bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-discharge telephonic follow-up of pediatric patients affected by SARS-CoV2 infection: a safe and feasible way to monitor children after hospitalization.The experience of a single Italian Pediatric COVID Center.
Authors: Clemente Vitangelo , Tripiciano Costanza , Moras Patrizio , Deriu Daniele , Giuseppe Martina Di , Piscitelli Annalucia , Cammerata Michela , Ioris Maria Antonietta De , Carducci Francesca Ippolita Calò , Bernardi Stefania , Campana Andrea , D'Argenio Patrizia , Rossi Paolo
Published: November 2020

BackgroundIn early January 2020, a novel type of Coronavirus was identified in a patient affected by pneumonia of unknown origin. The virus will be named SARS-CoV-2 and the disease COVID-19 a month later by the International Committee on Virus Taxonomy.Italy is one of the first countries in the world affected by the COVID-19 pandemic, with 1.2% of all patients represented by children. Although the infection in children is often non severe and in the majority of cases does not require long term hospitalization, it is burdened with social issues and managing difficulties.To our knowledge there is no literature on telephonic follow up in pediatric patients with positive rhino-pharyngeal swab for SARS-CoV-2 after discharge.Materials and MethodsWe monitored through a telephonic follow-up, using a specific survey, 19 children aged between 8 months and 15 years, hospitalized in the “Ospedale Pediatrico Bambino Gesù” COVID Center with positive rhino-pharyngeal swab at discharge. We checked if any symptoms occurred at home until recovery, defined as two consecutive negative rhino-pharyngeal swabs.ResultsDuring the follow up 7 patients had mild and self-limited symptoms related to SARS-CoV-2 infection, while 2 patients were re-hospitalized, 1 patient had Multisystem Inflammatory Syndrome in Children (MIS-C), the other patient had an increase in troponin a D-dimers.We didn’t miss any patient during the follow up.ConclusionWe demonstrated that daily telephonic follow up is safe in pediatric patients discharged with positive swab, it allows to avoid long term hospitalization and to promptly re-hospitalize children with major complication such as MIS-C.
Sexual violence in medical students and trainees in Flanders: a population survey 
Authors: Geldof Malaurie , Tijtgat Jens , Dewulf Laura , Haezeleer Matthias , Degryse Nicolas , Pouliart Nicole , Keygnaert Ines
Published: November 2020

Background: Sexual violence has globally been recognized as harmful to young people’s health. In medical school, which is a highly competitive environment, the risk is supposedly even bigger. In this study we firstly aimed to investigate the magnitude and promoting factors of sexual violence in medical students and trainees in Flanders. Secondly, we wanted to assess the reactive behaviours as well as the knowledge of possible types of bystander reactions as well as potential support resources for victims of sexual violence. Methods: This study was initiated and coordinated by the Flemish medical student representation organ (VGSO). A survey containing demographic and behaviour-specific questions based on the UN-MENAMAIS and SAS-V questionnaire was sent to all undergraduate, graduate and postgraduate students of the 5 medical schools in Flanders. Participants were asked to limit their responses to internship-related events. Further questions concerning reactions to sexual violence, perpetrators, bystander reactions and general knowledge concerning support after sexual violence were asked. Results: We received 3015 valid responses to our survey, obtaining a response rate of 29% in the potential target population. Within the total study population, 1168 of 3015 participants (38,73%) reported having been victim of at least one type of sexual violence as explored by our survey. This percentage was the highest in GP trainees (53%), followed by specialist trainees (50%) and master students (39%). Perpetrators of sexual violence varied, most often they were medical staff members, students or patients. In most types of sexual violence, nobody reacted to this behaviour. Women (57.3%) talked about what happened afterwards more often than men (39.7%). When asked about their knowledge of possible bystander reactions and support services for sexual violence, 60% of the respondents did not know about their existence. Conclusions: Sexual violence is still a relatively frequent issue in medical students and trainees. Patients form an important part of the assailants. In a third of reported sexual violence cases, nobody reacted. In addition, male victims seem to underreport. There is still much need for sensibilisation on support mechanisms and centres for victims and witnesses of sexual violence.
FOUR score versus GCS in patients with traumatic brain injury in the prehospital setting
Authors: Furman Matej Rubelli , Gorenjak Mario , Ravnik Janez
Published: November 2020

