bluuebunny/crossref_metadata_2025 huggingface dataset:
Shortwave infrared emitting multicolored nanoprobes for biomarker-specific cancer imaging in vivo
Authors: Kantamneni Harini , Barkund Shravani , Donzanti Michael , Martin Daniel , Zhao Xinyu , He Shuqing , Riman Richard E. , Tan Mei Chee , Pierce Mark C. , Roth Charles M. , Ganapathy Vidya , Moghe Prabhas V.
Published: November 2020

Background

The ability to detect tumor-specific biomarkers in real-time using optical imaging plays a critical role in preclinical studies aimed at evaluating drug safety and treatment response. In this study, we engineered an imaging platform capable of targeting different tumor biomarkers using a multi-colored library of nanoprobes. These probes contain rare-earth elements that emit light in the short-wave infrared (SWIR) wavelength region (900–1700 nm), which exhibits reduced absorption and scattering compared to visible and NIR, and are rendered biocompatible by encapsulation in human serum albumin. The spectrally distinct emissions of the holmium (Ho), erbium (Er), and thulium (Tm) cations that constitute the cores of these nanoprobes make them attractive candidates for optical molecular imaging of multiple disease biomarkers.

Methods

SWIR-emitting rare-earth-doped albumin nanocomposites (ReANCs) were synthesized using controlled coacervation, with visible light-emitting fluorophores additionally incorporated during the crosslinking phase for validation purposes. Specifically, HoANCs, ErANCs, and TmANCs were co-labeled with rhodamine-B, FITC, and Alexa Fluor 647 dyes respectively. These Rh-HoANCs, FITC-ErANCs, and 647-TmANCs were further conjugated with the targeting ligands daidzein, AMD3100, and folic acid respectively. Binding specificities of each nanoprobe to distinct cellular subsets were established by in vitro uptake studies. Quantitative whole-body SWIR imaging of subcutaneous tumor bearing mice was used to validate the in vivo targeting ability of these nanoprobes.

Results

Each of the three ligand-functionalized nanoprobes showed significantly higher uptake in the targeted cell line compared to untargeted probes. Increased accumulation of tumor-specific nanoprobes was also measured relative to untargeted probes in subcutaneous tumor models of breast (4175 and MCF-7) and ovarian cancer (SKOV3). Preferential accumulation of tumor-specific nanoprobes was also observed in tumors overexpressing targeted biomarkers in mice bearing molecularly-distinct bilateral subcutaneous tumors, as evidenced by significantly higher signal intensities on SWIR imaging.

Conclusions

The results from this study show that tumors can be detected in vivo using a set of targeted multispectral SWIR-emitting nanoprobes. Significantly, these nanoprobes enabled imaging of biomarkers in mice bearing bilateral tumors with distinct molecular phenotypes. The findings from this study provide a foundation for optical molecular imaging of heterogeneous tumors and for studying the response of these complex lesions to targeted therapy.
Ophthatome™: an integrated knowledgebase of ophthalmic diseases for translating vision research into the clinic
Authors: Raj Praveen , Tejwani Sushma , Sudha Dandayudhapani , Muthu Narayanan B. , Thangapandi Chandrasekar , Das Sankar , Somasekar J. , Mangalapudi Susmithasane , Kumar Durgesh , Pindipappanahalli Narendra , Shetty Rohit , Ghosh Arkasubhra , Kumaramanickavel Govindasamy , Chaudhuri Amitabha , Soumittra Nagasamy
Published: November 2020

Background

Medical big data analytics has revolutionized the human healthcare system by introducing processes that facilitate rationale clinical decision making, predictive or prognostic modelling of the disease progression and management, disease surveillance, overall impact on public health and research. Although, the electronic medical records (EMR) system is the digital storehouse of rich medical data of a large patient cohort collected over many years, the data lack sufficient structure to be of clinical value for applying deep learning methods and advanced analytics to improve disease management at an individual patient level or for the discipline in general. Ophthatome™ captures data contained in retrospective electronic medical records between September 2012 and January 2018 to facilitate translational vision research through a knowledgebase of ophthalmic diseases.

Methods

The electronic medical records data from Narayana Nethralaya ophthalmic hospital recorded in the MS-SQL database was mapped and programmatically transferred to MySQL. The captured data was manually curated to preserve data integrity and accuracy. The data was stored in MySQL database management system for ease of visualization, advanced search functions and other knowledgebase applications.

Results

Ophthatome™ is a comprehensive and accurate knowledgebase of ophthalmic diseases containing curated clinical, treatment and imaging data of 581,466 ophthalmic subjects from the Indian population, recorded between September 2012 and January 2018. Ophthatome™ provides filters and Boolean searches with operators and modifiers that allow selection of specific cohorts covering 524 distinct ophthalmic disease types and 1800 disease sub-types across 35 different anatomical regions of the eye. The availability of longitudinal data for about 300,000 subjects provides additional opportunity to perform clinical research on disease progression and management including drug responses and management outcomes. The knowledgebase captures ophthalmic diseases in a genetically diverse population providing opportunity to study genetic and environmental factors contributing to or influencing ophthalmic diseases.

