bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of the Mobilization of Uranium Isotopes in a Sandstone Aquifer Using Methods for the Extraction of Uranium with Different Strength Reagents in Combination with Groundwater Data
Authors: Malov Alexander I. , Zykov Sergey B.
Published: November 2019

A partial extraction procedure was used to study the distribution of uranium in the mineral phases of rocks of an aquifer of sandy-clay deposits of the Vendian in the northwest of Russia. This work is a part of a research project to develop a method for combined radiocarbon and uranium-isotope dating of groundwater. Representative aliquots of each core sample were subjected to five "partial" extractions by treatment with: distilled water, low mineralized fresh natural groundwater, minopolycarboxylic acid chelating agent (0.05M EDTA), 0.5M HCl, 15M HNO3, and a total digestion, with U isotopes reported in this study for each procedure. The following mineral phases of core samples: adsorbed material, carbonate minerals, amorphous iron oxides, aluminosilicates partial digestion and a crystalline iron oxides, aluminosilicates total digestion and a clay/quartz resistate were characterized. Red-colored siltstones depleted in uranium in relatively readily soluble mineral phases. The concentration of adsorbed uranium was established in the amount of 15.8±2.1 - 30.5±3.9 μg/kg. Carbonate minerals contain even less of this element. In iron hydroxides and the most readily soluble aluminosilicates, its concentrations are in the range 168±24 - 212±28 μg/kg. The most insoluble fraction contains 1.65±0.21 - 4.32±0.45 mg/kg of uranium. In green-colored siltstones, the concentration of adsorbed uranium is much higher: 106±14 - 364±43 μg/kg. Carbonate minerals and amorphous iron oxides contain 1.91±0.21 - 2.34±0.26 mg/kg of uranium. In aluminosilicates and a clay/quartz resistate, uranium concentrations are 5.6±0.5 - 16.8±1.4 mg/kg. Elevated values of 234U:238U activity ratio prevail in the adsorbed material and iron hydroxides. In aluminosilicates and clay/quartz resistate, the values decrease. This indicates the replacement of primary sedimentogenic uranium by secondary hydrogenic uranium adsorbed on the surface of minerals and coprecipitated with iron hydroxides. The results obtained made it possible to carry out preliminary quantitative estimates of the retardation factor and recoil loss factor of uranium in the groundwater of siltstones of the studied Vendian aquifer.
Hydrogen Evolution on Nano-Structured CuO/Pd Electrode: Raman Scattering Study
Authors: Juodkazyte Jurga , Juodkazis Kestutis , Matulaitiene Ieva , Sebeka Benjaminas , Savickaja Irena , Balcytis Armandas , Nishijima Yoshiaki , Niaura Gediminas , Juodkazis Saulius
Published: November 2019

In this study the processes taking place on the surfaces of nanostructurized Cu/CuO and Cu/CuO/Pd electrodes at different potential, $E$, values in the solutions of 0.1 M KOH in H$_2$O and D$_2$O (heavy water) were probed by the surface enhanced Raman spectroscopy (SERS) and analysis of electrochemical reactions occurring under experimental conditions is presented. Bands of the SERS spectra of Cu/CuO/Pd electrode observed in the range of $E$ values from +0.3~V to 0 V~(SHE) at 1328 - 1569~cm$^{-1}$ are consistent with the existence of species which are adsorbed or weakly bound to the surface with the energy of interaction close to 15 - 21~kJ mol$^{-1}$. These bands can be attributed to the ad(ab)sorbed (H$_3$O$^+$)$\rm{_{ad}}$, (H$_2^+$)$\rm{_{ab}}$ and (H$_2^+$)$\rm{_{ad}}$ ions as intermediates in reversible HER/HOR processes taking place on Cu/CuO/Pd electrode. There was no isotopic effect observed; this is consistent with a dipole nature of electron-ion pair formation of adsorbed (H$_3$O$^+$)$\rm{_{ad}}$ and (H$_2^+$)$\rm{_{ad}}$ or (D$_3$O$^+$)$\rm{_{ad}}$ and (D$_2^+$)$\rm{_{ad}}$. In accordance with literature data SERS bands at 125-146~cm$^{-1}$ and $\sim 520-565$~cm$^{-1}$ were assigned to Cu(I) and Cu(II) oxygen species. These findings corroborate the mechanism of cascading reduction of water.
WITHDRAWN: Evaluation of PAX8 Expression Promotes the Proliferation of Stomach Cancer cells
Authors: Bie Liang-Yu , Li Ning , Luo Su-Xia , Deng Wen-Ying , Lu Xiao-Yu , Guo Ping
Published: November 2019

