bluuebunny/crossref_metadata_2025 huggingface dataset:
Mobile hotel reservations and customer behavior: Channel familiarity and channel type
Authors: Kim Jinkyung Jenny , Chua Bee-Lia , Han Heesup
Published: August 2020

The present study is centered on mobile hotel reservations in the investigation of the interrelationships between value, attitude, satisfaction, and reuse intention in consideration of the moderating roles of the channel familiarity and the channel type. Utilizing a quantitative approach, the research hypotheses were tested using structural equation modeling and multiple-group analyses. The casual relationships proposed among the study variables were found to all be significant, and the importance of the utilitarian value was substantiated. Moreover, the analysis results denoted that the channel familiarity is an important moderator that affects the strength of the relationships between (1) the attitude and the reuse intention and (2) satisfaction and the reuse intention, which suggests that a different approach should be arranged for novice and expert users. Also, channel type moderated the links between (1) hedonic value and satisfaction, (2) utilitarian value and satisfaction, (3) attitude and the reuse intention, and (4) satisfaction and the reuse intention, which separately provided more relevant implications for the hotel owned and the third-party owned channels.
A systematic review of the prevalence of anxiety symptoms during coronavirus epidemics
Authors: da Silva Marianne Lucena , Rocha Rodrigo Santiago Barbosa , Buheji Mohamed , Jahrami Haitham , Cunha Katiane da Costa
Published: August 2020

Coronavirus pandemics causes systemic and mainly pulmonary changes. We assessed the prevalence of generalized anxiety disorder (GAD) in pandemic survivors and the general population. Papers indexed by MEDLINE/PubMed, The Cochrane, Embase, Lilacs, Scielo, Psycoinfo, and Pepsic databases were searched to April 2020, using GAD and Coronavirus (CoV) infection as keywords. Sixteen studies with 25,779 participants in eight countries were included. A 46% pooled prevalence of anxiety symptoms (95% CI 33.9–58.2%) was found with significant evidence of between-study heterogeneity (Q = 154953, I2 = 99.99%, p < 0.001). Age and sex were not found to be significant moderators for anxiety symptoms. Intervention programs for anxiety symptoms are highly recommended.
Causal Nexus Between FDI Inflows and Its Determinants in SAARC Countries
Authors: K. Rai Sushil , K. Sharma Akhilesh
Published: August 2020

This article aims to understand the drivers of foreign direct investment (FDI) inflows and its nexus with its determinants such as economic growth, inflation rate, labour productivity, infrastructure development, market size, openness of the economy, political stability and corporate tax for South Asian Association for Regional Corporation (SAARC) countries. The article is based on secondary data from the World Bank and International Labour Organization (ILO) for 19 years from 2001 to 2018 for 6 SAARC countries, viz. Bangladesh, Bhutan, India, Nepal, Pakistan and Sri Lanka. The findings indicate that there exists long-run, short-run and joint causal relationship among infrastructure development, market size, openness of the economy, political stability and corporate tax and FDI inflows. Among these variables, the corporate tax is the most important one because it shows bidirectional causality with FDI inflows in the long run as well as short run along with joint strong causality. However, only the coefficients of infrastructure development and corporate tax were found to be positively and negatively significant, respectively. Therefore, better infrastructure development and decrease in corporate tax may enhance FDI inflows in SAARC countries. This infers that with the decrease in corporate tax, more FDI inflows may take place, and higher FDI inflows may decrease in corporate tax further. Therefore, this article suggests that SAARC countries should accelerate the process of integration of their economy with the rest of the world along with political stability, enhance the infrastructure facility and reduce the corporate tax to get the higher FDI inflows.

JEL: F21, F02, C22
The effect of outer ring elastodynamics on vibration and power loss of radial ball bearings
Authors: Turnbull R , Rahmani R , Rahnejat H
Published: August 2020

Ball bearings are an integral part of many machines and mechanisms and often determine their performance limits. Vibration, friction and power loss are some of the key measures of bearing performance. Therefore, there have been many predictive analyses of bearing performance with emphasis on various aspects. The current study presents a mathematical model, incorporating bearing dynamics, mechanics of rolling element-to-races contacts as well as the elastodynamics of the bearing outer ring as a focus of the study. It is shown that the bearing power loss in cage cycles increases by as much as 4% when the flexibility of the outer ring is taken into account as a thick elastic ring, based on Timoshenko beam theory as opposed to the usual assumption of a rigid ring in other studies. Geometric optimisation has shown that the lifetime power consumption can be reduced by 1.25%, which is a significant source of energy saving when considering the abundance of machines using rolling element bearings. The elastodynamics of bearing rings significantly affects the radial bearing clearance through increased roller loads and generated contact pressures. The flexible ring dynamics is shown to generate surface waviness through global elastic wave propagation, not hitherto taken into account in contact dynamics of rollers-to-raceways which are generally considered to be subjected to only localised Hertzian deflection. The elastodynamic behaviour reduces the elastohydrodynamic film thickness, affecting contact friction, wear, fatigue, vibration, noise and inefficiency.
Surviving in the shadow of the un/seen: on the paradoxical in/visibility of El Kazovsky
Authors: Stryker Susan
Published: August 2020

