prevent recurrence. The clinical vigilance and investigation to identify tumor recurrent should be performed every 3 to 6 months, especially in the first 30 months and annually thereafter. Detection of recurrent in early stage with a small mass may be the best chance to perform an en-bloc margin-free resection to prevent further recurrence.
Using informative prior based on expert opinion in Bayesian estimation of the transition probability matrix in Markov modelling—an example from the cost-effectiveness analysis of the treatment of patients with predominantly negative symptoms of schizophrenia with cariprazine
Authors: Vokó Zoltán , Bitter István , Mersich Beatrix , Réthelyi János , Molnár Anett , Pitter János G. , Götze Árpád , Horváth Margit , Kóczián Kristóf , Fonticoli Laura , Lelli Filippo , Németh Bertalan
Published: August 2020

Background

When patient health state transition evidence is missing from clinical literature, analysts are inclined to make simple assumptions to complete the transition matrices within a health economic model. Our aim was to provide a solution for estimating transition matrices by the Bayesian statistical method within a health economic model when empirical evidence is lacking.

Methods

We used a previously published cost-effectiveness analysis of the use of cariprazine compared to that of risperidone in patients with predominantly negative symptoms of schizophrenia. We generated the treatment-specific state transition probability matrices in three different ways: (1) based only on the observed clinical trial data; (2) based on Bayesian estimation where prior transition probabilities came from experts’ opinions; and (3) based on Bayesian estimation with vague prior transition probabilities (i.e., assigning equal prior probabilities to the missing transitions from one state to the others). For the second approach, we elicited Dirichlet prior distributions by three clinical experts. We compared the transition probability matrices and the incremental quality-adjusted life years (QALYs) across the three approaches.

Results

The estimates of the prior transition probabilities from the experts were feasible to obtain and showed considerable consistency with the clinical trial data. As expected, the estimated health benefit of the treatments was different when only the clinical trial data were considered (QALY difference 0.0260), its combination with the experts’ beliefs were used in the economic model (QALY difference 0.0253), and when vague prior distributions were used (QALY difference 0.0243).

Conclusions

Imputing zeros to missing transition probabilities in Markov models might be untenable from the clinical perspective and may result in inappropriate estimates. Bayesian statistics provides an appropriate framework for imputing missing values without making overly simple assumptions. Informative priors based on expert opinions might be more appropriate than vague priors.
Low molecular weight serum cell-free DNA concentration is associated with clinicopathologic indices of poor prognosis in women with uterine cancer
Authors: Gressel Gregory M. , Maggi Elaine C. , Harmon Bryan E. , Ye Kenny Q. , Kuo D. Y. S. , Dolan Siobhan M. , Montagna Cristina
Published: August 2020

Background

Serum cell-free DNA (cfDNA) holds promise as a non-invasive cancer biomarker. The objective of this study was to evaluate the association of cfDNA concentration with clinicopathologic variables of poor prognosis and overall survival among women with uterine cancer compared to benign cancer-free controls.

Methods

cfDNA was extracted from the serum of 91 women with multiple uterine cancer histologies and 22 post-menopausal controls without cancer. Low molecular weight (LMW) cfDNA was separated from contaminating genomic high molecular weight cfDNA using paramagnetic bead purification and its concentration was measured using fluorometric quantification. Clinicopathologic data was abstracted from the electronic medical record. The association between serum cfDNA concentration, clinicopathologic variables, and overall survival was assessed using linear regression modelling, Cox proportional hazards modelling, and the Kaplan–Meier method.

Results

Median total serum cfDNA concentration for the cohort was 69.2 ng/mL (IQR 37.4, 132.3) and median LMW cfDNA concentration was 23.8 ng/mL (IQR 14.9, 44.4). There were no significant differences in total serum cfDNA concentration with any clinicopathologic variables. However, LMW cfDNA concentration was significantly higher in serum of women with cancer (25.8 ng/mL IQR 16.0, 49.6) compared to benign controls (15.5 ng/mL IQR 9.3, 25.8 ng/mL) (p < 0.01). It is also significantly higher among women with early stage cancer than benign controls (p < 0.01). There were also significant associations between LMW cfDNA concentration and stage of cancer (p = 0.01) and histology (p = 0.02). Patients with leiomyosarcoma and carcinosarcoma had higher cfDNA concentrations than those with endometrioid cancer. Over a median follow-up of 51.9 months, 75th percentile for overall survival for women with cancer was 24.0 months. Higher LMW cfDNA concentrations is associated with lower survival among women with cancer (p < 0.01).

