bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of the progression from mild cognitive impairment to Alzheimer’s disease using a radiomics-integrated model
Authors: Shu Zhen-Yu , Mao De-Wang , Xu Yu-yun , Shao Yuan , Pang Pei-Pei , Gong Xiang-Yang
Published: July 2021

Objective:

This study aimed to build and validate a radiomics-integrated model with whole-brain magnetic resonance imaging (MRI) to predict the progression of mild cognitive impairment (MCI) to Alzheimer’s disease (AD).

Methods:

357 patients with MCI were selected from the ADNI database, which is an open-source database for AD with multicentre cooperation, of which 154 progressed to AD during the 48-month follow-up period. Subjects were divided into a training and test group. For each patient, the baseline T1WI MR images were automatically segmented into white matter, gray matter and cerebrospinal fluid (CSF), and radiomics features were extracted from each tissue. Based on the data from the training group, a radiomics signature was built using logistic regression after dimensionality reduction. The radiomics signatures, in combination with the apolipoprotein E4 (APOE4) and baseline neuropsychological scales, were used to build an integrated model using machine learning. The receiver operating characteristics (ROC) curve and data of the test group were used to evaluate the diagnostic accuracy and reliability of the model, respectively. In addition, the clinical prognostic efficacy of the model was evaluated based on the time of progression from MCI to AD.

Results:

Stepwise logistic regression analysis showed that the APOE4, clinical dementia rating, AD assessment scale, and radiomics signature were independent predictors of MCI progression to AD. The integrated model was constructed based on independent predictors using machine learning. The ROC curve showed that the accuracy of the model in the training and the test sets was 0.814 and 0.807, with a specificity of 0.671 and 0.738, and a sensitivity of 0.822 and 0.745, respectively. In addition, the model had the most significant diagnostic efficacy in predicting MCI progression to AD within 12 months, with an AUC of 0.814, sensitivity of 0.726, and specificity of 0.798.

Conclusion:

The integrated model based on whole-brain radiomics can accurately identify and predict the high-risk population of MCI patients who may progress to AD. Radiomics biomarkers are practical in the precursory stage of such disease.
Adolescents’ Experiences of Using a Smartphone Application Hosting a Closed-loop Algorithm to Manage Type 1 Diabetes in Everyday Life: Qualitative Study
Authors: Rankin David , Kimbell Barbara , Allen Janet M. , Besser Rachel E. J. , Boughton Charlotte K. , Campbell Fiona , Elleri Daniela , Fuchs Julia , Ghatak Atrayee , Randell Tabitha , Thankamony Ajay , Trevelyan Nicola , Wilinska Malgorzata E. , Hovorka Roman , Lawton Julia
Published: July 2021

Background:

Closed-loop technology may help address health disparities experienced by adolescents, who are more likely to have suboptimal glycemic control than other age groups and, because of their age, find diabetes self-management particularly challenging. The CamAPS FX closed-loop has sought to address accessibility and usability issues reported by users of previous prototype systems. It comprises small components and a smartphone app used to: announce meal-time boluses, adjust (“boost” or “ease-off”) closed-loop insulin delivery, customize alarms, and review/share data. We explored how using the CamAPS FX platform influences adolescents’ self-management practices and everyday lives.

Methods:

Eighteen adolescents were interviewed after having ≥6 months experience using the closed-loop platform. Data were analyzed thematically.

Results:

Participants reported feeling less burdened and shackled by diabetes because closed-loop components were easier to carry/wear, finger-pricks were not required, the smartphone app provided a discreet and less stigmatizing way of managing diabetes in public, and they were able to customize alarms. Participants also reported checking and reviewing data more regularly, because they did so when using the smartphone for other reasons. Some reported challenges in school settings where use of personal phones was restricted. Participants highlighted how self-management practices were improved because they could easily review glucose data and adjust closed-loop insulin delivery using the “boost” and “ease-off” functions. Some described how using the system resulted in them forgetting about diabetes and neglecting certain tasks.

Conclusions:

A closed-loop system with small components and control algorithm on a smartphone app can enhance usability and acceptability for adolescents and may help address the health-related disparities experienced by this age group. However, challenges can arise from using a medical app on a device which doubles as a smartphone.

Trial registration:

Closed Loop From Onset in Type 1 Diabetes (CLOuD); NCT02871089; https://clinicaltrials.gov/ct2/show/NCT02871089
Negative Effects of Logging on Bird Dispersed Plants in Northern Papuan Lowland Forest, Indonesia
Authors: Pangau-Adam Margaretha , Slowik Jolanta , Trei Jan-Niklas , Waltert Matthias
Published: July 2021

Many plants in New Guinean rainforest have relatively larger fruits than those in other tropical forests and may depend on large animal dispersers, but little is known about the impacts of forest disturbance, especially logging, on the species composition and abundance of these trees. In order to provide a baseline for the understanding of their vulnerability, we counted fruiting plants and measured habitat parameters in primary and human-altered habitats in the little studied lowland forest of northern Papua, Indonesia. During the surveys coinciding with peak fruit season, eighty-nine species were recorded in fruit, with 71 species in 24 families known to be consumed by birds, and most of them (97%) were trees. The diversity of bird-consumed fruiting plants differed among the habitat types and was highest in undisturbed primary forest and hunted primary forest. Secondary forests still had a high number of species and individuals but were dominated by light demanding plants and a low number of uniquely found species. Logged forest and agricultural habitats showed only a low abundance of bird-consumed fruiting plants, being about 2-3 times lower than in primary forests. Plants with large sized fruits (diam. > 20 mm) were mainly found in primary forests, confirming their importance for maintaining interactions between large frugivorous birds and plants that are of relevance for forest regeneration.
Interactions Between People and Nigeria-Cameroon Chimpanzee (Pan troglodytes ellioti) Around Mbam-Djerem National Park, Central Cameroon
Authors: Kamgang Serge Alexis , Bobo Kadiri Serge , Gonder Mary Katherine , Fosso Bernard , Mounga Albert , Fotso Roger Corneille , Ngougni Kenfack Bertille Alix N. , Sinsin Brice
Published: July 2021

