bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of Dalbavancin for Primary Bloodstream Infections and Infectious Endocarditis: A Retrospective Chart Review
Authors: Evins Connor , MS- Harrison Lancaster , Schnee Amanda E.
Published: January 2021

Background: Dalbavancin is a semisynthetic antibiotic used as an alternative to vancomycin for skin infections as well as osteomyelitis. It is particularly useful due to its safety profile as well as long half-life, which allows for weekly outpatient infusions. This decreases the need for patients to have long term IV access and reduces hospital stays. This study analyzes the effectiveness of Dalbavancin for bacteremia and infective endocarditis Methods: Upon IRB approval, the authors performed a retrospective chart analysis on patients who fit our inclusion criteria between 2014 and 2020. Their hospitalizations were analyzed for demographics, medical history, indication, and follow up. The results were then analyzed using descriptive statistics. Results: Our cohort had 23 patients treated with Dalbavancin for endocarditis or bloodstream infections. There were no reported side effects from the medication, no readmissions for worsened infection, and no deaths from the infection. 11 patients were treated due to refusal of medical care, and 15 patients had follow-up visits within 90 days. Conclusions: Overall, patients responded well. The lack of readmission to the hospital is promising as it indicates a possible outpatient treatment. This would help decrease cost and comorbidities of long-term hospital stays. These positive results are limited by small sample size and treatment of other antibiotics prior to receiving Dalbavancin. Further research is required to accurately estimate the efficacy of Dalbavancin on bloodstream infections and endocarditis, but these results are promising especially for patients who are not candidates for long term hospitalization or IV access.
A Preliminary Estimate of the Number of People who Inject Drugs in Cherokee Nation using Capture-Recapture Methods
Authors: Feder Molly , Winters Amanda , Essex Whitney , Mera Jorge
Published: January 2021

Background: Injection drug use is an important public health issue in the United States, and estimates indicate that American Indian and Alaska Native people are disproportionately affected. Injection drug use is also the leading cause of Hepatitis C virus (HCV) infection in the United States, attributable to over half of all cases, and contributes to 44% of human immunodeficiency virus (HIV) acquisition in American Indian and Alaska Native females. Existing estimates of American Indian and Alaska Native people who inject drugs are limited. We aimed to estimate the number of people who inject drugs in Cherokee Nation.Methods: A two-sample, capture-recapture approach was used. The first data source was an abstraction of Cherokee Nation Health Services electronic medical records from February 2017 through December 2018. The second data source was an abstraction from Cherokee Nation’s HCV Elimination Program Database from August 2015 through December 2018. Individuals were included in the abstractions if they were asked if they had injected drugs in the past six months during their health visit. The indirect prevalence estimate of people who inject drugs was calculated in accordance with the UNAIDS/WHO Guidelines on Estimating the Size of Populations Most at Risk to HIV.Results: In total, 198 individuals across both data sources reported that they had injected drugs within the past six months. This included 123 unique individuals from the first source, 69 individuals from the second source, and six individuals who were included in both sources. Capture-recapture calculations indicated an estimate of 1,613 people who inject drugs (95% CI: 404, 2,821). Conclusions: This study was the first attempt at estimating the number of people who inject drugs in Cherokee Nation, and one of the few existing studies to estimate the number of American Indian/Alaska Native people who inject drugs in the United States. Gaining knowledge about the prevalence of people who inject drugs in Cherokee Nation will inform strategies to support addiction care and treatment among people who inject drugs living in Indian Country.
Associations of Midpoint of Sleep and Night Sleep Duration with Type 2 Diabetes Mellitus in Chinese Rural Population: The Henan Rural Cohort
Authors: Zhai Zhihan , Liu Xiaotian , Zhang Haiqing , Dong Xiaokang , He Yaling , Niu Miaomiao , Pan Mingming , Wang Chongjian , Wang Xiaoqiong , Li Yuqian
Published: January 2021

Background: The study aimed to explore the independent and combined associations of midpoint of sleep and night sleep duration with type 2 diabetes mellitus (T2DM) in areas with limited resources.Methods: A total of 37,276 participants (14,456 men and 22,820 women) were derived from the Henan Rural Cohort. Information on sleep were collected using the Pittsburgh Sleep Quality Index. Logistic regression models and restricted cubic splines were used to estimate the relationship of the midpoint of sleep and night sleep duration with T2DM.Results: Of the 37276 included participants, 3580 subjects suffered from T2DM. The mean midpoint of sleep among Early, Intermediate and Late groups were 1.09 ± 0.39, 1.93 ± 0.24 and 2.95 ± 0.56, respectively. Compared to Intermediate group, adjusted odd ratios (ORs) and 95% confidence interval (CI) of T2DM were 1.13 (1.04-1.22) and 1.16 (1.05-1.28) in Early group and Late group. Adjusted OR (95% CI) for T2DM compared with reference (7- h) was 1.27 (1.08-1.50) for longer (≥10 h) night sleep duration. The combination of late midpoint of sleep and night sleep duration (≥9 h) increased 39% (95% CI: 11%-75%) prevalence for T2DM. These associations were more obvious in women than men.Conclusions: Late and early midpoint of sleep and long night sleep duration were all associated with the higher odds of T2DM. Meanwhile, midpoint of sleep and night sleep duration might be jointly associated with a higher prevalence of T2DM. Sleep may be a modifiable behavior that has potential health implications for T2DM.Clinical Trail Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06.
Extra Pulmonary Drug Resistant Tuberculosis Patients Were Less Likely to Lost From Follow-up: a Systematic Review and Meta-analysis
Authors: Andargie Assefa , Molla Asressie , Tadese Fentaw , Zewdie Segenet
Published: January 2021