Conclusions

Serum LMW cfDNA concentration is associated with overall survival in women with uterine cancer, and it is higher among women with uterine cancer compared to those of controls.
Developmental changes in ACLs and semitendinosus tendons dimensions according to age in children
Authors: Tomaszewski Ryszard , Smyczek Dominika , Woś-Cieśla Izabela , Kluczewska Ewa , Koszutski Tomasz , Wiktor Łukasz
Published: August 2020

Purpose

Managing anterior cruciate ligament (ACL) injuries in skeletally immature patients remains difficult. The main aim of this study was to retrospectively compile normative data on the cross-sectional area (CSA) of the semitendinosus tendon (ST) and the diameter of the ACL in children and young adults.

Methods

Knee magnetic resonance imaging (MRI) examinations were performed for a 2-year period in 132 patients (83 female and 49 male patients). The mean age was 14.9 years (8–18 years). Measurements of the ST CSA were performed on axial views in greyscale by two independent researchers. The ACL diameter was measured as well.

Results

The results show the CSA of the ST was related to age, and its growth was not linear. The highest growth rate of the CSA of the ST occurred at age 12–13 at the level of the femoral growth plate and at the level of the tibial plateau. The growth of the ACL diameter was linear until 18 years of age.

Conclusions

ST growth (measured in CSA increments) is almost complete at the age of 13, even though the growth is not linear. ACL growth measured in diameter increments proceeds linearly from 8 to 18 years of age. MRI is a clinically useful tool for assessing hamstring tendon grafts preoperatively.

Level of evidence

Level III, diagnostic studies
Bilateral-pectoral major muscle advancement flap combined with vacuum-assisted closure therapy for the treatment of deep sternal wound infections after cardiac surgery
Authors: Song Feng , Liu Zhenzhong
Published: August 2020

Objectives

The median sternotomy is the most common surgical approach for cardiac surgery. Deep sternal wound infection is a fatal complication after median sternotomy. The aim of this study was to evaluate the therapeutic effect of Bilateral-pectoral major muscle advancement flap combined with Vacuum-assisted closure therapy on rehabilitation for the treatment of deep sternal wound infection after cardiac surgery.

Methods

Between January 2016 to January 2018, 21 patients (10 males, 11 females) with deep sternal wound infection after cardiac surgery underwent Bilateral-pectoral major muscle advancement flap combined with Vacuum-assisted closure therapy. These patients were followed-up 12 months postoperative. The patient characteristics, duration of vacuum-assisted closure therapy, the mean hospital stay, postoperative complications, long-term survival of patients were retrospectively analyzed.

Results

Most patients undergone 1–3 times vacuum-assisted closure treatment sessions before closure. All patients were cured to discharge, the mean hospital stay was 21.1 days. Most patients’ healing wounds were first-stage healing, only one patient’s wound was second-stage healing, none was third-stage healing. One patient developed pulmonary infection and respiratory failure during the 12-month follow-up. None of the patients died during follow-up.

Conclusions

Bilateral-pectoral major muscle advancement flap combined with Vacuum-assisted closure therapy for the treatment of deep sternal wound infections after cardiac surgery can shorten the hospital stays and few complications. However, this is a retrospective case series presentation with no comparison group, the number of inferences is limited, so further large-scale controlled studies are needed.
Health-related publications on people living in fragile states in the alert zone: a bibliometric analysis
Authors: Sweileh Waleed M.
Published: August 2020

Background

Fragile states pose a global challenge. Assessing health research activity on people living in these states can help identify neglected health domains in fragile settings. The objective of the current study was to assess and describe health research activity on people living in fragile states in the alert zone.

Method

A bibliometric method was applied using SciVerse Scopus. Research articles published on people in fragile states in the alert zone were retrieved and analyzed. The Fragile State Index (FSI) score was used for selection of states in the alert zone. The analysis was limited to 1 year; 2018.

