bluuebunny/crossref_metadata_2025 huggingface dataset:
A Systematic Review of Law Enforcement Training Related to Autism Spectrum Disorder
Authors: Railey Kirsten S. , Love Abigail M. A. , Campbell Jonathan M.
Published: June 2020

Although research confirms the effectiveness of training to improve law enforcement officers’ (LEOs) awareness and knowledge of people with intellectual disability and learning disabilities, review of the efficacy of autism-specific law enforcement training is needed. To provide up-to-date information regarding training for LEOs related to autism spectrum disorder (ASD), a systematic review of the literature was conducted. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (PRISMA), we conducted a search of 13 professional databases and 28 journals using search terms related to both ASD and law enforcement training. From 606 articles identified during the initial search, only two articles met inclusion criteria, which suggests that limited research exists that explores ASD and law enforcement training. Included studies were summarized in terms of participants as well as training format, content, and outcomes. Limitations of the current literature, directions for future research, and current implications for practice are discussed.
The pattern and gender disparity in global burden of age-related macular degeneration
Authors: Lin Xiling , Lou Lixia , Miao Qi , Wang Yijie , Jin Kai , Shan Pengfei , Xu Yufeng
Published: June 2020

Purpose:

To explore the trend patterns and gender disparity in global burden of age-related macular degeneration (AMD) by year, age, and socioeconomic status using disability-adjusted life-years (DALYs) from Global Burden of Disease (GBD) study 2017.

Methods:

DALYs and impairment data caused by AMD were extracted from GBD Study 2017. World Bank income level (WBIL) and human development index (HDI) in 2017 were cited as indicators of socioeconomic status. The Gini coefficients and the concentration indexes were calculated to unveil trends in between-country inequality. The association between gender inequality and socioeconomic levels was analyzed by Pearson correlation.

Results:

Total age-standardized DALYs of AMD showed a slightly descending pattern in recent years. However, gender disparity has existed since 1990 for almost three decades, with female being more heavily impacted. This pattern became more obvious with aging and varied among different WHO and WBIL regions. Meanwhile, female subjects tended to have higher vision impairments. Gini coefficients of AMD burden increased from 0.423 to 0.448, while the ones of female-to-male ratio fluctuated around 0.11 between 1990 and 2017, with concentration indexes changing from 0.024 to −0.057 and 0.046 to 0.029 respectively. Female-minus-male difference ( r = 0.1721, p = 0.0195) and female-to-male ratio ( r = 0.2072, p = 0.0048) of age-standardized DALYs rates were positively related to HDI.

Conclusions:

Though global AMD health care is progressing, gender imbalance in disease burden of AMD distribution barely improved. Gender sensitive health policy should be emphasized for the increasing elder population and relieving the higher AMD burden of females.
Caring for gender diverse children and adolescents in Italy: A mixed-method investigation of clinicians’ knowledge and approach to clinical practice
Authors: Fortunato Alexandro , Giovanardi Guido , Mirabella Marta , Di Ceglie Domenico , Speranza Anna Maria , Caviglia Giorgio , Lingiardi Vittorio
Published: June 2020

Introduction:

In today’s Italy, gender diversity has assumed a remarkable resonance and visibility in both scientific and popular literature, which has facilitated the development of studies regarding treatments and support for children and adolescents with gender-related issues.

Aim:

the aim of this study was to conduct a preliminary evaluation of how Italian clinicians (psychologists and pediatricians) perceive gender variant children and adolescents, evaluating their approach to clinical practice.

Methods:

An online questionnaire directed to clinicians regarding their experience with, and perceptions of, gender variant children and adolescents was used for the first part of the research. In the second part of this study, Consensual Qualitative Research (CQR) methodology was applied to semi-structured interviews aimed at investigating clinicians’ approach to clinical practice.

Results:

Professionals reported 374 cases, including 200 children (aged 2–11 years) and 174 adolescents (aged 12–19 years); a total of 10 interviews were conducted with professionals.

Conclusion:

This study highlights the increase of gender variant children and adolescents seen by professionals, but also the poor awareness of Italian professionals about gender diversity and their care, as well as an absence of a network model of intervention.
‘We are doing better’: Biopolitical nationalism and the COVID-19 virus in East Asia
Authors: Kloet Jeroen de , Lin Jian , Chow Yiu Fai
Published: June 2020

The COVID-19 pandemic stirs up strong nationalist and localist sentiments; places pride themselves on containing the virus more effectively: We are doing better. We call this ‘biopolitical nationalism’, understood by us as the dynamics between body, geopolitics and affect. When looking at mainland China, Taiwan and Hong Kong, we analyse how the biopolitical efforts of these places are being compared, applauded and supported. Under a discourse of life and survival, this celebration of biopolitical control does not fall into the classic reproduction of capital, but speaks to geopolitical identification. Biopolitics has morphed into a field of competition, of rivalry, of nationalistic – or, perhaps more generally, localist – power games. What can we do as Cultural Studies scholars?
Dominance, collaboration and resistance: Developing the idea of a national news agency in the Ottoman Empire, 1854–1914
Authors: Yanatma Servet
Published: June 2020

