bluuebunny/crossref_metadata_2025 huggingface dataset:
The Methylation Inhibitor 5-Aza-2′-Deoxycytidine Induces Genome-Wide Hypomethylation in Rice
Authors: Liu Shuo , Bao Yu , Deng Hui , Liu Guanqing , Han Yangshuo , Wu Yuechao , Zhang Tao , Chen Chen
Published: July 2022

DNA methylation is a conserved epigenetic modification which is vital for regulating gene expression and maintaining genome stability in both mammals and plants. Homozygous mutation of rice methyltransferase 1 (met1) gene can cause host death in rice, making it difficult to obtain plant material needed for hypomethylation research. To circumvent this challenge, the methylation inhibitor, 5-Aza-2′-deoxycytidine (AzaD), is used as a cytosine nucleoside analogue to reduce genome wide hypomethylation and is widely used in hypomethylation research. However, how AzaD affects plant methylation profiles at the genome scale is largely unknown. Here, we treated rice seedlings with AzaD and compared the AzaD treatment with osmet1-2 mutants, illustrating that there are similar CG hypomethylation and distribution throughout the whole genome. Along with global methylation loss class I transposable elements (TEs) which are farther from genes compared with class II TEs, were more significantly activated, and the RNA-directed DNA Methylation (RdDM) pathway was activated in specific genomic regions to compensate for severe CG loss. Overall, our results suggest that AzaD is an effective DNA methylation inhibitor that can influence genome wide methylation and cause a series of epigenetic variations.
OsPP65 Negatively Regulates Osmotic and Salt Stress Responses Through Regulating Phytohormone and Raffinose Family Oligosaccharide Metabolic Pathways in Rice
Authors: Liu Qing , Ding Jierong , Huang Wenjie , Yu Hang , Wu Shaowen , Li Wenyan , Mao Xingxue , Chen Wenfeng , Xing Junlian , Li Chen , Yan Shijuan
Published: July 2022

Although type 2C protein phosphatases (PP2Cs) have been demonstrated to play important roles in regulating plant development and various stress responses, their specific roles in rice abiotic stress tolerance are still largely unknown. In this study, the functions of OsPP65 in rice osmotic and salt stress tolerance were investigated. Here, we report that OsPP65 is responsive to multiple stresses and is remarkably induced by osmotic and salt stress treatments. OsPP65 was highly expressed in rice seedlings and leaves and localized in the nucleus and cytoplasm. OsPP65 knockout rice plants showed enhanced tolerance to osmotic and salt stresses. Significantly higher induction of genes involved in jasmonic acid (JA) and abscisic acid (ABA) biosynthesis or signaling, as well as higher contents of endogenous JA and ABA, were observed in the OsPP65 knockout plants compared with the wild-type plants after osmotic stress treatment. Further analysis indicated that JA and ABA function independently in osmotic stress tolerance conferred by loss of OsPP65. Moreover, metabolomics analysis revealed higher endogenous levels of galactose and galactinol but a lower content of raffinose in the OsPP65 knockout plants than in the wild-type plants after osmotic stress treatment. These results together suggest that OsPP65 negatively regulates osmotic and salt stress tolerance through regulation of the JA and ABA signaling pathways and modulation of the raffinose family oligosaccharide metabolism pathway in rice. OsPP65 is a promising target for improvement of rice stress tolerance using gene editing.
Marine gregarine genomes reveal the breadth of apicomplexan diversity with a partially conserved glideosome machinery
Authors: Boisard Julie , Duvernois-Berthet Evelyne , Duval Linda , Schrével Joseph , Guillou Laure , Labat Amandine , Le Panse Sophie , Prensier Gérard , Ponger Loïc , Florent Isabelle
Published: July 2022

Our current view of the evolutionary history, coding and adaptive capacities of Apicomplexa, protozoan parasites of a wide range of metazoan, is currently strongly biased toward species infecting humans, as data on early diverging apicomplexan lineages infecting invertebrates is extremely limited. Here, we characterized the genome of the marine eugregarinePorospora gigantea, intestinal parasite of Lobsters, remarkable for the macroscopic size of its vegetative feeding forms (trophozoites) and its gliding speed, the fastest so far recorded for Apicomplexa. Two highly syntenic genomes named A and B were assembled. Similar in size (~ 9 Mb) and coding capacity (~ 5300 genes), A and B genomes are 10.8% divergent at the nucleotide level, corresponding to 16–38 My in divergent time. Orthogroup analysis across 25 (proto)Apicomplexa species, includingGregarina niphandrodes, showed that A and B are highly divergent from all other known apicomplexan species, revealing an unexpected breadth of diversity. Phylogenetically these two species branch sisters to Cephaloidophoroidea, and thus expand the known crustacean gregarine superfamily. The genomes were mined for genes encoding proteins necessary for gliding, a key feature of apicomplexans parasites, currently studied through the molecular model called glideosome. Sequence analysis shows that actin-related proteins and regulatory factors are strongly conserved within apicomplexans. In contrast, the predicted protein sequences of core glideosome proteins and adhesion proteins are highly variable among apicomplexan lineages, especially in gregarines. These results confirm the importance of studying gregarines to widen our biological and evolutionary view of apicomplexan species diversity, and to deepen our understanding of the molecular bases of key functions such as gliding, well known to allow access to the intracellular parasitic lifestyle in Apicomplexa.
Effect of norepinephrine infusion on hepatic blood flow and its interaction with somatostatin: an observational cohort study
Authors: van Limmen Jurgen , Iturriagagoitia Xavier , Verougstraete Marilie , Wyffels Piet , Berrevoet Frederik , Abreu de Carvalho Luís Filipe , De Hert Stefan , De Baerdemaeker Luc
Published: July 2022