Background: Lost to follow-up is one of the causes of the development of acquired drug resistant tuberculosis. There is a gap in nationally representative information on lost to follow-up among patients with drug-resistant tuberculosis in Ethiopia. Therefore, the objective of this study was to estimate the pooled prevalence and associated factors of lost to follow-up among patients with multi-drug resistant tuberculosis in Ethiopia.Methods: Observational studies searched from PubMed, HINARI and CINAHL were screened for eligibility. After assessing the quality of studies, data were extracted using a checklist. The forest plot, Q-statistics and I2 were used to assess heterogeneity. We employed the random effects meta-analysis model to estimate the pooled prevalence and effects. The sources of heterogeneity were investigated using sub-group analysis and meta regression. Funnel plot with Egger’s and Begg’s tests were employed to detect publication bias. Results: The review was performed among 11 studies of which 9 were cohort studies. The sample sizes ranged from 90 to 612 and comprised a total of 3,510 participants. The pooled prevalence of lost to follow-up was 8.66% (95% CI, 5.01-13.14) with a high heterogeneity (I2=93.49%, p<0.001). Pulmonary drug resistant tuberculosis patients were 50% less likely to loss from follow-up compared to extra pulmonary tuberculosis patients (OR= 0.50, 95% CI 0.27, 0.96). Conclusion: The prevalence of lost to follow-up among drug resistant tuberculosis patients in Ethiopia was substantial. Anatomical site of tuberculosis had a significant effect on lost to follow-up. Strengthening the health care system and patient education should be given a due emphasis.
Effect of Acupuncture on Polycystic Ovary Syndrome in Animal Models: Study Protocol for a Systematic Review and Meta-Analysis
Authors: Gao Jinjin , Li Wei , Li Yangyang , Li Yan
Published: January 2021

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. As a widely used complementary and alternative therapy, acupuncture is increasingly used to treat PCOS. However, the effect of acupuncture in treating PCOS is uncertain and the mechanisms are unclear. This systematic review aims to determine the efficacy of acupuncture on PCOS in animal preclinical models.Methods: We will search the following databases: PubMed, Web of Science, China National Knowledge Infrastructure and Chinese Science and Technology Periodical Database. We will only include animal experiments of acupuncture in treating PCOS. The primary outcome will be homeostatic model assessment- insulin resistance. The risk of bias will be assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk of bias tool. Confidence in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. All meta-analyses will be conducted using Review Manager 5.4. Discussion: To the best of our knowledge, the use of acupuncture in treating PCOS has not yet been systematically reviewed in animal models. The evidence generated from this systematic review and meta-analysis could benefit future researches. Systematic review registration: OSF (Registration DOI: 10.17605/OSF.IO/FNM37)
Mobile-application Intervention on Physical Activity of Pregnant Women in Iran During the COVID-19 Epidemic in 2020
Authors: Kiani Neda , Pirzadeh Asiyeh
Published: January 2021

Background: Considering the low level of physical activity in pregnant women in the COVID-19 pandemic period and on the other hand the benefits of mobile app learning, we decided to conduct a study to determine the impact of educational intervention based on mobile app on physical activity in pregnant women.Methods: The present study was quasi-experimental and examined 93 pregnant women aged 16 to 20 weeks of gestation. Sampling was done on pregnant women participating in the childbirth preparation classes in Isfahan. We used the validated and reliable questionnaire including perceived benefits, perceived barriers, perceived enjoyment, perceived social support and Pregnancy Physical Activity Questionnaire (PPAQ). The intervention was based on mobile app and the content of the application contained 12 main domains such as : description of physical activity and benefits and barriers of exercise in the pregnancy, different types of proper pregnancy exercise , planning for exercise, different types of exercise. Finally, data were analyzed using SPSS20 and the Chi-square test, independent t-test Paired t-test were employed. The significance level was considered to be less than 0.05.Results: The results showed that after the intervention based on mobile app, the mean score of perceived benefits and enjoyment were significantly higher than before the intervention in the intervention group. Finally total mean score of physical activity significantly increased in the intervention group, while the change decreased in the control group.Conclusion: The results indicated that the use of mobile app can be used to promote physical activity in pregnant women. Therefore, it is recommended that mobile app education should apply with face-to-face classes in health centers for physical activity in pregnant women in pandemic situation.
MicroRNA-760 Resists Ambient PM2.5-induced Lung Injury Through Upregulating Heme-oxygenase 1 Expression
Authors: Xu Lin , Zhao Qianwen , Li Daochuan , Luo Jiao , Ma Wanli , Jin Yuan , Li Chuanhai , Cheng Jing , Zhao kungming , Chen Wen , Zheng Yuxin , Yu Dianke
Published: January 2021