Understanding the interactions between local people and chimpanzees is crucial to develop sustainable wildlife conservation strategies and management policy in the Mbam-Djerem National Park (MDNP). The MDNP covers about 416,512 ha and shelters the Nigeria-Cameroon chimpanzee ( Pan troglodytes ellioti) being the most endangered of all currently recognized chimpanzee subspecies. Close to 30,000 people live in the periphery of the MDNP and depend on the park’s resources for subsistence. We investigated the extent of, and factors leading to, the interactions between people and chimpanzees through a socio-economic survey focusing on households (124) and individual interviews (38) in 30% of villages around MDNP. About 95% of the respondents stated that human–wildlife conflict is an issue around MDNP. Access to resources (78.9%), crop damage (84%), and animal attack (11.3%) were the main sources of conflicts. The ground squirrel Xerus erythropus (59.7%), the green monkey Chlorocebus aethiops (20.2%), chimpanzees (7.3%) and baboons Papio anubis (5.6%) were identified as the main conflict animals and the destroyed crops included peanuts (70.2%), maize (15%) and cassava (5%). The population perceptions differed between the park’s four sectors and were significantly influenced by education and the main livelihood activity. The study also provided quantitative evidence on the role of personal and religious beliefs on the behavior towards chimpanzees. Our findings suggest that the improvement of income-generating activities and education will contribute to strengthening the conservation of chimpanzees.
Differential Contribution of the Medial and the Lateral Side of the Joint to Symptoms in Knee Osteoarthritis: A Radiographic and Laboratory Analysis in the Nagahama Study
Authors: Nigoro Kazuya , Ito Hiromu , Kawata Tomotoshi , Ishie Shinichiro , Morita Yugo , Nishitani Kohei , Aoyama Tomoki , Tabara Yasuharu , Matsuda Fumihiko , Narumiya Shu , Matsuda Shuichi
Published: July 2021

Objective:

This cross-sectional study aimed to explore the differences of the medial and lateral sides of the knee joint and precise radiographic abnormalities in contribution to the knee pain and clinical outcomes.

Design:

Participants 60 years or older who underwent radiographic evaluation were included. Knee radiography was assessed using grading systems of the Osteoarthritis Research Society International (OARSI) atlas. The Japanese Knee Osteoarthritis Measure (JKOM) was evaluated as clinical outcomes. Serum high-sensitivity C-reactive protein (hsCRP) was used to evaluate systemic inflammation. We divided the participants into normal, medial-, lateral-, and medial & lateral-OA types and compared their JKOM using an analysis of covariance. Furthermore, we analyzed the relationship between the knee pain and stiffness of JKOM and the grading of each radiographic feature using a multiple regression model.

Results:

Lateral- and medial & lateral-OA groups had a significantly worse symptoms in the total and the pain score, especially in movement subscales, in JKOM score. Lateral-OA groups had higher hsCRP than medial-OA group. Multivariate analysis showed that medial joint space narrowing (JSN), and lateral femoral and tibial osteophytes significantly affected knee pain (adjusted odds ratios: 1.73, 1.28, and 1.55, respectively). The radiographic changes are associated with pain more in JSN in the medial side and osteophytes in the lateral side.

Conclusion:

Lateral- and medial & lateral-OA groups showed worth symptom. In addition, medial JSN and lateral osteophytes have potent effects on the knee pain.
Isolated ten-eleven translocation 2 positive in triple negative essential thrombocythemia: Case report and literature review
Authors: AL-Ansari Rehab Y , Al Otaibi Dena , Al Hudaithi Nourah , Abdalla Leena
Published: July 2021

Essential thrombocythemia is one of the famous diseases under the category of myeloproliferative disorder. It is an end result of a genetic mutation of one or more of the most frequent oncogenes such as Janos kinase 2 (JAK2), MPL proto-oncogene, thrombopoietin receptor (MPL), and calreticulin (CALR). However, negative genetic markers, so-called (triple negative disease), can happen in the presence of other uncommon types of mutation. TET2 (ten-eleven translocation 2) positive as isolated genetic marker in triple negative essential thrombocythemia is uncommon genetic presentation. For that, we are reporting a 22-year-old lady who presented with a feature of dyspepsia and accidentally found to have persistently high platelet count, even after treating her mild iron deficiency anemia with no other secondary causes. Further investigations and bone marrow biopsy supported the diagnosis of isolated TET2 positive in triple negative essential thrombocythemia. We treated her conservatively with good hydration and low dose of aspirin. In conclusion, isolated TET2 positive in triple negative essential thrombocythemia at presentation is uncommon with no clear management or risk stratification guideline. However, it is hypothesized that TET2 mutation precedes JAK2; therefore, the detection of isolated TET2 in a triple negative essential thrombocythemia case should be closely followed for clonal evolution in long term. Further study and guidelines required in this area.
Social Media Skits: Reshaping the Entertainment Experience of Broadcast Audience
Authors: Ojomo Olusegun , Sodeinde Oluwaseyi Adewunmi
Published: July 2021

