bluuebunny/crossref_metadata_2025 huggingface dataset:
Reported Levels of Exhaustion by the Graduate Nurse Midwife and Their Perceived Potential for Unsafe Practice: A Phenomenological Study of Australian Double Degree Nurse Midwives
Authors: Donovan Helen , Welch Anthony , Williamson Moira
Published: August 2020

Background

The experiences of graduate nurses and midwives transitioning into the clinical environment as beginning practitioners has been reported as a time period of great challenge. For the graduate double degree nurse midwife, often transitioning into two disciplines of practice concurrently, their experiences have the potential to be heightened. The aim of this research was to explore the transition to practice experiences of double degree graduate nurse midwives practicing in either or both nursing and midwifery in the Australian health care system.

Methods

This research used a Husserlian descriptive phenomenological approach to understand the experiences of 23 double degree graduate nurse midwives working in 20 different health care facilities across Australia.

Results

The findings showed that most participants experienced exhaustion from an emotional, physical, and mental perspective during their first year of practice. These experiences were linked with cognitive saturation, professional loneliness, sleep deprivation, and an inability to achieve a work–life balance. The data also highlighted the graduate nurse midwife’s concerns for safe practice when feeling mentally, physically, and emotionally depleted.

Conclusion/Application to Practice

Safe practice is paramount for both patient and health care worker. The levels of exhaustion described by the participants in this study influenced their perceived ability to practice safely. As a result, it should be recognized that the graduate nurse midwife’s health and well-being is central to their perceptions of safe practice and is fundamental to a positive transition to practice experience.
Cleaning and Disinfection Perceptions and Use Practices Among Elastomeric Respirator Users in Health care
Authors: Hines Stella E. , Brown Clayton H. , Oliver Marc , Gucer Patricia , Frisch Melissa , Hogan Regina , Roth Tracy , Chang James , McDiarmid Melissa
Published: August 2020

Background:

Reusable elastomeric respirator use in health care may represent one solution to address N95 respirator shortages experienced during infectious disease outbreaks, but cleaning and disinfection requirements may limit their utility. Evidence of respirator cleaning and disinfection behaviors and practices by health care workers may inform guidance on reusable respirator use.

Methods:

Medical system elastomeric respirator users were surveyed about respirator cleaning and disinfection practices and perceptions via an electronic survey. Respondents were subsequently classified based on reported compliance with their assigned respirator use. To explore whether respirator cleaning and disinfection issues affected compliance with assigned device use, responses were compared between user groups and adjusted for covariates.

Results:

A total of 432 of 2,024 (21%) eligible elastomeric respirator users completed the survey. Most (>90%) reported that their respirator was clean, but only 52% reported that they always disinfect their respirators after use according to the hospital’s expected practice. Only 40 respondents (9%) reported regularly cleaning the respirator with soap and water, in accordance with manufacturer recommendations. Reporting of suboptimal decontamination practice was not associated with assigned device compliance, however, except among providers and respiratory therapists.

Conclusion/Application to Practice:

Although perceptions of cleanliness and adherence to expected decontamination practices during routine use did not appear to influence compliance with assigned respirator use overall, this did predict compliance among providers and respiratory therapists, both of whom have nonfixed workstations. Practical and effective strategies to assure easy access to and availability of clean reusable respiratory protective devices are needed to facilitate their use in health care respiratory protection programs.
Consuming for the Greater Good: “Woke” Commercials in Sports Media
Authors: de Oca Jeffrey Montez , Mason Sherry , Ahn Sung
Published: August 2020

Amidst a crisis in the US racial state over the summer of 2020, typically “politically” averse professional sports leagues proliferated anti-racist statements. We see the sudden advertising of corporate values and politics by sports leagues as stemming from the development of socially conscious marketing (SCM) in recent years. Marketers celebrate commercials such as Nike’s Dream Crazy (2019) since they amplify the political speech of activists, such as Colin Kaepernick, and advertise ways for consumers to engage in ethical consumption. Using discourse analysis of marketing literature on SCM and textual analysis of SCM commercials shown during sporting events, we show that SCM appropriates dissent against neoliberal capitalism in order to legitimate capitalism and resist systemic change during a moment of crisis. We conclude that while we can continue to expect professional sports leagues and other brands to appear “woke,” we should not expect to see change in the exploitative conditions that make them profitable.
Brain Characteristics Noted Prior to and Following Cranial Orthotic Treatment
Authors: DeGrazia Michele , Ahtam Banu , Rogers-Vizena Carolyn R. , Proctor Mark , Porter Courtney , Vyas Rutvi , Laurentys Cynthia T. , Bergling Emily , McLaughlin Kara , Grant Patricia Ellen
Published: August 2020

Objective:

This case report aims to assess a potential association between cranial asymmetry, brain deformation, and associated developmental delay.

Study Design:

Two infants born at ≥37 weeks pursuing cranial orthotic treatment for severe Deformational Plagiocephaly (DP) (cranial vault asymmetry index >8.75%) underwent developmental assessment using Mullen Scales of Early Learning (MSEL) and non-sedated brain structural and diffusion magnetic resonance imaging (MRI) prior to and following cranial orthotic treatment.

