bluuebunny/crossref_metadata_2025_split huggingface dataset:
REVIEW OF PROSTHETICS & ORTHOTICS NEEDS FOR 21ST CENTURY – VISION FOR 2025
Authors: Zahedi Saeed 
Published: September 2021

What would we do, if only we had the power to go back?! The best way to consider this is to align and join all the known dots. To think of Prosthetics and Orthotics (P&O) as a system holistically centred around care of the user, identifying all their needs continuously, in their environment and in their lifestyle. This could produce a new value proposition for all multi-disciplinary team members by generating patient-centred therapeutic benefits and clinical outcomes that align all stakeholders in P&O towards using a common narrative, which makes decisions based on data. In this case, data is the outcome, using Standards and Instruments which are validated (e.g. www.amprom.uk) to quantify questions such as: “Have we reduce risk of falls?”, “Have we reduced risk of tissue injury?”, “Have we reduced risk of low back pain?”, “Have we reduced long term risk of osteoarthritis?”, etc. If we have, we are assured this will benefit the comfort and confidence for the user. We can have confidence in rehabilitation measured by improved stability and increased activity, and other measures which enable the accurate classification of products and services to match users. A prescription index, based on Outcomes, could, for example, be calculated by a formula which accounts for the percentage reduction in falls probability, a patient satisfaction score, a mobility score and a quality-of-life score, allowing practitioners to base their choices of treatment pathways and component selection. This paper provides both the context for and contributing factors that make the proposing of such an objective Prescription Index an interesting thing to consider when discussing Health Economics in P&O. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/37113/28348 How To Cite: Zahedi S. Review of prosthetics & orthotics needs for 21st Century – Vision for 2025. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.20. https://doi.org/10.33137/cpoj.v4i2.37113 Corresponding Author: Professor Sir Saeed Zahedi,Blatchford Group, Unit D Antura, Bond Close, Basingstoke, RG24 8PZ, United Kingdom.E-Mail: saeed.zahedi@blatchford.co.ukORCID ID: https://orcid.org/0000-0002-6959-632X
EXOSEKETONS: A REHAB TECH CONSUMER’S UNEXPECTED MARCH TO ACTION
Authors: Angus Chloe 
Published: September 2021

This paper is both a stakeholder perspectives as well as a ‘case study’ describing a journey from sudden disability to participant and investor in exoskeleton design. It tells of my experiences and opinions, as a successful fashion designer, when my life took a drastic turn on becoming paralysed from the waist down over the course of 24 hours, by a spinal tumour. Getting this diagnosis was ‘the worst day in my life’, and it was quickly followed by the ‘second worst’ when, in my determination to walk again, I received Knee Ankle Foot Orthotics (KAFOs) and was shocked to learn that this appeared to be the best technology solution available on the market ‘suitable’ for use in the community. Initial anger at the system for not being better, at the rehab team for their complacency, and at myself for allowing a feeling of helplessness to take over led to questions such as: what does this say about our society? and what are we all willing to accept, for ourselves and others? This is professional opinion and an essay about how we see ourselves and how others see us. The journey from pre-injury ‘consumer’ to post-injury ‘disabled’ person and learning that being labeled ‘disabled’ leads to the additional handicap of the narrow vision of “cost” taken by the mobility industry where innovative ideas are stripped down to the bare minimum with the excuse that patients are “lucky” to have what they have been “given”. Grappling with these labels and inequities and seeking a better outcome, I became an integral team member of an exoskeleton development team, leading to the design of The Next Generation Exoskeleton! This is MY story, the story of Chloe Angus. It is the story of inclusive, user focused design and is a call to include and respect the end users of all assistive device technology design early in the design process and it is being told from the perspective of a person having experience and success in the world of business.
Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/37250/28296
How To Cite: Angus C. Exoseketons: a rehab tech consumer’s unexpected march to action. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.2. https://doi.org/10.33137/cpoj.v4i2.37250
Corresponding Author: Chloe AngusChloe Angus Design, Vancouver, BC, Canada.E-Mail: chloe@chloeangus.comORCID ID: https://orcid.org/0000-0002-5468-3121
Reduced Expression of Erythropoietin After Intravitreal Ranibizumab in Proliferative Diabetic Retinopathy Patients—Retrospective Interventional Study
Authors: Chen Li , Feng Jing , Shi Yanhong , Luan Fuxiao , Ma Fang , Wang Yingjie , Yang Weiqiang , Tao Yong 
Published: September 2021

