bluuebunny/crossref_metadata_2025 huggingface dataset:
Percutaneous Fixation of Unstable Proximal Phalanx Fractures: A Biomechanical Study
Authors: Nikci Valdet , Effiong Linda , Freibott Christina E. , Gardner Thomas R. , Strauch Robert J.
Published: June 2021

Background

Unstable extra-articular proximal phalanx fractures are common injuries to the hand that are often treated by closed reduction and percutaneous pinning. Fracture-induced shortening of the proximal phalanx leads to an extensor lag at the proximal interphalangeal joint. We describe a biomechanical study in cadaver hands to compare the ability of each of three different pin configurations to resist shortening in unstable fractures.

Methods

Seventeen fresh frozen hands were disarticulated at the proximal ends of the metacarpals. The second, third, and fourth proximal phalanges were tested. A 5-mm section of bone was resected from the mid-shaft of proximal phalanx to simulate an unstable fracture. Three techniques were employed and randomized for each finger: transmetacarpophalangeal joint pinning using 1 or 2 Kirschner wires (K-wires) and periarticular cross pinning using 2 K-wires. Compressive axial loads and energy at 1 mm, 2 mm, 3 mm, 4 mm, and 5 mm of subsidence were examined.

Results

The forces and energy required to shorten the finger for each amount of subsidence were similar for all 3 pinning techniques and for all 3 finger types. Greater amounts of shortening were found to require larger forces.

Conclusion

Closed reduction and percutaneous pinning using any of the presented techniques is an adequate method of treatment for unstable proximal phalanx fractures. All of the techniques were equivalent in their ability to resist axial loading, regardless of the complexity of technique, the number of pins used, or finger that was pinned.
Our clinical experiences of vascular injuries due to lumbar disc surgeries
Authors: Kaygin Mehmet Ali , Halici Umit
Published: June 2021

Objectives

We aimed to evaluate emergency vascular complications of the lumbar disc reconstructive surgery in this study.

Method

Between March 2006 and February 2020, nine patients (six males and three females; mean age: 53.4 ± 9.6 years; range: 38–64 years) who underwent emergent vascular intervention during lumbar spinal disc reconstructive surgery in our clinic were included in this retrospective study.

Result

The left common iliac artery injury, the left common iliac artery and left common iliac vein injuries, bilateral common iliac artery and abdominal aortic injuries, and vena cava inferior injury with left common iliac vein and right common iliac vein injuries were detected in two, three, two, and two patients, respectively. In addition, 16 mm Dacron tube graft interposition and graft patch plasty were performed in one and two patients who had an abdominal aortic injury, respectively. Also, 8 mm polytetrafluoroethylene straight graft interposition was performed in two patients with left common iliac artery injury, and lateral wall repair was performed in other patients. Graft patch plasty and 8 mm polytetrafluoroethylene graft interposition were performed in one patient with vena cava inferior injury and left common iliac vein injury, respectively. Also, lateral wall repair was performed in other patients with venous injuries. Deep venous thrombosis had developed in three patients, and one patient of these had a pulmonary embolism.

Conclusion

The incidence of vascular injury after the lumbar disc surgery is relatively low; however, the emergency vascular operation should be performed as soon as possible.
Hypertension: Diagnosis and management in primary care
Authors: Afroze Ayesha , Mohammed Imran
Published: June 2021

The global prevalence of hypertension is high and continues to rise, making it an increasingly common condition managed in primary care. Untreated hypertension can cause end-organ damage leading to complications that increase morbidity and mortality from cardiac, renal, and cerebrovascular disease. Hypertension can significantly affect an individual patient’s quality of life and can cause a considerable strain on the healthcare system. If hypertension is detected early, these events are avoidable, as there is an opportunity for intervention at a much lesser cost. Several proven, highly effective, and well-tolerated lifestyle and drug treatment strategies can achieve reduction in blood pressure. The aim of this article is to illustrate evidence-based steps that are applicable in the diagnosis and management of hypertension in primary care.
Haematospermia
Authors: Simpson Richard , Chow Karyee
Published: June 2021

Haematospermia is the presence of blood in the ejaculate. Noticing blood within the ejaculate can cause men great anxiety. In the majority of cases, the aetiology is benign with a self-limiting course. For a small proportion of men, haematospermia can indicate malignancy, so a thorough work up of certain cohorts is necessary. This article will discuss the initial investigation in primary care, when and which men to refer, and provide further evidence for GPs to counsel and reassure patients.
Urethral polyembolokoilamania: not a bread-and-butter issue
Authors: John Jeff , Kesner Ken
Published: June 2021

Urethral polyembolokoilamania, the self-insertion of a foreign body into the male urethra for sexual gratification and autoerotism, is an uncommon urological emergency with potentially severe consequences. We present the case of a 27-year-old male who presented to our emergency unit after apparently sustaining a penile injury during sexual intercourse. Clinically, a foreign body was thought to be palpable, extending from the mid-shaft of the penis to the penoscrotal junction. Pelvic X-rays confirmed a radiopaque penile foreign body in the region of the anterior urethra. Cystoscopy confirmed the presence of an encrusted foreign body in the anterior urethra. It noted that the surrounding mucosa was very inflamed with areas of necrosis, suggesting that the foreign body had been present in the urethra for some time. To avoid further urethral trauma, we approached the foreign body via an external urethrotomy and removed a plastic knife in three parts. The urethra was repaired over a 16F catheter. The patient had an uneventful postoperative course, and a peri-catheter urethrogram 6 weeks after the procedure showed no signs of contrast extravasation or urethral stricture.
Why do citizens (not) support democratic innovations? The role of instrumental motivations in support for participatory budgeting
Authors: van der Does Ramon , Kantorowicz Jaroslaw
Published: June 2021

