bluuebunny/crossref_metadata_2025 huggingface dataset:
Positioning work related stress – GPs’ reasoning about using the WSQ combined with feedback at consultation
Authors: Hultén Anna-Maria , Dahlin-Ivanoff Synneve , Holmgren Kristina
Published: September 2020

Background

General practitioners (GPs) regularly handle cases related to stress and work capacity, but often find this work difficult. However, using an assessment tool in a structured way can increase GPs’ awareness of the risk for sick leave and need of referrals to preventive measures. Today there is no established methodical practice for this in primary health care. The aim of this study was to explore GPs’ reasoning about using the Work Stress Questionnaire combined with feedback at consultation as an early intervention to reduce sick leave.

Methods

A focus group study was performed with 23 GPs at six primary health care centres. The discussions were analysed based on a method by Krueger.

Results

Three themes emerged. Positioning work-related stress describes the need to make fundamental standpoints on stress and how it should be handled, to make sense of their work concerning work-related stress. Making use of resources focuses on GPs performing to the best of their ability using assigned resources to treat patients with stress-related ill health, even if the resources were perceived as insufficient. Practising daily work focuses on the GPs’ regular and preferred way of working set against the degree of intrusion and benefits. The two related themes making use of resources and practising daily work were mirrored through the third theme, positioning work-related stress, to form an understanding of how GPs should work with patients perceiving work-related stress.

Conclusions

The GPs own competence and tools, those of other professionals and the time allocated were seen as important when treating patients perceiving ill health due to work-related stress. When resources were insufficient though, the GPs questioned their responsibility for these patients. The results also indicate that the GPs viewed their ordinary consultative way of working as sufficient to identify these patients. The intervention was therefore not seen as useful for early treatment of patients at risk of sick leave due to work-related stress. However, prevention is an important part of the PHC’s responsibility, and strategies concerning stress-related ill health therefore need to be more thoroughly formulated and incorporated.

Trial registration

ClinicalTrials.gov, NCT02480855. Registered 20 May 2015.
Biological reflect of Adiponectin hormone in postpartum marital satisfaction and depression scores
Authors: Pahlavan Fattaneh , Kazemnejad Anoshirvan , Razavinia Fatemeh , Daryasari Seyedeh Razieh Fazeli , Tahranian Najmeh
Published: September 2020

Background

There is a growing body of evidence regarding the association between Adiponectin and mental disorders. We aim to evaluate the association between serum level of Adiponectin hormone and postpartum depression and marital satisfaction scores.

Methods

A prospective cohort study of 90 pregnant women was conducted in Mahdieh Hospital, Tehran, Iran. Blood samples were collected during the first 24 h after delivery. The serum Adiponectin concentration was measured with an Enzyme-Linked Immunosorbent Assay (ELISA) kit. The depression score was measured using a validated Iranian version of the Edinburgh Postnatal Depression Scale (EPDS) questionnaire at six weeks (6-weeks) and twelve weeks (12-weeks) after delivery. Using the Kansas questionnaire at twelve weeks (12-weeks) after delivery, the marital satisfaction score was measured. The measurements were compared between two groups, satisfied and dissatisfied mothers. P-values lower than 0.05 were considered significant.

Results

The mean serum level of Adiponectin was significantly higher in the dissatisfied group. It was 10.9 ± 13.4 μg/ml and 15.2 ± 17.7 μg /ml in the satisfied and dissatisfied groups, respectively (P = 0.04).

The postpartum depression scores of 6- and 12-weeks after delivery were significantly higher in the dissatisfied group. At 6-weeks after delivery, the postpartum depression scores were 3.6 ± 3 and 8.7 ± 5.6 in satisfied and dissatisfied groups, respectively. Those were 2.7 ± 2.7 and 7.6 ± 5 at 12-weeks after delivery, respectively. There was a significant difference statistically (P <  0.001).

Conclusion

Mothers in the dissatisfied group, experienced higher depression scores at 12-weeks postpartum while they had shown higher serum Adiponectin levels at the first 24 h after delivery.
Well-being in high-risk pregnancy: an integrative review
Authors: Mirzakhani Kobra , Ebadi Abbas , Faridhosseini Farhad , Khadivzadeh Talaat
Published: September 2020

Background

A prerequisite to the interventions for well-being improvement in high-risk pregnancy (HRP) is to make the concept clear, objective, and measurable. Despite the wealth of studies into the concept of well-being in HRP, there is no clear definition for it. This study aimed to explore the concept of well-being in HRP.

Methods

This integrative review was conducted using the Whittemore and Knafl’s approach. A literature search was done without any data limitation in dictionaries, thesauruses, encyclopedias, well-being-related textbooks, midwifery, psychology, and mental health journals, and Iranian and international databases. The most primary inclusion criterion was relevance to well-being in HRP. The full-texts of all these articles were assessed using the checklists of the Joanna Briggs Institute. Data were analyzed through the constant comparison method and were managed using the MAXQDA 10 software. Meaning units were identified and coded. The codes were grouped into subcategories and categories according to the attributes, antecedents, and consequences of well-being in HRP.