Background: PM2.5 (particles matter smaller aerodynamic diameter of 2.5 μm ) exposure, as one major environmental risk factor for the global burden of disease, is associated with high risks of respiratory diseases and lung cancer. Heme-oxygenase 1 (HMOX1) has been considered as one of the major molecular antioxidant defenses to mediate cytoprotective effects against diverse stressors, including PM2.5-induced toxicity and SARS-CoV-2 infection; however, the regulatory mechanism of HMOX1 expression still needs to be elucidated. In this study, using PM2.5 as a typical stressor, we explored whether microRNAs (miRNAs) might modulate HMOX1 expression in lung cells. Results: Systematic bioinformatics analysis showed that seven miRNAs have the potential to target HMOX1 gene. Among these, hsa-miR-760 was identified as a response miRNA to PM2.5 exposure. More importantly, we revealed a “non-conventional” miRNA function in hsa-miR-760 upregulating HMOX1 expression, by targeting the coding region and interacting with YBX1 protein. In addition, we observed that exogenous hsa-miR-760 effectively elevated HMOX1 expression, reduced the reactive oxygen agents (ROS) levels, and then rescued the lung cells from PM2.5-induced apoptosis. Conclusion: Our results revealed that hsa-miR-760 might play an important role in protecting lung cells against PM2.5-induced toxicity, by elevating HMOX1 expression, and offered new clues to elucidate the diverse function of miRNAs.
Immediate Intravenous Epinephrine (Within 1-minute) Versus Early Intravenous Epinephrine (After 1-minute) for In-Hospital Cardiopulmonary Arrest: A Multicenter Retrospective Review
Authors: Bakhsh Abdullah , Safhi Maha , Alghamdi Ashwaq , Alharazi Amjad , Alshabibi Bedoor , Alobaidi Rajwa , Alnashri Maryam
Published: January 2021

Background: intravenous epinephrine has been a key treatment for cardiopulmonary arrest since the early 1960s. Although, many studies have questioned neurological outcome benefit, it remains to be recommended in international guidelines for its benefit on return of spontaneous circulation (ROSC). The ideal timing for the first epinephrine dose is uncertain. We aimed to look at the association of immediate epinephrine administration (within 1-minute of cardiac arrest recognition) with return of spontaneous circulation (ROSC) up to 24-hours and beyond 24-hours.Methods: this was a multicenter retrospective chart review of patients undergoing cardiopulmonary resuscitation.Results: immediate epinephrine administration (within 1-minute) is associated with higher rates of ROSC up to 24-hours (OR=2.36, 95% CI; [1.46-3.81]) and beyond 24-hours (OR=2.26, 95% CI; [1.06-4.83]).Conclusions: we encourage immediate administration of epinephrine in conjunction with high-quality CPR, as this is associated with higher rates of ROSC.
Aortic Arch Aneurysm. Compression Respiratory Complications as a Vital Indication for Emergency Surgery.
Authors: Balkhy Husam H. , Komarov Roman , Parshin Vladimir , Ismailbayev Alisher , Kurasov Nikolay , Keyko Olga , Ivashov Ivan , Danachev Alexander
Published: January 2021

Background: giant thoracic aortic aneurysms and aortic arch dissections are accompanied by high mortality rates, cardiac and neurologic events and pulmonary complications. Aorta-tracheal fistula and tracheobronchial compression are formidable and well-known complications of aneurysms of the thoracic aorta. Twenty-two percent of aneurysms that size >6 cm are ruptured with 80% mortality rate.Case presentation: a 56-year-old man with severe multivascular coronary artery injury and giant aneurysm of ascending aorta and aortic arch, complicated by respiratory failure and recurrent community-acquired pneumonia. Preoperative chest CT showed giant partially-thrombosed ampullary false aneurysm of ascending aorta, aortic arch and initial part of the thoracic aorta, 80x100x65 mm in size. Patient successfully underwent simultaneous surgical intervention with artificial blood circulation, the total time of cardiopulmonary bypass was 190 minutes.Conclusions: tracheobronchial compression syndrome with the aortic arch aneurysms is one of the urgent conditions that needs emergency surgery. Urgent indications for surgery in such cases include both significant size of the aneurysm and high risk of rupture, as well as potential for developing critical respiratory failure and recurrent nonresolving pneumonias. Preoperative CT enables to find out the exact location and evaluate the degree of airway compression, which determines further intraoperative actions. We recommend to use bronchoscopy at all steps of treatment of such patients, from intubation in operating room to extubation in intensive care unit. Thus, aggressive surgical tactics along with careful pre-operative diagnostic are the key to success and the only chance for such patients.
Coexistence of Papillary Thyroid Carcinoma in Secondary Hyperparathyroidism
Authors: Ma Junhao , Mao Zhuochao , Yao Yunjin , Lu Yimin , Wang Haohao , Yang Yan , Yang Jun , Wang Weibin , teng lisong
Published: January 2021

