bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors contributing to post-stroke health care utilization and costs. Secondary results from the Life After Stroke (LAST) study, a pragmatic randomized controlled trial
Authors: Døhl Øystein , Halsteinli Vidar , Askim Torun , Gunnes Mari , Hansen Hege Ihle , Indredavik Bent , Langhammer Birgitta , Phan Ailan , Magnussen Jon
Published: March 2020

Background The result from the Life After Stroke (LAST) study showed that an 18-month follow up program as part of the primary health care, did not improve maintenance of motor function for stroke survivors. In this study we evaluated whether the follow-up program could lead to a reduction in the use of health care compared to standard care. Furthermore, we analyse to what extent differences in health care costs for stroke patients could be explained by individual need factors (such as physical disability, cognitive impairment, age, gender and marital status), and we tested whether a generic health related quality of life (HRQoL) is able to predict the utilisation of health care services for patients post-stroke as well as more disease specific indexes.Methods The Last study was a multicentre, pragmatic, single-blinded, randomized controlled trial. Adults (age ≥18 years) with first-ever or recurrent stroke, community dwelling, with modified Rankin Scale <5. The study included 380 persons recruited 10 to 16 weeks post-stroke, randomly assigned to individualized coaching for 18 months (n=186) or standard care (n=194). Individual need was measured by the Motor assessment scale (MAS), Barthel Index, Hospital Anxiety and Depression Scale (HADS), modified Rankin Scale (mRS) and Gait speed. HRQoL was measured by EQ-5D-5L. Health care costs were estimated for each person based on individual information of health care use. Multivariate regression analysis was used to analyse cost differences between the groups and the relationship between individual costs and determinants of health care utilisation.Results There were higher total costs in the intervention group. MAS, Gait speed, HADS and mRS were significant identifiers of costs post-stroke, as was EQ-5D-5L.Conclusion Long term, regular individualized coaching did not reduce health care costs compared to standard care. We found that MAS, Gait speed, HADS and mRS were significant predictors for future health care use. The generic EQ-5D-5L performed equally well as the more detailed battery of outcome measures, suggesting that HRQoL measures may be a simple and efficient way of identifying patients in need of health care after stroke and targeting groups for interventions.Clinical Trial Registration: https://www.clinicaltrials.gov NCT01467206. The trial was retrospectively registered after the first 6 participants were included.
The use of olanzapine as an antiemetic in palliative medicine: a systematic review of the literature
Authors: Saudemont Gaëtan , Prod'Homme Chloé , Silva Arlette Da , Villet Stephanie , Reich Michel , Penel Nicolas , Gamblin Vincent
Published: March 2020

Background: Olanzapine is an atypical antipsychotic that has affinity for many central nervous system receptors. Its efficacy is supported by several studies in the prevention and treatment of chemotherapy-induced nausea and vomiting. No recommendations exist on the antiemetic use of olanzapine in the palliative care setting. The aim of this work is to complete the initial work of Fonte et al. published in 2015, to determine whether the literature supports the use of olanzapine as an antiemetic in palliative situations and, in practice, to propose a therapeutic schema adapted to the palliative setting.
Methods: Systematic review of the literature according to the PRISMA criteria. We searched the PubMed, Cochrane, RefDoc, EMBase databases and the gray literature databases. The bibliographic search was conducted between November 2016 and August 2017.
Results: Thirteen articles were included: 2 case studies, 3 case series, 3 retrospective studies, 2 prospective studies, 2 literature reviews. All studies concluded on the efficacy of olanzapine as an antiemetic in the palliative care setting. No serious adverse effects were reported. Based on the data from the literature review, we propose a therapeutic scheme adapted to the palliative care context.
Conclusion : Action of olanzapine on many receptors and its tolerance profile make it an interesting antiemetic treatment in palliative medicine. But to date, studies are scarce and have a low statistical power. Further investigation is therefore needed to determine the benefit of this treatment in palliative care patients, compared to usual treatments.
Transcriptome profiling of human thymic CD4+ and CD8+ T cells compared to primary peripheral T cells
Authors: Helgeland Hanna , Gabrielsen Ingvild , Akselsen Helle , Sundaram Arvind Y.M. , Flåm Siri Tennebø , Lie Benedicte Alexandra
Published: March 2020