The emergence of social media has produced diverse changes for broadcast media in the discharge of their entertainment function. While the uses and gratification theory identifies entertainment as one of the needs that motivate the audience to use the media, the technological determinism theory argues that the nature and strength of interaction in the society change as new media technologies evolve. This study is a descriptive and predictive discourse on how social media skits are reshaping audience consumption, participation, expectation, and production of entertainment. As opposed to broadcast experience, the audience engage with social media skits, own them, many times produce them, form relationships around them, demand for new contents, and through their reactions, affect the sustainability of the content providers online. They also redefine entertainment for comedians who release skits to test new comedy materials. These interacting features together reshape the way the audience experience entertainment on social media.
Building Educational Research Capacity: Challenges and Opportunities From the Perspectives of Faculty Members at a National University in Oman
Authors: Hammad Waheed , Al-Ani Wajeha
Published: July 2021

The purpose of this article is to explore the perceptions of faculty members regarding research capacity building in the field of Education. It particularly seeks to identify the challenges and opportunities associated with this practice from the perspectives of these members. The study adopted a qualitative research design, using focus group interviews to collect data from a sample of faculty members in the College of Education at a national university in Oman. The results revealed the existence of some challenges that hampered educational research, including time constraints, the lack of a collaborative research culture, the lack of research training, and the absence of a clear research agenda. The analysis also identified a number of capacity building opportunities such as a research-supportive environment, the availability of research funding, and the role of research groups. The study concludes with some recommendations to improve educational research capacity both in Oman and in the Arab region in general.
The Category of Deviation in the Novel The Master and Margarita by Mikhail Bulgakov
Authors: Ptashkin Alexander
Published: July 2021

This research deals with revealing various linguistic units: lexemes and collocations within the framework of semantic fields of notional components of the category of deviation that are reflected in the works of professional translators, Michael Glenny, Richard Pevear, and Larissa Volokhonsky of The Master and Margarita by Mikhail Bulgakov in the English language. The author takes the method of conceptual analysis of the linguistic units of expressing different parts of semantic fields of components of the mental unit of deviation in English as the basic one here. Lexemes and collocations are also the focus of a contextual method of reviewing the translators’ approaches to the linguistic units of the work under analysis. Different semantic spheres based on personal and professional experience of Michael Glenny, Richard Pevear, and Larissa Volokhonsky reflect the category of deviation in translations of the novel under study. This category includes the central part and periphery. The central part implies the lexemes and collocations of neutral-bookish style, and the periphery means lexical units of informal style. The author also distinguishes the interpretative field within the semantic fields of the category of deviation. The results given in this article can be a basis for comparative analysis of translations within one language or as a source of a contrastive analysis of literary works.
Reversible Encepahlopathy Induced by Ifosfamide with Brain Imaging
Authors: Ali Mohamed Daoud , Semedo Arthur , Adeyemi Boris , Hessissen Leila , El Kababri Maria , Allali Nazik , Chat Latifa , El Haddad Siham
Published: July 2021

Chemotherapy may be responsible for central and/or peripheral neurotoxicity. These neurological complications are frequent but little known. Some molecules are more providers, responsible for acute or late complications, sometimes not reversible. Some manifestations such as acute encephalopathy and acute reversible encephalopathy are increasingly understood. We report here a case of acute ifosfamide-induced encephalopathy (EII) with brain damage resolved after discontinuation of this treatment in a 13-years-old child.
The Gastrointestinal and Gastroesophageal Reflux (GIGER) Scale for Infants and Toddlers
Authors: Pados Britt F. , Repsha Christine , Hill Rebecca R.
Published: July 2021

The purpose of this study was to describe the development of the Gastrointestinal and Gastroesophageal Reflux (GIGER) Scale for Infants and Toddlers, and determine its factor structure and psychometric properties. Items were developed to comprehensively assess gastrointestinal (GI) and gastroesophageal reflux (GER) symptoms observable by a parent. Exploratory factor analysis on 391 responses from parents of children under 2 years old resulted in a 36-item scale with 3 subscales. Internal consistency reliability was acceptable (α = .78-.94). The GIGER total score and all 3 subscales were correlated with the Infant Gastroesophageal Reflux Questionnaire-Revised (I-GERQ-R) ( P < .05) and Infant Gastrointestinal Symptoms Questionnaire (IGSQ) ( P < .05). GIGER total score was higher in infants with a diagnosis of GER ( P < .05) or constipation ( P < .05) compared to those without. The GIGER is a parent-report measure of GI and GER symptoms in children under 2 years old with adequate psychometric properties.
HBV Seroprotection and Anamnestic Response to Booster Vaccination in Pediatric Cancer Survivors
Authors: Suwanpakdee Detchvijitr , Taweesith Wattanee , Traivaree Chanchai , Rujkijyanont Piya
Published: July 2021