Conclusion

Ophthatome™ will accelerate clinical, genomic, pharmacogenomic and advanced translational research in ophthalmology and vision sciences.
Assessing psychological adjustment and cultural reintegration after military service: development and psychometric evaluation of the post-separation Military-Civilian Adjustment and Reintegration Measure (M-CARM)
Authors: Romaniuk Madeline , Fisher Gina , Kidd Chloe , Batterham Philip J.
Published: November 2020

Background

The transition out of military service and subsequent reintegration to civilian life has been established as a period associated with an increased risk of psychological adjustment difficulties, psychiatric disorders and suicide risk, yet no tool exists to measure cultural and psychological adjustment following permanent separation from the military. This study describes the two-phase mixed-methods development and validation of the self-report Military-Civilian Adjustment and Reintegration Measure (M-CARM).

Methods

In Phase I, four focus groups (n = 20) and semi-structured one-on-one interviews (n = 80) enabled thematic analysis and generation of 53 initial items that were reviewed by an expert multidisciplinary panel (n = 12) and piloted for clarity and relevance in an Australian service-veteran sample (n = 11). In Phase II, psychometric properties of the 47 items resulting from Phase I were evaluated with online assessment of a convenience sample of transitioned Australian Defence Force veterans (n = 725). Analyses included exploratory and confirmatory factor analyses, as well as evaluation of test-retest reliability, internal consistency, and convergent, divergent and discriminant validity.

Results

Exploratory factor analysis on a randomized split-half sample (n = 357), resulted in a 21-item, five-factor solution of Purpose and Connection, Help seeking, Beliefs about civilians, Resentment and regret, and Regimentation, explaining 53.22% of the variance. Confirmatory factor analysis (n = 368) verified this factor structure without modification (χ2 = 304.96, df = 160; CFI = .96, TLI = .94, NFI = .91, RMSEA = .05). Strong convergent, divergent and discriminant validity was demonstrated as M-CARM scores significantly correlated with related constructs assessed by standardised clinical measures as well as differentiated groups based on three binary reintegration items, with large effect sizes (d = > 1). Strong test-retest reliability for the total score (n = 186, r = .93) and excellent internal consistency (n = 725, a = .90) were also found.

Conclusions

Results provide promising evidence the M-CARM is a valid, reliable measure of psychological and cultural reintegration to civilian life, with potential for considerable clinical and research application.
Association between birth weight and risk of abdominal obesity in children and adolescents: a school-based epidemiology survey in China
Authors: Yang Zhaogen , Dong Bin , Song Yi , Wang Xijie , Dong Yanhui , Gao Di , Li Yanhui , Zou Zhiyong , Ma Jun , Arnold Luke
Published: November 2020

Background

Abdominal obesity is becoming an increasingly serious public health challenge in children and adolescents, there remains controversial opinions on birth weight and risk of childhood abdominal obesity. This study aims to assess the association between birth weight and the risk of abdominal obesity in childhood, as well as to compare the associations among different sex and age groups.

Methods

A total number of 30,486 (15,869 boys and 14,617 girls) participants aged 6–17 years old were included in this study. Participants were classified into five groups according to their birth weight. Waist-to-height ratio (WHtR) was used to define abdominal obesity. Fractional polynomial regression model was used to assess the association between birth weight and WHtR, and a multi-variable logistic regression model was applied to evaluate the risk of abdominal obesity in different birth weight groups.

Results

A J-shaped association was observed between birth weight and WHtR. Compared with birth weight of 2500–2999 g, high birth weight was associated with increased risk of abdominal obesity [OR (95% CI) for 3000–3499 g: 1.12(1.00–1.24); 3500–3999 g: 1.19(1.07–1.34); ≥4000 g: 1.42(1.24–1.62)]. No significant correlation was observed in children with birth weight ≤ 2499 g. Similar patterns were observed across different age groups. Abdominal obesity risk for high birth weight was particularly pronounced in boys compared to girls.

Conclusions

Birth weight ≥ 3000 g, especially for boys, was associated with an elevated risk of abdominal obesity in childhood and may benefit from intervention to mitigate this risk.
Evidence-based strategy for prevention of hidden hunger among adolescents in a suburb of Nigeria
Authors: Ibeanu Vivienne N. , Edeh Chinonye G. , Ani Peace N.
Published: November 2020

Background

Hidden hunger (micronutrient deficiencies) among adolescents are linked to impaired physical growth, poor cognitive function, low resistance to infection as well as degenerative and chronic diseases at later age. To prevent these deleterious impacts of hidden hunger, effective intervention strategy that improves nutrition knowledge and promotes healthy food choices among this age-group becomes imperative. The intervention was to evaluate the impact of a 14-page locally developed nutrition education aids on the teenagers’ knowledge of the functions, food sources and deficiencies of some micronutrients and their food choices.

Methods

A one group pre-and post-intervention quasi-experimental study design was conducted with 869 adolescents (13–17 years) selected using multi-stage sampling technique in public secondary schools in a suburb of Nigeria. Using the instructional material development guidelines, the nutrition education aids were developed with nutrition facts, pictures of staple micronutrients-rich foods, and computer graphics. Baseline (pre-intervention) knowledge of nutrition and practice of food choices in relation to micronutrients were determined before exposing the students to the developed nutrition education aids and reassessing (post-intervention) them after 6 months. Data obtained were subjected to paired samples t-test using SPSS version 21.