This article investigates the relationship between the Ottoman state and the operations of the most powerful international news agencies of its time, Havas and Reuters, within the Ottoman Empire. The two agencies started to operate in Istanbul during the Crimean War and soon became the most influential sources of news both within and outside the Ottoman Empire. The article examines how the Ottoman state, perceiving them as a threat, attempted to resist their dominant role in news-production by collaborating with other different agencies and actors. When this failed, it tried to found a national news agency.
Grey relational optimization for factors influencing tensile, flexural, and impact properties of hybrid sisal banana fiber epoxy composites
Authors: Sumesh KR , Kanthavel K
Published: June 2020

This research investigates factors contributing mechanical stability of epoxy based composites using Taguchi optimization based grey relational approach. Natural fibers of sisal, banana reinforcement along with epoxy was used as the matrix material for this compression molding technique. The grey relational results observed 7th and 14th trials were having first and second position in mechanical properties: 10% sisal, 15% banana, 8% NaOH, 10 MPa pressure, and 100°C temperature composites; 20% sisal, 10% banana, 5% NaOH, 10 MPa pressure, and 120°C temperature were the combinations. The signal to noise ratio showed the optimized data as 20% sisal, 15% banana, 5% NaOH, 10 MPa pressure, and 100°C temperature. The relation between experimental and predicted grey relational grade using artificial neural network showed good correlation stating the network topology of 5-5-1 with good predictability for analyzing factors influencing mechanical properties. SEM analysis observed pullouts of fiber, breakage in the matrix, and these two causing voids in the single reinforcement substitution using sisal and banana. Hybridization using both the fiber reduces the surface abnormalities and adds to the properties.
Critical density for coverage and connectivity in non-orientation directional sensor network
Authors: Kang Lin , Dong Zengshou , Qi Yanjie
Published: June 2020

Both coverage and connectivity are important problems in wireless sensor networks. As more and more non-orientation sensors are continuously added into the region of interest, the size of covered component and connected component increases; at some point, the network can achieve an entire coverage and full connectivity after which the network percolates. In this article, we analyze the critical density in non-orientation directional sensor network in which the orientations of the sensors are random and the sensors are deployed according to the Poisson point process. We propose an approach to compute the critical density in such a network. A collaborating path is proposed with the sum of field-of-view angles of two collaborating sensors being π. Then a correlated model of non-orientation directional sensing sectors for percolation is proposed to solve the coverage and connectivity problems together. The numerical simulations confirm that percolation occurs on the estimated critical densities. It is worth mentioning that the theoretical analysis and simulation results give insights into the design of directional sensor network in practice.
Law and liberal pedagogy in a post-socialist society: The case of Poland
Authors: Bucholc Marta
Published: June 2020

The article offers a reconstruction of the interrelations between law, state, and culture in the design of Polish economic liberalism after 1989 based on an analysis of publications in the liberal journal Przegląd Polityczny. The notion of ‘liberal pedagogy’ is used to connect the liberal transformation design and the social ideal fuelling the democratic backsliding in Poland. The role of law as a pedagogical device is discussed together with the role of the state in liberal transformation design. The vulnerability of the liberal project is explained as a consequence of the liberals’ failure to appreciate the inseparability of the symbolic, epistemic, and organizational facets of the state’s institutional functionalities, including law-making.
Numerical investigation of porous stack for a solar-powered thermoacoustic refrigerator
Authors: Miled Oumayma , Dhahri Hacen , Mhimid Abdallah
Published: June 2020

This article proposes a numerical analysis for performance improvement of the stack, which represents a crucial element on the solar-powered thermoacoustic refrigerator. The stack is considered as a saturated parallelepiped homogeneous porous media. Numerical simulation of the flow and the heat transfer in the thermoacoustic refrigerator is carried out. The physical flow is governed by the modified Darcy–Brinkmann–Forchheimer model. The governing equations are solved numerically using the lattice Boltzmann method. Furthermore, the local thermal equilibrium assumption is applied to examine heat transfer. Particular attention is paid a new form of the lattice Boltzmann equation system describing the flow and the heat transfer in porous media and fluid regions. The effects of several parameters characterizing the thermal behaviour in the porous medium are studied. The parametric results lead to the optimization of the porous media form. The presence of the viscous dissipation term in the heat transfer formulation within the thermoacoustic system is particularly highlighted, due to its significant effects introduced by the Eckert number.
Research ethics courses as a vaccination against a toxic research environment or culture
Authors: Yeo-Teh Nicole Shu Ling , Tang Bor Luen
Published: June 2020

Hofmann and Holm’s (2019) recent survey on issues of research misconduct with PhD graduates culminated with a notable conclusion by the authors: ‘ Scientific misconduct seems to be an environmental issue as much as a matter of personal integrity’. Here, we re-emphasise the usefulness of an education-based countermeasure against toxic research environments or cultures that promote unethical practices amongst the younger researchers. We posit that an adequately conducted course in research ethics and integrity, with a good dose of case studies and analyses, can function in a manner that is metaphorically akin to vaccination. The training would cultivate the ability to analyse and build confidence in young researchers in making decisions with sound moral reasoning as well as in speaking up or arguing against pressure and coercions into unacceptable behaviour. A sufficiently large number of young researchers exposed to research ethics trainings would essentially provide a research community some degree of lasting herd immunity at its broadest base. Beyond passive immunity, a crop of research ethics-savvy young researchers could also play active and influential roles as role models for others at their level and perhaps even help correct the wayward attitudes of some senior researchers and initiate prompt action from institutional policy makers in a bottom-up manner.
Concise synthesis and antidiabetic activity of natural flavonoid glycosides, oroxins C and D, isolated from the seeds of Oroxylum indium
Authors: Li Gang , Wang Guanghui , Tong Yangliu , Zhu Junheng , Yun Tongtong , Ye Xiaoping , Li Fahui , Yuan Shengli , Liu Qingchao
Published: June 2020