Background: Coexistence of primary hyperparathyroidism and papillary thyroid carcinoma is common and may be associative with more aggressive papillary thyroid carcinoma for higher rates of extrathyroidal extension and multicentricity. However, it remains unclear whether secondary hyperparathyroidism accounts for more invasive papillary thyroid carcinoma in terms of morbidity, tumor pathological characteristics and prognosis. The aim of this study was to evaluate the rate and tumor characteristics of papillary thyroid carcinoma in patients of SHPT.Methods: A total of 531 patients diagnosed of SHPT and underwent surgery were evaluated retrospectively from January 2013 to December 2018 in the first affiliated hospital of the Zhejiang University. Patients’ demographics, operation records and follow-up information were recorded and analyzed. Among them, 34 patients had PTC concurrent with SHPT (PTC+SHPT) were enrolled. Control subjects were derived through 1:4 matching for age, sex and gender pathological subtype. 136 patients of papillary thyroid carcinoma were selected as control group after matching 1:4 for age, gender and pathological subtype.Results: There were 34 patients coexisting with PTC+SHPT among the 531 surgery patients diagnosed as SHPT (6.4%). Mean tumor diameter of PTC+SHPT group was smaller than that in PTC group(5.57mm vs 9.00mm, p＜0.001). The proportion of papillary thyroid micro-carcinoma in PTC+SHPT group were significantly higher than that in PTC group [29 (85.29%) vs 86 (63.24%), P=0.014]. There were no statistically significant difference among the tumor multicentricity [15 (44.12%) vs 39 (28.68%), P=0.066], tumor bilaterality [9(26.47%) vs29(21.32%), P=0.499]，tumor extrathyroidal extension [2(5.88%) vs19 (13.97%), P=0.255] and lymph node metastasizes rate [12 (35.29%) vs 49 (36.03%), P=1.000]. We found differences between PTC+SHPT group and PTC group patients with respect to contralateral thyroidectomy [10 (29.41%) vs 70(51.47%), P=0.023] and lymph node dissection [22 (64.71%) vs 125(91.91%), P＜0.001].There was no significant difference between PTC+SHPT group and PTC group in prognostic staging [33 (97.06%) vs 122 (89.71%), P=0.309] and recurrence [mean follow-up time 36 months vs 39 months, P=0.33].Conclusions: The prevalence of PTC is high in patients with SHPT. Compared with PTC in the general population, most of PTC with SHPT are occult thyroid carcinoma and present no significant difference in tumor pathological features and prognostic staging. It is necessary for surgeons to make more adequate preoperative prediction and do more careful examination during the surgery in case of missing the coexistence of PTC in SHPT patients.
Natural history of chronic hepatitis B infection in Eritrean patients: a laboratory-based cross-sectional study
Authors: Hamida Mohammed Elfatih , Raja Saud Mohammed , Seyoum Yemane , Elkhidir Isam Mohammed , Tekle Freweini
Published: January 2021

Background Understanding the natural history of chronic hepatitis B (CHB) virus infection is important for determining optimal management and predicting prognosis in patients. The aim of this study was to determine the prevalence of different phases of CHB infection among Eritrean patients and to identify the proportion of patients eligible for treatment according to 2018 American Association for the Study of Liver Diseases (AASLD) guidelines.Methods This cross-sectional study enrolled 293 CHB patients between Jan 2017 and Feb 2019 and classified them into four groups, namely, immunotolerant, immune clearance, immune control, and immune escape, based on the results of Hepatitis B virus (HBV) serological panel (HBsAg, anti-HBc total, HBeAg and anti-HBe), ALT levels, and HBV DNA viral load.Results Our study cohort of 293 patients comprised 213 males and 80 females, with a mean age of 41.66 ± 13.84 years. Of these, 5 (1.7%) were at the immune tolerant phase, 46 (15.7%) at immune clearance, 217 (74.1%) at immune control, and 25 (8.5%) at immune escape phase; thus, 71 (24.2%) patients were eligible for treatment, i.e., patients in immune clearance and immune escape phases. As most subjects (93%) were HBeAg-negative, based on AASLD guidelines, only 5 (1.7%) were eligible for treatment, and these patients were part of the group of 71 patients eligible for treatment based on chronic HBV status.Conclusions Our data show that CHB patients in Eritrea were predominantly in the immune control phase. Although initiating antiviral therapy is not recommended in these patients, periodic assessment of liver function and disease severity should be considered in patients older than 40 years. The immunotolerant phase had the fewest patients, most of whom were above 20 years old, attesting to the success of incorporating HBV vaccine in the national childhood immunization program since 2002. Our study shows that adopting AASLD treatment guidelines with adjustments to suit the local setting represent a suitable option in the management of Eritrean CHB patients.
Current Substances Use Among Students in Ethiopia: A Systematic Review and Meta-analysis of 20-years Evidence
Authors: Roba Hirbo Shore , Gebremichael Berhe , Abdi Hassen , Beyene Addisu Shunu
Published: January 2021

Background: The use of psychoactive substances is the main cause of morbidity and becomes important public health and socio-economic issue worldwide. However, there is a lack of evidence on the magnitude of current use substances among students in Ethiopia. Therefore, this review and meta-analysis aimed to provide comprehensive views of the current prevalence of substance use among students in Ethiopia.Methods: Literature searches were done from electronic biomedical databases; PubMed/Medline, HINARI, AJOL, Google Scholar, Science Direct and manully seared master thesis and dissertation done until 31/12/2019. Two authors autonomously selected studies, extracted data, and evaluated the quality of studies. The prevalence of current substances with 95% confidence interval (95%) estimated using the random-effects model. The results were displayed using forest plots, and Cochrane Q-test and I2 use to measure the extents of between-study variations.Results: A total of 1543 study articles were identified from electronic databases, and 32 of them were included in the meta-analysis. The prevalence of current use of at least one substance was 37.63% (95% CI: 33.66, 41.69; I2=91.2%, P<0.00), alcohol 27.61% (95%CI: 22.10, 33.48; I2=98.08%, P<0.00), khat 17.20% (95%CI: 14.03, 20.62; I2=97.2%, p<0.00) and smoking 9.74% (95%CI: 7.17, 12.64; I2=95.06%, P<0.00). Subgroup analysis revealed that the prevalence of any substance by high school students versus university/college students was 41.55% (95% CI: 38.83, 44.29) vs 36.24% (95% CI: 32.37, 40.20), alcohol 24.21% (95% CI: 14.05, 36.11) vs 25.27% (95% CI: 19.76, 31.20), khat 13.82% (95% CI: 8.61, 20.02) vs 17.30% (95%CI:13.75, 21.16), and cigarette 8.30% (95% CI: 1.89, 18.60) vs 9.80% (95% CI: 7.32, 12.58). Meta-regression analysis revealed publication year, sample size, female proportion, and age was not significantly associated with the current use of substances.Conclusion: The prevalence of the current use of substances was high and highlights the extent the problem among students in Ethiopia. Overall currrent substance use was high for all substances use categories; any substance, alcohol, chewing khat and smoking cigarettes. Comparable to university/college students a significant propoartion of high school students were already using susbstances before joining teritiary education. Caution is needed while interpreting the findings due to significant heterogeneity between studies. Policymakers should formulate and implement strictly binding regulations to control the pervasive use of substances around educational institution sites at the national level. Protocol registration: The protocol has been registered on 19 Auguest 2019 on PROSPERO (the International Prospective Register of Systematic Reviews) with ID: CDR42019130560.
Distributed Groundwater Recharge Potentials Assessment Based on GIS Model and Its Dynamics in the Crystalline Rocks of South India
Authors: Fauzia Fauzia , Lagudu Surinaidu , Rahman Abdur , Ahmed Shakeel
Published: January 2021

