bluuebunny/crossref_metadata_2025 huggingface dataset:
Targeted muscle reinnervation for the management of pain in the setting of major limb amputation
Authors: Peters Blair R , Russo Stephanie A , West Julie M , Moore Amy M , Schulz Steven A
Published: September 2020

The life altering nature of major limb amputations may be further complicated by neuroma formation in up to 60% of the estimated 2 million major limb amputees in the United States. This can be a source of pain and functional limitation of the residual limb. Pain associated with neuromas may limit prosthetic limb use, require reoperation, lead to opioid dependence, and dramatically reduce quality of life. A number of management options have been described including excision alone, excision with repair, excision with transposition, and targeted muscle reinnervation. Targeted muscle reinnervation has been shown to reduce phantom limb and neuroma pain for patients with upper and lower extremity amputations. It may be performed at the time of initial amputation to prevent pain development or secondarily for the treatment of established pain. Encouraging outcomes have been reported, and targeted muscle reinnervation is emerging as a leading surgical technique for pain prevention in patients undergoing major limb amputations and pain management in patients with pre-existing amputations.
Effect of parent-child relationship on physical aggression among adolescents: Global school-based student health survey
Authors: Lakhdir Maryam Pyar Ali , Rozi Shafquat , Peerwani Ghazal , Nathwan Apsara Ali
Published: September 2020

Data from the Global School-based Student Health Survey (GSHS) conducted in 2009 consisting of 5192 Pakistani school-going adolescents was used to assess the association between parent-child-relationship and physical-aggression. A multilevel-weighted-cox-proportional-algorithm was performed. The overall prevalence of physical-aggression was 41% of which 27% had a poor parent-child relationship. Male adolescents who have a poor bond with their parents had two times the prevalence of physical-aggression (95% CI: 1.82, 3.00) than those female adolescents with the strong parent-child-bonding. The findings of this study implicated that the poor parental bond and the role of gender as potential factors in physically aggressive adolescents.
The apparent diffusion coefficient is a useful biomarker in predicting treatment response in patients with locally advanced rectal cancer
Authors: Jiménez de los Santos Mayra Evelia , Reyes-Pérez Juan Armando , Sandoval-Nava Rosa Martha , Villalobos-Juárez José Luis , Villaseñor-Navarro Yolanda , Vela-Sarmiento Itzel , Sollozo-Dupont Isabel
Published: September 2020

Background

Apparent diffusion coefficient (ADC) values achieve promising results in treatment response prediction in patients with several types of cancers.

Purpose

To determine whether ADC values predict neoadjuvant chemoradiation treatment (nCRT) response in patients with locally advanced rectal cancer (LARC).

Material and Methods

Forty-four patients with LARC who underwent magnetic resonance imaging scans before and after nCRT followed by delayed surgery were enrolled retrospectively. The sample was distributed as follows: responders (R), n = 8; and non-responders (Non-R), n = 36. Three markers of treatment response were considered: post-nCRT measures; ΔADC; and Δ%ADC. Statistical analysis included a Wilcoxon test, a Mann–Whitney U test, and a receiver operating characteristic (ROC) analysis in order to evaluate the diagnostic accuracy for each ADC value marker to differentiate between R and Non-R.

Results

Both minimum and mean ADC values were significantly higher after nCRT in the R group, while non-significant differences between basal and control ADC values were found in the non-R group. In addition, ΔADC and Δ%ADC exhibited increased values after nCRT in R when compared with non-R. ROC analysis revealed the following diagnostic performance parameters: post-nCRT: ADCmin = 1.05 × 10−3 mm2/s (sensitivity 61.1% and specificity 66.7%), ADCmean = 1.50 × 10−3 mm2/s (sensitivity 72.2% and specificity 83.3%), ΔADC: ADCmin = 0.35 (sensitivity 66.7% and specificity 83.3%), ADCmean = 0.50 (sensitivity 72% and specificity 83%); and Δ%ADC: ADCmin = 44% (sensitivity 66.7% and specificity 83.3%) and ADCmean = 60% (sensitivity 83% and specificity 99%).

Conclusion

Our findings suggest that post-treatment rectal tumor ADC values, as well changes between pre- and post-treatment values, may be biomarkers for predicting treatment response in patients with LARC who underwent nCRT.
A Retrospective Analysis of Gender-Based Difference in Adherence to Influenza Vaccination during the 2018-2019 Season
Authors: Applewhite Andres , Stancampiano Fernando F. , Harris Dana M. , Manaois Alyssa , Dimuna John , Glenn Jada , Heckman Michael G. , Brushaber Danielle E. , Sher Taimur , Valery Jose Raul
Published: September 2020

Introduction:

Improving flu vaccination rates in the general population is an important and effective strategy toward reducing morbidity, mortality, and the cost of seasonal influenza. In order to optimize immunization strategies, factors associated with decreased vaccination rates need to be explored. The literature suggests that there is a gender difference in the rate of influenza vaccination but is limited to population-based survey studies and also is inconsistent as to which gender has a higher rate of vaccination. The purpose of this study was to evaluate for a gender-based difference in the rate of influenza vaccination among patients who presented for an annual physical examination during the 2018 to 2019 influenza season.