Background: The thymus is a highly specialized organ of the immune system where T cell precursors develop and differentiate into self-tolerant CD4+ or CD8+ T cells. No studies to date have investigated how the human transcriptome profiles differ, between T cells still residing in the thymus and T cells in the periphery. Results: We have performed high-throughput RNA sequencing to characterize the transcriptomes of primary single positive (SP) CD4+ and CD8+ T cells from infant thymic tissue, as well as primary CD4+ and CD8+ T cells from infant and adult peripheral blood, to enable the comparisons across tissues and ages. In addition, we have assessed the expression of candidate genes related to autoimmune diseases in thymic CD4+ and CD8+ T cells. The thymic T cells showed the largest number of uniquely expressed genes, suggesting a more diverse transcription in thymic T cells. Comparing T cells of thymic and blood origin, revealed more differentially expressed genes, than between infant and adult blood. Functional enrichment analysis revealed an over-representation of genes involved in cell cycle and replication in thymic T cells, whereas infant blood T cells were dominated by immune related terms. Comparing adult and infant blood T cells, the former was enriched for inflammatory response, cytokine production and biological adhesion, while upregulated genes in infant blood T cells were associated with cell cycle, cell death and gene expression. Conclusion: This study provides valuable insight into the transcriptomes of the human primary SP T cells still residing within the thymus, and offers a unique comparison to primary blood derived T cells. Interestingly, the majority of autoimmune disease associated genes were expressed in one or more T cell subset, however ~11% of these were not expressed in frequently studied adult peripheral blood.
Imaging study of coronal structural matching of the distal radius in normal adults
Authors: Zhang Xin , Yuan Feng , Yin Yong , Fan Jian
Published: March 2020

Background: As an important anatomical basis, coronal structural position matching of the distal radius has long been lacking in terms of a quantitative understanding, and such matching is correlated with the postoperative functional recovery of patients with distal radius fracture. The purpose of this study was to explore the degree of coronal structural matching of the distal radius in a normal population and to improve the detailed anatomical knowledge of the distal radius. Methods: The reconstructed 3D data were analysed using 3-matic research software from thin-film CT images of 80 normal adults, and the coronal structural matching of the distal radius was studied from two aspects: 1) self-matching of the distal radius; and 2) matching between the distal radius and ulna (i.e., the joint space of the distal radioulnar joint). Specific research methods: 1) The relative position of the medial wall of the distal radius with respect to the lunate was determined as the percentage (%) of the vertical distance from the medial wall of the radius to the most prominent ulnar point of the lunate in the corresponding plane from the ulna to the radius. 2) A total of 9 sets of data were collected for evaluating the palmar lateral spacing, median spacing, and dorsal lateral spacing at the distal, middle, and proximal levels of the radius. Results: In the study, 9 sets of data were obtained. And the data of self-matching of the coronal structural of distal radius was also obtained, was 45.0%±16.2%. The P values in the above data were all greater than 0.05, showing no statistical significance. Finally, data of coronal bone structural matching of distal radius in 80 normal adults were obtained. Conclusions: Our study refines the anatomical data of the degree of coronal bone structural matching of the distal radius in a normal population. To explore the relationship between coronal alignment and function in cases of distal radius fracture, a standardized approach was established. Thin- film CT may help diagnose patients with dysplasia around the lunate and radioulnar joint that is difficult to diagnose on MRI.
An Outbreak of Acute Respiratory Illness at a Training Base in Beijing, China, Due to Human Adenovirus Type B55
Authors: Lu Guilan , Peng Xiaomin , Li Renqing , Liu Yimeng , Wu Zhanguo , Wang Xifeng , Zhang Daitao , Zhao Jiachen , Sun Ying , Zhang Li , Yang Peng , Wang Quanyi
Published: March 2020

Background: Twelve students were diagnosed with symptoms of acute respiratory illness (ARI) at a training base in Beijing from August 26 to August 30, 2015. We investigated the cause of this ARI outbreak. Methods: In partnership with the local center for disease control, we collected a total of twelve pharyngeal swab specimens as well as demographic information for the affected patients. We used multiplex real-time PCR to screen for sixteen common respiratory viruses in these samples. To isolate the causative agent, we inoculated Hep-2 cells with the human adenovirus (HAdV)-positive samples and then carried out sequencing and phylogenetic analysis of the hexon, fiber, and penton genes of the isolated adenoviruses. In addition, we analyzed the entire genome of one strain isolated from the index case to identify single-nucleotide substitutions. Results: We identified ten HAdV-positive students using multiplex real-time PCR. None of the students were co-infected with other viruses. We successfully isolated seven HAdV strains from the pharyngeal swab specimens. The coding sequences of the hexon, fiber, and penton genes of these seven HAdV strains were identical, suggesting that they represented seven isolates of a single virus strain. One HAdV isolate obtained from the index case, BJDX-01-2015, was selected for whole genome analysis. From this isolate, we obtained a 34,774-nucleotide sequence. The genome of BJDX-01-2015 clustered with HAdV-B55 in phylogenetic analyses and had 99.97% identity with human adenovirus 55 isolate HAdV-B/CHN/BJ01/2011/55 (GenBank accession no. JX491639). Conclusions: We identified HAdV-B55 as the cause of the August 2015 ARI outbreak at this base. This outbreak was the first reported in Beijing due to HAdV-B55. Continuous surveillance of respiratory adenoviruses is urgently needed to understand the epidemiological and evolutionary features of HAdV-B55, and an epidemiological modeling approach may provide further insights into this emerging public health threat. Furthermore, the clinical laboratory data in this outbreak provided important reference for the clinical diagnosis and may ultimately aid to inform the development of strategies to control and prevent respiratory tract infections caused by HAdV-B55 later.
Spouse’s participation in perinatal care: a qualitative study
Authors: Mehran Nahid , Hajian Sepideh , Simbar Masoumeh , Majd Hamid Alavi
Published: March 2020