The first concise synthesis of natural flavonoid glycosides, oroxins C (1) and D (2), which were isolated from the seeds of Oroxylum indicum, was efficiently achieved by a convergent strategy. The synthesized natural products 1 and 2 were evaluated for their inhibitory activities against α-glucosidase, α-amylase, and lipase. Compound 1 showed strong α-amylase and lipase inhibition, with IC50 values of 210 and 190 μM, respectively, but exhibited no inhibitory activity against α-glucosidase. Compound 2 showed strong inhibition against α-glucosidase and lipase, with the respective IC50 values of 180 and 80 μM.
Identifying Exceptional Talent in Science, Technology, Engineering, and Mathematics: Increasing Diversity and Assessing Creative Problem-Solving
Authors: Maker C. June
Published: June 2020

In the Cultivating Diverse Talent in STEM project, funded by the National Science Foundation in the United States, new assessments were developed, field tested, used to identify students with exceptional talent in science, technology, engineering, and mathematics (STEM), and compared with existing methods (grade point average [GPA], letters of recommendation, self-statements). Students identified by both methods participated in an internship program in laboratories of scientists on the campus of an R1 university in the Southwest. Existing methods limited the diversity of students identified. Significant differences were found between students identified by the new methods (M2) and existing methods (M1) in GPA, ethnicity, and parent level of education. Ethnicity differences may be due to the ethnic makeup of the partner schools, but differences in GPA and parent level of education cannot be attributed to the location of schools. Although GPAs of M1 students were significantly higher (3.71) than those of M2 students (3.07) and M1 students came from higher income groups and schools in higher income areas, the M2 students scored higher on all the performance assessments of creative problem-solving and at similar levels on concept maps and mathematical problem-solving. Studies of the usefulness and psychometric properties of the new assessments are needed with different groups and in different contexts.
School Nurses on the Front Lines of Healthcare: A Guide in the Recognition of and Response to Teen Dating Violence in Your Schools
Authors: Lucas Christy , Brady Jodi , Olympia Robert P.
Published: June 2020

Teen dating violence (TDV) has become more prevalent in our schools, exacerbated by the omnipotent presence of social media and portals of what dating and gender roles “should be” in Hollywood films and television shows. It is important to recognize that TDV is a threat to mental health, and potentially physical health, and school nurses should develop a framework for recognizing problematic social, physical, and emotional interactions between students. This article describes typical presentations of TDV through a case, providing a mnemonic for recognition and resources for prevention.
Advances in research on the effects of natural drugs with immune-promoting effects on immune function
Authors: Wang Lu , Li Sha , Liu Haibo , Bao Lidao
Published: June 2020

Immune-enhanced natural medicines have gradually formed unique functions and usages through long-term medical practice, which contained rich immunological ideas and contents. The immune-enhancing natural medicine has a wide range of pharmacological effects in anti-inflammatory, anti-tumor, anti-viral, and immunity enhancement. In recent years, great progress has been made in the study of immune-enhanced natural drugs. In this article, the main active ingredients of some natural drugs with immune-enhancing function are reviewed, which can enhance immunity by regulating the level of some cytokines and affecting the function of non-specific immunity and specific immunity. The experimental research provides the basis and prospects for the research and development of immune-enhanced natural drugs in the future, providing new ideas for immunotherapy.
Adjacent Primary Care May Reduce Less Urgent Pediatric Emergency Department Visits
Authors: Ellbrant Julia , Åkeson Jonas , Sletten Helena , Eckner Jenny , Karlsland Åkeson Pia
Published: June 2020

Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P < .001), visits in the lowest triage group (36% lower; P < .001), patients presenting with fever ( P = .001) or ear pain ( P < .001), and nonadmitted ED patients ( P = .033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 ( P < .001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.
An Empirical Investigation of Chinese College Students in Volunteer Teaching Activities: Dilemmas, Challenges, and Solutions
Authors: Lili Liu , Yingjin Cui
Published: June 2020

Looking at the course of educational development in developing countries, nongovernmental organizations (NGOs), nonprofit organizations (NPOs), and volunteers have played a significant role in increasing educational resources in underdeveloped areas and moving educational resources to a balanced state. This study used a mixed-methods approach to investigate the underlying factors affecting volunteer teaching activities of Chinese college students. Data were collected from multiple resources using a self-developed questionnaire and semi-structured interviews. It was found that volunteer teaching activities of college students in China were affected by five key factors including motivation ambiguity, confused identity, unspecialized service, weak incentive mechanism, and a lack of supervision mechanism. In addition, exploratory factor analysis revealed that skills, activity experience, and volunteer performance were significantly correlated with the college students’ willingness to participate in volunteer teaching. Informed by the data, we proposed some tentative solutions to solve the challenges and dilemmas from the perspective of consciousness training, systematism cultivation, concept guidance, and the establishment of incentive and supervision mechanism.
A Systematic Review and Meta-analysis of Randomized Controlled Trials Comparing the Accuracy and Clinical Outcome of Pedicle Screw Placement Using Robot-Assisted Technology and Conventional Freehand Technique
Authors: Tarawneh Ahmad M. , Salem Khalid MI.
Published: June 2020

Study Design:

Systematic review and meta-analysis of randomized controlled trials (RCTs).