Results

The search query found 2299 research articles giving an average of 2 research articles per one million population per year in the selected fragile states. The number of research articles per one million population was not significantly correlated (p = 0.053; r = − 0.349) with FSI scores. However, it was significantly correlated with the extent of international research collaboration (p < 0.01, r = 065). Research on communicable diseases was the largest research domain (763 articles; 33.2%) followed by maternal/women’s health (430 articles; 18.7%), non-communicable diseases (291 articles; 12.7%), health system/policy (271 articles; 11.8%) and psychosocial and mental health (89; 3.9%). There were three research themes in the research domain of infectious diseases: HIV/AIDS; water-borne infectious diseases; and miscellaneous infectious diseases such as tuberculosis and malaria. The top ten cited articles were mainly on infectious diseases, particularly on malaria and Lassa fever. Of all the retrieved documents, 727 (31.6%) research articles appeared in national/regional journals while the remaining appeared in international journals. The World Health organization was the most active funding organization for research on fragile states. Top ten active institutions were mainly based in fragile states with the lowest FSI score, specifically Ethiopia, Uganda, Nigeria, and Pakistan.

Conclusion

Research on fragile states was relatively low. Research on mental health and health system/policy should be encouraged. Collaboration and funding might help academic institutions in fragile states to make health problems in these countries more visible.
Optimized polymer-based glucose release in microtiter plates for small-scale E. coli fed-batch cultivations
Authors: Keil Timm , Dittrich Barbara , Lattermann Clemens , Büchs Jochen
Published: August 2020

Background

Small-scale cultivation vessels, which allow fed-batch operation mode, become more and more important for fast and reliable early process development. Recently, the polymer-based feeding system was introduced to allow fed-batch conditions in microtiter plates. Maximum glucose release rates of 0.35 mg/h per well (48-well-plate) at 37 °C can be achieved with these plates, depending on the media properties. The fed-batch cultivation of fluorescent protein-expressingE. coliat oxygen transfer rate levels of 5 mmol/L/h proved to be superior compared to simple batch cultivations. However, literature suggests that higher glucose release rates than achieved with the currently available fed-batch microtiter plate are beneficial, especially for fast-growing microorganisms. During the fed-batch phase of the cultivation, a resulting oxygen transfer rate level of 28 mmol/L/h should be achieved.

Results

Customization of the polymer matrix enabled a considerable increase in the glucose release rate of more than 250% to up to 0.90 mg/h per well. Therefore, the molecular weight of the prepolymer and the addition of a hydrophilic PDMS-PEG copolymer allowed for the individual adjustment of a targeted glucose release rate. The newly developed polymer matrix was additionally invariant to medium properties like the osmotic concentration or the pH-value. The glucose release rate of the optimized matrix was constant in various synthetic and complex media. Fed-batch cultivations ofE. coliin microtiter plates with the optimized matrix revealed elevated oxygen transfer rates during the fed-batch phase of approximately 28 mmol/L/h. However, these increased glucose release rates resulted in a prolonged initial batch phase and oxygen limitations. The newly developed polymer-based feeding system provides options to manufacture individual feed rates in a range from 0.24–0.90 mg/h per well.

Conclusions

The optimized polymer-based fed-batch microtiter plate allows higher reproducibility of fed-batch experiments since cultivation media properties have almost no influence on the release rate. The adjustment of individual feeding rates in a wide range supports the early process development for slow, average and fast-growing microorganisms in microtiter plates. The study underlines the importance of a detailed understanding of the metabolic behavior (through online monitoring techniques) to identify optimal feed rates.
Membranous aplasia cutis congenita in trisomy 18
Authors: Cammarata-Scalisi Francisco , Diociaiuti Andrea , de Guerrero Blanca , Willoughby Colin Eric , Callea Michele
Published: August 2020

Background

Aplasia cutis congenita (ACC) is a rare congenital condition characterized by the absence of skin layers and sometimes other underlying structures, in a localized or widespread area. The exact etiopathogenesis is not yet completely understood. Membranous ACC (MACC) also described as bullous or cystic ACC is a clinical subtype of ACC, covered with a membranous or glistening surface, and appears as a flat scar. There are less than 20 cases reported in the literature. It has been proposed an abortive form of a defective closure of the neural tube. On the other hand, the trisomy 18 is a chromosomal abnormality characterized by a broad clinical spectrum and the presence of defective closure of the neural tube.

Case presentation

We report on an 18-months-old Venezuelan boy, who presented on the parietal scalp a distinctive localized MACC appearing as an oval lesion covered with a membranous surface, characterized by the absence of hairs and the presence of a sharp hair collar. The karyotype in peripheral blood was 47,XY,+ 18.