Background: Pregnancy is one of the most important and sensitive periods for any woman that in the case of the support of her relatives, especially her spouse, feels more ability to tolerate it’s difficulties and gives them good memory. However, there are very few studies about the participation of spouses/partners in perinatal period in Iran. Therefore, the present study aimed to explain the concept of spouses' participation in perinatal care. Methods: This is a qualitative study that was carried out in Qom, Iran in 2018. Purposive sampling was done from pregnant or postpartum women, spouses, midwifery care providers and key informants according to study inclusion criteria. Semi-structured in-depth interviews were carried out until data saturation. Data analysis was done based on conventional content analysis approach according to Graneheim & Lundman steps and using MaxQDA software (v.10). To ensure the trustworthiness of data, the five Guba and Lincoln criteria were used. Also, COREQ checklist was used for reporting this qualitative research. Results: fifty-three final codes were classified into 18 sub-categories, 7 main categories and 3 themes include of empathy (emotional understanding, cognitive understanding), accountability (supporting, position management, compassion) and consequences (help improve family function, improve maternal-neonatal health). Conclusion: since, spouses’ participatory behaviors in perinatal period can lead to improve maternal and neonatal health and family function, it is necessary to be considered in family-based health promotion policies and programming based on these policies such as improving the public culture of spouse participation in the process of child-rearing.
The relationship between umbilical cord blood vitamin A levels and late preterm infant morbidities: A prospective cohort study
Authors: Tao En-Fu , Chen Cai-E , Chen Yun-Qin , Cai Lin-Yan , Yuan Tian-Ming
Published: March 2020

Background: Low plasma vitamin A levels increases the risk of neonates’ morbidity. However, the relationship between umbilical cord blood (UCB) vitamin A levels and late-preterm infant (LPI) consequences is inconclusive. Herein, we attempted to clarify the association between UCB vitamin A levels and LPI morbidities.Methods: We conducted a prospective cohort study of 208 LPI (from 34+0 to 36+6 weeks gestational age) between January 1, 2014 and June 30, 2015. UCB specimens were collected shortly after birth, and vitamin A levels were determined by enzyme-linked immunosorbent assay. Jaundice, sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, and death were recorded.Results: Prevalence of low UCB vitamin A level <0.7 μmol/L was 37.5% in LPI. Cesarean section was an independent risk factor of UCB vitamin A level < 0.7 μmol/L. Nevertheless, UCB vitamin A levels did not correlate with gestational age, birthweight, and gender. UCB vitamin A level < 0.7 μmol/L was not an independent risk factor for hospitalization, oxygen supplementation, hyperbilirubinemia, sepsis and respiratory distress syndrome. However, cesarean section, gestational age < 35 weeks and birthweight < 2500 g were independent risk factors for hospitalization and RDS. In addition, cesarean section increased the risk of oxygen supplementation, while gestational age < 35 weeks increased the risk of hyperbilirubinemia. Conclusions: Cesarean section delivery is an independent risk factor of low UCB vitamin A levels, and increases the risk of RDS. On the basis of our results, there is no association between low vitamin A levels and morbidity of late-preterm infants, including hyperbilirubinemia, sepsis and respiratory distress syndrome. Trial registration: Not applicable.
Predictive Value of Circulating Plasma Mitochondrial DNA for Sepsis in the Emergency Department: Observational Study Based on the Sepsis-3 Definition.
Authors: Wang Li feng , Zhou Wei , Wang Kai wen , He Shuang jun , Chen Yi
Published: March 2020

Background: The definition of sepsis is regularly updated; however, there is no standard diagnostic test. To improve diagnosis and prognostic prediction, the aim of this study was to determine the predictive value of circulating plasma mitochondrial DNA (mtDNA) levels in patients admitted to the emergency department (ED) with sepsis. Methods: A total of 107 patients hospitalized from June 2018 to January 2019 were divided into the sepsis (n = 72) and septic shock (n = 35) groups based on the sepsis-3 definition. Clinical and laboratory data were measured within 24 h of admission. The mtDNA concentrations in clarified plasma were estimated by quantitative polymerase chain reaction. Binary logistic regression analysis and the receiver operating characteristic (ROC) curve were used to determine predictive value of mtDNA and other markers for sepsis outcome (28-day mortality). Results: The median plasma mtDNA levels on admission were significantly higher in the septic shock patients than in the sepsis patients (P < 0.0 1), and were also higher in non-survivors than in survivors within 28 days (P < 0.01). Binary logistic regression showed that plasma lactate and mtDNA levels were independent risk factors for 28-day mortality [odds ratio (OR) 1.341, 95% confidence interval (CI) 1.035–1.736, P = 0.026 and OR 13.299, 95%CI 2.765–63.956, P = 0.001, respectively).The area under the ROC curve values for plasma mtDNA levels, lactate concentration, and their combined were 0.781 (p < 0.001, 95%CI 0.671–0.891), 0.733 (p < 0.001, 95%CI 0.635–0.832), and 0.799 (p < 0.001, 95%CI 0.698–0.901), respectively. The calibration test for the combined variable showed X 2 of 2.559 and P = 0.923. Conclusion: A higher plasma mtDNA level was associated with a poor prognosis of sepsis in the emergency room, and was a superior predictor to lactate for predicting 28-day mortality.
Genome re-sequencing and reannotation of the Escherichia coli ER2566 strain and transcriptome sequencing under overexpression conditions
Authors: Zhou Lizhi , Wang Kaihang , Chen Tingting , Ma Yue , Huang Yang , Li Jiajia , Liu Liqin , Li Yuqian , Kong Zhibo , Zheng Qingbing , Wang Yingbin , Gu Ying , Yu Hai , Li Shaowei , Xia Ningshao
Published: March 2020