Results

Thirty articles were included in the review, from which 540 codes were extracted. The codes were grouped into seven main attributes, eight main antecedents, and five main consequences of well-being in HRP. The four unique dimensions of well-being in HRP are physical, mental-emotional, social, and spiritual well-being. These dimensions differentiate well-being in HRP from well-being in low-risk pregnancy and in non-pregnancy conditions.

Conclusion

As a complex and multidimensional concept, well-being in HRP refers to the pregnant woman’s evaluation of her life during HRP. It includes physical, hedonic, and eudaimonic components. The assessment of well-being in HRP should include all these components.
Chemotherapy-induced release of circulating-tumor cells into the bloodstream in collective migration units with cancer-associated fibroblasts in metastatic cancer patients
Authors: Ortiz-Otero Nerymar , Marshall Jocelyn R. , Lash Bradley , King Michael R.
Published: September 2020

Background

Recent studies have shown that chemotherapy destabilizes the blood vasculature and increases circulating tumor cell (CTC) influx into the circulation of metastatic cancer patients (Met-pa). CTCs are a precursor of cancer metastasis, in which they can migrate as single CTCs or as CTC clusters with stromal cells such as cancer-associated fibroblasts (CAFs) as cell aggregates.

Methods

Blood samples were collected from 52 Met-pa, and the number of CTC and CAF was determined along with the temporal fluctuation of these through the chemotherapy treatment.

Results

In this study, CTC level was found to increase two-fold from the initial level after 1 cycle of chemotherapy and returned to baseline after 2 cycles of chemotherapy. Importantly, we determined for the first time that circulating CAF levels correlate with worse prognosis and a lower probability of survival in Met-pa. Based on the CTC release induced by chemotherapy, we evaluated the efficacy of our previously developed cancer immunotherapy to eradicate CTCs from Met-pa blood using an ex vivo approach and demonstrate this could kill over 60% of CTCs.

Conclusion

Collectively, we found that CAF levels in Met-pa serve as a predictive biomarker for cancer prognosis. Additionally, we demonstrate the efficacy of our therapy to kill primary CTCs for a range of cancer types, supporting its potential use as an anti-metastasis therapy in the clinical setting.
Prevalence of DSM-5 diagnostic threshold eating disorders and features amongst Aboriginal and Torres Strait islander peoples (First Australians)
Authors: Burt Adam , Mannan Haider , Touyz Stephen , Hay Phillipa
Published: September 2020

Background

There is a dearth of research into mental disorders amongst Aboriginal and Torres Strait Islander peoples (herein First Australians) and especially into eating disorders. In order to understand the healthcare needs of this population, accurate prevalence data is needed. This study aimed to estimate the prevalence of eating disorders amongst First Australians at the diagnostic threshold level and to compare clinical features and health related quality of life (HRQoL) in First and other Australians with and without an eating disorder.

Methods

Data were sourced from the general population 2015 and 2016 Health Omnibus Surveys in South Australia. Trained interviewers conducted via face to face interviews with 6052 people over 15 years old. Eating disorder questions were based on the Eating Disorder Examination and Health Related Quality of Life (HRQoL) measured with the Short-Form 12 v1. The response and participation rates were over 50% and 68% respectively in both surveys. Body Mass Index (BMI) and First Australian status were derived from interview questions. Data were weighted to population norms and analysed using statistical methods for complex surveys.

Results

Twenty-five of 92 (27%) First Australian survey respondents had an eating disorder (majority Other or Unspecified Feeding or Eating Disorder characterised by recurrent binge eating). This was significantly more than the prevalence of other Australians with an eating disorder group (p = .04). First Australians with an eating disorder had higher levels of weight/shape overvaluation than all other groups. They were also younger and had poorer Mental HRQoL (MHRQoL) than other Australians without an eating disorder. On logistic regression, First Australian status was not independently associated with having an eating disorder, however, age, Body Mass Index (BMI) and MHRQoL emerged as significant independent variables for the increased rate of eating disorders in First Australians.

Conclusions

Eating disorders were very common in First Australians and were associated with high levels of overvaluation, binge eating frequency and poor MHRQoL. High levels of overvaluation were unexpected. The implications of these findings include an urgent need for further research, and the development of culturally appropriate assessment instruments and treatments for First Australians with eating disorders.
Cluster-randomised trial to test the effect of a behaviour change intervention on toilet use in rural India: results and methodological considerations
Authors: Schmidt Wolf-Peter , Chauhan Kavita , Bhavsar Priya , Yasobant Sandul , Patwardhan Vaibhav , Aunger Robert , Mavalankar Dileep , Saxena Deepak , Curtis Val
Published: September 2020

Background

Effective and scalable behaviour change interventions to increase use of existing toilets in low income settings are under debate. We tested the effect of a novel intervention, the ‘5 Star Toilet’ campaign, on toilet use among households owning a toilet in a rural setting in the Indian state of Gujarat.

Methods

The intervention included innovative and digitally enabled campaign components delivered over 2 days, promoting the upgrading of existing toilets to achieve use by all household members. The intervention was tested in a cluster randomised trial in 94 villages (47 intervention and 47 control). The primary outcome was the proportion of households with use of toilets by all household members, measured through self- or proxy-reported toilet use. We applied a separate questionnaire tool that masked open defecation questions as a physical activity study, and excluded households surveyed at baseline from the post-intervention survey. We calculated prevalence differences using linear regression with generalised estimating equations.