Extensive change in land use, climate, and over-exploitation of groundwater has increased pressure on aquifers, especially in the case of crystalline rocks throughout the world. To support sustainability in groundwater management, require proper understating of groundwater dynamics and recharge potential. The present study utilized a GIS-based Weighted Overlay Index (WOI) model to identify the potential recharge zones and to gain deep knowledge of groundwater dynamics. The in situ infiltration tests have been carried out, which is the key process in groundwater recharge and is neglected in many cases for WOI. In the WOI, 10 thematic layers from the parameters influencing and involved in the recharge process are considered to identify potential recharge zones. The results suggested a significant underestimation of recharge potential, without considering site-specific infiltration rates that one needs to be considered. The WOI model considering in situ infiltration information classified the entire area into four recharge zones, good, moderate, poor, and very poor. The final integrated map compared with the real-time field data like water level fluctuation and infiltration to analyse occurrence and quantification of recharge. The estimated average groundwater draft is 21.9 mcm while annual renewable recharge is only 5.7 mcm that causing a continuous fall of the groundwater table. The study is useful in selecting regions with more focussed recharge studies and suggested that the need of reducing groundwater demand with the change in cropping pattern through a predictive decision support tool.
Radiofrequency Therapy Improves Exercise Capacity of Mice with Emphysema
Authors: Tsutsui Mai , Cheung Chung Yan , Wada Takeyuki , Jaw Jen-erh , Yang Cheng Wei Tony , Bernatchez Pascal , White Zoe , Yang Chen Xi , Bae Eun Jeong , Choi Lauren H. , Gelbart Dan , Lichtenstein Samuel , Machan Lindsay , Elizur Eran , Wolff Kim , Goodacre Evan , Lipnicki Marek , Wong Denny , Sin Don
Published: January 2021

Background; Emphysema is a common phenotype of chronic obstructive pulmonary disease (COPD). Although resection of emphysematous tissue can improve lung mechanics, it is invasive and fraught with adverse effects. Meanwhile, radiofrequency (RF) treatment is an extracorporeal method that leads to tissue destruction and remodeling, resulting in “volume reduction” and overall improvement in lung compliance of emphysematous lungs. Whether these changes lead to improved exercise tolerance is unknown. Here, we investigated the effectiveness of RF treatment to improve the exercise capacity of mice with emphysema.Methods;Fifty-two mice (7 weeks of age) were used in this experiment. A bilateral emphysema model was created by intratracheally instilling porcine pancreatic elastase (PPE) (1.5U/100g body weight). RF treatment (0.5W/ g body weight) was performed extracorporeally 14 days later and mice were sacrificed after another 21 days. The exercise capacity of mice was measured using a treadmill. Treadmill runs were performed just before PPE instillation (baseline), before RF treatment and before sacrifice. Following sacrifice, lung compliance and mean linear intercept (Lm) were measured and fibrosis was assessed using a modified Ashcroft score.Results; There were 3 experimental groups: controls (instilled with saline, n=12), emphysema (instilled with porcine pancreatic elastase, PPE, n=11) and emphysema + treatment (instilled with PPE and given RF, n=9). At endpoint, the maximum velocity of the emphysema + treatment group was significantly higher than that of the emphysema group, indicating improved exercise tolerance (86.29% of baseline vs 61.69% of baseline, p=0.011). Histological analysis revealed a significant reduction in emphysema as denoted by Lm between the two groups (median 29.60 µm vs 35.68 µm, p=0.033). The emphysema + treatment group also demonstrated a higher prevalence of lung fibrosis (≧Grade 3) compared with the emphysema group (11.7% vs 5.4%, p<0.0001). No severe adverse events from RF were observed.Conclusion;RF treatment improved the exercise capacity of mice with emphysema. These data highlight the therapeutic potential of RF treatment in improving the functional status of patients with COPD.
Branchial Chamber and Gastrointestinal Tracts Parasites of Fish Species in Rivers Niger and Benue at Lokoja, North Central, Nigeria
Authors: Onoja-Abutu Agatha Eleojo , Okpanachi Martin Abdubala , Yaro Clement Ameh , Nasif Omaima , Alharbi Sulaiman Ali , Batiha Gaber El-Saber
Published: January 2021

Background

Freshwater fish species are posing health challenges by either serving as host of parasites that are harmful to man and animals. This study was conducted to determine the parasitic profile of the branchial and gastrointestinal tracts of freshwater fish species from Niger and Benue Rivers at Lokoja. Fish samples were collected within a period of 12 months, the species and sex of the fish were identified. The two opercula of each fish were removed and examined for parasites, parasites recovered were preserved in 0.7% physiological saline. Gastrointestinal tracts were removed from each fish, placed in physiological saline and examined microscopically for parasites. Prevalence of parasites was calculated and comparison among categories was done using chi-square and student t-test.
Results