Background: PAX8 was identified as a mitosis-related regulator involved in the pathogenesis of human tumors and an indicator of the prognosis for patients. However, PAX8 function on proliferation in stomach cancer have not been studied. Aim: This study was aimed to explore the expression pattern of PAX8 in stomach cancer, and investigate the effect of PAX8 on the proliferation of stomach cancer cells. Methods: PAX8 expression pattern in stomach cancer was investigated in the “TCGA” database and compared in cancer and adjacent tissues of 36 clinical samples, in which the co-expression of SOX13 and PAX8 was confirmed by qRT-PCR. Based on the clinical record and IHC staining results, the survival curve was also mapped. Western blotting and qRT-PCR was used to analyze the effect of SOX13 on PAX8 expression in AGS and MGC803 cells, and the downstream effector Aurora B and Cyclin B1 expression. ChIP and luciferase assay were performed to explore SOX13 locate on the promoter of PAX8. Furthermore, CCK8, clone formation, EdU incorporation assay, and flow cytometry were used to detect the proliferative ability of AGS and MGC803 cell lines stably silenced PAX8. Results: PAX8 and SOX13 were identified to be synchronously upregulated in primary stomach cancer tissues and the stomach cancer TCGA datasets, and stomach cancer patients of combined high PAX8 and SOX13 expression showed worse prognosis. Furthermore, SOX13 can mediate PAX8 and its targeted genes expression, including Aurora B and Cyclin B1, in AGS and MGC803 cell lines. Flow cytometry and EdU incorporation assays showed that silencing PAX8 can block the cell cycle of stomach cancer cell in G1 phase and SOX13 expression can rescue the arrested proliferative process induced by PAX8 silenced in CCK8 and colony formation assays. Conclusion: -SOX13 participated in the elevated expression of PAX8, which promote the proliferation of stomach cancer cells, and both SOX13 and PAX8 play an oncogene role in stomach cancer.
Trends in maternal use of snus and smoking tobacco in pregnancy. A register study in Southern Norway
Authors: Rygh Ellen , Gallefoss Frode , Grøtvedt Liv
Published: November 2019

Background The use of tobacco products including Swedish snus (moist snuff) in pregnancy may cause adverse health outcomes. While smoking prevalence has decreased among fertile women in Norway, snus use has increased during the last years. We investigated whether these trends were reflected also during pregnancy in a population of women in Southern Norway. Methods Data on smoking tobacco and snus use at three time points before and during pregnancy for 20 844 women were retrieved from the electronic birth record for the years 2012-2017. The results for the three-year period 2015-2017 were compared with a previously studied period 2012-2014. Prevalence and quit rates of tobacco use within groups of age, parity and education were reported. Within the same groups adjusted quit rates were analyzed using logistic regression. Mean birthweight and Apgar score of offspring were calculated for tobacco-users and non-users. Results There was an increase of snus use before pregnancy from the period 2012-2014 to the period 2015-2017 from 5.1% (CI; 4.6 to 5.5) to 8.4% (CI; 7.8 to 8.9). Despite this, the use of snus during pregnancy did not increase from the first to the second period, but stabilized at 2.8% (CI; 2.5 to 3.2) in first trimester and 2.0% (CI; 1.7 to 2.2) in third trimester. Cigarette smoking decreased significantly both before and during pregnancy. Snus use and smoking during pregnancy were associated with a reduction in average birthweight, but no significant effects on Apgar scores. Odds ratios for quitting both snus and smoking tobacco during pregnancy were higher for women aged 25-34 years, for the primiparas and for those with a high level of education. Pregnant women were more likely to have quit tobacco use in the last time period compared to the first. Conclusions While smoking during pregnancy was decreasing, the use of snus remained constant, levelling off to around 3% in first trimester and 2% in third trimester. Approximately 25% of those that used snus, and 40% that smoked before pregnancy, continued use to the third trimester. This calls for a continuous watch on the use of snus and other nicotine products during pregnancy.
Identification and characterization of differentially expressed exosomal microRNAs in bovine milk infected with Staphylococcus aureus
Authors: Ma Shaoyang , Tong Chao , Ibeagha-Awemu Eveline M. , Zhao Xin
Published: November 2019

Background: MicroRNAs (miRNA) in milk-derived exosomes may reflect pathophysiological changes caused by mastitis. This study profiled miRNAs in exosomes from both normal milk and mastitic milk infected by Staphylococcus aureus (S. aureus). The potential targets for differentially expressed (DE) miRNAs were predicted and the target genes for bta-miR-378 and bta-miR-185 were also validated. Results: Total RNA from milk exosomes was collected from healthy cows (n=3, the control group) and S. aureus infected cows (n=6, the SA group). Two hundred ninety miRNAs (221 known and 69 novel ones) were identified. Among them, 22 known and 15 novel miRNAs were differentially expressed. Target genes of DE miRNAs were significantly enriched in intracellular protein transport, endoplasmic reticulum and identical protein binding. Two miRNAs (bta-miR-378 and bta-miR-185) with high read counts and log 2 fold changes (>3.5) were significantly higher in mastitic milk infected with S. aureus. One target gene (VAT1L) of bta-miR-378 and five target genes (DYRK1B, MLLT3, HP1BP3, NPR2 and PGM1) of bta-miR-185 were validated. Conclusion: DE miRNAs in exosomes from normal and S. aureus infected milk were identified. The predicted targets for two DE miRNAs (bta-miR-378 and bta-miR-185) were further validated. The linkage between the validated target genes and diseases suggested that we should pay particular attention to exosome miRNAs from mastitic milk in terms of milk safety.
Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism
Authors: Park Eun Sil , Yoon Ju Young
Published: November 2019

Background

Congenital hypothyroidism (CH) is one of the most common endocrine diseases in childhood. A significant proportion of CH cases are transient, but the risk factors for permanent CH (PCH) are not yet well established. The current guidelines suggest using levothyroxine until the age of 3 years, but some studies suggest the possibility of earlier discontinuation. However, few, if any, studies have followed up on the results of early discontinuation. This study aimed to identify predictive factors of transient CH among infants with CH. We also investigated the results in patients who underwent a trial of early discontinuation.

Methods

We gathered data regarding infants diagnosed with CH between July 2005 and July 2014 by retrospective chart review. Among them, early discontinuation subgroup was defined as those who discontinued levothyroxine before 30 months of age.