Results

The primary study outcome was assessed in 2483 households (1275 intervention and 1208 control). Exposure to the intervention was low. Post-intervention, toilet use was 83.8% in the control and 90.0% in the intervention arm (unadjusted difference + 6.3%, 95%CI 1.1, 11.4, adjusted difference + 5.0%, 95%CI -0.1, 10.1. The physical activity questionnaire was done in 4736 individuals (2483 intervention and 2253 control), and found no evidence for an effect (toilet use 80.7% vs 82.2%, difference + 1.7%, 95%CI -3.2, 6.7). In the intervention arm, toilet use measured with the main questionnaire was higher in those exposed to the campaign compared to the unexposed (+ 7.0%, 95%CI 2.2%, 11.7%), while there was no difference when measured with the physical activity questionnaire (+ 0.9%, 95%CI -3.7%, 5.5%). Process evaluation suggested that insufficient campaign intensity may have contributed to the low impact of the intervention.

Conclusion

The study highlights the challenge in achieving high intervention intensity in settings where the proportion of the total population that are potential beneficiaries is small. Responder bias may be minimised by masking open defecation questions as a physical activity study. Over-reporting of toilet use may be further reduced by avoiding repeated surveys in the same households.

Trial registration

The trial was registered on the RIDIE registry (RIDIE-STUDY-ID-5b8568ac80c30, 27-8-2018) and retrospectively on clinicaltrials.gov (NCT04526171, 30-8-2020).
Prevalence of anxiety, depression and post-traumatic stress disorder among Ebola survivors in northern Sierra Leone: a cross-sectional study
Authors: Bah Abdulai Jawo , James Peter Bai , Bah Nuhu , Sesay Amara Bangali , Sevalie Stephen , Kanu Joseph Sam
Published: September 2020

Background

There is limited data available on the long-term mental health impact of Ebola virus disease (EVD) on survivors despite the disease experience of survivors meeting the criteria of a traumatic event as defined in the Diagnostic and Statistical Manual of Mental Disorders version IV (DSM IV). This study aimed to assess the prevalence and predictive factors of anxiety, depression and posttraumatic stress disorder among EVD survivors, approximately 2 years after discharge from the Ebola treatment centre (ETC).

Methods

We conducted a cross-sectional study between May and August 2017 among 197 adults Ebola survivors in Bombali district, Northern Sierra Leone. We collected information about demographics, mental health status and possible predictive factors. The HAD scale was used to measure anxiety and depression. PTSD was measured using the PTSD-checklist (PCL). Chi-square test or Fisher exact two-tailed tests were used to test for associations and the multiple logistic regressions model to determine factors that were independently associated with the outcome variables.

Results

The mean anxiety, depression and PTSD scores were (5.0 ± 3.9), (7.1 ± 3.8) and (39.5 ± 6.4) respectively. Based on cut-off scores, the prevalence of anxiety (HADs score ≥ 8), depression (HADs score ≥ 8) and PTSD (PCL ≥ 45) among Ebola survivors were (n = 49, 24.9%), (n = 93, 47.2%) and (n = 43, 21.8%) respectively. Older Ebola survivors (≥30 years) were more likely to show symptoms of depression (AOR = 8.5, 95% CI: 2.68–27.01,p = 0.001) and anxiety (AOR = 3.04; 95%CI: 1.2–7.7,p = 0.019) compared to younger ones (< 30 years). In addition, Ebola survivors who experienced a decreased level of exercise post-ETC discharge were more likely to show symptoms of depression (AOR = 2.63; 95%CI: 1.25–5.54,p = 0.011) and anxiety (AOR = 3.60; 95%CI: 1.33–9.72,p = 0.012) compared to those whose exercise remained the same post-ETC discharge.

Conclusion

Our findings show that anxiety, depression and PTSD are common among the Ebola survivors in Bombali district, Northern Sierra Leone, and that underscores the need to diagnose and manage mental health morbidities among Ebola survivors long after their recovery from Ebola virus disease. Cognitive Behaviour Therapy (CBT) and Interpersonal Therapy (IPT) need to be explored as part of overall mental healthcare package interventions.
Growth retardation among children in southern Iran: a 7-year population based cohort study
Authors: Fatemi Mohammad Javad , Dianatinasab Mostafa , Sharifnia Golnaz , Moravej Hossein , Fararouei Mohammad
Published: September 2020

Background

Growth retardation is a common health problem, which requires early prevention and detection. This study was conducted to define the approximate age at which stunting starts among the Iranian boys and girls.

Method

The second phase of a population-based retrospective cohort nested case-control study on 400 children who were followed from birth to 7 years of age. This study was performed to define the pattern of growth among stunted and normal children and to reveal the age at which stunting starts in each gender.