Hepatitis B is a major global health concern and can be prevented in the era of vaccination. Impaired immunological memory to primary immunization is a common chemotherapy-related complication among cancer survivors. The study aimed to determine protective immunity against hepatitis B virus (HBV) and anamnestic response to booster vaccination. In all, 107 pediatric cancer survivors previously immunized with primary hepatitis B vaccination were enrolled. A hepatitis B booster dose was administered to those with suboptimal seroprotection (anti-HBs < 10 mIU/mL) and 2 additional doses were subsequently administered at 1 and 6 months to those whose anti-HBs remained low. Clinical and serologic parameters were analyzed. Sero-protective rate against HBV (anti-HBs ≥ 10 mIU/mL) among survivors was 20.6% with geometric mean titer (GMT) of 95.7 ± 265.6 mIU/mL. Anamnestic response was 61% after a booster vaccine among those with suboptimal seroprotection and 100% after 2 additional booster doses among those whose anti-HBs remained low. GMTs among those survivors after the First and third booster vaccines were 320.0 ± 412.4 mIU/mL and 826.5 ± 343.8 mIU/mL, respectively. Age at diagnosis was a significant independent risk factor for adequate seroprotection (adjusted OR = 0.84, 95%CI: 0.71-0.99) with a P-value of .034. No associated risk factors to predict optimal anamnestic response to booster vaccination were identified. Loss of immunological memory to primary hepatitis B immunization is an inevitable complication among most pediatric cancer survivors; therefore, assessing adequate seroprotection is essentially required. For those with limited accessibility to serologic tests, completion of full 3-booster-dose series is alternative and highly recommended.
Cultivating response: Peasant seed and plant–human collaboration in an agro-industrial heartland
Authors: Rezvani Leila
Published: July 2021

Using Donna Haraway’s notion of “response-ability”, or the cultivation of the capacity for response, this paper seeks to understand seed saving and plant breeding as politically and ethically charged modes of interspecies communication. In Brittany, France, a region known for its industrial-scale fresh vegetable production, peasant farmers and organic plant breeders question the modernist plant breeding and agro-industrial paradigm, cross-pollinating ideas to produce new understandings of genotype-environment interaction, biodiversity and heredity. Plant liveliness is understood as politically transformative, constitutive of an agriculture that supports peasant farmer and crop plant creativity and self-determination. In contrast to F1 hybrids, open-pollinated semences paysannes (peasant seed) retain the ability to respond to environmental changes, adapt and evolve over (human and plant) generations. Farmers must in turn engage specific modes of attention, interpreting plant expressions and shaping future generations through rouging and crossing, selecting and saving, watching and learning from their crops. Mutual response is the foundation of interdependence, in which nonconspecific partners adjust to one another’s ways of being and doing in order to labor together. In remaining response-able, farmers reckon with the liveliness and agential capacities of plants, qualities that work against their subsumption into factory-like methods of cultivation. These communicative practices hint at the radical potential for interspecies resistance to monoculture within plant breeding and cultivation, practices that are so often molded by the interests of agro-industrial capital.
Impact of Protocolized Pharmacist Intervention on Critical Activated Partial Thromboplastin Time Values With Heparin Infusions
Authors: Barry Rachelle , Stevens Craig A. , Huynh Trina , Lerner Dmitri
Published: July 2021

Background: Unfractionated heparin (UFH) infusions are commonly managed with nurse-driven nomograms titrated to activated partial thromboplastin time (aPTT). In some patients, anti-Xa values may be more appropriate measures of anticoagulation. At the present institution, an update to the nurse-driven aPTT nomogram requires pharmacist notification and clinical assessment for critically supratherapeutic aPTT results. Objective: The purpose of this study was to evaluate the efficacy and safety of the nomogram update. Methods: A single-center, retrospective, pre-post analysis was conducted in patients treated with UFH who experienced a critical aPTT during the 6 months preceding and following the nomogram update. Patients with erroneous critical aPTT results were excluded. The primary endpoint was the time in therapeutic range (Rosendaal method) from the first critical aPTT until UFH discontinuation. Secondary endpoints included the proportion of patients transitioned to anti-Xa monitoring and the incidence of Bleeding Academic Research Consortium (BARC) 2, 3, 5 bleeding. Data were analyzed by the χ2 test. The study was institutional review board approved. Results: Of 277 UFH infusions, 142 belonged to the pre-implementation group and 135 to the post-implementation group. Baseline aPTTs were similar between the 2 groups. Time in therapeutic range was 58.1% versus 62.4% of between groups ( P = .467). UFH was transitioned to pharmacist-driven anti-Xa monitoring in 16.2% versus 40.3% of patients ( P < .001). BARC 2, 3, 5 bleeding occurred in 23.2% versus 13.4% of patients ( P < .001). Conclusions: Application of these data suggest improved safety and efficacy outcomes with directed pharmacist management of UFH in patients with critically elevated aPTTs.
Haemodynamic effects of riociguat in CTEPH and PAH: a 10-year observational study
Authors: Yang Suqiao , Yang Yuanhua , Zhang Yixiao , Kuang Tuguang , Gong Juanni , Li Jifeng , Li Yidan , Wang Jianfeng , Guo Xiaojuan , Miao Ran
Published: July 2021

Background

Long-term treatment with riociguat has been shown to enhance exercise capacity in patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH). This study sought to evaluate the long-term haemodynamic effects of riociguat in patients with PAH and inoperable CTEPH.