Results

The adolescents were mostly females (58.92%) aged 16–17 years (53.62%). There was significantly (p < 0.05) higher mean knowledge scores of general nutrition (65.77 vs. 39.61%) and food sources of nutrients (82.26 vs. 66.87%) at post-intervention compared to pre-intervention. Also, the mean knowledge of functions and deficiencies of vitamin C, folic acid, iron, calcium, and zinc were significantly (p < 0.05) higher at post-intervention than at pre-intervention. The study further revealed percentage increase in the proportion of respondents who consumed meat (27.72%), mango (128.20%), watermelon (152.29%), carrot (336.34%) and leafy vegetables (85.56%) daily after the intervention. In addition, the percentage of students who rarely consumed all the studied micronutrient-rich foods decreased after the intervention.

Conclusion

The intervention strategy increased the nutrition knowledge and the consumption of some micronutrients-rich food sources among the adolescents. The developed nutrition education aids are recommended for use in the fight to reduce/eradicate hidden hunger among adolescents in Nigeria.
The impact of change in neighborhood poverty on BMI trajectory of 37,544 New York City youth: a longitudinal study
Authors: Schroeder Krista , Day Sophia , Konty Kevin , Dumenci Levent , Lipman Terri
Published: November 2020

Background

Neighborhood poverty may increase childhood obesity risk. However, evidence for the neighborhood poverty-obesity relationship is limited. The purpose of this study was to examine how moving to a higher or lower poverty neighborhood impacts body mass index (BMI) z-score trajectories among youth, with the goal of informing policy change, interventions, and clinical practices to reduce childhood obesity.

Methods

Methods entailed secondary analysis of existing longitudinal data. The sample included youth attending New York City public schools in grades kindergarten through twelfth from school years 2006/2007 through 2016/2017. Eligibility criteria included moving to a higher or lower poverty neighborhood during the data midpoint [school years 2010/2011 through 2013/2014] of the 12-year data-period; New York City-specific metrics were used to define both neighborhood (Neighborhood Tabulation Area) and relevant neighborhood poverty levels (< 5, 5 to < 10%, 10 to < 20%, 20 to < 30%, 30 to < 40% and ≥ 40% of individuals below Federal Poverty Level). Two-piece latent growth curve models were used to describe BMI z-score trajectories of youth who moved to higher versus lower poverty neighborhoods, with propensity score weighting to account for preexisting differences between the two groups. Primary analyses were stratified by sex and exploratory subgroup analyses were stratified by sex and developmental stage (early childhood, middle childhood, and adolescence) to explore sensitive periods for neighborhood poverty exposure.

Results

Of 532,513 youth with home address data, 18,370 youth moved to a higher poverty neighborhood and 19,174 moved to a lower poverty neighborhood (n = 37,544). Females and males who moved to a higher poverty neighborhood experienced less favorable BMI z-score trajectories for obesity risk, though effects were small. Exploratory subgroup analyses demonstrated that negative effects of neighborhood poverty were most pronounced among young and adolescent females and young males, whereas effects were mixed for other subgroups.

Conclusions

Youth who moved to higher poverty neighborhoods experienced less favorable BMI z-score trajectories for obesity risk, though effects were small and most consistent for females and younger youth. Additional research is needed to illuminate neighborhood poverty’s impact on obesity, in order to inform policy, intervention, clinical, and research efforts to reduce obesity and improve child well-being.
Promoting healthy foods in the new digital era on Instagram: an experimental study on the effect of a popular real versus fictitious fit influencer on brand attitude and purchase intentions
Authors: Folkvord Frans , Roes Elze , Bevelander Kirsten
Published: November 2020

Background

Most studies on social influencer marketing techniques have focused on the promotion of unhealthy foods whereas little is known about the promotion of healthier foods. The present experimental study investigated whether a popular real versus fictitious fit influencer is more successful in promoting healthy food products. In addition, we examined the role of parasocial interaction as an underlying mechanism of healthy food product endorsement.

Methods

We used a randomized between-subject design with 154 participants (mean age: 24.0 years). Viewers’ product attitude and purchase intention were tested after exposure to an Instagram post by a popular real fit influencer (n = 77) or fictitious fit influencer (n = 77).

Results

Results showed that parasocial interaction mediated the relation between the type of influencer and product attitude as well as purchase intention. Parasocial interaction was higher for participants exposed to the popular real fit influencer compared to the fictitious fit influencer, leading to higher healthy food brand attitude and purchase intention.

Discussion

The findings showed that it is crucial for social influencers to establish a warm personal relationship and connection with the their followers when promoting a healthy product successfully. We suggest that the promotion of healthy foods could be more successful in public health when using popular fit influencers.
Young women’s autonomy and information needs in the schools-based HPV vaccination programme: a qualitative study
Authors: Fisher Harriet , Evans Karen , Ferrie Jo , Yates Julie , Roderick Marion , Audrey Suzanne
Published: November 2020

Background

Until 2019, the English schools-based human papillomavirus (HPV) vaccination programme was offered to young women (but not young men) aged 12 to 13 years to reduce HPV-related morbidity and mortality. The aim of this study is to explore the extent to which young women were able to exercise autonomy within the HPV vaccination programme. We consider the perspectives of young women, parents and professionals and how this was influenced by the content and form of information provided.