Results

Of the selected participants, 53% were girls. Also, about 18% of the children registered by the selected health centers were defined as stunted (under the 3rd percentile of the corresponding sex-age NCHS/WHO growth reference). For boys, the height was relatively similar between the two groups until the age of 6 months at which the difference in height between normal and stunted children starts to become significantly large (difference = 0.70 cm, P = 0.04). For girls, height in the two groups is relatively similar until the age of 9 months at which the difference starts to become significantly large (difference = 0.97 cm, P = 0.01). No significant difference in the weight of the girls was observed between the normal and stunted groups during the study period (difference = 283.21 g, P > 0.05). However, boys from the stunted group were lighter since almost the same time that they started to become significantly shorter (difference = 1265.19 g, P = 0.001).

Conclusions

Soon after birth (at about the 6 months of age), the growth pattern of some (stunted) children starts to stumble and divert from normal. The sixth month of age is the age at which mothers start weaning with withdrawing breast milk and start supplementary foods and adult diet. A specially designed study is needed to understand the actual reason for observing such a phenomenon among Iranian children.
Laparoscopic monolateral suspension for vaginal vault prolapse: a report of an exit surgical strategy during sacralcolpopexy
Authors: Romano Federico , Sartore Andrea , Mordeglia Denise , Di Lorenzo Giovanni , Stabile Guglielmo , Ricci Giuseppe
Published: September 2020

Background

Vaginal vault prolapse is the most frequent long-term complication in patients undergoing hysterectomy and sacralcolpopexy is considered the gold standard. We report our surgical strategy maintaining single-arm mesh when the sacral promontory is not accessible to fix the mesh for an unknown sacral osteophytosis during a laparoscopic sacralcolpopexy. This is significant because, to our knowledge, the bone variant as a procedure limiting factor has never been described before. This opens new horizons for the sacralcolpopexy surgery, because it becomes necessary to know of a valid surgical alternative with mesh maintenance if this complication occurs again or to perform an assessment of the accessibility of the sacral promontory immediately after its dissection.

Case presentation

We present a case of a 75-year-old woman with recurrence of vaginal vault prolapse. A laparoscopic sacralcolpopexy was recommended. During surgery, we found that the procedure was not feasible due to the presence of an unknown osteophytosis of the sacrum which prevented the fixing of the mesh to the sacral promontory. We decided to proceed with a single-arm lateral suspension by using a modified approach of the original technique, maintaining the mesh originally shaped for the sacral colpopexy. At follow-up, the vaginal vault is well suspended.

Conclusion

This exit strategy may represent a valid surgical alternative when laparoscopic sacral colpopexy is not possible for anatomical variants, allowing to keep the laparoscopic approach using mesh. To our knowledge, cases in which the anatomical bone variant prevented access to the sacral promontory have never been described in the literature, as bone evaluation has never been considered a limiting element of this procedure.
Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports
Authors: Yamada Tomoko , Fukuoka Hidenori , Hosokawa Yusei , Odake Yukiko , Yoshida Kenichi , Matsumoto Ryusaku , Bando Hironori , Okada Yuko , Hirota Yushi , Iguchi Genzo , Ogawa Wataru , Takahashi Yutaka
Published: September 2020

Background

Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA).

Methods

In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n = 18), SCS (n = 18), and NFA (n = 31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled.

Results

PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3 ~ 2.8) vs. 0.7 (0.5 ~ 1.8) and 0.9 (0.6 ~ 1.4) ng/mL/h; p = 0.018 and p = 0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5 ~ 79.5) vs. 156.0 (92.9 ~ 194.5) and 114.9 (90.1 ~ 153.4); p = 0.001 and p < 0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA > 1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR < 95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA.

Conclusions

ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC.

Trial registration

This study was not registered because of the retrospective analysis.
Bridging different realities - a qualitative study on patients’ experiences of preoperative care for benign hysterectomy and opportunistic salpingectomy in Sweden
Authors: Collins Elin , Lindqvist Maria , Mogren Ingrid , Idahl Annika
Published: September 2020

Background

Hysterectomy is a common procedure worldwide and removing healthy fallopian tubes at the time of hysterectomy (opportunistic salpingectomy) to possibly prevent ovarian cancer is increasing in frequency, but still controversial. The experiences and perceptions of women, eligible for the procedure, have not been previously investigated.

This study aims to, among women waiting to undergo hysterectomy, explore i) experiences and perceptions of self and healthcare in relation to their elective surgery, ii) perceptions of risks and benefits of hysterectomy, including opportunistic salpingectomy.

Methods

A qualitative study, with focus group discussions including women < 55 years, planned for hysterectomy with ovarian preservation, was performed. Participants were recruited through purposive sampling from six gynecological departments in different parts of Sweden, including both country and university hospitals. Focus group discussions were conducted using a semi-structured interview guide, digitally recorded, transcribed verbatim and analysed by qualitative manifest and latent content analysis.

Results

Twenty-one Swedish-speaking women participated. They were 40–53 years of age, reported varying educational levels, countries of birth and indications for hysterectomy. Analysis rendered a theme “Bridging different realities” over four categories: “Being a woman today”, “Experiencing and managing body failure”, “Navigating the healthcare system” and “Processing continuously until surgery”, including 17 subcategories. The participants displayed varying attitudes towards the significance of their uterus in being a woman. A vague understanding of their body was described, leading to fear related to the reasons for surgery as well as surgery itself. Participants described difficulties understanding and recalling information but also stated that insufficient information was provided. Perceptions of the risks and benefits of opportunistic salpingectomy varied. Involvement in decisions regarding the hysterectomy and potential opportunistic salpingectomy was perceived to be dependent on the counselling gynecologist.