Conclusions

This is the second case report of ACC in trisomy 18 and reinforces the interpretation of a non-fortuitous association as well as of a defective closure of the neural tube as pathogenetic mechanism. The case highlights the importance of examining for dermatological alterations such as ACC in cases of chromosomopathy.
Kawasaki disease epidemic: pitfalls
Authors: Gallizzi Romina , Corsello Giovanni , Pajno Giovanni Battista
Published: August 2020

Recent reports have described in the pediatric population a new type of hyperinflammatory response manifested following contact with SARS-CoV-2, with some of the clinical features attributable to Kawasaki disease (KD). The purpose of this commentary is to remark on a possible recent association between SARS-CoV-2 and KD. Although today little is known about the etiology of KD, the most accepted hypothesis is that of a probable viral etiology, therefore, even the SARS-CoV-2 virus could trigger, in genetically predisposed subjects, an exaggerated inflammatory response that is clinically evident like the one described in KD.
Hydroxychloroquine for post-exposure prophylaxis of COVID-19 among naval personnel in Sri Lanka: study protocol for a randomized, controlled trial
Authors: Niriella Madunil A. , Ediriweera Dileepa S. , De Silva Arjuna P. , Premarathne Ranjan , Balasooriya Priyantha , Duminda Kaluthanthri D. , Malavige Neelika G. , Wanigasuriya Kamani , Lekamwasam Sarath , Kularathne Senanayake A. , Siribaddana Sisira , de Silva Hithanadura J. , Jayasinghe Saroj
Published: August 2020

Background

The first case of a coronavirus 2019 (COVID-19) infection in a Sri Lankan was reported on March 11, 2020. The situation in Sri Lanka changed with the rapid increase of personnel contracting COVID-19 in a naval base camp that housed more than 4000 people. This provided a unique opportunity to study the effectiveness of hydroxychloroquine (HCQ) for post-exposure prophylaxis (PEP), while taking stringent, non-pharmacologic, public health measures to prevent spread. Our aim is to study the effectiveness and safety of HCQ for PEP among naval personnel with exposure to COVID-19-positive patients.

Methods/design

This is a placebo-controlled, randomized, clinical trial carried out in the naval base camp and quarantine centers of the Sri Lanka Navy, Ministry of Defense, Sri Lanka. Navy personnel who are exposed to a patient with confirmed COVID-19 infection but test negative for the virus on reverse real-time polymerase chain reaction (rRT-PCR) at recruitment will be randomized, 200 to each arm, to receive HCQ or placebo and monitored for the development of symptoms or rRT-PCR positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus for 14 days.

Discussion

This trial will provide high-quality evidence of the effectiveness and safety of HCQ as PEP for COVID-19. The study design is unique due to the circumstances of the outbreak in a confined area among otherwise healthy adults, at a relatively early stage of its spread.

Trial registration

Sri Lanka Clinical Trials Registry (SLCTR) SLCTR/2020/011. Registered on 04 May 2020
Hepatocyte paraffin 1 and arginase-1 are effective panel of markers in HBV-related HCC diagnosis in fine-needle aspiration specimens
Authors: Moudi Bita , Mahmoudzadeh-Sagheb Hamidreza , Heidari Zahra
Published: August 2020

Objective

In order to make successful treatment for HBV-related hepatocellular carcinoma, an early diagnosis is necessary. In this research we aimed to evaluate the IHC staining pattern of Hepatocyte paraffin 1 and arginase-1 and their performance in early diagnosis of HCC. The incidence of HepPar-1 and Arg-1 were evaluated by IHC in 121 patients (HBV, HCC, HBV + HCC) and 30 healthy subjects.

