bluuebunny/crossref_metadata_2025 huggingface dataset:
Pleuritis associated with immunoglobulin G4-related disease under normal thoracoscopic findings: a case report
Authors: Shimada Hiroki , Kato Yuto , Okuda Miyuki , Fukuda Koji , Tanaka Nobuya , Okuda Yutaro , Yoshizawa Akihiko
Published: April 2021

Background

Immunoglobulin G4 (IgG4)-related disease is a chronic inflammatory disease that was recognized in 2011. Pleuritis associated with IgG4-related disease is rare and can be difficult to diagnose. Although there have been previous reports on pleuritis associated with IgG4-related disease by thoracoscopic findings, this is the first to observe pleuritis with IgG4-related disease from normal pleural thoracoscopic findings.

Case presentation

A 70-year-old Japanese female treated for breast cancer 33 years ago was referred to our hospital complaining of dyspnea on exertion. Chest computed tomography (CT) revealed left pleural effusion that was exudative and predominant with lymphocytes, elevated adenosine deaminase (ADA) and Class III cytology (malignancy suspected). Subsequently, thoracoscopic pleural biopsy was performed for definitive diagnosis. Although pleural macroscopic findings appeared normal, we performed pleural biopsy at random sites. This patient was negative for mycobacterium tuberculosis, and neither granulomas nor malignant cells were found in the collected specimens. An infiltration of inflammatory cells, mainly plasma cells and lymphocytes, was observed. Immunostaining revealed the number of IgG4-positive plasma cells was 102/high power field (HPF), and the percentage of IgG4 positive/immunoglobulin G (IgG)-positive cells was 41.4%. Since IgG4 serum levels were high and IgG4-related submandibular sialadenitis was also observed, a definitive diagnose of pleuritis associated with IgG4-related disease was confirmed.

Conclusions

We diagnosed pleuritis associated with IgG4-related disease by thoracoscopic pleural biopsy samples taken from a visually normal pleura. Although exudative pleural effusion with high ADA and lymphocyte predominance is a characteristic of tuberculous pleuritis, other diseases might be present. Since thoracoscopy can increase the diagnostic yield, pleural biopsy should be considered even if thoracoscopic pleural findings are deemed normal.
Assessing the calibration in toxicological in vitro models with conformal prediction
Authors: Morger Andrea , Svensson Fredrik , Arvidsson McShane Staffan , Gauraha Niharika , Norinder Ulf , Spjuth Ola , Volkamer Andrea
Published: April 2021

Machine learning methods are widely used in drug discovery and toxicity prediction. While showing overall good performance in cross-validation studies, their predictive power (often) drops in cases where the query samples have drifted from the training data’s descriptor space. Thus, the assumption for applying machine learning algorithms, that training and test data stem from the same distribution, might not always be fulfilled. In this work, conformal prediction is used to assess the calibration of the models. Deviations from the expected error may indicate that training and test data originate from different distributions. Exemplified on the Tox21 datasets, composed of chronologically released Tox21Train, Tox21Test and Tox21Score subsets, we observed that while internally valid models could be trained using cross-validation on Tox21Train, predictions on the external Tox21Score data resulted in higher error rates than expected. To improve the prediction on the external sets, a strategy exchanging the calibration set with more recent data, such as Tox21Test, has successfully been introduced. We conclude that conformal prediction can be used to diagnose data drifts and other issues related to model calibration. The proposed improvement strategy—exchanging the calibration data only—is convenient as it does not require retraining of the underlying model.
Analytic and numerical solutions of discrete Bagley–Torvik equation
Authors: Meganathan Murugesan , Abdeljawad Thabet , Motawi Khashan M. , Britto Antony Xavier Gnanaprakasam , Jarad Fahd
Published: April 2021

In this research article, a discrete version of the fractional Bagley–Torvik equation is proposed:$$ \nabla _{h}^{2} u(t)+A{}^{C} \nabla _{h}^{\nu }u(t)+Bu(t)=f(t),\quad t>0, $$∇h2u(t)+AC∇hνu(t)+Bu(t)=f(t),t>0,where$0<\nu <1$0<ν<1or$1<\nu <2$1<ν<2, subject to$u(0)=a$u(0)=aand$\nabla _{h} u(0)=b$∇hu(0)=b, withaandbbeing real numbers. The solutions are obtained by employing the nabla discrete Laplace transform. These solutions are expressed in terms of Mittag-Leffler functions with three parameters. These solutions are handled numerically for some examples with specific values of some parameters.
Adverse childhood experiences and psychological distress among higher education students in Southeast Nigeria: an institutional-based cross-sectional study
Authors: Agbaje Olaoluwa Samson , Nnaji Chinwe Patience , Nwagu Evelyn Nwanebe , Iweama Cylia Nkechi , Umoke Prince Christian Ifeanachor , Ozoemena Lawretta Eyuche , Abba Charles Chike
Published: April 2021

Background

Exposure to adverse childhood experiences (ACEs) constitutes public health problems linked to adverse mental outcomes such as psychological distress during adulthood. This study examines the prevalence of ACEs and psychological distress and explores the association between ACEs and psychological distress and demographic factors among young adults.