Results

From the 80 infants (40 males, 40 females) enrolled in this study, 51 were preterm. Nine (11.3%) were diagnosed with PCH. Compared with transient cases, those with PCH were on higher levothyroxine dose at discontinuation (4.3 vs 2.9 µg/kg, P < 0.001). There was no difference in the proportion of permanent cases between preterm and full-term groups. In preterm group,infants with PCH required higher levothyroxine dose at discontinuation than those with transient CH (3.8 vs 2.5 µg/kg, P = 0.018). Levothyroxine discontinuation at a dose of 2.86 µg/kg could suggest PCH (sensitivity, 88.9%; specificity, 71.0%). Among the 9 patients who underwent a trial of early discontinuation, 8 successfully discontinued levothyroxine.

Conclusion

The majority of CH patients discontinued levothyroxine successfully, including those who underwent a trial of early discontinuation. Higher levothyroxine dose at the time of discontinuation was found to be a predictive factor for PCH.
Correlation between clinical parameters of crown and gingival morphology of anterior teeth and periodontal biotypes
Authors: Yin Xiao-jie , Wei Bang-yan , Ke Xiu-ping , Zhang Ting , Jiang Meng-yang , Luo Xia-yan , Sun Hui Qiang
Published: November 2019

Background: In this study, we conducted a quantitative analysis of the clinical parameters of crown and gingival morphology (CGM) of the maxillary anterior teeth (MAT). We also analyzed the correlation of these parameters with periodontal biotype (PB), with a view to providing objective standards for PB diagnosis. Methods: The three-dimensional (3D) maxillary digital models of 56 individuals were obtained using an intra-oral scanner. The following parameters were measured with the SpaceClaim software: gingival angle (GA), papilla width (PW), papilla height (PH), crown length (CL), crown width (CW), crown width/crown length ratio (CW/CL), bucco-lingual width of the crown (BLW), contact surface width (CSW), and contact surface height/crown length ratio (CS/CL). The PBs were determined based on the transparency of the periodontal probe through the gingival sulcus. Independent factors influencing PB were analyzed by logistic regression, and the optimal cutoff values for the independent influencing factors were analyzed using receiver operating characteristic curves (ROC curves). Results: There was a significant difference in the parameters of CGM of the MAT at the left and right sides. The thick biotype accounted for 69.6%, and the parameters of sex, GA, PW, PH, CW and CW/CL were significantly correlated with PBs (P ≤ 0.043). GA (odds ratio (OR) = 1.206) and PW (OR = 5.048) were identified as independent predictive factors of PBs, with areas under the ROC curve (AUC) of 0.807 and 0.881, respectively, and optimal cutoff values of 95.95° and 10.01 mm, respectively. Conclusion: The CGMs of the MAT at the left and right side are symmetrical. The thin biotype accounts for a small proportion, and GA and PW are independent influencing factors of PBs. GA of 95.95° and PW of 10.01 mm are the optimal cutoff values for categorization of individuals as thick biotype. This indicates that when the GA and PW of the right maxillary central incisor are G ≥95.95° and ≥10.01 mm, respectively, there is a higher probability that these individuals will be categorized as thick biotype.
Molecular evolution and expression of opsin genes in Hydra vulgaris
Authors: Munoz Aide Macias , Murad Rabi , Mortazavi Ali
Published: November 2019

Background: The evolution of opsin genes is of great interest because it can provide insight into the evolution of light detection and vision. An interesting group in which to study opsins is Cnidaria because it is a basal phylum sister to Bilateria with much visual diversity within the phylum. Hydra vulgaris (H. vulgaris) is a cnidarian with a plethora of genomic resources to characterize the opsin gene family. This eyeless cnidarian has a behavioral reaction to light, but it remains unknown which of its many opsins functions in light detection. Here, we used phylogenetics and RNA-seq to investigate the molecular evolution of opsin genes and their expression in H. vulgaris. We explored where opsin genes are located relative to each other in an improved genome assembly and where they belong in a cnidarian opsin phylogenetic tree. In addition, we used RNA-seq data from different tissues of the H. vulgaris adult body and different time points during regeneration and budding stages to gain insight into their potential functions. Results: We identified 45 opsin genes in H. vulgaris, many of which were located near each other suggesting evolution by tandem duplications. Our phylogenetic tree of cnidarian opsin genes supported previous claims that they are evolving by lineage-specific duplications. We identified two H. vulgaris genes (HvOpA1 and HvOpB1) that fall outside of the two commonly determined Hydra groups; these genes possibly have a function in nematocytes and mucous gland cells respectively. We also found opsin genes that have similar expression patterns to phototransduction genes in H. vulgaris. We propose a H. vulgaris phototransduction cascade that has components of both ciliary and rhabdomeric cascades. Conclusions: This extensive study provides an in-depth look at the molecular evolution and expression of H. vulgarisopsin genes. The expression data that we have quantified can be used as a springboard for additional studies looking into the specific function of opsin genes in this species. Our phylogeny and expression data are valuable to investigations of opsin gene evolution and cnidarian biology.
Uses of Quick Response Codes in Healthcare Education: A Scoping Review
Authors: Karia Chiraag Thakrar , Hughes Andrew , Carr Sue
Published: November 2019