Background

Norepinephrine (NE) is a α1-adrenergic mediated vasopressor and a key player in the treatment of perioperative hypotension. Apart from modulating systemic hemodynamics, NE may also affect regional blood flow, such as the hepatic circulation, which contains a wide variety of adrenergic receptors. It may alter regional vascular tonus and hepatic blood flow (HBF) by reducing portal vein flow (PVF) or hepatic arterial flow (HAF). The aim of this study was to assess the effects of NE on HBF.

Methods

Patients scheduled for pancreaticoduodenectomy were included. All patients received standardized anesthetic care using propofol and remifentanil and were hemodynamically stabilized using a goal-directed hemodynamic strategy guided by Pulsioflex™. On surgical indication, somatostatin (SOMATO) was given to reduce pancreatic secretion. HBF measurements were performed using transit-time ultrasound (Medistim™). Baseline hemodynamic and HBF measurements were made after pancreatectomy, at T1. Afterwards, NE infusion was initiated to increase mean arterial pressure (MAP) by 10 – 20% of baseline MAP (T2) and by 20 – 30% of baseline MAP (T3). HBF and hemodynamic measurements were performed simultaneously at these three time-points.

Results

A total of 28 patients were analyzed. Administration of NE significantly increased MAP but had no effect on cardiac index. NE infusion reduced total HBF in all patients (p < 0.01) by a reduction HAF (p < 0.01), while the effect on PVF remained unclear. Post-hoc analysis showed that SOMATO-treated patients had a significant lower PVF at baseline (p < 0.05), which did not change during NE infusion. In these patients, reduction of total HBF was primarily related to a reduction of HAF (p < 0.01). In untreated patients, NE infusion reduced total HBF both by a reduction HAF (p < 0.01) and PVF (p < 0.05).

Conclusion

Administration of NE reduced total HBF, by decreasing HAF, while the effect on PVF remained unclear. SOMATO-treated patients had a lower PVF at baseline, which remained unaffected during NE infusion. In these patients the decrease in total HBF with NE was entirely related to the decrease in HAF. In SOMATO-untreated patients PVF also significantly decreased with NE.

Trial registration

Study protocol EC: 2019/0395.

EudraCT n°: 2018–004,139-66 (25 – 03 – 2019).

Clin.trail.gov: NCT03965117 (28 – 05 – 2019).
A spray-as-you-go airway topical anesthesia attenuates cardiovascular responses for double-lumen tube tracheal intubation
Authors: Chen Changlin , Wen Di , Wang Yizheng , Li Hongqiong , Yu Qi , Li Mao
Published: July 2022

Background

Spray-as-you-go (SAYGo) airway topical anesthesia and nerve block are common techniques used during awake tracheal intubation. However, their effects have not been described during double-lumen tube intubation. We report on a prospective randomized study that aimed to compare the intubation effects of SAYGo and nerve block patients undergoing thoracic surgery.

Methods

Sixty-six American Society of Anesthesiologists (ASA) physical status I and II patients were scheduled to undergo double-lumen tube (DLT) tracheal intubation for thoracic surgery. The patients were randomly assigned into control (Group C), ultrasound (Group U), and flexible intubation scope (Group F) groups with 22 cases in each group. Patients in Group C were induced with a standard anesthetic regimen. Patients in Groups U and F were treated with superior laryngeal nerve (SLN) block combined with transtracheal injection (TTI) and given a SAYGo airway topical anesthesia before intubation. Hemodynamic variables during intubation process were recorded as the primary outcome. Additional patient data were recorded including the occurrence of adverse events, the level of hoarseness, the occurrence of sore throats, memory function and the level of patient satisfaction with anesthesia.

Results

The blood pressure (BP) and heart rate (HR) of patients in group C was significantly increased 1 min after tracheal intubation (P < 0.05) compared to before anesthesia. The BP and HR of patients in Groups U and F remained stable. 10 cases of hypertension were observed in Group C, 6 cases in Group U and 1 case in Group F. In Group C, tachycardia was observed in 9 patients along with 9 cases in Group U and 4 cases in Group F. In Group U, 4 patients experienced puncture and bleeding were and 8 patients had a poor memory of TTI. No significant differences were found in the incidence of hoarseness, sore throats, and satisfaction with anesthesia in postoperative follow-up.