Methods

We conducted a cross-sectional study of 330 students from May 2018 to July 2018. The participants completed the Adverse Childhood Experiences International Questionnaire (ACE-IQ), Kessler Psychological Distress Scale (K10), and the sociodemographic profile scale. We used descriptive statistics to describe the prevalence of ACEs and psychological distress in our sample. After adjusting for the demographic covariates, ACEs’ association with psychological distress was determined using binary and multivariate logistic regressions.

Results

A total of 203 students with a mean age of 20.76 ± 2.73 years completed the study. The total mean ACE score was 4.58 ± 1.59, and the total mean psychological distress score was 20.76 ± 6.31. Most of the participants (86.7%) experienced ACEs, 14.8% reported experiencing one ACE, 30.5% reported experiencing 2–3 ACEs, and 41.3% reported experiencing 4+ ACEs. Further, about 85% of the youth have experienced at least one form of sexual abuse during childhood, and females reported a higher number of ACEs than males. Sexual abuse (OR = 2.36; 95% CI: 2.36, 7.65), physical neglect (OR = 2.87; 95% CI: 1.57, 5.31), overall ACE exposure (OR = 6.66; 95% CI: 2.41, 18.42), having 1 ACE (OR = 4.40; 95% CI: 1.32, 14.70), having 2–3 ACEs (OR = 4.13; 95% CI: 1.39, 12.29), and having 4+ (OR = 11.67; 95% CI: 3.95, 34.45) were significantly associated with psychological distress.

Conclusions

ACEs are prevalent among young adults and are associated with psychological distress in adulthood. Furthermore, parental factors are associated with ACEs and psychological distress. Thus, implementation of school, community-and facility-based routine mental health screening programs is essential for prompt identification, prevention, and treatment of youth with childhood adversities and poor mental health outcomes.
Calculation and internal validation of a new synthetic and autocorrelate index to combine the determinants of health of a population
Authors: Tebala Domenico , Tebala Giovanni Domenico
Published: April 2021

Background

The status of health of an individual and - more broadly - of a community or population is defined by the status of their determinants of health. A “systemic” approach to define the health determinants is necessary in order to explore the complex relations existing among them. This study is aimed at identifying a ‘composite systemic’ index of health to measure the impact of socioeconomic factors on public health at local level and to analyze possible spatial autocorrelations between neighboring regions.

Results

A Composite Index of Health (CIH) was constructed on the basis of known indicators of socio-economic well-being by using the COMIC (COMposite Indices Creator) Software and was validated on the Italian population and a nationwide comparison has been performed.

Analysis of the determinants showed a significant direct correlation between health, environment, work and wealth and inverse correlation between health and social distress. The analysis of data from Italian provinces confirmed the South-North gradient of well-being.

Conclusion

The CIH is a reliable and robust index to evaluate the health of a local population. Although it was validated on Italian data, the index can be easily adapted to any Country.
Experimental Study on Spall Resistance of Steel-Fiber Reinforced Concrete Slab Subjected to Explosion
Authors: Yang Dapeng , Zhang Bei , Liu Guojun
Published: April 2021

Steel-fiber reinforced concrete slabs have good blast and spall resistance. In this study, compression and splitting tensile experiments were carried out to obtain the basic quasi-static mechanical properties of the steel-fiber concrete specimens and the influence of steel-fiber parameters was revealed. In-field explosion experiments were performed to study the dynamic responses and damage modes of the steel-fiber reinforced concrete slabs. Five typical spall damage modes were observed, the distribution law of the spalling fragments was obtained, and the influence of steel-fiber shape, length, length–diameter ratio and volume percentage on the spall performance were revealed. These results will provide a basis for the application of steel-fiber reinforced concrete slabs in protective structures.
Experimental Research on Bond Behaviour of Fabric Reinforced Cementitious Matrix Composites for Retrofitting Masonry Walls
Authors: Wang Fayu , Kyriakides Nicholas , Chrysostomou Christis , Eleftheriou Eleftherios , Votsis Renos , Illampas Rogiros
Published: April 2021

Fabric reinforced cementitious matrix (FRCM) composites, also known as textile reinforced mortars (TRM), an inorganic matrix constituting fibre fabrics and cement-based mortar, are becoming a widely used composite material in Europe for upgrading the seismic resistance of existing reinforced concrete (RC) frame buildings. One way of providing seismic resistance upgrading is through the application of the proposed FRCM system on existing masonry infill walls to increase their stiffness and integrity. To examine the effectiveness of this application, the bond characteristics achieved between (a) the matrix and the masonry substrate and (b) the fabric and the matrix need to be determined. A series of experiments including 23 material performance tests, 15 direct tensile tests of dry fabric and composites, and 30 shear bond tests between the matrix and brick masonry, were carried out to investigate the fabric-to-matrix and matrix-to-substrate bond behaviour. In addition, different arrangements of extruded polystyrene (XPS) plates were applied to the FRCM to test the shear bond capacity of this insulation system when used on a large-scale wall.
An isogeometric b-rep mortar-based mapping method for non-matching grids in fluid-structure interaction
Authors: Apostolatos Andreas , Emiroğlu Altuğ , Shayegan Shahrokh , Péan Fabien , Bletzinger Kai-Uwe , Wüchner Roland
Published: April 2021