This short, first-person essay describes and briefly evaluates the life and work of the Russian–Hungarian trans-identified artist El Kazovsky (1948–2008). It principally focuses the author’s viewing of ‘The Survivor’s Shadow: The Life and Work of El Kazovsky’ – a massive, 19-room retrospective exhibition at the Hungarian National Gallery in 2015–2016. The author explores the paradox of El Kazovsky’s visibility as a nationally celebrated artist in a moment of extreme state-sanctioned queer-phobia, and the illegibility of his transness. It ends by suggesting that the practice of ‘surviving in shadow’ is increasingly necessary given the continued worldwide drift toward reactionary ethno-nationalist politics that are hostile to trans lives.
Chasing Charley, finding Reed: reaching toward the ghosts of the archive
Authors: Cerankowski KJ
Published: August 2020

The archive consists of memories, documents, and images waiting to be curated into a story. In this article, the author collates archival object encounters into a transgender ‘ghost story’ that marks the impossibility of a straightforward history of the subject, relying instead on embodied encounters with archive objects, or the remnants (ghostly and tangible) of archival subjects. Following the materials of Charley Parkhurst and Reed Erickson, the author makes connections where none previously existed, asking: How do we put life back into the materials of the dead? What do the traces and memories of these ghosts offer the living? What do archive objects activate in the eyes that see them, the ears that listen, and the hearts that race or slow with each haptic encounter? Following these questions, this article pieces together a different kind of narrative history and transition story through the unexpected encounters with the archive and its ghosts.
Trans men’s stealth aesthetics: navigating penile prosthetics and ‘gender fraud’
Authors: Straayer Chris
Published: August 2020

This article examines trans commercial production of penile prosthetics, the efficacy of such products in personal and sex-segregated spaces, and their negative valence in the public sphere. Responding to his own experience of gender dysphoria, Transthetics founder Alex designs and produces products for the reparative and enabling embodiment of trans men. Penile prosthetics reflect the longstanding tension between aesthetics and function in the history of prosthetic limbs. The author posits ‘stealth aesthetics’ as a function-injected realism that pushes into reality via utilization of prosthetics in the performance of real life. For some trans men, the phenomenologically incorporated prosthetic is tantamount to a corporeal penis. Cisnormativity, however, outlaws this equivalence. Recent prosecutions of penile prosthetic embodiment as ‘gender fraud’ punitively restrict trans men’s claim on reality, instead exposing their private bodies to public judgment, where genitals produce gender. By contrast, the author advocates the authorization of gender to produce genitals.
The Influence of Spirituality and Religiosity on US Oncologists’ Personal Use of and Clinical Practices Regarding Complementary and Alternative Medicine
Authors: Powers-James Catherine , Alvarez Adriana , Milbury Kathrin , Barbo Andrea , Daunov Katherine , Lopez Gabriel , Cohen Lorenzo , Delgado-Guay Marvin O. , Olopade Olufunmilayo I. , Lee Richard T.
Published: August 2020

Background:

Cancer patients frequently use complementary and alternative medicine (CAM), and spirituality has been associated with CAM use among patients. We evaluated how oncologists’ spirituality and religiosity are associated with personal use and patient recommendations for CAM.

Methods:

A survey was mailed to 1000 medical oncologists in the United States. The questionnaire asked about oncologists’ approaches to CAM use by patients, focusing on the use of herbs and supplement (HS), and about religiosity and spirituality.

Results:

Of 937 deliverable questionnaires, 392 were returned (response rate 42%). Respondents were mostly men (71%) and Caucasian (76%), with a median age of 48. Approximately 16% reported no religion, 19% Jewish, 24% Catholic, 28% Christian, and 13% other religions. Eighteen percent reported attending religious services at least once a week, including 15% who attend several times per week. Twenty-eight percent reported high theological pluralism (skepticism regarding whether one religion is comprehensively and uniquely true); 58% described themselves as moderately or very spiritual. Self-reported spirituality and religious service attendance were associated with using CAM personally and recommending HS to patients. In multivariate analyses, moderate-high spirituality and attending religious services less than monthly was positively associated with personal use of CAM: odds ratio (OR) = 3.10 (confidence interval [CI] = 1.5-6.5) and OR = 3.04 (CI = 1.5-6.6), respectively. Physicians with moderate to high spirituality were more likely to report recommending CAM in general (OR = 3.07, CI = 1.3-7.1), but less likely to report recommending HS (OR = 0.33, CI = 0.14-0.75).

Conclusion:

Self-reported spirituality is a significant factor among US oncologists’ decision to use CAM and recommend CAM to patients.
Wire Cerclage Versus Cable Closure After Sternotomy for Dehiscence and DSWI: A Systematic Review and Meta-Analysis
Authors: Dixit Apurva , Tam Derrick Y. , Yu Monica , Yanagawa Bobby , Gaudino Mario , Lam Tiffany , Fremes Stephen E.
Published: August 2020

Objective

Cable closure has been introduced as a potential alternative to traditional wire cerclage (WC) for closure of median sternotomy. To evaluate whether cable closure improves patient outcomes, we conducted a systematic review and meta-analysis of the literature.

Methods

Ovid versions of Medline and Embase, and Google Scholar were used for the literature search. This yielded 7 studies ( n = 2,758), which compared traditional WC to cable closure systems. Outcomes included deep sternal wound infection, sternal dehiscence, postoperative pain score, and sternal wound infection.

