bluuebunny/crossref_metadata_2025 huggingface dataset:
In vivo measurement of distal radioulnar translation following distal radius fracture
Authors: Giddins Grey E. B. , Pickering Greg T.
Published: May 2021

The incidence of distal radioulnar joint instability following a distal radius fracture is estimated around one in three based upon clinical examination. Using a validated rig, we objectively measured distal radioulnar joint translation in vivo following distal radius fracture. Dorsopalmar translation of the distal radioulnar joint was measured in 50 adults with previous distal radius fractures. Measurements were compared with the uninjured wrist and against a database of previous measurements within healthy and clinically lax populations. Translation at the distal radioulnar joint was greater in injured wrists at 12.2 mm (range 10–15, SD 1.2) than the uninjured wrists at 6.4 (range 4–9, SD 0.8) ( p < 0.001) and was always outside the established normal range. There was no statistically significant link between translation and the severity of the injury. Instability appears almost inevitable following a distal radius (wrist) fracture, albeit subclinical in the vast majority.
Investigation of Anti-SARS, MERS, and COVID-19 Effect of Jinhua Qinggan Granules Based on a Network Pharmacology and Molecular Docking Approach
Authors: Zhang Ying , Yao Yunfeng , Yang Yanfang , Wu Hezhen
Published: May 2021

Objective

Jinhua Qinggan Granules (JQGs) have achieved certain results in the prevention and treatment of COVID-19 in China during this coronavirus storm. In this study, we aimed to analyze the common mechanisms of JQG in the treatment of coronavirus-induced diseases, such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19 via network pharmacology and molecular docking.

Methods

The active compounds of JQG were collected through Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform. The common targets associated with these 3 diseases were screened from GeneCards database. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of JQG’s core targets were analyzed using The Database for Annotation, Visualization, and Integrated Discovery and KOBAS 3.0 system. Further, the protein-protein interaction network was built using STRING database. The compound-target- signaling pathway network was constructed using Cytoscape 3.7.2. The core components of JQG were docked with core targets, COVID-19 coronavirus 3 Cl hydrolase, and angiotensin-converting enzyme 2 (ACE2) via Discovery Studio 2016 software.

Results

A total of 139 active compounds, 50 core targets, and 122 signaling pathways were screened out. The results of molecular docking showed that arctiin and linarin had a higher docking score with 3 Cl, ACE2, and core targets of JQH for antiviral effect.

Conclusion

The potential mechanism of action of JHQ in the treatment of MERS, SARS, and COVID-19 may be associated with the regulation of genes co-expressed with ACE2 and immune- related signaling pathways.
Efficacy of Transcranial Motor Evoked Potential Monitoring During Intra- and Extramedullary Spinal Cord Tumor Surgery: A Prospective Multicenter Study of the Monitoring Committee of the Japanese Society for Spine Surgery and Related Research
Authors: Ushirozako Hiroki , Yoshida Go , Imagama Shiro , Kobayashi Kazuyoshi , Ando Kei , Ando Muneharu , Kawabata Shigenori , Yamada Kei , Kanchiku Tsukasa , Fujiwara Yasushi , Taniguchi Shinichirou , Iwasaki Hiroshi , Shigematsu Hideki , Tadokoro Nobuaki , Takahashi Masahito , Wada Kanichiro , Yamamoto Naoya , Funaba Masahiro , Yasuda Akimasa , Hashimoto Jun , Morito Shinji , Takatani Tsunenori , Tani Toshikazu , Matsuyama Yukihiro
Published: May 2021

Study Design:

Multicenter prospective study.

Objectives:

Although intramedullary spinal cord tumor (IMSCT) and extramedullary SCT (EMSCT) surgeries carry high risk of intraoperative motor deficits (MDs), the benefits of transcranial motor evoked potential (TcMEP) monitoring are well-accepted; however, comparisons have not yet been conducted. This study aimed to clarify the efficacy of TcMEP monitoring during IMSCT and EMSCT resection surgeries.

Methods:

We prospectively reviewed TcMEP monitoring data of 81 consecutive IMSCT and 347 EMSCT patients. We compared the efficacy of interventions based on TcMEP alerts in the IMSCT and EMSCT groups. We defined our alert point as a TcMEP amplitude reduction of ≥70% from baseline.

Results:

In the IMSCT group, TcMEP monitoring revealed 20 true-positive (25%), 8 rescue (10%; rescue rate 29%), 10 false-positive, a false-negative, and 41 true-negative patients, resulting in a sensitivity of 95% and a specificity of 80%. In the EMSCT group, TcMEP monitoring revealed 20 true-positive (6%), 24 rescue (7%; rescue rate 55%), 29 false-positive, 2 false-negative, and 263 true-negative patients, resulting in a sensitivity of 91% and specificity of 90%. The most common TcMEP alert timing was during tumor resection (96% vs. 91%), and suspension surgeries with or without intravenous steroid administration were performed as intervention techniques.

Conclusions:

Postoperative MD rates in IMSCT and EMSCT surgeries using TcMEP monitoring were 25% and 6%, and rescue rates were 29% and 55%. We believe that the usage of TcMEP monitoring and appropriate intervention techniques during SCT surgeries might have predicted and prevented the occurrence of intraoperative MDs.
Triggered Electromyography is a Useful Intraoperative Adjunct to Predict Postoperative Neurological Deficit Following Lumbar Pedicle Screw Instrumentation
Authors: Reddy Rajiv P. , Chang Robert , Coutinho Dominic V. , Meinert Justin W. , Anetakis Katherine M. , Crammond Donald J. , Balzer Jeffrey R. , Shaw Jeremy D. , Lee Joon Y. , Thirumala Parthasarathy D.
Published: May 2021

Study Design:

Systematic review and meta-analysis.