Why do citizens (not) support democratic innovations? Existing research shows that citizens mostly support such new ways of involving citizens in policy-making for instrumental reasons: the more a democratic innovation leads to outcomes they favour, the more likely they are to express support for it. However, it remains ambiguous why citizens care so much about favourable outcomes. This study disentangles the effect of outcome favourability on support for democratic innovations by testing two mechanisms: self-interest and sociotropy. It relies on three survey experiments on Dutch citizens’ support for a local democratic innovation (participatory budgeting) ( N = 2,491). The results confirm that outcome favourability is important in explaining citizens’ support for participatory budgets (Study 1). We find evidence for both self-interest (Study 2) and sociotropy (Study 3) as drivers of the effect and present preliminary evidence that self-interest may trump sociotropy in citizens’ evaluations of democratic innovations.
Capitalizing on Game Theory for Optimal Marketing Decision in Service Industry: Evidence From Telecommunication Industry in Nigeria
Authors: Oreagba Oluwakemi T. , Ogunnaike Olaleke O. , Kehinde Oladele J.
Published: June 2021

This article aims to capitalize on game theoretic techniques for optimal service marketing decision based on existing literature review. The study collated relevant literature and reviewed the relationship that exists between game theory and marketing mix—product, price, place, and promotion within the Telecommunication industry. Using the game theory techniques—prisoner’s dilemma, Cournot model, Bertrand model, quasi-game model, Stackelberg model for making marketing decisions—the article shows that there is a consensus among scholars that game theoretic techniques facilitate product, pricing, promotion, and distribution decision in the service industry. In addition, an integrated marketing mix model was developed to support this study.
Reemployment Needs and Barriers of Users of Workforce Development Programs: A Mixed-Methods Study
Authors: Madigan Dana , Bonney Tessa
Published: June 2021

Background:

Employment is an important social determinant of health, and supporting individuals’ return to the workforce is likely to have robust impacts on their health and well-being. The aim of this study was to identify (a) the self-perceived employment needs and expectations of users of community employment services; (b) the assets, needs, and barriers to reemployment among users of community employment services; and (c) areas of priority for programmatic development, including implications for patient–worker needs assessment and care coordination in clinical settings.

Methods:

We conducted structured interviews with 71 adults recruited from three workforce development programs located in the Chicago metropolitan area serving vulnerable workers. Topics of discussion included job histories, financial and social assets, and the respondents’ motivation and expectations for their return to the workforce. We used descriptive statistics to analyze quantitative responses and performed content analysis for qualitative data.

Findings:

Users reported discrimination, legal barriers, family responsibilities, physical or mental health concerns, and needs related to transportation and housing as common challenges to reemployment. Concerns regarding navigating complex social support programs to meet individual and family needs, as well as uncertainty regarding what would qualify as sufficient employment in order to not be reliant on these programs in the future, were expressed.

Conclusion/Application to practice:

Health care providers have opportunities to identify those that may benefit from comprehensive referrals to reemployment programs and social services. Occupational health providers are also in a unique position to enhance workforce development programs through collaborations to better educate and support workers.
Smoking is associated with prolonged time of the return to daily and sport activities and decreased knee function after meniscus repair with outside-in technique: Retrospective cohort study
Authors: Domzalski Marcin , Muszynski Krystian , Mostowy Marcin , Wojtowicz Julia , Garlinska Anna
Published: June 2021

Background:

Arthroscopic repair of post-traumatic meniscal lesion is one of the most common procedures in the orthopedics. Although algorithm of the treatment of meniscal lesion, this procedure is rarely discussed in combination with smoking as a risk factor for the meniscal healing.

Purpose:

The aim of this study was to assess the knee function, and the amount of time needed to return to daily and sport activities after the non-bucket-handle meniscal outside-in repair depending on Tobacco use.

Methods:

Retrospective chart review identified 99 patients after isolated outside-in meniscal repair within a series of 292 consecutive patients who underwent meniscus repair during a 3 years period. Ninety-two patients were available for follow-up and were divided into smokers and non-smokers group. Demographic data were collected from their medical records which included: age and body mass index, gender, side of index knee, duration of symptoms prior to surgery, meniscal involvement. At the time of the minimum 2 years follow-up examination: KOOS, time of the return to daily activities, time of the return to sport activities, and Tegner scale were collected.

Results:

The smoking and non-smoking groups were similar in age, sex, BMI, side, meniscus involved, Tegner scale, and duration of symptoms. Smokers population was 3.5 years older on average. The knee function was significantly better in non-smokers group with average KOOS score 80.2 vs 67.4 in smokers group. In smokers population delayed time of return to daily activities (5.4 vs 4.2 months) and prolonged time of the return to sport activities (9.4 vs 7.6 months) were observed.