Background

The Escherichia coli ER2566 strain (NC_CP014268.2) was developed as a BL21 (DE3) derivative strain and has been widely used in recombinant protein expression. However, like many other current RefSeq annotations, the annotation of the ER2566 strain is incomplete, with missing gene names and miscellaneous RNAs, as well as uncorrected annotations of some pseudogenes. Here, we performed a systematic reannotation of the ER2566 genome by combining multiple annotation tools with manual revision to provide a comprehensive understanding of the E. coli ER2566 strain, and used high-throughput sequencing to explore how the strain adapts under external pressure.

Results

The reannotation included noteworthy corrections to all protein-coding genes, led to the exclusion of 120 hypothetical genes or pseudogenes, and resulted in the addition of 65 coding sequences and 230 miscellaneous noncoding RNAs and 2 tRNAs. In addition, we further manually examined all 194 pseudogenes in the Ref-seq annotation and directly identified 144 (74%) as coding genes. The remaining pseudogenes without explicit function were removed. We then used whole-genome sequencing and high-throughput RNA sequencing to assess mutational adaptations under consecutive subculture or overexpression burden. Whereas no mutations were detected in response to consecutive subculture, overexpression of the human papillomavirus 16 type capsid led to the identification of a mutation (position 1,094,824 within the 3’ non-coding region) positioned 19-bp away from the lac I gene in the transcribed RNA, which was not detected at the genomic level by Sanger sequencing.

Conclusion

The ER2566 strain is used by both the general scientific community and the biotechnology industry. Reannotation of the E.coli ER2566 strain not only improved the RefSeq data but uncovered a key site that might involve in the transcription and translation of genes encoding the lactose operon repressor. We propose that our pipeline might offer a universal method for the reannotation of other bacterial genomes with high speed and accuracy. This study may facilitate a better understanding of gene function for the ER2566 strain under external burden and provide more clues to engineer bacteria for biotechnological applications.
Prevalence and Correlates of Bullying in Physiotherapy Education in Nigeria
Authors: Mbada Chidozie Emmanuel , Ogunseun Idowu Phebean , Fasuyi Francis Oluwafunso , Adegbemigun Oluwafemi David , Fatoye Clara Toyin , Idowu Opeyemi Ayodiipo , Johnson Olubusola Esther , Odole Adesola Christiana , Okonji Adaobi Margaret , Kaka Basir , Fatoye Francis
Published: March 2020

Background: Bullying is an unexpressed part and parcel of medical education but it is largely unexplored in physiotherapy. This study assessed the prevalence and socio-demographic correlates of bullying in physiotherapy education in Nigeria.
Methods: Two hundred and nineteen clinical physiotherapy students from three purposively selected Federal Universities in Nigeria participated in this study. Following a cross-sectional design, the Students Perception of Professor Bullying Questionnaire (SPPBQ) was used to obtain information on bullying. The SPPBQ includes a working definition of lecturer bullying followed by two sections inquiring about lecturers bullying experiences. Data was collected on socio-demographic characteristics, availability of adequate policy and support and the different forms of bullying experienced. Descriptive and inferential statistics were used analyze data. Alpha level was set at p<0.05.
Results: Lifetime and point prevalence of bullying in physiotherapy education was 98.6% and 99.1% respectively. 94.5% of the respondents had witnessed physiotherapy students bullying and there was a 100% rate of ‘no attempt’ to stop a physiotherapy lecturer from bullying. There was no significant association between bullying and each of age (𝜒2=0.117, p=0.943), gender (𝜒2=0.001,p=0.974), university (𝜒2=1.343,p=0.511) and level of study (𝜒2=0.000,p=0.995).
Conclusion: There is high lifetime and point prevalence of bullying in physiotherapy education in Nigeria, which are largely unchallenged or redressed. Also, being a clinical physiotherapy student makes prone to bullying without necessary contributions of other intrinsic and extrinsic factors.
Genome-wide analysis of Jatropha curcas MADS-box gene family and functional characterization of the JcMADS40 gene in transgenic rice
Authors: Tang Yuehui , Wang Jian , Bao Xinxin , Wu Qian , Yang Tongwen , Li Han , Wang Wenxia , Zhang Yizhen , Bai Nannan , Guan Yaxin , Dai Jiaxi , Xie Yanjie , Li Shen , Huo Rui , Cheng Wei
Published: March 2020