Objectives:

Malposition of pedicle screws during instrumentation in the lumbar spine is associated with complications secondary to spinal cord or nerve root injury. Intraoperative triggered electromyographic monitoring (t-EMG) may be used during instrumentation for early detection of malposition. The association between lumbar pedicle screws stimulated at low EMG thresholds and postoperative neurological deficits, however, remains unknown. The purpose of this study is to assess whether a low threshold t-EMG response to lumbar pedicle screw stimulation can serve as a predictive tool for postoperative neurological deficit.

Methods:

The present study is a meta-analysis of the literature from PubMed, Web of Science, and Embase identifying prospective/retrospective studies with outcomes of patients who underwent lumbar spinal fusion with t-EMG testing.

Results:

The total study cohort consisted of 2,236 patients and the total postoperative neurological deficit rate was 3.04%. 10.78% of the patients incurred at least 1 pedicle screw that was stimulated below the respective EMG alarm threshold intraoperatively. The incidence of postoperative neurological deficits in patients with a lumbar pedicle screw stimulated below EMG alarm threshold during placement was 13.28%, while only 1.80% in the patients without. The pooled DOR was 10.14. Sensitivity was 49% while specificity was 88%.

Conclusions:

Electrically activated lumbar pedicle screws resulting in low t-EMG alarm thresholds are highly specific but weakly sensitive for new postoperative neurological deficits. Patients with new postoperative neurological deficits after lumbar spine surgery were 10 times more likely to have had a lumbar pedicle screw stimulated at a low EMG threshold.
Nanoparticles: A New Approach to Upgrade Cancer Diagnosis and Treatment
Authors: Yu Zhongyang , Gao Lei , Chen Kehan , Zhang Wenqiang , Zhang Qihang , Li Quanwang , Hu Kaiwen
Published: May 2021

Traditional cancer therapeutics have been criticized due to various adverse effects and insufficient damage to targeted tumors. The breakthrough of nanoparticles provides a novel approach for upgrading traditional treatments and diagnosis. Actually, nanoparticles can not only solve the shortcomings of traditional cancer diagnosis and treatment, but also create brand-new perspectives and cutting-edge devices for tumor diagnosis and treatment. However, most of the research about nanoparticles stays in vivo and in vitro stage, and only few clinical researches about nanoparticles have been reported. In this review, we first summarize the current applications of nanoparticles in cancer diagnosis and treatment. After that, we propose the challenges that hinder the clinical applications of NPs and provide feasible solutions in combination with the updated literature in the last two years. At the end, we will provide our opinions on the future developments of NPs in tumor diagnosis and treatment.
Accel-Align: a fast sequence mapper and aligner based on the seed–embed–extend method
Authors: Yan Yiqing , Chaturvedi Nimisha , Appuswamy Raja
Published: May 2021

Background

Improvements in sequencing technology continue to drive sequencing cost towards $100 per genome. However, mapping sequenced data to a reference genome remains a computationally-intensive task due to the dependence on edit distance for dealing with INDELs and mismatches introduced by sequencing. All modern aligners use seed–filter–extend methodology and rely on filtration heuristics to reduce the overhead of edit distance computation. However, filtering has inherent performance–accuracy trade-offs that limits its effectiveness.

Results

Motivated by algorithmic advances in randomized low-distortion embedding, we introduce SEE, a new methodology for developing sequence mappers and aligners. While SFE focuses on eliminating sub-optimal candidates, SEE focuses instead on identifying optimal candidates. To do so, SEE transforms the read and reference strings from edit distance regime to the Hamming regime by embedding them using a randomized algorithm, and uses Hamming distance over the embedded set to identify optimal candidates. To show that SEE performs well in practice, we present Accel-Align an SEE-based short-read sequence mapper and aligner that is 3–12$$\times$$
×
faster than state-of-the-art aligners on commodity CPUs, without any special-purpose hardware, while providing comparable accuracy.

Conclusions

As sequencing technologies continue to increase read length while improving throughput and accuracy, we believe that randomized embeddings open up new avenues for optimization that cannot be achieved by using edit distance. Thus, the techniques presented in this paper have a much broader scope as they can be used for other applications like graph alignment, multiple sequence alignment, and sequence assembly.
Dynamic transcriptome and histomorphology analysis of developmental traits of hindlimb thigh muscle from Odorrana tormota and its adaptability to different life history stages
Authors: Shu Yilin , He Jun , Zhang Huijuan , Liu Guangxuan , Li Shikun , Deng Shuaitao , Wu Hailong
Published: May 2021

Background

Systematic studies on the development and adaptation of hindlimb muscles in anura amphibians are rare. Here, we integrated analysis of transcriptome and histomorphological data for the hindlimb thigh muscle ofOdorrana tormota(concave-eared torrent frog) at different developmental stages, to uncover the developmental traits of hindlimb thigh muscle fromO. tormotaand its adaptability to different life history stages.