Methods

Recruitment was facilitated through a healthcare organisation, schools and community organisations in a local authority in the south-west of England. Researcher observations of HPV vaccination sessions were carried out in three schools. Semi-structured interviews took place with 53 participants (young women, parents of adolescent children, school staff and immunisation nurses) during the 2017/18 and 2018/19 programme years. Interviews were recorded digitally and transcribed verbatim. Thematic analysis was undertaken, assisted by NVivo software.

Results

Young women’s active participation and independence within the HPV vaccination programme was constrained by the setting of vaccination and the primacy of parental consent procedures. The authoritarian school structure influenced the degree to which young women were able to actively participate in decisions about the HPV vaccination programme. Young women exercised some power, either to avoid or receive the vaccine, by intercepting parental consent forms and procedures. Reliance on leaflets to communicate information led to unmet information needs for young women and their families. Communication may be improved by healthcare professional advocacy, accessible formats of information, and delivery of educational sessions.

Conclusions

Strategies to improve communication about the HPV vaccine may increase young people’s autonomy in consent procedures, clarify young people’s rights and responsibilities in relation to their health care services, and result in higher uptake of the HPV vaccination programme.

Trial registration

ISRCTN 49086105; Date of registration: 12 January 2018; Prospectively registered.
Correction to: Silent hypoxia: higher NO in red blood cells of COVID-19 patients
Authors: Mortaz Esmaeil , Malkmohammad Majid , Jamaati Hamidreza , Naghan Parisa Adimi , Hashemian Seyed Mohamad Reza , Tabarsi Payam , Varahram Maohammad , Zaheri Hamidreza , Chousein Efsun Gonca Uğur , Folkerts Gert , Adcock Ian M.
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
New-onset nontuberculous mycobacterial pulmonary disease in bronchiectasis: tracking the clinical and radiographic changes
Authors: Kwak Nakwon , Lee Jong Hyuk , Kim Hyung-Jun , Kim Sung A. , Yim Jae-Joon
Published: November 2020

Background

The close association between bronchiectasis and nontuberculous mycobacterial pulmonary disease (NTM-PD) is well-known. However, the clinical impact of subsequent new-onset NTM-PD in bronchiectasis patients has not been elucidated. The aim of this study is to investigate the clinical courses and radiographic changes of patients with bronchiectasis in whom NTM-PD subsequently developed.

Methods

A total of 221 patients with bronchiectasis who had participated in a non-NTM bronchiectasis cohort between July 1st 2011 and August 31st 2019 at Seoul National University Hospital were included in this study. The data of patients in whom NTM-PD developed during this observation period were analyzed; specifically, changes in the Bronchiectasis Severity Index (BSI) and lesions on computerized tomography (CT) scan of the chest arising during the observation period.

Results

During the observation period, NTM was isolated from 35 patients. A total of 31 patients (14.0%) satisfied the diagnostic criteria of NTM-PD. The median time from enrollment in the cohort to the development of subsequent NTM-PD was 37 months (Interquartile range [IQR], 18–78 months). Mycobacterium avium complex was the most common pathogen (80.6%). Twelve patients underwent antibiotic treatment for NTM-PD with a median interval of 20 months (IQR, 13–30) from the time of NTM-PD diagnosis. When NTM-PD developed, the severity and extent of bronchiectasis, cellular bronchiolitis, and the extent of nodules worsened on CT scans, while BSI did not change.

Conclusions

NTM-PD can develop in previously negative bronchiectasis patients. It is associated with worsening radiographic lesions. Active screening of non-NTM bronchiectasis patients for new-onset NTM infection should be considered, especially if radiographic findings worsen. The BSI is not a reliable predictor of new-onset NTM-PD.

Trial registration

This study was performed at Seoul National University Hospital (NCT01616745).
Fibroma of tendon sheath of the hand in a 3-year-old boy: a case report
Authors: Shibayama Hiroki , Matsui Yuichiro , Kawamura Daisuke , Urita Atsushi , Ishii Chikako , Kamishima Tamotsu , Nishida Mutsumi , Shimizu Ai , Iwasaki Norimasa
Published: November 2020

Background

Fibroma of tendon sheath (FTS) is a rare benign soft tissue tumor that often occurs in the upper extremities. It manifests as a slow-growing mass, often without tenderness or spontaneous pain. FTS occurs most commonly in people aged 20–40 years and is extremely rare in young children. Because FTS presents with atypical physical and imaging findings, it might be misdiagnosed as another soft tissue tumor such as a ganglion cyst or tenosynovial giant cell tumor (TSGCT). Although marginal resection is usually performed, a high rate of local recurrence is reported.

