bluuebunny/crossref_metadata_2025 huggingface dataset:
Honors and Costs of Being Heroes: Risk Factors and Epidemiology of COVID-19 Infection among Health Care Workers of a Severely Hit COVID-19-Referral Hospital in Italy
Authors: Colaneri Marta , Novelli Viola , Cutti Sara , Muzzi Alba , Resani Guido , Monti Cristina , Rona Claudia , Grugnetti Anna Maria , Rettani Marco , Rovida Francesca , Zuccaro Valentina , Triarico Antonio , Marena Carlo
Published: August 2020

Purpose: During the COVID-19 pandemic, the health care workers (HCWs) at the frontline have been largely exposed to infected patients, running an high risk of being infected by the SARS-CoV-2 virus. This study investigates the epidemiological, clinical and lifestyles characteristics that might play roles in the susceptibility of HCWs to COVID-19 in a hit Italian hospital. Methods:Demographic, lifestyle, work-related and comorbidities data of 1447 HCWs which underwent a nasopharyngeal swab for SARS-CoV-2 were retrospectively collected. For the 164 HCWs positive for SARS-CoV-2, data about safety in the workplace, symptoms and clinical course of COVID-19 were also collected. Cumulative incidence of SARS-CoV-2 infection was estimated. Risk factors for SARS-CoV-2 infection were assessed using a multivariable Poisson regression. Results: The cumulative incidence of SARS-CoV-2 infection among the screened HCWs was 11.33 (9.72-13.21). Working in a COVID-19 ward, being a former smoker (vs being a person who never smoked) and BMI were positively associated with SARS-CoV-2 infection, whereas being a current smoker was negatively associated with this variable. Conclusions: Assuming an equal accessibility and proper use of PPE of all the HCWs of our Hospital, the great and more prolonged contact with COVID-19 patients remains the crucial risk factor for SARS-CoV-2. Therefore, increased and particular care needs to be focused specifically on the most exposed HCWs groups, which should be safeguarded. Furthermore, in order to limit the risk of asymptomatic spread of SARS-CoV-2 infection, the HCWs mild symptoms of COVID-19 should be considered when evaluating the potential benefits of universal staff testing
Globalization, Quality and Systems Thinking: Integrating Global Quality Management and a Systems View
Authors: Bashan Aviva , Kordova Sigal
Published: August 2020

A global approach towards quality management highlights the need for constructing a new body of knowledge that views the field of global quality from a systems perspective. Based on the results of field experiments, and in light of the need to develop new global quality management terminology, the current article presents several key concepts in this field, with emphasis on a systems-oriented rationale and perspective. As such, the article is an important stage in building this body of knowledge, and towards the conceptualization of key variables used in global quality management, from a systems approach that interacts with the fields of international management and strategic management.
The MW = 5.6 Kanallaki Earthquake of March 21, 2020 in West Epirus, Greece: Reverse Fault Model From Insar Data and Seismotectonic Implications for Apulia-Eurasia Collision
Authors: Valkaniotis Sotiris , Briole Pierre , Ganas Athanassios , Elias Panagiotis , Kapetanidis Vasilis , Tsironi Varvara , Fokaefs Anna , Partheniou Helena , Paschos Panagiotis
Published: August 2020

We identify the source of the Mw = 5.6 earthquake that hit west-central Epirus on March 21, 2020 00:49:52 UTC. We use synthetic aperture radar interferograms tied to one permanent Global Navigation Satellite System (GNSS) station (GARD). We model the source by inverting the INSAR displacement data. The inversion model suggests a shallow source on a low-angle fault (39°) dipping towards east with a centroid depth of 8.5 km. The seismic moment deduced from our model agrees with those of the published seismic moment tensors. This geometry is compatible with the Margariti thrust fault within the collision zone between Apulia and Eurasia. We also processed new GNSS data and estimate a total convergence rate between Apulia and Eurasia of 8.9 mm yr-1 , of which shortening of the crust between the Epirus coastal GNSS stations and station PAXO in the Ionian Sea is equivalent to ~ 50% of it or 4.6 mm yr−1. A 60-km wide deformation zone takes up nearly most of the convergence between Apulia-Eurasia, trending N318°E. Its central axis runs along the southwest coast of Corfu, along the northeast coast of Paxos, heading toward the northern extremity of the Lefkada island.
Sex Differences in Exercise Induced Bronchoconstriction in Athletes: A Systematic Review and Meta-Analysis
Authors: Rodriguez Bauza Daniel , Silveyra Patricia
Published: August 2020