Background: In the last few decades, different coma scoring scales have been proposed. The purpose of this study is to compare two coma scales:, the GCS (Glasgow Coma Scale) and the FOUR score (Full Outline of UnResponsiveness score), aiming to examine which scale is better for predicting outcome in traumatic brain injury (TBI) patients in the prehospital setting.Methods: We evaluated the GCS and FOUR scores in the prehospital setting at three different prehospital timepoints, and we reassessed the scores in surviving patients 24 hours, one month and three months after the injury. Then, we compared the outcomes.We used the χ² method, and based on the analysis with the best cut-off point for each model, we calculated the sensitivity, specificity and correct prediction of outcomes with four severity scores. The Youden index, Z score, McNemar's test and ROC curve were also assessed. P < 0.05 was considered statistically significant. Both scales were ranked with gain ratios.Results: We included 200 TBI patients who were treated in a prehospital setting by a prehospital specialized medical unit. In terms of the predictions of positive outcomes, our study showed the following:1. Twenty-four hours after the injury, the best cut-off points obtained were from the FOUR 1 and GCS 1 models.2. One month after the injury, the best cut-off points obtained were from the following models: FOUR 2 and GCS 3 as well as FOUR 3 and GCS 3.3. Three months after the injury, the best cut-off points obtained were from the following models: FOUR 2 and GCS 1, FOUR 3 and GCS 1, and GCS 1 and GCS 2.Conclusions: In our study, the results of our research confirm that there are no practical or clinical differences between the GCS and FOUR scores in terms of predicting morality outcomes 24 hours, one month, and three months after injury. No statistically significant differences were found in the Youden index or the area under the ROC curve 24 hours, one month or three months after the injury.
Dietary pattern and its’ association with anemia among infants aged 6-23 months in central-south China. 
Authors: Zou Shao-hui , Liu Yuan , Zhen Ai-bing , Huang Zhi
Published: November 2020

Backgroud: Anemia is widely prevalent among children, and this study aims to understand dietary patterns and its’ association with anemia.Methods: A cross-sectional design in two time period was conducted at Mayang in 2015 and in 2018. The diet data was collected by questionnaire, and dietary patterns were identified by exploratory factor analysis. Hemoglobin (Hb) was measured to assess the status of anemia. The association between the dietary patterns and anemia was assessed by the logistic regression model.Results: The mean age of infants were 14.06 months in 2015 and 16.58 months in 2018. Four dietary patterns were identified among infants aged 6-23 months in central-south China. Diversified pattern: mainly tubers, dairy products, bean and bean products; traditional pattern:mainly cereals, water and soup, and other vegetables and fruits; breast milk pattern: mainly breast milk but less powered formulas; and multi-nutrient powders pattern: mainly multi-nutrient powders. The prevalence of anemia among infant reduced from 29.49% in 2015 to 20.26% in 2018. The top quartile (Q4) of diversified pattern and multi-nutrient powders pattern deminished the risk of anemia by 45% (OR = 0.55, 95% CI: 0.30 to 0.99, P = 0.047) and 59% (OR = 0.41,95% CI: 0.22 to 0.78, P = 0.006) compared to the lowest quartile (Q1), while the breast milk pattern had a 3.26-fold greater risk of anemia than the lowest quartile (Q1) (OR = 3.26,95%CI:1.83 to 5.81, P <0.001).Conclusions: Four dietary patterns were identified among infants aged 6-23 months in central-south China. The pattern with a variety of food groups should be strengthened to improve anemia among infants.
Peer-Assisted Injection as a Harm Reduction Measure in a Supervised Consumption Service: A Qualitative Study of Client Experiences
Authors: Pijl Em M. , Oosterbroek Tracy , Motz Takara , Mason Erin , Hamilton Keltie
Published: November 2020

Background: Peer assistance is an emerging area of study in injection drug use. When Canada’s first supervised consumption site (SCS) opened in 2003 in Vancouver, BC, clients were prohibited from injecting their peers; only recently has this practice been introduced as a harm reduction measure at these sites. In 2018, Health Canada granted federal exemption to allow peer-assisted injection at certain SCS sites, under the Controlled Drugs and Substances Act. Literature pertaining to peer-assisted injection addresses several topics: interpersonal relationships between the injection provider and recipient; the role of pragmatism; trust and expertise; and gender relations. Methods: In this qualitative study, participants (n=16) were recruited to be interviewed about their experiences in a peer-assisted injection program (PAIP) at one SCS regulated by Health Canada. Interview data were transcribed and thematically analyzed. Quantitative administrative data was used to provide context and to describe the study population, comprised of people in the PAIP (n=248) Results: PAIP clients made up 17.4% of all SCS clients. PAIP clients were more likely to be female and Indigenous. Injection providers expressed being moved by compassion to help others inject. While their desire to assist was pragmatic, they felt a significant burden of responsibility for the outcomes. Other prominent factors related to the injection provider-recipient relationship were social connection, trust, safety, social capital, and reciprocity. Participants also made suggestions for improving the PAIP which included adding more inhalation rooms so that if someone was unable to inject they could smoke in a safe place instead. Additionally, being required by law to divide drugs outside of the SCS, prior to preparing and using in the site, created unsafe conditions for clients. Conclusions: Regular use of the SCS, and access to its resources, enabled participants to lower their risk through smoking and to practise lower-risk injections. At the federal level, there is considerable room to advocate for allowing clients to divide drugs safely within the SCS, and to increase capacity for safer alternatives such as inhalation.
Health literacy and health outcomes in China’s floating population: mediating effects of health services
Authors: Yu Haiyan , Wu Wei-ling , Yu lin-wei , Wu Lei
Published: November 2020