Case presentation

A boy aged 3 years and 1 month visited our outpatient clinic with a complaint of a mass of the left hand. An elastic hard mass approximately 20 mm in diameter could be palpated on the volar side of his left little finger. This mass was initially diagnosed as a ganglion cyst at another hospital. Ultrasonography revealed a well-circumscribed hypoechoic mass with internal heterogeneity on the flexor tendon. On magnetic resonance imaging (MRI), the mass showed iso signal intensity to muscle on T1-weighted images, and homogeneously low signal intensity to muscle on T2-weighted images. The mass was peripherally enhanced after contrast administration. FTS was initially suspected as the diagnosis on the basis of these imaging features. Because of the limited range of motion of his little finger, surgery was performed when he was 4 years old. Histopathological findings indicated the mass was well-circumscribed and contained scattered spindle cells embedded in a prominent collagenous matrix. The spindle cells contained elongated and cytologically bland nuclei with a fine chromatin pattern. Nuclear pleomorphism and multinucleated giant cells were not observed. On the basis of these findings, we made a diagnosis of FTS. One year after surgery, no signs of local recurrence were observed.

Conclusions

We experienced an extremely rare case of FTS in the hand of a 3-year-old child. We especially recommend ultrasonography for hand tumors of young children to diagnose or eliminate ganglion cysts. MRI helped differentially diagnose FTS from TSGCT. Although marginal resection can be performed as a treatment, great care should be taken postoperatively because FTS has a high possibility of local recurrence.
Mapping of cis-acting expression quantitative trait loci in human scalp hair follicles
Authors: Herrera-Rivero Marisol , Hochfeld Lara M. , Sivalingam Sugirthan , Nöthen Markus M. , Heilmann-Heimbach Stefanie
Published: November 2020

Background

The association of molecular phenotypes, such as gene transcript levels, with human common genetic variation can help to improve our understanding of interindividual variability of tissue-specific gene regulation and its implications for disease.

Methods

With the aim to capture the spectrum of biological processes affected by regulatory common genetic variants (minor allele frequency ≥ 1%) in healthy hair follicles (HFs) from scalp tissue, we performed a genome-wide mapping of cis-acting expression quantitative trait loci (eQTLs) in plucked HFs, and applied these eQTLs to help further explain genomic findings for hair-related traits.

Results

We report 374 high-confidence eQTLs found in occipital scalp tissue, whose associated genes (eGenes) showed enrichments for metabolic, mitotic and immune processes, as well as responses to steroid hormones. We were able to replicate 68 of these associations in a smaller, independent dataset, in either frontal and/or occipital scalp tissue. Furthermore, we found three genomic regions overlapping reported genetic loci for hair shape and hair color. We found evidence to confirm the contributions of PADI3 to human variation in hair traits and suggest a novel potential candidate gene within known loci for androgenetic alopecia.

Conclusions

Our study shows that an array of basic cellular functions relevant for hair growth are genetically regulated within the HF, and can be applied to aid the interpretation of interindividual variability on hair traits, as well as genetic findings for common hair disorders.
Efficient CRISPR/Cas9 genome editing with Citrus embryogenic cell cultures
Authors: Dutt Manjul , Mou Zhonglin , Zhang Xudong , Tanwir Sameena E. , Grosser Jude W.
Published: November 2020

Background

Development of precise genome editing strategies is a prerequisite for producing edited plants that can aid in the study of gene function and help understand the genetic traits in a cultivar. Citrus embryogenic cell cultures can be used to rapidly produce a large population of genome edited transformed citrus lines. The ability to introduce specific mutations in the genome of these cells using two constructs (pC-PDS1 and pC-PDS2) was evaluated in this study.

Results

Citrus sinensis ‘EV2’ embryogenic cell cultures are amenable to Agrobacterium-mediated CRISPR/Cas9-based genome editing. Guide RNAs (gRNAs) targeting two locations in the phytoene desaturase (PDS) gene were either driven by the Arabidopsis U6–26 promoter (pC-PDS1) or assembled as a Csy4 array under the control of the CmYLCV promoter (pC-PDS2). All transgenic embryos were completely albino and no variegated phenotype was observed. We evaluated 12 lines from each construct in this study and the majority contain either insertion (1–2 bp), substitution (1 bp), or deletion (1–3 bp) mutations that occurred close to the protospacer adjacent motif.

Conclusions

Both the pC-PDS1 and pC-PDS2 could successfully edit the citrus embryogenic cell cultures. However, the editing efficiency was dependent on the gRNA, confirming that the selection of a proper gRNA is essential for successful genome editing using the CRISPR/Cas9 technique. Also, utilization of embryogenic cell cultures offers another option for successful genome editing in citrus.
High intensity interval training exercise-induced physiological changes and their potential influence on metabolic syndrome clinical biomarkers: a meta-analysis
Authors: Serrablo-Torrejon I. , Lopez-Valenciano A. , Ayuso M. , Horton E. , Mayo X. , Medina-Gomez G. , Liguori G. , Jimenez A.
Published: November 2020

Background

Despite the current debate about the effects of high intensity interval training (HIIT), HIIT elicits big morpho-physiological benefit on Metabolic Syndrome (MetS) treatment. However, no review or meta-analysis has compared the effects of HIIT to non-exercising controls in MetS variables. The aim of this study was to determine through a systematic review, the effectiveness of HIIT on MetS clinical variables in adults.

Methods

Studies had to be randomised controlled trials, lasting at least 3 weeks, and compare the effects of HIIT on at least one of the MetS clinical variables [fasting blood glucose (BG), high-density lipoprotein (HDL-C) triglyceride (TG), systolic (SBP) or diastolic blood pressure (DBP) and waist circumference (WC)] compared to a control group. The methodological quality of the studies selected was evaluated using the PEDro scale.