Conclusions

SAYGo airway topical anesthesia and SLN block combined with the TTI technique can inhibit the cardiovascular response during DLT tracheal intubation. The SAYGo technique has fewer complications and more advantages compared to other approaches.
Assessment of myocardial salvage in patients with STEMI undergoing thrombolysis: ticagrelor versus clopidogrel
Authors: Petousis Stylianos , Hamilos Michalis , Pagonidis Konstantinos , Vardas Panos , Lazopoulos Georgios , Anastasiou Ioannis , Zacharis Evangelos , Kochiadakis George , Skalidis Emmanouil
Published: July 2022

Background

In the setting of ST-segment elevation myocardial infarction (STEMI), the faster and stronger antiplatelet action of ticagrelor compared to clopidogrel, as well as its pleiotropic effects, could result in a greater degree of cardioprotection and final infarct size (FIS) limitation. The aim of our study was to comparatively evaluate the effect of ticagrelor and clopidogrel on myocardial salvage index (MSI) in STEMI patients undergoing thrombolysis.

Methods

Forty-two STEMI patients treated with thrombolysis were randomized to receive clopidogrel (n = 21) or ticagrelor (n = 21), along with aspirin. Myocardial area at risk (AAR) was calculated according to the BARI and the APPROACH jeopardy scores. FIS was quantified by cardiac magnetic resonance imaging (CMR) performed 5–6 months post-randomization. MSI was calculated as (AAR-FIS)/AAR × 100%. Primary endpoint of our study was MSI. Secondary endpoints were FIS and CMR-derived left ventricular ejection fraction (LVEF) at 5 –6 months post-randomization.

Results

By using the BARI score for AAR calculation, mean MSI was 52.25 ± 30.5 for the clopidogrel group and 54.29 ± 31.08 for the ticagrelor group (p = 0.83), while mean MSI using the APPROACH score was calculated at 51.94 ± 30 and 53.09 ± 32.39 (p = 0.9), respectively. Median CMR-derived FIS—as a percentage of LV—was 10.7% ± 8.25 in the clopidogrel group and 12.09% ± 8.72 in the ticagrelor group (p = 0.6). Mean LVEF at 5–6 months post-randomization did not differ significantly between randomization groups.

Conclusions

Our results suggest that the administration of ticagrelor in STEMI patients undergoing thrombolysis offer a similar degree of myocardial salvage, compared to clopidogrel.
Does social participation decrease the risk of frailty? Impacts of diversity in frequency and types of social participation on frailty in middle-aged and older populations
Authors: Sun Ju , Kong Xuying , Li Haomiao , Chen Jiangyun , Yao Qiang , Li Hanxuan , Zhou Feng , Hu Hua
Published: July 2022

Background

Social participation (SP) may be an effective measure for decreasing frailty risks. This study investigated whether frequency and type of SP is associated with decreased frailty risk among Chinese middle-aged and older populations.

Methods

Data were derived from the China Health and Retirement Longitudinal Study (CHARLS). Frailty was assessed using the Rockwood’s Cumulative Deficit Frailty Index. SP was measured according to frequency (none, occasional, weekly and daily) and type (interacting with friends [IWF]; playing mah-jong, chess, and cards or visiting community clubs [MCCC], going to community-organized dancing, fitness, qigong and so on [DFQ]; participating in community-related organizations [CRO]; voluntary or charitable work [VOC]; using the Internet [INT]). Smooth curves were used to describe the trend for frailty scores across survey waves. The fixed-effect model (N = 9,422) was applied to explore the association between the frequency/type of SP and frailty level. For baseline non-frail respondents (N = 6,073), the time-varying Cox regression model was used to calculate relative risk of frailty in different SP groups.

Results

Weekly (β =  − 0.006; 95%CI: [− 0.009, − 0.003]) and daily (β =  − 0.009; 95% CI: [− 0.012, − 0.007]) SP is associated with lower frailty scores using the fixed-effect models. Time-varying Cox regressions present lower risks of frailty in daily SP group (HR = 0.76; 95% CI: [0.69, 0.84]). SP types that can significantly decrease frailty risk include IWF, MCCC and DFQ. Daily IWF and daily DFQ decreases frailty risk in those aged < 65 years, female and urban respondents, but not in those aged ≥ 65 years, male and rural respondents. The impact of daily MCCC is significant in all subgroups, whereas that of lower-frequent MCCC is not significant in those aged ≥ 65 years, male and rural respondents.

Conclusion

This study demonstrated that enhancing participation in social activities could decrease frailty risk among middle-aged and older populations, especially communicative activities, intellectually demanding/engaging activities and community-organized physical activities. The results suggested very accurate, operable, and valuable intervening measures for promoting healthy ageing.
The role of routine SARS-CoV-2 screening of healthcare-workers in acute care hospitals in 2020: a systematic review and meta-analysis
Authors: Jabs J. M. , Schwabe A. , Wollkopf A. D. , Gebel B. , Stadelmaier J. , Erdmann S. , Radicke F. , Grundmann H. , Kramer A. , Monsef I. , Rücker G. , Rupp J. , Scheithauer S. , Schmucker C. , Simon A. , Mutters Nico T.
Published: July 2022

Background

Healthcare workers (HCW) are at increased risk of infection with SARS-CoV-2. Vulnerable patient populations in particular must be protected, and clinics should not become transmission hotspots to avoid delaying medical treatments independent of COVID. Because asymptomatic transmission has been described, routine screening of asymptomatic HCW would potentially be able to interrupt chains of infection through early detection.

Methods

A systematic search was conducted in the Cochrane COVID-19 Study Register, Web of Science and WHO COVID‐19 Global literature on coronavirus with regard to non-incident related testing of healthcare workers using polymerase chain reaction on May 4th 2021. Studies since January 2020 were included. An assessment of risk of bias and representativeness was performed.