Results

We found significantly lower incidence of sternal dehiscence for cable closure compared to WC (risk ratio [RR] 0.14, 95% confidence interval [CI]: 0.03 to 0.59 , P < 0.01 , I 2 = 0%) but no difference in DSWI (RR 0.97, 95% CI: 0.39 to 2.42, P = 0.95, I 2 = 33%). Cable closure was also associated with lower pain when compared with the WC group (mean difference −1.04 points, 95% CI: −1.89 to −0.19 , P = 0.02, I 2 = 87%).

Conclusions

This study suggests that cable closure results in less incidence of sternal dehiscence and pain compared to WC. Nonetheless, there remains a limited number of studies on this topic and further high-quality studies are required to confirm the results of this meta-analysis.
Hemodynamic differences by increasing low profile visualized intraluminal support (LVIS) stent local compaction across intracranial aneurysm orifice
Authors: Tian Zhongbin , Zhang Mingqi , Li Gaohui , Jin Rongbo , Leng Xiaochang , Zhang Ying , Wang Kun , Zhang Yisen , Yang Xinjian , Xiang Jianping , Liu Jian
Published: August 2020

Background

The Low-profile Visualized Intraluminal Support device (LVIS) has been successfully used to treat cerebral aneurysm, and the push-pull technique has been used clinically to compact the stent across aneurysm orifice. Our aim was to exhibit the hemodynamic effect of the compacted LVIS stent.

Methods

Two patient-specific aneurysm models were constructed from three-dimensional angiographic images. The uniform LVIS stent, compacted LVIS and Pipeline Embolization Device (PED) with or without coil embolization were virtually deployed into aneurysm models to perform hemodynamic analysis. Intra-aneurysmal flow parameters were calculated to assess hemodynamic differences among different models.

Results

The compacted LVIS had the highest metal coverage across the aneurysm orifice (case 1, 46.37%; case 2, 67.01%). However, the PED achieved the highest pore density (case 1, 19.56 pores/mm2; case 2, 18.07 pores/mm2). The compacted LVIS produced a much higher intra-aneurysmal flow reduction than the uniform LVIS. The PED showed a higher intra-aneurysmal flow reduction than the compacted LVIS in case 1, but the results were comparable in case 2. After stent placement, the intra-aneurysmal flow was further reduced as subsequent coil embolization. The compacted LVIS stent with coils produced a similar reduction in intra-aneurysmal flow to that of the PED.

Conclusions

The combined characteristics of stent metal coverage and pore density should be considered when assessing the flow diversion effects of stents. More intra-aneurysmal flow reductions could be introduced by compacted LVIS stent than the uniform one. Compared with PED, compacted LVIS stent may exhibit a flow-diverting effect comparable to that of the PED.
Development and application of a temperature gradient detector for manned underwater robot
Authors: Li Dewei , Li Ye , Ding Zhongjun , Wang Xiangxin , Liu Baohua
Published: August 2020

Manned underwater robot is an important platform to carry various sensors and working tools to finish the in situ measurement and sampling in the deep sea. Due to its limited loading capacity, the device it will be carried, usually, requires to be able to dive to its working depth with a small volume and weight. According to the application requirements of deep-sea sediment temperature gradient in situ measurement observed, a detector system that can obtain data in situ is designed, which mainly includes a titanium alloy electronic cabin and a temperature probe. A comprehensive design analysis method is used to compare and analyze the ultimate static pressure, stability limit load, bending moment load, and transient temperature field on the underwater operation conditions. Optimal dimensions and filled media in the probe are decided. Finally, the pressure resistance test is finished in the lab, and scientific application is conducted on Jiaolong’s 127th dive in the Northwest Indian Ocean, which successfully sampling the temperature gradient data of deep-sea sediments in the Daxi hydrothermal area. The method introduced in this article can effectively improve the safety and reliability of deep-sea structure and greatly reduce costs throughout the design cycle.
Dienogest suppresses cellular proliferation status of endometrial polyps and acts differently depending on the morphological type
Authors: Inaba Kei , Wada-Hiraike Osamu , Harada Miyuki , Hirota Yasushi , Koga Kaori , Fujii Tomoyuki , Osuga Yutaka
Published: August 2020

Administration of Dienogest prior to hysteroscopic polypectomy is empirically performed, but the physiological effects of Dienogest on endometrial polyps are unclear. We aimed to investigate the effects of Dienogest on the proliferation and inflammation of endometrial polyps. We conducted a retrospective case study on 40 menstruating women who underwent hysteroscopic polypectomy at our hospital. We collected clinical data, and the polyps were divided by morphological appearance. The specimens obtained were immunostained for Ki67 as a marker of cellar proliferation and CD138 as a marker of plasmacytes, which are a hallmark of chronic endometritis. Dienogest significantly suppressed the proliferation status of EPs because Dienogest treatment prior to the operation significantly reduced the Ki67 index (41.25 ± 16.85 vs 7.18 ± 9.82, p  < 0.01). We found that sessile-type polyps showed a significantly lower Ki67 index than the pedunculated type (12.28 ± 11.12 vs 2.09 ± 2.73, p = 0.026). The presence of CD138-positive cells was more pronounced in sessile-type polyps than in pedunculated polyps ( p = 0.018). However, Dienogest treatment showed no apparent effect on inflammation status, as detected by CD138-positive cells. We revealed that Dienogest suppressed cellular proliferation, and morphological classification of endometrial polyps could be used to predict the responsiveness to Dienogest. However, Dienogest might not affect cellular inflammation.
A New Medical Device for Improved Rotation of Insulin Injections in Type 1 Diabetes Mellitus: A Proof-of-Concept Study
Authors: Klarskov Carina Kirstine , Hamid Yasmin Hassan , Tjalk-Bøggild Rasmus , Tarnow Lise , Kristensen Peter Lommer
Published: August 2020