Background: Physic nut (Jatropha curcas), a non-edible oilseed plant, is among the most promising alternative energy sources because of its high seed oil content, rapid growth and extensive adaptability. Proteins encoded by MADS-box genes are important transcription factors involved in the regulation of plant growth, seed development and responses to abiotic stress. However, there has been no in-depth research on the MADS-box genes and their roles in physic nut. Results: In the present study, 63 MADS-box genes (JcMADSs) were identified in the physic nut genome, and classed into five groups (MIKC, Mα, Mβ, Mγ, MIKC*) based on phylogenetic comparison with Arabidopsis homologs. Expression profile analysis based on RNA-seq suggested that many JcMADS genes were expressed most strongly in seeds, and seven of them responded in leaves to at least one abiotic stressor (drought and/or salinity) at one or more time points. Transient expression analysis and a transactivation assay indicated that JcMADS40 is a nucleus-localized transcriptional activator. Plants overexpressing JcMADS40 did not show altered plant growth, but the overexpressing plants did exhibit reductions in grain size, grain length, grain width, 1000-seed weight and yield per plant. Further data on the reduced grain size in JcMADS40-overexpressing plants supported the putative role of JcMADS genes in seed development. Conclusions: This study will be useful in understanding the involvement of MADS-box genes in growth and development in addition to their functions in abiotic stress resistance, and will ultimately form the basis for functional characterization and the exploitation of candidate genes for the genetic engineering of physic nut.
Toluene Biodegradation using a Lab-Scale Biofilter Inoculated with Pseudomonas Putida PTCC 1694
Authors: Ghasemi Roohollah , Golbabaei Farideh , Pourmand Mohammad Reza , Rezaei Sasan , Jafari Mohammad Javad , Nabizadeh Ramin , Masoorian Ensieh
Published: March 2020

Biomanipulation is reliable method for treating volatile organic compounds (VOCs) in polluted air. The performances of two biofilters in the removal of toluene vapors from air stream were compared. Two identical biofilters designed in parallel configuration were operated in lab-scale for 20 days; one of them was filled by sterilized media (compost and wood charcoal 2:1 v/v) and another was filled by the same media inoculated with Pseudomonas putida PTCC 1694, as a native strain. Moreover, batch tests were performed to determine the biodegradation rate of toluene. The results showed that, in comparison with the sterilized BF (89% vs 58%), the inoculated BF could effectively eliminate toluene from air stream. The pressure drop across the inoculated BF and the sterilized BF were 0.66±0.28 and 0.47±0.27 mm water respectively. The batch test results showed that loss of toluene in the control bottles was greater than the blanks. Based on the experimental results, inoculated BFs can effectively treat toluene vapors from gaseous streams.
Association between malaria-related health service readiness and malaria mortality in under 5-year-old children in Burkina Faso
Authors: Millogo Ourohiré , Doamba Jean Edouard Odilon , Sié Ali , Utzinger Juerg , Vounatsou Penelope
Published: March 2020

Background: The Service Availability and Readiness Assessment (SARA) surveys generate data on the readiness of health facility services. We constructed a readiness index related to malaria services and determined the association between health facility malaria readiness and malaria mortality in children under the age of 5 years in Burkina Faso. Methods: Data on malaria-related visits and deaths in under 5-year-old children were extracted from the national Health Management Information System (HMIS) in Burkina Faso. Bayesian geostatistical models with variable selection were fitted to malaria mortality data. The most important facility readiness indicators related to general and malaria-specific services were determined. Multiple correspondence analysis (MCA) was used to construct a composite facility readiness score based on multiple factorial axes. The analysis was carried out separately for 112 medical centers and 546 peripheral health centers. Results: Malaria mortality rate in medical centres was 4.8 times higher than that of peripheral health centres (3.46 vs 0.72%, p<0.0001). Essential medicines was the domain with the lowest readiness (only 0.1% of medical centres and 0% of peripheral health centres had the whole set of essential medicines tracer indicators). Basic equipment readiness was the highest. The composite readiness score explained 30% and 53% of the original indicators for medical centers and peripheral health centers, respectively. Mortality rate ratio (MRR) was by 59% (MRR = 0.41, 95% Bayesian credible interval (BCI): 0.19-0.91) lower in the high readiness group of peripheral health centers, compared to the low readiness group. Medical centers readiness was not related to malaria mortality. The geographical distribution of malaria mortality rate showed that regions with high mortality rate have also high proportion of health facilities with low readiness and vice versa. Conclusion: Performant health services in Burkina Faso are associated with lower malaria mortality rates. Health system readiness should be strengthened in the regions of Sahel, Sud-Ouest and Boucle du Mouhoun. Emphasis should be given to improving the management of essential medicines and to reducing delays of emergency transportation between the different levels of the health system.
Transbronchial Lung Cryobiopsy May be of Value for Nonresolving Acute Respiratory Distress Syndrome: Case series and Systematic literature Review
Authors: Zhou Guowu , Feng Yingying , Wang Shiyao , Zhang Yi , Tian Ye , Wu Xiaojing , Zhao Ling , Wang Dan , Li Yi , Tian Zheng , Zhan Qingyuan
Published: March 2020