Conclusions:

Smoking is associated with significantly prolonged time of the return to daily and sport activities and decreased knee function after meniscus repair with outside-in technique. Level of evidence: III
Contemporary Socio-Economic Challenges and Legal Intervention to Nomadic Tribal Community: A Case Study of Nomadic Prisoners in Bihar
Authors: Kumar Praveen
Published: June 2021

Nomadic, de-notified and semi-nomadic tribes are considered to be the earliest inhabitants of any nation. Their sacrifices and sufferings in the past and present have resulted in a developing nation that we are today. Despite that, today, the nomadic tribal communities are the worst sufferers because of the lack of education, livelihood, occupation, fundamental rights, legal rights,etc.; they are considered to be the least developed. Failure in implementing the framework and crooked legislations had harvested their souls for our own selfish needs, and incarcerated the nomadic tribal community without providing them access to free legal aid service endeavouring for due justice. The present study broadly scrutinises these issues, problems and their ill effects because of which these communities are facing a lot of challenges and are unable to secure justice.
Tolerating subretinal fluid in the treatment of neovascular age-related macular degeneration with intravitreal aflibercept
Authors: Yildiz Dilan , Cakir Akin , Erden Burak , Bolukbasi Selim , Erdenöz Serkan , Elcioglu Mustafa Nuri
Published: June 2021

Objective:

To compare the anatomical and functional outcomes of intensive and relaxed intravitreal aflibercept regimen in the management of neovascular age-related macular degeneration.

Methods:

The medical records of 50 eyes of 50 patients with treatment-naive neovascular age-related macular degeneration, who underwent intravitreal aflibercept therapy in the Retinal Department of University of Health Sciences Okmeydanı Training and Research Hospital (Istanbul, Turkey), were retrospectively reviewed. The demographic features and best-corrected visual acuities at baseline and at 1st-, 2nd-, 3rd-, 4th-, 6th-, 10th- and 12th- months, optical coherence tomography measurements, presence of intraretinal fluid, subretinal fluid and intraocular pressure values were studied. The patients were divided into two groups: intensive (subretinal fluid intolerant) and relaxed (<200 microns subretinal fluid tolerated) intravitreal aflibercept regimens.

Results:

The change in the mean best-corrected visual acuities from baseline to 12th month was 13.72 ± 33.97 letters in the intensive treatment group and 8.68 ± 27.22 in the relaxed group. There was no statistically significant difference between the groups ( p = 0.566). Similar proportions of both groups achieved ⩾10 letters gain (%48 vs. %40, respectively; p = 0.755) and ⩾10 letters loss (%20 vs. %24, respectively; p = 0.755). The mean central subfield thickness values decreased statistically significantly in both groups ( p < 0.001). There was no statistically significant difference between the groups (442.40 ± 161.32 to 318.0 ± 63.10 vs. 431.64 ± 151.52 to 303.08 ± 140.91, respectively; p = 0.724). The mean total injection numbers were significantly lower in the relaxed group (6.4 ± 1.65 vs. 4.8 ± 1.45, respectively; p = 0.01).

Conclusion:

Relaxed intravitreal aflibercept regimen has comparable efficiency and safety outcomes at 12 months with intensive intravitreal aflibercept regimen with fewer injections in the management of neovascular age-related macular degeneration.
Genetic variation and population structure of clonal Zingiber zerumbet at a fine geographic scale: a comparison with two closely related selfing and outcrossing Zingiber species
Authors: Huang Rong , Wang Yu , Li Kuan , Wang Ying-Qiang
Published: June 2021

Background

There has always been controversy over whether clonal plants have lower genetic diversity than plants that reproduce sexually. These conflicts could be attributed to the fact that few studies have taken into account the mating system of sexually reproducing plants and their phylogenetic distance. Moreover, most clonal plants in these previous studies regularly produce sexual progeny. Here, we describe a study examining the levels of genetic diversity and differentiation within and between local populations of fully clonal Zingiber zerumbet at a microgeographical scale and compare the results with data for the closely related selfing Z. corallinum and outcrossing Z. nudicarpum. Such studies could disentangle the phylogenetic and sexually reproducing effect on genetic variation of clonal plants, and thus contribute to an improved understanding in the clonally reproducing effects on genetic diversity and population structure.

Results

The results revealed that the level of local population genetic diversity of clonal Z. zerumbet was comparable to that of outcrossing Z. nudicarpum and significantly higher than that of selfing Z. corallinum. However, the level of microgeographic genetic diversity of clonal Z. zerumbet is comparable to that of selfing Z. corallinum and even slightly higher than that of outcrossing Z. nudicarpum. The genetic differentiation among local populations of clonal Z. zerumbet was significantly lower than that of selfing Z. corallinum, but higher than that of outcrossing Z. nudicarpum. A stronger spatial genetic structure appeared within local populations of Z. zerumbet compared with selfing Z. corallinum and outcrossing Z. nudicarpum.

Conclusions

Our study shows that fully clonal plants are able not only to maintain a high level of within-population genetic diversity like outcrossing plants, but can also maintain a high level of microgeographic genetic diversity like selfing plant species, probably due to the accumulation of somatic mutations and absence of a capacity for sexual reproduction. We suggest that conservation strategies for the genetic diversity of clonal and selfing plant species should be focused on the protection of all habitat types, especially fragments within ecosystems, while maintenance of large populations is a key to enhance the genetic diversity of outcrossing species.
Increased whiB7 expression and antibiotic resistance in Mycobacterium chelonae carrying two prophages
Authors: Cushman Jaycee , Freeman Emma , McCallister Sarah , Schumann Anna , Hutchison Keith W. , Molloy Sally D.
Published: June 2021

Background

The global rise in the incidence of non-tuberculosis mycobacterial infections is of increasing concern due their high levels of intrinsic antibiotic resistance. Although integrated viral genomes, called prophage, are linked to increased antibiotic resistance in some bacterial species, we know little of their role in mycobacterial drug resistance.