Introduction:

Lipohypertrophy (LH) is caused by repetitively injecting insulin into the same location. This can lead to unpredictable insulin absorption and increased glucose variability (GV). A new medical device, ROTO Track, automatically guides the user to rotate abdominal insulin injections to avoid LH lesions. This study aimed to test whether the medical device could reduce the number of insulin injections in the same subcutaneous area as compared with non-aided standard insulin injection techniques.

Methods:

In this proof-of-concept cross-over study, baseline data about injection site in the abdominal region were collected blinded for 1 week with a nonguiding version of the device and compared to 1 and 12 weeks of device guidance in 35 people with type 1 diabetes. The device registered time and location of abdominal injections. The primary endpoint was a “rotation score.” Secondary endpoints included number and size of LH, GV, and hemoglobin A1c.

Results:

The rotation score improved significantly from a baseline mean of 40.2% to 49.9% after 1 week (confidence interval: 2.2-17.2%, P = .012) and improved further after 12 weeks to 52.2% ( P < .001). After 12 weeks, LH was reduced both in median size from 9.2 (range: [0.9-29.4]) cm2 to 5.4 (range: [0.0- 26.8]) cm2 ( P = .041) and mean count from 1.4 (range: [1-2]) to 1.1 (range: [0-2], P = .039) and the coefficient of variation of interstitial glucose was reduced from 38.6 to 35.1 ( P = .009).

Conclusion:

This proof-of-concept study indicates that the device improves rotation of insulin injections, and reduces LH and GV.
Nationwide Analysis of Total Ankle Replacement and Ankle Arthrodesis in Medicare Patients: Trends, Complications, and Cost
Authors: Tucker William A. , Barnds Brandon L. , Morris Brandon L. , Tarakemeh Armin , Mullen Scott , Schroeppel J. Paul , Vopat Bryan G.
Published: August 2020

Background

Surgical management of end-stage ankle arthritis consists of either ankle arthrodesis (AA) or total ankle replacement (TAR). The purpose of this study was to evaluate utilization trends in TAR and AA and compare cost and complications.

Methods

Medicare patients with the diagnosis of ankle arthritis were reviewed. Patients undergoing surgical intervention were split into AA and TAR groups, which were evaluated for trends as well as postoperative complications, revision rates, and procedure cost.

Results

A total of 673 789 patients were identified with ankle arthritis. A total of 19 120 patients underwent AA and 9059 underwent TAR. While rates of AA remained relatively constant, even decreasing, with 2080 performed in 2005 and 1823 performed in 2014, TAR rates nearly quadrupled. Average cost associated with TAR was $12559.12 compared with $6962.99 for AA ( P < .001). Overall complication rates were 24.9% in the AA group with a 16.5% revision rate compared with 15.1% and 11.0%, respectively, in the TAR group ( P < .001). Patients younger than 65 years had both higher complication and revision rates.

Discussion

TAR has become an increasingly popular option for the management of end-stage ankle arthritis. In our study, TAR demonstrated both lower revision and complication rates than AA. However, TAR represents a more expensive treatment option.

Levels of Evidence:

Level III: Retrospective comparative study
The Art of Not Knowing: The Position of Non-Knowledge as Activisms
Authors: Reinertsen Anne Beate
Published: August 2020

It seems we are obsessed with knowledge and facts. Evidence-based science and research gain terrain in more and more fields. We speak of action and activism being knowledge based: informed or infused by knowledge. Being active, an activist, and/or living an activist life, however, I claim, is paradoxically dependent on the opposite: dependent on the opening up to the art of not knowing, the position of non-knowledge as activism. Being alert to the potentiality in/of the moment is for me as educator and researcher how I work with qualitative inquiry as activisms, taking my objectivity back. I call it nomadic showing waiting.
The Use of Technology in Managing Diabetes in Youth Part 3–Special Considerations: Integration Into the School Setting
Authors: Wyckoff Leah , Berget Cari
Published: August 2020

The advantages of continuous glucose monitoring (CGM) and insulin pump systems have increased the popularity of these devices among students in the school setting. The use of diabetes technology at school and school-sponsored activities strengthens the student’s consistent use of the technology and increases the overall beneficial effects. The school nurse has many considerations when supporting the student with diabetes technology. Integrating this technology into diabetes care at school can be complex with collaboration and safety considerations fundamental to success. This is the third article in a three-part series on the use of technology in managing diabetes in youth. The first article described CGM devices and provided tips for the school nurse in incorporating CGM into the student’s individualized healthcare plan. The second article summarized insulin pump technologies, from conventional insulin pump therapy to advance automated insulin delivery systems and described keys to success with insulin pump technologies. The purpose of this article is to address some special considerations for facilitating the use of diabetes technology in the school setting. Topics to be discussed are tips on including insulin pump therapy in the student’s individualized healthcare plan, safe use of diabetes technology during physical activity, and implications for school nursing practice.
International Platforms, International Prejudice in the Platformization of Crafting
Authors: Close Samantha , Wang Cynthia
Published: August 2020