Conclusions

The theme Bridging different realities captures the complexity of women deciding on removal of their uterus, and possibly fallopian tubes. It also describes the women’s interactions with healthcare and perceived difference between the health professionals and the women’s perception of the situation, as viewed by the women. Bridging the different realities faced by patients is required to enable shared decision-making, through sufficient support from healthcare.
Step-by-step teaching method: improving learning outcomes of undergraduate dental students in layering techniques for direct composite resin restorations
Authors: Yuan Jia-xue , Yang Ke-yu , Ma Jing , Wang Zhen-zhen , Guo Qing-yu , Liu Fei
Published: September 2020

Background

Layering techniques for direct composite resin restorations might be complicated for inexperienced learners, as a number of materials and instruments are required at each step. The present study aimed to compare and assess the teaching effect of step-by-step and all-in-one teaching methods in layering techniques for direct composite resin restorations among undergraduate dental students.

Methods

A total of 68 junior dental students participated in this study, which was a prospective and single-blind trial. The students were randomly divided into a step-by-step group (experimental group, n = 34) and all-in-one group (control group, n = 34). The same teacher taught the two groups, ensuring a comparable teaching effect. The final score of each student was an average of scores by two experts who were blinded to the grouping. The scoring system was consisted by five parts. Each part was assigned scores of 3.0, 1.5, or 0. The total maximum score was 15 and minimum was 0. The total time taken by each group was also calculated.

Results

The values of the quality of tooth restorations evaluated by experts for step-by-step and all-in-one groups were 11.29 ± 2.13 from 15 and 9.00 ± 2.71 from 15 (t = 3.88, P < 0.001), respectively. In addition, the time spent by the experimental group was significantly lesser than that spent by the control group, which was 122.47 ± 2.82 and 137.18 ± 6.75 min, respectively (t = 11.72, p < 0.001).

Conclusion

With regard to the layering techniques for direct composite resin restorations, the outcomes were better in the step-by-step group than in the all-in-one group.
A new childhood ALL case with an extremely complex karyotype and acute spontaneous tumor lysis syndrome
Authors: Wafa Abdulsamad , Jarjour Rami A. , Alolabi Doaa , Liehr Thomas , Hamdan Othman , Melo Joana B. , Carreira Isabel M. , Othman Moneeb A. K. , Al-Achkar Walid
Published: September 2020

Background

B cell precursor acute lymphoblastic leukemia (B-ALL) is the most common malignancy of childhood, with, after corresponding treatment, an overall complete remission rate of 90%. Approximately 75% of B-ALL cases harbor recurrent abnormalities, including so-called complex karyotypes (CK). Tumor lysis syndrome (TLS) is a metabolic abnormality which may arise during cancer therapy and also, extremely rarely, as spontaneous TLS before initiation of chemotherapy in patients with ALL.

Case presentation

Here we report a 9-year-old male, diagnosed with a de novo pre-B-ALL according to the WHO classification. Cytogenetic, molecular cytogenetic approaches and array comparative genomic hybridization analyses revealed a unique CK involving five chromosomes. It included four yet unreported chromosomal aberrations: a der(11)t(7;11)(p22.1;q24.2), a der(18)t(7;18)(q21.3;p11.22), del(11)(q24.2q25) and dup(18)(q11.1q23). Unfortunately, the patient died 3 months after the initial diagnosis.

Conclusions

To the best of our knowledge, a comparable childhood ALL case was not previously reported. Thus, the combination of the here seen chromosomal aberrations in childhood primary ALL seems to indicate for an extremely adverse prognosis.
Altered presynaptic function and number of mitochondria in the medial prefrontal cortex of adult Cyfip2 heterozygous mice
Authors: Kim Gyu Hyun , Zhang Yinhua , Kang Hyae Rim , Lee Seung-Hyun , Shin Jiwon , Lee Chan Hee , Kang Hyojin , Ma Ruiying , Jin Chunmei , Kim Yoonhee , Kim Su Yeon , Kwon Seok-Kyu , Choi Se-Young , Lee Kea Joo , Han Kihoon
Published: September 2020

Variants of the cytoplasmic FMR1-interacting protein (CYFIP) gene family, CYFIP1 and CYFIP2, are associated with numerous neurodevelopmental and neuropsychiatric disorders. According to several studies, CYFIP1 regulates the development and function of both pre- and post-synapses in neurons. Furthermore, various studies have evaluated CYFIP2 functions in the postsynaptic compartment, such as regulating dendritic spine morphology; however, no study has evaluated whether and how CYFIP2 affects presynaptic functions. To address this issue, in this study, we have focused on the presynapses of layer 5 neurons of the medial prefrontal cortex (mPFC) in adult Cyfip2 heterozygous (Cyfip2+/−) mice. Electrophysiological analyses revealed an enhancement in the presynaptic short-term plasticity induced by high-frequency stimuli in Cyfip2+/− neurons compared with wild-type neurons. Since presynaptic mitochondria play an important role in buffering presynaptic Ca2+, which is directly associated with the short-term plasticity, we analyzed presynaptic mitochondria using electron microscopic images of the mPFC. Compared with wild-type mice, the number, but not the volume or cristae density, of mitochondria in both presynaptic boutons and axonal processes in the mPFC layer 5 of Cyfip2+/− mice was reduced. Consistent with an identification of mitochondrial proteins in a previously established CYFIP2 interactome, CYFIP2 was detected in a biochemically enriched mitochondrial fraction of the mouse mPFC. Collectively, these results suggest roles for CYFIP2 in regulating presynaptic functions, which may involve presynaptic mitochondrial changes.
Subjective cognitive decline, anxiety symptoms, and the risk of mild cognitive impairment and dementia
Authors: Liew Tau Ming
Published: September 2020