Results

We present here for the first time, evidence of increased antibiotic resistance and expression of intrinsic antibiotic resistance genes in a strain of Mycobacterium chelonae carrying prophage. Strains carrying the prophage McProf demonstrated increased resistance to amikacin. Resistance in these strains was further enhanced by exposure to sub-inhibitory concentrations of the antibiotic, acivicin, or by the presence of a second prophage, BPs. Increased expression of the virulence gene, whiB7, was observed in strains carrying both prophages, BPs and McProf, relative to strains carrying a single prophage or no prophages.

Conclusions

This study provides evidence that prophage alter expression of important mycobacterial intrinsic antibiotic resistance genes and additionally offers insight into the role prophage may play in mycobacterial adaptation to stress.
The association of lipoprotein(a) and intraplaque neovascularization in patients with carotid stenosis: a retrospective study
Authors: Xia Shuang , Qiu Weida , Cai Anping , Kong Bo , Xu Lan , Wu Zejia , Li Liwen
Published: June 2021

Background

Lipoprotein(a) is genetically determined and increasingly recognized as a major risk factor for arteriosclerotic cardiovascular disease. We examined whether plasma lipoprotein(a) concentrations were associated with intraplaque neovascularization (IPN) grade in patients with carotid stenosis and in terms of increasing plaque susceptibility to haemorrhage and rupture.

Methods

We included 85 patients diagnosed with carotid stenosis as confirmed using carotid ultrasound who were treated at Guangdong General Hospital. Baseline data, including demographics, comorbid conditions and carotid ultrasonography, were recorded. The IPN grade was determined using contrast-enhanced ultrasound through the movement of the microbubbles. Univariate and multivariate binary logistic regression analyses were used to evaluate the association between lipoprotein(a) and IPN grade, with stepwise adjustment for covariates including age, sex, comorbid conditions and statin therapy (model 1), total cholesterol, triglyceride, low-density lipoprotein cholesterol calculated by Friedwald's formula, high-density lipoprotein cholesterol, apolipoprotein A and apolipoprotein B (model 2), maximum plaque thickness and total carotid maximum plaque thickness, degree of carotid stenosis and internal carotid artery (ICA) occlusion (model 3).

Results

Lipoprotein(a) was a significant predictor of higher IPN grade in binary logistic regression before adjusting for other risk factors (odds ratio [OR] 1.238, 95% confidence interval [CI] (1.020, 1.503), P = 0.031). After adjusting for other risk factors, lipoprotein(a) still remained statistically significant in predicting IPN grade in all model. (Model 1: OR 1.333, 95% CI 1.074, 1.655, P = 0.009; Model 2: OR 1.321, 95% CI 1.059, 1.648, P = 0.014; Model 3: OR 1.305, 95% CI 1.045, 1.628, P = 0.019). Lp(a) ≥ 300 mg/L is also significantly related to IPN compare to < 300 mg/L (OR 2.828, 95% CI 1.055, 7.580, P = 0.039) as well as in model 1, while in model 2 and model 3 there are not significant difference.

Conclusions

Plasma lipoprotein(a) concentrations were found to be independently associated with higher IPN grade in patients with carotid stenosis. Lowering plasma lipoprotein(a) levels may result in plaque stabilization by avoiding IPN formation.
Cancer risk in tuberculosis patients in a high endemic area
Authors: Chen Guang-Liang , Guo Li , Yang Shun’e , Ji Dong-Mei
Published: June 2021

Background

Tuberculosis (TB) may facilitate carcinogenesis. We performed a case-control study of the association between TB and cancer in Xinjiang, a high TB endemic area of China.

Methods

From January 2016 to December 2018, a total of 45,455 patients hospitalized in Xinjiang Cancer Hospital were consecutively enrolled and divided into a malignant tumor group (n = 32,539) and a benign tumor group (n = 12,916). Patients with active and previous TB before the diagnosis of cancer were retrospectively identified in the two groups.

Results

A significantly higher proportion of TB was found in the malignant tumor group (n = 1776, 5.46%) than in the control (benign tumor) group (n = 175, 1.35%) (p < 0.0001). The highest and lowest proportions of TB in the malignant group were in patients with non-Hodgkin’s lymphoma (16.74%) and thyroid cancer (0.77%), respectively. In multivariate analysis adjusting for age, sex, and ethnicity, TB remained an independent risk factor for all cancers (odds ratio (OR) 1.68; 95% confidence interval (CI) 1.43–1.97). Furthermore, TB was associated with a significantly higher risk of non-Hodgkin’s lymphoma, cervical cancer, esophageal cancer, “other” cancers, ovarian cancer, and breast cancer. Moreover, females with TB were more likely to develop cancer than males (p < 0.0001), except for esophageal cancer and lymphoma.

Conclusion

TB patients have an elevated cancer risk. A screening strategy for TB should be taken into consideration before treatment in patients with some cancer types that are associated with a high proportion of TB.
ERK activation via A1542/3 limonoids attenuates erythroleukemia through transcriptional stimulation of cholesterol biosynthesis genes
Authors: Yu Fang , Gajendran Babu , Wang Ning , Sample Klarke M. , Liu Wuling , Wang Chunlin , Hu Anling , Zacksenhaus Eldad , Hao Xiaojiang , Ben-David Yaacov
Published: June 2021

Background

Cholesterol plays vital roles in human physiology; abnormal levels have deleterious pathological consequences. In cancer, elevated or reduced expression of cholesterol biosynthesis is associated with good or poor prognosis, but the underlying mechanisms are largely unknown. The limonoid compounds A1542 and A1543 stimulate ERK/MAPK by direct binding, leading to leukemic cell death and suppression of leukemia in mouse models. In this study, we investigated the downstream consequences of these ERK/MAPK agonists in leukemic cells.