Exercise induced bronchoconstriction (EIB) is a common complication of athletes and individuals who exercise regularly. It is estimated that about 90% of patients with underlying asthma experience EIB. Sex differences in the prevalence of asthma have been widely reported, with higher rates in boys vs. girls before puberty, and higher rates in women than men after puberty. Because atopy has been reported to occur at higher rates in athletes than in non-athletes, in this study we investigated sex differences in EIB and atopy in athletes. A systematic literature review identified 60 studies evaluating EIB and/or atopy in post-pubertal adult athletes (n=7501). Collectively, these studies reported: 1) a 23% prevalence of EIB in athletes; 2) a higher prevalence of atopy in male athletes vs. females; 3) a higher prevalence of atopy in athletes with EIB; and 4) a significantly higher rate of atopic EIB in male vs. female athletes. Our analysis indicates that the physiological changes that occur during exercise may differentially affect male and female athletes, and suggest an interaction between male sex, exercise, and atopic status in the course of EIB. Understanding these sex differences is important to provide personalized management plans to athletes with underlying asthma and/or atopy.
De-novo Assembly of RaTG13 Genome Reveals Inconsistencies Further Obscuring SARS-CoV-2 Origins
Authors: Singla Mohit , Ahmad Saad , Gupta Chandan , Sethi Tavpritesh
Published: August 2020

An intense scientific debate is ongoing as to the origin of SARS-CoV-2. An oft-cited piece of information in this debate is the genome sequence of a bat coronavirus strain referred to as RaTG13 1 mentioned in a recent Nature paper 2 showing 96.2% genome homology with SARS-CoV-2. This is discussed as a fossil record of a strain whose current existence is unknown. The said strain is conjectured by many to have been part of the ancestral pool from which SARS-CoV-2 may have evolved 7, 8, 9. Multiple groups have been discussing the features of the genome sequence of the said strain. In this paper, we report that the currently specified level of details are grossly insufficient to draw inferences about the origin of SARS-CoV-2. De-novo assembly, KRONA analysis for metagenomic and re-examining data quality highlights the key issues with the RaTG13 genome and the need for a dispassionate review of this data. This work is a call to action for the scientific community to better collate scientific evidence about the origins of SARS-CoV-2 so that future incidence of such pandemics may be effectively mitigated.
Fabrication of Metal Matrix Composites Based on Hydroxyapatite by Self-high Propagating Temperatures Synthesis (SHS)
Authors: Pramono Agus , Sulaiman Fatah , Milandia Anistasia
Published: August 2020

The use of cow bones for biomaterial is still limited; accordingly, the cow bones waste has low economic value. Basically, a human’s and a cow’s bones are the same in terms of their forming compound. Aluminum (Al) has the potential to combine with hydroxyapatite (HAp) to make metal matrix composites (MMC) that have the potential for biomaterials. Compatible elements to be combined with Al and HAp are magnesium (Mg), titanium (Ti), and Copper (Cu), used self-high propagating temperatures synthesis (SHS). MMC can be processed to be a useful, solid product. Applying pressure to the SHS reaction and heating process may result in biomaterial composite product consisting of some matrix materials such as Al come from cans materials used in the experiment was HAp that was processed from cow bones calcination, added by can that contained aluminum and wetting agent, namely magnesium. The exothermic temperature was 800-900°C. The compaction process was done to allow materials to be bound. Based on the ASTM F138 standard for element of biomaterials, the porosity value was below 30% and hardness level above 40 HV. Cow bones and can-based composite sample with the composition of HAp-Al-Mg: 85%-10%-5% met the standard since the hardness value was: 73.3 HV with a porosity value of 29.88%.
Preparation of PP-g-(AA-MAH) Fibers Using Suspension Grafting and Melt-blown Spinning and Its Adsorption for Aniline in Wastewater
Authors: Lian Zhouyang , Xu Yiyang , Zuo Jie , Qian Hui , Luo Zhengwei , Wei Wuji
Published: August 2020

This paper uses polypropylene (PP) as the matrix and acrylic acid (AA) and maleic anhydride (MAH) as functional monomers to prepare PP-g-(AA-MAH) fibers by suspension grafting and melt-blown spinning technology that are easy to industrially scale-up. The fibers can be used to adsorb aniline from wastewaters. Results showed that the grafting ratio reached the maximum of 12.47%. The corresponding optimal conditions were grafting time of 3h, AA : MAH = 0.75, total monomer content of 55%, benzoyl peroxide 1.4%, xylene concentration of 6 mL/g PP, and deionized water content of 8 mL/g PP. Owing to its good fluidity and thermal stability, the product of suspension grafting can be used for melt-blown spinning. Infrared spectroscopic and nuclear magnetic resonance spectroscopic analyses indicated that AA and MAH were successfully grafted onto PP fibers. After grafting, the hydrophilicity of PP-g-(AA-MAH) fiber increased. Therefore, it had higher adsorptivity for aniline and the adsorption capacity could reach 42.2 mg/g at 45 min. Moreover, the PP-g-(AA-MAH) fibers showed good regeneration performance.
Impact of the Aerobic Mesophilic Microorganisms on Black Sigatoka of Bananas According to the Cropping Systems in the Region of Kisangani (Case of the Old Secondary Forest)
Authors: Akwakwa Hopla Gabriel , Sun Chunyu , Onautshu Didy , Sun Yang
Published: August 2020