In this study the isogeometric B-Rep mortar-based mapping method for geometry models stemming directly fromComputer-Aided Design(CAD) is systematically augmented and applied to partitionedFluid-Structure Interaction(FSI) simulations. Thus, the newly proposed methodology is applied to geometries described by theirBoundary Representation(B-Rep) in terms of trimmed multipatchNon-Uniform Rational B-Spline(NURBS) discretizations as standard in modern CAD. The proposed isogeometric B-Rep mortar-based mapping method is herein extended for the transformation of fields between a B-Rep model and a low order discrete surface representation of the geometry which typically results when theFinite Volume Method(FVM) or theFinite Element Method(FEM) are employed. This enables the transformation of such fields as tractions and displacements along the FSI interface whenIsogeometric B-Rep Analysis(IBRA) is used for the structural discretization and the FVM is used for the fluid discretization. The latter allows for diverse discretization schemes between the structural and the fluidBoundary Value Problem(BVP), taking into consideration the special properties of each BVP separately while the constraints along the FSI interface are satisfied in an iterative manner within partitioned FSI. The proposed methodology can be exploited in FSI problems with an IBRA structural discretization or to FSI problems with a standard FEM structural discretization in the frame of theExact Coupling Layer(ECL) where the interface fields are smoothed using the underlying B-Rep parametrization, thus taking advantage of the smoothness that the NURBS basis functions offer. All new developments are systematically investigated and demonstrated by FSI problems with lightweight structures whereby the underlying geometric parametrizations are directly taken from real-world CAD models, thus extending IBRA into coupled problems of the FSI type.
Simultaneous implant placement with autogenous onlay bone grafts: a systematic review and meta-analysis
Authors: Ma Guoqiang , Wu Chaoan , Shao Miaoting
Published: April 2021

Several authors have suggested that implants can be placed simultaneously with onlay bone grafts without affecting outcomes. Therefore, the purpose of this study was to answer the following clinical questions: (1) What are the outcomes of implants placed simultaneously with autogenous onlay bone grafts? And (2) is there a difference in outcomes between simultaneous vs delayed placement of implants with autogenous onlay bone grafts? Databases of PubMed, Embase, and Google Scholar were searched up to 15 November 2020. Data on implant survival was extracted from all the included studies (single arm and comparative) to calculate point estimates with 95% confidence intervals (CI) and pooled using the DerSimonian–Laird meta-analysis model. We also compared implant survival rates between the simultaneous and delayed placement of implants with data from comparative studies. Nineteen studies were included. Five of them compared simultaneous and delayed placement of implants. Dividing the studies based on follow-up duration, the pooled survival of implant placed simultaneously with onlay grafts after <2.5 years of follow-up was 93.1% (95% CI 82.6 to 97.4%) and after 2.5–5 years was 86% (95% CI 78.6 to 91.1%). Implant survival was found to be 85.8% (95% CI 79.6 to 90.3%) with iliac crest grafts and 95.7% (95% CI 83.9 to 93.0%) with intra-oral grafts. Our results indicated no statistically significant difference in implant survival between simultaneous and delayed placement (OR 0.43, 95% 0.07, 2.49, I2=59.04%). Data on implant success and bone loss were limited. Data indicates that implants placed simultaneously with autogenous onlay grafts have a survival rate of 93.1% and 86% after a follow-up of <2.5 years and 2.5–5years respectively. A limited number of studies indicate no significant difference in implant survival between the simultaneous and delayed placement of implants with onlay bone grafts. There is a need for randomized controlled trials comparing simultaneous and delayed implant placement to provide robust evidence.
Adolescents’ nutritional status and its association with academic performance in South Ethiopia; a facility-based cross-sectional study
Authors: Katiso Selamawit Woldeyohanes , Kerbo Amene Abebe , Dake Samson Kastro
Published: April 2021

Background

Adolescence is a particularly vulnerable stages of life in which malnutrition inhibits academic performance through poor growth and development, mental retardation, poor overall cognitive function and poor health status. However, there is a dearth of evidence regarding the association between nutritional status and academic performance among adolescent students. Therefore, this study aimed to determine the association of nutritional status and academic performance among adolescent secondary school students in Wolaita Sodo town, Southern Ethiopia.

Methods

A facility-based cross-sectional study was conducted among 670 systematically selected adolescents in secondary schools of Wolaita Sodo town from April to June 2019. The academic performance of the adolescents was measured using the mean mark score of two consecutive semesters’ results of all subjects. Data were analyzed using Stata software Version 15. Descriptive statistics, binary and multiple linear regression analysis were done. Statistical association of dependent and independent variables was declared at p-value < 0.05.

Results

The mean academic performance of students was 69.21 ± 0.42 (95% CI: 68.34–70.02%). A mean mark score of students increased by 1.89 (β = 1.89; 95%CI: 1.14, 2.64) for a unit increase in BMI for age z-score. Being female decreased a mean mark score by 2.63 (β = − 2.63; 95%CI: − 4.28, − 0.98) and being from a separated parents decreased by 4.73 (β = − 4. 73; 95%CI: − 6.73, − 2.74). A mean mark score of students from the first wealth class decreased by 9.92 (− 9.92; 95%CI: − 12.79, − 7.04) as compared to students from the highest wealth class. Attending private schools increased the mean mark score of students by 4.18 (β = 4.18; 95% CI: 2.46, 5.90).