Methods

During this single-centre long-term observational study, riociguat was administered at a three-times-daily dose of up to 2.5 mg. The primary outcome was pulmonary vascular resistance (PVR). The secondary outcomes included mean pulmonary arterial pressure (PAP), cardiac index, mortality, clinical worsening events, 6-min walk distance (6MWD) and World Health Organization functional class (WHO FC).

Results

37 patients (CTEPH n=19; PAH n=18) were included. The median follow-up period was 96 months. The survival estimates for all the patients at 1/3/5/8 years were 0.97/0.86/0.72/0.61, without significant differences between patients with CTEPH and PAH. At the final data cut-off, PVR decreased (1232±462 dyn·s·cm–5versus835±348 dyn·s·cm–5, p<0.001), cardiac index increased (1.7±0.4 L·min−1·m−2versus2.4±0.5 L·min−1·m−2, p<0.001), 6MWD increased by 43.1±59.6 m, and WHO FC improved/stabilised/worsened in 40%/35%/25% of patientsversusbaseline. Improvement in PAP was not shown. Compared with patients in WHO FC I/II and III/IV at baseline, the 8-year clinical worsening-free survival estimates were 0.51versus0.19 (p=0.026).

Conclusions

Riociguat improved PVR and cardiac index for up to 8 years, but not PAP. WHO FC may have certain predictive value for the long-term prognosis.
G protein γ subunit qPE9-1 is involved in rice adaptation under elevated CO2 concentration by regulating leaf photosynthesis
Authors: Wang Ke , Xu Feiyun , Yuan Wei , Sun Leyun , Wang Shaoxian , Aslam Mehtab Muhammad , Zhang Jianhua , Xu Weifeng
Published: July 2021

G protein γ subunit qPE9-1 plays multiple roles in rice growth and development. However, the role of qPE9-1 in rice exposed to elevated carbon dioxide concentration (eCO2) is unknown. Here, we investigated its role in the regulation of rice growth under eCO2 conditions using qPE9-1 overexpression (OE) lines, RNAi lines and corresponding WT rice. Compared to atmospheric carbon dioxide concentration (aCO2), relative expression of qPE9-1 in rice leaf was approximately tenfold higher under eCO2. Under eCO2, the growth of WT and qPE9-1-overexpressing rice was significantly higher than under aCO2. Moreover, there was no significant effect of eCO2 on the growth of qPE9-1 RNAi lines. Furthermore, WT and qPE9-1-overexpressing rice showed higher net photosynthetic rate and carbohydrate content under eCO2 than under aCO2. Moreover, the relative expression of some photosynthesis related genes in WT, but not in RNAi3 line, showed significant difference under eCO2 in RNA-seq analysis. Compared to WT and RNAi lines, the rbcL gene expression and Rubisco content of rice leaves in qPE9-1-overexpressors were higher under eCO2. Overall, these results suggest that qPE9-1 is involved in rice adaptation under elevated CO2 concentration by regulating leaf photosynthesis via moderating rice photosynthetic light reaction and Rubisco content.
Altered precipitation and root herbivory affect the productivity and composition of a mesic grassland
Authors: Barnett Kirk L. , Johnson Scott N. , Facey Sarah L. , Gibson-Forty Eleanor V. J. , Ochoa-Hueso Raul , Power Sally A.
Published: July 2021

Background

Climate change models predict changes in the amount, frequency and seasonality of precipitation events, all of which have the potential to affect the structure and function of grassland ecosystems. While previous studies have examined plant or herbivore responses to these perturbations, few have examined their interactions; even fewer have included belowground herbivores. Given the ecological, economic and biodiversity value of grasslands, and their importance globally for carbon storage and agriculture, this is an important knowledge gap. To address this, we conducted a precipitation manipulation experiment in a former mesic pasture grassland comprising a mixture of C4grasses and C3grasses and forbs, in southeast Australia. Rainfall treatments included a control [ambient], reduced amount [50% ambient] and reduced frequency [ambient rainfall withheld for three weeks, then applied as a single deluge event] manipulations, to simulate predicted changes in both the size and frequency of future rainfall events. In addition, half of all experimental plots were inoculated with adult root herbivores (Scarabaeidae beetles).

Results

We found strong seasonal dependence in plant community responses to both rainfall and root herbivore treatments. The largest effects were seen in the cool season with lower productivity, cover and diversity in rainfall-manipulated plots, while root herbivore inoculation increased the relative abundance of C3, compared to C4, plants.

Conclusions

This study highlights the importance of considering not only the seasonality of plant responses to altered rainfall, but also the important role of interactions between abiotic and biotic drivers of vegetation change when evaluating ecosystem-level responses to future shifts in climatic conditions.
Impaired vascular endothelial function as a perioperative risk predictor – a prospective observational trial
Authors: Schick Volker , Boensch Marc , van Edig Milan , Alfitian Jonas , Pola Tülay , Ecker Hannes , Lindacher Falko , Shah-Hosseini Kija , Wetsch Wolfgang A. , Riedel Bernhard , Schier Robert
Published: July 2021

Background

In the recent years, an increasing number of patients with multiple comorbidities (e.g. coronary artery disease, diabetes, hypertension) presents to the operating room. The clinical risk factors are accompanied by underlying vascular-endothelial dysfunction, which impairs microcirculation and may predispose to end-organ dysfunction and impaired postoperative outcome. Whether preoperative endothelial dysfunction identifies patients at risk of postoperative complications remains unclear. In this prospective observational study, we tested the hypothesis that impaired flow-mediated dilation (FMD), a non-invasive surrogate marker of endothelial function, correlates with Days at Home within 30 days after surgery (DAH30). DAH30 is a patient-centric metric that captures postoperative complications and importantly also hospital re-admissions.