Methods:

In this multi-site, retrospective chart review, a total of 1193 patients (608 female and 585 male) who underwent an annual physical examination in April of 2019 were included. Baseline medical information was collected, as well as demographic characteristics and influenza vaccination status. The proportion of patients who underwent influenza vaccination was compared between males and females using multivariable logistic regression models; odds ratios (ORs) were estimated.

Results:

The likelihood of influenza vaccination was significantly higher in females (62.8%) compared to males (53.2%) in both unadjusted analysis (OR = 1.49, P < .001) and in multivariable analysis adjusting for the potential confounding influences of clinic location, BMI, insurance type, and occupation (OR = 1.42, P = .005). Interestingly, a higher influenza vaccination rate for females compared to males was observed in patients age<60 years (OR = 1.70, P = .025) and between ages 60 and 75 (OR = 1.66, P = .009), but not for patients older than 75 years (OR = 1.12, P = .66).

Conclusion:

Our findings indicate that the rate of influenza vaccination is higher for females than for males who presented for an annual preventive physical exam and who are younger than 75 years old.
Genetic and Environmental Influences on Disgust Proneness, Contamination Sensitivity, and Their Covariance
Authors: Tybur Joshua M. , Wesseldijk Laura W. , Jern Patrick
Published: September 2020

Dozens of studies have indicated that individuals more prone to experiencing disgust have stronger symptoms of anxiety disorders—especially contamination sensitivity. However, no work has informed the degree to which this relationship arises from genetic factors versus environmental factors. In the present study, we fill this gap by measuring disgust proneness and contamination sensitivity in a sample of 7,199 twins and siblings of twins, including 1,411 complete twin pairs. Disgust proneness was related to contamination sensitivity, r = .32. Multivariate twin modeling revealed that genetic factors accounted for 34% and 40% of the variance in disgust proneness and contamination sensitivity, respectively, and that the correlation between the two traits reflected overlapping genetic (54%) and unshared environmental (46%)—but not shared environmental—influences. Although consistent with work indicating that disgust proneness relates to contamination sensitivity, results suggest that prevailing parental-modeling hypotheses for explaining this relationship be reevaluated.
No Differences in Clinical Outcomes of Suture Tape Augmented Repair Versus Broström Repair Surgery for Chronic Lateral Ankle Instability
Authors: Li Hong , Zhao Yujie , Chen Wenbo , Li Hongyun , Hua Yinghui
Published: September 2020

Background:

Suture tape (ST) augmented repair, an alternative to traditional Broström repair (BR), may protect the repaired anterior talofibular ligament during ligament healing. No systematic review of cohort studies has been conducted to compare traditional BR with ST-augmented repair for chronic lateral ankle instability.

Purpose:

To review the current evidence in the literature to ascertain whether ST-augmented repair is superior to traditional BR in managing chronic lateral ankle instability.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

A literature search was performed to identify relevant articles published in PubMed, Embase, and Cochrane Library databases in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included cohort studies comparing the efficacy of BR and ST-augmented repair procedures in terms of incidence of instability recurrence, functional scores, talar tilt angle (TTA), anterior talar translation (ATT), and complication rate. Methodological quality was assessed using the Jadad scale for randomized studies and the Newcastle-Ottawa Scale for nonrandomized studies.

Results:

A total of 4 clinical trials with 254 patients were included. No significant differences were detected between BR and ST-augmented repair procedures in terms of incidence of recurrent instability, American Orthopaedic Foot & Ankle Society score, Foot and Ankle Outcome Score, Foot and Ankle Ability Measure, TTA, ATT, or complication rate. The ST group appeared to have a shorter operation time compared with the BR group.

Conclusion:

No significant differences were found between ST-augmented repair and BR surgery regarding incidence of recurrent instability, functional outcome scores, or complication rates. Although technically challenging, the ST-augmented repair procedure appears to be a safe and fast option.
The Effect of Graft Harvest and Skin Incision Angle on Sensory Disturbance in ACL Reconstruction With Semitendinosus-Gracilis Tendon Graft: A Randomized Controlled Trial and Cadaveric Study
Authors: Leiter Jeffrey , Peeler Jason , McRae Sheila , Wiens Scott , Hammond Allan , Froese Warren , MacDonald Peter
Published: September 2020

Background:

Injury to the inferior branch of the saphenous nerve (IBSN) and the subsequent loss of skin sensation after anterior cruciate ligament (ACL) reconstruction are common. The literature suggests that the incision angle may affect the incidence and area of loss of skin sensation.

Purpose:

To determine whether there is a difference in the incidence and area of altered sensory loss on the tibia between vertical (VI) and oblique (OI) incisions for semitendinosus-gracilis tendon graft harvest during ACL reconstruction. The cadaveric component was designed to determine whether there is a “safe zone” for incision by identifying the location and number of branches of the IBSN.

Study Design:

Randomized controlled trial; Level of evidence, 2.

Methods:

Patients (n = 37) were randomized to receive either VI or OI. Incidence and area of altered skin sensation were documented during at least 1 postoperative visit. In addition, 18 cadaveric knees were dissected.