Background To review published literature on the use of quick response (QR) codes within healthcare education. In addition, the authors aimed to gain information on user perceptions and the challenges faced when implementing QR codes in an educational context. Methods Medline, EMBASE, CINAHL, HMIC and HBE were searched using specified search terms that included ‘quick response code’ and ‘education’. Title and abstract review of 217 publications was performed. Papers which discussed the application of QR codes relevant to healthcare education were included. A total of 24 articles were reviewed and thematic analysis conducted to generate themes. Results Use of QR codes in healthcare education could be broadly aligned to four common themes These included: to increase participant engagement, for simulation training, for just-in-time learning and to facilitate with administrative tasks in training. Perceptions towards the use of QR codes was generally positive. Challenges identified included: problems with technical infrastructure, unavailability of smartphones and resistance to use in certain environments. Conclusions The use of QR codes for healthcare education is increasing and whilst they offer some advantages there are also some important considerations including: provision of the necessary technological infrastructure, patient and staff safety, and governance and adherence to guidelines on safe and appropriate use of this technology in sensitive settings.
Avatar-based versus conventional vital signs display in a central monitor for monitoring multiple patients: A multicenter computer-based laboratory study.
Authors: Garot Olivier , Rössler Julian , Pfarr Juliane , Ganter Michael T. , Spahn Donat R. , Nöthiger Christoph B. , Tscholl David Werner
Published: November 2019

Background Maintaining adequate situation awareness is crucial for patient safety. Previous studies found that the use of avatar-based monitoring (Visual Patient Technology) improved the perception of vital signs compared to conventional monitoring showing numerical and waveform data; and was further associated with a reduction of perceived workload. In this study, we aimed to evaluate the effectiveness of Visual Patient Technology on perceptive performance and perceived workload when monitoring multiple patients at the same time, such as in central station monitors in intensive care units or operating rooms.Methods A prospective, within-subject, computer-based laboratory study was performed in two tertiary care hospitals in Switzerland in 2018. Thirty-eight physician and nurse anesthetists volunteered for the study. The participants were shown four different central monitor scenarios in sequence, where each scenario displayed two critical and four healthy patients simultaneously for 10 or 30 seconds. After each scenario, participants had to recall the vital signs of the critical patients. Perceived workload was assessed with the National Aeronautics and Space Association Task-Load-Index (NASA TLX) questionnaire.Results In the 10-second scenarios, the median number of perceived vital signs significantly improved from 7 to 11 using avatar-based versus conventional monitoring with a median of differences of 5 vital signs, p < 0.001. At the same time, the median NASA TLX scores were significantly lower for avatar-based monitoring (67 vs. 77) with a median of differences of 5 points, p = 0.024. In the 30-second scenarios, vital sign perception and workload did not differ significantly.Conclusions In central monitor multiple patient monitoring, we found a significant improvement of vital sign perception and reduction of perceived cognitive workload using Visual Patient Technology, compared to conventional monitoring. The technology enabled improved assessment of patient status and may, thereby, increase situation awareness and enhance patient safety.
Genomic and evolutionary features of two AHPND positive Vibrio parahaemolyticus strains isolated from shrimp (Penaeus monodon) of south-west Bangladesh
Authors: Ahmmed Shawon , Khan Md. Abdullah-Al-Kamran , Eshik Md. Mostavi Enan , Punom Nusrat Jahan , Islam Abul B.M.M.K. , Rahman Mohammad Shamsur
Published: November 2019

Background Due to its rapid lethal effect in the early stage of shrimp, acute hepatopancreatic necrosis disease (AHPND) causing great economic losses, since its first outbreak in southeast China in 2009. Vibrio parahaemolyticus, carrying the pirA and pirB toxin genes is known to cause AHPND in shrimp. The overall objective of this study was to sequence the whole genome of AHPND positive V. parahaemolyticus strains isolated from shrimp (Peneaus monodon) of south-west region of Bangladesh in 2016 and 2017 and characterize the genomic features and emergence pattern of this marine pathogen. Results Two targeted AHPND positive V. parahaemolyticus strains were confirmed using PCR with 16S rRNA, ldh, AP3 and AP4 primers. The assembled genomes of strain MSR16 and MSR17 were comprised of a total of 5,393,740 bp and 5,241,592 bp, respectively. From annotation, several virulence genes involved in chemotaxis and motility, EPS type II secretion system, Type III secretion system-1 (T3SS-1) and its secreted effectors, thermolabile hemolysin were found in both strains. Importantly, the ~69 kb plasmid was identified in both MSR16 and MSR17 strains containing the two toxin genes pirA and pirB. Antibiotic resistance genes were predicted against β-lactam, fluoroquinolone, tetracycline and macrolide groups in both MSR16 and MSR17 strains. Conclusions The findings of this research may facilitate the tracking of pathogenic and/or antibiotic-resistant V. parahaemolyticus isolates between production sites, and the identification of candidate strains for the production of vaccines as an aid to control of this devastating disease. Also, the emergence pattern of this pathogen can be highlighted to determine the characteristic differences of other strains found all over the world.
Analysis of factors related to recurrence of paediatric hepatoblastoma -A single centre retrospective study
Authors: Yang Wei , Chen Yiwei , Huang Yijin , Wang Huanmin
Published: November 2019