The microorganisms play crucial roles in the cycle of matter and damage the organic substances, sources of electrons, source of carbon, source of energy for their biosynthesis. While dying, the microorganisms contribute on their turn to enrich soil in different composed of the carbon. In this work, we studied the impact of the aerobic mesophiles microorganisms on the black sigatoka of banana in the old secondary forest. The objective was to count and to identify the microbial diversity of the forest ecosystems, as well as to study their impact on the development of the black sigatoka of banana around the forest reserve of Masako. The assessment of the microbial populations has been done in an experimental field according to a device in blocks of Fischer by the method of successive dilutions of coloration of Gram and by the discharge of ascospores. The results showed that the rain season was lower in total microbial biomass (700, 7 colonies) than the subdry season (840,3 colonies). The Bacillus genera have been more represented more than the Coccus genera. The impact of black sigatoka of banana was raised at the cultivar Libanga Likale (40%) and low at Yangambi 5 Km (14%). The distribution of microorganisms in depth in the sub-dry season to the level of surface with vegetation was considerable either 3819, 3. 103 UFC( UNIT FORMAT COLONY) by gram of soil between 0 and 5 cm against 2754,5.103 UFC by gram of soil between 15 and 20 cm. This suggests that the raised number of microorganisms could have positive impact on soil fertility by decreasing the illnesses in this ecosystem.
Updated Taxonomy of Pectobacterium genus in the CIRM-CFBP Bacterial Collection: When Newly Described Species Reveal “Old” Endemic Population
Authors: Portier Perrine , Pédron Jacques , Taghouti Géraldine , Dutrieux Cécile , Barny Marie-Anne
Published: August 2020

Bacterial collections are invaluable tools for microbiologists. However, their practical use is compromised by imprecise taxonomical assignation of bacterial strains. This is particularly true for soft rotting plant pathogens of the Pectobacterium genus. To solve this difficulty, we analyzed the taxonomic status of 265 Pectobacterium strains deposited at CIRM-CFBP collection from 1944 to 2020. This collection gathered Pectobacterium strains isolated in 27 countries from 32 plant species representing 17 botanical families or from non-host environments. MLSA approach completed by genomic analysis of 15 strains was performed to update the taxonomic status of these 265 strains. Results showed that the CIRM-CFBP Pectobacterium collection harboured at least one strain of each species to the exception of P. polonicum. Yet, 6 strains could not be assigned to any of the described species and may represent at least two new species. Surprisingly, the P. versatile species, recently described in 2019, is the most prevalent species among CIRM-CFBP strains. Analysis of P. versatile strains revealed that this species is endemic all over the world on various host plants and environments. At the opposite, other species gathered strains isolated from only one botanical family or exclusively from fresh water environment. Our work also revealed new host plants for several Pectobacterium spp.
Dairy Consumption and Metabolic Health
Authors: Timon Claire , O'Connor Aileen , Bhargava Nupur , Gibney Eileen , Feeney Emma
Published: August 2020

Milk and dairy foods are naturally rich sources of a wide range of nutrients, and when consumed according to recommended intakes contribute essential nutrients across all stages of the life cycle. Since then, seminal studies recommendations with respect to intake of saturated fat have been consistent and clear; limit total fat intake to 30% or less total dietary energy, with a specific recommendation for intake of saturated fat to less than 10% of total dietary energy. However, recent work has re-opened the debate on intake of saturated fat in particular, with suggestions that recommended intakes be considered not at a total fat intake within the diet, but at a food specific level. A large body of evidence exists examining the impact of dairy consumption on markers of metabolic health, both at a total dairy intake and also at a food level, with mixed findings to date, but suggests that the impact of saturated fat intake on health differs both across food groups and even between foods within the same good group such as dairy. Milk and dairy foods contain a range of nutrients and bioactive components in different levels, housed within very different food structures. The interaction of the overall food structure and the nutrients describes the concept of the ‘food matrix effect’ which has been well documented for dairy foods. Studies show that nutrients from different dairy food sources can have different effects on health and for this reason, they should be considered individually rather than grouped as a single food category in epidemiological research. This review examines the current evidence from randomised controlled trials and meta-analyses, with respect to dairy, milk, yoghurt and cheese on aspects of metabolic health, and summarises some of the potential mechanisms for these findings.
The Role of GPR109a Signaling in Niacin Induced Effects on Fed and Fasted Hepatic Metabolism
Authors: Geisler Caroline , Renquist Benjamin
Published: August 2020