Results:

The presence or absence of hypoesthesia did not differ between groups postoperatively. Although no statistical differences between groups were seen in the total area of perceived altered skin sensation at 3 ( P = .57), 6 ( P = .08), 12 ( P = .65), and 24 months ( P = .27), data demonstrated a trend toward VI participants having a larger area of hypoesthesia at every time point. Among the 18 cadaveric specimens, 4 variations in the distribution of IBSN were noted: 18 (100%) had 1 branch, 14 (78%) had 2 branches, 6 (33%) had 3 branches, and 1 (6%) had 4 branches. No safe zone for incision could be identified.

Conclusion:

No difference was found between a vertical and an oblique incision with respect to incidence or area of sensory loss. Furthermore, it was not possible to identify a safe zone that would prevent transection of all nerves branches of the IBSN based on the cadaveric component of this study.
Co-presence patterns in dispersed residential neighbourhoods of Brazilian medium-sized cities
Authors: Maciel Filipe BM , Zampieri Fábio LL
Published: September 2020

This research aimed to explain the co-presence patterns in public spaces, i.e. pedestrian movement rates, based on the analysis of spatial patterns established in street segments. Two dispersed residential neighbourhoods with different spatial characteristics – morphological configuration, land use and physical/visual permeability – were analysed in Santa Maria city. Generalized linear regression models were used to infer the relations among variables. The research question was: which spatial characteristics are related to co-presence in public spaces of dispersed residential neighbourhoods? The configurational morphological attributes had statistical significance for almost all regression models for neighbourhood 1. In neighbourhood 2, commercial activity was significant and positively related with all models. The results regarding physical and visual permeability were inconclusive for both study areas.
Sex- and Gender-Related Factors in Blood Product Transfusions
Authors: Zimmerman Barret J. , McGregor Alyson J.
Published: September 2020

Blood products are indicated for a plethora of conditions in several settings, with a variety of products available for transfusion, from highly processed specific components to whole blood. Matching the donor product to the recipient is crucial in avoiding serious transfusion reactions, with the extent of matching depending on the physiological need, setting, and product. There are important factors related to sex and gender differences in donated blood products, adverse reactions to those products, interplay with underlying pathology, as well as sociocultural differences in the collection. This article will review key sex- and gender-specific research related to the use of blood products with an emphasis on the acute care setting.
Primary Versus Salvage Reverse Total Shoulder Arthroplasty for Displaced Proximal Humerus Fractures in the Elderly: A Systematic Review and Meta-analysis
Authors: Nelson Patrick A , Kwan Changyow C , Tjong Vehniah K , Terry Michael A , Sheth Ujash
Published: September 2020

Background

There is currently no established consensus on best treatment for complex proximal humerus fractures (PHFs) in the elderly. Reverse total shoulder arthroplasty (RTSA) is a viable option in this population but many times is used as a salvage procedure.

Methods

A systematic review of studies comparing RTSA as a primary treatment for PHF versus as a salvage procedure following failed open reduction internal fixation (ORIF), humeral intramedullary nailing, hemiarthroplasty (HA) or non-operative treatment was conducted using PRISMA guidelines. Pooled outcomes and sub-group analyses assessing range of motion, patient reported outcomes and complications were examined using RevMan.

Results

Five articles were included in final analysis with 104 patients in the primary RTSA group and 147 in the salvage RTSA group compromising 251 total patients. Primary RTSA had a statistically significant advantage in range of motion (forward flexion and external rotation), patient reported outcomes, and complications compared to salvage RTSA.

Conclusions

Based on the best available evidence, primary RTSA may result in slightly better patient reported outcomes, range of motion and a lower rate of complication when compared to salvage RTSA. Further high-quality prospective studies are needed to confirm the findings of the current review.
Vestibular migraine presenting with acute peripheral vestibulopathy: Clinical, oculographic and vestibular test profiles
Authors: Calic Zeljka , Nham Benjamin , Taylor Rachael L , Young Allison S , Bradshaw Andrew P , McGarvie Leigh M , Colebatch James G , Cordato Dennis , Cappelen-Smith Cecilia , Welgampola Miriam S
Published: September 2020

To describe clinical, oculographic and vestibular test profiles in patients with vestibular migraine (VM) who presented with acute peripheral vestibulopathy. VM was diagnosed according to Bárány Society or Neuhauser criteria. Neuro-otological examination, video-head impulse tests (v-HIT), cervical and ocular vestibular-evoked myogenic potentials (cVEMP/oVEMP), subjective visual horizontal (SVH) and audiometry were undertaken. Ten patients presented with prolonged vertigo. All had primary position unidirectional horizontal spontaneous nystagmus (mean slow-phase velocity 9.6 ± 7.0°). Horizontal canal vestibulo-ocular reflex was reduced in all (mean gain 0.54 ± 0.2) with refixation saccades (cumulative amplitude 6.4 ± 3.2°). Abnormality rates for cVEMP, oVEMP and SVH were 30%, 80%, 78%, respectively. Magnetic resonance imaging brain was normal in all patients. Patients were followed up over 6 months to 8 years with no change in the final diagnosis. VM can rarely present as an acute peripheral vestibulopathy with findings that mimic vestibular neuritis and should be considered in the differential diagnosis of acute prolonged vertigo.
Bone marrow regeneration requires mitochondrial transfer from donor Cx43-expressing hematopoietic progenitors to stroma
Authors: Golan Karin , Singh Abhishek K. , Kollet Orit , Bertagna Mayla , Althoff Mark J. , Khatib-Massalha Eman , Petrovich-Kopitman Ekaterina , Wellendorf Ashley M. , Massalha Hassan , Levin-Zaidman Smadar , Dadosh Tali , Bohan Breanna , V. Gawali Mruniya , Dasgupta Biplab , Lapidot Tsvee , Cancelas Jose A.
Published: September 2020