Conclusions

Interventions targeted at adolescents’ nutritional status should be designed and implemented. The town education office and concerned bodies should launch a school feeding program for public schools. Development and income generation activities should target households in the first wealth status. Schools are recommended to design additional teaching and learning schemes such as tutorial classes for girl students.
The Underrepresentation of Females in Studies Assessing the Impact of High-Dose Exercise on Cardiovascular Outcomes: a Scoping Review
Authors: Patel Roshan , Kemp Caitlin L. , Hafejee Muneebah , Peckham Nicholas , Jain Vageesh , McCann Gerry P. , Pallikadavath Susil
Published: April 2021

High-dose exercise-induced cardiac outcomes may vary between sexes. However, many studies investigating the cardiovascular effects of high-dose exercise have excluded or under-recruited females. This scoping review aimed to describe the recruitment of females in studies assessing the impact of high-dose exercise on cardiovascular outcomes and describe how this has changed over time. This scoping review followed the protocol outlined by Arksey and O’Malley and is reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines. The OVID and EMBASE databases were searched for studies that assessed the effects of high-dose exercise on cardiovascular outcomes. Both professional and nonprofessional groups were included. The review found 2973 studies, and 250 met the inclusion criteria including cumulatively 17,548,843 subjects. Over half the studies (n= 127) excluded females entirely, and only 8 (3.2%) studies recruited all-female participants. The overall mean percentage of females recruited was 18.2%. The mean percentage was 14.5% in studies conducted before 2011 and 21.8% in studies conducted after 2011. Females are an underrepresented group in studies assessing the cardiovascular outcomes related to high-dose exercise. As cardiovascular outcomes vary between sexes, translating findings from a largely male-based evidence may not be appropriate. Future investigators should aim to establish and overcome barriers to female recruitment.
Building impactful systems-focused simulations: integrating change and project management frameworks into the pre-work phase
Authors: Dubé Mirette , Posner Glenn , Stone Kimberly , White Marjorie , Kaba Alyshah , Bajaj Komal , Cheng Adam , Grant Vincent , Huang Simon , Reid Jennifer
Published: April 2021

Healthcare organizations strive to deliver safe, high-quality, efficient care. These complex systems frequently harbor gaps, which if unmitigated, could result in harm. Systems-focused simulation (SFS) projects, which include systems-focused debriefing (SFD), if well designed and executed, can proactively and comprehensively identify gaps and test and improve systems, enabling institutions to improve safety and quality before patients and staff are placed at risk.

The previously published systems-focused debriefing framework, Promoting Excellence and Reflective Learning in Simulation (PEARLS) for Systems Integration (PSI), describes a systematic approach to SFD. It includes an essential “pre-work” phase, encompassing evidence-informed steps that lead up to a SFD. Despite inclusion in the PSI framework, a detailed description of the pre-work phase, and how each component facilitates change management, was limited.

The goal of this paper is to elucidate the PSI “Pre-work” phase, everything leading up to the systems-focused simulation and debriefing. It describes how the integration of project and change management principles ensures that a comprehensive collection of safety and quality issues are reliably identified and captured.
How role-taking in a group-work setting affects the relationship between the amount of collaboration and germane cognitive load
Authors: Costley Jamie
Published: April 2021

This research investigates how learning groups affect student learning from two perspectives: first, the amount of group work students do, and second, the role that they take within the group. It is not clear from the current research how a student’s role in collaborative learning affects his/her development of critical thinking and the construction of knowledge. The present study looks into whether the positive relationships found between collaboration and germane cognitive load are affected by a learner’s role within the group. Using cognitive load theory, this study analyzed survey responses from a group of university students (n = 1399) who engaged in collaborative study groups when taking online classes in South Korea. While it was found that the amount of collaboration a student engaged in positively affected levels of germane load and that their level of contribution negatively moderated that relationship. In other words, while more group work is beneficial, students who contribute less to the group have greater gains from higher levels of collaboration than students who take a more active role.
Decompressive laminectomy with instrumented posterolateral fusion for degenerative lumbar disease in elderly, is it safe and beneficial?
Authors: Arab Ahmed A. , Eltantawy Mohammed H. , El-Desouky Ashraf
Published: April 2021

Background

With improvement of health care in last decades, the age of general population increased. As the elderly with degenerative lumbar disease needs to remain physically active for more years, lumbar decompression surgery with instrumented fusion is further considered and is gaining wide acceptance as it provides good results with relative minimal risk. This study aim to evaluate the safety and efficacy of lumbar decompression with instrumented fusion in elderly

Results

This is a prospective non-randomized clinical study conducted from July 2014 to July 2019. The included patients had chronic low back pain, radiculopathy, and/or neurogenic claudication due to degenerative lumbar disease with failed conservative management. They underwent lumbar decompression with instrumented posterolateral fusion. All patients were at least 55 years old at time of surgery and were clinically assessed as regard perioperative risk and morbidity, besides assessment of pre- and postoperative visual analog score (VAS) and Oswestry Disability Index (ODI). Data was collected and analyzed. Thirty-five patients were included in this study with mean age of 63 years. All patients presented with back pain, 77.1% with radiculopathy, and 60% with neurogenic claudication. Preoperative comorbidity was present in 60% of cases, where hypertension, diabetes, and cardiac troubles were 31.4%, 31.4%, and 14.3% respectively. The average operated level was 3.1. The complication rate was 11.4% with 2 cases with dural tear (5.7%), 2 cases with CSF leakage (5.7%), 1 case with wound seroma (2.8%), and 1 case with wound infection. Postoperative new comorbidity occurred in 5 cases (14.3%). Visual analog score (VAS) and Oswestry disability index (ODI) were recorded preoperatively and 18 months postoperatively; as regards pain, VAS improved significantly from 7.8 ± 0.87 to 1.8 ± 1.04 (P value< 0.00001), and ODI improved significantly from 58.1 ± 11 to 17.5 ± 8.3 (P value< 0.00001).