Results

Arg-1 had significantly increased sensitivity in identification of HBV + HCC patients compared to HepPar-1 (P < 0.001). The sensitivity of arginase-1 is 96.3% whereas, the sensitivity of HepPar-1 is 72.7%. Arg-1 had higher specificity in identification of HBV + HCC patients compared to HepPar-1 (P < 0.05). With one positive marker, the sensitivity, the specificity and the positive predictive values and negative predictive value were 84.3%, 82.4%, 88.6% and 85.4% respectively. Also with one positive marker, the sensitivity and negative predictive value were significantly higher compared to the both 2 positive combinations. It was concluded that Arg-1 can improves the ability to detect HBV + HCC patients when compared with HepPar-1. When, both markers being positive, the specificity and PPVs of this combination were fairly higher. Concurrent use of these two proteins may be one of the best HCC detection patterns in needle specimens.
Potential of termite mounds and its surrounding soils as soil amendments in smallholder farms in central Uganda
Authors: Apori Samuel Obeng , Murongo Marius , Hanyabui Emmanuel , Atiah Kofi , Byalebeka John
Published: August 2020

Objectives

The low fertility of highly weathered soils has been a major problem for resource-constrained smallholder farmers. In central Uganda, smallholder farmers have been collecting termite mound soils anywhere around the termite mound to improve their soil fertility. However, no studies have been conducted on which sections of the termite mounds consist of high soil nutrients. This study was conducted to assess selected major soil essential plant nutrients of soils collected from the top of the mound (TPMS), and the basal part of the mound (BPMS). The surrounding soil samples were collected from five, fifteen, and thirty meters away from the mound (TMSS1, TMSS2, and TMSS3 respectively), covering ten termite mounds in five different maize fields in central Uganda.

Results

TPMS and BPMS had significant (P-value < 0.05) higher N, P, K, OC, Ca and Mg levels than TMSS1, TMSS2, and TMSS3. However, OC levels in BPMS was higher than TPMS. On the whole, termite mounds are beneficial as a source for essential plant nutrients. It will be best if smallholder farmers could collect the termite mound soils from the top and the basal part of the mound to improve the fertility of their soil.
Urinary cytology: a potential tool for differential diagnosis of acute kidney injury in patients with nephrotic syndrome
Authors: de Melo Caroline Vilas Boas , Tavares Maria Brandão , Fernandes Paula Neves , dos Santos Silva Carlos Alberto , Couto Ricardo David , Oliveira Marília Bahiense , dos-Santos Washington L. C.
Published: August 2020

Objective

Acute tubular necrosis (ATN) is a frequent cause of acute kidney injury (AKI). In patients with nephrotic syndrome (NS), AKI demands the differential diagnosis between ATN and rapidly progressive glomerulonephritis. In some cases, conclusive diagnosis is possible only by kidney biopsy. We aimed to study the potential use of urine cytology in the differential diagnosis between ATN and proliferative glomerular lesion in patients with NS.

Results

Cell size analysis showed a higher proportion of small cells and a lower proportion of large cells in the urine of patients with AKI. Cells phenotypes were easily defined using cytological preparations. Leukocytes were found to be a primary classifier of NS groups, with higher number in patients with AKI and patients with proliferative glomerular lesions. Although renal biopsy is still required for confirmative diagnosis, our data suggests that urinary cytology can be readily performed and support the differential diagnosis between proliferative glomerular lesion and ATN in patients with NS and AKI.
NLRP3 played a role in Trichinella spiralis-triggered Th2 and regulatory T cells response
Authors: Jin Xuemin , Bai Xue , Yang Yong , Ding Jing , Shi Haining , Fu Baoquan , Boireau Pascal , Liu Mingyuan , Liu Xiaolei
Published: August 2020

Trichinella spiralis maintains chronic infections within its host. Muscle larvae excretory-secretory products (MLES) typically induce parasite-specific immune responses such as the Th2 response and regulatory T cells (Tregs) by modulating dendritic cell (DC) phenotype via the recognition of pattern recognition receptors (PRRs), such as Nod-like receptors (NLRs). We aimed to investigate the role of NLRP3 in T. spiralis-triggered immune response. We found that larvae burden was increased in NLRP3−/− mice compared to wild type (WT) mice. Administration of MLES induced higher levels of IL-4, IL-10, TGF-β and population of Tregs in WT mice than in NLRP3−/− mice. In vitro, we showed that increased expression of CD40 on the surface of MLES-treated DCs was inhibited after NLRP3 knockout. Increased production of IL-1β, IL-18, IL-10 and TGF-β, but not IL-12p70, was significantly diminished in the absence of NLRP3. Furthermore, our results demonstrated that MLES-treated DCs induced higher levels of IL-4, IL-10 and TGF-β and populations of Tregs in vitro. These inductions were abolished by NLRP3 deficiency in DCs, suggesting that NLRP3 in MLES-treated DCs plays a role in promoting the Th2 and Treg response. Taken together, we identified for the first time the involvement of NLRP3 in host defences against T. spiralis.
Research on simulation technology of wireless sensor in swimming mechanics
Authors: Xu Zhiwen
Published: August 2020