The fate of hematopoietic stem and progenitor cells (HSPC) is tightly regulated by their bone marrow (BM) microenvironment (ME). BM transplantation (BMT) frequently requires irradiation preconditioning to ablate endogenous hematopoietic cells. Whether the stromal ME is damaged and how it recovers after irradiation is unknown. We report that BM mesenchymal stromal cells (MSC) undergo massive damage to their mitochondrial function after irradiation. Donor healthy HSPC transfer functional mitochondria to the stromal ME, thus improving mitochondria activity in recipient MSC. Mitochondrial transfer to MSC is cell-contact dependent and mediated by HSPC connexin-43 (Cx43). Hematopoietic Cx43-deficient chimeric mice show reduced mitochondria transfer, which was rescued upon re-expression of Cx43 in HSPC or culture with isolated mitochondria from Cx43 deficient HSPCs. Increased intracellular adenosine triphosphate levels activate the purinergic receptor P2RX7 and lead to reduced activity of adenosine 5′-monophosphate–activated protein kinase (AMPK) in HSPC, dramatically increasing mitochondria transfer to BM MSC. Host stromal ME recovery and donor HSPC engraftment were augmented after mitochondria transfer. Deficiency of Cx43 delayed mesenchymal and osteogenic regeneration while in vivo AMPK inhibition increased stromal recovery. As a consequence, the hematopoietic compartment reconstitution was improved because of the recovery of the supportive stromal ME. Our findings demonstrate that healthy donor HSPC not only reconstitute the hematopoietic system after transplantation, but also support and induce the metabolic recovery of their irradiated, damaged ME via mitochondria transfer. Understanding the mechanisms regulating stromal recovery after myeloablative stress are of high clinical interest to optimize BMT procedures and underscore the importance of accessory, non-HSC to accelerate hematopoietic engraftment.
Specialized regulatory T cells control venous blood clot resolution through SPARC
Authors: Shahneh Fatemeh , Grill Alexandra , Klein Matthias , Frauhammer Felix , Bopp Tobias , Schäfer Katrin , Raker Verena K. , Becker Christian
Published: September 2020

The cells and mechanisms involved in blood clot resorption are only partially known. We show that regulatory T cells (Tregs) accumulate in venous blood clots and regulate thrombolysis by controlling the recruitment, differentiation and matrix metalloproteinase (MMP) activity of monocytes. We describe a clot Treg population that forms the matricellular acid– and cysteine-rich protein SPARC (secreted protein acidic and rich in cysteine) and show that SPARC enhances monocyte MMP activity and that SPARC+ Tregs are crucial for blood clot resorption. By comparing different treatment times, we define a therapeutic window of Treg expansion that accelerates clot resorption.
Flotetuzumab as salvage immunotherapy for refractory acute myeloid leukemia
Authors: Uy Geoffrey L. , Aldoss Ibrahim , Foster Matthew C. , Sayre Peter H. , Wieduwilt Matthew J. , Advani Anjali S. , Godwin John E. , Arellano Martha L. , Sweet Kendra L. , Emadi Ashkan , Ravandi Farhad , Erba Harry P. , Byrne Michael , Michaelis Laura , Topp Max S. , Vey Norbert , Ciceri Fabio , Carrabba Matteo Giovanni , Paolini Stefania , Huls Gerwin A. , Jongen-Lavrencic Mojca , Wermke Martin , Chevallier Patrice , Gyan Emmanuel , Récher Christian , Stiff Patrick J. , Pettit Kristen M. , Löwenberg Bob , Church Sarah E. , Anderson Erica , Vadakekolathu Jayakumar , Santaguida Marianne , Rettig Michael P. , Muth John , Curtis Teia , Fehr Erin , Guo Kuo , Zhao Jian , Bakkacha Ouiam , Jacobs Kenneth , Tran Kathy , Kaminker Patrick , Kostova Maya , Bonvini Ezio , Walter Roland B. , Davidson-Moncada Jan K. , Rutella Sergio , DiPersio John F.
Published: September 2020