Results

Ten articles fulfilled the selection criteria, with a mean quality score on the PEDro scale of 6.7. Compared with controls, HIIT groups showed significant and relevant reductions in BG (− 0.11 mmol/L), SBP (− 4.44 mmHg), DBP (− 3.60 mmHg), and WC (− 2.26 cm). Otherwise, a slight increase was observed in HDL-C (+ 0.02 mmol/L). HIIT did not produce any significant changes in TG (− 1.29 mmol/L).

Conclusions

HIIT improves certain clinical aspects in people with MetS (BG, SBP, DBP and WC) compared to people with MetS who do not perform physical exercise. Plausible physiological changes of HIIT interventions might be related with large skeletal muscle mass implication, improvements in the vasomotor control, better baroreflex control, reduction of the total peripheral resistance, increases in excess post-exercise oxygen consumption, and changes in appetite and satiety mechanisms.
Molecular diagnosis of patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency
Authors: Espinosa Reyes Tania Mayvel , Collazo Mesa Teresa , Lantigua Cruz Paulina Arasely , Agramonte Machado Adriana , Domínguez Alonso Emma , Falhammar Henrik
Published: November 2020

Background

Congenital adrenal hyperplasia (CAH) is an autosomal recessive group of diseases. 21-Hydroxylase deficiency (21OHD) accounts for between 95 and 99% of all CAH cases.

Objectives

To characterize the genotype of patients clinically diagnosed with 21OHD and to identify the most frequent mutations in the Cuban population.

Methods

Cross-sectional descriptive study that included all patients diagnosed with 21OHD from January 2000 to December 2018. For the molecular analysis of the CYP21A2 gene, a protocol was used that used the polymerase chain reaction in 2 stages; in the first stage genomic DNA was amplified and 5 point mutations were detected in the second stage (Intron 2, Deletion of 8 bp, G318X, I172N and P30L).

Results

The 5 point mutations were identified in 31 of the 55 (56%) studied patients, 16/21 (76%) in the salt-wasting, 12/18 (67%) in the simple virilizing and 3/16 (19%) in the nonclassical form. The Intron 2 mutation was the most frequent, followed by G318X and 8 bp deletion. Compound heterozygotes were found in 10 patients, all corresponded to classic forms of the disease.

Conclusions

The causal CYP21A2 gene mutation was detected in 56% (72% in classic CAH), which makes the method encouraging. The most frequent mutations observed were Intron 2 and G318X. The detection of mutations offers confirmation of diagnosis, prediction of phenotype and genetic counseling.
An objective system for appraising clear aligner treatment difficulty: clear aligner treatment complexity assessment tool (CAT–CAT)
Authors: Long Hu , Wu Zhouqiang , Yan Xinyu , Wang Qingxuan , Liu Lu , Wang Yan , Jian Fan , Liao Lina , Li Xiaolong , Lai Wenli
Published: November 2020

Background

Recent years have witnessed a remarkable evolution of clear aligner technology and clear aligners are becoming more and more versatile in treating orthodontic patients. The aim of this study was to develop an objective evaluation system for assessing clear aligner treatment difficulty.

Methods

A total of 120 eligible patients (100 patients for developing and testing the evaluation system and 20 patients for validating this system) were recruited in this retrospective cross-sectional study. Based on clinical data (dental models, radiographs and photographs), complexity levels of cases were evaluated by two experts and regarded as the gold standard. Difficulty scores were determined through an evaluation system encompassing three domains (dental model analysis, radiographic examinations and clinical examinations). The reliability of the evaluation system was examined through analyzing the agreement between complexity levels and difficulty scores. Moreover, multivariable linear regression test was used to examine the independent association of each variable (e.g. overbite and crowding) with the complexity level.

Results

The results revealed that the assessment of treatment difficulty by this objective evaluation system substantially matched the gold standard (R2 = 0.80). The multivariable regression test revealed that complexity level was significantly associated with difficulty score (p < 0.001), age (p = 0.015), tooth extraction (p < 0.001), treatment stage (p < 0.01) and the number of difficult tooth movement (p = 0.005). This objective evaluation system elaborated in this study was viable and reliable in appraising clear-aligner treatment difficulty in clinical practice.

Conclusions

We suggest orthodontists and general practitioners use this objective evaluation system (CAT-CAT) to appraise clear aligner treatment difficulty and to select appropriate clear aligner patients.
Effect of PTH and corticotomy on implant movement under mechanical force
Authors: Kim Jiyeon , Kim Heon-Young , Kim Won-Ho , Kim Jin-Woo , Kim Min-Ji
Published: November 2020

Background

Osseointegrated implants are considered as clinically non-movable. Parathyroid hormone (PTH) is known to play a significant role in the regulation of bone remodeling and in intermittent, low doses, result in osteoanabolic effects. This study aimed to investigate the effects of PTH and corticotomy, both under traction force, on osseointegrated implants.

Methods

Four implants—two in each hemimandible—were placed in each of the three study mongrels. Each mongrels were designated as control, normal dose PTH (PTH-1), and high dose PTH (PTH-2) groups, with each groups further subdivided into non-surgery implant and surgery implant. After osseointegration, mechanical force with NiTi closed coil springs (500 g) was applied around each implants. Corticotomy was performed around one of four implants in each mongrels. Parathyroid hormone was administered locally on a weekly basis for 20 weeks. Clinical movement of the implants were evaluated with the superimposed 3D- scanned data, bone- microarchitectural and histologic examinations.