Results

The development of hindlimb thigh muscle fromO. tormotahas the following characteristics. Before metamorphosis, myogenous cells proliferate and differentiate into myotubes, and form 11 muscle groups at G41; Primary myofibers and secondary myofibers appeared during metamorphosis; 11 muscle groups differentiated continuously to form myofibers, accompanied by myofibers hypertrophy after metamorphosis; During the growth process ofO. tormotafrom G42 to G46, there were differences between the sexes in the muscle groups that differentiate into muscle fibers, indicating that there was sexual dimorphism in the hindlimb thigh muscles ofO. tormotaat the metamorphosis stages. Some genes and pathways related to growth, development, and movement ability ofO. tormotaat different developmental stages were obtained. In addition, some pathways associated with adaptation to metamorphosis and hibernation also were enriched. Furthermore, integrated analysis of the number of myofibers and transcriptome data suggested that myofibers of specific muscle groups in the hindlimbs may be degraded through lysosome and ubiquitin pathways to transform into energy metabolism and other energy-related substances to meet the physiological needs of hibernation.

Conclusions

These results provide further understanding the hindlimb thigh muscle development pattern of frogs and their adaption to life history stages.
Residual paralysis caused by 50 mg rocuronium after reversal with 4 mg/kg sugammadex: a case report
Authors: Uzawa Kohji , Seki Hiroyuki , Yorozu Tomoko
Published: May 2021

Background

Rocuronium-induced neuromuscular blockade can be quickly and completely reversed by administration of an optimal dose of sugammadex. Sugammadex antagonizes rocuronium-induced neuromuscular blockade by encapsulating rocuronium. Herein, we report a case of residual neuromuscular paralysis in which the recommended dose of sugammadex (4 mg·kg− 1) failed to antagonize a rocuronium-induced blockade.

Case presentation

A 71-year-old man (body mass index: 26.7 kg·m− 2) underwent endoscopic submucosal dissection of early-stage gastric cancer. He had no known factors that may have affected the effects of rocuronium and sugammadex. He received rocuronium (50 mg; 0.7 mg·kg− 1) for anesthesia induction. No additional rocuronium was administered during the 71-min procedure. Ninety-four minutes after rocuronium administration, neuromuscular monitoring showed 20 twitches in response to post-tetanic count stimulation. The train-of-four (TOF) ratio was not measurable despite sugammadex (280 mg; 4 mg/kg) administration, although four weak twitches in response to TOF stimulation appeared in 3 min. The TOF ratio became detectable following administration of an additional dose of sugammadex (120 mg; 1.7 mg·kg− 1), and it recovered to 107% 8 min after the second dose. The patient opened his eyes; moved his neck, arms, and limbs; and regained consciousness. The trachea was extubated and the patient was transferred to the ward.

Conclusions

Neuromuscular monitoring should be used if a neuromuscular blockage agent is administered, even if the recommended dose of sugammadex is administered.
Socio-economic inequality in the prevalence of violence against older adults – findings from India
Authors: Sinha Debashree , Mishra Prem Shankar , Srivastava Shobhit , Kumar Pradeep
Published: May 2021

Background

Violence against older adults is a well-recognised socio-psychological and public health problem. It is uncared-for, undiagnosed, and an untreated problem that is widespread across both developed and developing countries. The present paper aims to understand the extent of the socio-economic status related inequality in violence against older adults in India.

Methods

The study uses data from Building a Knowledge Base on Population Aging in India (BKPAI). Violence against older adults is the outcome variable for the study and is defined as older adults who faced any abuse or violence or neglect or disrespect by any person. Bivariate analysis and regression-based decomposition technique is used to understand the relative contribution of various socio-economic factors to violence against older adults (N = 9541).

Results

The prevalence of violence faced by older adults was 11.2%. Older adults aged 80+ years [OR: 1.49; CI: 1.14–1.93] and working [OR: 1.26; CI: 1.02–1.56] had higher likelihood to face violence than their counterparts. On the other hand, older adults who were currently in union [OR: 0.79; CI: 0.65–0.95], lived with children [OR: 0.53; CI: 0.40–0.72] and who belonged to richer wealth quintile [OR: 0.35; CI:0.24–0.51] had lower likelihood to suffer from violence than their counterparts. The decomposition results revealed that poor older adults were more prone to violence (Concentration index: − 0.20). Household’s wealth status was responsible for explaining 93.7% of the socio-economic status related inequality whereas living arrangement of older adults explained 13.7% of the socio-economic related inequality. Education and working status of older adults made a substantial contribution to the inequalities in reported violence, explaining 3.7% and 3.3% of the total inequality, respectively.

Conclusion

Though interpretation of the results requires a cautious understanding of the data used, the present study highlights some of the relevant issues faced by the country’s older adults. With no or meagre income of their own, older adults belonging to the poorest wealth quintile have little or no bargaining power to secure a violent free environment for themselves. Therefore, special attention in terms of social and economic support should be given to the economically vulnerable older population.
A case report of endocarditis and spondylitis caused by Brucella melitensis biovar 3
Authors: Zhang Huan , Xie Songsong , Wang Yueli , Zhao Xiaoli , Yi Jihai , Wang Zhen , Liu Qi , Deng Xiaoyu , Li Bingjie , Cui Buyun , Wang Yuanzhi , Chen Chuangfu
Published: May 2021

Background

This case report describes the clinical process of a shepherd who suffered brucellosis-related endocarditis (BE) and spondylitis (BS) and was infected with Brucella melitensis biovar 3 (B. melitensis biovar 3).