The platformization of crafting in an unequal world encourages discriminatory attitudes toward ethnic Others. Imagining that the “magic circle” of a subcultural platform can insulate users from racism is deeply misguided. We examine this thesis through a mixed-methods approach combining an online survey assessing perceived experiences of racism online and willingness to communicate with people of different ethnicities, discourse analysis of crafters’ online posts, and ethnographic interviews. As the e-commerce platform Etsy allowed “manufactured goods” to be sold in their marketplace as handmade, Western crafters channel their frustrations with a broken platform economy into racist sentiment against Chinese crafters. This study explores the implications of these Orientalist sentiments as a reinforcement of Western exceptionalism around originality and creativity, and it analyzes White fragility and the assumption of Whiteness within the crafting subculture.
Bridging or Widening the Gap? Narrative Discourses of the West and Westerners in Jordan’s My American Neighbor Television Program
Authors: Kubeisy Sumaya , Freeman Bradley C.
Published: August 2020

Media researchers have often examined how film and television can have an impact on audiences. Media have various effects on audience members. When it comes to representing ‘the other’, the media often rely on stereotypes. Research has shown that ethnic Arabs are under-represented in US film and television, and their depictions are distorted with stereotypical portrayals. The current study joins the discussion on ‘media representation’ (in this case, informed by the construct of Occidentalism) by conducting a qualitative, thematic, content analysis (informed by narrative analysis, both socio-linguistic and socio-cultural) of the Jordanian television show My American Neighbor. Stereotypes can be both positive and negative, and they are often used by media storytellers regardless of their background or location in the World.
Should we build better? The case for resilient earthquake design in the United States
Authors: Porter Keith A
Published: August 2020

America seems to have an earthquake investment gap, paying billions more annually on average to recover from earthquakes than it invests to prevent losses beforehand. Two large studies for Federal Emergency Management Agency (FEMA) and the US Geological Survey (USGS) offer insight into how well American buildings will resist future catastrophic earthquakes. They suggest that the public prefers new buildings to do more than to assure life safety, which has been the building code’s historic objective. They also suggest that greater resilience would better serve society’s economic interests. People expect to be safe in new buildings and the building code delivers safety. But people also want to use buildings after the Big One. America has a few options for meeting those expectations, including stronger, stiffer construction, with geographically optimized strength and stiffness. Greater strength and stiffness is not the only option to improve resilience, but such an approach offers the advantages that it could be implemented in practice by any structural designer without requiring additional technical expertise, software, of proprietary technology. It would produce a healthier economy and save society an average of $4 for every $1 of added cost. The savings cross property lines, benefiting tenants, owners, lenders, developers, and everyone who does business with them. The added cost would amount to approximately 1%, and experience in Moore, Oklahoma, shows that it would probably affect real estate sales and prices little or not at all. The solution addresses ethical considerations by responding to the public’s expectations for better performance and by optimizing utilitarian outcomes. Other options such as second-generation performance-based earthquake engineering, innovative technologies, and rating systems could complement this approach and further increase resilience.
Immunological status and virological suppression among HIV-infected adults on highly active antiretroviral therapy
Authors: Melku Mulugeta , Abebe Gizachew , Teketel Amanuel , Asrie Fikir , Yalew Aregawi , Biadgo Belete , Kassa Eyuel , Damtie Debasu , Anlay Degefaye Zelalem
Published: August 2020

Background

World Health Organization (WHO) recommends that viral load ([VL) is a primary tool that clinicians and researchers have used to monitor patients on antiretroviral therapy (ART), an antiviral drug against retroviruses. Whereas, CD4 cell counts can only be used to monitor clinical response to ART in the absence of VL testing service. Therefore, this study is aimed to assess the level of immunological status and virological suppression, and identify associated factors among human immunodeficiency virus ([HIV)-infected adults who were taking antiretroviral drugs of combination regimen know as highly active antiretroviral therapy (HAART).

Methods

A hospital-based cross-sectional study was conducted at the University of Gondar comprehensive specialized referral hospital from February to April 2018. A total of 323 adult participants on HAART were selected using a systematic random sampling technique and enrolled into the study. Blood samples for viral load determination and CD4 cell count were collected. Binary logistic regression analysis was used to determine factors associated with immunologic status and virological suppression in HIV patients on HAART. Odds ratio with 95% CI was used to measure the strength of association.

Results

Virological suppression (VL level < 1000 copies/ml) was found in 82% (95% CI 77.7, 86.1) of study participants, and it has been associated with CD4 cell count between 350 and 499 cells/mm3 (adjusted odds ratio (AOR) = 2.56; 95% CI 1.14, 5.75) and > 499 cells/mm3 (AOR = 7.71; 95% CI 3.48, 17.09) at VL testing and current age > 45 years old (AOR = 5.99; 95% CI 2.12, 16.91). Similarly, favorable immunological status (≥ 400 cells/mm3 for male and ≥ 466 cells/mm3 for female) was observed in 52.9% (95% CI 47.4, 58.8) of the study participants. Baseline CD4 cell count of > 200 cells/mm3, age at enrollment of 26 through 40 years old, and urban residence were significantly associated with favorable immunological status.