Results

Superimposition analysis showed continuous movement of the non-surgery implant of PTH-1 group. Movement was further justified with lowest bone implant contact (adjusted BIC; 44.77%) in histomorphometric analysis. Upregulation of bone remodeling around the implant was observed in the normal dose PTH group. In the surgery implants, the remarkably higher adjusted BIC compared to the non-surgery implants indicated increased bone formation around the implant surface.

Conclusion

The results indicate that the catabolic and anabolic balance of osseointegrated implants in terms of bone remodeling can be shifted via various interventions including pharmacological, surgical and mechanical force.

Clinical relevance

Upregulated bone remodeling by PTH and corticotomy under continuous mechanical force showed the possible implications for the movement of osseointegrated dental implant.
COVID-19 and violence: a research call to action
Authors: Evans Dabney P.
Published: November 2020

COVID-19 related guidelines and movement restrictions are designed to protect the public’s health and reduce disease transmission; yet, COVID-19 related restrictions on movement including social distancing, isolation, quarantine, and shelter-in-place orders have an unknown effect on violence and abuse within relationships. As the pandemic has progressed, many have justifiably speculated that such restrictions may pose a danger to the safety and well-being of people experiencing such violence. Early in the pandemic, countries hard hit by COVID-19 began raising the alarm bell about the impacts of the disease on IPV occurrence. Police in China report that 90% of the causes of recent IPV cases could be attributed to the COVID-19 epidemic. Rising fears and anxiety about prolonged movement restrictions, increased economic strain and diminished health care capacity to support survivors are among the potential reasons for such dramatic effects. Under normal circumstances: low income, unemployment, economic stress, depression, emotional insecurity and social isolation are all risk factors for using violence against partners. Many of these factors may worsen in the context of COVID-19. Despite the urgency in addressing COVID-19, existing health concerns like Intimate Partner Violence (IPV) persist—and may well be worsened by the virus. We simply do not yet know the effects of COVID-19 on violence, nor do we know which interventions work best to prevent and respond to it within the context of the pandemic. The vast majority of information available about IPV and violence during the pandemic has been based on anecdotal reports. The call to action for the research community is clear. We must systematically measure the effects of COVID-19 and movement related restrictions on violence. As always when researching violence, serious consideration must be given to ethics and safety. Violence researchers must mobilize to investigate the impacts of COVID-19 on violence and human health.
Examining aptitude and barriers to evidence-based medicine among trainees at an ACGME-I accredited program
Authors: Mahmoud Mai A. , Laws Sa’ad , Kamel Antoun , Al Mohanadi Dabia , Al Mohammed Ahmed , Mahfoud Ziyad R.
Published: November 2020

Background

The aims of Evidence-Based medicine (EBM) are to promote critical thinking and produces better patients’ outcome (Profetto-McGrath J, J Prof Nurs Off J Am Assoc Coll Nurs 21:364-371, 2005). Accreditation Council for Graduate Medical Education (ACGME) competencies require trainees to locate, appraise and apply clinical evidence to patients’ care. Despite the emphasis that ACGME place on EBM, few organizations provide adequate training in EBM. This is even more critical in regions where medical trainees matriculate from diverse backgrounds of undergraduate medical education, where EBM may not be emphasized nor taught at all. EBM practice has a history of research in the West, however, EBM has not been widely studied in the Middle East.

Methods

Clinicians and trainees at Hamad Medical Corporation (HMC) matriculate from many countries in the Middle East and North Africa (MENA) and Asia. Because trainees in Graduate Medical Education (GME) come to HMC from a variety of geographic backgrounds, it is assumed that they also have a variety of experiences and aptitudes in EBM. To assess trainees EBM attitudes and knowledge in the internal medicine department at HMC in Doha, Qatar, the authors surveyed residents and fellows using a two-part survey. The first part was adapted from the evidence-based practice inventory by Kaper to assess trainees’ attitudes and perceptions of EBM. Trainees were also asked to complete the Assessing Competency in Evidence Based Medicine (ACE) tool to evaluate their aptitude in different elements of EBM. The results from the two parts were analyzed.

Results

The average score on the ACE tool among the participants was 8.9 (±1.6). Most participants rated themselves as beginners or intermediate in their EBM capabilities. Higher ACE scores were observed from participants with educational background from South Asia, and among those with more favorable attitudes towards EBM. There was no clear pattern that early incorporation of EBM into practice will result in better ACE score. Participants also reported reasonable abilities in EBM tasks and a favorable work atmosphere for EBM implementation. Lack of knowledge, resources, and time were the most reported barriers to utilizing EBM.

Conclusions

While it is clear that participants are enthusiastic about EBM and see it as a useful method for clinical decision making, their aptitude in EBM is not optimal and there are gaps and barriers for them to practice.
The erosion of ambiguity tolerance and sustainment of perfectionism in undergraduate medical training: results from multiple samplings of a single cohort
Authors: Ndoja Silvio , Chahine Saad , Saklofske Donald H. , Lanting Brent
Published: November 2020

Background

Medicine is a field that is simultaneously factual and ambiguous. Medical students have their first exposure to full time clinical practice during clerkship. While studies have examined medical trainees’ tolerance of ambiguity (TOA), the extent to which TOA is affected by clinical experiences and its association with perfectionism is unknown. The aim of this study was to evaluate the effect of clerkship experience on TOA and perfectionism in medical students.