Case presentation

A 55-year-old male patient was admitted to The First Affiliated Hospital of Shihezi University on October 11, 2018, due to over 3 months of intermittent fever, back pain, and heart trouble. The Rose Bengal Plate test was positive, the standard agglutination test titer for brucellosis was 1/800, and the blood culture was positive for B. melitensis biovar 3. Three instances of transthoracic echocardiography examination at days 1, 25, and 376 after admission to the hospital and magnetic resonance imaging (MRI) and computed tomography (CT) checks at days 5 and 38 revealed that the size of the vegetation on the posterior leaflet of the mitral valve increased from 0.7 × 1.4 cm to 1.2 × 1.5 cm and that the left atrium and ventricle were enlarged. The MRI and CT results showed hyperplasia of the second and third vertebra, a cold abscess formed on both sides of the psoas major muscles, and the vertebra hyperplasia became aggravated at a later time point. The patient’s situation deteriorated, and heart failure was discovered on October 22, 2019. At the moment of submission of this manuscript, the patient remains in bed at home because of severe debility caused by brucellosis.

Conclusions

This is the first reported case of endocarditis combined with spondylitis caused by B. melitensis biovar 3 in a shepherd. Brucellosis infection can cause work-power losses because of misdiagnosis or a lack of proper treatment. Early diagnosis and treatment are essential for a successful outcome.
Crossed brainstem syndrome revealing bleeding brainstem cavernous malformation: an illustrative case
Authors: Beucler Nathan , Boissonneau Sébastien , Ruf Aurélia , Fuentes Stéphane , Carron Romain , Dufour Henry
Published: May 2021

Background

Since the nineteenth century, a great variety of crossed brainstem syndromes (CBS) have been described in the medical literature. A CBS typically combines ipsilateral cranial nerves deficits to contralateral long tracts involvement such as hemiparesis or hemianesthesia. Classical CBS seem in fact not to be so clear-cut entities with up to 20% of patients showing different or unnamed combinations of crossed symptoms. In terms of etiologies, acute brainstem infarction predominates but CBS secondary to hemorrhage, neoplasm, abscess, and demyelination have been described. The aim of this study was to assess the proportion of CBS caused by a bleeding episode arising from a brainstem cavernous malformation (BCM) reported in the literature.

Case presentation

We present the case of a typical Foville syndrome in a 65-year-old man that was caused by a pontine BCM with extralesional bleeding. Following the first bleeding episode, a conservative management was decided but the patient had eventually to be operated on soon after the second bleeding event.

Discussion

A literature review was conducted focusing on the five most common CBS (Benedikt, Weber, Foville, Millard-Gubler, Wallenberg) on Medline database from inception to 2020. According to the literature, hemorrhagic BCM account for approximately 7 % of CBS. Microsurgical excision may be indicated after the second bleeding episode but needs to be carefully weighted up against the risks of the surgical procedure and openly discussed with the patient.

Conclusions

In the setting of a CBS, neuroimaging work-up may not infrequently reveal a BCM requiring complex multidisciplinary team management including neurosurgical advice.
In utero fetal left ventricular rupture and pseudoaneurysm formation: a case report
Authors: Heland Sarah , Hope Sarah , Edwards Andrew , Chalmers Rebecca , Stewart Alice , Kroushev Annie , Sheridan Bennett , Hooper Stuart , Palmer Kirsten R.
Published: May 2021

Background

Cardiac ventricular aneurysms affect 1 in 200,000 live births. To the best of our knowledge, no reported cases of a left ventricular pseudoaneurym and in utero rupture exist to guide optimal management.

Case presentation

We present a case of fetal left ventricular rupture with a large pericardial effusion, cardiac tamponade and subsequent pseudoaneurysm formation with concerns for a poor prognosis. Interventional drainage of the pericardial effusion led to resolution of tamponade and significant improvement in fetal condition. A multidisciplinary team was utilised to plan birth to minimise risk of pseudoaneurysmal rupture and a catastrophic bleed at birth.

Conclusion

For similar cases we recommend consideration of birth by caesarean section, delayed cord clamping and a prostaglandin E1 infusion, to reduce the systemic pressures on the left ventricle during transition from fetal to neonatal circulations, until definitive surgical repair. In this case, this resulted in a successful outcome.
Can an amino acid mixture alleviate gastrointestinal symptoms in neuroendocrine tumor patients?
Authors: Chauhan Aman , Das Satya , Miller Rachel , Luque Laura , Cheuvront Samuel N. , Cloud James , Tarter Zach , Siddiqui Fariha , Ramirez Robert A. , Anthony Lowell
Published: May 2021

Background

Neuroendocrine tumors, although relatively rare in incidence, are now the second most prevalent gastrointestinal neoplasm owing to indolent disease biology. A small but significant sub-group of neuroendocrine tumor patients suffer from diarrhea. This is usually secondary to carcinoid syndrome but can also be a result of short gut syndrome, bile acid excess or iatrogenic etiologies. Recently, an amino acid based oral rehydration solution (enterade® Advanced Oncology Formula) was found to have anti-diarrheal properties in preclinical models.

Methods

A retrospective chart review of all NET patients treated with enterade® AO was performed after IRB approval.

Results

Ninety-eight NET patients who had received enterade® AO at our clinic from May 2017 through June 2019 were included. Patients (N = 49 of 98) with follow up data on bowel movements (BMs) were included for final analysis. Eighty-four percent of patients (41/49) had fewer BMs after taking enterade® AO and 66% (27/41) reported more than 50% reduction in BM frequency. The mean number of daily BMs was 6.6 (range, 3–20) at baseline before initiation of therapy, while the mean number of BMs at 1 week time point post enterade® AO was 2.9 (range, 0–11).