Conclusion

Though the majority of HIV-infected adults who were on HAART had shown viral suppression, the rate of suppression was sub-optimal according to the UNAIDS 90-90-90 target to help end the AIDS pandemic by 2020. Nonetheless, the rate of immunological recovery in the study cohort was low. Hence, early initiation of HAART should be strengthened to achieve good virological suppression and immunological recovery.
Using short read sequencing to characterise balanced reciprocal translocations in pigs
Authors: Bouwman Aniek C. , Derks Martijn F. L. , Broekhuijse Marleen L. W. J. , Harlizius Barbara , Veerkamp Roel F.
Published: August 2020

Background

A balanced constitutional reciprocal translocation (RT) is a mutual exchange of terminal segments of two non-homologous chromosomes without any loss or gain of DNA in germline cells. Carriers of balanced RTs are viable individuals with no apparent phenotypical consequences. These animals produce, however, unbalanced gametes and show therefore reduced fertility and offspring with congenital abnormalities. This cytogenetic abnormality is usually detected using chromosome staining techniques. The aim of this study was to test the possibilities of using paired end short read sequencing for detection of balanced RTs in boars and investigate their breakpoints and junctions.

Results

Balanced RTs were recovered in a blinded analysis, using structural variant calling software DELLY, in 6 of the 7 carriers with 30 fold short read paired end sequencing. In 15 non-carriers we did not detect any RTs. Reducing the coverage to 20 fold, 15 fold and 10 fold showed that at least 20 fold coverage is required to obtain good results. One RT was not detected using the blind screening, however, a highly likely RT was discovered after unblinding. This RT was located in a repetitive region, showing the limitations of short read sequence data. The detailed analysis of the breakpoints and junctions suggested three junctions showing microhomology, three junctions with blunt-end ligation, and three micro-insertions at the breakpoint junctions. The RTs detected also showed to disrupt genes.

Conclusions

We conclude that paired end short read sequence data can be used to detect and characterize balanced reciprocal translocations, if sequencing depth is at least 20 fold coverage. However, translocations in repetitive areas may require large fragments or even long read sequence data.
Construction and screening of a glycosylphosphatidylinositol protein deletion library in Pichia pastoris
Authors: Wang Pan , Lin Ying , Zou Chengjuan , Zhao Fengguang , Liang Shuli , Zheng Suiping , Han Shuangyan
Published: August 2020

Background

Glycosylphosphatidylinositol (GPI)-anchored glycoproteins have diverse intrinsic functions in yeasts, and they also have different uses in vitro. In this study, the functions of potential GPI proteins inPichia pastoriswere explored by gene knockout approaches.

Results

Through an extensive knockout of GPI proteins inP. pastoris, a single-gene deletion library was constructed for 45 predicted GPI proteins. The knockout of proteins may lead to the activation of a cellular response named the ‘compensatory mechanism’, which is characterized by changes in the content and relationship between cell wall polysaccharides and surface proteins. Among the 45 deletion strains, five showed obvious methanol tolerance, four owned high content of cell wall polysaccharides, and four had a high surface hydrophobicity. Some advantages of these strains as production hosts were revealed. Furthermore, the deletion strains with high surface hydrophobicity were used as hosts to displayCandida antarcticalipase B (CALB). The strain gcw22Δ/CALB-GCW61 showed excellent fermentation characteristics, including a faster growth rate and higher hydrolytic activity.

Conclusions

This GPI deletion library has some potential applications for production strains and offers a valuable resource for studying the precise functions of GPI proteins, especially their putative functions.
Genome-wide identification and characterization of gibberellin metabolic and signal transduction (GA MST) pathway mediating seed and berry development (SBD) in grape (Vitis vinifera L.)
Authors: Wang Wenran , Bai Yunhe , Koilkonda Padmalatha , Guan Le , Zhuge Yaxian , Wang Xicheng , Liu Zhongjie , Jia Haifeng , Wang Chen , Fang Jinggui
Published: August 2020

Background

Grape is highly sensitive to gibberellin (GA), which is crucial during seed and berry development (SBD) either by itself or by interacting with other hormones, such as auxin, Abscisic acid (ABA), and Cytokinin (CK). However, no systematic analysis of GA metabolic and signal transduction (MST) pathway has been undertaken in grapevine.