A total of seven parasites species were harboured in branchial chamber and gastrointestinal tracts of fish species from Rivers Niger and Benue at Lokoja; Clinostomum sp. (trematode), Camallanus sp. (nematode), Capillaria sp., Rhabdochona congolensis (nematode), Contracaecum sp. (nematode), Proteocephalus sp. (cestode) and Spinitectus guntheri. T. zilli 81(95.3%) had the highest prevalence while O. niloticus, Clarias sp., S. schall and M. atlanticus had prevalence of 87(89.7%), 96(80.0%), 48(70.6%) and 27(38.6%) respectively with prevalence of 191(80.3%) and 148(73.3%) in females and males respectively. The gastrointestinal tracts 287(65.2%) was significantly harboured more parasites than branchial chamber 52(11.8%).
Conclusion

Fish species in Rivers Niger and Benue are highly infected with parasites. Fish consumers should subject the fish to proper processing before consumption, as some of these parasites maybe of zoonotic importance.
Classifying Patients Seen at an Urban Healthcare for the Homeless Site: A Clinically-Driven Latent Class Analysis
Authors: Mitchell Matthew , Chan Brian , King Caroline , Sledd Miles , Dorr David , Solotaroff Rachel
Published: January 2021

Introduction: Federally qualified health centers (FQHC) provide care to over 28 million people in the United States, primarily serving people with low incomes who are underinsured or not insured. FQHC patients have different patterns of illness than non-FQHC populations, which may require tailored interventions to support at the population level. Model based segmentation methods can identify patterns of need but may generate spurious results without clinical context. Here, we used stakeholder feedback combined with machine learning methods to identify subgroups of patients seen by a large FQHC in an urban setting. Methods: We used electronic health record and administrative hospital utilization data to identify subgroups of patients seen at the FQHC in 2017 using latent class analysis (LCA). We designed an activity to gather feedback from physicians, social service staff, and administrators during model design. We trained a final model using a feed-forward neural network.Results: Using data from 5,985 primary care patients, we identified four candidate LCA models—with 26, 27, 28, and 29 classes—and integrated inter-professional feedback to develop a final model with 19 clinically meaningful classes. Three classes had greater medical complexity and older age, 15 classes were separated primarily by behavioral health diagnoses, and a final class had low complexity.Conclusions: Populations served by FQHCs are clinically heterogenous with varying levels of complexity. Use of LCA can provide insights into patterns among FQHC patients, which can be used to inform the development of interventions tailored to the needs of specific classes.
Specific Time Determinism: Circadian Rhythm of Microbial Community Assembly Patterns Under Common Light in Feces of Laying Hens
Authors: Zhang Yu , Sun Lan , Zhu Run , Zhang Shiyu , Wang Yan , Wu Yinbao , Liao Xindi , Mi Jiandui
Published: January 2021

BackgroundAs an important part of biological rhythm, the circadian rhythm of the gut microbiota plays a crucial role in host health. However, few studies have determined the associations between the circadian rhythm and gut microbiota in laying hens. The purpose of this experiment was to investigate the circadian rhythm of the feces microbiota in laying hens.ResultsFeces samples were collected from ten laying hens at nine different time points (06:00-12:00-18:00-00:00-06:00-12:00-18:00-00:00-06:00) to demonstrate the diurnal oscillation of the feces microbiota. We described the phenomenon of circadian rhythmicity of the feces microbiota in laying hens based on 16S rRNA gene sequencing. According to the results, the α and β diversity of the feces microbiota fluctuated significantly at different time points. Beta Nearest Taxon Index analysis suggested that assembly strategies of the abundant and rare amplicon sequence variants (ASVs) sub-communities are different. Abundant ASVs preferred disperal limitation (weak selction), whereas rare ASVs randomly formed due to the “non-dominant” fractions. Highly robust circadian fluctuations were found, for instance, in Firmicutes and Proteobacteria, which fluctuated oppositely, and the total ratio remained in a dynamic balance over 48 h. We found that temporal dynamic changes had a significant effect on the relative abundance of the important bacteria in the feces microbiota community by using the random forest algorithm. Eight bacteria, Ruminococcus gnavus, Faecalibacterium, Ruminococcaceae, Enterococcus cecorum, Lachnospiraceae, Clostridium, Clostridiales, and Megamonas, gained rhythmicity. Interestingly, one unexpected finding was the fact that these eight bacteria all belong to Firmicutes. In particular, the microbiota profile appears to favor butyrate production, a common indicator of gut health, potentially through increases in the members of Lachnospiraceae, Faecalibacterium and Ruminococcaceae. The pathways were the functionalities that gained rhythmicity within the microbiota, which belonged to the most abundant functions, including xenobiotic biodegradation and metabolism, carbohydrate metabolism, and amino acid metabolism, which were consistent with the metabolic functions of amino acids and carbohydrates from feed.ConclusionThis study has shown that the defecation time could be among the important factors influencing the diversity, proportion, and functions of the feces microbiota community. We also note the potential application of beneficial microbial communities in livestock species, especially in the environment of raising antibiotic-free animals. These results provide references for further exploring the circadian rhythm of the gut microbiota in laying hens.
Multi-breed Genetic Parameters and Genome-wide Association Studies for Mortality Rate at Birth in Pigs
Authors: An Meijing , Zhou Guangliang , Li Yang , Xiang Tao , Ma Yunlong , Liu Xiaolei , Li Xinyun , Zhao Shuhong , Zhu Mengjin
Published: January 2021