Background: The floating population in China consists primarily of internal immigrants and represents a typical health vulnerable group. Poor health literacy has recently become an obstacle in the accessibility and utilization of health services for the vulnerable population, leading to adverse health outcomes. This study aimed to examine whether health literacy affected health outcomes in China’s floating population and whether health service utilization had a mediating effect between health literacy and health outcomes. Method: The current study utilized a cross-sectional stratified, multistage, proportional to scale (PPS) study in Zhejiang Province, China, in November and December 2019. In total, 657 valid self-reported questionnaires were recovered and used for data collection. Questionnaires included questions regarding sociodemographic characteristics, health literacy, health outcomes, and health service utilization. Confirmatory factor analysis was used to test questionnaire validity; descriptive statistics were used to understand the demographic characteristics of the floating population; and structural equation modeling was used to determine whether health service utilization mediated health literacy and health outcomes. Results: We report positive correlations between health literacy, health service utilization, and health outcomes. Mediation analysis demonstrated that health service utilization had partial mediating effects between health literacy and health outcomes. In the relationship between health literacy and health outcomes, the indirect effects of health service utilization accounted for 6.6%–8.7% of the total effects. Conclusion: Complete health literacy, through health care literacy and health promotion literacy, affects the mobile population's initiative to use health services, which, in turn, affects health outcomes. Thus, improving the health literacy of the floating population will help to improve health outcomes. Furthermore, health service providers should enhance the diversity of health service supply to ensure that the floating population has the external resources to improve personal health literacy.
A GIS based approach to neighbourhood physical environment and walking among adults in Colombo Municipal Council Area, Sri Lanka
Authors: Weliange Shreenika De Silva , Fernando Dulitha , Withanage Shanthi , Gunatilake Jagath
Published: November 2020

BackgroundPhysical Activity (PA) promotes health and wellbeing and walking is one of the easiest and commonest way to incorporate activity into everyday life. This study examined the association between the objectively measured neighbourhood physical environment and walking among the adults in Colombo Municipal Council (CMC) area in Sri Lanka. Methods A cross sectional study was carried out and primary data collection carried out to assess walking, socio-demographic characteristics and geo location of residence. Secondary data was obtained to assess neighbourhood environment from existing spatially referenced data from the survey department of Sri Lanka. Geographic Information Systems (GIS) was used to calculate density measures (residential density, land use, connectivity and access) and distance measures, which were then correlated with walking. ResultsA sample consisted of 284 adults aged 29-59 years with a mean age of 40.6 (SD,10.9) years. The total mean minutes walked a week was 175.8 minutes with a standard deviation of 214.0. The mean and the standard deviations of walking per week for transportation and leisure were 158.4 (SD,196.6) and 17.5 (SD,70.1) respectively. Residential density measures, building foot print area, length of major roads, number of intersections, number of bus stops, and distance to nearest major roads showed significant moderate degree of correlations with total minutes of walked per week, (p < 0.001). These results were similar with walking for transportation. ConclusionThere is indication that neighbourhood features are associated with walking among the adults in the CMC area using secondary data on physical environment. This paves way for further exploration to understand the relationship between neighbourhood physical environment and walking which could be used for effective interventions to promote walking.
Prevalence and determinants of intimate partner violence against mothers of children under-five years in central Malawi
Authors: Chilanga Emmanuel , Collin-Vezina Delphine , Khan Mohammad Nuruzzaman , Riley Liam
Published: November 2020

Background Intimate partner violence (IPV) against women is a global human rights violation and a public health problem. The phenomenon is linked to adverse health effects for women and children. Mothers of young children in Malawi can be particularly at risk because of gender-based power imbalances. The objectives of this study were to examine the prevalence and the risk factors of IPV against mothers of children under-five years of age in rural Malawi.Methods A multistage, cross-sectional study design was used. A sample of 538 mothers of young children was randomly selected from postnatal clinics in Dowa district. The WHO's Violence against women screening instrument was used to collect data. Logistic regressions were used to determine risk factors that were associated with IPV against mothers. ResultsOverall prevalence of all four forms of IPV against mothers of under-five children was 60.2%. The prevalence of IPV controlling behavior, psychological, physical, and sexual violence were 74.7%, 49.4%, 43.7% and 73.2% respectively. In multivariate analyses, mothers whose partners had extra marital affairs were more likely to experience controlling behavior (AOR: 4.97, 95% CI: 2.59-8.55, P = 0.001), psychological (AOR: 2.14, 95% CI: 1.486-3.472, P = 0.001) and physical (AOR: 2.29, 95% CI: 1.48-3.94, P = 0.001) violence than mothers whose partners did not have extra marital affairs. Mothers whose partners consume alcohol were more likely to experience sexual violence (AOR: 2.00, 95% CI: 1.17-3.41, P = 0.001) than mothers whose partners did not drink. Finally, mothers who spent more than 30 minutes drawing water were at greater risk of experiencing IPV than mothers who spent less than 30 minutes. Conclusion This study found a significantly higher prevalence of IPV against mothers of under-five children in rural Malawi compared to women in the general population. Micro and macro-level programs aimed at mitigating the partners’ potential risk behaviors identified in this study are suggested. Public health programs that support increased household access to safe water are also recommended to help undermine IPV against mothers.
Kinetic Analysis of Dominant Intraprostatic Lesion of Prostate Cancer Using Quantitative Dynamic [18F]DCFPyL-PET: Comparison to [18F]fluorocholine-PET
Authors: Yang Dae-Myoung , Li Fiona , Bauman Glenn , Chin Joseph , Pautler Stephen , Moussa Madeleine , Rachinsky Irina , Valliant John , Lee Ting-Yim
Published: November 2020