Results:

In both infants with DP, tractography results revealed alterations in the white matter pathways of the brain. Both infants also had low to low/normal visual receptivity and fine motor skills. After cranial orthotic treatment, cranial asymmetry improved but did not completely resolve, tractography demonstrated a change toward normalized white matter pathways, and visual receptivity and fine motor skills improved.

Conclusions:

These preliminary findings suggest a potential link between DP, altered brain structures, and developmental assessment. Further investigation with a larger sample is warranted.
Auditory Attention and Spatial Unmasking in Children With Cochlear Implants
Authors: Misurelli Sara M. , Goupell Matthew J. , Burg Emily A. , Jocewicz Rachael , Kan Alan , Litovsky Ruth Y.
Published: August 2020

The ability to attend to target speech in background noise is an important skill, particularly for children who spend many hours in noisy environments. Intelligibility improves as a result of spatial or binaural unmasking in the free-field for normal-hearing children; however, children who use bilateral cochlear implants (BiCIs) demonstrate little benefit in similar situations. It was hypothesized that poor auditory attention abilities might explain the lack of unmasking observed in children with BiCIs. Target and interferer speech stimuli were presented to either or both ears of BiCI participants via their clinical processors. Speech reception thresholds remained low when the target and interferer were in opposite ears, but they did not show binaural unmasking when the interferer was presented to both ears and the target only to one ear. These results demonstrate that, in the most extreme cases of stimulus separation, children with BiCIs can ignore an interferer and attend to target speech, but there is weak or absent binaural unmasking. It appears that children with BiCIs mostly experience poor encoding of binaural cues rather than deficits in ability to selectively attend to target speech.
Discussing Cervical Cancer Screening Options: Outcomes to Guide Conversations Between Patients and Providers
Authors: Holt Hunter K. , Kulasingam Shalini , Sanstead Erinn C. , Alarid-Escudero Fernando , Smith-McCune Karen , Gregorich Steven E. , Silverberg Michael J. , Huchko Megan J. , Kuppermann Miriam , Sawaya George F.
Published: August 2020

Purpose. In 2018, the US Preventive Services Task Force (USPSTF) endorsed three strategies for cervical cancer screening in women ages 30 to 65: cytology every 3 years, testing for high-risk types of human papillomavirus (hrHPV) every 5 years, and cytology plus hrHPV testing (co-testing) every 5 years. It further recommended that women discuss with health care providers which testing strategy is best for them. To inform such discussions, we used decision analysis to estimate outcomes of screening strategies recommended for women at age 30. Methods. We constructed a Markov decision model using estimates of the natural history of HPV and cervical neoplasia. We evaluated the three USPSTF-endorsed strategies, hrHPV testing every 3 years and no screening. Outcomes included colposcopies with biopsy, false-positive testing (a colposcopy in which no cervical intraepithelial neoplasia grade 2 or worse was found), treatments, cancers, and cancer mortality expressed per 10,000 women over a shorter-than-lifetime horizon (15-year). Results. All strategies resulted in substantially lower cancer and cancer death rates compared with no screening. Strategies with the lowest likelihood of cancer and cancer death generally had higher likelihood of colposcopy and false-positive testing. Conclusions. The screening strategies we evaluated involved tradeoffs in terms of benefits and harms. Because individual women may place different weights on these projected outcomes, the optimal choice for each woman may best be discerned through shared decision making.
The Pedagogical Shift During COVID 19 Pandemic: Online Medical Education, Barriers and Perceptions in Central Kerala
Authors: Rafi Aboobacker Mohammed , Varghese Pulikkottil Raphael , Kuttichira Praveenlal
Published: August 2020

Owing to COVID 19 pandemic, all educational institutions including medical colleges were closed by the second week of March 2020 in Kerala, India. This college started online classes using various e-platforms by the third week of March. In this study, we report the barriers and perceptions of undergraduate students by an online questionnaire after 2.5 months of e-classes. The study participants were 364 students who responded in a week’s time. Most of the faculty used platforms like Google class room or recorded YouTube videos. The department of Physiology used the Impartus platform. Among the respondents 72.8% were using mobile data and 17.8% were using broadband facilities. Among network providers Jio was the most used. Only first year students were exposed to 3 different online platforms. Among those students, 63.6% reported in favor of Impartus, followed by YouTube and Google class room. Most of the students preferred recorded classes (69.2%) over live classes (33.5%). Submissions were mainly through the online platform itself (69.5%), email submission to the department (17%) or to the faculty (13.5%). Forty seven percent of the students wanted the classes to be of 30 to 45 minutes duration and 42% felt that the classes should be short and below 30 minutes. Only 28.3% of the students favored centralized online class by the university. Providing education to students cannot be discontinued for long. In the present study students are able to follow the online classes and have good learning experience on in the Didactic part. The medical educators could rise up to the challenge of continuing to teach even in times of crisis.
Mild inflammation causes a reduction in resting-state amplitude of low-frequency fluctuation in healthy adult males
Authors: Stefanov Kristian , McLean John , Allan Becky , Cavanagh Jonathan , Krishnadas Rajeev
Published: August 2020