Objective:

This systematic review and meta-analysis was performed with the aim of exploring the differences in pedicle screw positioning accuracy, surgical time, length of hospital stay, postoperative back and leg Visual Analog Scale, revision surgeries, and intraoperative radiation time and exposure between robot-assisted technology and conventional freehand technique based on RCTs.

Methods:

Several databases, including the Cochrane library, PubMed, and EMBASE were systematically searched to identify potentially eligible articles. Meta-analysis was done using STATA 13 software. The odds ratios and 95% CIs were calculated for the studied categories.

Results:

Seven RCTs involving 290 patients (1298 pedicle screws) in the robot-assisted group and 288 patients (1348 pedicle screws) in the conventional freehand group were analyzed. The results revealed that grade (A) and grade (A+B) screw accuracies were significantly superior in the robot-assisted group ( P = .008 and P = .009, respectively). Overall surgical duration and number of revision surgeries were significantly higher in the robot-assisted group ( P = .014 and P < .0001, respectively). Intraoperative radiation time and dosage were significantly lower in the robot-assisted group ( P < .0001 and P = .036, respectively).

Conclusion:

It was demonstrated that robot-assisted technology is superior to the conventional freehand technique in terms of grade (A) and grade (A+B) screw accuracies and in the reduction of intraoperative radiation time and dosage. On the other hand, the freehand technique showed superior results in terms of overall surgical duration and revision surgery rates.
The Coincidence of 2 Epidemics, Coccidioidomycosis and SARS-CoV-2: A Case Report
Authors: Shah Amar S. , Heidari Arash , Civelli Valerie F. , Sharma Ritika , Clark Charles S. , Munoz Augustine D. , Ragland Alan Scott , Johnson Royce H.
Published: June 2020

In the middle of a pandemic, patients with cough and fever are thought to have SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2). It should be remembered that in the desert southwest of the United States, we have an ongoing epidemic of coccidioidomycosis (CM). There are additionally many other respiratory illnesses that could be confused with CoV-2 or overlooked. This is a case report of CoV-2 engrafted on chronic cavitary pulmonary CM. In a time where the coronavirus pandemic is becoming rampant, we demonstrate the case of a coinfection with cavitary pulmonary CM. In this case, the importance of detection of the coronavirus and treatment of the coinfection is explored.
COVID-19 Presented With Deep Vein Thrombosis: An Unusual Presenting
Authors: Davoodi Lotfollah , Jafarpour Hamed , Taghavi Morteza , Razavi Alireza
Published: June 2020

On December 31, 2019, the World Health Organization was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province, China. The pneumonia was caused by a virus called SARS-Cov-2 (severe acute respiratory syndrome coronavirus 2), which was later named coronavirus infectious disease 2019 (COVID-19). The symptoms most commonly reported by patients affected by COVID-19 include fever, dry cough, and shortness of breath. In this report, we present a case of a 57-year-old woman who presented to the clinic’s infectious department with swelling, pain, warmth, and redness in the left leg who was treated with therapeutic heparin. There were no typical and distinguished symptoms of COVID-19, and she had no risk factor for deep vein thrombosis. Then chest X-ray revealed bilateral patchy ground-glass opacity, and computed tomography angiography was performed to rule out pulmonary thromboembolism, which showed no evidence of thrombosis. Left lower limb venous color Doppler ultrasound revealed dilatation and thrombosis in the external iliac and left iliac veins up to the level of the bifurcation of the common iliac veins, as well as thrombosis to the superficial and small saphenous veins. Because of ground-glass opacity and lymphopenia, nasal swabs were used for sampling, and SARS-CoV-2 nucleic acid was detected by reverse transcription polymerase chain reaction (RT-PCR). This case aims to arouse the medical staff’s awareness of deep vein thrombosis as a clinical symptom of COVID-19 even if the patient has no typical symptoms of COVID-19.
Coronal Alignment Correction and Maintenance of Tibial Slope in Opening-Wedge Valgus High Tibial Osteotomy Using a 4-Reference Kirschner Wire Technique: A Cadaveric Study
Authors: Chuaychoosakoon Chaiwat , Parinyakhup Wachiraphan , Kwanyuang Atichart , Duangnumsawang Yada , Tangtrakulwanich Boonsin , Boonriong Tanarat
Published: June 2020

Background:

Opening-wedge valgus high tibial osteotomy (OWHTO) is a common surgical procedure used to treat symptomatic varus femorotibial malalignment in adults. Several intraoperative methods are available to determine the correct correction alignment, but achieving the desired alignment correction is difficult.