PurposeIdentification of the dominant intraprostatic lesion(s) (DILs) can facilitate diagnosis and treatment by targeting biologically significant intra-prostatic foci. A PSMA ligand, [18F]DCFPyL (2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid), is better than choline-based [18F]FCH (Fluorocholine) in detecting and localizing DIL because of higher tumour contrast, particularly when imaging is delayed to one hour post injection. The goal of this study was to investigate whether the different imaging performance of [18F]FCH and [18F]DCFPyL can be explained by their kinetic behaviour in prostate cancer (PCa) and to evaluate whether DIL can be accurately detected and localized using a short duration dynamic positron emission tomography (PET).Methods19 and 23 PCa patients were evaluated with dynamic [18F]DCFPyL and [18F]FCH PET, respectively. The dynamic imaging protocol with each tracer had a total imaging time of 22 mins and consisted of multiple frames with acquisition times from 10-180 s. Tumour and benign tissue regions identified by sextant biopsy were compared using standardized uptake value (SUV) and tracer kinetic parameters from kinetic analysis of time-activity curves.ResultsFor [18F]DCFPyL, logistic regression identified Ki and k4 as the optimal model to discriminate tumour from benign tissue (84.2% sensitivity and 94.7% specificity) while only SUV was predictive for [18F]FCH (82.6% sensitivity and 87.0% specificity) The higher k3 (binding) of [18F]FCH than [18F]DCFPyL explains why [18F]FCH SUV can differentiate tumour from benign tissue within minutes of injection. Superior [18F]DCFPyL tumour contrast was due to the higher k4/k3 (more rapid washout) in benign tissue compared to tumour tissue.ConclusionsDIL was detected with good sensitivity and specificity using 22-min dynamic [18F]DCFPyL PET and avoids the need for delayed post-injection imaging timepoints. The dissimilar in-vivo kinetic behaviour of [18F]DCFPyL and [18F]FCH could explain their different SUV images.
International Travel is Not a Significant Risk of Exposure for Patients at a Midwestern United States Travel Clinic
Authors: Patel Pooja , House Hans
Published: November 2020

The Novel Coronavirus (SARS-CoV-2) was introduced into the United States via travel from Asia and Europe, although the extent of the spread of the disease was limited in the early days of the pandemic. Consequently, international travel may have played a role in the transmission of the disease into Iowa. This study seeks to determine how preferences for international travel changed as novel Coronavirus Disease (COVID-19) spread throughout the world and if any of these returning travelers developed COVID-19 as a result of their trips. This is a retrospective chart review of patients presenting to a travel clinic in Bettendorf, Iowa for pre-travel advice and vaccinations. From October 2019 to March 2020, four hundred twelve (n=412) patients presented to the clinic. Intended travel to the Western Pacific region (China, Japan, Korea, etc.) decreased dramatically during the study period. All 412 patients were followed in the electronic medical record for the period after their planned travel and only three (3) presented for COVID-19 testing. Two (2) tested positive, and both of these infections were linked to workplace exposures and not due to travel. News of the growing pandemic and travel warnings likely altered patients’ travel plans and decreased travel to the most affected regions of the world in the early months of the COVID-19 pandemic. Based on our study, travel was not a significant source of COVID-19 exposure for patients seen at this clinic.
Clinical implementation of PLANET®Dose for dosimetric assessment after [177Lu]Lu-DOTA-TATE: comparison with Dosimetry Toolkit® and OLINDA/EXM® V1.0
Authors: Santoro Lore , Pitalot Laurine , Trauchessec Dorian , Mora-Ramirez Erick , Kotzki Pierre-Olivier , Bardiès Manuel , Deshayes Emmanuel
Published: November 2020