Conclusion

Lumbar decompression surgery with posterolateral instrumented fusion is a safe and effective surgery in elderly, as it provides significant results and gives them a chance for better quality of life. Preoperative comorbidity could be dealt with, and it should not be considered as a contraindication for surgery in this age group.
Correction to: Modified valsalva versus standard valsalva for cardioversion of supraventricular tachycardia: systematic review and meta-analysis
Authors: Abdulhamid Ahmed S. , Almehmadi Fahad , Ghaddaf Abdullah A. , Alomari Mohammed S. , Zagzoog Amin , Al-Qubbany Atif
Published: April 2021

A correction to this paper has been published: https://doi.org/10.1186/s42444-021-00034-y
Circadian Regulation of the Pancreatic Beta Cell
Authors: Seshadri Nivedita , Doucette Christine A
Published: April 2021

Beta cell dysfunction is central to the development of type 2 diabetes (T2D). In T2D, environmental and genetic influences can manifest beta cell dysfunction in many ways, including impaired glucose-sensing and secretion coupling mechanisms, insufficient adaptative responses to stress, and aberrant beta cell loss through increased cell death and/or beta cell de-differentiation. In recent years, circadian disruption has emerged as an important environmental risk factor for T2D. In support of this, genetic disruption of the circadian timing system in rodents impairs insulin secretion and triggers diabetes development, lending important evidence that the circadian timing system is intimately connected to, and essential for the regulation of pancreatic beta cell function; however, the role of the circadian timing system in the regulation of beta cell biology is only beginning to be unraveled. Here, we review the recent literature that explores the importance of the pancreatic islet/beta cell circadian clock in the regulation of various aspects of beta cell biology, including transcriptional and functional control of daily cycles of insulin secretion capacity, regulation of postnatal beta cell maturation, and control of the adaptive responses of the beta cell to metabolic stress and acute injury.
Black Study @ GSU
Authors: Raengo Alessandra
Published: April 2021

Tasked with the mandate to “set the record straight” about the beginning of the liquid blackness research group and journal and to explicate the theoretical and conceptual parameters of the idea of black liquidity, this introduction negotiates the irreconcilable tension between keeping record and record keeping as a way to maintain the anaoriginarity of black study as an ensemblic and jurisgenerative practice. To do so, it draws inspiration from one of its objects of study, Larry Clark's 1977 cult film Passing Through, and specifically from the way the film's formal structure and historical existence as a withdrawing object mirror the elusiveness of the album that the musicians it depicts were never able to record. This introduction is divided into “tracks” to reproduce the same withdrawing effect, trigger a similar ensemblic gathering, and in the process, honor the object-oriented and immanent methodology developed by the liquid blackness project.
Hedgehog signaling and the primary cilium: implications for spatial and temporal constraints on signaling
Authors: Ho Emily K. , Stearns Tim
Published: April 2021

The mechanisms of vertebrate Hedgehog signaling are linked to the biology of the primary cilium, an antenna-like organelle that projects from the surface of most vertebrate cell types. Although the advantages of restricting signal transduction to cilia are often noted, the constraints imposed are less frequently considered, and yet they are central to how Hedgehog signaling operates in developing tissues. In this Review, we synthesize current understanding of Hedgehog signal transduction, ligand secretion and transport, and cilia dynamics to explore the temporal and spatial constraints imposed by the primary cilium on Hedgehog signaling in vivo.
Ret signaling in ureteric bud epithelial cells controls cell movements, cell clustering and bud formation
Authors: Packard Adam , Klein William H. , Costantini Frank
Published: April 2021

Ret signaling promotes branching morphogenesis during kidney development, but the underlying cellular mechanisms remain unclear. While Ret-expressing progenitor cells proliferate at the ureteric bud tips, some of these cells exit the tips to generate the elongating collecting ducts, and in the process turn off Ret. Genetic ablation of Ret in tip cells promotes their exit, suggesting that Ret is required for cell rearrangements that maintain the tip compartments. Here, we examine the behaviors of ureteric bud cells that are genetically forced to maintain Ret expression. These cells move to the nascent tips, and remain there during many cycles of branching; this tip-seeking behavior may require positional signals from the mesenchyme, as it occurs in whole kidneys but not in epithelial ureteric bud organoids. In organoids, cells forced to express Ret display a striking self-organizing behavior, attracting each other to form dense clusters within the epithelium, which then evaginate to form new buds. The ability of forced Ret expression to promote these events suggests that similar Ret-dependent cell behaviors play an important role in normal branching morphogenesis.
Artificial intelligence in brachytherapy: a summary of recent developments
Authors: Banerjee Susovan , Goyal Shikha , Mishra Saumyaranjan , Gupta Deepak , Bisht Shyam Singh , K Venketesan , Narang Kushal , Kataria Tejinder
Published: April 2021