Purpose/Hypothesis:

The aim of this study was to assess a 4-reference K-wire technique that is relatively easy to apply and can reliably assess actual alignment correction during surgery after determination of the desired corrective angle. We hypothesized that this technique would accurately determine the coronal correction and properly maintain the tibial slope intraoperatively during OWHTO.

Study Design:

Descriptive laboratory study.

Methods:

This study was conducted using 12 fresh-frozen cadavers; 12 randomly chosen knees were corrected 5° and 12 knees were corrected 10° by use of 2 coronal and 2 sagittal K-wires. The first and second coronal K-wires were drilled at 4 cm and 1 to 2 cm below the medial joint line toward the tibiofibular joint, respectively. The angles of these 2 coronal K-wires were measured before and after the gap was opened via a modified goniometer. The difference in the angle formed by these 2 coronal K-wires from before to after opening of the gap was the alignment correction angle. In addition, 2 sagittal K-wires were drilled parallel to each other before the gap opening above and below the osteotomy site. Ensuring that these 2 sagittal K-wires remained parallel after the gap opening confirmed that the tibial slope had been maintained. The paired t test was used to compare the desired alignment corrections and the different angles measured between the pre- and postoperative radiographic alignments.

Results:

The mean ± SD differences in angles between the pre- and postoperative alignments of the 5° and 10° corrections were 5.04° ± 0.68° and 10.03° ± 0.68°, respectively, indicating no statistically significant differences between pre- and postoperative alignment in both groups. As well, no significant difference was noted between the pre- and postoperative medial tibial slope ( P = .54).

Conclusion:

The coronal alignment correction and maintenance of the tibial slope using the 4-reference K-wire technique was found to be highly accurate and reliable.

Clinical Relevance:

Achieving the correct angle in OWHTO is difficult, and the 4-reference K-wire technique provides an easier and more reliable way to obtain the correct angle. This technique can be used in most hospital settings, with no need for expensive equipment.
Creating Virtual Presence During a Pandemic
Authors: Millstein Jeffrey H , Chaiyachati Krisda H
Published: June 2020

This article describes ways in which telemedicine has reshaped the doctor–patient relationship, and how we may face the challenge of maintaining a clinician’s presence in the virtual environment.
Rationale and design of a longitudinal study of cerebral small vessel diseases, clinical and imaging outcomes in patients presenting with mild ischaemic stroke: Mild Stroke Study 3
Authors: Clancy Una , Garcia Daniela Jaime , Stringer Michael S , Thrippleton Michael J , Valdés-Hernández Maria C , Wiseman Stewart , Hamilton Olivia KL , Chappell Francesca M , Brown Rosalind , Blair Gordon W , Hewins Will , Sleight Emilie , Ballerini Lucia , Bastin Mark E , Maniega Susana Munoz , MacGillivray Tom , Hetherington Kirstie , Hamid Charlene , Arteaga Carmen , Morgan Alasdair G , Manning Cameron , Backhouse Ellen , Hamilton Iona , Job Dominic , Marshall Ian , Doubal Fergus N , Wardlaw Joanna M
Published: June 2020

Background

Cerebral small vessel disease is a major cause of dementia and stroke, visible on brain magnetic resonance imaging. Recent data suggest that small vessel disease lesions may be dynamic, damage extends into normal-appearing brain and microvascular dysfunctions include abnormal blood–brain barrier leakage, vasoreactivity and pulsatility, but much remains unknown regarding underlying pathophysiology, symptoms, clinical features and risk factors of small vessel disease. Patients and Methods: The Mild Stroke Study 3 is a prospective observational cohort study to identify risk factors for and clinical implications of small vessel disease progression and regression among up to 300 adults with non-disabling stroke. We perform detailed serial clinical, cognitive, lifestyle, physiological, retinal and brain magnetic resonance imaging assessments over one year; we assess cerebrovascular reactivity, blood flow, pulsatility and blood–brain barrier leakage on magnetic resonance imaging at baseline; we follow up to four years by post and phone. The study is registered ISRCTN 12113543.

Factors which influence direction and rate of change of small vessel disease lesions are poorly understood. We investigate the role of small vessel dysfunction using advanced serial neuroimaging in a deeply phenotyped cohort to increase understanding of the natural history of small vessel disease, identify those at highest risk of early disease progression or regression and uncover novel targets for small vessel disease prevention and therapy.
Characteristics of migraine patients with Migraine Disability Assessment (MIDAS) scores in real-world clinical practice
Authors: Chia Victoria , Bogdanov Alina , Yusuf Akeem , Kallenbach Lee
Published: June 2020

Background:

Better understanding of migraine treatment in US clinical practice could be facilitated by availability of Migraine Disability Assessment (MIDAS) questionnaire results collected in routine care. We present results for migraine patients with MIDAS collected in routine clinical practice through an electronic medical record (EMR) system that presented the MIDAS questionnaire as an electronic form during the patient office encounter. The purpose of this retrospective observational study was to gain better understanding of migraine disability and migraine treatment patterns in US real-world clinical practice.