In order to improve the quantitative teaching level of swimming sports, it is necessary to carry out quantitative analysis of swimming sports mechanics. A method of swimming mechanics analysis based on computer simulation technology is proposed. The ARMA model is used to analyze the mechanics of the limb movement of swimming, the Lagrange dynamics model is used to model the characteristics of the mechanics of swimming movement, and the distributed characteristic parameter model of the dynamics of swimming is analyzed in the space of six degrees of freedom. The dynamic distribution space of swimming motion is obtained by using the forward kinematics analysis model, and the inverse kinematics of multiple degrees of freedom is solved by analytic method, and the global and local joint force and force parameters in swimming are estimated. The model of swimming mechanics is realized. The simulation results show that the proposed method is accurate and accurate in estimating the mechanical parameters of swimming movement, and it can effectively guide swimming training.
Existence and multiplicity of positive solutions to a system of fractional difference equations with parameters
Authors: Siricharuanun Pimchana , Chasreechai Saowaluck , Sitthiwirattham Thanin
Published: August 2020

We consider a fractional difference-sum boundary problem for a system of fractional difference equations with parameters. Using the Banach fixed point theorem, we prove the existence and uniqueness of solutions. We also prove the existence of at least one and two solutions by using the Krasnoselskii’s fixed point theorem for a cone map. Finally, we give some examples to illustrate our results.
Dynamics of a stochastic eutrophication-chemostat model with impulsive dredging and pulse inputting on environmental toxicant
Authors: Jiao Jianjun , Li Qiuhua
Published: August 2020

In this paper, we present a stochastic eutrophication-chemostat model with impulsive dredging and pulse inputting on environmental toxicant. The sufficient condition for the extinction of microorganisms is obtained. The sufficient condition for the investigated system with unique ergodic stationary distribution is also obtained. The results show that the stochastic noise, impulsive dredging, and pulse input on the environmental toxicant play important roles in the extinction of microorganisms. The results also indicate the effective and reliable controlling strategy for water resource management. Finally, numerical simulations are employed to illustrate our results.
Extension of generalized Fox’s H-function operator to certain set of generalized integrable functions
Authors: Al-Omari Shrideh Khalaf
Published: August 2020

In this article, we investigate the so-called Inayat integral operator $T_{p,q}^{m,n}$

T

p
,
q

m
,
n

, $p,q,m,n\in \mathbb{Z}$
p
,
q
,
m
,
n
∈
Z
, $1\leq m\leq q$
1
≤
m
≤
q
, $0\leq n\leq p $
0
≤
n
≤
p
, on classes of generalized integrable functions. We make use of the Mellin-type convolution product and produce a concurrent convolution product, which, taken together, establishes the Inayat integral convolution theorem. The Inayat convolution theorem and a class of delta sequences were derived and employed for constructing sequence spaces of Boehmians. Moreover, by the aid of the concept of quotients of sequences, we present a generalization of the Inayat integral operator in the context of Boehmians. Various results related to the generalized integral operator and its inversion formula are also derived.
Technology-supported management education: a systematic review of antecedents of learning effectiveness
Authors: Müller Fabian Alexander , Wulf Torsten
Published: August 2020

This paper provides a systematic, multidisciplinary review of antecedents of the effectiveness of technology-supported management learning and highlights potential directions for future research. Passive knowledge acquisition in physical classrooms is no longer the hallmark of higher education. Instead, the introduction of new technologies allows for active knowledge construction in increasingly virtual spaces. Such changes in the learning environment affect the education of the managers of tomorrow. Nevertheless, research on technology-supported management learning and its implications for management educators is fragmented and inconsistent across research areas. This paper uses a systematic approach to structure and integrate results from the fields of educational psychology, educational technology, higher education, and management education. This allows us to derive a comprehensive overview of the antecedents of the effectiveness of technology-supported management learning from the various disciplines. Our work reveals several areas that require further investigation, including: (i) the best way to blend and flip formats for different management disciplines and content types, (ii) the selection, design, and richness of the technologies used, (iii) the instructor’s teaching style, including feedback and deliberate confusion, and (iv) learners’ affective states, such as their motivations and emotions, and the role of prior knowledge.
Zebrafish as a prodigious tool in neuropsychiatric research
Authors: Durairaj Brindha , Dhanabal Madhumitha
Published: August 2020