Results

The search identified 39 studies with heterogeneous designs. Data collection of the included studies took place from January to August 2020. The studies were conducted worldwide and the sample size of the included HCW ranged from 70 to 9449 participants. In total, 1000 of 51,700 (1.9%) asymptomatic HCW were tested positive for SARS-CoV-2 using PCR testing. The proportion of positive test results ranged between 0 and 14.3%. No study reported on HCW-screening related reductions in infected person-days.

Discussion and conclusions

The heterogeneous proportions might be explained by different regional incidences, lock-downs, and pre-analytical pitfalls that reduce the sensitivity of the nasopharyngeal swab. The very high prevalence in some studies indicates that screening HCW for SARS-CoV-2 may be important particularly in geographical regions and pandemic periods with a high-incidence. With low numbers and an increasing rate of vaccinated HCW, a strict cost–benefit consideration must be made, especially in times of low incidences. Since we found no studies that reported on HCW-screening related reductions in infected person-days, re-evaluation should be done when these are available.
Experiences and needs of women in vulnerable situations receiving additional interventions in maternity care: a qualitative study
Authors: Feijen-de Jong Esther I. , Dalmaijer Maria , van der Stouwe Relinde A. , Jansen Danielle E. M. C. , Warmelink J. Catja
Published: July 2022

Background

Tailoring an intervention to the needs and wishes of pregnant women in vulnerable situations (e.g., socioeconomic disadvantages) can reduce the risk of adverse outcomes and empower these women. A relatively high percentage of pregnant women in the North of the Netherlands are considered vulnerable to adverse pregnancy outcomes because of their low socioeconomic status and the intergenerational transmission of poverty. In order to improve perinatal and maternal health, next to standard prenatal care, various interventions for pregnant women in vulnerable situations have been developed. We do not know to what extent these additional interventions suit the needs of (pregnant) women. Therefore, the aim of this study is to gain insight into the experiences and needs of women in vulnerable situations who receive additional maternity care interventions in the Northern Netherlands.

Methods

Qualitative research was performed. We used a phenomenological framework, which is geared towards understanding people’s experiences in the context of their everyday lives. In-depth semi-structured interviews were conducted with 17 pregnant women in vulnerable situations living in the Northern Netherlands. A thematic analysis was carried out.

Results

We found three themes that reflect the experiences and needs of pregnant women in vulnerable situations in relation to the intervention they receive. These themes relate to the care provided by health professionals, to the impact of being offered an intervention, and to practical issues related to receiving an additional intervention. We found that the needs of pregnant women in vulnerable situations who received an additional maternity care intervention varied. This variation in needs was mainly related to practical issues. Women also expressed common needs, namely the desire to have control over their situation, the wish to receive tailor-made information about the intervention, and the wish for the intervention to be specifically tailored to their circumstances.

Conclusions

Living in vulnerable situations and being offered additional care evoked diverse reactions and emotions from pregnant women. We recommend that health professionals ensure open and clear communication with women, that they ensure continuity of care and relationship-centered care, and that they become aware of the process of stigmatization of women in vulnerable situations.
Diffuse myometrium thinning and placenta accreta spectrum in a patient with systemic lupus erythematosus (SLE): a case report and review of the literature
Authors: Mitoma Tomohiro , Hayata Kei , Yokohata Satomi , Ohira Akiko , Kashino Chiaki , Kirino Satoe , Tani Kazumasa , Maki Jota , Eto Eriko , Masuyama Hisashi
Published: July 2022

Background

Cases of uterine wall thinning and placental abnormalities complicated with systemic lupus erythematosus (SLE) during pregnancy have been reported in Asian countries for ten years. Long-term steroid use can cause muscle degeneration, but the mechanism of myometrium thinning was not known. Through the review of published articles, this report is the first review of cases to discuss the pathogenesis and clinical features of thinned myometrium and placenta accreta spectrum (PAS) in pregnant patients with SLE.

Case presentation

A twenty-nine-year-old primigravida with a history of lupus enteritis and paralytic ileus had a natural conception after less than two years of steroid treatment. An ultrasonographic study showed a thin uterine wall with a widespread thick placenta on the entire surface of the uterine cavity in the third trimester. At the 39th gestational week, she underwent a cesarean section due to the failure of the uterus to contract, even though the injection of oxytocin. There were several engorged vessels on the surface of the anterior uterine wall at the time of laparotomy. We decided to perform a hysterectomy because diffuse PAS replaced her uterus.

Conclusion

A review of reported cases and our case shows an unusual complication of SLE that might be related to the particular condition of the estrogen-mediated immune system. Clinicians should always pay attention to the possibility of uterine wall thinning as uterine atony and the structural abnormality of the placenta for SLE patients with the unscarred uterus.
Kayadiol exerted anticancer effects through p53-mediated ferroptosis in NKTCL cells
Authors: He Cuiying , Wang Chengzhao , Liu Haisheng , Shan Baoen
Published: July 2022

Background

Extranodal natural killer/T cell lymphoma (NKTCL) is a highly aggressive type of non-Hodgkin lymphoma that facing the treatment challenges. Natural compounds are important sources for drug development because of their diverse biological and chemical properties, among which terpenoids have strong anticancer activities.