Background: Identifying pathologic features is helpful for the management of nonresolving acute respiratory distress syndrome (ARDS). Transbronchial lung cryobiopsy (TBLC) is a novel biopsy technique that may have comparable utility to surgical biopsy. The aim of this study was to assess the value of TBLC in patients with nonresolving ARDS.
Methods: All patients with nonresolving ARDS who underwent TBLC from January 2019 to August 2019 in a tertiary medical ICU were included. In addition, a literature search of TBLC for ARDS was performed by searching PubMed, EMBASE, ATS/ERS/APSR meeting abstracts, clinicaltrial.gov, and Google Scholar. Data on complications, histologic diagnosis, management changes, and outcomes were analyzed.
Results: Five patients (three women and two men) underwent TBLC. None of the patients developed pneumothorax although in two patients massive bleeding occurred, which was controlled by continuous occlusion using bronchial blockers. There were no procedure-related deaths. Diffuse alveolar damage (DAD) and alternative histologic patterns were found in two and three patients, respectively, resulting in management changes in all cases. Literature search yielded four studies, which together with the present study resulted in data from 25 cases in which TBLC was used in nonresolving ARDS. The summary diagnostic yield was 92% (23/25). Only 44% (11/25) of cases were proven to be DAD. TBLC contributed to management changes in 80% of patients (20/25). Procedure-related complications consisted of pneumothorax (16%, 4/25), significant bleeding (12%, 3/25), and persistent air leak (8%, 2/25). There were no procedure-related deaths. The follow-up survival rate was 61.9% (13/21).
Conclusions: Given its acceptable safety profile and high diagnostic yield, TBLC may be of value in selected patients with nonresolving ARDS.
An Integrated Humanities–Social Sciences Course in Health Sciences Education: Its Proposed Design, Effectiveness and Associated Factors
Authors: Lee Jihyun , Lee Jueyeun , Jung Ilyoung
Published: March 2020

BackgroundPrevious research has not provided enough direction regarding effective content design of courses integrating humanities and social sciences in medical and dental education This study aims at exploring how an Integrated Medical/Dental Humanities–Social Medicine/Dentistry course can be designed; how effective it can be in terms of students’ growth in knowledge, attitudes, skills, and aspirations; and what can be associated factors. MethodsThe course was designed by distilling commonalities in the international standards for medical/dental education proposed by seven major health organizations. This analysis resulted in a curriculum covering eight major topics (history; professionalism; communication; ethics; management; policy; insurance; law; and research methodology). During the 2017 calendar year, data was collected and statistically analyzed from 68 third-year pre-doctoral students enrolled in the resulting MDHS 13-week course. ResultsParticipants showed growth in skills, aspirations, knowledge, and attitudes, with the greatest change occurring in skills, then aspirations, knowledge, and attitude. However, knowledge growth was the only variable significantly related to student achievement of course objectives ( β = 0.635, t (63) = 3.394, p = 0.001). The topics that students perceived as most critical were insurance, policy, management, and law. Perceived importance of research was the most common and was significantly related to all types of learning outcomes (For knowledge, β =0.213, t (63) = 2.203, p = 0.031; for attitudes, β = 0.784, t (63) = 10.257, p = 0.000; for skills, β = 0.769, t (63) = 9.772, p = 0.000; and aspirations β = 0.639, t (63) = 7.595, p = 0.000). ConclusionsThis study proposed a framework for a humanities-social sciences education for health sciences education, and analyzed its implementation. The empirical evaluation of its effectiveness and factors related to successful outcomes found that students perceived gains in their knowledge, attitudes, skills, and aspirations for humanistic and social aspects of dentistry/medicine, and that recognized importance of research was associate with the greatest growth in all four areas of learning outcomes. This study hopes to contribute to the improved design of integrated humanities–social sciences courses.
Genetic basis analysis for indica germinability under low temperature using a new RILs population genotyping by whole-genome resequencing
Authors: Wang Peng , Wu Guangliang , Luo Xin , Liu Ruiqi , Zhou Andong , Cai Yicong , Zhou Dahu , Tan Jingai , Tong Shan , Zhang Xiangyu , Li Caijin , Li Cuijuan , Wang Yanning , Cheng Qin , He Haohua , Jianmin Bian
Published: March 2020