Background

Subjective cognitive decline (SCD) and anxiety symptoms both predict neurocognitive disorders, but the two correlate strongly with each other. It is unclear whether they reflect two independent disease processes in the development of neurocognitive disorders and hence deserve separate attention. This cohort study examined whether SCD and anxiety symptoms demonstrate independent risks of mild cognitive disorder and dementia (MCI/dementia).

Methods

The study included 14,066 participants aged ≥ 50 years and diagnosed with normal cognition at baseline, recruited from Alzheimer’s Disease Centers across the USA. The participants were evaluated for SCD and anxiety symptoms at baseline and followed up almost annually for incident MCI/dementia (median follow-up 4.5 years; interquartile range 2.2–7.7 years). SCD and anxiety symptoms were included in Cox regression to investigate their independent risks of MCI/dementia.

Results

SCD and anxiety symptoms demonstrated independent risks of MCI/dementia, with HR 1.9 (95% CI 1.7–2.1) and 1.3 (95% CI 1.2–1.5), respectively. Co-occurring SCD and anxiety symptoms demonstrated the highest risk (HR 2.4, 95% CI 1.9–2.9)—participants in this group had a 25% probability of developing MCI/dementia by 3.1 years (95% 2.4–3.7), compared to 8.2 years among those without SCD or anxiety (95% CI 7.9–8.6). The results remained robust even in the sensitivity analyses that took into account symptom severity and consistency of symptoms in the first 2 annual visits.

Conclusions

The findings suggest that clinicians should not dismiss one over the other when patients present with both SCD and anxiety and that both constructs may potentially be useful to identify high-risk populations for preventive interventions and trials. The findings also point to the need for further research to clarify on the neurobiological distinctions between SCD and anxiety symptoms, which may potentially enrich our understanding on the pathogenesis of neurocognitive disorders.
MicroRNA-27b targets CBFB to inhibit differentiation of human bone marrow mesenchymal stem cells into hypertrophic chondrocytes
Authors: Lv Shuang , Xu Jinying , Chen Lin , Wu Haitao , Feng Wei , Zheng Yangyang , Li Pengdong , Zhang Haiying , Zhang Lihong , Chi Guangfan , Li Yulin
Published: September 2020

Background

Human bone marrow-derived mesenchymal stem cells (hBMSCs) have chondrocyte differentiation potential and are considered to be a cell source for cell-transplantation-mediated repair of cartilage defects, including those associated with osteoarthritis (OA). However, chondrocyte hypertrophic differentiation is a major obstacle for the application of hBMSCs in articular cartilage defect treatment. We have previously shown that microRNA-27b (miR-27b) inhibits hypertrophy of chondrocytes from rat knee cartilage. In this study, we investigated the role of miR-27b in chondrocyte hypertrophic differentiation of hBMSCs.

Methods

Chondrogenic marker and microRNA expression in hBMSC chondrogenic pellets were evaluated using RT-qPCR and immunohistochemistry. The hBMSCs were transfected with miR-27b before inducing differentiation. Gene and protein expression levels were analyzed using RT-qPCR and western blot. Coimmunoprecipitation was used to confirm interaction between CBFB and RUNX2. Luciferase reporter assays were used to demonstrate that CBFB is a miR-27b target. Chondrogenic differentiation was evaluated in hBMSCs treated with shRNA targeting CBFB. Chondrogenic hBMSC pellets overexpressing miR-27b were implanted into cartilage lesions in model rats; therapeutic effects were assessed based on histology and immunohistochemistry.

Results

The hBMSCs showed typical MSC differentiation potentials. During chondrogenic differentiation, collagen 2 and 10 (COL2 and COL10), SOX9, and RUNX2 expression was upregulated. Expression of miR-140, miR-143, and miR-181a increased over time, whereas miR-27b and miR-221 were downregulated. Cartilage derived from hBMSC and overexpressing miR-27b exhibited higher expression of COL2 and SOX9, but lower expression of COL10, RUNX2, and CBFB than did the control cartilage. CBFB and RUNX2 formed a complex, and CBFB was identified as a novel miR-27b target. CBFB knockdown by shRNA during hBMSC chondrogenic differentiation led to significantly increased COL2 and SOX9 expression and decreased COL10 expression. Finally, miR-27b-overexpressing hBMSC chondrogenic pellets had better hyaline cartilage morphology and reduced expression of hypertrophic markers and tend to increase repair efficacy in vivo.