Approximately 50% of acute myeloid leukemia (AML) patients do not respond to induction therapy (primary induction failure [PIF]) or relapse after <6 months (early relapse [ER]). We have recently shown an association between an immune-infiltrated tumor microenvironment (TME) and resistance to cytarabine-based chemotherapy but responsiveness to flotetuzumab, a bispecific DART antibody-based molecule to CD3ε and CD123. This paper reports the results of a multicenter, open-label, phase 1/2 study of flotetuzumab in 88 adults with relapsed/refractory AML: 42 in a dose-finding segment and 46 at the recommended phase 2 dose (RP2D) of 500 ng/kg per day. The most frequent adverse events were infusion-related reactions (IRRs)/cytokine release syndrome (CRS), largely grade 1-2. Stepwise dosing during week 1, pretreatment dexamethasone, prompt use of tocilizumab, and temporary dose reductions/interruptions successfully prevented severe IRR/CRS. Clinical benefit accrued to PIF/ER patients showing an immune-infiltrated TME. Among 30 PIF/ER patients treated at the RP2D, the complete remission (CR)/CR with partial hematological recovery (CRh) rate was 26.7%, with an overall response rate (CR/CRh/CR with incomplete hematological recovery) of 30.0%. In PIF/ER patients who achieved CR/CRh, median overall survival was 10.2 months (range, 1.87-27.27), with 6- and 12-month survival rates of 75% (95% confidence interval [CI], 0.450-1.05) and 50% (95% CI, 0.154-0.846). Bone marrow transcriptomic analysis showed that a parsimonious 10-gene signature predicted CRs to flotetuzumab (area under the receiver operating characteristic curve = 0.904 vs 0.672 for the European LeukemiaNet classifier). Flotetuzumab represents an innovative experimental approach associated with acceptable safety and encouraging evidence of activity in PIF/ER patients. This trial was registered at www.clinicaltrials.gov as #NCT02152956.
Phenotyping Root Systems in a Set of Japonica Rice Accessions: Can Structural Traits Predict the Response to Drought?
Authors: Guimarães Paulo Henrique Ramos , de Lima Isabela Pereira , de Castro Adriano Pereira , Lanna Anna Cristina , Guimarães Santos Melo Patrícia , de Raïssac Marcel
Published: September 2020

Background

The root system plays a major role in plant growth and development and root system architecture is reported to be the main trait related to plant adaptation to drought. However, phenotyping root systems in situ is not suited to high-throughput methods, leading to the development of non-destructive methods for evaluations in more or less controlled root environments. This study used a root phenotyping platform with a panel of 20 japonica rice accessions in order to: (i) assess their genetic diversity for a set of structural and morphological root traits and classify the different types; (ii) analyze the plastic response of their root system to a water deficit at reproductive phase and (iii) explore the ability of the platform for high-throughput phenotyping of root structure and morphology.

Results

High variability for the studied root traits was found in the reduced set of accessions. Using eight selected traits under irrigated conditions, five root clusters were found that differed in root thickness, branching index and the pattern of fine and thick root distribution along the profile. When water deficit occurred at reproductive phase, some accessions significantly reduced root growth compared to the irrigated treatment, while others stimulated it. It was found that root cluster, as defined under irrigated conditions, could not predict the plastic response of roots under drought.

Conclusions

This study revealed the possibility of reconstructing the structure of root systems from scanned images. It was thus possible to significantly class root systems according to simple structural traits, opening up the way for using such a platform for medium to high-throughput phenotyping. The study also highlighted the uncoupling between root structures under non-limiting water conditions and their response to drought.
ADEPT: a domain independent sequence alignment strategy for gpu architectures
Authors: Awan Muaaz G. , Deslippe Jack , Buluc Aydin , Selvitopi Oguz , Hofmeyr Steven , Oliker Leonid , Yelick Katherine
Published: September 2020

Background

Bioinformatic workflows frequently make use of automated genome assembly and protein clustering tools. At the core of most of these tools, a significant portion of execution time is spent in determining optimal local alignment between two sequences. This task is performed with the Smith-Waterman algorithm, which is a dynamic programming based method. With the advent of modern sequencing technologies and increasing size of both genome and protein databases, a need for faster Smith-Waterman implementations has emerged. Multiple SIMD strategies for the Smith-Waterman algorithm are available for CPUs. However, with the move of HPC facilities towards accelerator based architectures, a need for an efficient GPU accelerated strategy has emerged. Existing GPU based strategies have either been optimized for a specific type of characters (Nucleotides or Amino Acids) or for only a handful of application use-cases.

Results

In this paper, we present ADEPT, a new sequence alignment strategy for GPU architectures that is domain independent, supporting alignment of sequences from both genomes and proteins. Our proposed strategy uses GPU specific optimizations that do not rely on the nature of sequence. We demonstrate the feasibility of this strategy by implementing the Smith-Waterman algorithm and comparing it to similar CPU strategies as well as the fastest known GPU methods for each domain. ADEPT’s driver enables it to scale across multiple GPUs and allows easy integration into software pipelines which utilize large scale computational systems. We have shown that the ADEPT based Smith-Waterman algorithm demonstrates a peak performance of 360 GCUPS and 497 GCUPs for protein based and DNA based datasets respectively on a single GPU node (8 GPUs) of the Cori Supercomputer. Overall ADEPT shows 10x faster performance in a node-to-node comparison against a corresponding SIMD CPU implementation.