Artificial intelligence (AI) applications, in the form of machine learning and deep learning, are being incorporated into practice in various aspects of medicine, including radiation oncology. Ample evidence from recent publications explores its utility and future use in external beam radiotherapy. However, the discussion on its role in brachytherapy is sparse. This article summarizes available current literature and discusses potential uses of AI in brachytherapy, including future directions. AI has been applied for brachytherapy procedures during almost all steps, starting from decision-making till treatment completion. AI use has led to improvement in efficiency and accuracy by reducing the human errors and saving time in certain aspects. Apart from direct use in brachytherapy, AI also contributes to contemporary advancements in radiology and associated sciences that can affect brachytherapy decisions and treatment. There is a renewal of interest in brachytherapy as a technique in recent years, contributed largely by the understanding that contemporary advances such as intensity modulated radiotherapy and stereotactic external beam radiotherapy cannot match the geometric gains and conformality of brachytherapy, and the integrated efforts of international brachytherapy societies to promote brachytherapy training and awareness. Use of AI technologies may consolidate it further by reducing human effort and time. Prospective validation over larger studies and incorporation of AI technologies for a larger patient population would help improve the efficiency and acceptance of brachytherapy. The enthusiasm favoring AI needs to be balanced against the short duration and quantum of experience with AI in limited patient subsets, need for constant learning and re-learning to train the AI algorithms, and the inevitability of humans having to take responsibility for the correctness and safety of treatments.
Imaging diagnosis of basal ganglia germ cell tumors: subtype features subtype imaging features of GCTs
Authors: Li Wei , Kong Xin , Ma Jun
Published: April 2021

Objectives:

To evaluate the subtype imaging features of basal ganglia germ cell tumors (GCTs).

Methods:

Clinical and imaging data of 33 basal ganglia GCTs were retrospectively analyzed, including 17 germinomas and 16 mixed germ cell tumors (MGCTs).

Results:

The cyst/mass ratio of germinomas (0.53 ± 0.32) was higher than that of MGCTs (0.28 ± 0.19, p = 0.030). CT density of the solid part of germinomas (41.47 ± 5.22 Hu) was significantly higher than that of MGCTs (33.64 ± 3.75 Hu, p < 0.001), while apparent diffusion coefficients (ADC, ×10-3 mm2/s) value of the solid part was significantly lower in geminomas (0.86 ± 0.27 ×10-3 mm2/s) than in MGCTs (1.42 ± 0.39 ×10-3 mm2/s, p < 0.001). MGCTs were more common with intratumoral hemorrhage (68.75% vs 11.76%, p = 0.01), T1 hyperintense foci (68.75% vs 5.88%, p < 0.001) and calcification (64.29% vs 20.00%, p = 0.025) than germinomas. There was no significant difference in internal capsule involvement between the two subtypes (p = 0.303), but Wallerian degeneration was more common in germinomas than in MGCTs (70.59% vs 25.00%, p = 0.015).

Conclusion:

The subtypes of GCT have different imaging features. Tumoral cystic-solidity, heterogeneity, ADC value, CT density, and Wallerian degeneration are helpful to differentiate germinomas and MGCTs in basal ganglia.

Advances in knowledge:

The subtypes of GCT have different histological characteristics, leading to various imaging findings. The imaging features of GCT subtypes in basal ganglia may aid clinical diagnosis and treatment.
Vaccination against hepatitis B virus in hemodialysis patients: trends in dialysis centers of Northern Pakistan
Authors: Nadeem Muhammad , Shah Syed Asim Ali , Arshad Naveed , Riaz Faiza , Kiani Rizwan Saeed , Quddus Muhammad Abdul
Published: April 2021

Background: Chronic kidney disease (CKD) patients, especially those on hemodialysis, are at increased risk of developing hepatitis B virus (HBV) infection. Guidelines suggest that all patients with CKD should be vaccinated against HBV, but these guidelines are usually not followed. We conducted this study to know the status of vaccination against HBV in CKD patients on regular hemodialysis.

Methods: This observational descriptive study was conducted at the Department of Medicine, Sheikh Khalifa Bin Zayed Teaching Hospital, Poonch Medical College Rawalakot , and POF Teaching Hospital, Wah Medical College Wah Cantt, from March to July 2019. Patients reporting to the dialysis center of both hospitals on regular dialysis were included in the study. Patient information (HBV vaccination status, age, gender, education, socioeconomic status, duration of CKD and duration of dialysis) were collected on a specially designed questionnaire. The statistical analysis of data was done in SPSS for Windows, version 20.

Results: A total 149 patients were included in the study, 63.1% were male and 36.9% were female. Out of these 24.2% were uneducated, 33.6% had 1-10 years school education, 38.2% had 10-14 years education, and 4% had more than 14 years education. About 35% patients were from low socioeconomic class, 54% from middle and 11% from higher class. Only 45.6% (n=68) of patients were vaccinated and 54.4% (n=81) were not vaccinated against HBV. Vaccination status was significantly associated with education (p=0.004) and socioeconomic status (p=0.008).

Conclusion: The HBV status of patients on regular hemodialysis is not satisfactory at the two centers observed. It is associated with education and socioeconomic status of the patient.
Differentiation of subjects of competence and powers in the system of public power
Authors: Osavelyuk Aleksey , Zabelina Elena , Nevinskiy Valeriy , Komarova Valentina
Published: April 2021

The book, based on a large amount of factual and legislative material, analysis of decisions of domestic judicial bodies and the ECHR, shows the powers and functions of state and local self-government bodies in the conditions of differentiation of subjects of competence and powers to ensure the most effective solution of tasks in the interests of the population. The paper examines foreign experience and the regulation of these issues by international law.