Methods

The human NK/T cell lymphoma cell line YT and peripheral blood lymphocytes isolated from NKTCL patients were treated with different concentrations of kayadiol. Then, the following experiments were performed: CCK-8 assay for cell viability, reactive oxygen species (ROS) and glutathione (GSH) assay and co-treatment with NAC, reduced GSH, or ferrostatin-1 for ferroptosis, the proteome profiling for elucidating signaling pathways, and western blot for the expression of p53, SCL7A11, and GPX4. siRNA and CRISPR/Cas9 plasmid for p53 knockout was designed and transfected into YT cells to evaluate the causal role of p53 in kayadiol-induced ferroptosis. The synergistic effect was evaluated by CCK8 assay after co-treatment of kayadiol with L-asparaginase or cisplatin.

Results

In this study, we found that kayadiol, a diterpenoid extracted from Torreya nucifera, exerted significant killing effect on NKTCL cells without killing the healthy lymphocytes. Subsequently, we observed that kayadiol treatment triggered significant ferroptosis events, including ROS accumulation and GSH depletion. ROS scavenger NAC, GSH, and ferroptosis inhibitor ferrostatin-1 (Fer-1) reversed kayadiol-induced cell death in NKTCL cells. Furthermore, kayadiol decreased the expression of SLC7A11 and GPX4, the negative regulatory proteins for ferroptosis. We then demonstrated that p53 was the key mediator of kayadiol-induced ferroptosis by SLC7A11/GPX4 axis through p53 knockout experiments. In addition, kayadiol exerted a synergistic effect with L-asparaginase and cisplatin in NKTCL cells.

Conclusion

Taken together, our results suggested that the natural product kayadiol exerted anticancer effects through p53-mediated ferroptosis in NK/T cell lymphoma cells. Hence, it can serve as an effective alternative in the treatment of NK/T cell lymphoma, especially for patients exhibiting chemoresistance.
Changes of retinal ganglion cell complex after vitrectomy in rhegmatogenous retinal detachment patients and its correlation with inflammatory blood biomarkers
Authors: Song Jiayi , Chen Ting , Zuo Wen , Chen Wenyu , Lei Min , Ai Ming
Published: July 2022

Purpose

To compare retinal ganglion cell complex (GCC) parameters between rhegmatogenous retinal detachment (RRD) eyes and normal contralateral eyes after vitrectomy and to evaluate their correlation with inflammatory blood markers.

Methods

We investigated 25 eyes that underwent vitrectomy due to RRD. Venous blood samples were collected from all participants before 08:00 a.m. on the second day of admission after a 12-hour fast for blood counts. The differences of retinal structure between RRD and contralateral eyes were compared 1 week postoperatively.

Results

Focal loss volume (FLV) (2.009 ± 1.286)% was significantly increased compared with the contralateral eyes (p <  0.001). Monocyte-to-high-density lipoprotein was significantly positively correlated with GCC thickness parameters, and negatively correlated with FLV and global loss volume (GLV). Postoperative best-corrected visual acuity was negatively correlated with GLV (p = 0.039, R2 = 0.172).

Conclusion

Retinal ganglion cells (RGCs) loss might present early postoperatively in RRD eyes, and was associated with systemic inflammation. RGCs loss might affect postoperative vision.
Reliability and structural validity of the Danish Short 4-item version of the Center for Epidemiological Studies Depression Scale for Children (CES-DC4) in adolescents
Authors: Sørensen Christine Leonhard Birk , Grønborg Therese Koops , Biering Karin
Published: July 2022

Background

The 4-item version of the Center of Epidemiological Studies Depression Scale (CES-DC4) is a self-reported questionnaire used to measure depressive symptoms in adolescents, but the psychometric properties of the scale have been tested to only a limited extent. The aim of this study was to examine the reliability and structural validity of the Danish CES-DC4 in 9th graders.

Methods

Using a sample of 72 adolescents 15 to 17 years of age from five 9th grade classes, the reliability of the CES-DC4 was determined by a test–retest study at a 2-week interval. Descriptive statistics of the adolescents were presented, and internal consistency, structural validity, reliability, and agreement between tests were evaluated. The structural validity of the scale was tested by confirmatory factor analysis (CFA), and the sumscores of the test and retest were presented.

Results

The estimated Cronbach’s α was 0.61 (95% CI 0.50; 0.71). Inter-item and item-rest correlations indicated that one of the four items (item 20) did not fit well on the scale. CFA found a one-factor model suited for the scale, but the factor loadings indicated that item 20 contributed the least to measure the factor (0.29). Sum scores ranged from 0–9 within a possible interval of 0–12. There were no signs of systematic error of the scale. Limits of Agreement (-3.01; 3.79) were broad. The standard error of measurement (SEM = 1.25 point (95% CI.1.05; 1.47)) and intraclass correlation (ICC(2,1) = 0.60 (95% CI: 0.44; 0.73)) calculations showed low reliability of the CES-DC4.