Systemic inflammation has been associated with negative mood states and human sickness behaviour. Previous studies have shown an association between systemic inflammation and changes in task-related blood-oxygen-level-dependent activity and functional connectivity within large-scale networks. However, no study has examined the effect of inflammation on the magnitude of blood-oxygen-level-dependent low-frequency fluctuations at rest. We used a double-blind placebo-controlled crossover design to randomise 20 male subjects (aged 20–50 years) to receive either a Salmonella typhi vaccine or a placebo saline injection at two separate sessions. All participants underwent a resting-state functional magnetic resonance scan and a measure of inflammation (interleukin 6) and mood (Profile of Mood States) 3 h after injection. We compared the whole brain amplitude of low-frequency fluctuations between the vaccine and placebo conditions using a repeated measures design. Vaccine condition was associated with greater interleukin 6 levels (p < 0.001). Vaccine condition was also associated with lower amplitude of low-frequency fluctuations in the right and left frontal pole, superior frontal gyrus, paracingulate gyrus (Cluster 1) and the right mid and inferior frontal gyrus (Cluster 2) (p < 0.001, false discovery rate corrected). Lower amplitude of low-frequency fluctuations pertaining to first cluster correlated with greater total Profile of Mood States score (worse mood) (r = −0.38; p = 0.04). These results imply possible excitation/inhibition imbalance mechanisms during inflammation that may be a relevant target in psychiatric disease, especially mood disorders.
Treatment sequencing strategies in metastatic renal cell carcinoma: A critical interpretation of available data
Authors: Rizzo Mimma , Santoni Matteo , Porta Camillo
Published: August 2020

Therapeutic sequencing strategies for metastatic renal cell carcinoma have evolved significantly over time. For about 10 years, vascular endothelial growth factor receptor-targeted therapies and mammalian target of rapamycin inhibitors have been the standard of care. About 5 years ago an immunocheckpoint inhibitor, nivolumab, has opened new therapeutic perspectives. Recent clinical studies have confirmed the biological rationale of combining two immunocheckpoint inhibitors or vascular endothelial growth factor-targeted therapies plus immunocheckpoint inhibitors, demonstrating an improvement in clinical outcomes. We are still unable to recognize immunocheckpoint inhibitors responder patients from vascular endothelial growth factor-targeted therapies responder patients and, therefore, to quantify in a certain patient the benefits/harms ratio of upfront combination over sequence therapy in a certain patient. However, the metastatic renal cell carcinoma records of high-volume cancer centers could reveal the effectiveness and tolerability of combined treatments and indicate the potentially predictive factors and the management strategies in the real-world population.
Orthognathic Surgery in a Patient With Clear Aligners and Veneers: Options for Interim Fixation and Early Elastic Physiotherapy—Case Report
Authors: Naung Noel Ye , Van Sickels Joseph E. , Hartsock Tom E. , Sword Jacob L.
Published: August 2020

When clear aligners and veneers are used preoperatively, placement of orthodontic brackets is not possible. The MatrixWAVE maxillomandibular fixation (MMF) screws are readily available in many operating rooms and can be used as an alternative interim fixation device. Screws from this system can be left in place for postoperative elastic physiotherapy. In this case report, MMF screws were left in place for muscle memory training and an aid to prevent relapse. The screws were well tolerated by the patient. Removal at 14 weeks resulted in small wounds, which healed quickly.
Genetics and Age-Related Eye Disease Study Formulation Interaction in Neovascular Age-Related Macular Degeneration
Authors: Kaufman Stephen R. , Yoganathan Pradeepa , Small Kent W. , Rusia Deepam , Pachydaki Sophia I. , Conti Stephen M. , Wenz Robert E. , Gersman Mark A. , Shaya Fadi S. , Kustra Rafal
Published: August 2020

Purpose:

This work aims to determine whether previously defined genotype risk groups interact with Age-Related Eye Disease Study formulation (AREDS-F) use in progression to neovascular age-related macular degeneration (nvAMD).

Methods:

We conducted a case-only study of 265 nvAMD patients. Patients were anonymously genotyped at the complement factor H and age-related maculopathy susceptibility 2 loci and segregated into genotype groups (GTGs) defined by specific combinations of risk alleles. Physicians, who were blind to patients’ GTGs, obtained patients’ AREDS-F use history. The facility performing genetic analysis was blind to the AREDS-F use history. We used logistic analysis to estimate the interaction coefficient between AREDS-F use and GTG 2 vs GTG 3 in a general-population model.

Results:

The odds ratio of numbers of patients reporting prior AREDS-F use to nonuse for GTG 2 vs GTG 3 was 4.18 ( P = .001). Logistic regression, correcting for nongenetic risk factors, gave an estimate of the β for interaction of AREDS-F with genotype of 1.57 ( P = .001). This estimates a corrected odds ratio associated with the effect of interaction of 4.81 between those in GTG 2 compared with those in GTG 3.