Purpose: To evaluate the expressions of erythropoietin (EPO) and vascular endothelial growth factor (VEGF) in the vitreous and fibrovascular membranes (FVMs) of proliferative diabetic retinopathy (PDR) after the intravitreal injection of ranibizumab (IVR) and further explore the relationship between EPO and VEGF.Method: The concentrations of EPO and VEGF levels in the vitreous fluid were measured in 35 patients (24 PDR and 11 non-diabetic patients) using enzyme-linked immunosorbent assay. The patients were divided into three groups: PDR with IVR (IVR group) before par plana vitrectomy (n = 10), PDR without IVR (Non-IVR group) (n = 14) and a control group [macular holes (MHs) or epiretinal membranes (ERM), n = 11]. Fluorescence immunostaining was performed to examine the expressions of VEGF, EPO and CD 105 in the excised epiretinal membranes.Result: The PDR eyes of Non-IVR group had the highest vitreous VEGF and EPO levels (836.30 ± 899.50 pg/ml, 99.29 ± 27.77 mIU/ml, respectively) compared to the control group (10.98 ± 0.98 pg/ml and 18.96 ± 13.30 mIU/ml/ml). Both the VEGF and EPO levels in the IVR group (13.22 ± 2.72 pg/ml and 68.57 ± 41.47 mIU/ml) were significantly lower than the Non-IVR group (P = 0.004 and P = 0.04, respectively). Furthermore, no significant difference was observed for VEGF levels between the control and IVR groups (10.9 ± 0.98 pg/ml and 13.22 ± 2.72 pg/ml, respectively, P = 0.9). Yet the EPO level in the IVR group was significantly higher than that in the Non-diabetic group (68.57 ± 41.47 pg/ml and 18.96 ± 13.30 pg/ml, respectively, P = 0.001). The expressions of EPO, VEGF, and CD105 were significantly reduced in fluorescence immunostaining of FVMs in the IVR group compared with the Non-IVR group. The receiver operating characteristic (ROC) curve of the EPO and VEGF levels were 0.951 and 0.938 in the PDR group.Conclusion: Both of the VEGF and EPO level were significantly increased in PDR patients, which have equal diagnostic value in the prediction of PDR. IVR could reduce the EPO level, but not enough to the normal level.
A SMYD3/ITGB6/TGFβ1 Positive Feedback Loop Promotes the Invasion and Adhesion of Ovarian Cancer Spheroids
Authors: Jiang Yahui , Zhou Tianyu , Shi Yiwen , Feng Weiwei , Lyu Tianjiao 
Published: September 2021

BackgroundImplantation metastasis is the main means of dissemination in ovarian cancer. Our previous studies showed that SET and MYND domain-containing protein 3 (SMYD3) expression was higher in ovarian cancer spheroids than in monolayers. SMYD3 enhancement of spheroid invasion and adhesion is mediated by the downstream effectors ITGB6 and ITGAM. However, the potential mechanisms underlying the SMYD3/integrin-mediated invasion and adhesion of spheroids still need to be explored.MethodsWestern blotting was used to examine the expression of SMYD3, ITGB6 and downstream molecules under different treatments. Immunofluorescence was used to detect the expression of F-actin, E-cadherin and N-cadherin. Anti-ITGB6 antibody-based inhibition and dual-luciferase reporter assays were used to confirm the binding between ITGB6 and latent TGFβ1. Transwell invasion, adherence and 3D tumor spheroid invasion assays were employed to test the effects of TGFβ1 on the invasion and adhesion of ovarian cancer spheroids. ELISA was performed to assess the release of latent TGFβ1 from ovarian cancer spheroids.ResultsSMYD3 and ITGB6 activated the TGFβ1/Smad3 pathway and then induced the upregulation of Snail, Vimentin and N-cadherin and the downregulation of E-cadherin in 3D-cultured ovarian cancer spheroids. In this process, latent TGFβ1 could bind to ITGB6 and become activated to stimulate the Smad3 pathway. Moreover, SMYD3 and ITGB6 could facilitate the release of latent TGFβ1 from 3D-cultured ovarian cancer spheroids. Interestingly, TGFβ1 could promote the expression of SMYD3 and ITGB6 via feedback. This positive feedback loop could further amplify the biological effect and promote the invasion and adhesion of ovarian cancer spheroids.ConclusionOur results demonstrated that the SMYD3/ITGB6/TGFβ1-Smad3 positive feedback loop could promote the invasion and adhesion of ovarian cancer spheroids by upregulating the expression of N-cadherin, Snail, and Vimentin and downregulating the expression of E-cadherin. Thus, our study unmasked the mechanism of SMYD3- and ITGB6-induced ovarian cancer metastasis and provides new ideas for targeted ovarian cancer treatment.
Comparison of Perioperative, Renal Functional, and Oncological Outcomes Between Off-Clamp and On-Clamp Robot-Assisted Partial Nephrectomy for Renal Tumors: An Updated Evidence-Based Analysis
Authors: Huang Yin , Cao Dehong , Chen Zeyu , Chen Bo , Li Jin , Guo Jianbing , Dong Qiang , Wei Qiang , Liu Liangren 
Published: September 2021