Conclusions

Our retrospective observations are encouraging and support prospective validation with appropriate controls in NET patients. This is first published report of the potential anti-diarrheal activity of enterade® AO in NET patients.
Refractive errors and visual impairment among children and adolescents in southernmost China
Authors: Peng Li , Gao Ling , Zheng Yunyan , Dai Yanan , Xie Qing
Published: May 2021

Background

Refractive errors and visual impairment in southernmost China have not been reported previously. We aim to investigate and determine the age-specific prevalence of myopia, hyperopia, astigmatism, and visual impairment based on a large population cross-sectional study in Hainan area of southernmost tropical province in China.

Methods

A population-based sample of 31,524 children aged 6–15 years from Hainan was assessed. Non-cycloplegic autorefraction and visual acuity (VA) analyses were performed on all participants and a subgroup of participants undergoing cycloplegia.

Results

Of all participants, 23.0% presented uncorrected VA (UCVA) was worse than 20/40 in worse eye, 6.0% presented mild presenting visual acuity impairment (PVAI), 7.0% presented moderate PVAI, 0.2% presented severe PVAI in the better eye, and 46.9% presented abnormal UCVA [worse than 20/25 (≥ 6, < 8 years old) and worse than 20/20 (≥ 8 years and older)] at least in one eye. The overall prevalence of myopia [spherical equivalent (SE) ≤  − 0.50 D] and high myopia (SE ≤  − 6.00 D) were 46.0%, 1.0% respectively. Hyperopia [SE ≥  + 1.00 D (≥ 7 years old) and SE ≥  + 2.00 D (≥ 6, < 7 years old)] and significant hyperopia (SE ≥  + 3.00 D) were 4.2 and 0.6%, respectively. Astigmatism [cylinder ≥ 1.00 D (≥ 7 years old) and ≥ 1.75 D (≥ 6, < 7 years old)] was found in 31.9%.

Conclusions

Myopia was the most common refractive error in southernmost province in China (Hainan). Its prevalence increased with age, while hyperopia prevalence showed a decreasing trend. However, myopia, especially high myopia prevalence was much lower than in other urban regions across China.
The effectiveness of graphic health warnings on tobacco products: a systematic review on perceived harm and quit intentions
Authors: Pang Bo , Saleme Pamela , Seydel Tori , Kim Jeawon , Knox Kathy , Rundle-Thiele Sharyn
Published: May 2021

Background

Examination of the format and framing of the graphic health warnings (GHWs) on tobacco products and their impact on tobacco cessation has received increasing attention. This review focused on systematically identifying and synthesizing evidence of longitudinal studies that evaluate different GHW formats and specifically considered GHW influence on perceived risk of tobacco use and quit intentions.

Methods

Ten databases were systematically searched for relevant records in December 2017 and again in September 2019. Thirty-five longitudinal studies were identified and analyzed in terms of the formatting of GHWs and the outcomes of perceived risk and quit intentions. Quality assessment of all studies was conducted.

Results

This review found graphics exceeding 50% of packs were the most common ratio for GHWs, and identified an ongoing reliance on negatively framed messages and limited source attribution. Perceived harms and quit intentions were increased by GHWs. However, wear-out effects were observed regardless of GHW format indicating the length of time warnings are present in market warrants ongoing research attention to identify wear out points. Quit intentions and perceived harm were also combined into a cognitive response measure, limiting the evaluation of the effects of each GHW format variables in those cases. In addition, alternative GHW package inserts were found to be a complimentary approach to traditional GHWs.

Conclusions

This review demonstrated the role of GHWs on increasing quit intentions and perceptions of health risks by evaluating quality-assessed longitudinal research designs. The findings of this study recommend testing alternate GHW formats that communicate quit benefits and objective methodologies to extend beyond self-report.
Lung function impairment and cardiometabolic risks among rural adults: implication for an aging society
Authors: Lin Yu-Chih , Huang Tung-Jung , Yeh Mei-Hua , Lin Ming-Shyan , Chen Mei-Yen
Published: May 2021

Background

Early detection and prevention of cardiometabolic risk factors in an increasingly aging society are a global public health concern. Maintaining adequate lung function is important for healthy aging. Few studies exist on lung function impairment and decline in primary healthcare settings, especially among rural adults with cardiometabolic risks. This study aimed to explore the prevalence of impaired lung function and its association with cardiometabolic risks among rural adults.

Methods

A community-based, cross-sectional study was conducted between March and December 2019 in western coastal Yunlin County, Taiwan. The lung function test was measured by spirometry, based on the American Thoracic Society recommendations. Three lung function parameters were obstructive lung impairment, restrictive lung impairment, and mixed lung impairment. Restrictive, obstructive, and mixed type lung function was categorized as impaired. Cardiometabolic risk factors and metabolic syndrome were based on the national standard and include five abnormal biomarkers, including abdominal obesity, blood pressure, fasting plasma glucose, triglycerides, and decreased high-density cholesterol levels.

Results

The median age of the 1653 (92.9%) participants with complete data was 66 years (interquartile range: 55 to 75 years). The prevalence of impaired lung function was 37%, including 31.7% restrictive, 2.5% obstructive, and 2.7% mixed type. Adults with impaired lung function (86% restrictive type) engaged more in smoking and betel nut chewing, ate fewer vegetables and fruit, and drank less water compared to the normal lung function group. After adjusting for potential confounding variables, multivariate logistic regression analysis showed that cardiometabolic risk factors were independently associated with restrictive lung impairment, while cigarette smoking (OR = 2.27, 95% CI = 1.14–4.53) and betel nut chewing (OR = 2.33, 95% CI = 1.09–5.01) were significantly associated with the obstructive type of lung impairment.