Methods:

In this EMR database study, patients were required to have 12 months baseline time for review of patient and clinical characteristics. Adult patients with documentation of migraine with subsequent MIDAS questionnaire data collected between March 2017 and September 2018 were included. Based on MIDAS responses patients were categorized into grade I—little or no disability, grade II—mild disability, grade III—moderate disability, and grade IV—severe disability.

Results:

This study included 2731 migraine patients with MIDAS results. Overall, 2309 (84.5%) were female with an average age of 46.7 years. Distribution by disability grade was 1161 (42.5%) little or no disability, 424 (15.5%) mild disability, 477 (17.5%) moderate disability, and 669 (24.5%) severe disability. Compared to overall, a larger proportion of patients with severe disability had baseline treatment with acute (71.3% vs. 67.6%) or preventive medications (70.4% vs. 62.0%) and to be on 3+ acute (9.4% vs. 7.0%) or 3+ preventive therapies (17.0% vs. 14.5%).

Conclusion:

Availability of MIDAS results in usual care provides additional insight into migraine care.
Does time from diagnosis to treatment affect the prognosis of patients with newly diagnosed acute myeloid leukemia?
Authors: Röllig Christoph , Kramer Michael , Schliemann Christoph , Mikesch Jan-Henrik , Steffen Björn , Krämer Alwin , Noppeney Richard , Schäfer-Eckart Kerstin , Krause Stefan W. , Hänel Mathias , Herbst Regina , Kunzmann Volker , Einsele Hermann , Jost Edgar , Brümmendorf Tim H. , Scholl Sebastian , Hochhaus Andreas , Neubauer Andreas , Sohlbach Kristina , Fransecky Lars , Kaufmann Martin , Niemann Dirk , Schaich Markus , Frickhofen Norbert , Kiani Alexander , Heits Frank , Krümpelmann Ulrich , Kaiser Ulrich , Kullmer Johannes , Wass Maxi , Stölzel Friedrich , von Bonin Malte , Middeke Jan Moritz , Thiede Christian , Schetelig Johannes , Berdel Wolfgang E. , Ehninger Gerhard , Baldus Claudia D. , Müller-Tidow Carsten , Platzbecker Uwe , Serve Hubert , Bornhäuser Martin
Published: June 2020

In fit patients with newly diagnosed acute myeloid leukemia (AML), immediate treatment start is recommended due to the poor prognosis of untreated acute leukemia. We explored the relationship between time from diagnosis to treatment start (TDT) and prognosis in a large real-world data set from the German Study Alliance Leukemia–Acute Myeloid Leukemia (SAL-AML) registry. All registered non–acute promyelocytic leukemia patients with intensive induction treatment and a minimum 12 months of follow-up were selected (n = 2263). We analyzed influence of TDT on remission, early death, and overall survival (OS) in univariable analyses for each day of treatment delay, in groups of 0 to 5, 6 to 10, 11 to 15, and >15 days of TDT, adjusted for influence of established prognostic variables on outcomes. Median TDT was 3 days (interquartile range, 2-7). Unadjusted 2-year OS rates, stratified by TDT of 0 to 5, 6 to 10, 11 to 15, and >15 days, were 51%, 48%, 44%, and 50% (P = .211). In multivariable Cox regression analysis accounting for established prognostic variables, the TDT hazard ratio as a continuous variable was 1.00 (P = .617). In OS analyses, separately stratified for age ≤60 and >60 years and for high vs lower initial white blood cell count, no significant differences between TDT groups were observed. Our study suggests that TDT is not related to survival. As stratification in intensive first-line AML treatment evolves, TDT data suggest that it may be a feasible approach to wait for genetic and other laboratory test results so that clinically stable patients are assigned the best available treatment option. This trial was registered at www.clinicaltrials.gov as #NCT03188874.
The protective effects of the β3 adrenergic receptor agonist BRL37344 against liver steatosis and inflammation in a rat model of high-fat diet-induced nonalcoholic fatty liver disease (NAFLD)
Authors: Wang Ziwen , Li Shanshan , Wang Ruifeng , Guo Liansheng , Xu Dan , Zhang Tieyuan , Xu Yifan , Wang Wenlong , Wang Min , Gan Zhongwei , Wang Xiaobing
Published: June 2020

Background

Our objective was to investigate the efficacy of the beta-3 adrenergic receptor (β3-AR) agonist BRL37344 for the prevention of liver steatosis and inflammation associated with nonalcoholic fatty liver disease (NAFLD).

Methods

Four groups were established: a control group (given a standard diet), a high-fat diet (HFD) group, an HFD + β3-AR agonist (β3-AGO) group, and an HFD + β3-AR antagonist (β3-ANT) group. All rats were fed for 12 weeks. The β3-AR agonist BRL37344 and the antagonist L748337 were administered for the last 4 weeks with Alzet micro-osmotic pumps. The rat body weights (g) were measured at the end of the 4th, 8th, and 12th weeks. At the end of the 12th week, the liver weights were measured. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were analyzed with a Hitachi automatic analyzer. The lipid levels of the triglycerides (TGs), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) and the concentrations of free fatty acids (FFAs) were also measured. An oil red O kit was used to detect lipid droplet accumulation in hepatocytes. Steatosis, ballooning degeneration and inflammation were histopathologically determined. The protein and mRNA expression levels of β3-AR, peroxisome proliferator-activated receptor-alpha (PPAR-α), peroxisome proliferator-activated receptor-gamma (PPAR-γ), mitochondrial carnitine palmitoyltransferase-1 (mCPT-1), and fatty acid translocase (FAT)/CD36 were measured by western blot analysis and RT-qPCR, respectively.