Conclusion

This study found low reliability of the CES-DC4 with low estimates of ICC and Cronbach’s α. The CES-DC4 needs revision, and removal of item 20 and adding more items from the CES-DC should be considered.
Adolescent suicide assessment and management in primary care
Authors: Aalsma M. , Keys J. , Ferrin S. , Shan M. , Garbuz T. , Scott T. , Adams Z. , Hulvershorn L. , Downs S.
Published: July 2022

Background

To understand how suicide management occurs within the primary care setting in terms of follow-up assessments and referral practices.

Methods

At an initial primary care visit, adolescents (aged 12–20 years old) completed electronic screening. Data were focused on youth who endorsed a suicidal risk item while completing screening at two Midwestern primary care clinics. Data were collected through retrospective chart reviews to analyze actions taken by the primary care physician at the youth’s initial visit and follow-up visit within the next 12 months.

Results

At initial visits 200 adolescents endorsed a suicidal risk item and 39 (19.5%) were considered to be concerning by their primary care physician. The average age was 14.7 years old (SD ± 2.0). Seventy-two percent (n = 144) were female, and 65% (n = 129) identified as Black. At initial visits, significant differences between suicidal concern groups were found in reporting active suicidal ideation, past suicide attempts, those who were referred to behavioral health counseling, and those who had a diagnosis of depression. Interestingly, only 13% (n = 25) of all patients who endorsed the suicide item were asked whether or not there were weapons in their home and primary care providers asked only 7% (n = 13) of all patients whether they had a safety plan.

Conclusions

There was inconsistent follow-up for adolescents with a history of suicide concerns. At this time, national guidelines do not exist regarding primary care follow-up of youth with suicide concerns. Guidelines are a necessary precursor for practice improvement.

Trial Registration

Clinical Trials Registry:NCT02244138. Registration date, September 1, 2014.
Impacts of COVID-19 on trans and non-binary people in Canada: a qualitative analysis of responses to a national survey
Authors: Kia Hannah , Rutherford Leo , Jackson Randy , Grigorovich Alisa , Ricote Carol Lopez , Scheim Ayden I. , Bauer Greta R.
Published: July 2022

Background

Emerging international evidence indicates the COVID-19 pandemic has exacerbated socioeconomic and health challenges faced by transgender (trans) and non-binary populations globally. This qualitative study is among the first to characterize impacts of the pandemic on these groups in Canada.

Methods

Drawing on data from the Trans PULSE Canada survey (N = 820), we used thematic analysis to examine the free-form responses of 697 participants to one open-ended question on impacts of the pandemic. We first organized responses into descriptive themes, and then used this preliminary analytical process to construct more refined, higher order themes that provided a rich account of the pandemic’s impacts.

Results

Our results are organized into five themes that highlight the pandemic’s impacts on trans and non-binary populations in Canada. These include: (1) reduced access to both gender-affirming and other healthcare, (2) heightened financial, employment, and housing precarity, (3) strained social networks in an era of physical distancing and virtual communication, (4) an intensification of safety concerns, and (5) changes in experiences of gender affirmation.

Conclusion

Our findings highlight the pandemic’s systemic impacts on the lives of trans and non-binary people in domains such as healthcare, employment, and housing, and on the social networks of these groups, many of which reflect an exacerbation of pre-existing inequities. Based on our analysis, we recommend that public health researchers, policymakers, and practitioners attend to the structural impacts of the pandemic on these groups as primary sites of inquiry and intervention.
Comparative intra- and inter-observer reliability of two methods for evaluating intraoperative ultrasonography-based spinal cord hyperechogenicity intensity in degenerative cervical myelopathy
Authors: Wu Huachuan , Chen Guoliang , Li Xianlong , Zhu Zhengya , Xu Zuofeng , Liu Xizhe , Liu Shaoyu
Published: July 2022

Objectives

During French-door laminoplasty, a linear array transducer of IOUS was used to observe and record the spinal cord decompression. To acquire a higher-reliability method, and compare the in-observer and inter-observer reliability of two methods in evaluating the hyperechoic intensity of spinal cord ultrasound in degenerative cervical myelopathy (DCM).

Background

The intensity of spinal cord hyperechogenicity is considered as a potential predictor of neurological recovery in DCM after decompression, but the accuracy of gray value ratio (GVR) is affected by many factors.

Methods

Totally 28 patients (20 males and 8 females) who had been followed up for 12 months were included. Their mean age at surgery was 61.2 ± 10.8 years and the average symptom duration was 23.36 ± 22.11 months. The gray values of circles 1, 2 and 3 were recorded as Gcompression, Gnorml and Gsac, respectively. Circle 1 was drawn with the maximum brightness point within the spinal cord as the center, circle 2 with the same area was plotted on the spinal cord with uniform echogenicity, without compression and at least 1 cm away from the circle 1, and circle 3 was drawn on the dorsal dural sac at the same segment as circle 1. GVR was calculated as follows: GVR-A = Gcompression/Gnorml (method A), and GVR-B = Gcompression/Gsac (method B). The in-observer and inter-observer reliabilities of the two methods were compared. It is generally believed a reliability coefficient < 0.40 and > 0.75 indicate poor and good reliability respectively. The images-based GVR-B using this protocol demonstrates higher inter- and intraobserver reliabilities than GVR-A, and can be used as the basis for prognostic prediction and future studies.