Conclusions:

Our data indicate an interaction between GTGs and AREDS-F use that is consistent in size and direction with previously published reports, which had found that using AREDS-F supplements significantly increases the risk of nvAMD for some users and significantly protects other users.
How Does Governance Influence Decision Making on Projects and in Project-Based Organizations?
Authors: Turner Rodney
Published: August 2020

Research on the governance of project management suggests governmentality and governance are associated with improved project performance. However, the mechanism is unknown. We propose that they influence decision making, which, in turn, improves performance. Few articles on governance comment directly on how governance influences decision making. We identify six areas of organizational psychology that influence decision making, and study what research on the governance of project management suggests about how governance influences those six areas. We review 36 articles on the governance of project management published in the past six years in the three main journals in project management.
Use of thrombopoietin receptor agonists for immune thrombocytopenia in pregnancy: results from a multicenter study
Authors: Michel Marc , Ruggeri Marco , Gonzalez-Lopez Tomas Jose , Alkindi Salam , Cheze Stéphane , Ghanima Waleed , Tvedt Tor Henrik Anderson , Ebbo Mikael , Terriou Louis , Bussel James B. , Godeau Bertrand
Published: August 2020

Management of immune thrombocytopenia (ITP) during pregnancy can be challenging because treatment choices are limited. Thrombopoietin receptor agonists (Tpo-RAs), which likely cross the placenta, are not recommended during pregnancy. To better assess the safety and efficacy of off-label use of Tpo-RAs during pregnancy, a multicenter observational and retrospective study was conducted. Results from 15 pregnant women with ITP (pregnancies, n = 17; neonates, n = 18) treated with either eltrombopag (n = 8) or romiplostim (n = 7) during pregnancy, including 2 patients with secondary ITP, were analyzed. Median time of Tpo-RA exposure during pregnancy was 4.4 weeks (range, 1-39 weeks); the indication for starting Tpo-RAs was preparation for delivery in 10 (58%) of 17 pregnancies, whereas 4 had chronic refractory symptomatic ITP and 3 were receiving eltrombopag when pregnancy started. Regarding safety, neither thromboembolic events among mothers nor Tpo-RA–related fetal or neonatal complications were observed, except for 1 case of neonatal thrombocytosis. Response to Tpo-RAs was achieved in 77% of cases, mostly in combination with concomitant ITP therapy (70% of responders). On the basis of these preliminary findings, temporary off-label use of Tpo-RAs for severe and/or refractory ITP during pregnancy seems safe for both mother and neonate and is likely to be helpful, especially before delivery.
Performance of the modified HEART score in an Asian population
Authors: Sajeed Shanaz Matthew , De Dios Michael P. , Ong Dan Wei Jun , Punyadasa Amila Clarence
Published: August 2020

Introduction

Chest pain is the most common potentially life-threatening presentation to the emergency department (ED). Furthermore, the identification of acute coronary syndrome (ACS) including its risk stratification and subsequent disposition can be challenging. The original HEART score was derived as a predictive tool to risk stratify patients presenting with undifferentiated chest pain (CP) and aid physician decision-making. However, it utilized conventional troponins as its cardiac biomarker component. Our study aims to assess the utility of the modified HEART score with highly sensitive troponins in an Asian setting with mixed ethnicity to determine if it corroborates the findings of another recent Chinese study by Chun-Peng et al. (Journal of Geriatric Cardiology 13:64–69, 2016).

Methods

Clinical data from 413 patients presenting to the ED for evaluation of chest pain were analyzed. The predictive value of the modified HEART score for determining major adverse cardiac events (MACE) was then evaluated.

Results

A total of 49 patients (11.9%) had a MACE: 31 patients (7.5%) underwent PCI and 1 patient (0.2%) underwent CABG. There were 17 (4.1%) deaths.

Three risk groups were elucidated based on MACE. In the low-risk group (0–2), there were 72 patients (17.4%), with a MACE rate of 1.4%. In the intermediate-risk group (3–5), there were 233 patients (56.4%), with a MACE rate of 5.2%. In the high-risk group (6–10), there were 108 patients (26.2%), with a MACE rate of 33.3%.

Conclusion

The modified HEART score is an effective risk stratification tool in an ethnically diverse Asian population. Furthermore, it identifies low-risk patients who are candidates for early discharge from a local emergency department.
Increased serum IL-36γ levels are associated with disease severity in myasthenia gravis patients
Authors: Zhang Qiu-Xia , Li Yue , Jiang Shu-Min , Zhang Lin-Jie , Yi Ming , Wang Jing , Qi Yuan , Yang Li , Yang Chun-Sheng
Published: August 2020

Background

Interleukin 36 (IL-36), as a gradually recognized cytokine, is involved in the occurrence and evolution of autoimmune diseases. Nevertheless, the relationship between myasthenia gravis (MG) and IL-36 is rarely reported.

Methods

We evaluated the serum levels of IL-36 (IL-36α, IL-36β and IL-36γ) by enzyme-linked immunosorbent assay (ELISA). Further, clinical parameters in 97 MG patients and 49 healthy controls (HCs) were carefully measured.