Methods

We employed RNAseq analysis combined with Q-RT-PCR, western blot and bioinformatics to identify and confirm genes whose expression was altered by A1542 and A1543 in leukemic cells. ShRNA lentiviruses were used to silence gene expression. Cell culture and an animal model (BALB/c) of erythroleukemia induced by Friend virus were utilized to validate effects of cholesterol on leukemia progression.

Results

RNAseq analysis of A1542-treated cells revealed the induction of all 18 genes implicated in cholesterol biosynthesis. Expression of these cholesterol genes was blocked by cedrelone, an ERK inhibitor. The cholesterol inhibitor lovastatin diminished ERK/MAPK activation by A1542, thereby reducing leukemic cell death induced by this ERK1/2 agonist. Growth inhibition by cholesterol was observed both at the intracellular level, and when orally administrated into a leukemic mouse model. Both HDL and LDL also suppressed leukemogenesis, implicating these lipids as important prognostic markers for leukemia progression. Mechanistically, knockdown experiments revealed that the activation of SREBP1/2 by A1542-A1543 was responsible for induction of only a sub-set of cholesterol biosynthesis genes. Induction of other regulatory factors by A1542-A1543 including EGR1, AP1 (FOS + JUN) LDLR, IER2 and others may cooperate with SREBP1/2 to induce cholesterol genes. Indeed, pharmacological inhibition of AP1 significantly inhibited cholesterol gene expression induced by A1542. In addition to leukemia, high expression of cholesterol biosynthesis genes was found to correlate with better prognosis in renal cancer.

Conclusions

This study demonstrates that ERK1/2 agonists suppress leukemia and possibly other types of cancer through transcriptional stimulation of cholesterol biosynthesis genes.
Surgical management of patent ductus arteriosus in pre-term infants - a british paediatric surveillance study
Authors: Warnock A. , Szatkowski L. , Lakshmanan A. , Lee L. , Kelsall W.
Published: June 2021

Background

This study aimed to provide UK data describing the incidence of patent ductus arteriosus (PDA) surgery in the neonatal population, including: pre-ligation management, and outcomes until discharge. We used British Paediatric Surveillance Unit (BPSU) methodology; collecting data via questionnaires for preterm neonates undergoing PDA ligation (PDAL) between 1st Sept 2012 – 30th Sept 2013. Infants born less than 37 weeks gestation, who underwent PDAL prior to discharge home, with no other structural cardiac abnormality, were included. Information collected included: patient demographics, pre and post-operative clinical characteristics, pre-operative medical management, post-operative complications and outcome.

Results

Over the study, 263 infants underwent PDAL an incidence of 3.07 per 10,000 live births. 88% were born extremely preterm (< 28 weeks) and 60% were male. The commonest reasons for ligation were inability to wean respiratory support (83.7%) and haemodynamically significant PDA (87.8%). Pre-operatively 65.7% received medical therapy. Surgery was performed at a median age of 33 days (range 9-260, IQR 24-48); the corrected age was less than 31 + 6 week in 50.6% babies at PDAL. Most, (90%), of procedures were open ligation; only 9 (3.4%) were catheter occlusions (PDACO). 20.5% of patients had post-operative complications. The 30-day mortality was 3%, with 93.5% surviving to hospital discharge.

Conclusion

This study showed there was little consensus over medical and surgical management of the PDA or timing of surgery.
Awareness and outcomes of the fruits and veggies (FNV) campaign to promote fruit and vegetable consumption among targeted audiences in California and Virginia: a cross-sectional study
Authors: Englund Tessa R. , Hedrick Valisa E. , Patiño Sofía Rincón-Gallardo , Kennedy Lauren E. , Hosig Kathryn W. , Serrano Elena L. , Kraak Vivica I.
Published: June 2021

Background

In 2015, the Partnership for a Healthier America launched the branded Fruits & Veggies (FNV) Campaign to apply a unique industry-inspired marketing approach to promote fruit and vegetable sales and intake to moms and teens in two US pilot markets: Fresno, California and Hampton Roads, Virginia. The aims of this cross-sectional study were to: 1) assess brand awareness and fruit- and vegetable-related outcomes among FNV Campaign target audiences in the California and Virginia market locations; and 2) examine whether reported awareness of the FNV Campaign was associated with differences in fruit- and vegetable-related cognitive and behavioral outcomes.

Methods

Data for this cross-sectional study were collected using an online survey administered to a non-probability convenience sample (n = 1604; February–July 2017) of youth aged 14–20 years (n = 744) and moms aged 21–36 years (n = 860) in the two pilot markets. Descriptive statistics were computed and outcomes compared between unaware and aware respondents, controlling for sociodemographic covariates. Multivariate analysis of covariance (MANCOVA) was conducted to assess whether fruit- and vegetable-related attitude, belief, and encouragement outcomes differed by FNV Campaign awareness; logistic regression was used to examine associations between FNV brand awareness and dichotomous variables (fruit- and vegetable-related behavioral intentions, trying new fruits and vegetables); and ANCOVA was used to assess associations with daily fruit and vegetable intake frequency.