The textbook is prepared taking into account the Law of the Russian Federation on the Amendment to the Constitution of the Russian Federation of March 14, 2020 No. 1-FKZ On Improving the regulation of certain issues of the organization and functioning of public Power".
(In)segurança alimentar e disponibilidade domiciliar de alimentos de moradores da região norte do Estado do Tocantins
Authors: Cantanhêde Ligia Da Silva , Alves Rafaella Lemos , Schott Eloise
Published: April 2021

Introdução: Estudos que analisam fatores associados à (in)segurança alimentar e nutricional são imprescindíveis para o planejamento de ações e políticas públicas de promoção da saúde. Objetivo: Avaliar a disponibilidade domiciliar de alimentos de acordo com a classificação NOVA e sua associação com a situação de (in)segurança alimentar das famílias. Métodos: Estudo transversal realizado com 199 famílias residentes na microrregião do Bico do Papagaio, no estado do Tocantins. Foram analisados dados socioeconômicos e demográficos das famílias. A situação de insegurança alimentar foi avaliada a partir da Escala Brasileira de Insegurança Alimentar. Para o cálculo da disponibilidade energética diária no domicílio, seguiu-se a metodologia sugerida pela FAO, agrupada conforme o grau de processamento dos alimentos. Utilizou-se o teste qui-quadrado e teste de tendência linear para verificar a associação entre as variáveis. Resultados: No total, 69,9% da população apresentou algum grau de insegurança alimentar, e 43,2% não possuía disponibilidade calórica de alimentos suficiente. Observou-se que, conforme aumentava o grau de insegurança alimentar, reduzia-se o valor calórico disponível no domicílio, sendo que a maior contribuição calórica foi advinda dos alimentos in natura e/ou minimamente processados, seguida de ingredientes culinários, alimentos ultraprocessados e de alimentos processados, independentemente do grau de insegurança alimentar (p<0,05). Conclusão: Ressalta-se a importância de avaliar diferentes determinantes relacionados à (in)segurança alimentar nessa região, além de adotar políticas públicas que melhorem as condições de vida das famílias e implementem estratégias que incentivem a produção e consumo de alimentos regionais.
Food consumption pattern and health risk factors in Brazilian population from 2008 to 2017
Authors: Abbade Eduardo Botti , Oliveira Gabriel Mutschal de , Peters Gabriel Colpo
Published: April 2021

Objetivo: Este estudo teve como objetivo analisar as mudanças na frequência de consumo de certos alimentos e indicadores relacionados aos fatores de risco à saúde na população brasileira. Método: Foram utilizados dados obtidos em pesquisas da VIGITEL dos anos de 2008, 2011, 2014 e 2017. O estudo selecionou variáveis relacionadas aos hábitos alimentares e indicadores de percepção de saúde, além de peso e altura, para o cálculo do IMC (Índice de Massa Corporal), idade e anos de estudo dos entrevistados. Os dados foram analisados por meio de tabelas de frequências e procedimentos estatísticos específicos, como o teste t de Student, correlação de Pearson e a inclinação da regressão linear. Resultados: Os resultados sugerem que o IMC médio da população brasileira está aumentando, atingindo um valor médio de 26,32 em 2017. Observa-se também que os brasileiros avaliam sua saúde como positiva, embora a prevalência de diagnósticos de pressão alta, diabetes e dislipidemia tenha aumentado consideravelmente nos últimos anos. Indivíduos diagnosticados com pressão alta, diabetes ou dislipidemia apresentam frequência significativamente menor de consumo de feijão, vegetais, refrigerantes e álcool; e frequência significativamente maior de consumo de frutas. Os resultados também revelaram que o número de anos de estudo está associado positiva e significativamente com a frequência de consumo de vegetais, frutas, álcool e o hábito de trocar o jantar por lanches. Conclusão: Embora os hábitos alimentares dos brasileiros tenham melhorado, o aumento do número de diagnósticos de doenças não transmissíveis é preocupante e requer a adoção de políticas públicas de saúde.
Assistência de enfermagem no atendimento pré-hospitalar a vítimas de queimaduras: scoping review
Authors: Silva Rosivânia Ingrid Medeiros , Oliveira Eloysa Santos , Rocha Rodrigo Rhuan Andrade , Costa Thatiane Monick Souza , Dantas Rodrigo Assis Neves , Dantas Daniele Vieira
Published: April 2021

Objetivo: identificar as evidências científicas sobre a assistência de enfermagem no atendimento pré-hospitalar a vítima de queimadura. Método: revisão de escopo realizada conforme orientações do Instituto Joanna Briggs e protocolo PRISMA-ScR. A busca foi executada em seis fontes de dados, no recorte temporal de 2016 a 2020. Doze artigos atenderam aos critérios de inclusão, sendo selecionados para a amostra dos resultados.  Resultados: no âmbito da assistência de enfermagem, destacaram-se reposição volêmica com infusão de fluidos; resfriamento local com água limpa, corrente e em temperatura ambiente; monitoramento/controle dos sinais vitais, uso de oxigenoterapia; analgesia e cuidados com a ferida, utilizando coberturas oclusivas, identificação do agente causador, avaliação da Superfície Corporal Queimada, extensão e profundidade da lesão. Conclusão: a assistência de enfermagem frente ao atendimento pré-hospitalar às vítimas de queimaduras se dá principalmente pelo controle da evolução dos danos causados pelo incidente desde o momento da chegada até o atendimento terciário.
Academic Exchange Programs between China and the Arab Region: A Means of Cultural Harmony or Indirect Chinese Influence?
Authors: Zreik Mohamad
Published: April 2021