Signaling through GPR109a, the putative receptor for the endogenous ligand β-OH butyrate, inhibits adipose tissue lipolysis. Niacin, an anti-atherosclerotic drug that can induce insulin resistance, activates GPR109a at nM concentrations. GPR109a is not essential for niacin to improve serum lipid profiles. To better understand the involvement of GPR109a signaling in regulating glucose and lipid metabolism, we treated GPR109a wildtype (+/+) and knockout (-/-) mice with repeated overnight injections of saline or niacin in physiological states characterized by low (ad libitum fed) or high (16h fasted) concentrations of the endogenous ligand, β-OH butyrate. In the fed state, niacin increased expression of PEPCK mRNA independent of genotype, while increasing CPT1 mRNA only in GPR109a -/- mice. Niacin decreased fasting serum non-esterified fatty acid concentrations in both GPR109a +/+ and -/- mice. Independent of GPR109a expression, niacin blunted fast-induced hepatic triglyceride accumulation and peroxisome proliferator activated receptor α (PPARα) mRNA expression. Surprisingly, GPR109a knockout did not affect glucose or lipid homeostasis or hepatic gene expression in either fed or fasted mice. In turn, GPR109a does not appear to be essential for the metabolic response to the ketogenic state or the pharmacological benefits associated with niacin.
Clinical Characteristics of Coronavirus disease 2019 (COVID-19) Among Patients at a Movement Disorders Center
Authors: de Marcaida J. Antonelle , Lahrmann Jeffrey , Machado Duarte , Bluth Lawrence , Dagostine Michelle , Moro-de Casillas Maria , Bortan Elena , Kanchana Sulada , Alberts Mark
Published: August 2020

It is not established whether SARS-CoV-2 (COVID-19) patients with movement disorders, are at greater risk for more serious outcomes than the larger COVID-19 population beyond the susceptibility associated with greater age. We reviewed electronic health records and conducted telephone interviews to collect the demographics and clinical outcomes of patients seen at our Movement Disorders Center who tested positive for COVID-19 from 8 March 2020 through 6 June 2020. Thirty-six patients were identified, 23 men and 13 women, median age of 74.5 years. They primarily carried diagnoses of idiopathic Parkinson disease (n=22; 61%) and atypical parkinsonism (n=7; 19%) with the balance having other diagnoses. Twenty-seven patients (75%) exhibited alteration in mental status and fifteen (42%) had abnormalities of movement as common manifestations of COVID-19; in 61% and 31%, these were the presenting symptoms of the disease. 67% of patients in our cohort required hospitalization, and the mortality rate was 39%.. These data demonstrate that in patients with movement disorders, the likelihood of hospitalization and death after contracting COVID-19 was substantially greater than in the general population. Patients with movement disorders frequently presented with altered mental status, generalized weakness, or worsening mobility but not anosmia.
The Effect of Supplemental High Fidelity Simulation Training in Preclinical Medical Students
Authors: Meyers Lori , Mahoney Bryan , Schaffernocker Troy , Way David , Winfield Scott , Uribe Alberto , Mavarez-Martinez Ana , Palettas Marilly , Lipps Jonathan
Published: August 2020

Background: Simulation-based education (SBE) with high-fidelity simulation (HFS) offers medical students early exposure to the clinical environment, allowing development of clinical scenarios and management. We hypothesized that supplementation of standard pulmonary physiology curriculum with HFS would improve the performance of first-year medical students on written tests of pulmonary physiology.Methods: This observational pilot study included SBE with three HFS scenarios of patient care that highlighted basic pulmonary physiology. First-year medical students’ test scores of their cardio-pulmonary curriculum were compared between students who participated in SBE versus only lecture-based education (LBE). A survey was administered to the SBE group to assess their perception of the HFS. Results: From a class of 188 first-year medical students, 89 (47%) participated in the SBE and the remaining 99 were considered as the LBE group. On their cardio-pulmonary curriculum test, the SBE group had a median score of 106 [IQR: 97,110] and LBE group of 99 [IQR: 89,105] (p<0.001). For the pulmonary physiology subsection, scores were also significantly different between groups (p<0.001).Conclusions: Implementation of supplemental SBE could be an adequate technique to improve learning enhancement and overall satisfaction in preclinical medical students.
Impact of low skeletal muscle mass index and perioperative blood transfusion on the prognosis for HCC following curative resection
Authors: Bekki Tomoaki , Abe Tomoyuki , Amano Hironobu , Hattori Minoru , Kobayashi Tsuyoshi , Nakahara Masahiro , Ohdan Hideki , Noriyuki Toshio
Published: August 2020