Results

Serum IL-36γ levels were significantly elevated in the MG patients compared with the HCs (p < 0.0001). Compared to those in remission, patients in the acute phase exhibited higher levels of IL-36α and IL-36γ (p = 0.038 andp = 0.011, respectively). Furthermore, patients with generalized MG (GMG) exhibited markedly higher serum IL-36γ levels than those with ocular MG (OMG) (p = 0.003).

Conclusions

The serum levels of IL-36γ in patients with MG were increased and positively correlated with disease severity and may thus have potential as a serological MG marker.
Comparison of child and family reports of health-related quality of life in pediatric acute lymphoblastic leukemia patients after induction therapy
Authors: Nakajima Shohei , Sato Iori , Soejima Takafumi , Koh Katsuyoshi , Kato Motohiro , Okamoto Yasuhiro , Imamura Toshihiko , Maeda Miho , Ishida Yasushi , Manabe Atsushi , Kamibeppu Kiyoko
Published: August 2020

Background

This study aims at determining the health-related quality of life (HRQOL) of children with acute lymphoblastic leukemia (ALL) after the induction therapy, assessing the agreement between child self-reports and family proxy-reports HRQOL, and determining the factors related to this agreement, especially child age, family attendance, and children’s social relationships beyond the family.

Methods

We analyzed questionnaire data (2012–2017) from the Japanese Pediatric Leukemia/Lymphoma Study Group’s clinical study (ALL-B12). Participants were children with B-cell precursor ALL aged 5–18 and their family members, who mostly took care of the child during hospitalization. Participants answered the Pediatric Quality of Life Inventory™ (PedsQL™) Generic Core Scales (PedsQL-G), and Cancer Module (PedsQL-C) to measure pediatric HRQOL. We calculated the differences between child self-reported and family proxy-reported subscale scores along with intraclass correlation coefficients (ICC). We conducted multiple regression analyses according to all participant pairs and age groups (young children, school age, and adolescents), with ICCs for all PedsQL-G subscales (ICC-G) and all PedsQL-C subscales (ICC-C) as the outcome variables.

Results

Five hundred twenty-two pairs of children and their families were analyzed. We observed a moderate level of agreement on most PedsQL subscales between child self-reports and family proxy-reports; however, worry had the weakest agreement for all PedsQL subscales (ICC = .32, 95% confidence interval = .24–.40). The agreement of ICC-C was positively related to family attendance in the hospitalization, only for the young children group (B = .185, p = .003).

Conclusions

We observed some differences between child self-reports and family proxy-reports of HRQOL of children with ALL. Both child self-reports and family proxy-reports captured HRQOL in the induction therapy. We suggest that attending to young children’s hospitalization affects the level of agreement between reports on their HRQOL.
Large-scale discovery of male reproductive tract-specific genes through analysis of RNA-seq datasets
Authors: Robertson Matthew J. , Kent Katarzyna , Tharp Nathan , Nozawa Kaori , Dean Laura , Mathew Michelle , Grimm Sandra L. , Yu Zhifeng , Légaré Christine , Fujihara Yoshitaka , Ikawa Masahito , Sullivan Robert , Coarfa Cristian , Matzuk Martin M. , Garcia Thomas X.
Published: August 2020

Background

The development of a safe, effective, reversible, non-hormonal contraceptive method for men has been an ongoing effort for the past few decades. However, despite significant progress on elucidating the function of key proteins involved in reproduction, understanding male reproductive physiology is limited by incomplete information on the genes expressed in reproductive tissues, and no contraceptive targets have so far reached clinical trials. To advance product development, further identification of novel reproductive tract-specific genes leading to potentially druggable protein targets is imperative.

Results

In this study, we expand on previous single tissue, single species studies by integrating analysis of publicly available human and mouse RNA-seq datasets whose initial published purpose was not focused on identifying male reproductive tract-specific targets. We also incorporate analysis of additional newly acquired human and mouse testis and epididymis samples to increase the number of targets identified. We detected a combined total of 1178 genes for which no previous evidence of male reproductive tract-specific expression was annotated, many of which are potentially druggable targets. Through RT-PCR, we confirmed the reproductive tract-specific expression of 51 novel orthologous human and mouse genes without a reported mouse model. Of these, we ablated four epididymis-specific genes (Spint3,Spint4,Spint5, andCes5a) and two testis-specific genes (Pp2d1andSaxo1) in individual or double knockout mice generated through the CRISPR/Cas9 system. Our results validate a functional requirement forSpint4/5andCes5ain male mouse fertility, while demonstrating thatSpint3,Pp2d1, andSaxo1are each individually dispensable for male mouse fertility.