Conclusion

MiR-27b plays an important role in preventing hypertrophic chondrogenesis of hBMSCs by targeting CBFB and is essential for maintaining a hyaline cartilage state. This study provides new insights into the mechanism of hBMSC chondrocyte differentiation and will aid in the development of strategies for treating cartilage injury based on hBMSC transplantation.
The Urgent Need for Transparent and Accountable Procurement of Medicine and Medical Supplies in Times of COVID-19 Pandemic
Authors: Kohler Jillian Clare , Wright Tom
Published: September 2020

The COVID-19 pandemic has unleashed unprecedented and complex public policy issues. One that has emerged as a challenge for many countries globally is how to ensure the efficient and effective procurement of quality medical supplies. Existing corruption pressures on procurement—everything from undue influence to the outright bribery of public officials—has been amplified by the pandemic, and thus demands commensurate policy responses. We argue that transparency and accountability in procurement are essential to preventing the corruption risks that threaten the health and well-being of populations.
MR imaging in Kallmann syndrome: a case report
Authors: Allu Sameera , Gorantla Rajani , Ankamma Rao D.
Published: September 2020

Background

A rare genetic disorder called Kallmann syndrome results from a defect in the neuronal migration of olfactory axons and gonadotropin-releasing hormone neurons. MR imaging helps in confirming the diagnosis of Kallmann syndrome with characteristic morphological findings in the brain, in clinically suspicious cases of hypogonadotropic hypogonadism with anosmia/hyposmia.

Case presentation

A 15-year-old male teenager presented with complaints of a small penis and anosmia. Hormonal assay of gonadotropins and testosterone revealed low serum concentrations. MRI brain revealed the absence of the olfactory bulbs in the olfactory grooves and hypoplastic olfactory sulcus. With the gonadotropic hormonal assay showing low levels and characteristic MR imaging features of absent olfactory tracts and olfactory sulcus, the diagnosis of Kallmann syndrome was confirmed.

Conclusions

Morphological abnormalities of olfactory tracts and olfactory sulcus can be accurately depicted with MR imaging through anterior fossa in the coronal plane. Therefore, MR imaging of the brain plays a significant role in diagnosing uncommon Kallmann syndrome and other associated brain abnormalities.
Developing implementation research capacity: longitudinal evaluation of the King’s College London Implementation Science Masterclass, 2014–2019
Authors: Davis Rachel , Mittman Brian , Boyton Madelene , Keohane Aoife , Goulding Lucy , Sandall Jane , Thornicroft Graham , Sevdalis Nick
Published: September 2020

Background

Despite an increasing number of training opportunities in implementation science becoming available, the demand for training amongst researchers and practitioners is unmet. To address this training shortfall, we developed the King’s College London ‘Implementation Science Masterclass’ (ISM), an innovative 2-day programme (and currently the largest of its kind in Europe), developed and delivered by an international faculty of implementation experts.

Methods

This paper describes the ISM and provides delegates’ quantitative and qualitative evaluations (gathered through a survey at the end of the ISM) and faculty reflections over the period it has been running (2014–2019).

Results

Across the 6-year evaluation, a total of 501 delegates have attended the ISM, with numbers increasing yearly from 40 (in 2014) to 147 (in 2019). Delegates represent a diversity of backgrounds and 29 countries from across the world. The overall response rate for the delegate survey was 64.5% (323/501). Annually, the ISM has been rated ‘highly’ in terms of delegates’ overall impression (92%), clear and relevant learning objectives (90% and 94%, respectively), the course duration (85%), pace (86%) and academic level 87%), and the support provided on the day (92%). Seventy-one percent of delegates reported the ISM would have an impact on how they approached their future work. Qualitative feedback revealed key strengths include the opportunities to meet with an international and diverse pool of experts and individuals working in the field, the interactive nature of the workshops and training sessions, and the breadth of topics and contexts covered.

Conclusions

Yearly, the UK ISM has grown, both in size and in its international reach. Rated consistently favourably by delegates, the ISM helps to tackle current training demands from all those interested in learning and building their skills in implementation science. Evaluation of the ISM will continue to be an annual iterative process, reflective of changes in the evidence base and delegates changing needs as the field evolves.
Ammonia inhibits energy metabolism in astrocytes in a rapid and glutamate dehydrogenase 2-dependent manner
Authors: Drews Leonie , Zimmermann Marcel , Westhoff Philipp , Brilhaus Dominik , Poss Rebecca E. , Bergmann Laura , Wiek Constanze , Brenneisen Peter , Piekorz Roland P. , Mettler-Altmann Tabea , Weber Andreas P. M. , Reichert Andreas S.
Published: September 2020