China relies on soft power for its economic and political expansion, and this strategy has proven effective in achieving the goals set by the Chinese administration. China-Arab relations have developed greatly in the past ten years, in parallel with the increase in the number of Arab students in China. This article examines the Chinese soft power strategy towards the Arab region through student exchange programs, and the role of students in the development of Sino-Arab relations. China achieves strategic goals through soft power. A survey was conducted on a group of Arab students in China, specifically in Wuhan, to learn more about the orientations of Arab students towards Chinese policies and to get a clearer idea of life and study in China. The article concludes with new concepts about life in China, and about the Chinese environment, which have proved to be attractive to Arab students.
Vineland-3 Structural Validity and Interpretability of Domain Scores: Implications for Practitioners Assessing Adolescents With Developmental Conditions
Authors: Pandolfi Vincent , Magyar Caroline I.
Published: April 2021

The Vineland-3 purports to measure three dimensions of adaptive behavior, but empirical evidence pertaining to its structural validity is lacking. In this study, factor analyses were conducted on the standardization sample data for the comprehensive forms within the 11- to 20-year-old age range. Results did not support the three domain structure of the test and indicated domain scores did not add additional information about an individual's adaptive performance that was not already accounted for by the Adaptive Behavior Composite (ABC) score alone. Practitioners assessing adolescents with developmental conditions should consider using the ABC score within a multimethod assessment protocol for the various purposes of adaptive behavior assessment including the identification of intellectual disability.
Information Avoidance and Information Seeking Among Parents of Children With ASD
Authors: Sicherman Nachum , Law Kiely , Lipkin Paul H. , Loewenstein George , Marvin Alison R. , Buxbaum Joseph D.
Published: April 2021

We estimated the effects of information avoidance and information seeking among parents of children diagnosed with autism spectrum disorder (ASD) on age of diagnosis. An online survey was completed by 1,815 parents of children with ASD. Children of parents who self-reported that they had preferred “not to know,” reported diagnoses around 3 months later than other children. Children of parents who raised concerns that they perceived as having been dealt with adequately reported diagnoses about 4 months earlier, but the children of parents who reported raising concerns repeatedly and felt that those concerns were dealt with inadequately were diagnosed over a year later. These findings suggest that failure of educational and healthcare professionals, in either substituting for parents who avoid information, or supporting those who seek information, can significantly delay the age of diagnosis.
Examination of the ADOS-2 Expressive Language Score in Fragile X Syndrome
Authors: Fielding-Gebhardt Heather , Bredin-Oja Shelley L. , Warren Steven F.
Published: April 2021

The development of an expressive language score for people with autism based on the ADOS-2 was recently reported by Mazurek et al. (2019). The current study examined the construct validity of the ADOS-2 expressive language score (ELS) in a sample of adolescents with fragile X syndrome (n = 45, 10 girls), a neurodevelopmental disorder with high rates of autism symptomology. The ADOS-2 ELS showed strong convergent validity with multiple assessments of expressive language, receptive language, and nonverbal cognition. Divergent validity was demonstrated between the expressive language score and chronological age, symptoms of anxiety/depression, and rule-breaking behaviors. This expressive language score is a promising measure of expressive language ability that can be used in research when other language assessments are unavailable.
Effects of photobiomodulation on the redox state of healthy and cancer cells
Authors: Gonçalves de Faria Clara Maria , Ciol Heloisa , Salvador Bagnato Vanderlei , Pratavieira Sebastião
Published: April 2021

Photobiomodulation therapy (PBMT) uses light to stimulate cells. The molecular basis of the effects of PBMT is being unveiled, but it is stated that the cytochrome-c oxidase enzyme in mitochondria, a photon acceptor of PBMT, contributes to an increase in ATP production and modulates the reduction and oxidation of electron carriers NADH and FAD. Since its effects are not fully understood, PBMT is not used on tumors. Thus, it is interesting to investigate if its effects correlate to mitochondrial metabolism and if so, how it could be linked to the optical redox ratio (ORR), defined as the ratio of FAD/(NADH + FAD) fluorescences. To that end, fibroblasts (HDFn cell line) and oral squamous cell carcinoma (SCC-25 cell line) were irradiated with a light source of 780 nm and a total dose of 5 J/cm2, and imaged by optical microscopy. PBMT down-regulated the SCC-25 ORR by 10%. Furthermore, PBMT led to an increase in ROS and ATP production in carcinoma cells after 4 h, while fibroblasts only had a modest ATP increase 6 h after irradiation. Cell lines did not show distinct cell cycle profiles, as both had an increase in G2/M cells. This study indicates that PBMT decreases the redox state of oral cancer by possibly increasing glycolysis and affects normal and tumor cells through distinct pathways. To our knowledge, this is the first study that investigated the effects of PBMT on mitochondrial metabolism from the initiation of the cascade to DNA replication. This is an essential step in the investigation of the mechanism of action of PBMT in an effort to avoid misinterpretations of a variety of combined protocols.