ObjectivesWe aimed to report the latest and largest pooled analysis and evidence update to compare the perioperative, renal functional, and oncological outcomes between off-clamp and on-clamp robot-assisted partial nephrectomy (RAPN) for renal tumors.Patients and methodsWe performed a systematic literature search using PubMed, Embase, and Web of Science up to August 2021 for studies that compared the efficacy and/or safety between off-clamp and on-clamp RAPN for renal tumors. Outcomes measured were operating time, estimated blood loss (EBL), conversion rate, length of stay (LOS), complication rate, transfusion rate, long-term % decrease in estimated glomerular filtration rate (eGFR), positive surgical margin rate, and recurrence rate.ResultsA total of 21 eligible articles involving 4,493 patients (1,274 off-clamp versus 3,219 on-clamp) were included for the evidence synthesis. Baseline characteristics of the two groups were similar in all outcomes except that lower R.E.N.A.L. score and smaller tumor size were observed in the off-clamp group. Pooled analysis showed shorter operative time, higher EBL, and lower complication rate in the off-clamp group. No significant difference was observed in the conversion rate, LOS, and transfusion rate. The recurrence rates were similar in the two groups, while a lower positive surgical margin rate was observed in the off-clamp group. Finally, the off-clamp group had a superior postoperative renal functional outcome.ConclusionsGiven the presence of heterogeneity and potential bias, urologists should select the clamp strategy based on their experience and patient-specific factors.
MEDEX 2015: Prophylactic Effects of Positive Expiratory Pressure in Trekkers at Very High Altitude
Authors: Rupp Thomas , Maufrais Claire , Walther Guillaume , Esteve François , Macdonald Jamie Hugo , Bouzat Pierre , Verges Samuel 
Published: September 2021

Purpose: Positive expiratory pressure (PEP) breathing has been shown to increase arterial oxygenation during acute hypoxic exposure but the underlying mechanisms and consequences on symptoms during prolonged high-altitude exposure remain to be elucidated.Methods: Twenty-four males (41 ± 16 years) were investigated, at sea level and at 5,085 m after 18 days of trekking from 570 m. Participants breathed through a face-mask with PEP = 0 cmH2O (PEP0, 0–45th min) and with PEP = 10 cmH2O (PEP10, 46–90th min). Arterial (SpO2), quadriceps and prefrontal (near infrared spectroscopy) oxygenation was measured continuously. Middle cerebral artery blood velocity (MCAv, transcranial Doppler), cardiac function (2D-echocardiography), extravascular lung water accumulation (UsLC, thoracic ultrasound lung comets) and acute mountain sickness (Lake Louise score, LLS) were assessed during PEP0 and PEP10.Results: At 5,085 m with PEP0, SpO2 was 78 ± 4%, UsLC was 8 ± 5 (a.u.) and the LLS was 2.3 ± 1.7 (all P &lt; 0.05 versus sea level). At 5,085 m, PEP10 increased significantly SpO2 (+9 ± 5%), quadriceps (+2 ± 2%) and prefrontal cortex (+2 ± 2%) oxygenation (P &lt; 0.05), and decreased significantly MCAv (−16 ± 14 cm.s–1) and cardiac output (−0.7 ± 1.2 L.min–1) together with a reduced stroke volume (−9 ± 15 mL, all P &lt; 0.05) and no systemic hypotension. PEP10 decreased slightly the number of UsLC (−1.4 ± 2.7, P = 0.04) while the incidence of acute mountain sickness (LLS ≥ 3) fell from 42% with PEP0 to 25% after PEP10 (P = 0.043).Conclusion: PEP10 breathing improved arterial and tissue oxygenation and symptoms of acute mountain sickness after trekking to very high altitude, despite reduced cerebral perfusion and cardiac output. Further studies are required to establish whether PEP-breathing prophylactic mechanisms also occur in participants with more severe acute mountain sickness.
High Proteoglycan Decorin Levels Are Associated With Acute Coronary Syndrome and Provoke an Imbalanced Inflammatory Response
Authors: Zhuang Lingfang , Ge Yulong , Zong Xiao , Yang Qian , Zhang Ruiyan , Fan Qin , Tao Rong 
Published: September 2021