Conclusions

A high prevalence of restrictive lung impairment, cardiometabolic risks, and unhealthy lifestyles among rural adults were found in this study. For adults with cardiometabolic risks in rural areas, initiating lifestyle modifications with culture-tailored programs to improve lung function should be an important issue for clinicians and primary healthcare providers.
Systematic review: cystic fibrosis in the SARS-CoV-2/COVID-19 pandemic
Authors: Mathew Hannah R. , Choi May Y. , Parkins Michael D. , Fritzler Marvin J.
Published: May 2021

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the development of life-threatening COVID-19 are believed to disproportionately affect certain at-risk populations. However, it is not clear whether individuals with cystic fibrosis (CF) are at a higher risk of COVID-19 or its adverse consequences. Recurrent respiratory viral infections are often associated with perturbation and pulmonary exacerbations of CF as evidenced by the significant morbidity observed in CF individuals during the 2009 H1N1 pandemic. The primary goal of this review was to systematically survey published accounts of COVID-19 in CF and determine if individuals with CF are disproportionally affected by SARS-CoV-2 and development of COVID-19.

Methods

We conducted a systematic literature search using EMBASE and Medline between April 28 and December 10, 2020. Six evaluable studies reporting on a total of 339 individuals with CF who developed COVID-19 were included in this study.

Results

We found that although individuals with CF generally experience acute exacerbations of lung disease from infectious agents, COVID-19 incidence estimates in CF appear to be lower than in the general population. However, there are reports of subsets of CF, such as those who had organ transplants, that may experience a more severe COVID-19 course. Potential protective mechanisms in the CF population include pre-pandemic social isolation practices, infection prevention and control knowledge, altered expression of angiotensin-converting enzyme, and the use of certain medications.

Conclusions

Although individuals with CF are at risk of acute exacerbations often precipitated by respiratory tract viral infections, published evidence to date indicated that individuals with CF do not experience higher risks of contracting SARS-CoV-2 infection. However, there is evidence that some subsets within the CF population, including those post-transplantation, may experience a more severe clinical course. As SARS-CoV-2 variants are identified and the pandemic goes through additional waves of disease outbreaks, ongoing monitoring of the risk of COVID-19 in individuals with CF is required.
Replication of GWAS significant loci in a sub-Saharan African Cohort with early childhood caries: a pilot study
Authors: Olatosi Olubukola O. , Li Mary , Alade Azeez A. , Oyapero Afolabi , Busch Tamara , Pape John , Olotu Joy , Awotoye Waheed , Hassan Mohaned , Adeleke Chinyere , Adeyemo Wasiu L. , Sote Elizabeth O. , Shaffer John R. , Marazita Mary , Butali Azeez
Published: May 2021

Background

Early childhood caries (ECC) is a rapidly progressing form of dental infection and a significant public health problem, especially among socially and economically disadvantaged populations. This study aimed to assess the risk factors for ECC among a cohort of Sub-Saharan African children and to determine the role of genetics in the etiology of ECC.

Methods

A sample of 691 children (338 with ECC, 353 without ECC, age < 6 years) was recruited from schools in Lagos, Nigeria. Socio-demographic, dental services utilization and infant dietary data were obtained with interviewer-administered questionnaire. Oral examination was conducted using the WHO oral health diagnostic criteria. Saliva samples were collected from the children for genetic analysis. Single nucleotide polymorphisms were selected from previous study for genotyping. Genetic association analyses to investigate the role of genetics in the etiology of ECC was done. Bivariate comparisons and Multivariate logistic regression analyses were conducted to assess associations between ECC and predictor variables, p < 0.05.

Results

Of the 338 children with ECC, 64 (18.9%) had Severe-Early Childhood Caries (S-ECC). Children aged 48–59 months comprised the highest proportion of subjects with ECC (165; 48.8%) and S-ECC (24; 37.5%) while female subjects had higher dt (3.13 ± 2.56) and dmft values 3.27 ± 2.64. ECC was significantly more prevalent among children who were breastfed at night ≥ 12 months (OR 3.30; CI 0.39, 4.75), those with no previous dental visit (OR 1.71; CI 0.24, 2.77), those who used sweetened pacifiers (OR 1.85; CI 0.91, 3.79) and those who daily consumed sugar-sweetened drinks/snacks (OR 1.35; CI 0.09, 18.51). A suggestive increased risk for ECC (OR 1.26, p = 0. 0.0397) was observed for the genetic variant rs11239282 on chromosome 10. We also observed a suggestive reduced risk for ECC (OR 0.80, p = 0.03) for the rs131777 on chromosome 22. None of the genetic variants were significant after correction for multiple testing (Bonferroni p value p = 0.004).

Conclusions

Prolonged night-time breastfeeding, poor utilization of dental services and daily consumption of sugar were risk factors for ECC. Larger sample size is needed to confirm the results of the genetic analysis and to conduct genome wide studies in order to discover new risk loci for ECC.
Tongue ulcer in a patient with COVID-19: a case presentation
Authors: Nejabi Mohammad Bashir , Noor Noor Ahmad Shah , Raufi Nahid , Essar Mohammad Yasir , Ehsan Ehsanullah , Shah Jaffer , Shah Asghar , Nemat Arash
Published: May 2021

Background

The emergence of COVID-19 has devastated many parts of the world. From asymptomatic to symptomatic, the virus causes a wide spectrum of presentations. COVID-19 patients may present with oral manifestations. In Afghanistan, where COVID-19 has severely strained the health care system, much of the population lacks proper oral hygiene. This makes the oral cavity a perfect site for SARS-CoV-2 to manifest clinical signs.