Conclusions

Our work provides a plethora of novel testis- and epididymis-specific genes and elucidates the functional requirement of several of these genes, which is essential towards understanding the etiology of male infertility and the development of male contraceptives.
In utero and childhood exposure to tobacco smoke and multi-layer molecular signatures in children
Authors: Vives-Usano Marta , Hernandez-Ferrer Carles , Maitre Léa , Ruiz-Arenas Carlos , Andrusaityte Sandra , Borràs Eva , Carracedo Ángel , Casas Maribel , Chatzi Leda , Coen Muireann , Estivill Xavier , González Juan R. , Grazuleviciene Regina , Gutzkow Kristine B. , Keun Hector C. , Lau Chung-Ho E. , Cadiou Solène , Lepeule Johanna , Mason Dan , Quintela Inés , Robinson Oliver , Sabidó Eduard , Santorelli Gillian , Schwarze Per E. , Siskos Alexandros P. , Slama Rémy , Vafeiadi Marina , Martí Eulàlia , Vrijheid Martine , Bustamante Mariona
Published: August 2020

Background

The adverse health effects of early life exposure to tobacco smoking have been widely reported. In spite of this, the underlying molecular mechanisms of in utero and postnatal exposure to tobacco smoke are only partially understood. Here, we aimed to identify multi-layer molecular signatures associated with exposure to tobacco smoke in these two exposure windows.

Methods

We investigated the associations of maternal smoking during pregnancy and childhood secondhand smoke (SHS) exposure with molecular features measured in 1203 European children (mean age 8.1 years) from the Human Early Life Exposome (HELIX) project. Molecular features, covering 4 layers, included blood DNA methylation and gene and miRNA transcription, plasma proteins, and sera and urinary metabolites.

Results

Maternal smoking during pregnancy was associated with DNA methylation changes at 18 loci in child blood. DNA methylation at 5 of these loci was related to expression of the nearby genes. However, the expression of these genes themselves was only weakly associated with maternal smoking. Conversely, childhood SHS was not associated with blood DNA methylation or transcription patterns, but with reduced levels of several serum metabolites and with increased plasma PAI1 (plasminogen activator inhibitor-1), a protein that inhibits fibrinolysis. Some of the in utero and childhood smoking-related molecular marks showed dose-response trends, with stronger effects with higher dose or longer duration of the exposure.

Conclusion

In this first study covering multi-layer molecular features, pregnancy and childhood exposure to tobacco smoke were associated with distinct molecular phenotypes in children. The persistent and dose-dependent changes in the methylome make CpGs good candidates to develop biomarkers of past exposure. Moreover, compared to methylation, the weak association of maternal smoking in pregnancy with gene expression suggests different reversal rates and a methylation-based memory to past exposures. Finally, certain metabolites and protein markers evidenced potential early biological effects of postnatal SHS, such as fibrinolysis.
The effect of travel restrictions on the geographical spread of COVID-19 between large cities in China: a modelling study
Authors: Quilty Billy J. , Diamond Charlie , Liu Yang , Gibbs Hamish , Russell Timothy W. , Jarvis Christopher I. , Prem Kiesha , Pearson Carl A. B. , Clifford Samuel , Flasche Stefan ,   CMMID COVID-19 working group, Emery Jon C. , Auzenbergs Megan , Davies Nicholas , Nightingale Emily S. , van Zandvoort Kevin , Jombart Thibaut , Deol Arminder K. , Edmunds W. John , Hellewell Joel , Funk Sebastian , Abbott Sam , Sun Fiona , Endo Akira , Rosello Alicia , Gimma Amy , Procter Simon R. , Bosse Nikos I. , O’Reilly Kathleen , Medley Graham , Munday James D. , Houben Rein M. G. J. , Kucharski Adam J. , Knight Gwenan M. , Klepac Petra , Eggo Rosalind M. , Jit Mark
Published: August 2020

Background

To contain the spread of COVID-19, a cordon sanitaire was put in place in Wuhan prior to the Lunar New Year, on 23 January 2020. We assess the efficacy of the cordon sanitaire to delay the introduction and onset of local transmission of COVID-19 in other major cities in mainland China.

Methods

We estimated the number of infected travellers from Wuhan to other major cities in mainland China from November 2019 to February 2020 using previously estimated COVID-19 prevalence in Wuhan and publicly available mobility data. We focused on Beijing, Chongqing, Hangzhou, and Shenzhen as four representative major cities to identify the potential independent contribution of the cordon sanitaire and holiday travel. To do this, we simulated outbreaks generated by infected arrivals in these destination cities using stochastic branching processes. We also modelled the effect of the cordon sanitaire in combination with reduced transmissibility scenarios to simulate the effect of local non-pharmaceutical interventions.

Results

We find that in the four cities, given the potentially high prevalence of COVID-19 in Wuhan between December 2019 and early January 2020, local transmission may have been seeded as early as 1–8 January 2020. By the time the cordon sanitaire was imposed, infections were likely in the thousands. The cordon sanitaire alone did not substantially affect the epidemic progression in these cities, although it may have had some effect in smaller cities. Reduced transmissibility resulted in a notable decrease in the incidence of infection in the four studied cities.

Conclusions

Our results indicate that sustained transmission was likely occurring several weeks prior to the implementation of the cordon sanitaire in four major cities of mainland China and that the observed decrease in incidence was likely attributable to other non-pharmaceutical, transmission-reducing interventions.
Salivary proteomic profile of dogs with and without dental calculus
Authors: Bringel Mayara , Jorge Paula Karine , Francisco Priscila Amanda , Lowe Cadance , Sabino-Silva Robinson , Colombini-Ishikiriama Bella Luna , Machado Maria Aparecida de Andrade Moreira , Siqueira Walter Luiz
Published: August 2020

Background

Dogs’ saliva is a complex mixture of inorganic and organic constituents, rich in proteins. Therefore, knowing the saliva composition of these animals is extremely important to identify the presence of proteins that may be involved in physiological and pathological mechanisms of their oral cavity. The present study aimed to characterize the proteomic profile of saliva from dogs with and without dental calculus.