Results

Approximately 20% (n = 315/1604) of respondents reported awareness of the FNV Campaign. Youth that reported awareness of the FNV Campaign (n = 167, 22.4%) had higher intentions to buy (p = 0.003) and eat (p = 0.009) fruits and vegetables than unaware respondents. Mothers that reported awareness of the FNV Campaign (n = 148, 17.2%) reported greater encouragement for friends and family to eat fruits and vegetables (p = 0.013) and were approximately 1.5 times more likely to report trying a new fruit or vegetable (p = 0.04) than mothers unaware of the Campaign. Daily fruit and vegetable intake frequency did not differ by Campaign awareness.

Conclusions

FNV Campaign awareness was associated with limited but positive short- and intermediate-term cognitive and behavioral outcomes among target audience respondents. These findings can inform future research to enhance understanding and improve the FNV Campaign as it is expanded to new markets nationwide.
Seasonal and socio-demographic patterns of self-reporting major disease groups in north-west Burkina Faso: an analysis of the Nouna Health and Demographic Surveillance System (HDSS) data
Authors: Gottlieb-Stroh Tobias , Souares Aurélia , Bärnighausen Till , Sié Ali , Zabre Somkeita Pascal , Danquah Ina
Published: June 2021

Background

Sub-Saharan Africa (SSA) is facing a rapid growth of non-communicable diseases (NCDs), while communicable diseases still prevail. For rural SSA, evidence for this development is scarce. We aimed at quantifying self-reported major disease groups according to season, and determining the associations with socio-economic factors in rural Burkina Faso.

Methods

This study used data of 4192 adults (age range: 18–101 years; male: 49.0%) from the Nouna Health and Demographic Surveillance System (HDSS) in north-west Burkina Faso, rainy season of 2010 and dry season of 2011. We assessed the proportions and their 95% confidence intervals (CIs) of self-reported major disease groups as defined by the World Health Organization. For their associations with socio-economic factors, odds ratios (OR), 95% CIs and p-values were calculated by logistic regression.

Results

The surveys were completed by 3949 adults in 2010 (mean age: 37.5 ± 14.9 years, male: 48.8%) and by 4039 adults in 2011 (mean age: 37.3 ± 16.2 years, male: 49.1%). The proportions of self-reported communicable diseases were 20.7% (95% CI: 19.4–21.9%) in the rainy season and 11.0% (10.0–11.9%; McNemar’s p < 0.0001) in the dry season. Self-reported NCDs amounted to 5.3% (4.6–6.0%) and 4.5% (3.8–5.1%; p = 0.08), respectively. In each year, less than 1% reported injuries (p = 0.57). Few individuals reported an overlap of communicable diseases and NCDs: 1.4% in 2010 and 0.6% in 2011. In the multiple-adjusted models, formal education (vs. lack of education) showed the strongest association with self-reporting of communicable diseases in both seasons. For NCD-reporting, non-manual occupation (vs. manual) was positively associated, only in the rainy season.

Conclusions

Self-reporting of communicable diseases is subject to seasonal variation in this population in north-west Burkina Faso. The exact reasons for the low overall self-reporting of NCDs and injuries, apart from a low socio-demographic position, require further investigation.
Influence of Sociospatial determinants on knowledge, attitudes and practices related to the plague in a population living in endemic areas in the central highlands, Madagascar
Authors: Rakotosamimanana Sitraka , Rakotoarimanana Feno Jacob , Raharimanga Vaomalala , Taglioni François , Ramamonjisoa Josélyne , Randremanana Rindra Vatosoa , Rajerison Minoarisoa , Rakotomanana Fanjasoa
Published: June 2021

Background

Plague is endemic to the central highlands of Madagascar. Sporadic human cases or outbreaks can occur annually in these areas. In Madagascar, the associations between endemicity and the knowledge, attitudes and practices (KAP) of the population with regard to this disease remain poorly documented. The aim of this study was to assess KAP related to plague among the population living in the central highlands.

Methods

A cross-sectional survey was conducted in the general population from June to August 2017. Based on the reported cases of plague between 2006 and 2015 in two central highland districts, a KAP questionnaire was administered in the population. Based on the proportion of correct answers provided by respondents, KAP scores were classified into three KAP categories: low (< Mean - SD), medium (Mean ± SD) and good (> Mean + SD). Multivariate analyses were performed to determine the associations between population KAP scores related to plague and sociodemographic and epidemiological factors. In addition, individual interviews and focus groups with health professionals were conducted to assess plague perception.

Results

A total of 597 individuals participated in the survey; 20% (n = 119) had a good KAP score, 62% (n = 370) a medium KAP score and 18% (n = 108) a low KAP score. Among the 119 respondents with good KAP scores, 80% (n = 95) resided in Ambositra district, and 20% (n = 24) resided in Tsiroanomandidy district. According to the health professionals in the two districts, populations in endemic areas are well aware of the plague. There were significant associations (p <  0.05) of not owning a mobile phone, having no contact with a former plague case, and living in Tsiroanomandidy district with a lower KAP score.

Conclusion

The results of the study showed the need to adapt plague control interventions to the local context to allow a better allocation of human and financial resources. Doing so would minimize delays in patient management care and increase community resilience to plague epidemics.
Risk analysis of pulmonary metastasis of chondrosarcoma by establishing and validating a new clinical prediction model: a clinical study based on SEER database
Authors: Li Wenle , Dong Shengtao , Wang Haosheng , Wu Rilige , Wu Huitao , Tang Zhi-Ri , Zhang Junyan , Hu Zhaohui , Yin Chengliang
Published: June 2021

Background

The prognosis of lung metastasis (LM) in patients with chondrosarcoma was poor. The aim of this study was to construct a prognostic nomogram to predict the risk of LM, which was imperative and helpful for clinical diagnosis and treatment.