Background: This study aimed to assess the prognostic factors including low skeletal muscle mass index (SMI) and perioperative blood transfusion for patients with hepatocellular carcinoma (HCC) following curative surgery. Methods: This study included 139 patients with HCC who underwent hepatectomy between 2005 and 2016. Univariate and multivariate analyses were performed to identify variables associated with overall survival (OS) and recurrence-free survival (RFS). Results: Low SMI was significantly related with poor OS, while blood transfusion had a strong impact on RFS. The male ratio and body mass index in the low SMI group were significantly higher than those in the high SMI group. There were no significant differences in age, virus etiology, laboratory data, liver function, tumor makers, and operative variables between the groups. Tumor factors such as tumor diameter, tumor number, poor differentiation, and intrahepatic metastasis (IM) did not significantly differ between the two groups. Operation time, intraoperative blood loss volume, and recurrence ratio were significantly higher in the blood transfusion group than in the non-transfusion group. IM was associated with poor OS and RFS.Conclusions: Low SMI and blood transfusion were independently related with long-term prognosis in patients with HCC following curative surgery.
Reliability and validity of the Mandarin version of the Supportive Care Needs Survey Short-Form (SCNS-SF34) and the Head and Neck Cancer-specific Supportive Care Needs (SCNS-HNC) module
Authors: LYU Jianxia , Yin Li , Cheng Ping , Li Bin , Peng Shanshan , Yang Chunlian , Yang Jing , Liang Haixin , Jiang Qinghua
Published: August 2020

Background: This study aimed to translate the English version of the supportive care needs scale of head and neck cancer patients (SCNS-HNC) questionnaire into Mandarin and to test the reliability and validity of the SCNS-SF34 and SCNS-HNC module in head and neck cancer patients.
Methods: The Mandarin version of the Supportive Care Needs Survey Short-Form (SCNS-SF34) and SCNS-HNC scales were used to assess 206 patients with head and neck cancer in Chengdu, China. Among them, 51 patients were re-tested 2 or 3 days after the first survey. The internal consistency of the scale was evaluated by Cronbach's alpha coefficient, the retest reliability of the scale was evaluated by retest correlation coefficient r, the structural validity of the scale was evaluated by exploratory factor analysis, and the ceiling and floor effects of the scale were evaluated.
Results: The Mandarin version of the SCNS-HNC had Cronbach's alpha coefficients greater than 0.700 (0.737 ≤ 0.962) for all of the domains. Except for the psychological demand dimension (r=0.674) of the SCNS-SF34 scale, the retest reliability of the other domains was greater than 0.8. Three common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 64.39%.
Conclusions: The Mandarin version of the SCNS-SF34 and SCNS-HNC demonstrated satisfactory reliability and validity and is able to measure the supportive care needs of Chinese patients with head and neck cancer.
The erosion of ambiguity tolerance and sustainment of perfectionism in undergraduate Medical training: Results from multiple samplings of a single cohort.
Authors: Ndoja Silvio , Chahine Saad , Saklofske Donald H. , Lanting Brent
Published: August 2020

Background: Medicine is a field that is simultaneously factual and ambiguous. Medical students have their first exposure to full time clinical practice during clerkship. While studies have examined medical trainees’ tolerance of ambiguity (TOA), the extent to which TOA is affected by clinical experiences and its association with perfectionism is unknown. The aim of this study was to evaluate the effect of clerkship experience on TOA and perfectionism in medical students.Methods: This was a multiple sampling, single cohort study of students in their first year of clinical clerkship which is comprised of 6 core rotations. Consenting students completed an online anonymous survey assessing their tolerance of ambiguity (TOA) and perfectionism in their first (pre) and last (post) 12 weeks of their clinical clerkship year. Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) and The Big Three perfectionism scale-short form (BTPS-SF) were used to assess TOA and perfectionism respectively. Pre-Post mean comparisons of TOA and perfectionism were assessed via t-tests. Results: From a total possible sample of 174 clinical clerkship students, 51 students responded to pre-survey, 62 responded to post-survey. Clerkship was associated with a significant decrease in TOA (p<0.00) with mean pre-TOA scores of 59.57 and post TOA of 43.8. Perfectionism scores were not significantly different over time (p>0.05). There was a moderate inverse correlation between TOA and perfectionism before clerkship (r=0.32) that increased slightly after clerkship (r=0.39). Those preferring primary care specialties had significantly lower rigid and total perfectionism scores in pre-clerkship than those choosing other specialties, but this difference was not found post-clerkship.Conclusion: Exposure to clerkship decreased TOA while perfectionism remained stable in medical students. We discuss these findings in the context of an underlying anxiety cycle related to frequent rotation changes. Implications of the role of perfectionism and primary care is discussed. Overall these results require further investigation to better characterize the role of clinical exposure on TOA.
Analysis of Risk Factor for Anastomotic Leakage after Lower Rectal Cancer Resection, Including Drain Type: A Retrospective Single-Center Study
Authors: Kinugasa Tetsushi , Nagasu Sachiko , Murotani Kenta , Mizobe Tomoaki , Ochi Takafumi , Isobe Taro , Fujita Fumihiko , Akagi Yoshito
Published: August 2020