Methods

This was a multiple sampling, single cohort study of students in their first year of clinical clerkship which is comprised of 6 core rotations. Consenting students completed an online anonymous survey assessing their tolerance of ambiguity (TOA) and perfectionism in their first (pre) and last (post) 12 weeks of their clinical clerkship year. Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) and The Big Three perfectionism scale-short form (BTPS-SF) were used to assess TOA and perfectionism respectively. Pre-Post mean comparisons of TOA and perfectionism were assessed via t-tests.

Results

From a cohort of 174 clinical clerkship students, 51 students responded to pre-survey, 62 responded to post-survey. Clerkship was associated with a significant decrease in TOA (p < 0.00) with mean pre-TOA scores of 59.57 and post TOA of 43.8. Perfectionism scores were not significantly different over time (p > 0.05). There was a moderate inverse correlation between TOA and perfectionism before clerkship (r = 0.32) that increased slightly after clerkship (r = 0.39). Those preferring primary care specialties had significantly lower rigid and total perfectionism scores in pre-clerkship than those choosing other specialties, but this difference was not found post-clerkship.

Conclusion

Exposure to clerkship decreased TOA while perfectionism remained stable in medical students. These results were not expected as exposure has been previously shown to increase TOA. The frequency of rotation changes maintaining a cycle of anxiety may be an underlying factor accounting for these results. Overall these results require further investigation to better characterize the role of clinical exposure on TOA.
Identifying and supporting students at risk of failing the National Medical Licensure Examination in Japan using a predictive pass rate
Authors: Tsunekawa Koji , Suzuki Yasuyuki , Shioiri Toshiki
Published: November 2020

Background

Students who fail to pass the National Medical Licensure Examination (NMLE) pose a huge problem from the educational standpoint of healthcare professionals. In the present study, we developed a formula of predictive pass rate (PPR)” which reliably predicts medical students who will fail the NMLE in Japan, and provides an adequate academic support for them.

Methods

Six consecutive cohorts of 531 medical students between 2012 and 2017, Gifu University Graduate School of Medicine, were investigated. Using 7 variables before the admission to medical school and 10 variables after admission, we developed a prediction formula to obtain the PPR for the NMLE using logistic regression analysis. In a new cohort of 106 medical students in 2018, we applied the formula for PPR to them to confirm the capability of the PPR and predicted students who will have a strong likelihood of failing the NMLE.

Results

Medical students who passed the NMLE had the following characteristics: younger age at admission, graduates of high schools located in the surrounding area, high scores in the graduation examination and in the comprehensive computer-based test provided by the Common Achievement Test Organization in Japan. However, total score of examination in pre-clinical medical sciences and Pre-CC OSCE score in the 4th year were not correlated with the PPR. Ninety-one out of 531 students had a strong likelihood of failing the NMLE between 2012 and 2017 and 33 of these 91 students failed NMLE. Using the PPR, we predicted 12 out of 106 students will have a strong likelihood of failing the NMLE. Actually, five of these 12 students failed NMLE.

Conclusions

The PPR can be used to predict medical students who have a higher probability of failing the NMLE. This prediction would enable focused support and guidance by faculty members. Prospective and longitudinal studies for larger and different cohorts would be necessary.
Routine measurement of satisfaction with life and treatment aspects in mental health patients – the DIALOG scale in East London
Authors: Mosler Franziska , Priebe Stefan , Bird Victoria
Published: November 2020

Aims

The DIALOG scale has been implemented as a routine patient outcome and experience measure (PROM/PREM) in a mental health trust in East London since 2017. The resulting healthcare dataset was used to estimate satisfaction with life and treatment aspects over time and factors associated with it.

Methods

Variables available from the Trust were DIALOG items, service level, clinical and basic demographic data. Data was extracted in February 2019. Data is described using a range of descriptive statistics and looking at the subgroups: treatment stage, diagnosis, service type. Predictors for average DIALOG scores across patients was explored with clustered linear regression models. A fixed effect model was chosen to estimate the impact of clinical and service related variables on patient’s average DIALOG scores over time. Sensitivity analyses with the whole data set and complete cases were carried out.

Results

Of the original 18,481 DIALOG records 12, 592 were kept after data cleaning (5646 patients). The average DIALOG score was 4.8 (SD 1.0) on the 7-point scale. Average satisfaction with life aspects (PROM) was 4.65 (SD 1.1) and with treatment aspects (PREM) was 5.25 (SD 1.17). Across all 11 items, “job situation” scored lowest (mean 4.05) and “meetings with professionals” highest (mean 5.5). Satisfaction for all items increased over time (average increase 0.47). The largest increase was in “mental health” (0.94) and the smallest in “family relationships” (0.34).

Conclusions

Patients in mental healthcare services were “fairly satisfied” in both life and treatment aspects with improvements seen over time. These results will act as a benchmark for clinical services currently implementing DIALOG across the UK and inform local service developments.