Methods

Seventy-one patients scheduled for major abdominal surgery were enrolled. FMD was performed pre-operatively prior to major abdominal surgery and patients were dichotomised at a threshold value of 10%. FMD was then correlated with DAH30 (primary endpoint) and postoperative complications (secondary endpoints).

Results

DAH30 did not differ between patients with reduced FMD and normal FMD (14 (4) (median (IQR)) vs. 15 (8), P = 0.8). Similary, no differences between both groups were found for CCI (normal FMD: 21 (30) (median (IQR)), reduced FMD: 26 (38), P = 0.4) or frequency of major complications (normal FMD: 7 (19%) (n (%)), reduced FMD: 12 (35%), P = 0.12). The regression analyses revealed that FMD in combination with ASA status and surgery duration had no additional significant predictive effect for DAH30, CCI or Clavien-Dindo score.

Conclusion

FMD does not add predictive value with regards to DAH30, CCI or Clavien-Dindo score within our study cohort of patients undergoing abdominal surgery.

Trial registration

The study was registered in the German Clinical Trials Register (DRKS00005472), prospectively registered on 25/11/2013.
Assessing prognostic value of early tumor shrinkage and depth of response in first-line therapy for patients with advanced unresectable pancreatic cancer
Authors: Yang Xiaojuan , Xian Xinghong , Wang Yongsheng , Qiu Meng
Published: July 2021

Background

The prognostic potential of early tumor shrinkage (ETS) and depth of response (DpR) in pancreatic cancer (PC) is unclear. Here, we recruited 90 patients with recurrent and metastatic PC (RMPC) who had received chemotherapy as first-line therapy to assess the prognostic potential of these markers.

Methods

ETS is characterized as a ≥ 20% depletion in the sum-of-the-longest-diameters (SLD) of measurable tumor lesions at 6–12 weeks than the baseline. DpR is the maximum shrinkage (%) from the baseline to nadir. We evaluated corrections in ETS and DpR with survival.

Results

Of the 63 patients in which ETS assessment was possible, 21 (33.3%) achieved ETS. We found a significant association between the incidence of ETS and an improved rate of progression-free survival (PFS; 6.5 vs. 2.2 months; p < 0.001) and overall survival (OS; 12.1 vs. 6.0 months; p = 0.014). The median value of DpR was − 23.66%. DpR was also related to improved PFS (9.3 vs. 3.1 months; p < 0.001) and OS (18.2 vs. 7.3 months; p < 0.001). Patients who had distant metastasis, not local recurrence, with ETS showed markedly better outcomes. In a multivariate model, both ETS and DpR were independent predictors of OS in the whole population.

Conclusions

ETS and DpR may predict favorable outcomes for RMPC patients who had received chemotherapy as first-line therapy, independent of the agents used. Further studies on the exploratory analyses of the optimum ETS cut-off value in recurrent PC patients to predict favorable clinical outcomes are required.
Backyard benefits? A cross-sectional study of yard size and greenness and children’s physical activity and outdoor play
Authors: Oakley Jessica , Peters Rachel L. , Wake Melissa , Grobler Anneke C. , Kerr Jessica A. , Lycett Kate , Cassim Raisa , Russell Melissa , Sun Cong , Tang Mimi L. K. , Koplin Jennifer J. , Mavoa Suzanne
Published: July 2021

Background

The home environment is the most important location in young children’s lives, yet few studies have examined the relationship between the outdoor home environment and child physical activity levels, and even fewer have used objectively measured exposures and outcomes. This study examined relationships between objectively assessed home yard size and greenness, and child physical activity and outdoor play.

Methods

Data were drawn from the HealthNuts study, a longitudinal study of 5276 children in Melbourne, Australia. We used cross-sectional data from a sample at Wave 3 (2013–2016) when participants were aged 6 years (n = 1648). A sub-sample of 391 children had valid accelerometer data collected from Tri-axial GENEActive accelerometers worn on their non-dominant wrist for 8 consecutive days. Yard area and greenness were calculated using geographic information systems. Objective outcome measures were minutes/day in sedentary, light, and moderate-vigorous physical activity (weekday and weekend separately). Parent-reported outcome measures were minutes/day playing outdoors (weekend and weekday combined). Multi-level regression models (adjusted for child’s sex, mother’s age at the birth of child, neighbourhood socioeconomic index, maternal education, and maternal ethnicity) estimated effects of yard size and greenness on physical activity.

Results

Data were available on outdoor play for 1648 children and usable accelerometer data for 391. Associations between yard size/greenness and components of physical activity were minimal. For example, during weekdays, yard size was not associated with daily minutes in sedentary behaviour (β: 2.4, 95% CI: − 6.2, 11.0), light physical activity (β: 1.4, 95% CI: − 5.7, 8.5) or MVPA (β: -2.4, 95% CI: − 6.5, 1.7), with similar patterns at weekends. There was no relationship between median annual yard greenness and physical activity or play.