Background: We investigated the correlations between surgery-related factors and the incidence of leakage after low anterior resection (LAR) for lower rectal cancer.Methods: A total of 630 patients underwent colorectal surgery between 2011 and 2014 in our department. Of these, 97 patients (15%) underwent LAR and were included in this retrospective study. Temporary ileostomy was performed in each patient.Results: Anastomotic leakage occurred in 21 patients (21.7%). Univariate analysis showed that operative duration (p=0.005), transanal hand-sewn anastomosis (p=0.014), and operation procedure (p=0.019) were significantly associated with the occurrence of leakage. Multivariate analysis showed that underlying disease (p=0.044), transanal hand-sewn anastomosis (p=0.019) and drain type (p=0.025) were significantly associated with the occurrence of leakage. Propensity-score analysis showed that closed drainage were 6.3 times more likely to have anastomotic leakage than open drainage in relation to the amount of postoperative drainage (ml), according to inverse probability of treatment-weighted analysis.Conclusions: Our results indicate that underlying disease, transanal hand-sewn anastomosis, and closed drain may be risk factors for anastomotic leakage after LAR for lower rectal cancer. The notable finding was that closed drainage was related to the occurrence of anastomotic leakage and closed drainage was correlated with the less volume of postoperative drain discharge than open drain.
The role of Mycobacterium tuberculosis complex species on apoptosis and necroptosis state of macrophages derived from active pulmonary tuberculosis patients
Authors: Yanti Budi , Mulyadi Mulyadi , Amin Muhammad , Harapan Harapan , Mertaniasih Ni Made , Soetjipto Soetjipto
Published: August 2020

Objective: The role of Mycobacterium tuberculosis complex (MTBC) species in tuberculosis (TB) infection in human is still questioned. The aim of this study was to determine whether M. tuberculosis and M. bovis is associated with apoptosis and necroptosis by measuring the expression of specific signaling pathways components (Fas-associated protein with death domain (FADD) and receptor interacting protein 3 (RIP3)), and the level of apoptosis. Results: We recruited 30 patients with pulmonary TB; 24 patients were infected with M. tuberculosis Beijing strain and six patients with M. bovis BCG strain. M. tuberculosis-infected patients were more likely to have severe lung damage compared to those infected with M. bovis (odds ratio [OR]: 7.60; 95% confidence interval [CI]: 1.07-54.09). M. tuberculosis infection was associated with lower expression of FADD and lower apoptosis level of macrophages compared to M. bovis. No significant different of RIP3 between MTBC species groups. In conclusion, M. tuberculosis Beijing strain was associated with severe pulmonary damage, inhibited FADD expression and reduced apoptosis level of macrophages derived from pulmonary TB patients. This suggests that the M. tuberculosis Beijing strain is potentially to be used as determinant of disease progressivity and tissue damage in TB cases.
Pigmented villonodular synovitis does not influence the outcomes following cruciate-retaining total knee arthroplasty: a case-control study with minimum five year follow-up
Authors: Lin Wei , Dai Yike , Niu Jinghui , Yang Guangmin , Li Ming , Wang Fei
Published: August 2020

Background: Pigmented villonodular synovitis (PVNS) is a rare synovial disease with benign hyperplasia, which has been successfully treated with total knee arthroplasty (TKA). The purpose of this study was to investigate the middle-term follow-up outcomes of cruciate-retaining (CR) TKA in patients with PVNS.Methods: From January 2012 to December 2014, a retrospective study was conducted in 17 patients with PVNS who underwent CR TKA as PVNS group. During this period, we also selected 68 patients with osteoarthritis who underwent CR TKA (control group) for comparison. The two groups matched in a 1:4 ratio based on age, sex, body mass index and follow-up time. The range of motion, Knee Society Score, revision rate, disease recurrence, wound complications and the survivorship curve of Kaplan-Meier implant were assessed between the two groups.Results: All patients were followed up at least five years. There were no difference in range of motion, and Knee Society Score between the two groups before surgery and at last follow-up after surgery (p > 0.05). In the PVNS group, no patients with the recurrence of PVNS were found at the last follow-up, one patient underwent revision surgery due to periprosthetic fracture, and three patients had stiffness one year after surgery (17.6% vs 1.5%, p = 0.005; ROM:16°- 81°), but no revision was needed. At seven years, the implant survivorship was 90.0% in the PVNS group and 96.6% in the control group (p = 0.54).Conclusions: This study demonstrated that the function of patients with PVNS who underwent CR TKA had been significantly improved, and the survival rate of implants in these patients were similar to the patients with OA. Consequently, the patients with PVNS who underwent CR TKA might be an achievable option. However, these patients should pay more attention to the occurrence of postoperative stiffness complication.
Impact of donor lung pathogenic bacteria detected by next-generation sequencing on early post-transplant outcomes in lung transplant recipients
Authors: Liu Dong , Zhang Ji , Wu Bo , Liu Feng , Ye Shugao , Wang Hongmei , Lv Jian , Weng Xing , Chen Yan , Han Weili , Chen Jingyu
Published: August 2020