Conclusions

ADEPT demonstrates a performance that is either comparable or better than existing GPU strategies. We demonstrated the efficacy of ADEPT in supporting existing bionformatics software pipelines by integrating ADEPT in MetaHipMer a high-performance denovo metagenome assembler and PASTIS a high-performance protein similarity graph construction pipeline. Our results show 10% and 30% boost of performance in MetaHipMer and PASTIS respectively.
Establishment of a PEG-mediated protoplast transformation system based on DNA and CRISPR/Cas9 ribonucleoprotein complexes for banana
Authors: Wu Shaoping , Zhu Haocheng , Liu Jinxing , Yang Qiaosong , Shao Xiuhong , Bi Fangcheng , Hu Chunhua , Huo Heqiang , Chen Kunling , Yi Ganjun
Published: September 2020

Background

To date, CRISPR/Cas9 RNP editing tools have not been applied to the genetic modification of banana. Here, the establishment of a PEG-mediated banana protoplast transformation system makes it possible to build an efficient DNA-free method for a site-directed mutagenesis system.

Results

Protoplasts constitute a versatile platform for transient expression in plant science. In this study, we established a PEG-mediated banana protoplast transformation system. This system was further optimized for successfully delivering CRISPR/Cas9 and CRISPR/Cas12a plasmids and CRISPR/Cas9 ribonucleoproteins (RNPs) for targeted delivery of the PDS gene into banana protoplasts. Specific bands were observed in PCR-Restriction Enzyme Digestion (PCR-RE) assays, and Sanger sequencing of single clones further confirmed the occurrence of indels at target sites. Deep amplicon sequencing results showed that the editing efficiency of the CRISPR/Cas9 system was higher than that of the other two systems.

Conclusions

The PEG-mediated banana protoplast transformation system can serve as a rapid and effective tool for transient expression assays and sgRNA validation in banana. The application of the CRISPR/Cas9 RNP system enables the generation of banana plants engineered by DNA-free gene editing.
Dose–response relationship between intergenerational contact frequency and depressive symptoms amongst elderly Chinese parents: a cross-sectional study
Authors: Xie Yaofei , Ma Mengdi , Wu Wenwen , Zhang Yupeng , Zhang Yuting , Tan Xiaodong
Published: September 2020

Background

Given the high prevalence of depressive symptoms amongst the elderly Chinese population and the significance of intergenerational contact in this demographic group, the purpose of this study was to examine the association and dose–response relationship between the frequency of intergenerational contact and depressive symptoms.

Methods

Data were obtained from the third wave of the China Health and Retirement Longitudinal Study. A total of 5791 participants at age 60 or older were included in this study. Depressive symptoms were defined by the 10-item version of the Centre for Epidemiologic Studies Depression Scale. Intergenerational contact included in-person meeting and remote connecting, and they were analysed separately. Intergenerational contact frequency was classified into ten categories and then treated as a continuous variable for analysis. We performed univariate and multivariate logistic regressions to identify risk covariables. Restrictive cubic spline analysis was used to examine the dose–response relationship between intergenerational contact frequency and the outcome of depressive symptoms.

Results

Both the frequency of meeting and the frequency of connecting with children were independently associated with depressive symptoms in the elderly, and the odds ratios for depressive symptoms increased with decreasing frequencies (P < 0.01). There was a negative dose–response relationship between intergenerational contact frequency and depressive symptoms. The odds of depressive symptoms steadily decreased with increasing frequency of meeting with their children. Following an initial increase, the odds rapidly decreased as the frequency of connecting with children increased with an inflection point at once a monthly. Both associations were nonlinear (P < 0.001).

Conclusions

Our findings revealed a negative dose–response relationship between intergenerational contact frequency and depressive symptoms in the elderly Chinese population. Thus, future health interventions should consider cultural norms in shaping the mental well-being of Chinese elderly persons.
Survey and analysis of the availability and affordability of essential drugs in Hefei based on WHO / HAI standard survey methods
Authors: Dong Zuojun , Tao Qiucheng , Sun Guojun
Published: September 2020

Background

The 2018 edition of the National Essential drugs List came into effect in September 2018. Relevant policies require that all primary medical and health institutions should supply national essential drugs, while secondary and tertiary medical and health institutions should supply a certain percentage of essential drugs.

Methods

Our research used the standard methods of WHO and HAI, selected 50 basic drugs, combined with the actual situation of Hefei City, selected 30 medical institutions and 30 pharmacies, conducted drug availability and affordability studies.

Results

The availability of the lowest-price generics (LPGs) of essential drug in Hefei is much higher than that of the Originator brands (OBs); the overall affordability is better, but there is a large gap between the affordability levels of OBs and LPGs. OBs are relatively poorly affordable.

Conclusion

The implementation of the national essential drug system in Hefei has achieved certain results, but there is still a gap from the expected target. It is recommended to update and adjust the list of essential drugs in accordance with the demand for clinical medicines, ensure that medical and health institutions at all levels supply essential drugs, popularize knowledge of essential drugs, and moderately adjust the price of OBs to reduce the medication burden.
Spatial access inequities and childhood immunisation uptake in Kenya
Authors: Joseph Noel K. , Macharia Peter M. , Ouma Paul O. , Mumo Jeremiah , Jalang’o Rose , Wagacha Peter W. , Achieng Victor O. , Ndung’u Eunice , Okoth Peter , Muñiz Maria , Guigoz Yaniss , Panciera Rocco , Ray Nicolas , Okiro Emelda A.
Published: September 2020

Background

Poor access to immunisation services remains a major barrier to achieving equity and expanding vaccination coverage in many sub-Saharan African countries. In Kenya, the extent to which spatial access affects immunisation coverage is not well understood. The aim of this study was to quantify spatial accessibility to immunising health facilities and determine its influence on immunisation uptake in Kenya while controlling for potential confounders.