Background: The aim of this study was to compare a commercial dosimetry workstation (PLANET®Dose) and the dosimetry approach (GE Dosimetry Toolkit® and OLINDA/EXM® V1.0) currently used in our department for quantification of the absorbed dose (AD) to organs at risk after peptide receptor radionuclide therapy with [177Lu]Lu-DOTA-TATE.Methods: An evaluation on phantom was performed to determine the SPECT calibration factor variations over time and to compare the Time Integrated Activity Coefficients (TIACs) obtained with the two approaches. Then, dosimetry was carried out with the two tools in 21 patients with neuroendocrine tumours after the first and second injection of 7.2 ± 0.2 GBq of [177Lu]Lu-DOTA-TATE (40 dosimetry analyses with each software). SPECT/CT images were acquired at 4h, 24h, 72h and 192h post-injection and were reconstructed using the Xeleris software (General Electric). The liver, spleen and kidneys masses and TIACs were determined using Dosimetry Toolkit® (DTK) and PLANET®Dose. The ADs were calculated using OLINDA/EXM® V1.0 and the Local Deposition Method (LDM) or Dose voxel-Kernel convolution (DK) on PLANET®Dose.Results: With the phantom, the 3D calibration factors showed a slight variation (0.8% and 3.3%) over time, and TIACs of 225.19h and 217.52h were obtained with DTK and PLANETâDose, respectively. In patients, the root mean square deviation value was 8.9% for the organ masses, 8.1% for the TIACs, and 9.1% and 7.8% for the ADs calculated with LDM and DK, respectively. The Lin’s concordance correlation coefficient was 0.99 and the Bland-Altman plot analysis estimated that the AD value difference between methods ranged from -0.75 Gy to 0.49 Gy, from -0.20 Gy to 0.64 Gy, and from -0.43 to 1.03 Gy for 95% of the 40 liver, kidneys and spleen dosimetry analyses. The dosimetry method had a minor influence on AD differences compared with the image registration and organ segmentation steps.Conclusions: The ADs to organs at risk obtained with the new workstation PLANET®Dose are concordant with those calculated with the currently used software and in agreement with the literature. These results validate the use of PLANET®Dose in clinical routine for patient dosimetry after targeted radiotherapy with [177Lu]Lu-DOTA-TATE.
Water treadmill training attenuates blood-spinal cord barrier disruption in rats by promoting angiogenesis and inhibiting matrix metalloproteinase-2/9 expression following spinal cord injury
Authors: Ying Xinwang , Xie Qingfeng , Li Shengcun , Yu Xiaolan , Zhou Kecheng , Yue Jingjing , Chen Xiaolong , Tu Wenzhan , Yang Guanhu , Jiang Songhe
Published: November 2020

Background: The permeability of the blood-spinal cord barrier (BSCB) is mainly determined by junction complexes between adjacent endothelial cells (ECs), including tight junctions (TJs) and adherens junctions (AJs), which can be severely damaged after spinal cord injury (SCI). Exercise training is a recognized method for the treatment of SCI. The destruction of the BSCB mediated by matrix metalloproteinases (MMPs) leads to inflammation, neurotoxin production, and neuronal apoptosis. The failure of new blood vessels to effectively regenerate is also an important cause of delayed recovery after SCI. For the first time, we introduced water treadmill training (TT) to help SCI rats successfully exercise and measured the effects of TT in promoting recovery after SCI and the possible mechanisms involved.Methods: Sprague-Dawley (200–250g) rats were randomly divided into the following three groups: sham operated, SCI, and SCI + TT. Animals were sacrificed at 7 or 14 d post-surgery. The degree of neurological deficit, tissue morphology and BSCB permeability were assessed by the Basso-Beattie-Bresnahan (BBB) motor function scale and appropriate staining protocols, and apoptosis, protein expression and vascular EC ultrastructure were assessed by TUNEL staining, Western blotting, immunofluorescence and transmission electron microscopy (TEM).Results: Our experiments showed that TT reduced permeability of the BSCB and decreased structural tissue damage. TT significantly improved functional recovery when compared with that in the SCI group; TJ and AJ proteins expression increased significantly after TT, and training reduced apoptosis induced by SCI. TT could promote angiogenesis, and MMP-2 and MMP-9 expression was significantly inhibited by TT.Conclusions: The results of this study indicate that TT promotes functional recovery for the following reasons: TT (1) protects residual BSCB structure from further damage, (2) promotes vascular regeneration, and (3) inhibits MMP-2/9 expression to mitigate BSCB damage.
First absolute seasonal temperature estimates for greenhouse climate from clumped isotopes in bivalve shells
Authors: Winter Niels de , Müller Inigo , Kocken Ilja , Thibault Nicolas , Ullmann Clemens Vinzenz , Farnsworth Alexander , Lunt Daniel , Claeys Philippe , Ziegler Martin
Published: November 2020

The seasonal variability of sea surface temperatures plays a fundamental role in climate dynamics and species distribution. As such, it is essential to better understand seasonal variability in warm climates of the past. Previous reconstructions of seasonality in deep time are relatively unconstrained, relying on unsupported assumptions such as estimates of seawater composition and negligible seasonal bias. This work presents the first absolute seasonal temperature reconstructions based on clumped isotope measurements in bivalve shells which, critically, do not rely on these assumptions. Our new approach reconstructs highly precise mid-latitude (~50°N) monthly temperatures from individual oyster and rudist shells of the Campanian (78 million years ago) greenhouse period (15—27 °C seasonal range). Our analysis demonstrates that seasonal bias and previous assumptions about sea water oxygen isotope composition can lead to highly inaccurate temperature reconstructions, distorting our understanding of the behavior of greenhouse climates and our ability to model them. Our results agree remarkably well with fully coupled climate model simulations showing greenhouse climates outside the tropics were warmer with higher seasonality than previously thought.
Genetic and clinical phenotypic analysis of familial stapes sclerosis caused by a NOG mutation
Authors: Yu Rong , Jiang Hongqun , Luo Wugen
Published: November 2020