Results

In this study, total endogenous GA3 content significantly decreased during SBD, and a total of 48 known genes in GA metabolic (GAM; 31) and signal transduction (ST; 17) pathways were identified in this process. In the GAM pathway, out of 31 genes, VvGA20ox1–1, VvGA3ox4–1, and VvGA2ox1–1 may be the major factors interacting at the green-berry stage (GBS) accompanied with higher accumulation rate. GA biosynthesis was greater than GA inactivation at GBS, confirming the importance of seeds in GA synthesis. The visible correlation between endogenous GA3 content and gene expression profiles suggested that the transcriptional regulation of GA biosynthesis pathway genes was a key mechanism of GA accumulation at the stone-hardening stage (SHS). Interestingly, we observed a negative feedback regulation between VvGA3oxs-VvGAI1–4, VvGA2oxs-VvGAI1–4, and VvGID1B-VvGAI1–4 in maintaining the balance of GA3 content in berries. Moreover, 11 miRNAs may be involved in the modulation of GA MST pathway by mediating their target genes, such as VvGA3ox, VvGID1B, and VvGAMYB. Many genes in auxin, ABA, and CK MST pathways were further identified and found to have a special pattern in the berry, and the crosstalk between GA and these hormones may modulate the complex process during SBD through the interaction gene network of the multihormone pathway. Lastly, based on the expression characterization of multihormone MST pathway genes, a proposed model of the GA-mediated multihormone regulatory network during SBD was proposed.

Conclusions

Our results provided novel insights into GA-mediated regulatory networks during SBD in grape. The complexity of GA-mediated multihormone ST in SBD was also elucidated, thereby providing valuable information for future functional characterizations of specific genes in grape.
P-selectin (CD62P) and soluble TREM-like transcript-1 (sTLT-1) are associated with coronary artery disease: a case control study
Authors: Shen Li , Yang Tianlun , Xia Ke , Yan Zhiqiang , Tan Juanjuan , Li Lei , Qin Yingchun , Shi Wei
Published: August 2020

Background

Platelet activation plays a crucial role in the pathogenesis of coronary artery disease (CAD). Platelet P-selectin (CD62P) is a classic platelet activation indicator on the platelet surface, and soluble TREM-like transcript-1 (sTLT-1) is a new indicator. However, the relationship between these two markers and CAD, especially in acute coronary syndrome (ACS), has not been elucidated. This study aimed to investigate CD62P expression on the platelet surface and sTLT-1 expression in serum, as well as to assess their relationship with CAD.

Methods

We measured the levels of CD62P and sTLT-1 in 83 patients with CAD compared to 49 controls. The association of these indicators with age, blood pressure, lipid profile, body mass index, and liver injury marker level were also examined.

Results

CD62P concentration was higher in CAD patients than in the control group (P < 0.01), especially in acute myocardial infarction (AMI) patients (P < 0.01). Serum sTLT-1 concentration was higher in the AMI and unstable angina pectoris (UAP) groups than in the normal control (NC) group (P < 0.01).

Conclusions

The consistency of sTLT-1 and CD62P expression levels in CAD patients indicates that sTLT-1 level, the same as CD62P, may be a new marker of platelet activation that is positively related to CAD.
Small intestinal bacterial overgrowth as a cause of protracted wound healing and vitamin D deficiency in a spinal cord injured patient with a sacral pressure sore: a case report
Authors: Kubota Yoshitaka , Nagano Hidekazu , Ishii Kentaro , Kono Takashi , Kono Satomi , Akita Shinsuke , Mitsukawa Nobuyuki , Tanaka Tomoaki
Published: August 2020

Background

Pressure sores are sometimes refractory to treatment, often due to malnutrition. Small intestinal bacterial overgrowth (SIBO) obstructs absorption in the digestive tract and causes malnutrition. However, little is known about the association between pressure sore wound healing and SIBO. Here, we report a case of a patient with a refractory sacral pressure sore and SIBO.

Case presentation

A 66-year-old woman who was spinal cord injured 14 years before visiting our hospital presented with the chief complaint of a sacral pressure sore, 10.0 × 6.5 cm in size, which was refractory to treatment. Physical examination showed abdominal distension and emaciation, with a body mass index of 15. Further examination revealed elevated serum alkaline phosphatase (1260 U/L), bilateral tibial fracture, multiple rib fracture, and osteoporosis. We diagnosed the patient with osteomalacia with vitamin D deficiency. Despite oral supplementation, serum levels of calcium, phosphorous, and vitamin D remained low. Also, despite concentrative wound therapy for the sacral pressure sore by plastic surgeons, no wound healing was achieved. Due to a suspicion of disturbances in nutrient absorption, we performed bacterial examination of collected gastric and duodenal fluid, which showed high numbers of bacteria in gastric content (104E. coli, 105Streptococcus species, and 105Neisseria species) and duodenal content (106E. coli, 104Candida glabrata). Therefore, we diagnosed the patient with SIBO and started selective decontamination of the digestive tract using polymyxin B sulfate and amphotericin B. After starting treatment for SIBO, the sacral pressure sore began to heal and was nearly healed after 285 days. The patient’s serum levels of calcium, phosphorous, vitamin D, and other fat-soluble vitamins also gradually increased after starting treatment for SIBO.

Conclusion

We report a case of a patient with a refractory sacral pressure sore that healed after starting treatment for SIBO. We conclude that SIBO may be an overlooked cause of malnutrition and poor wound healing in patients with chronic pressure sores.
Neisseria macacae bacteremia: report of two cases with a literature review
Authors: Yamamoto Yasumasa , Terada Norihiko , Sugiyama Tomoyo , Kurai Hanako , Ohkusu Kiyofumi
Published: August 2020

Background

Neisseria macacae was discovered in the oral cavity of monkeys in 1983. In humans, it has been isolated from the upper respiratory tract of neutropenic patients. However, only two cases of N. macacae bacteremia have been reported in a 65-year-old man with infective endocarditis and a 5-month-old child with fever and petechiae. There are no reports of infections in cancer patients. Here, we present two cases of N. macacae bacteremia in cancer patients.