Background

Piglet mortality is an economically important complex trait that impacts sow prolificacy in the pig industry. The genetic parameters estimations and genome-wide association studies will help us to better understand the genetic fundamentals of piglet mortality. However, compared with other economically important traits, a little breakthrough in the genetic analyses of the trait has been achieved.
Results

In this study, we used multi-breed data sets from Yorkshire, Landrace, and Duroc sows and characterized the genetic and genomic properties of mortality rate at birth by treating each parity as a different trait. The heritability of mortality rate from parity I to III were estimated to be 0.0630, 0.1031, and 0.1140, respectively. The phenotypic and genetic correlations with its component traits were all positive with ranges from 0.0897 to 0.9054, and 0.2388 to 0.9999, respectively. Integrating the results, we identified 21 loci that were detected at least by two tools from standard MLM, FarmCPU, BLINK and mrMLM, and these loci were annotated to 22 genes. The annotations revealed that the gene expressions were associated with the reproductive system, nervous system, digestive system, and embryonic development, which are reasonably related to the piglet mortality.
Conclusions

In brief, the genetic properties of piglet mortality at birth were reported. These findings are expected to provide much information for understanding the genetic and genomic fundamentals of farrowing mortality and also identify candidate molecular markers for breeding practice.
SMAD4 Feedback Activates The Canonical TGF-β Family Signaling Pathways
Authors: Du Xing , Li Qiqi , Yang Liu , Li Qifa
Published: January 2021

Background: TGF-β family signaling pathways, including TGF-β and BMP signaling pathways, are widely involved in the regulation of health and disease, which are also regulated by multiple validated mechanisms, such as genetic regulation, epigenetic regulation, and feedback regulation. The objective of this research is to investigate the molecular mechanism and function mode of SMAD4 directly feedback regulation of TGF-β family signaling pathways in porcine granulosa cells (GC).Results: The transcriptomic alteration of porcine GCs induced by SMAD4 silencing was re-analyzed with the background of Sus scrofa RefSeq 11.1 (Sscrofa 11.1). A total of 986 differentially expressed mRNAs (DEmRNAs) were identified, including 467 down-regulated and 519 up-regulated genes. Functional assessment showed the impacts of DEmRNAs on the regulation of states and function of GCs, and the oocyte development. As the upstream receptors of SMAD4, ACVR1B, BMPR2, and TGFBR2 were selected from down-regulated DEmRNAs for further research. In vitro, qRT-PCR and western blotting were performed and confirmed that SMAD4 significantly induced the expression of ACVR1B, BMPR2, and TGFBR2 in porcine GCs. Besides, RACE and luciferase activity assays were carried out to identified the core promoter of porcine ACVR1B, BMPR2, and TGFBR2. Results from ChIP assays showed that SMAD4 directly binds to the SMAD4 binding elements (SBEs) within the core promoter of its upstream receptors by acting as a transcription factor. Furthermore, c-JUN, CREB1, and SP1 were identified as SMAD4-interacted co-activators by IP assays and inhibition of which could dramatically suppress the expression of porcine ACVR1B, BMPR2, and TGFBR2 that induced by SMAD4 over-expression. Furthermore, three different interaction modes between SMAD4 and co-activators were identified by reciprocal ChIP assays.Conclusions: Take together, our findings revealed a novel feedback regulatory mechanism of TGF-β family signaling pathways in porcine GCs, and demonstrated for the first time that SMAD4, the only Co-SMAD, directly feedback activates the transcription of canonical TGF-β family signaling pathway receptors by interacting with three co-activators in different modes, which improves and expands the regulatory network, especially the feedback regulation modes of TGF-β family signaling pathways in the ovary.
Identification of metabolites and Evaluation of the seeds of Abrus precatorius (L.) by high resolution mass spectrometry 
Authors: Raithak Pranita V. , Atkore Sandeep T. , Bondle Giribala M.
Published: January 2021

Natural products from medicinal plants, either as pure compounds or as standardized extracts, provide unlimited opportunities for new drug leads because of unmatched availability of chemical diversity. The present study is performed to investigate the presence of phytochemicals for using selected medicinal plant such as Abrus precatorius (L.) Soxhlet apparatus was used for the organic solvent extraction. Abrus precatorius (L.) an important medicinal plant is enriched with remarkable highly potent anti-inflammatory, antimicrobial, antioxidant, antifertility, antispermatogenic activity. Metabolites are identified by high resolution mass spectrometry (HR-LCMS). These metabolites are found in various drug compounds used for drug industry as well as in Ayurveda, folk, Homeopathy, Sidha and Unani.
Arthroplasty Is Not Superior Than Internal Fixation for Intertrochanteric Fractures in the Elderly: a Meta-analysis
Authors: Yu Kexiao , Lu Weizhong , Xiao Qiuke , Wan Ruijie , Dong Lujue , Dai Zhenyu
Published: January 2021