Methods

Data of all chondrosarcoma patients diagnosed between 2010 and 2016 was queried from the Surveillance, Epidemiology, and End Results (SEER) database. In this retrospective study, a total of 944 patients were enrolled and randomly splitting into training sets (n = 644) and validation cohorts(n = 280) at a ratio of 7:3. Univariate and multivariable logistic regression analyses were performed to identify the prognostic nomogram. The predictive ability of the nomogram model was assessed by calibration plots and receiver operating characteristics (ROCs) curve, while decision curve analysis (DCA) and clinical impact curve (CIC) were applied to measure predictive accuracy and clinical practice. Moreover, the nomogram was validated by the internal cohort.

Results

Five independent risk factors including age, sex, marital, tumor size, and lymph node involvement were identified by univariate and multivariable logistic regression. Calibration plots indicated great discrimination power of nomogram, while DCA and CIC presented that the nomogram had great clinical utility. In addition, receiver operating characteristics (ROCs) curve provided a predictive ability in the training sets (AUC = 0.789, 95% confidence interval [CI] 0.789–0.808) and the validation cohorts (AUC = 0.796, 95% confidence interval [CI] 0.744–0.841).

Conclusion

In our study, the nomogram accurately predicted risk factors of LM in patients with chondrosarcoma, which may guide surgeons and oncologists to optimize individual treatment and make a better clinical decisions.

Trial registration

JOSR-D-20-02045, 29 Dec 2020.
The accuracy of gypsum casts obtained from the disinfected extended-pour alginate impressions through prolonged storage times
Authors: Sharif Rania A. , Abdelaziz Khalid M. , Alshahrani Najla M. , Almutairi Fatimah S. , Alaseri Mohrah A. , Abouzeid Hoda L. , Elagib Mohamed F. A.
Published: June 2021

Background

Manufacturers of the extended-pour alginates claimed their dimensional stability through prolonged storage. No data confirmed the ability of these materials to maintain their dimensions and the reproduced oral details following their chemical disinfection. Therefore, this study evaluated the dimensional stability and surface detail reproduction of gypsum casts obtained from disinfected extended-pour alginate impressions through different storage time intervals.

Methods

Two hundred and forty three hydrocolloid impressions were made from one conventional (Tropicalgin) and two extended-pour (Hydrogum 5 and Chromaprint premium) alginates. These impressions were subjected to none, spray and immersion disinfection before their storage in 100% humidity for 0, 72 and 120 h. The dimensional stability and the surface detail reproduction were indirectly evaluated under low angle illumination on the resulted gypsum casts. At α = 0.05, the parametric dimensional stability data were analyzed using One-Way ANOVA and Tukey’s comparisons, while the nonparametric detail reproduction data were analyzed using KrusKal Wallis and Mann–Whitney's tests.

Results

All gypsum casts exhibited a degree of expansion; however, the recorded expansion values did not differ between test categories (P > 0.05). Generally, casts obtained from spray-disinfected impressions showed lower detail accuracy (P < 0.05). Immersion-disinfected extended-pour alginates produced casts with better detail accuracy following 120 h of storage (P < 0.05).

Conclusion

All alginates materials offer comparable cast dimensions under different testing circumstances. Extended-pour alginates offer casts with superior surface details following their immersion disinfection and 120 h of storage. Spray-disinfection using 5.25% sodium hypochlorite affects the surface details of casts obtained from conventional and extended-pour alginates adversely.
Building family caregiver skills using a simulation-based intervention for care of patients with cancer: protocol for a randomized controlled trial
Authors: Mazanec Susan R. , Blackstone Eric , Daly Barbara J.
Published: June 2021

Background

Family caregivers of patients with cancer undergoing radiation therapy experience significant distress and challenges related to high symptom burden and complex care demands. This is particularly true for caregivers of patients with head and neck, esophageal, anal, rectal, and lung cancers, who are often receiving combined-modality treatment and may have tracheostomy tubes, gastrostomy tubes, or colostomies/ileostomies. This study aims to evaluate a simulation-based nursing intervention to provide information, support, and training to caregivers during radiation therapy.

Methods

This randomized controlled trial will include a sample of 180 patients and their family caregivers. Caregivers assigned to the control group will receive usual care and an informational booklet from the National Cancer Institute (NCI). Those in the intervention group will receive usual care, the NCI booklet, and three meetings with a nurse interventionist during radiation treatment followed by a booster call two weeks posttreatment. Intervention sessions focus on themes consistent with the trajectory of radiation therapy: the patient experience/needs, the caregiver experience and dyad communication, and transition to survivorship. Outcomes are measured at baseline, end of treatment (T2), and 4 (T3) and 20 (T4) weeks posttreatment, with the primary outcome being caregiver anxiety at T4.

Discussion

This trial is innovative in its use of simulation in a psychoeducational intervention for family caregivers. The intervention is administered at point-of-care and aimed at feasibility for integration into clinical practice. Patient quality of life and healthcare utilization measures will assess how providing support and training to the caregiver may impact patient outcomes.