Purpose: This study was performed to identify risk factors associated with recurrence of hepatoblastoma. Methods: A retrospective study was conducted on 56 patients with hepatoblastoma from 2012 to 2015 in Beijing Children’s Hospital. PRETEXT stage, serum alpha fetoprotein (AFP) value, change trend of tumors after treatment and some other clinical characteristics were collected and analyzed. The comparison of independent variables that were not distributed normally was performed with the log-rank test. Results: 28 patients with tumor recurrence and 28 non-recurrence patients were included in this study, the median age at presentation was 46.5 (26, 71.5) months. There was a significant difference in the 3-year recurrence free survival (RFS) probability between the patients over 54 months and those younger than 54 months (p=0.007). After neoadjuvant chemotherapy, the chance of recurrence in PR patients was shown to be significantly lower than that in SD patients (p=0.004). The 3-year RFS of patients with a decrease in AFP of more than 60% after neoadjuvant chemotherapy was significantly higher than that of patients with a decrease rate of less than 60% (p=0.005). Postoperative follow-up revealed that patients whose postoperative AFP fell to normal levels within six months of the start of treatment had a three-year RFS of 68.6%, which is higher than that of patients whose AFP fell below the normal range after six months (p=0.0005). Finally, multivariate analysis by Cox regression showed that AFP that decreased by less than 60% and tumour size that decreased by less than 50% after neoadjuvant chemotherapy were significant independent prognostic risk factors for 3-year RFS. Other clinical features were not significantly associated with tumor recurrence in this study. Conclusion: Through this study, we concluded that the prognosis of childhood HB is related to the age at presentation and the response of chemotherapy. The results of the multivariate analysis showed that AFP that decreased by less than 60% and tumour size that decreased by less than 50% after neoadjuvant chemotherapy were significant independent prognostic risk factors. These findings can be helpful to evaluate therapeutic effects and predict prognosis. Key words: hepatoblastoma; alpha fetoprotein; risk factor
SUDDEN INTRAUTERINE UNEXPLAINED DEATH: TIME TO ADOPT UNIFORM POSTMORTEM INVESTIGATIVE GUIDELINES?
Authors: Lavezzi Anna , Piscioli Francesco , Pusiol Teresa , Jorizzo Gianfranco , Ferrero Stefano
Published: November 2019

Background: Worldwide approximately 2.6 million are stillborn, mostly occurring in developing countries. In the great part these deaths are inexplicable. The evenness and standardisation of the diagnostic criteria are prerequisites to understand their pathogenesis. The core goal of this article is to propose new evidence based investigative post-mortem guidelines that should be adopted in all the Institutions especially when a fetal death, after a routine autopsy procedure, is diagnosed as “unexplained”. The proposed protocol is mainly focused on the anatomopathological examination of the autonomic nervous system and in particular of the brainstem where the main centers that control vital functions are located. Methods: Updated investigative guidelines for the examination of unexplained stillbirths, prevalently focused on the histological examination of the brainstem, where the main centers that are involved in monitoring the vital functions are located, are here presented. A section of this protocol concerns the Immunohistochemical evaluation of specific functional markers such as the neuronal nuclear antigen, nicotinic acetylcholine receptors, serotonin, orexin, apoptosis and gliosis. The important role of risk factors, having regard in particular to maternal smoking and air pollution is also contemplated in these guidelines. Results: Specific morphological and/or functional alterations of vital brainstem structures have been found with high incidence in over 100 cases of unexplained fetal death sent to the “Lino Rossi Research Center” of the Milan University according to the Italian law. These alterations were rarely detected in a group of control cases. Conclusions: We hope this protocol can be adopted in all the Institutions notably for the examination of unexplained fetal deaths, in order to make uniform investigations. This will lead to identify a plausible explanation of the pathogenetic mechanism behind the unexplained fetal deaths and to design preventive strategies to decrease the incidence of these very distressing events for both parents and clinicians.
Estimating the number of usability problems affecting medical devices: modelling the discovery matrix
Authors: Vandewalle Vincent , Caron Alexandre , Delettrez Coralie , Pelayo Sylvia , Duhamel Alain , Dervaux Benoit
Published: November 2019

Background Usability studies of medical devices are mandatory for market access. The studies’ goal is to identify and eliminate usability problems that could cause harm the user or limit the device’s effectiveness. In practice, human factor engineers study participants under actual conditions of use and list the problems encountered. This results in a binary discovery matrix in which each row corresponds to a participant, and each column corresponds to a usability problem. One of the main challenges in usability studies is estimating the total number of problems, in order to assess the completeness of the discovery process. Today’s margin-based methods fit the column sums to a binomial model of problem detection. However, the discovery matrix actually observed is truncated because of undiscovered problems, which corresponds to fitting the marginal sums without the zeros. Margin-based methods fail to overcome the bias related to truncation of the matrix. The objective of the present study was to develop and test a matrix-based method for estimating the total number of usability problems. Methods The matrix-based method models the likelihood of the discovery matrix, and allows one to account for all the available information. It also circumvents a drawback of margin-based methods by simultaneously estimating two unknown parameters: the probability of problem detection and the total number of problems. Furthermore, the matrix-based method takes account of a heterogeneous probability of detection, which better reflects a real-life setting. As suggested in the usability literature, a logit-normal prior for the probability of detection is selected. Results We assessed the matrix-based method’s performance in a range of settings reflecting real-life usability studies and with both homogeneous and heterogeneous probabilities of problem detection. In our simulations, the matrix-based method improved the estimation of the number of problems (in terms of bias, consistency, and coverage probability of the confidence interval) in a wide range of settings. We also applied our method to real data from a usability study of infusion pumps. Conclusions Our method should be applied by regulators and device manufacturers to estimate the number of usability problems using the set of statistical routines provided.
Prevalence of depressive symptoms and associated factors among people with Tuberculosis in Ethiopia: meta-analysis
Authors: Bifftu Berhanu Boru , Tiruneh Bewket Tadesse , Guracho Yonas Deressa , Dachew Berihun Assefa
Published: November 2019