Case presentation

In the first case, a 42-year-old woman who underwent ovarian cancer surgery presented with duodenal invasion associated with multiple lymph node metastasis. N. macacae was isolated from her blood culture and identified using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry (MS). In the second case, a 69-year-old woman with a long-standing history of esophagogastric junction cancer presented with fever. She had stage IVB cancer with lung, bone, and multiple lymph node metastasis. The last chemotherapy was administered 5 weeks before N. macacae was detected using MALDI-TOF MS and nitrate test negative. In both cases, transthoracic echography showed no vegetation. Antibiotics were administered for 14 and 13 days in the first and second cases, respectively. In both cases, fever alleviated on day 4 of antibiotic administration. Both patients were discharged after their conditions improved.

Conclusions

This, to our knowledge, is the first report of N. macacae bacteremia in cancer patients. Both patients, mucosal damage was observed in the upper gastrointestinal tract. Therefore, exclusion diagnosis suggested that bacteremia invasion was caused by mucosal rupture in both cases. Both cases responded well to treatment with β-lactam antibiotics and improved after 2 weeks. Modifying the treatment based on the source of the infection may shorten the treatment period. Therefore, further research on N. macacae bacteremia is necessary. Immunocompromised patients such as those with cancer are susceptible to mucosal damage by unusual bacterial species such as N. macacae despite not having contact with monkeys.
Prediction of treatment failure and compliance in patients with tuberculosis
Authors: Koo Hyeon-Kyoung , Min Jinsoo , Kim Hyung Woo , Lee Joosun , Kim Ju Sang , Park Jae Seuk , Lee Sung-Soon
Published: August 2020

Background

To improve treatment outcomes for tuberculosis (TB), efforts to reduce treatment failure are necessary. The aim of our study was to describe the characteristics of subjects who had failed treatment of tuberculosis and identify the risk factors for treatment failure and poor compliance using national data.

Methods

A multicenter cross-sectional study was performed on tuberculosis subjects whose final outcome was reported as treatment failure during 2015–2017. The same number of subjects with treatment success during the same study period were randomly selected for comparison. Demographics, microbiological, radiographic, and clinical data were collected based on in-depth interviews by TB nurse specialists at all Public Private Mix (PPM) participating hospitals in South Korea.

Results

A total of 52 tuberculosis patients with treatment failure were enrolled. In a multivariable analysis, the presence of diabetes, previous history of tuberculosis, and cavity were identified as risk factors for treatment failure; and Medicaid support was a favorable factor for treatment success (area under the curve [AUC]: 0.79). Age, low body mass index (BMI), presence of diabetes, preexisting lung disease, positive sputum acid-fast bacilli (AFB) smear result, and the presence of multidrug-resistant tuberculosis (MDR-TB) were significantly associated with presence of cavities. Younger age, lower BMI and previous history of TB were associated with poor compliance during treatment (AUC: 0.76).

Conclusion

To reduce treatment failure, careful evaluation of the presence of diabetes, previous TB history, underlying lung disease, cavity, results of sputum AFB smears, and socioeconomic status are needed. To enhance treatment compliance, more attention should be paid to younger patients with lower BMIs during follow-up.
Clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women: a retrospective study
Authors: Wang Yong-xue , Deng Shan
Published: August 2020

Background

Adnexal torsion during pregnancy is a gynecological emergency. Delayed diagnosis and treatment can cause ovarian necrosis and fetal loss. This study assessed the clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women.

Methods

A retrospective study was conducted at a tertiary center between January 2008 and January 2018. Eighty-two pregnant women with surgically confirmed adnexal torsion were included. The clinical characteristics, ultrasound data, surgical interventions and pregnancy outcomes were analyzed.

Results

The median age of the patients was 28 (range, 18–38) years. The median gestational age was 11 (range, 6–31) weeks: 53 (64.6%) were in the first trimester, 21 (25.6%) were in the second trimester, and 8 (9.8%) were in the third trimester. The most common symptoms and signs were sudden pelvic pain (100%) and adnexal or pelvic masses (97.6%), followed by nausea and vomiting (61%). The Doppler blood flow signal disappeared in 62.5% of the patients. Sixty-three (76.8%) patients underwent laparoscopy, and 29 (24.2%) underwent laparotomy. The median gestational age in patients undergoing laparotomy was higher than that in those undergoing laparoscopy (26 weeks vs 10 weeks, p < 0.001). Fifty-three (64.6%) patients underwent conservative surgery, with 48 detorsions and cystectomies, 2 detorsions and cyst fenestrations, 1 detorsion only and 2 salpingectomies only. Twenty-nine (25.4%) patients underwent unilateral salpingo-oophorectomy. There were no cases of postoperative thrombosis, spontaneous abortion or recurrence during the same pregnancy. Seven patients underwent simultaneous artificial abortion. One patient experienced intrauterine fetal death, and 74 patients had live births.

Conclusion

Surgical intervention was required as soon as possible. Laparoscopic conservative surgery is safe and may be appropriate to preserve ovarian function.