Results

After treatment with the β3-AR agonist BRL37344 for 4 weeks, the levels of ALT, AST, TGs, TC, LDL-C and FFAs were decreased in the NAFLD model group compared with the HFD group. Body and liver weights, liver index values and lipid droplet accumulation were lower in the HFD + β3-AGO group than in the HFD group. Decreased NAFLD activity scores (NASs) also showed that liver steatosis and inflammation were ameliorated after treatment with BRL37344. Moreover, the β3-AR antagonist L748337 reversed these effects. Additionally, the protein and gene expression levels of β3-AR, PPAR-α, and mCPT-1 were increased in the HFD + β3-AGO group, whereas those of PPAR-γ and FAT/CD36 were decreased.

Conclusion

The β3-AR agonist BRL37344 is beneficial for reducing liver fat accumulation and for ameliorating liver steatosis and inflammation in NAFLD. These effects may be associated with PPARs/mCPT-1 and FAT/CD36.
Transcription factor TabHLH49 positively regulates dehydrin WZY2 gene expression and enhances drought stress tolerance in wheat
Authors: Liu Hao , Yang Ying , Liu Dandan , Wang Xiaoyu , Zhang Linsheng
Published: June 2020

Background

As functional proteins, dehydrins are found in many maturing seeds and vegetable tissues under adverse environmental conditions. However, the regulation of dehydrin expression remains unclear.

Results

In this study, a novel drought stress-related bHLH transcription factor, TabHLH49, was isolated from a wheat cDNA library treated with the drought and cold stress by using yeast one-hybrid system. TabHLH49 protein possesses a typical conserved bHLH domain and is a Myc-type bHLH transcription factor. TabHLH49 was detected in the nucleus of tobacco epidermal cells, and the amino acid sequences at the C-terminus (amino acids 323–362) is necessary for its transactivation activity. Real-time PCR analyses revealed the tissue-specific expression and drought stress-responsive expression of TabHLH49 in wheat. In addition, the verification in Y1H and electrophoretic mobility shift assays illustrated that TabHLH49 protein can bind and interact with the promoter of the wheat WZY2 dehydrin. Furthermore, the dual-luciferase assays showed that TabHLH49 can positively regulate the expression of WZY2 dehydrin. The transient expression and BSMV-mediated gene silencing of TabHLH49 also showed that TabHLH49 positively regulates the expression of WZY2 dehydrin and improves drought stress resistance in wheat.

Conclusions

These results provide direct evidences that TabHLH49 positively regulates expression level of dehydrin WZY2 gene and improves drought tolerance of wheat.
Technologically-enhanced psychological interventions for older adults: a scoping review
Authors: Vailati Riboni F. , Comazzi B. , Bercovitz K. , Castelnuovo G. , Molinari E. , Pagnini F.
Published: June 2020

Background

The world population is getting older. As life expectancy increases, traditional health care systems are facing different challenges in terms of cost reduction and high-quality service delivery capability. New ways to improve older adults’ quality of life have been explored, taking advantage of new technological solutions. Our focus is on the integration of technology in clinical treatments to facilitate or deliver psychological interventions meant to improve well-being in older adults. Our aims were to describe the main technology-based interventions supporting seniors’ quality of life or psychological well-being and to provide greater clarity to what is described in the current literature as their effects on seniors’ cognitive and psychological outcomes and healthcare policies.

Methods

We reviewed the scientific literature looking for studies that investigated how technology can be implemented into clinical psychology treatments for older adults. Our search was conducted using the following databases: PubMed, PsycINFO, Scopus, ISI Web of Science, and CINAHL. The search provided 350 articles, mostly (≈90%) dated after 2002. Abstract analysis narrowed the selection to 150 papers, according to their relevance and actuality as judged by a restricted group of independent researchers.

Results

Through a thematic analysis, we found that virtual reality (VR), robots, telemedicine, software, video games, and smartphone applications could potentially support older adults’ psychological treatment with a positive impact on healthcare systems.

Conclusion

Findings from the literature are encouraging, although most of these results are only preliminary.
Prostate-specific membrane antigen (PSMA) expression in adenoid cystic carcinoma of the head and neck
Authors: Klein Nulent Thomas J. W. , Valstar Matthijs H. , Smit Laura A. , Smeele Ludwig E. , Zuithoff Nicolaas P. A. , de Keizer Bart , de Bree Remco , van Es Robert J. J. , Willems Stefan M.
Published: June 2020

Background

Treatment options for advanced head and neck adenoid cystic carcinoma (AdCC) are limited. Prostate-Specific Membrane Antigen (PSMA), a transmembrane protein that is known for its use in diagnostics and targeted therapy in prostate cancer, is also expressed by AdCC. This study aimed to analyse PSMA expression in a large cohort of primary, recurrent and metastasized AdCC of the head and neck.