Tuberculosis (TB) is a chronic infectious disease caused by mycobacterium tuberculosis. Co-morbid depression among individual with TB is common public health concern that adversely affect the psychological well being of the patient. Thus, the aims of this study were to determine the magnitude of depression and its associated factors among people with TB in Ethiopia. Methods: Databases including: PubMed/Medline, SCOPUS, and HINARI were searched. Weighted inverse variance random-effects model was used to calculate the pooled prevalence of depression. The heterogeneity between studies was measured by the index of heterogeneity (I2 statistics) test. Funnel plots and Egger’s test were used to determine publication bias. Sensitivity test and subgroup analysis were also performed to identify influential study and to account for heterogeneity. Results: In this study, a total of 6430individuals with TB were included from 15 studies. The pooled prevalence of depression was 46% (95% CI; 40% -53%). Tests of heterogeneity was significant (I2= 96.33% and p <0.001). However, funnel plots and Egger’s test showed no evidence of publication bias. Being female, low income, substance use, perceived stigma, extra-pulmonary TB and treatment phase were factors associated with depressive symptoms. Conclusion: In Ethiopia, around half of the TB patients had depressive symptoms. Thus, authors’ suggest the need of mental health screening for people with TB particularly for substance users and socioeconomic disadvantage TB patients. Authors’ also suggest the needs of improving awareness of TB.
Vitamin D and 17β-estradiol upregulate each other's receptors and regulating the AMPK/NF-κB pathway to relieve depressive-like behaviors in female ovariectomized rats
Authors: Zhang Wen-yuan , Guo Yujin , Wang Ke-yi , Jiang Pei
Published: November 2019

Background: A deficiency of vitamin D (VD) or 17β-estradiol (E2) is associated with increased risk of mood disorders such as depression in menopausal females, but the mechanism underlying is still elusive. The present study aims to evaluate whether vitamin D and 17β-estradiol could relieve a depressive-like state through neuroinflammatory regulation in ovariectomized (OVX) rats. Methods: Female SD rats were randomly divided into four groups, namely, control (SHAM), OVX, OVX+VD, and OVX+E2. The treatment procedure was performed for 10 weeks until sacrifice. Results: The chronic administration of vitamin D and 17β-estradiol showed anti-depressive-like activity in the OVX rats. Additionally, vitamin D and 17β-estradiol upregulated each other's receptors, including VDR, ERα, and ERβ in the hippocampus of OVX rats. Vitamin D and 17β-estradiol showed neuroprotective effects by decreasing OVX-induced apoptosis and neuronal damage, regulating the AMPK/NF-κB signaling pathway, and reducing the proinflammatory cytokines (IL-1β, IL-6, and TNFα), as well as iNOS and COX-2 in the hippocampus of OVX rats. Conclusions: The present study demonstrated that vitamin D and 17β-estradiol could upregulate each other's receptors and regulate the AMPK/NF-κB pathway to relieve the OVX-induced depressive-like state. The results should stimulate translational research towards the vitamin D potential for prevention or treatment of menopause-related depression.
Association Between Developmental Dental Anomalies, Early Childhood Caries and Oral Hygiene Status of 3-5-Year-Old Children in Ile-Ife, Nigeria
Authors: Folayan Morenike Oluwatoyin , Alade Michael , Adeniyi Abiola , Tantawi Maha El , Finlayson Tracy L
Published: November 2019

Objectives To determine the association between developmental dental anomalies (DDA), early childhood caries (ECC) and oral hygiene status of 3-5-year-old children resident in Ile-Ife, Nigeria.Methods We analyzed a household survey and clinical examination data collected to determine the association between ECC and maternal psychosocial wellbeing. The outcome variables for the study were ECC and poor oral hygiene. The explanatory variable was the presence of developmental dental anomalies (supernumerary, supplemental, mesiodnes, hypodontial, macrodontial, microdontia, peg-shaped lateral, dens evaginatus, dens invaginatus, talons cusp, fusion/germination, hypoplasia, hypomineralized second molar, fluorosis, amelogenesis imperfecta). The prevalence of each anomaly was determined. Poisson regression analysis was conducted to determine the association between presence of developmental dental anomalies, ECC and oral hygiene status. The model was adjusted for sex, age and socioeconomic status.Results Of the 918 children examined, 75 (8.2%) had DDA, 43 (4.7%) had ECC, and 38 (4.1%) had poor oral hygiene. The most prevalent DDA was enamel hypoplasia (3.9%). Of the 43 children with ECC, 6 (14.0%) had enamel hypoplasia and 3 (7.6%) had hypomineralized second primary molar. There was a significant association between ECC and enamel hypoplasia (p<0.001) and a borderline association between ECC and hypomineralized second primary molars (p=0.05). The proportion of children with poor oral hygiene (PR: 2.03; 95% CI: 0.91-4.56; p=0.09) and ECC (PR: 2.02; 95% CI: 0.92-4.46; p=0.08) who had DDA was twice that of children with good oral hygiene and without ECC respectively, although the differences did not reach statistical significance.Conclusion For a population with a high prevalence of enamel hypoplasia and hypomineralized second primary molars, screening for these dental anomalies may be a strategic public health response to reduce the risk of children for ECC.
Two-way Messaging Therapy for Depression and Anxiety: Longitudinal Response Trajectories
Authors: Hull Thomas Derrick , Malgaroli Matteo , Connolly Philippa , Feuerstein Seth , Simon Naomi
Published: November 2019