Background: The effect of donor lung pathogenic bacteria on the prognosis of lung transplantation is not clear. We used the technique of next-generation sequencing (NGS) to detect the pathogenic bacteria from the lower respiratory tract and analyzed whether the colonized bacteria of donor lung could affect the outcomes of lung transplantation.Methods: All patients who underwent lung transplantation from March 2018 to June 2018 at Wuxi People's Hospital affiliated to Nanjing Medical University were included in this study. Twelve cases of donor lung were obtained, and 17 lung transplants were performed, including 12 single lung transplantation and 5 bilateral lung transplantation. The colonized bacteria in the lower lobe tissue of donor lung were detected by NGS, and the bacteria culture method was used to detect the bacteria in the airway secretion before and after the operation. The information of length of extracorporeal membrane oxygenation (ECMO) support, mechanical ventilation time, length of intensive care unit (ICU) stay, duration of fever and length of hospital stay were collected for prognostic analysis.Results: Compared with bacterial culture methods, the positive rate by using NGS in the lungs were higher (52.9% vs 41.2%). Among the patients who had detected bacteria by NGS in donor lungs before surgery, only one patient (1/9) developed the same bacteria after lung transplantation. Based on results of NGS and bacterial culture, there is no association between the colonized bacteria in donor lungs and the patient outcomes of immediate posttransplant period. Conclusion: NGS showed more sensitive than bacterial culture for detection of bacteria. The colonized bacteria in different parts of the lung are inconsistent. There is no association between the colonized bacteria in donor lungs and short-term outcome of lung transplantation patients.
Mortality of severely injured patients after ICU discharge: An underestimated problem?
Authors: Hamsen Uwe , Drotleff Niklas , Lefering Rolf , Gerstmeyer Julius , Schildhauer Thomas Armin , Waydhas Christian
Published: August 2020

BackgroundMost trauma patients admitted to the hospital alive and die later on, decease during the initial care in the emergency department or the intensive care unit (ICU). However, a number of patients pass away after having been discharged from the ICU during the initial hospital stay. On first sight these cases could be seen as “failure to rescue” of potentially salvageable patients. A low rate of such patients might be a potential indicator of quality for trauma care on ICUs and surgical wards.MethodsRetrospective analysis of the TraumaRegister DGU® with data from 2015-2017. Patients that died during the initial ICU stay were compared to those who were discharged from the initial ICU stay for at least 24 hours but died later on.ResultsA total of 82,313 trauma patients were included in the TraumaRegister DGU®. In total, 6,576 patients (8.0%) died during their hospital stay. Out of those, 5,481 were admitted to the ICU alive and 972 patients (17.7%) were discharged from ICU and died later on. Those were older (mean age: 77 vs. 68 years), less severely injured (mean ISS: 23.1 vs. 30.0 points) and had a longer mean ICU length of stay (10 vs. 6 days). A limitation of life-sustaining therapy due to a documented living will was present in 46.1% of all patients who died during their initial ICU stay and in 59.9% of patients who died after discharge from their initial ICU stay.Conclusions17.7% of all non-surviving severely injured trauma patients died within the hospital after discharge from their initial ICU treatment. Their death can partially be explained by a limitation of therapy due to a living will. In conclusion, the rate of such late deaths may represent patients that died of potentially avoidable or treatable complications.
Effects of continuous infusion of phenylephrine vs. norepinephrine on parturients and fetuses under LiDCOrapid monitoring: A randomized, double-blind, placebo-controlled study
Authors: Feng Kunpeng , Wang Xiaohua , Feng Xuexin , Zhang Jinfeng , Xiao Wei , Wang Fengying , Zhou Qi , Wang Tianlong
Published: August 2020