Case presentation

A 62-year-old male was evaluated in the Dentistry Teaching Clinic of Kabul University of Medical Sciences for a painful erosive lesion on dorsal surface of his tongue. He also complained of fever, cough, and taste alteration. He was referred to Afghan Japan Hospital for COVID-19 testing and tested positive. He was followed on for the treatment of SARS-CoV2. After 2 weeks, the patient tested negative and returned to the dentistry clinic for follow-up. Although there were no other signs of COVID-19, the painful erosive lesion on his tongue persisted. Oral evaluation were performed and the patient was advised to practice good hygiene. After 10 days, we observed an asymptomatic geographic tongue without fever and myalgias and the lesion of dorsal surface of tongue improved from severe condition to moderate.

Conclusion

In conclusion, patients with suspected or confirmed SARS-CoV-2 should be screened for symptoms and physical findings in the oral mucosa To prevent such an outcome, awareness programs need to be implemented for the diagnosis and management of clinical symptoms among patients.
Anastrozole and levonorgrestrel-releasing intrauterine device in the treatment of endometriosis: a randomized clinical trial
Authors: Acién Pedro , Velasco Irene , Acién Maribel
Published: May 2021

Background

To study the effectiveness of an aromatase inhibitor (Anastrozole) associated with levonorgestrel-releasing intrauterine device (LNG-IUD, Mirena®) in the treatment of endometriosis.

Methods

Prospective, randomized clinical trial. Setting: University Hospital (single center). Elegibility criteria: Endometriomas > 3 × 4 cm, CA-125 > 35 U/mL and endometriosis symptoms. Patients: Thirty-one women randomized to anastrozole + Mirena® + Conservative Surgery(CS) (n = 8), anastrozole + Mirena® + transvaginal ultrasound-guided puncture-aspiration (TUGPA) (n = 7), Mirena® + CS (n = 9), or Mirena® + TUGPA (n = 7). Interventions: Anastrozole 1 mg/day and/or only Mirena® for 6 months; CS (ovarian and fertility-sparing) or TUGPA of endometriomas one month after starting medical treatment. Main Outcome Measures: Visual analogic scale for symptoms, CA-125 levels, ultrasound findings of endometriomas and recurrences.

Results

A significant improvement in symptoms during the treatment (difference of 43%, 95% CI 29.9–56.2) occurred, which was maintained at 1 and 2 years. It was more significant in patients including anastrozole in their treatment (51%, 95% CI 33.3–68.7). For CA-125, the most significant decrease was observed in patients not taking anastrozole (73.8%, 95% CI 64.2–83.4 vs. 53.8%, 95% CI 25.7–81.6 under Mirena® + anastrozole). After CS for endometriosis, a reduction of ultrasound findings of endometriomas and long-term recurrence occurred, with or without anastrozole. At 4.2 ± 1.7 years (95% CI 3.57–4.85), 88% of the patients who underwent CS were asymptomatic, without medication or reoperation, compared to only 21% if TUGPA was performed, with or without anastrozole (p = 0.019).

Conclusions

Dosing anastrozole for 6 months, starting one month before CS of endometriosis, reduces significantly the painful symptoms and delays recurrence, but has no other significant advantages over the single insertion of LNG-IUD (Mirena®) during the same time. Anastrozole and/or only Mirena® associated with TUGPA are not effective.

Trial registration

Eudra CT System of the European Medicines Agency (London, 29-Sept-2008) Nº EudraCT: 2008-005744-17 (07/11/2008). Date of enrolment of first patient: 15/01/2009.
Explainable AI enables clinical trial patient selection to retrospectively improve treatment effects in schizophrenia
Authors: Mellem Monika S. , Kollada Matt , Tiller Jane , Lauritzen Thomas
Published: May 2021

Background

Heterogeneity among patients’ responses to treatment is prevalent in psychiatric disorders. Personalized medicine approaches—which involve parsing patients into subgroups better indicated for a particular treatment—could therefore improve patient outcomes and serve as a powerful tool in patient selection within clinical trials. Machine learning approaches can identify patient subgroups but are often not “explainable” due to the use of complex algorithms that do not mirror clinicians’ natural decision-making processes.

Methods

Here we combine two analytical approaches—Personalized Advantage Index and Bayesian Rule Lists—to identify paliperidone-indicated schizophrenia patients in a way that emphasizes model explainability. We apply these approaches retrospectively to randomized, placebo-controlled clinical trial data to identify a paliperidone-indicated subgroup of schizophrenia patients who demonstrate a larger treatment effect (outcome on treatment superior than on placebo) than that of the full randomized sample as assessed with Cohen’s d. For this study, the outcome corresponded to a reduction in the Positive and Negative Syndrome Scale (PANSS) total score which measures positive (e.g., hallucinations, delusions), negative (e.g., blunted affect, emotional withdrawal), and general psychopathological (e.g., disturbance of volition, uncooperativeness) symptoms in schizophrenia.

Results

Using our combined explainable AI approach to identify a subgroup more responsive to paliperidone than placebo, the treatment effect increased significantly over that of the full sample (p < 0.0001 for a one-sample t-test comparing the full sample Cohen’s d = 0.82 and a generated distribution of subgroup Cohen’s d’s with mean d = 1.22, std d = 0.09). In addition, our modeling approach produces simple logical statements (if–then-else), termed a “rule list”, to ease interpretability for clinicians. A majority of the rule lists generated from cross-validation found two general psychopathology symptoms, disturbance of volition and uncooperativeness, to predict membership in the paliperidone-indicated subgroup.