Results

All examination acquisitions were successfully completed. GVR-A averaged 2.043 (0.318–5.56), and GVR-B averaged 0.578(0.06–1.41). GVR-B has better repeatability of gray value measurement, smaller relative standard deviation (RSD%) (0.298 vs. 0.32) and larger inter-group correlation coefficient compared with GVR-A. The mean value (MD) of the GVR difference calculated by GVR-B between the two clinicians was closer to 0.

Conclusions

For DCM patients routinely using ultrasound for real-time cord visualization during spinal cord decompression by French-door laminoplasty, the images-based GVR-B using this protocol demonstrates better inter- and intraobserver reliabilities compared with GVR-A.
Sequence of flexion contracture development in the lower limb: a longitudinal analysis of 1,071 children with cerebral palsy
Authors: Cloodt Erika , Lindgren Anna , Lauge-Pedersen Henrik , Rodby-Bousquet Elisabet
Published: July 2022

Background

To prevent severe contractures and their impact on adjacent joints in children with cerebral palsy (CP), it is crucial to treat the reduced range of motion early and to understand the order by which contractures appear. The aim of this study was to determine how a hip–knee or ankle contracture are associated with the time to and sequence of contracture development in adjacent joints.

Methods

This was a longitudinal cohort study of 1,071 children (636 boys, 435 girls) with CP born 1990 to 2018 who were registered before 5 years of age in the Swedish surveillance program for CP and had a hip, knee or ankle flexion contracture of ≥ 10°. The results were based on 1,636 legs followed for an average of 4.6 years (range 0–17 years). The Cox proportional-hazards model adjusted for Gross Motor Function Classification System (GMFCS) levels I–V was used to compare the percentage of legs with and without more than one contracture.

Results

A second contracture developed in 44% of the legs. The frequency of multiple contractures increased with higher GMFCS level. Children with a primary hip or foot contracture were more likely to develop a second knee contracture. Children with a primary knee contracture developed either a hip or ankle contracture as a second contracture.

Conclusions

Multiple contractures were associated with higher GMFCS level. Lower limb contractures appeared in specific patterns where the location of the primary contracture and GMFCS level were associated with contracture development in adjacent joints.
Effects of neuromuscular training on postural control of children with intellectual disability and developmental coordination disorders
Authors: Balayi Esmail , Sedaghati Parisa , Ahmadabadi Somayeh
Published: July 2022

Background

Children with Intellectual disabilities who suffer from developmental coordination disorder represent insignificant physical fitness, strength, and balance. The prime objective of this research is to explore the impact of eight weeks of neuromuscular (combined physio-hemsball) training on postural control and balance of students with intellectual disabilities suffering from developmental coordination disorder.

Methods

The present study was a prospective randomized clinical trial with a pretest–posttest design. The statistical population consisted of boys with intellectual disabilities, suffering from developmental coordination disorder randomly divided into two groups: the experimental group (n = 15) and the control group (n = 15). informed consent was obtained from all participants’ parents. Parents completed developmental coordination disorder questionnaires. Tests (Balance Error Scoring System, Y-Balance, timed Get Up & Go) were used to determine postural control, dynamic balance, and functional balance of subjects. The experimental group performed a combined physio-hemsball training for 8 weeks. Ethical considerations were observed according to the Helsinki Declaration and the CONSORT guidelines and regulations were followed to report this study.

Results

Results showed that combined physio-hemsball training for 8 weeks can greatly improve postural control and dynamic and postural balance among students with intellectual disabilities suffering from developmental coordination disorder.

Conclusions

According to the results, instructors can use this type of training to improve postural control and balance in boys with intellectual disabilities enduring developmental coordination disorders.

Trial registration

This research was registered by the clinical trial centers of Iran (code IRCT20200125046254N1, Date of registration: 24/04/2020).
Isolated compounds from Dracaena angustifolia Roxb and acarbose synergistically/additively inhibit α-glucosidase and α-amylase: an in vitro study
Authors: Yi Jiling , Zhao Ting , Zhang Yuanlin , Tan Yanxing , Han Xiao , Tang Yulin , Chen Guangying
Published: July 2022

Background

As a traditional herbal medicine,Dracaena angustifoliaRoxb has been used as an anti-inflammatory agent by the Li people in Hainan, China. In preliminary phytochemical studies conducted in our lab, its fractions were found to inhibit α-glucosidase in vitro, indicating a potential for alleviating glucose dysregulation.

Methods

Through in vitro enzymatic assays, the abilities of the separated components to affect α-glucosidase and α-amylase were evaluated. By establishing concentration gradients and generating Lineweaver–Burk plots, the corresponding inhibition modes together with kinetic parameters were assessed. Following the evaluation of the outcomes of their combination with acarbose, computational docking and molecular dynamic simulations were carried out to analyse the interaction mechanisms and perform virtual screening against human enzymes.

Results

Compared with acarbose, 7 compounds, including flavonoid derivatives, amides and aromatic derivatives, with higher α-glucosidase inhibitory efficiencies were confirmed. It was found that those competitive/mixed candidates and acarbose interacted synergistically or additively on α-glucosidase. Moreover, 3 of them were able to inhibit α-amylase in mixed mode, and additive effects were observed in combination with acarbose. Through in silico docking, it was found that the active site residues as well as adjacent residues were involved in α-glucosidase and α-amylase binding, which were mainly achieved through hydrogen bonding. Among those dual-function flavonoids, Compound 9 was predicted to be a considerable inhibitor of human enzymes, as the formation of ligand–enzyme complexes was mediated by the residues responsible for substrate recognition and catalysis, the stabilities of which were reiterated by molecular dynamics simulations.