Methods

Spatial databases of immunising facilities, road network, land use and elevation were used within a cost friction algorithim to estimate the travel time to immunising health facilities. Two travel scenarios were evaluated; (1) Walking only and (2) Optimistic scenario combining walking and motorized transport. Mean travel time to health facilities and proportions of the total population living within 1-h to the nearest immunising health facility were computed. Data from a nationally representative cross-sectional survey (KDHS 2014), was used to estimate the effect of mean travel time at survey cluster units for both fully immunised status and third dose of diphtheria-tetanus-pertussis (DPT3) vaccine using multi-level logistic regression models.

Results

Nationally, the mean travel time to immunising health facilities was 63 and 40 min using the walking and the optimistic travel scenarios respectively. Seventy five percent of the total population were within one-hour of walking to an immunising health facility while 93% were within one-hour considering the optimistic scenario. There were substantial variations across the country with 62%(29/47) and 34%(16/47) of the counties with < 90% of the population within one-hour from an immunising health facility using scenarios 1 and 2 respectively. Travel times > 1-h were significantly associated with low immunisation coverage in the univariate analysis for both fully immunised status and DPT3 vaccine. Children living more than 2-h were significantly less likely to be fully immunised [AOR:0.56(0.33–0.94) and receive DPT3 [AOR:0.51(0.21–0.92) after controlling for household wealth, mother’s highest education level, parity and urban/rural residence.

Conclusion

Travel time to immunising health facilities is a barrier to uptake of childhood vaccines in regions with suboptimal accessibility (> 2-h). Strategies that address access barriers in the hardest to reach communities are needed to enhance equitable access to immunisation services in Kenya.
Deep learning based feature-level integration of multi-omics data for breast cancer patients survival analysis
Authors: Tong Li , Mitchel Jonathan , Chatlin Kevin , Wang May D.
Published: September 2020

Background

Breast cancer is the most prevalent and among the most deadly cancers in females. Patients with breast cancer have highly variable survival lengths, indicating a need to identify prognostic biomarkers for personalized diagnosis and treatment. With the development of new technologies such as next-generation sequencing, multi-omics information are becoming available for a more thorough evaluation of a patient’s condition. In this study, we aim to improve breast cancer overall survival prediction by integrating multi-omics data (e.g., gene expression, DNA methylation, miRNA expression, and copy number variations (CNVs)).

Methods

Motivated by multi-view learning, we propose a novel strategy to integrate multi-omics data for breast cancer survival prediction by applying complementary and consensus principles. The complementary principle assumes each -omics data contains modality-unique information. To preserve such information, we develop a concatenation autoencoder (ConcatAE) that concatenates the hidden features learned from each modality for integration. The consensus principle assumes that the disagreements among modalities upper bound the model errors. To get rid of the noises or discrepancies among modalities, we develop a cross-modality autoencoder (CrossAE) to maximize the agreement among modalities to achieve a modality-invariant representation. We first validate the effectiveness of our proposed models on the MNIST simulated data. We then apply these models to the TCCA breast cancer multi-omics data for overall survival prediction.

Results

For breast cancer overall survival prediction, the integration of DNA methylation and miRNA expression achieves the best overall performance of 0.641 ± 0.031 with ConcatAE, and 0.63 ± 0.081 with CrossAE. Both strategies outperform baseline single-modality models using only DNA methylation (0.583 ± 0.058) or miRNA expression (0.616 ± 0.057).

Conclusions

In conclusion, we achieve improved overall survival prediction performance by utilizing either the complementary or consensus information among multi-omics data. The proposed ConcatAE and CrossAE models can inspire future deep representation-based multi-omics integration techniques. We believe these novel multi-omics integration models can benefit the personalized diagnosis and treatment of breast cancer patients.
An app for supporting older people receiving home care – usage, aspects of health and health literacy: a quasi-experimental study
Authors: Göransson Carina , Wengström Yvonne , Hälleberg-Nyman Maria , Langius-Eklöf Ann , Ziegert Kristina , Blomberg Karin
Published: September 2020

Background

During the last decade, there has been an increase in studies describing use of mHealth, using smartphones with apps, in the healthcare system by a variety of populations. Despite this, few interventions including apps are targeting older people receiving home care. Developing mobile technology to its full potential of being interactive in real time remains a challenge. The current study is part of a larger project for identifying and managing health concerns via an app by using real-time data. The aim of the study was to describe older people’s usage of an app and to evaluate the impact of usage on aspects of health and health literacy over time.

Methods

A quasi-experimental design was employed. Seventeen older people self-reported health concerns via Interaktor twice a week for 3-months and answered questionnaires at baseline, the end of the intervention and at a 6–month follow-up. Logged data on app usage and data on Sense of Coherence, Health Index, Nutrition Form for the Elderly, Geriatric Depression Scale-20, Swedish Communicative and Critical Health Literacy and Swedish Functional Health Literacy were collected and analysed using descriptive and non-parametric inferential statistics.