Background : Improving the cold tolerance of rice at germination stage is an important objective to maintain rice yields. However, less analyses were carried out to detect the quantitative trait loci (QTLs) associated with cold tolerance using indica/indica population. Therefore, the genetic basis of cold tolerance of the indica varieties should be provided considerable attentionResults: In this study, a recombinant inbred lines (RILs) population comprising 126 lines derived from two widely used double-cropped indica rice varieties Wufeng B (WFB) and Changhui T025 (CHT025) was used to construct a high-density linkage map based on whole-genome resequencing. The high-density genetic map included 2,578 bins on 12 linkage groups and was 1762.80 cM in length, with an average interlocus distance of 0.68 cM. On the basis of newly constructed high-density genetic map, a total of 18 additive QTLs ranging from 34.55 to 315.21 kb on Nipponbare genome and two pairs of epistatic QTLs associated with cold stress at germination stage were detected, which indicated that the genetic basis of cold tolerance of WFB and CHT025 at germination stage is manly due to additive effects of several QTLs. Otherwise, the phylogenetic analysis showed that WFB is a typical indica variety while CHT025 is an interphyletic rice variety. Most of the favorable QTLs harbouring in indica WFB showed different chromosomal region from the QTLs associating with cold stress from japonica rice in previous studies, which indicated that indica might have different cold stress genetic mechanism comparing to japonica subspecies. Furthermore, we can incorporate these favorable QTLs existing in WFB into rice varieties to breed new cold tolerance indica male sterile maintenance line via marker-assisted selection; CHT025 is a better source of these cold tolerance favorable QTLs only only for the improvement of indcia but also for japonica restorer line germinability under low temperature via marker-assisted selection.Conclusion : This population with high density genetic map will serve as better choice for identifying important quantitative traits of these two good indica germplasms, and these favorable QTLs exist in WFB and CHT025 can be used to breed new cold tolerance indica varieties via marker-assisted selection. These authors have contributed equally to this work
A hypoxia-related signature for clinically predicting diagnosis, prognosis and immune microenvironment of hepatocellular carcinoma patients.
Authors: Zhang Baohui , Tang Bufu , Gao Jianyao , Li Jiatong , Kong Lingming , Qin Ling
Published: March 2020

Background Hypoxia plays an indispensable role in the development of hepatocellular carcinoma (HCC). However, there are few studies on the application of hypoxia molecules in the prognosis predicting of HCC. We aimed to identify the hypoxia-related genes in HCC and construct reliable models for diagnosis, prognosis and recurrence of HCC patients as well as exploring the potential mechanism.Methods Differentially expressed genes (DEGs) analysis was performed using The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database and four clusters were determined by a consistent clustering analysis. Three DEGs closely related to overall survival（OS）were identified using Cox regression and LASSO analysis and the hypoxia-related signature was developed and validated in TCGA and International Cancer Genome Consortium (ICGC) database. Then the Gene Set Enrichment Analysis (GSEA) was performed to explore signaling pathways regulated by the signature and the CIBERSORT was used for estimating the fractions of immune cell types.Results A total of 397 hypoxia-related DEGs were detected and three genes (PDSS1, CDCA8 and SLC7A11) were selected to construct a prognosis, recurrence and diagnosis model. Then patients were divided into high- and low-risk groups. Our hypoxia-related signature was significantly associated with worse prognosis and higher recurrence rate. The diagnostic model also accurately distinguished HCC from normal samples and nodules. Furthermore, the hypoxia-related signature could positively regulate immune response and the high-risk group had higher fractions of macrophages, B memory cells and follicle-helper T cells, and exhibited higher expression of immunocheckpoints such as PD1and PDL1.Conclusions Altogether, our study showed that hypoxia-related signature is a potential biomarker for diagnosis, prognosis and recurrence of HCC, and it provided an immunological perspective for developing personalized therapies.
Rectal douching before sexual intercourse and inappropriate douching tool use associated with increased HIV infection among men who have sex with men: a cross-sectional study from Shenyang, China
Authors: Chu ZhenXing , Shen Guangquan , Hu Qinghai , Wang Hongyi , Zhang Jing , Dong Willa , Jiang Yongjun , Geng Wenqing , Shang Hong , Xu Junjie
Published: March 2020

Background: Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is correlated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex.Methods: Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection.Results: A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%). The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD (adjusted odds ratio (AOR), 2.8; 95% confidence interval (CI), 1.4-5.5), practicing RD before sex (AOR, 2.3; 95% CI, 1.2–4.3), practicing RD after sex (AOR, 1.8; 95% CI, 1.0–3.1), using a shower hose for RD (AOR, 3.5; 95% CI, 1.1–13.0), condomless receptive anal intercourse (CRAI) (AOR, 2.9; 95% CI, 1.6–5.5), and using nitrite inhalants (AOR, 2.8; 95 % CI, 1.6-5.1) in the most recent anal intercourse.Conclusions: RD is popular among Chinese MSM. Improper noncommercial RD tools increase the rates of HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM, and we recommend that better tools be offered to assist in RD in order to decrease the risk of acquiring HIV.
Examining fidelity in the INFORM trial, a complex team-based behavioural intervention
Authors: Ginsburg Liane , Hoben Matthias , Easterbrook Adam , Andersen Elizabeth , Anderson Ruth , Cranley Lisa , Lanham Holly , Norton Peter , Weeks Lori , Estabrooks Carole
Published: March 2020