Conclusion

Despite their mild effects on α-amylase, considerable α-glucosidase inhibitory efficiencies and potential synergy with acarbose were exhibited by these natural candidates. Furthermore, a stable ligand, human α-glucosidase, was predicted by the performed simulations, which provided useful information for the application ofDracaena angustifoliaRoxb in diabetes treatment.
Are there differences between SIMG surgeons and locally trained surgeons in Australia and New Zealand, as rated by colleagues and themselves?
Authors: Narayanan Ajit , Greco Michael , Janamian Tina , Fraser Tamieka , Archer Julian
Published: July 2022

Background

Representation of specialist international medical graduates (SIMGs) in specific specialties such as surgery can be expected to grow as doctor shortages are predicted in the context of additional care provision for aging populations and limited local supply. Many national medical boards and colleges provide pathways for medical registration and fellowship of SIMGs that may include examinations and short-term training. There is currently very little understanding of how SIMGs are perceived by colleagues and whether their performance is perceived to be comparable to locally trained medical specialists. It is also not known how SIMGs perceive their own capabilities in comparison to local specialists. The aim of this study is to explore the relationships between colleague feedback and self-evaluation in the specialist area of surgery to identify possible methods for enhancing registration and follow-up training within the jurisdiction of Australia and New Zealand.

Methods

Feedback from 1728 colleagues to 96 SIMG surgeons and 406 colleagues to 25 locally trained Fellow surgeons was collected, resulting in 2134 responses to 121 surgeons in total. Additionally, 98 SIMGs and 25 Fellows provided self-evaluation scores (123 in total). Questionnaire and data reliability were calculated before analysis of variance, principal component analysis and network analysis were performed to identify differences between colleague evaluations and self-evaluations by surgeon type.

Results

Colleagues rated SIMGs and Fellows in the ‘very good’ to ‘excellent’ range. Fellows received a small but statistically significant higher average score than SIMGs, especially in areas dealing with medical skills and expertise. However, SIMGs received higher scores where there was motivation to demonstrate working well with colleagues. Colleagues rated SIMGs using one dimension and Fellows using three, which can be identified as clinical management skills, inter-personal communication skills and self-management skills. On self-evaluation, both SIMGs and Fellows gave themselves a significant lower average score than their colleagues, with SIMGs giving themselves a statistically significant higher score than Fellows.

Conclusions

Colleagues rate SIMGs and Fellows highly. The results of this study indicate that SIMGs tend to self-assess more highly, but according to colleagues do not display the same level of differentiation between clinical management, inter-personal and self-management skills. Further research is required to confirm these provisional findings and possible reasons for lack of differentiation if this exists. Depending on the outcome, possible support mechanisms can be explored that may lead to increased comparable performance with locally trained graduates of Australia and New Zealand in these three dimensions.
Effect of introducing interprofessional education concepts on students of various healthcare disciplines: a pre-post study in the United Arab Emirates
Authors: Zaher Shroque , Otaki Farah , Zary Nabil , Al Marzouqi Amina , Radhakrishnan Rajan
Published: July 2022

Background

The value of interprofessional education (IPE) in nurturing healthcare professionals, and in shaping their professional identities, and their attitudes towards interdisciplinary teamwork and collaboration is established in the literature. IPE is an emerging concept in the Middle East and North Africa (MENA) region and is new to the United Arab Emirates (UAE). To date, the applicability and feasibility of IPE and of the corresponding collaborative practice in MENA countries remain largely unexamined.

Purpose

To investigate the effect of one of the first experiences of IPE in the UAE, which was purposefully designed in alignment with the principles of the Situated Learning Theory (SLT), on the readiness for interprofessional learning and collaboration among students of various healthcare disciplines in the UAE.

Methods

A pre-post intervention quantitative research design was adopted for this study. The intervention focused on communication skills, and consisted of 2 tailor-made case-based scenarios. A total of 90 students (40 medical, 16 nursing, 16 pharmacy, and 18 physiotherapy), spread across two sessions (1 session per academic year across 2 academic years), took part in the IPE intervention. Readiness for Interprofessional Learning Scale (RIPLS) was used as the pre- and post- intervention assessments; aggregate data was analyzed using SPSS.

Results

Of those who participated in the intervention (across both rounds), 77 participants responded to the pre-assessment (85. 6%) and 84 responded to the post-assessment (93. 3%). The IPE intervention under investigation significantly increased the level of readiness to engage in cross-disciplinary learning and collaboration among participating health professions’ students. In terms of the subscales, the participants’ openness to engage in teamwork was raised and their professional identity was fostered. Yet, no statistical significance around clarity of roles and responsibilities was detected.

Conclusion

The findings of this study encourage other universities in the MENA region to adopt IPE to improve future health professionals’ capacity to develop shared understanding and mutual respect within cross-disciplinary teams. This, ultimately, feeds into improved quality of care and patient outcomes.