Results

Saliva samples were collected from 20 dogs. Before the collection, a visual clinical examination was performed and 8 subjects (40%) did not present any signs of dental calculus, while 12 (60%) presented dental calculus. After saliva collection, the samples were submitted to protein quantification (mBCA), and then they were prepared for analysis by nLC-ESI-MS/MS. A total of 658 unique proteins were identified, of which 225 were specific to dogs without dental calculus, 300 were specific to dogs with dental calculus, and 133 were common to all subjects. These proteins presented functions including transportation, immune response, structural, enzymatic regulation, signal transduction, transcription, metabolism, and some proteins perform functions as yet unknown. Several salivary proteins in dogs with dental calculus differed from those found in the group without dental calculus. Among the abundant proteins detected in periodontal affected cases, can be highlighting calcium-sensing receptor and transforming growth factor beta. Enrichment analysis reveled the presence of Rho GTPases signaling pathway.

Conclusions

This research identified salivary proteins, that should be further investigated as potencial biomarkers of chronic periodontits with dental calculus formation in dogs.
Detection of remaining Plasmodium DNA and gametocytes during follow up after curative malaria treatment among returned travellers in Norway
Authors: Haanshuus Christel Gill , Mørch Kristine
Published: August 2020

Background

PCR can be positive weeks after effective malaria treatment, potentially leading to over diagnose of recrudescence and re-infections. The DNA detected by PCR post-treatment might stem from residuals of destroyed asexual parasites, or from live gametocytes. The objective of this clinical observational study was to describe the presence of positive PCR for Plasmodium falciparum and Plasmodium vivax in follow-up samples post-treatment from returned travellers, and the proportion of positive PCR due to gametocytes.

Methods

Whole blood was collected during hospitalization and outpatient routine follow-up from 13 patients with imported malaria. DNA was extracted applying QIAamp DNA Blood Mini Kit, while mRNA was collected and extracted applying PAXgene Blood RNA Tubes and Kit. All DNA samples (N = 25) were analysed with a genus-specific cytb real-time SYBR PCR, and P. falciparum DNA samples (N = 22) were also analysed with a falciparum-specific varATS real-time TaqMan PCR. All the mRNA samples (N = 18) were analysed with both a genus-specific 18S rRNA RT-PCR and a gametocyte-specific Pfs25 (P. falciparum)/Pvs25 (P. vivax) RT-PCR.

Results

Latest samples were collected at day 1 (n = 2) and from day 11–54 (n = 11) after treatment. Genus DNA cytb PCR was positive up to 49 days after effective treatment, and 18S rRNA transcripts from active P. falciparum parasites were detectable for at least 11 days. Gametocyte-specific mRNA was detected at latest only two days after treatment. Among six patients with late positive PCR for P. falciparum, four had high parasitaemia at admittance (6–30%), while two had parasitaemia < 2%. Late detection of P. vivax was not found by any of the PCR methods.

Conclusions

DNA-based PCR can be positive up to at least seven weeks after curative malaria treatment, potentially leading to over-diagnose of recrudescence and re-infections. Based on the observations in this study, it is unclear if the DNA origins from residuals of destroyed parasites or live gametocytes, warranting further investigations.
Comparative analysis of the biomechanical behavior of two different design metaphyseal-fitting short stems using digital image correlation
Authors: Tatani I. , Megas P. , Panagopoulos A. , Diamantakos I. , Nanopoulos Ph. , Pantelakis Sp.
Published: August 2020

Background

The progressive evolution in hip replacement research is directed to follow the principles of bone and soft tissue sparing surgery. Regarding hip implants, a renewed interest has been raised towards short uncemented femoral implants. A heterogeneous group of short stems have been designed with the aim to approximate initial, post-implantation bone strain to the preoperative levels in order to minimize the effects of stress shielding. This study aims to investigate the biomechanical properties of two distinctly designed femoral implants, the TRI-LOCK Bone Preservation Stem, a shortened conventional stem and the Minima S Femoral Stem, an even shorter and anatomically shaped stem, based on experiments and numerical simulations. Furthermore, finite element models of implant–bone constructs should be evaluated for their validity against mechanical tests wherever it is possible. In this work, the validation was performed via a direct comparison of the FE calculated strain fields with their experimental equivalents obtained using the digital image correlation technique.

Results

Design differences between Trilock BPS and Minima S femoral stems conditioned different strain pattern distributions. A distally shifting load distribution pattern as a result of implant insertion and also an obvious decrease of strain in the medial proximal aspect of the femur was noted for both stems. Strain changes induced after the implantation of the Trilock BPS stem at the lateral surface were greater compared to the non-implanted femur response, as opposed to those exhibited by the Minima S stem. Linear correlation analyses revealed a reasonable agreement between the numerical and experimental data in the majority of cases.