Conclusion

In our study of young children residing in higher socio-economic areas of Melbourne yard characteristics did not appear to have a major impact on children’s physical activity. Larger studies with greater variation in yard characteristics and identification of activity location are needed to better understand the importance of home outdoor spaces and guide sustainable city planning.
Design and rationale of the ATtune Knee Outcome Study (ATKOS): multicenter prospective evaluation of a novel uncemented rotating platform knee system
Authors: Rassir Rachid , Sierevelt Inger N. , Schager Marjolein , Nolte Peter A. ,   the ATKOS group, Rademakers Maarten V. , Vergroesen Diederik A. , Spruijt Paul , Baas Niels R. A. , Sonnega Remko J. A. , van Kampen Paulien M. , Lacroix Herman , Verra Wiebe C. , van Lingen Christiaan P. , Boymans Tim A. E. J. , Feczkó Peter Z. , Jütten-Brouwer Liesbeth , Jansen Joris A. , Henkus Hans Erik , Benard Menno R. , Meermans Geert
Published: July 2021

Background

Total Knee Arthroplasty (TKA) remains the gold standard for treatment of debilitating symptoms of knee osteoarthritis (OA). Even though providing satisfactory results for the majority of patients, some studies report dissatisfaction after TKA to be as high as 20%. Among other things, pain catastrophising and self-efficacy are thought to compromise results of TKA. Implant manufacturers keep improving upon their designs in an attempt to improve functional outcomes. One of these novel knee systems is the Attune. To our knowledge, there are no clinical follow-up studies reporting results of the uncemented version. The main objective of this multicentre prospective observational study is to evaluate revision rate, complications, radiographic outcomes (i.e. alignment and radiolucent lines) and patient reported outcomes of the uncemented Attune mobile bearing TKA. Secondary objectives are (1) to assess physical function, return to sport and return to work after TKA and (2) to evaluate the long-term effect of preoperative psychological factors on satisfaction after TKA.

Methods

All patients presenting in the participating centres with knee pathology warranting joint replacement therapy will be considered for inclusion, an absolute indication for cemented fixation is the only exclusion criterium. Evaluation of clinical and radiographic performance (e.g. radiolucent lines) is done at 6 weeks, 6 months, 1 year, 5 years and 10 years after surgery using validated patient reported outcome measures. Cumulative revision rates are calculated after 5 and 10 years using Kaplan–Meier methods. Physical function is assessed with performance based measurements before and 1 year after surgery. Return to sports is assessed using the Tegner and University of California Los Angeles (UCLA) activity rating scale before and 1 year after surgery. Return to work is evaluated by inviting patients of working age to complete a short questionnaire 1 year after surgery. Psychologic factors are assessed using questionnaires for pain catastrophising, pain self-efficacy and mental health before, 5 years and 10 years after surgery. Preoperative psychologic scores are correlated to functional outcomes.

Discussion

The current study aims to report the clinical performance of a novel implant and can help provide insight in factors that play a role in satisfaction after TKA.

Trial registration

ClinicalTrials.gov identifier: NCT04247672 (January 30, 2020)
Experimental study on the factors affecting torque of beam-type implant torque wrenches
Authors: Shiba Hiroki , Sato Yuji , Furuya Junichi , Osawa Tokiko , Isobe Akio , Hayashi Myu , Kitagawa Noboru
Published: July 2021

Background

Screw breakage and loosening are the most common mechanical complications associated with implant treatment, and they may occur due to excess or inadequate screw tightening torque. When fastening and fixing the implant superstructure, screws are tightened using a torque wrench, which is essential for an accurate tightening force. However, the characteristics of the torque wrench have not been fully verified. Therefore, we aimed to clarify the factors affecting the torque with a focus on beam-type torque wrenches, which are the main types of wrenches.

Methods

The torque values generated by beam-type torque wrenches from eight manufacturers were measured using a torque gauge. To investigate the influence of the location of the beam relative to the scale, measurements were performed with a scale aligned with the trailing edge, center, and leading edge of the beam respectively. Additionally, measurements were taken at 90°, 60°, and 30° to examine the effect of the angle at which the examiner read the torque value. Under each condition, a single examiner applied the recommended torque to each manufacturer's screws five times in a clockwise direction. The average measured torque, standard deviation, bias, and coefficient of variation were calculated and compared accordingly.

Results

Wrenches from six manufacturers demonstrated excellent accuracy for measurements at the center of the beam (bias within ± 4%). For measurements at 90°, equipments from five manufacturers displayed excellent accuracy (bias within ± 7%), and seven showed excellent repeatability (coefficient of variation ≤ 2%).

Conclusion

The scale should be aligned with the center of the beam and read from 90° while using a torque wrench. The accuracy and repeatability torques generated by the wrenches differed according to the manufacturer, scale width, scale line width, beam width, and distance between the scale and beam center. Based on these results, we suggest that a torque wrench must be selected after determining the difference in the structure of the torque wrench.
Serum 8-isoprostane levels in patients with resistant oral lichen planus before and after treatment with lycopene: a randomized clinical trial
Authors: Eita Aliaa Abdelmoniem Bedeir , Zaki Azza Mohamed , Mahmoud Sabah Abdelhady
Published: July 2021

Background

Oral lichen planus is an autoimmune disease in which topical steroids are the first line of treatment. The adverse effects of systemic corticosteroids prescribed for resistant oral lichen planus cases advocate alternative modalities. Lycopene is an antioxidant with a wide range of beneficial properties. This trial aimed to evaluate the effect of pure lycopene as compared to systemic corticosteroids (Prednisolone) on the symptoms, signs and oxidative stress in patients with erosive oral lichen planus recalcitrant to topical steroids.