Astrocyte dysfunction is a primary factor in hepatic encephalopathy (HE) impairing neuronal activity under hyperammonemia. In particular, the early events causing ammonia-induced toxicity to astrocytes are not well understood. Using established cellular HE models, we show that mitochondria rapidly undergo fragmentation in a reversible manner upon hyperammonemia. Further, in our analyses, within a timescale of minutes, mitochondrial respiration and glycolysis were hampered, which occurred in a pH-independent manner. Using metabolomics, an accumulation of glucose and numerous amino acids, including branched chain amino acids, was observed. Metabolomic tracking of 15N-labeled ammonia showed rapid incorporation of 15N into glutamate and glutamate-derived amino acids. Downregulating human GLUD2 [encoding mitochondrial glutamate dehydrogenase 2 (GDH2)], inhibiting GDH2 activity by SIRT4 overexpression, and supplementing cells with glutamate or glutamine alleviated ammonia-induced inhibition of mitochondrial respiration. Metabolomic tracking of 13C-glutamine showed that hyperammonemia can inhibit anaplerosis of tricarboxylic acid (TCA) cycle intermediates. Contrary to its classical anaplerotic role, we show that, under hyperammonemia, GDH2 catalyzes the removal of ammonia by reductive amination of α-ketoglutarate, which efficiently and rapidly inhibits the TCA cycle. Overall, we propose a critical GDH2-dependent mechanism in HE models that helps to remove ammonia, but also impairs energy metabolism in mitochondria rapidly.
Previsão de value-at-risk para o mercado de criptomoedas usando modelos EGARCH com regimes markovianos
Authors: Marschner Paulo Fernando , Ceretta Paulo Sergio
Published: September 2020

Essa pesquisa teve como objetivo compreender o comportamento volátil em seis criptomoedas de grande representatividade. Para tal, foram estimados modelos EGARCH com e sem regimes markovianos, combinados com diferentes distribuições de probabilidade estatística e testada a capacidade preditiva dos melhores modelos resultantes dessa combinação por meio da previsão do value-at-risk. Esse estudo demonstrou que os log-retornos diários das criptomoedas analisadas apresentam claramente mudanças de regime em sua dinâmica de volatilidade. Na análise in-sample, o modelo com mudança de regime confirma a existência de dois estados: o primeiro caracterizado por um maior efeito ARCH e menos afetado por assimetrias, enquanto o segundo revela maior efeito da chegada de informações, ou seja, é mais sensível à choques assimétricos. Na análise out-sample, as previsões de valor em risco dos modelos com mudançade regime superam claramente os modelos de regime único em um α = 1%.
Η βιοηθική διάσταση της ατομικής ευθύνης στην αντιμετώπιση του COVID 19 (κορωνοϊός)
Authors: National Bioethics Commission (Εθνική Επιτροπή Βιοηθικής) Hellenic
Published: September 2020

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Βιοηθικά ζητήματα της χρήσης πτωματικών βιολογικών υλικών στην εκπαίδευση και στην έρευνα
Authors: Katsos (Κωνσταντίνος Κάτσος) Konstantinos , Moraitis (Κωνσταντίνος Μωραΐτης) Konstantinos , Spiliopoulou (Χαρά Σπηλιοπούλου) Chara
Published: September 2020

Can someone claim property rights on a corps e? If so, to whom it belongs? If not, are there anylimits to the "use exploitation" of the human body? This paper discusses the ethical issues that arise ineducation and research with cadaveric materials by conducting a review of the international litera ture. Inthe light of various scandals concerning the retention of cadaveric tissues and organs and their use ineducation and research, the legislative framework in the UK was revised in 2006 to regulate themanagement of a corpse. Similar acts exist in m any other countries. In Greece, the current legal systemonly regulates the use of biological materials for transplantation, leaving a "gap" in education andresearch issues after death. Greece must leave behind the paternalism of the past and follow the p rinciplesof information and consent.
Problems and Prospects of Mixed Education at the University During the Digitalization Period
Authors: Semenova L.
Published: September 2020

The author addresses the urgent problem of the synthesis of traditional and e-learning and considers one of the promising formats of study at a university - blended learning. The terminological analysis revealed analogues to this training: blend training, mix training, blended learning, hybrid learning, integrated or web-based advanced learning. Its essence is a reasonable combination of offline and online technologies, methods, interaction techniques and tools. The methodological basis of the study was a comprehensive, integrative-competency and professional approaches. Turning to numerous domestic and foreign studies, the author proves the inevitability and popularity of this form of education. One of the varieties of this approach is described - inverted learning. In blended learning in the digital age, along with traditional technologies, web services and platforms, social networks, instant messengers, distance learning systems, collaboration environments, smart contracts, etc. are actively used. The article outlines the advantages, problems and prospects of the blended learning concept. One of the acute problems is the online training of teachers. Minister of Science and Higher Education of the Russian Federation V. Falkov urges urgent training of all teachers by 100%.
Technical Advertising of the Digital Epoch: The Emotionality of a Language Sign
Authors: Hunbo Yuy
Published: September 2020

Communication strategies are systematized at the lexical and syntactic levels to express high qualifications, authority, moreover, gaining confidence in the reliability of the advertised product or service from potential buyers. The object of our consideration was an advertising technical discourse - media texts advertising technologies and high-tech products (all smart electronics - computers and smartphones, sensors, eco-friendly lighting, etc.). It contains an analysis of the purposes of expressive means (name, explanation and description of technical characteristics, attracting attention) and the purposes of their use (informing, persuading, suggesting) in an advertising technical discourse, taking into account the psychological need, desire, and interest of the recipient.