Conclusion

The study findings support the use of DIC technique as a preclinical evaluation tool of the biomechanical behavior induced by different implants and also identify its potential for experimental FE model validation. Furthermore, a proximal stress-shielding effect was noted after the implantation of both short-stem designs. Design-specific variations in short stems were sufficient to produce dissimilar biomechanical behaviors, although their clinical implication must be investigated through comparative clinical studies.
A fast and safe technique for sperm preparation in ICSI treatments within a randomized controlled trial (RCT)
Authors: Baldini Domenico , Baldini Annamaria , Silvestris Erica , Vizziello Giovanni , Ferri Daniele , Vizziello Damiano
Published: August 2020

Recently a novel method based on horizontal sperm migration in injection dishes has been introduced as an additional tool for preparation of semen sample in assisted reproductive technology (ART) procedures. In the present study, we evaluated both timing and reproductive outcomes in a randomized controlled study including 1034 intra-cytoplasmic sperm injection (ICSI) procedures followed by fresh embryo transfer. Couples enrolled were divided into two sub-groups, namely conventional swim-up method (Group A), and horizontal sperm migration in injection dishes (Group B).

No significant differences were found between groups with respect to fertilization rate, implantation success, clinical pregnancy outcomes and ongoing pregnancies. On the contrary, both cleavage and blastocyst rates were statistically higher in Group B, suggesting superior efficiency and safety of this innovative technique also including time-saving and cheaper costs as compared to the classical swim-up sperm preparation.

Our data support the interpretation of the horizontal sperm migration as a promising procedure for semen preparation in ART cycles.
Migrant workers in China need emergency psychological interventions during the COVID-19 outbreak
Authors: Liu Zi-Han , Zhao Yan-Jie , Feng Yuan , Zhang Qinge , Zhong Bao-Liang , Cheung Teris , Hall Brian J. , Xiang Yu-Tao
Published: August 2020

The 2019 novel coronavirus disease (COVID-19) has been found in more than 200 countries worldwide since December, 2019. In China, a major reason for the rapid transmission of the COVID-19 in early stage of the outbreak is the huge numbers of passengers boarding their “last train home” to meet family members during the Spring Festival. Most of these travelers were internal migrant workers. In order to reduce the risk of the COVID-19 transmission, public transportation networks were suspended, and many migrant workers who returned to their hometowns needed to be quarantined for 2 weeks, which led to the delay of returning back to cities to work. Many businesses have temporarily closed because of the risk of COVID-19 transmission, leading to unemployment of many workers. Sudden loss of income and further quarantine enforcement in cities can exacerbate existing mental health problems or trigger new mental disorders among affected migrant workers. However, to date no specific guidelines or strategies about mental health services of migrant workers have been released. Health authorities and professionals should pay more attention to this vulnerable group and provide timely mental health service support for those in need.
Factors associated with abandoning exclusive breastfeeding in Mexican mothers at two private hospitals
Authors: Ávila-Ortiz María Natividad , Castro-Sánchez Ana Elisa , Martínez-González Elizabeth Andrea , Núñez-Rocha Georgina Mayela , Zambrano-Moreno Adriana
Published: August 2020

Background

Exclusive breastfeeding (EBF) has multiple benefits for both the child and the mother; however, there is little data regarding the reason why Mexican mothers with a high socio-economic level abandon EBF before 6 months, and there is limited information about the practice of breastfeeding in private hospitals. The objective was to identify the factors associated with the cessation of exclusive breastfeeding in Mexican mothers at two private hospitals.

Methods

A cross-sectional study was conducted with 218 upper-class mothers selected according to their place of residence by geographic location, socio-economic level, and pediatric consultations cost. They were over 18 years old and with children aged 6 to 24 months.

Data were collected between July and November 2016 by face to face interview using a structured questionnaire while the mothers waited for the pediatric postnatal care consultation in two private hospitals in northeastern Mexico. Exclusive breastfeeding was measured according to World Health Organization (WHO) recommendations, which consist of providing only breast milk for the first 6 months of life. Chi-squared tests and multivariate logistic regression were performed.

Results

Mean maternal age was 31.4 years (SD of 4.4) and most of the participants had an undergraduate education, were married, and worked outside the home. The prevalence of exclusive breastfeeding at 6 months was 28%. Upper-class working mothers are less likely to continue breastfeeding. There was a negative association with employment (AOR 13.69; 95% CI 1.59, 111.11), bottle use in the first 6 months (AOR 7.93; 95% CI 3.07, 20.48), and a low level of knowledge (AOR 2.18; 95% CI 1.04, 4.56). After 6 months, only 61 mothers (28%) maintained exclusive breastfeeding.

Conclusions

Knowledge level, bottle use, and employment are associated with premature cessation of EBF in Mexican upper-class mothers, attending two private hospitals. There was a high percentage of breastfeeding cessation in the sample. It is necessary to reinforce a strategy that coordinates the action of the different laws, regulations and programs affecting the exclusive breastfeeding practice, in order to adequately promote breastfeeding and support mothers in both public and private sectors.