Background Fidelity in complex behavioural interventions is underexplored. This study examines fidelity of the INFORM trial and explores the relationship between fidelity, study arm and the trial’s primary outcome – care aide involvement in formal team communications about resident care. We examined fidelity of intervention delivery, receipt, and enactment. The primary outcome in the INFORM study (care aide involvement in formal team communications about resident care) was also included as an outcome in this fidelity study.Methods A concurrent process evaluation of implementation fidelity was conducted in 33 nursing homes in Western Canada (Alberta and British Columbia). Study participants are from 106 clinical care units clustered in 33 nursing homes randomized to the Basic and Enhanced Assisted Feedback arms of the INFORM trial.Results Fidelity of the INFORM intervention was moderate to high, with fidelity delivery and receipt higher than fidelity enactment for both study arms. Higher enactment teams experienced a significantly larger improvement in formal team communications between baseline and follow-up than lower enactment teams ( F (1, 70) = 4.27, p = .042).Conclusions Overall fidelity enactment was associated with improvements in formal team communications, but study arm was not. This suggests that the intensity with which an intervention is offered and delivered may be less important than the intensity with which intervention participants enact the core components of an intervention. Greater attention to fidelity assessment and publication of fidelity results through studies such as this one is critical to improving the utility of published trials.
Clinical outcomes of Ti-Ni shape-memory patella concentrator combined with cannulated compression screws in the treatment of C2 and C3 patella fracture: a retrospective study of 54 cases
Authors: Chen Yao , Jie Sun , Jiancheng Wu , Zhenyu Zhou , Fan Liu , Ran Tao , Yafeng Zhang
Published: March 2020

Purpose The purpose of this study was to investigate the efficiency of Ti-Ni shape-memory patella concentrator(TNSMPC) combined with cannulated compression screws in the treatment of comminuted patella fracture. Methods Between January 2014 and January 2017, 54 patients of C2 and C3 patella fractures underwent open reduction and internal fixation with TNSMPC combined with cannulated compression screws. All the patients got standard postoperative rehabilitation programs and were regularly followed up for at least 12 months after the operation. X-rays, knee functions and life quality were evaluated during the follow-up. Results All the patients achieved bone healing and recovery of knee function with low incidence of complications according to X-rays and questionnaire surveys. The average operation time and blood loss during surgery were 77.5±25.12minutes and 24.25±4.70ml respectively. The Knee Outcome Survey Activities of Daily Living Scale, range of motion, 36-item Short-form heath survey after the operation were all improved. According to the Bostman’s criteria, the excellent to good rate was 92.6%. Conclusion TNSMPC combined with cannulated compression screws is an effective fixation for C2 and C3 patella fracture with excellent clinical outcomes. In addition, the operation does not increase extra technique difficult or tissue damage relatively, which is worth promotion.
Management of thoracic trauma and analysis of risk factors in thoracic trauma patients
Authors: Beshay Morris , Mertzlufft Fritz , Kottkamp Hans Werner , Vordemvenne Thomas , Reymond Marc , Schmid Ralph Alexander , Branscheid Detlev
Published: March 2020

Objectives:Thoracic trauma (TT) is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. Its management is still a very challenging task. The purpose of this study was to analyse the epidemiological finding, risk factors affecting the outcome in a high volume trauma centre.Patients and methods:Between January 2003 and December 2012 data of all patients admitted to the Accident and Emergency (A&E) were prospectively collected at the German Trauma Registry (GTR) thereafter retrospectively analysed.Patients with chest trauma and Injury Severity Score (ISS) ≥18 and Abbreviated Injury Scale (AIS) >2 in more than one body region were included. Patients were divided into two groups; group I included patients with thoracic trauma between January 2003 to December 2007. The results of this group were compared with the results of other group (group II) in a later five years period (Jan. 2008-Dec. 2012). Univariate and multivariate analysis was done, Statistical difference with P<0.05 were considered significant.Results:There were 630 patients (56%) with thoracic trauma. 540 patients (48%) had associated extra thoracic injuries. Group I consisted of 285 patients (197 male, mean age 46 years). Group II consisted of 345 patients (251 male, mean age 49 year). Overall 90 days mortality was 17% (n=48) in group I vs. 9% (n=31) in group II (p=0.024). Complication rates were higher in group I (p=0.019). Higher injury severity score (ISS), and higher abbreviated injury score (AIS) thoracic showed higher rate of mortality (p<0.0001). Young patients (< 40 years) were frequently exposed to severe thoracic injury but showed less mortality rates (p=0.014). Patients with severe lung contusions (n=94) (15%) had higher morbidity and mortality (p<0.001). 23 (8%) Patients had emergency thoracotomy in group I vs. 14 patients (4%) in group II (p=0.041). Organ replacement procedures were needed in 18% in group I vs. 31% in group II (p=0.038).Conclusions:The presence of severe lung contusion, higher ISS and AISthoracic and advanced age are directly related to higher mortality rate. Instantly management of blunt chest trauma with corrected chest tube insertion, optimal pain control and chest physiotherapy resulted in good outcome in the majority of patients. Optimal management with better survival rates is achievable in specialized centre with a multidisciplinary teamwork and the presence of thoracic surgical experience.