Methods

Twenty patients were randomly divided into the test (lycopene) and control (corticosteroids) groups. Numeric rating scale and Escudier et al. (Br J Dermatol 4:765–770, 2007. 10.1111/j.1365-2133.2007.08106.x) lesion scores were assessed at baseline and weeks 4 and 8 from baseline. Serum levels of 8-isoprostane were measured in all patients at baseline and at the end of treatment (week 8).

Results

There was a significant reduction in signs and symptoms after the end of treatment in each group. However, no significant difference was found between the lycopene and the corticosteroids group. Moreover, a significant reduction in 8-isoprostane levels was observed in the lycopene group from baseline and as compared to the control group.

Conclusions

Based on the study results, lycopene is a safe and effective therapeutic modality for resistant oral lichen planus. 8-isoprostane is a biomarker of lipid peroxidation that can be reduced by lycopene.

Trial registration ID: PACTR202003484099670. 'Retrospectively registered on 11/3/2020'.
Trends in socioeconomic inequality of periodontal health status among Dutch adults: a repeated cross-sectional analysis over two decades
Authors: Li An , Vermaire Jan Hendrik , Chen Yuntao , van der Sluis Luc W. M. , Thomas Renske Z. , Tjakkes Geerten-Has E. , Schuller Annemarie A.
Published: July 2021

Background

Studies exclusively focusing on trends in socioeconomic inequality of oral health status in industrialized countries are relatively sparse. This study aimed to assess possible differences in oral hygiene and periodontal status among people of different socioeconomic status (SES) in the Netherlands over two decades.

Methods

A repeated cross-sectional analysis of 3083 participants aged 25–54 years was conducted on the Dutch National Oral Health Surveys of 1995, 2002, 2007, and 2013. Plaque-free was defined according to the Simplified Oral Hygiene Index (OHI-S = 0). Periodontal status was classified in two different ways, either periodontal health/disease (probing pocket depth index [PDI] = 0/ ≥ 1) or with/without deep pockets (PDI = 2). We used the regression-based absolute and relative effect index to measure the absolute and relative socioeconomic inequalities. Multivariable logistic regressions were used to explore temporal trends in oral hygiene and periodontal status by low- and high-SES groups.

Results

Age-standardized percentages of individuals with plaque-free increased in the whole population from 1995 to 2013 (12.7% [95% CI 10.5–14.9] to 28.1% [24.8–31.5]). Plaque-free showed significant socioeconomic differences in absolute and relative inequalities in 2007 and 2013. Between 1995 and 2013, age-standardized percentage of periodontal health increased (from 51.4% [48.1–54.7] to 60.6% [57.0–64.1]). The significant absolute inequalities for periodontal health were seen in 2002 and 2013. The relative scale presented a similar pattern. Regarding deep pockets, there was little difference in the age-standardized overall prevalence in 1995 versus 2013 (from 6.5% [4.9–8.2] to 5.4% [3.7–7.0]). The significant absolute and relative inequalities in deep pockets prevalence were found in 1995. Yet, all interaction terms between survey year and SES did not reach significance (plaque-free: P = .198; periodontal health: P = .490; deep pockets: P = .678).

Conclusions

Socioeconomic inequalities in oral hygiene and periodontal status were present in the Netherlands in the last two decades.
Validation of the psychometric properties of the Malay advance care planning questionnaire
Authors: Lim Mun Kit , Lai Pauline Siew Mei , Wong Pei Se , Othman Sajaratulnisah , Mydin Fadzilah Hanum Mohd
Published: July 2021

Background

There is a growing interest among the developing countries on advance care planning (ACP) due to the reported benefits of planning ahead in the developed countries. Validated instruments in various languages have been developed to facilitate study on the views of public prior to its implementation. However, instrument to explore the views on ACP in Malay has not been developed and validated yet, even though Malay is spoken extensively by approximately 220 million people in the Malay Archipelago. There is also a need for instrument in Malay language to facilitate the assessment of knowledge, attitude and practice (KAP) of Malaysians regarding ACP. Therefore, the aim of this study was to validate the psychometric properties of the Malay Advance Care Planning Questionnaire (ACPQ-M).

Methods

The ACPQ was translated according to international guidelines. This validation study was conducted from January to June 2018. Participants who were ≥ 21 years old, and able to understand Malay were recruited from an urban primary care clinic and a tertiary education institution in Malaysia. A researcher administered the ACPQ-M to participants via a face-to-face interview at baseline and 2 weeks later. Each interview took approximately 10–20 min.

Results

A total of 222/232 participants agreed to participate (response rate = 96.0%). Exploratory factor analysis and confirmatory factor analysis found that the ACPQ-M was a 4-factor model. The Cronbach’s α values for the four domains ranged from 0.674–0.947. Only 157/222 participants completed the test-retest (response rate = 71%). At test-retest, quadratic weighted kappa values for all domains ranged from 0.340–0.674, except for two domains which ranged from − 0.200-0.467.

Conclusions

The ACPQ-M was found to be a 4-factor model, and a valid and reliable instrument to assess the KAP regarding ACP. This instrument can contribute to profound understanding of the KAP of Malaysians regarding ACP, and assist policy makers in determining the readiness for legislation of ACP in Malaysia.