Methods

One hundred ten consecutive patients with histologically confirmed AdCC in the period 1990–2017 were included. An analysis was made of clinical details, revised pathology and semiquantitative immunohistochemical expression of PSMA on tissue microarray and whole slides. Associations of PSMA expression with clinicopathological parameters were explored and survival was analysed by multivariate Cox-proportional Hazard analysis.

Results

PSMA expression was present in 94% of the 110 primary tumours, with a median of 31% positive cells (IQR 15–60%). Primary tumours (n = 18) that recurred (n = 15) and/or had metastases (n = 10) demonstrated 40, 60 and 23% expression respectively. Expression was not independently related to increased pathological stage, tumour grade, and the occurrence of locoregional recurrence or metastasis. After dichotomization, only primary tumour PSMA expression ≤10% appeared to be associated with reduced 10-years recurrence-free survival (HR 3.0, 95% CI 1.1–8.5, p = .04).

Conclusions

PSMA is highly expressed in primary, recurrent and metastatic AdCC of the salivary and seromucous glands. PSMA expression has no value in predicting clinical behaviour of AdCC although low expression may indicate a reduced recurrence-free survival. This study provides supporting results to consider using PSMA as target for imaging and therapy when other diagnostic and palliative treatment options fail.
Bringing new tools, a regional focus, resource-sensitivity, local engagement and necessary discipline to mental health policy and planning
Authors: Atkinson Jo-An , Skinner Adam , Lawson Kenny , Rosenberg Sebastian , Hickie Ian B.
Published: June 2020

Background

While reducing the burden of mental and substance use disorders is a global challenge, it is played out locally. Mental disorders have early ages of onset, syndromal complexity and high individual variability in course and response to treatment. As most locally-delivered health systems do not account for this complexity in their design, implementation, scale or evaluation they often result in disappointing impacts.

Discussion

In this viewpoint, we contend that the absence of an appropriate predictive planning framework is one critical reason that countries fail to make substantial progress in mental health outcomes. Addressing this missing infrastructure is vital to guide and coordinate national and regional (local) investments, to ensure limited mental health resources are put to best use, and to strengthen health systems to achieve the mental health targets of the 2015 Sustainable Development Goals.

Most broad national policies over-emphasize provision of single elements of care (e.g. medicines, individual psychological therapies) and assess their population-level impact through static, linear and program logic-based evaluation. More sophisticated decision analytic approaches that can account for complexity have long been successfully used in non-health sectors and are now emerging in mental health research and practice. We argue that utilization of advanced decision support tools such as systems modelling and simulation, is now required to bring a necessary discipline to new national and local investments in transforming mental health systems.

Conclusion

Systems modelling and simulation delivers an interactive decision analytic tool to test mental health reform and service planning scenarios in a safe environment before implementing them in the real world. The approach drives better decision-making and can inform the scale up of effective and contextually relevant strategies to reduce the burden of mental disorder and enhance the mental wealth of nations.
Clinical analysis of HPV58-positive cervical cancer
Authors: Chen Mengjie , Wang He , Liang Yuejuan , Li Li
Published: June 2020

Objective

To study the clinical features of HPV58-positive cervical cancer.

Methods

A retrospective analysis of 347 patients with HPV58- or HPV16 positive cervical cancer from the Department of Gynecology Tumor of Guangxi Medical University Affiliated Cancer Hospital was performed. Molecular hybridization was used to detect HPV genotypes. The clinical features, including age, pathology, and invasion, were compared between the HPV58 positive and HPV16 positive cervical cancer groups.

Results

A total of 347 patients were eligible for this study, and the proportion of patients who were with poorly differentiated cancer (P = 0.015) was significantly higher in the HPV58 positive group. HPV58 positivity was an independent risk factor for poorly differentiated cancer [HR 2.156, 95% confidence interval: 1.167–3.984, P = 0.014]. The percentage of uterus corps invasion is significantly lower in HPV58 (p = 0.041), but HPV58 positivity is the independent risk factor for uterus corps invasion [HR = 3.985, 95% confidence interval: 1.066–14.893, P = 0.040]. The overall survival of HPV58-positive cervical cancer patients with uterine corpus invasion was significantly lower (P = 0.000). The age of patients in the HPV58-positive cervical cancer at advanced stage was significantly older (P = 0.045).

Conclusions

HPV58-positive cervical cancer patients are at higher risk of poorly differentiated cancer and uterus corps invasion. The patients with HPV58 positive cervical cancer with uterus corps invasion may result a worse prognosis.
Evaluation of commercial veterinary probiotics containing enterococci for transferrable vancomycin resistance genes
Authors: Berreta Ana , Baumgardner Rachel M. , Kopper Jamie J.
Published: June 2020

Objective

Vancomycin resistant enterococci (VRE) are of significant public health concern. The identification of VRE in livestock and food has increased. The objective of this study was to determine if the transferrable vancomycin resistance genes vanA and vanB were present in probiotics marketed for use in animals that claimed to contain Enterococcus spp.

Results

Of the 40 products selected, Enterococcus spp. DNA was successfully extracted from 36 products. Of these 36 products with enterococcal DNA, 2 (6%) had a PCR product consistent with vanA which was confirmed by sequencing. None of the products appeared to contain vanB.