Background: The noggin protein encoded by the NOG gene can interfere with the binding of bone morphogenetic protein to its receptor, thus affecting bone and joint development. The symptoms include abnormal skeletal development and conductive deafness.Methods: In a retrospective study, clinical data of the proband and her family members, including 8 people and 50 healthy normal controls, were collected. Second-generation sequencing was performed on peripheral blood samples from them.Results: The sequencing analysis indicated that in the proband, the NOG gene had a c.532T>C, p.C178R (cytosine deletion, NM_005450.6:c.532T>C), leading to an amino acid change. The proband's father, grandmother, second sister, and third sister also had this mutation, whereas family members with normal phenotypes did not have the mutation.Conclusion: Analysis of this family showed that the novel presentation of the c.532T>C mutation in the NOG gene resulted in syndrome-type autosomal dominant inheritance reflected in a mild clinical phenotype, which is of great importance for further studies of the clinical phenotype and pathogenesis of stapes sclerosis.
The effects of family physician–contracted service on health-related quality of life and equity in health in China
Authors: Lai Sha , Lu Li , Zhou Zhongliang , Shen Chi , Yang Xiaowei , Zhao Yaxin , Zhang Xiaolong
Published: November 2020

Background: Family physician–contracted service (FPCs) has been recently implemented in Chinese primary care settings. This study was aimed at measuring the effects of FPCs on residents’ health-related quality of life (HRQoL) and equity in health among the Chinese population. Methods: The study data was drawn from the 2018 household health survey (Shaanxi Province, China) using multistage, stratified cluster random sampling. We measured HRQoL using EQ-5D-3L based on the Chinese-specific time trade-off values set. Coarsened exact matching (CEM) technique was used to control for confounding factors between residents with and without a contracted family physician. The concentration index (C) was calculated to measure equity in health. Results: Individuals with a contracted family physician had significantly higher HRQoL than those without, after data matching (0.9355 vs. 0.8995; P < 0.001). Additionally, the inequity in HRQoL among respondents with a contracted family physician was significantly lower than those without a contracted FP (Cs of EQ-5D utility score: 0.0084 vs. 0.0263; p<0.001). Conclusions: This study highlights the positive effects of FPCs on HRQoL and socioeconomic-related equity in HRQoL. Future efforts should prioritize the economically and educationally disadvantaged groups, the expansion of service coverage, and the competency of family physician teams to further enhance health outcome and equity in health.
Radiosensitization of breast cancer cells using AS1411 aptamer-conjugated gold nanoparticles
Authors:   Somayeh Sadat Mehrnia1, Hashemi Bijan , Mowla Seyed Javad , Nikkhah Maryam , Arbabi Azim
Published: November 2020

Background: Gold nanoparticles (GNPs) have been used to sensitize cancer cells and enhance the absorbed dose delivered to such cells. Active targeting can provide specific effect and higher uptake of the GNPs in the tumor cells, while having small effect on healthy cells. The aim of this study was to assess the possible radiosensitiazation effect of GNPs conjugated with AS1411 aptamer (AS1411/GNPs) on cancer cells treated with 4 MeV electron beams.Materials and Methods: Cytotoxicity studies of the GNPs and AS1411/GNPs were carried out with MTT and MTS assay in different cancer cell lines of MCF-7, MDA-MB-231 and mammospheres of MCF-7 cells. Atomic absorption spectroscopy (AAS) confirmed the cellular uptake of the gold particles. Radiosensitizing effect of the GNPs and AS1411/GNPs on the cancer cells was assessed by clonogenic assay.Result: AS1411 aptamer increased the Au uptake in MCF-7 and MDA-MB-231 cells. Clonogenic survival data revealed that AS1411/GNPs at 12.5 mg/L could result in radiosensitization of the breast cancer cells and lead to a sensitizer enhancement ratio (SER) of 1.35 and 1.66 and 1.91 for MCf-7, MDA-MB-231 and mammosphere cells.Conclusion: Gold nanoparticles delivery to the cancer cells was enhanced by AS1411 aptamer and led to enhanced radiation induced cancer cells death. The combination of our clonogenic assay and Au cell uptake results suggested that AS1411 aptamer has enhanced the radiation-induced cell death by increasing Au uptake. This enhanced sensitization contributed to cancer stem cell-like cells to 4 MeV electron beams. This is particularly important for future preclinical testing to open a new insight for the treatment of cancers.
Personal Social Capital and Self-Rated Health among Middle-Aged and Older Adults: A Cross-sectional Study Exploring the Roles of Leisure-Time Physical Activity and Socioeconomic Status
Authors: Kim Youngdeok , Schneider Tim , Faß Eric , Lochbaum Marc
Published: November 2020