Results

The median usage of the app as intended was 96%. Pain was one of the most reported health concerns and was also the health concern that triggered an alert (n = 33). The older people’s communicative and critical health literacy improved significantly over time. Regarding the scores of Sense of Coherence, Health Index, Nutritional Form for the Elderly, Geriatric Depression Scale-20 and Swedish Functional Health Literacy scale, there were no significant differences over time.

Conclusions

The high app usage showed that an app may be a suitable tool for some older people living alone and receiving home care. The results indicate that the usage of Interaktor can support older people by significantly improving their communicative and critical health literacy. Aspects of health were not shown to be affected by the usage of the app. Further research with larger sample is needed for evaluation the effect on health literacy, and which aspects of health of importance to support by an app.
Personal selling in health and medicine: using sales agents to engage audiences
Authors: Elrod James K. , Fortenberry John L.
Published: September 2020

Background

Personal selling—the use of sales agents to personally deliver messages to target audiences—is often not the first conveyance pathway that comes to mind when thinking about marketing communications in the health services industry. This is not surprising given that sales force roles are not as public and prominent as other promotional avenues, such as advertising and public relations. Further, the titles held by those in sales-oriented roles in the health services industry are usually more discreet, carrying designations such as community liaison, business development officer, and the like. Regardless of title, sales roles involve personally interacting with desired audiences to compel some sort of action, adding a vital form of communication that bolsters engagement opportunities.

Discussion

Personal selling plays a critical role in the promotion of health services organizations. Perhaps most obviously, it is distinguished from its counterparts in the marketing communications mix by its use of people to deliver messages to desired audiences. Associated titles, duties, and expectations vary widely between and among those healthcare entities which make use of personal selling, as there is no pat formula for deployment within health services environments. To shed light on personal selling, this article presents an associated overview through the lens of Willis-Knighton Health System, sharing practical insights and experiences which can assist peer healthcare establishments in understanding, shaping, and honing sales roles within their own facilities.

Conclusions

Taking advantage of the utility afforded by direct, personal interactions with audiences, personal selling provides a helpful communications resource that better enables healthcare providers to connect proficiently with target markets. It supplements other forms of marketing communication, operating synergistically to help healthcare institutions achieve their conveyance goals. Prudent deployment of this unique marketing communications method affords health and medical institutions with a capable conveyance asset that can provide great assistance in achieving communicative ambitions.
Direct marketing in health and medicine: using direct mail, email marketing, and related communicative methods to engage patients
Authors: Elrod James K. , Fortenberry John L.
Published: September 2020

Background

Direct marketing—the delivery of messages via mail, the Internet, and similar routes directly to consumers—is used extensively by healthcare organizations to attract and inform current and prospective patients of health and medical offerings and opportunities. Examples of direct marketing include direct-mail marketing, telemarketing, and Internet marketing, with routes being selected on the basis of their ability to reach desired audiences. The various avenues offered by direct marketing afford options to address most any sought group.

Discussion

Direct marketing is one of the most recognized forms of marketing communication, thanks in large part to its widespread use and direct engagement of consumers. While some applications clearly have the potential to irritate consumers (e.g., junk mail in post boxes, spam in email inboxes), direct marketing can be deployed in manners respectful of recipients and, in such cases, it can prove to be a helpful communications asset. To aid others in understanding this particular conveyance method, this article presents an overview of direct marketing and shares deployment insights and experiences from Willis-Knighton Health System.

Conclusions

Direct marketing provides a useful communications pathway, permitting health and medical institutions to educate and enlighten desired audiences. Given instances of overuse and misuse by organizations, however, great care must be taken to design and deploy direct marketing initiatives inoffensively. If well designed and respectfully implemented, direct marketing affords significant communications utility, earning a valued place in the marketing communications arsenals of healthcare establishments.
Foundational elements of communication in health and medicine: avenues for strengthening the marketing communications mix
Authors: Elrod James K. , Fortenberry John L.
Published: September 2020

Background

When one thinks of opportunities to engage patients, the marketing communications mix often is the first thing that comes to mind. Its five components of advertising, personal selling, sales promotion, public relations, and direct marketing represent tried and true pathways for establishing productive dialogues with customers of healthcare institutions. But in formulating and deploying the marketing communications mix, health and medical establishments must not neglect foundational elements which play vital communicative roles, impacting the perspectives of patients and influencing associated patronage.

Discussion

Many things communicate on behalf of healthcare organizations, including the people employed by them, the places in which they deliver services, and the brands that represent them. As foundational elements of communication, these must be addressed prior to formulating the marketing communications mix, as they influence and impact an institution’s entire communicative potential. Their initial development, however, is just the beginning, as these elements must be managed and maintained continually over the course of organizational life. This article profiles foundational elements of communication and discusses their importance in healthcare marketing, generally, and marketing communications, specifically, providing useful insights for maximizing communicative synergies.

Conclusions

Given the importance of engaging current and prospective patients, healthcare establishments must take steps to ensure exceptional prowess in this area, with communicative skills and abilities being of paramount importance. Proficient deployment of the marketing communications mix is essential, but healthcare providers must also be certain to direct attention toward foundational elements, ensuring that given institutions realize their full communicative potential.