Background

The zebrafish is the system of choice in developmental biology and genetics in the recent years. Zebrafish genetics is improving, and this opens up new ways to understand genetic mechanisms. The zebrafish (Danio rerio) is used for investigation of developmental pathways and neurobiology because of its progression and physiological resemblance to humans. This species strikes stability between the sophistication as a vertebrate and its ease to be used as a model organism. In addition to this, the optical transparency of the developing fish together with novel imaging techniques enables a potent visualization of complex mechanisms at the level of the whole organism.

Methods

This review comprises information regarding zebrafish and its potent use as a model organism to study neurological disorders. The literature was collected from articles published in MEDLINE, SCOPUS, and PUBMED from 1974 to 2018.

Results

This review highlights the applications of Danio rerio in major neuropsychiatric disorders. It paves way to understand the biochemical and molecular pathways that infer in the neuropsychiatric disorders.

Conclusion

The present review discuss the significance of zebrafish as an animal model to study neurological disorders and to demonstrate the behavioural features observed which may be a precursor of a new loom for drug development.
An intimate view into the silica deposition vesicles of diatoms
Authors: Heintze Christoph , Formanek Petr , Pohl Darius , Hauptstein Jannes , Rellinghaus Bernd , Kröger Nils
Published: August 2020

Diatoms are single-celled microalgae that produce silica-based cell walls with intricate nano- and micropatterns. Biogenesis of diatom biosilica is a bottom-up process that occurs in large intracellular compartments termed silica deposition vesicles (SDVs). Investigating the mechanisms of silica morphogenesis has so far been severely limited by the lack of methods for imaging the entire volume of an SDV with high spatial resolution during all stages of development. Here we have developed a method that allows for rapid identification and electron microscopy imaging of many different, full sized SDVs that are in the process of producing biosilica valves. This enabled visualizing the development of characteristic morphological biosilica features with unprecedented spatio-temporal resolution. During early to mid-term development, valve SDVs contained ~ 20 nm sized particles that were primarily associated with the radially expanding rib-like biosilica structures. The results from electron dispersive X-ray analysis suggests that the immature biosilica patterns are silica-organic composites. This supports the hypothesis that silica morphogenesis is dependent on organic biomolecules inside the SDV lumen.
COVID-19 pandemic and total knee arthroplasty: the concept of a containment sheet—a frugal innovation
Authors: Shah Vikram Indrajit , Upadhyay Sachin , Shah Kalpesh , Singh Vipin
Published: August 2020

Background

The primary purpose of the present study was to assess whether use of proposed containment sheet (so called “a frugal innovation”) minimizes the aerosol and splatter dispersion during total knee arthroplasty (TKA).

Material and method

A total of 32 patients with knee osteoarthritis who were scheduled to undergo primary and unilateral TKA reported during the COVID-19 pandemic were enrolled into this prospective single-institution cohort study. Demographic and epidemiological data, travel and contact history were collected. Eligible cohort was randomly assigned to a study (TKA using containment sheet) group and a control group (TKA without containment sheet). Radiological and functional outcomes before operation and at the final follow-up were assessed using Western Ontario and Mc-master Universities Osteoarthritis Index score (WOMAC) and the visual analog scale (VAS). The primary outcome was the postoperative effectiveness of containment sheet and face shield, defined as the numbers of countable macroscopic aerosols and/or splatters to naked eyes. The level of significance was set at p < 0.05 levels.

Results

Present cohort was comprised of 14 men (43.75%) and 18 women (56.25%) with an average age of 65.45 ± 4.07 years (range, 62–75 years). There were no statistically significant differences with regard to baseline parameters and perioperative demographics. Functional outcomes for knee function at the last follow-up showed significant improvement in both the groups (p < 0.05). Face shield showed significant number of aerosols/splatters in control group. Highest number/concentration of aerosols/splatters was contained within the sheet.

Conclusion

The proposed containment sheet can minimize the dispersion of aerosols and splatters generated during TKA and provide a safe healthcare environment in a cost-effective manner.