Trial registration

The trial was registered on 08/14/2019 at ClinicalTrials.gov (identifier NCT04055948).
The Wnt-specific astacin proteinase HAS-7 restricts head organizer formation in Hydra
Authors: Ziegler Berenice , Yiallouros Irene , Trageser Benjamin , Kumar Sumit , Mercker Moritz , Kling Svenja , Fath Maike , Warnken Uwe , Schnölzer Martina , Holstein Thomas W. , Hartl Markus , Marciniak-Czochra Anna , Stetefeld Jörg , Stöcker Walter , Özbek Suat
Published: June 2021

Background

The Hydra head organizer acts as a signaling center that initiates and maintains the primary body axis in steady state polyps and during budding or regeneration. Wnt/beta-Catenin signaling functions as a primary cue controlling this process, but how Wnt ligand activity is locally restricted at the protein level is poorly understood. Here we report a proteomic analysis of Hydra head tissue leading to the identification of an astacin family proteinase as a Wnt processing factor.

Results

Hydra astacin-7 (HAS-7) is expressed from gland cells as an apical-distal gradient in the body column, peaking close beneath the tentacle zone. HAS-7 siRNA knockdown abrogates HyWnt3 proteolysis in the head tissue and induces a robust double axis phenotype, which is rescued by simultaneous HyWnt3 knockdown. Accordingly, double axes are also observed in conditions of increased Wnt activity as in transgenic actin::HyWnt3 and HyDkk1/2/4 siRNA treated animals. HyWnt3-induced double axes in Xenopus embryos could be rescued by coinjection of HAS-7 mRNA. Mathematical modelling combined with experimental promotor analysis indicate an indirect regulation of HAS-7 by beta-Catenin, expanding the classical Turing-type activator-inhibitor model.

Conclusions

We show the astacin family protease HAS-7 maintains a single head organizer through proteolysis of HyWnt3. Our data suggest a negative regulatory function of Wnt processing astacin proteinases in the global patterning of the oral-aboral axis in Hydra.
Unraveling synonymous and deep intronic variants causing aberrant splicing in two genetically undiagnosed epilepsy families
Authors: Li Qiang , Wang Yiting , Pan Yijun , Wang Jia , Yu Weishi , Wang Xiaodong
Published: June 2021

Background

Variants identified through parent–child trio-WES yield up to 28–55% positive diagnostic rate across a variety of Mendelian disorders, there remain numerous patients who do not receive a genetic diagnosis. Studies showed that some aberrant splicing variants, which are either not readily detectable by WES or could be miss-interpreted by regular detecting pipelines, are highly relevant to human diseases.

Methods

We retrospectively investigated the negative molecular diagnostics through trio-WES for 15 genetically undiagnosed patients whose clinical manifestations were highly suspected to be genetic disorders with well-established genotype–phenotype relationships. We scrutinized the synonymous variants from WES data and Sanger sequenced the suspected intronic region for deep intronic variants. The functional consequences of variants were analyzed by in vitro minigene experiments.

Results

Here, we report two abnormal splicing events, one of which caused exon truncating due to the activation of cryptic splicing site by a synonymous variant; the other caused partial intron retention due to the generation of splicing sites by a deep intronic variant.

Conclusions

We suggest that, despite initial negative genetic test results in clinically highly suspected genetic diseases, the combination of predictive bioinformatics and functional analysis should be considered to unveil the genetic etiology of undiagnosed rare diseases.
Development of IL-15/IL-15Rα sushi domain-IgG4 Fc complexes in Pichia pastoris with potent activities and prolonged half-lives
Authors: Xu Huan , Shi Mingyang , Shao Changsheng , Li Hao , Wu Jing , Yu Yin , Fang Fang , Guo Yugang , Xiao Weihua
Published: June 2021

Background

Interleukin-15 (IL-15) is a critical cytokine for the development, proliferation, and function of natural killer (NK) cells, NKT cells, and CD8+ memory T cells and has become one of the most promising protein molecules for the treatment of cancer and viral diseases. However, there are several limitations in applying IL-15 in therapy, such as its low yield in vitro, limited potency, and short half-life in vivo. To date, there are several recombinant IL-15 agonists based on configurational modifications that are being pursued in the treatment of cancer, such as ALT-803, which are mainly produced from mammalian cells.

Results

In this study, we designed two different forms of the IL-15 complex, which were formed by the noncovalent assembly of IL-15 with dimeric or monomeric sushi domain of IL-15 receptor α (SuIL-15Rα)-IgG4 Fc fusion protein and designated IL-15/SuIL-15Rα-dFc and IL-15/SuIL-15Rα-mFc, respectively. The two IL-15 complexes were expressed in Pichia pastoris (P. pastoris), and their activities and half-lives were evaluated and compared. Pharmacokinetic analysis showed that IL-15/SuIL-15Rα-dFc had a half-life of 14.26 h while IL-15/SuIL-15Rα-mFc had a half-life of 9.16 h in mice, which were much longer than the 0.7-h half-life of commercial recombinant human IL-15 (rhIL-15). Treatment of mice with intravenous injection of the two IL-15 complexes resulted in significant increases in NK cells, NKT cells, and memory CD8+ T cells, which were not observed after rhIL-15 treatment. Treatment of human peripheral blood mononuclear cells (PBMCs) from healthy donors with the two IL-15 complexes yielded enhanced NK and CD8+ T cell activation and proliferation, which was comparable to the effect of rhIL-15.

Conclusions

These findings indicate that the IL-15/SuIL-15Rα-dFc and IL-15/SuIL-15Rα-mFc produced in P. pastoris exhibit potent activities and prolonged half-lives and may serve as superagonists for immunotherapy in further research and applications.