Background Telemedicine is an ongoing strategy for overcoming access barriers to evidence-based psychotherapy and modes that operate outside pre-scheduled, session-based formats (e.g., two-way messaging) may further address these challenges. However, no study to date has established suitability criteria for this medium.Methods We evaluated individual response trajectories for daily two-way messaging therapy by licensed clinicians using a longitudinal design with a large outpatient sample (n = 10,718) from a telemedicine provider serving urban and rural patients in all 50 states of the US. Symptoms were measured at baseline and every three weeks for a 12 week treatment course with the nine-item Patient Health Questionnaire (PHQ-9) for depression and the seven-item Generalized Anxiety Disorder (GAD-7) for anxiety. Demographics and engagement metrics, such as word count for both patients and therapists, were also included. Growth mixture modeling identified response trajectories and predictors of membership in each trajectory.Results Two subpopulations had remission outcomes (Recovery and Acute Recovery, 30.7% of patients), while two others showed amelioration of symptoms (Depression and Anxiety Improvement, 36.9% of patients). Two subpopulations experienced marginal to no changes in symptoms (Chronic and Elevated Chronic, 32.4% of patients). Patients characterized by the greatest level of remission with treatment (Recovery and Acute Recovery groups) were reliably distinguished by patient characteristics and engagement metrics, including higher use of written communication.Conclusions Patient characteristics suggesting suitability for two-way messaging were identified and could be used for further research and treatment recommendation for individuals presenting with depression and anxiety in digital media.
Coping with Wolf-Hirschhorn Syndrome: quality of life and psychosocial features of family carers
Authors: Berrocoso Sarah , Amayra Imanol , Lázaro Esther , Martínez Oscar , López-Paz Juan Francisco , García Maitane , Pérez Manuel , Al-Rashaida Mohammad , Rodríguez Alicia Aurora , Luna Paula Maria , Pérez-Núñez Paula , Blanco Raquel , Nevado Julián
Published: November 2019

Background: Wolf-Hirschhorn Syndrome (WHS) is a rare, congenital disease characterized by a distinctive facial phenotype, seizures, intellectual disability and developmental delay, and pre and postnatal growth requiring lifelong care. The psychosocial status of the family caregivers of children diagnosed with WHS is unknown. This study aims to characterize the sociodemographic and psychosocial profile of WHS caregivers and analyze how these variables impact their quality of life (QoL) and well-being. Results: The sociodemographic and clinical profile of 22 Spanish caregivers of children with WHS and the characteristics of those affected have been described. Significant relationships were found between sociodemographic and psychosocial characteristics among caregivers. The impact on the parents' QoL and negative relationship with the symptomatology were assessed. The use of engagement strategies such as problem focused coping was associated with improved psychological QoL and social support. Conclusions: WHS caregivers share similarities in their profile and needs with caregivers of children with other rare diseases. Pychosocial support groups involving parents caring for children with the same disease could improve caregivers’ well-being and QoL by strengthening their social support network and using positive coping styles.
Sexual dimorphism in behavior, neuropathology, and biomarkers in a tau P301S mouse model of Alzheimer’s disease
Authors: Sun Yao , Guo Yongqing , Feng Xuejian , Jia Meng , Ai Ning , Dong Yue , Zheng Yayuan , Fu Lu , Yu Bin , Zhang Haihong , Wu Jiaxin , Yu Xianghui , Wu Hui , Kong Wei
Published: November 2019

Tau hyper-phosphorylation has been considered a major contributor to neurodegeneration in Alzheimer’s disease (AD) and related tauopathies, and has gained prominence in therapeutic development for AD. To elucidate the pathogenic mechanisms underlying AD and evaluate therapeutic approaches targeting tau, numerous transgenic mouse models that recapitulate critical AD-like pathology have been developed. Tau P301S transgenic mice is one of the most widely used mouse models in AD research. Extensive studies have demonstrated that sex significantly influences AD pathology, behavioral status and therapeutic outcomes, suggesting that studies using mouse models of AD must consider sex- and age-related differences in neuropathology, behavior, and plasma content. Method: We systematically investigated differences in tau P301S transgenic mice (PS19 line) and wildtype littermates of different sex behavioral performance, tau neuropathology and biomarkers in plasma and brain. Results: Male P301S transgenic mice exhibited significant changes in weight loss, survival rate, clasping, kyphosis, composite phenotype assessment, nest building performance, tau phosphorylation at Ser202/Thr205 and astrocyte activation compared to that of wild type littermates. In contrast, female P301S transgenic mice were only sensitive in the Morris Water Maze and open field test. In addition, we characterized the upregulation of interferon (IFN)-γ, interleukin (IL)-5, and IL-6 and the absense of macrophage-inflammatory protein (MIP)-3α. Male P301S transgenic mice expressed more plasma biomarkers than those of female P301S mice. Conclusion: Our findings highlight sexual dimorphism in the behavior, neuropathology, and biomarkers in tau P301S transgenic AD mice, indicating that the use of male P301S transgenic mice may be more suitable for assessing anti-phosphorylated tau therapeutic strategies for AD and related tauopathies.
Views of health care professionals and policy-makers on the use of surveillance data to combat antimicrobial resistance
Authors: Al-Haboubi Mustafa , Trathen Andrew , Black Nick , Eastmure Elizabeth , Mays Nicholas
Published: November 2019