Background: Personal social capital, which refers to the scope and quality of an individual’s social networks within a community, has received increasing attention as a potential sociological factor associated with better individual health; yet, the mechanism relating social capital to health is still not fully understood. This study examined the associations between social capital and self-rated health while exploring the roles of leisure-time physical activity (LTPA) and socioeconomic status (SES) among middle-aged and older adults. Methods:Cross-sectional data were collected from 662 middle-aged and older adults (Mean age: 58.11±10.59 years old) using the Qualtrics survey panel. Personal Social Capital Scale was used to measure bonding and bridging social capital and the International Physical Activity Questionnaire was used to assess LTPA levels. SES was assessed by education and household income levels. Self-rated health was assessed using a single item, by which the participants were categorized into the two groups, having ‘good’ vs. ‘not good’ self-rated health. A series of univariate and multivariate logistic regression models were established to examine the independent and adjusted associations of social capital with self-rated health and to test mediating and moderating roles of LTPA and SES, respectively.Results:Bonding and bridging social capital were positively associated with self-rated health (Odds ratios = 1.11 and 1.09; P’s <.05, respectively), independent of LTPA that was also significantly associated with greater self-rated health (P-for-linear trends = .007). After adjusting SES, the associations of social capital were significantly attenuated and there was a significant interaction effect by household income (P-for-interaction = .012). Follow-up analyses stratified by household income showed that beneficial associations of social capital with self-rated health were more apparent among the people with low and high levels of household income; yet, LTPA was the stronger predictor of self-rated health among those in the middle class of household income. Conclusions: Findings suggest that both social capital and LTPA are associated with better self-rated health; yet, these associations vary by SES. The health policymakers should address both social capital and LTPA for enhancing perceived health among aging populations but may need to consider varying SES backgrounds.
A Preliminary Clinical Trial to Evaluate 64Cu-NOTA-Trastuzumab as a Positron Emission Tomography Imaging Agent in Patients with Breast Cancer
Authors: Lee Inki , Lim Ilhan , Byun Byung Hyun , Kim Byung Il , Choi Chang Woon , Woo Sang-Keun , Kim Kwang Il , Lee Kyo Chul , Kang Joo Hyun , Seong Min-Ki , Kim Hyun-Ah , Noh Woo Chul , Lim Sang Moo
Published: November 2020

Background: The purpose of this study was to evaluate both the biodistribution and safety of 64Cu-1,4,7-triazacyclononane-1,4,7-triacetic acid (NOTA)-Trastuzumab, a novel 64Cu-labelled positron emission tomography (PET) tracer for human epidermal growth factor receptor 2 (HER2) in patients with breast cancer.Methods: PET images at 1, 24, and 48 h after 296 MBq of 64Cu-NOTA-Trastuzumab injection were obtained from seven patients with breast cancer. Both the primary tumors’ and metastatic lesions’ maximum standardized uptake value (SUVmax) was evaluated. The mean SUVmax (SUVmean) was evaluated in the other organs, including the blood pool, liver, kidney, muscle, spleen, bladder, and the lungs, as well as the bones. Moreover, the internal radiation dosimetry was calculated using the OLINDA/EXM software. Safety was assessed based on feedback regarding adverse reactions and safety-related issues within 1 month after 64Cu-NOTA-Trastuzumab administration.Results: 64Cu-NOTA-Trastuzumab PET images showed that the overall SUVmean values in each organ negatively correlated with time. The liver’s average SUVmean values were measured at 5.3 ± 0.7, 4.8 ± 0.6, and 4.4 ± 0.5 on 1 h, 24 h, and 48 h after injection, respectively. The average SUVmean blood values were measured at 13.1 ± 0.9, 9.1 ± 1.2, and 7.1 ± 1.9 on 1 h, 24 h, and 48 h after injection, respectively. The SUVmax of HER2-positive tumors were relatively higher than HER2-negative tumors (8.6 ± 5.1 and 5.2 ± 2.8 on 48 h after injection, respectively). Tumor-to-background ratios were higher in the HER2-positive tumors than in the HER2-negative tumors. No adverse events related to 64Cu-NOTA-Trastuzumab were reported. The calculated effective dose with a 296 MBq injection of 64Cu-NOTA-Trastuzumab was 2.96 mSv. The highest absorbed dose was observed in the liver (0.076 mGy/MBq), followed by the spleen (0.063 mGy/MBq), kidney (0.044 mGy/MBq), and heart wall (0.044 mGy/MBq).Conclusions: 64Cu-NOTA-Trastuzumab showed a specific uptake at the HER2-expressing tumors, thus making it a feasible and safe monitoring tool of HER2 tumor status in patients with breast cancer.Trial registration: CRIS, KCT0002790. Registered 02 February 2018, https://cris.nih.go.kr
Embedding the United Nations sustainable development goals into energy systems analysis – expanding the food-energy-water nexus
Authors: Niet Taco , Arianpoo Nastaran , Kuling Kamaria , Wright Andrew
Published: November 2020

BackgroundThere have been numerous studies that consider the nexus interactions between energy systems, land use, water use and climate adaptation and impacts. These studies have filled a gap in the literature to allow for more effective policymaking by considering the trade-offs between land use, energy infrastructure as well as the use of water for agriculture and providing energy services. Though these studies fill a significant gap in the modelling literature, we argue that more work is needed to effectively consider policy trade-offs between the 17 United Nations Sustainable Development Goals (SDGs) to avoid missing important interactions.ResultsWe examine the 17 SDGs individually to determine if it should be included in a modelling framework and the challenges of doing so. We show that the nexus of climate, land, energy and water needs to be expanded to consider economic well-being of both individuals and the greater economy, health benefits and impacts, as well as land use in terms of both food production and in terms of sustaining ecological diversity and natural capital. Such an expansion will allow energy systems models to better address the trade-offs and synergies inherent in the SDGs. Luckily, although there are some challenges with expanding the nexus in this way, we feel the challenges are generally modest and that many model structures can already incorporate many of these factors without significant modification.Finally, we argue that SDGs 16 and 17 cannot be met without open-source models and open data to allow for transparent analysis that can be used and reused with a low cost of entry for modellers from less well off nations.ConclusionsTo effectively address the SDGs there is a need to expand the common definition of the nexus of climate, land, energy, and water to include the synergies and trade-offs of health impacts, ecological diversity and the system requirements for human and environmental well-being. In most cases, expanding models to be able to incorporate these factors will be relatively straight forward, but open models and analysis are needed to fully support the SDGs.
Pretreatments for enhancing sewage sludge reduction and reuse in lipid production
Authors: Chen Jiaxin , Li Ji , Zhang Xiaolei , Wu Zhaoyang
Published: November 2020