Background: Surgical treatment is the first choice for intertrochanteric fractures in the elderly as it allows early rehabilitation and functional recovery. Recently, more and more surgeons prefer arthroplasty instead of internal fixation in the treatment of senile intertrochanteric fractures. However, there is conflicting evidence as to which is the best surgical treatment for them. In this article, we performed a systematic review and meta-analysis to compare the clinical effectiveness of internal fixation (IF) and arthroplasty (AR) for intertrochanteric fractures in the elderly. Methods: The online databases of PubMed, Cochrane Database, and Web of Science were searched to include studies conducted from 01/01/2000 to 11/30/2018 in English using keywords to identify articles relevant to this study. All studies had to have evaluated the treatment of patients with intertrochanteric fractures in the elderly(≥60 years of age). The quality of the trials was assessed and meta-analyses were conducted using the Cochrane Collaboration’s RevMan 5.3 version. Results: A total of 14 studies involving a total of 1588 patients were suitable for inclusion in this meta-analysis. There was no significant difference between the IF and AR groups for postoperative complications-related general condition (OR=1.24; 95% CI= 0.90, 1.70; P=0.19), hospital stay (SMD=0.16; 95% CI= -0.5, 0.82; P =0.64), and Harris hip score (SMD= -0.12; 95% CI= -0.79, 0.54; P =0.71). AR group had a significantly lower rate of complications-related operation (OR= 2.21; 95% CI= 1.41, 3.45; P=0.0005) and reoperation (OR=2.74; 95% CI= 1.57, 4.76; P=0.0004). However, compared with AR group, IF group could reduce the blood loss (OR=-4.08; 95% CI=-4.58, -3.59; P<0.00001), transfusion requirement (SMD= -0.67; 95% CI= -1.08, -0.26; P=0.001), operation time (SMD= -0.80; 95% CI= -1.47, -0.12; P < 0.00001), and have a lower rate of mortality within 1-year (OR= 0.67; 95% CI= 0.52, 0.86; P=0.002).Conclusion: AR is associated with less rates of complications-related operation and reoperation but has an increased risk of blood loss, transfusion, operation time and mortality within 1-year. Our findings demonstrated that AR does not have significant advantages over IF for intertrochanteric fractures in the elderly.
Establishment and Clinical Application of One-stage Posterior Limited Lesion Clearanceand Internal Fixation Combined With Personalized Drug Therapy System for Brucellosis Spondylitis
Authors: Yang Xinmin , Tian Ye , Yao Yao
Published: January 2021

ObjectiveTo investigate the feasibility and clinical effect of one-stage posterior limited lesion clearance and internal fixation combined with individualized drugs in the treatment of brucidosis spondylitis.Methods44 patients who conform to inclusion criteria, including 2 cases thoracolumbar segment, 32 cases lumbar segment and 10 cases lumbosacral segment. Preoperative VAS(Visua Analogue Scales) 5~8,ODI(Oswestry disability index) 51.15~84.36%, Body Mass Index （BMI） 16.2~17.5, American Spinal Injury Association（ASIA）classification C grade 6 and D grade 10. Magnetic Resonance Imaging（MRI） showed compression of dural sac in 16 cases. Preoperative medication regimen was developed according to the patient's medication allergy history, weight, liver and kidney function, and T-lymphocyte spot test（T-SOPT）.ResultsPostoperative individualized medication was used according to the drug sensitivity test and T-SOPT to select 3 kinds of sensitive drugs for 2 courses of treatment, and the patients were clinically cured 3 to 9 months. The evaluation indexes of Erythrocyte Sedimentation Rate （ESR）, C-reactive protein （CRP）, Rose Bengal Plate agglutination Test （RBPT）, VAS,BMI,ASIA,ODI and MRI at each time point were significantly improved compared with those before surgery (P<0.05). Follow-up showed that the lesions were completely cleared, inflammation was absorbed, pedicle screw fixation was good, spine stable, intervertebral bone grafting was fused, and the spinal cord were well aligned without compression.ConclusionPersonalized medication is highly targeted, conforms to pharmacokinetics, has low toxic and side effects, no drug allergy or drug resistance, so as to reduce medical expenses and obtain the maximum clinical efficacy with the minimum cost. One-stage posterior limited lesion clearance and internal fixation surgery has little trauma, and the lesions are completely removed. The correct choice of screw placement and short segment internal fixation of diseased vertebra is safe and reliable.
Multivariate Multiscale Entropy: An Approach to Estimating Vigilance of Driver
Authors: Ahammed Kawser , Ahmed Mosabber Uddin
Published: January 2021

Various driver’s vigilance estimation techniques currently exist in literature. But none of them detects the vigilance of driver in complexity domain. As a result, we have proposed the recently introduced multivariate multiscale entropy (MMSE) method to ﬁll this research gap. In this research, we have applied the MMSE technique to diﬀerential entropy features of electroencephalogram (EEG) and electrooculogram (EOG) signals for detecting vigilance of driver in complexity domain. The MMSE has also been employed to PERCLOS (Percentage of Eye Closure) values to analyse cognitive states (awake, tired and drowsy) in complexity domain. The contribution of this research is to show how a new feature called MMSE can eﬃciently classify the awake, tired and drowsy state of the driver in complexity domain. Another contribution is to demonstrate the distinguishing ability of the MMSE by validating it with applying multivariate sample entropy feature of cognitive states to support vector machine (SVM). The experimental MMSE analysis curves show statistically signiﬁcant diﬀerences (p < 0.01) in terms of complexity among brain EEG signals, forehead EEG signals and EOG signals. Moreover, the diﬀerence in the multivariate sample entropy across all scales in awake (1.0828 ± 0.4664), tired (0.7841 ± 0.3183) and drowsy (0.2938 ± 0.1664) states are statistically signiﬁcant (p <0.01). Also, the SVM, a machine learning technique, has discriminated the cognitive states with the promising classiﬁcation accuracy of 76.2%. As a result, the MMSE analysis of cognitive states can be implemented practically for vigilance detection by building a programmable vigilance detection system.