Conclusions

These results help to technically validate our explainable AI approach to patient selection for a clinical trial by identifying a subgroup with an improved treatment effect. With these data, the explainable rule lists also suggest that paliperidone may provide an improved therapeutic benefit for the treatment of schizophrenia patients with either of the symptoms of high disturbance of volition or high uncooperativeness.

Trial Registration: clincialtrials.gov identifier: NCT 00,083,668; prospectively registered May 28, 2004
Mind the gap: an analysis of core capacities of the international health regulations (2005) to respond to outbreaks in Yemen
Authors: Noman Hanan , Dureab Fekri , Ahmed Iman , Al Serouri Abdulwahed , Hussein Taha , Jahn Albrecht
Published: May 2021

Background

Yemen that has been devastated by war is facing various challenges to respond to the recent potential outbreaks and other public health emergencies due to lack of proper strategies and regulations, which are essential to public health security. The aim of this study is to assess the implementation of the International Health Regulations (IHR 2005) core capacities under the current ongoing conflict in Yemen.

Methods

The study simulated the World Health Organization (WHO) Joint External Evaluation (JEE) tool to assess the IHR core capacities in Yemen. Qualitative research methods were used, including desk reviews, in-depth interviews with key informants and analysis of the pooled data.

Result

Based on the assessment of the three main functions of the IHR framework (prevention, detection, and response), Yemen showed a demonstrated or developed capacity to detect outbreaks, but nevertheless limited or no capacity to prevent and respond to outbreaks.

Conclusion

This study shows that there has been poor implementation of IHR in Yemen. Therefore, urgent interventions are needed to strengthen the implementation of the IHR core capacities in Yemen. The study recommends 1) raising awareness among national and international health staff on the importance of IHR; 2) improving alignment of INGO programs with government health programs and aligning both towards better implementation of the IHR; 3) improving programmatic coordination, planning and implementation among health stakeholders; 4) increasing funding of the global health security agenda at country level; 5) using innovative approaches to analyze and address gaps in the disrupted health system, and; 6) addressing the root cause of the collapse of the health services and overall health system in Yemen by ending the protracted conflict situation.
Laboratory and field evaluation of MAÏA®, an ointment containing N,N-diethyl-3-methylbenzamide (DEET) against mosquitoes in Burkina Faso
Authors: Traoré Alphonse , Niyondiko Gérard , Sanou Antoine , Langevin Franck , Sagnon N’Falé , Gansané Adama , Guelbeogo Moussa Wamdaogo
Published: May 2021

Background

Malaria vector control relies upon the use of insecticide-treated nets and indoor residual spraying. However, as the emergency of insecticide resistance in malaria vectors grows, the effectiveness of these measures could be limited. Alternative tools are needed. In this context, repellents can play an important role against exophagic and exophilic mosquitoes. This study evaluated the efficacy of MAÏA®, a novel repellent ointment, in laboratory and field conditions in Burkina Faso.

Methods

For laboratory and field assessment, 20 volunteers were enrolled and trained for nocturnal collection of mosquitoes using human landing catches (HLC). In the laboratory tests, 2 mg/sq cm of treatment (either MAIA® or 20 % DEET) were used to assess median complete protection time (CPT) against two species: Anopheles gambiae and Aedes aegypti, following WHO guidelines. For both species, two strains consisting of susceptible and local strains were used. The susceptible strains were Kisumu and Bora Bora for An. gambiae and Ae. aegypti, respectively. For the field test, the median CPT of MAÏA® was compared to that of a negative (70 % ethanol) and positive (20 % DEET) after carrying out HLCs in rural Burkina Faso in both indoor and outdoor settings.

Results

Laboratory tests showed median Kaplan-Meier CPT of 6 h 30 min for An. gambiae (Kisumu), 5 h 30 min for An. gambiae (Goden, local strain), and 4 h for Ae. aegypti for both the local and sensitive strain. These laboratory results suggest that MAÏA® is a good repellent against the three mosquito species. During these field tests, a total of 3979 mosquitoes were caught. In this population, anophelines represented 98.5 %, with culicines (Aedes) making up the remaining 1.5 %. Among anopheline mosquitoes, 95 % belonged to the An. gambiae complex, followed by Anopheles funestus and Anopheles pharoensis. The median CPT of 20 % DEET and MAÏA® were similar (8 h) and much longer than that of the negative control (2 h).

Conclusions

Results from the present studies showed that MAÏA® offers high protection against anophelines biting indoors and outdoors and could play an important role in malaria prevention in Africa.
MichiGAN: sampling from disentangled representations of single-cell data using generative adversarial networks
Authors: Yu Hengshi , Welch Joshua D.
Published: May 2021

Deep generative models such as variational autoencoders (VAEs) and generative adversarial networks (GANs) generate and manipulate high-dimensional images. We systematically assess the complementary strengths and weaknesses of these models on single-cell gene expression data. We also develop MichiGAN, a novel neural network that combines the strengths of VAEs and GANs to sample from disentangled representations without sacrificing data generation quality. We learn disentangled representations of three large single-cell RNA-seq datasets and use MichiGAN to sample from these representations. MichiGAN allows us to manipulate semantically distinct aspects of cellular identity and predict single-cell gene expression response to drug treatment.