Background: Converting wastewater sludge to lipid is considered as one of the best strategies of sludge management. The current problem of lipid production from wastewater sludge is the low yield (0.10-0.16 g lipid/g dry sludge) due to the low availability of easily uptaken materials (such as soluble monosaccharide and oligosaccharide) in sludge to oleaginous microorganism (Rhodotorula glutinis, Trichosporon oleaginosus, Lipomyces starkeyi). Pretreatments are efficient methods to improve sludge bioavailability. This study is aimed to achieve high lipid production from sludge and high sludge reduction. Results: In this study, it was observed that the soluble chemical oxygen demand (SCOD) had significantly increased after different pretreatment. The SCOD in the supernatant was increased from 32.64 to 180.25 mg/L, 924.16 mg/L, 1029.89mg/L and 3708.31 mg/L after acidic (pH 2 for 2 h), alkaline (pH 12 for 2 h), microwave irradiation (15 min with 5 min interval), and ultrasonication (30 min at 450 W and 20 kHz frequency with 5 s on and 2 s off mode) pretreatment, respectively. Pretreatments have also increased the release of total nitrogen (TN) and total phosphorus (TP) from solids. The sludge after different pretreatments were used as medium for lipid production, and the highest lipid content (36.67% g/g) was obtained in the fermentation with ultrasonication pretreatment sludge, and the sludge reduction was 63.10%. For other pretreatments, the lipid content and sludge reduction were 18.42% and 32.63% in acid pretreatment case, 21.08% and 36.44% in alkaline pretreatment case, and 26.31% and 43.03% in microwave pretreatment case, respectively.Conclusion: It was found that ultrasonication pretreatment was the most efficient way to increase the sludge biodegradability (SCOD) and to release TN and TP from solid phase to liquid phase. Pretreated sludge for lipid production achieved significant improvement in lipid yield and sludge reduction. Lipids produced from pretreated sludge were transesterified to biodiesel and the analysis showed that the biodiesel had a similar composition as commercial biodiesel. The study reveals that pretreatment on sludge is a promising method for enhancing biological sludge management efficiency.
Modelling Cost-Effectiveness of Syphilis Detection Strategies in Prisoners: Exploratory Exercise in a Chilean Male Prison
Authors: Castillo-Laborde Carla , Gajardo Pedro , Ferrari Manuel Nájera-De , Matute Isabel , Hirmas-Adauy Macarena , Aguirre Pablo , Ramírez Héctor , Rámirez Daniel , Aguilera Ximena
Published: November 2020

BACKGROUND: Syphilis, together with other sexually transmitted infections, remains a global public health problem that is far from being controlled. People deprived of liberty are one of the vulnerable population. Control activities in prisons rely mostly on passive case detection, despite the existence of affordable alternatives that would allow switching to active case-finding strategies. Our objective was to develop a mathematical modelling framework for cost-effectiveness evaluation, from a health system perspective, of different approaches using rapid tests for the detection of syphilis in inmates' populations and to explore the results based on a Chilean male prison population. Methods: A compartmental model was developed to characterize the transmission dynamics of syphilis inside a prison with the ongoing strategy (passive case detection, with VRDL + FTA-ABS), considering the entrance and exit of inmates over a 40 year period. The model allows simulation of the implementation of a reverse algorithm for the current situation (rapid test + VDRL), different screening strategies (entry point, massive periodically; both with rapid test + VDRL) and treatment of detected cases. The parameters for the exploratory exercise were obtained from systematic searches of indexed and grey literature and field work (EQ-5D questionnaire application and key actors interviews). Probabilistic sensitivity analysis was conducted to account for uncertainty in relevant parameters. RESULTS: The proposed framework allows the evaluation of different detection strategies. In this study, all the strategies were cost-effective in the baseline scenario when considering an ICER threshold of 1 Chilean GDP per capita (US$15,000). The strategies most likely to be cost-effective (over 80% probability) were: current situation with reverse algorithm, entry point screening and mass screening every two years; the latter was the most effective, achieving the lowest prevalence (0.7% and 1.7% over the period versus the 3% prevalence in the current situation).CONCLUSIONS: Mathematical modelling that considers the performance of different tests and detection strategies could be a useful tool for decision making. The exploratory results show the efficiency of adopting both the use of the rapid tests and performing active case detection to significantly reduce the burden of syphilis in Chilean prisons in the near future.