Background Providing healthcare professionals with health surveillance data aims to support professional and organisational behaviour change. The UK Five Year Antimicrobial Resistance (AMR) Strategy 2013 to 2018 identified better access to and use of surveillance data as a key component. Our aim was to determine the extent to which data on antimicrobial use and resistance met the needs of health care professionals and policy-makers at national, regional and local levels, and how provision could be improved. Methods We conducted 41 semi-structured interviews with national policy makers in the four Devolved Administrations and 71 interviews with health care professionals in six locations across the United Kingdom selected to achieve maximum variation in terms of population and health system characteristics. Transcripts were analysed thematically using a mix of a priori reasoning guided by the main topics in the interview guide together with themes emerging inductively from the data. Views were considered at three levels - primary care, secondary care and national - and in terms of availability of data, current uses, benefits, gaps and potential improvements. Results Respondents described a range of uses for prescribing and resistance data. The principal gaps identified were prescribing in private practice, internet prescribing and secondary care (where hospitals did not have electronic prescribing systems). Some respondents under-estimated the range of data available. There was a perception that the responsibility for collecting and analysing data often rests with a few individuals who may lack sufficient time and appropriate skills. Conclusions There is a need to raise awareness of data availability and the potential value of these data, and to ensure that data systems are more accessible. Any skills gap at local level in how to process and use data needs to be addressed. This requires an identification of the best methods to improve support and education relating to AMR data systems.
Lifetime Ultraviolet Radiation Exposure and Dna Methylation In Blood Leukocytes: The Norwegian Women And Cancer Study
Authors: Page Christian M , Djordjilović Vera , Nøst Therese H , Ghiasvand Reza , Sandanger Torkjel M , Frigessi Arnoldo , Thoresen Magne , Veierød Marit B
Published: November 2019

Background Ultraviolet radiation (UVR) exposure is a leading cause of skin cancers and an ubiquitous environmental exposure. However, the molecular mechanisms relating UVR exposure to melanoma is not fully understood. We aimed to investigate if lifetime UVR exposure influences DNA methylation, and if individual CpG sites could be robustly associated with UVR exposures.Methods We assessed DNA methylation in whole blood in three data sets (N = 183, 191, and 125) from the Norwegian Women and Cancer cohort, using Illumina methylation platforms (450k & EPIC). We studied genome-wide DNA methylation, targeted analyses of CpG sites indicated in the literature, global methylation (average over all CpGs and imputation of LINE-1 specific CpGs), and accelerated aging. Lifetime history of UVR exposure (residential ambient UVR, sunburns, sunbathing vacations and indoor tanning) was collected by questionnaires. Cumulative UVR exposure was calculated by adding sunbathing vacations and indoor tanning. We used one data set for discovery and the other two for replication. Results One CpG site showed a genome-wide significant association between cumulative UVR exposure and DNA methylation (cg01884057) (pnominal=3.96e-08), but was not replicated in any of the two replication sets (pnominal≥0.42). Four CpG sites (cg05860019, cg00033666, cg18984282, cg25792367) showed suggestive associations with the other UVR exposures. Conclusion We performed extensive analyses of the association between long-term UVR exposure and DNA methylation in lymphocytes. There was no indication of a robust effect of past UVR exposure on DNA methylation, and our results do not suggest mediation of UVR effects on melanoma risk by DNA methylation.
Increase of vancomycin-resistant Enterococcus faecium strain type ST117 CT71 at Charité - Universitätsmedizin Berlin, 2008 to 2018
Authors: Weber Anna , Maechler Friederike , Schwab Frank , Gastmeier Petra , Kola Axel
Published: November 2019

In addition to an overall rise in vancomycin-resistant Enterococcus faecium (VREfm), an increase in certain other strain types has been reported in Germany over the past few years. Outbreak analyses at Charité - Universitätsmedizin Berlin revealed the frequent occurrence of VREfm ST117 CT71 isolates in 2017 and 2018. To investigate whether ST117 CT71 have emerged in recent years or whether these strains have been circulating for a longer time, we retrospectively analyzed non-outbreak strains that occurred between 2008 and 2018 to identify frequent sequence types (STs) and cluster types (CTs). Methods In total, 120 VREfm isolates obtained from clinical and surveillance cultures from the years 2008, 2013, 2015, and 2018 were analyzed. Thirty isolates per year comprising the first 7 to 8 non-outbreak isolates of each quarter of the respective year were sequenced using whole genome sequencing. MLST and cgMLST were determined as well as resistance genes and virulence factors. Risk factors for VREfm ST117 were analyzed in a multivariable analysis with patient characteristics as possible confounders. Results The percentage of VREfm of type ST117 increased from 17% in 2008 to 57% in 2018 (p=0.012). In 2008, vanA genotype accounted for 80% of all ST117 isolates compared to 6% in 2018. VanB CT71 first appeared in 2018 and predominated over all other ST117 at 43% (p<0.0001). The set of resistance genes and virulence factors in CT71 (msrC, efmA, ermB, dfrG, and aac(6')-Ii) and virulence factors (acm, esp, hyl, ecbA and sgrA) was also found in other ST117 non-CT71 strains, mainly in CT36. The study population did not differ among the different calendar years analyzed in terms of age, gender, length of stay, or ward type (each p>0.2). Conclusion This study revealed an increase in ST117 strains from 2008 to 2018, accompanied by a shift toward CT71 strains with the vanB genotype in 2018. We did not detect resistance or virulence traits in CT71 that could confer survival advantage compared to other CTs among ST117 strains. To date, it is not clear why ST117 and in particular strain type ST117 CT71 predominates over other strains.