Background and Aims: Acute coronary syndrome (ACS) has become one of the most common causes of disability. It is thus important to identify ACS early in the disease course of patients using novel biomarkers for prompt management. Decorin (DCN) was well-acknowledged for its effect on collagen fibrillogenesis and maintaining tissue integrity. Additionally, DCN could release as secreted proteoglycan under pathological conditions. Hence, we aimed to determine the relationship between serum DCN concentration and ACS.Methods: A total of 388 patients who underwent coronary angiography (CAG) in the cardiovascular center of Ruijin Hospital between June 2016 and December 2017 were enrolled in this study. Blood samples were drawn during CAG surgery to determine the serum DCN level of patients with ACS (n = 210) and control subjects (n = 178) using enzyme-linked immunosorbent assay.Results: We found that the serum DCN levels of ACS patients were elevated compared with those of the control subjects (13.59 ± 0.50 vs. 13.17 ± 0.38, respectively, p &lt; 0.001). Furthermore, the serum DCN level, after being adjusted with other cardiovascular factors, was independently associated with ACS. Moreover, an increased serum DCN level was positively correlated with the number of white blood cells and the level of high-sensitivity C-reactive protein (R = 0.3 and 0.11, respectively). Mechanistically, DCN might have elicited an imbalanced inflammatory response during cardiac ischemia by suppressing the expression of anti-inflammatory genes.Conclusion: Serum DCN is a novel biomarker of ACS and contributes to the increased inflammatory response in ischemic heart disease.
Psychological Inflexibility and Loneliness Mediate the Impact of Stress on Anxiety and Depression Symptoms in Healthcare Students and Early-Career Professionals During COVID-19
Authors: Bonilla-Sierra Patricia , Manrique-G Alexis , Hidalgo-Andrade Paula , Ruisoto Pablo 
Published: September 2021

Background: The current mental health state of healthcare professionals and students during the COVID-19 pandemic in Ecuador remains understudied and how to improve their mental health is a challenge.Objective: This study aimed to explore the anxiety and depressive symptomatology among healthcare students and professionals in Ecuador and to examine the role of psychological inflexibility, loneliness, and psychological stress as predictors of anxiety and depression symptoms.Methods: A total of 191 undergraduate and graduate healthcare students in clinical practice (early-career healthcare professionals) in Ecuador were surveyed between January and March 2021 using standardized measures of psychological stress (PSS), psychological inflexibility (AAQ), loneliness (UCLA), alcohol consumption (AUDIT-C), and anxiety and depressive symptomatology (PHQ). Macro Process for SPSS (models 4 and 7) were used to test mediation effects.Results: Alcohol consumption varied between men and women and anxiety and depression symptomatology was generally low among the sample. Psychological inflexibility and loneliness mediated the impact of stress on anxiety and depressive mood in participants, regardless of gender and previous personal history of COVID-19.Discussion: Implications of psychological inflexibility and the prevention and coping with stress in healthcare professionals during COVID-19 are further discussed.
COVID-19 Critical Care Simulations: An International Cross-Sectional Survey
Authors: Temsah Mohamad-Hani , Alrabiaah Abdulkarim , Al-Eyadhy Ayman , Al-Sohime Fahad , Al Huzaimi Abdullah , Alamro Nurah , Alhasan Khalid , Upadhye Vaibhavi , Jamal Amr , Aljamaan Fadi , Alhaboob Ali , Arabi Yaseen M. , Lazarovici Marc , Somily Ali M. , Boker Abdulaziz M. 
Published: September 2021

Objective:To describe the utility and patterns of COVID-19 simulation scenarios across different international healthcare centers.Methods:This is a cross-sectional, international survey for multiple simulation centers team members, including team-leaders and healthcare workers (HCWs), based on each center's debriefing reports from 30 countries in all WHO regions. The main outcome measures were the COVID-19 simulations characteristics, facilitators, obstacles, and challenges encountered during the simulation sessions.Results:Invitation was sent to 343 simulation team leaders and multidisciplinary HCWs who responded; 121 completed the survey. The frequency of simulation sessions was monthly (27.1%), weekly (24.8%), twice weekly (19.8%), or daily (21.5%). Regarding the themes of the simulation sessions, they were COVID-19 patient arrival to ER (69.4%), COVID-19 patient intubation due to respiratory failure (66.1%), COVID-19 patient requiring CPR (53.7%), COVID-19 transport inside the hospital (53.7%), COVID-19 elective intubation in OR (37.2%), or Delivery of COVID-19 mother and neonatal care (19%). Among participants, 55.6% reported the team's full engagement in the simulation sessions. The average session length was 30–60 min. The debriefing process was conducted by the ICU facilitator in (51%) of the sessions followed by simulation staff in 41% of the sessions. A total of 80% reported significant improvement in clinical preparedness after simulation sessions, and 70% were satisfied with the COVID-19 sessions. Most perceived issues reported were related to infection control measures, followed by team dynamics, logistics, and patient transport issues.Conclusion:Simulation centers team leaders and HCWs reported positive feedback on COVID-19 simulation sessions with multidisciplinary personnel involvement. These drills are a valuable tool for rehearsing safe dynamics on the frontline of COVID-19. More research on COVID-19 simulation outcomes is warranted; to explore variable factors for each country and healthcare system.
Characterization of Oral Squamous Cell Carcinoma Associated Inflammation: A Pilot Study
Authors: Laliberté Catherine , Ng Nicole , Eymael Denise , Higgins Kevin , Ali Aiman , Kiss Alex , Bradley Grace , Magalhaes Marco A. O. 
Published: September 2021

Background: Oral squamous cell carcinoma (OSCC) is a devastating disease that is usually associated with a dense associated inflammatory infiltrate. Characterizing tumor-associated inflammation is critical to understand the pathogenies of tumor development and progression.Methods: We have tested a protocol to analyze tissue and salivary immune cells and mediators of 37 patients with OSCC at different stages and compared to eight chronic periodontitis patients and 24 healthy controls. Tissue analysis was based on fluorescent immunohistochemistry (FIHC) and inflammatory mediators were analyzed using a Luminex-based 30-Plex panel. Immune cells were analyzed using multichannel flow cytometry including CD45, CD66b, CD3, CD4, CD8, CD25, CD56, CD68, CD138, PD-1, and PD-L1.Results: We show an increase in OSCC-associated inflammation characterized by increased pro-inflammatory cytokines including IL-6, IL-8, TNFα, and GMCSF and increased salivary immune cells.Conclusion: We described a new method to analyze salivary inflammatory markers that can be used in future studies to monitor disease progression and prognosis.
MEDIOS DE COMUNICACIÓN Y CULTURA DE PAZ PARA LA CONVIVENCIA DEMOCRÁTICA
Authors: Hernández-Milla Ana Julia 
Published: September 2021

El desarrollo de las sociedades dentro de un orden establecido considera una cultura basada en las normas y obligaciones competentes al ciudadano, estructuras sociales e instituciones del sistema de justicia. En ese sentido, potencializar los medios de comunicación para asegurar una sociedad con cultura de paz reflejada en una convivencia democrática, involucra a diversos actores con un fin de bien común, que de forma directa e indirecta beneficie a otros sectores o ámbitos de la población e instituciones. Este documento pretende dar un panorama de lo benéfico que resulta socializar, interactuar e innovar mecanismos de acción que preponderen a una sociedad sostenible, democrática e integral, basada en la participación, pluralidad, tolerancia y respeto, teniendo como finalidad realizar reflexiones sobre la importancia de la implementación de la cultura de paz como mecanismo que permita favorecer y promover valores cívicos y sociales, en la construcción de una eficaz convivencia democrática y por ende la prevención de la violencia, incluida la política, y el rol importante que tienen los medios de comunicación, como ente de procesamiento de información oportuna a la ciudadanía, que muchas veces sobrepasan la intención de informar, para influir en las simpatías o ánimos, “contrario sensu”, confrontando a actores políticos y sus simpatizantes.