Background: Hypotension following spinal anesthesia (SA) during cesarean delivery (CD) occurs commonly and is related with maternal and fetal complications. Norepinephrine infusion is increasingly used for prevention of post-SA hypotension; however, its effects as compared to the traditional phenylephrine infusion remain unclear. This study aimed to compare the effects of phenylephrine and norepinephrine administered as continuous infusion during elective CD on maternal hemodynamic parameters and maternal and fetal outcomes.Methods: This prospective, single-center, randomized, controlled study included 238 consecutive term parturients who underwent CD from February 2019 to October 2019. They were randomized to receive continuous infusion of 0.25 μg/kg/min phenylephrine, 0.05 μg/kg/min norepinephrine, or placebo. Hemodynamic monitoring was performed at 10 time points using LiDCOrapid. We analyzed umbilical vein (UV), umbilical artery (UA), and peripheral vein (PV) blood gas indexes and recorded intraoperative complications.Results: In phenylephrine group, the systolic blood pressure (SBP) remain during the whole operation. Compared to the control group, phenylephrine, but not norepinephrine, significantly increased the systemic vascular resistance (SVR) to counteract the SA-induced vasodilatation, 3 min following norepinephrine/phenylephrine/LR administration (T4): 957.4±590.3 vs 590.1±273.7 (P<0.000001); 5 min following norepinephrine/phenylephrine/LR administration (T5): 1104±468.0 vs 789.4±376.2 (P=0.000002). at the time of incision (T6): 1084±524.8 vs 825.2± 428.6 (P=0.000188). Parturients in the phenylephrine group had significantly lower UV (1.91±0.43) (P=0.0003) and UA (2.05±0.61) (P=0.0038) lactate level compared to controls. Moreover, the UV pH value was higher in the phenylephrine than in the control group7.37±0.03(P=0.0013). Parturients had lower incidence of nausea, tachycardia, hypotension in phenylephrine group.Conclusions: In this dataset, continuous phenylephrine infusion reduced the incidence of SA-induced hypotension, ameliorated SVR, while decreasing overall maternal complications. Phenylephrine infusions are considered the better choice during CD because of the significant benefit to the fetus.Trial registration: Clinicaltrial.gov Registry, NCT03833895, Registered on 1 February 2019.
Comparative transcriptome analysis of genes involved in the drought stress response of two peanut (Arachis hypogaea L.) varieties
Authors: Jiang Chunji , Li Xinlin , Zou Jixiang , Ren Jingyao , Jin Chunyi , Zhang He , Yu Haiqiu , Jin Hua
Published: August 2020

Background: The peanut is one of the most important oil crops worldwide. Qualities and yields of peanut can be dramatically diminished by abiotic stresses particularly by drought. Therefore, it would be beneficial to gain a comprehensive understanding on peanut drought-responsive transcriptional regulatory activities, and hopefully to extract critical drought-tolerance-related molecular mechanism from it.Results: In this study, two peanut Arachis hypogaea L. varieties, NH5 (tolerant) and FH18 (sensitive), which show significantly differential drought tolerance, were screened from 23 main commercial peanut cultivars and used for physiological characterization and transcriptomic analysis. NH5 leaves showed higher water and GSH contents, faster stomatal closure, and lower relative conductivity (REC) than FH18. Under the time-course of drought-treatments 0 h (CK), 4 h (DT1), 8 h (DT2) and 24 h (DT3), the number of down-regulated differential expressed genes (DEGs) increased with the progression of treatments indicating repressive impacts on transcriptomes by drought in both peanut varieties.Conclusions: Nevertheless, NH5 maintained more stable transcriptomic dynamics than FH18. Furthermore, annotations of identified DEGs implicate signal transduction, the elimination of reactive oxygen species, and the maintenance of cell osmotic potential which are key drought-tolerance-related pathways. Finally, evidences from the examination of ABA and SA components suggested that the fast stomatal closure in NH5 was likely mediated through SA rather than ABA signaling. In all, these results have provided us a comprehensive overview of peanut drought-responsive transcriptomic changes, which could serve as solid foundation for further identification of the molecular drought-tolerance mechanism in peanut and other oil crops.
Reduced intensity of early intensification does not increase the risk of relapse in children with standard risk acute lymphoblastic leukemia - A multi-centric clinical study of GD-2008-ALL protocol
Authors: Li Xin-Yu , Li Jia-Qiang , Luo Xue-Qun , Wu Xue-Dong , Sun Xin , Xu Hong-Gui , Li Chang-Gang , Liu Ri-Yang , Sun Xiao-Fei , Chen Hui-Qin , Lin Yu-Deng , LI Chi-Kong , Fang Jian-Pei
Published: August 2020

Background The prognosis of childhood acute lymphoblastic leukemia (ALL) is optimistic with a 5-year event-free survival (EFS) rate of 70%-85%. However, the major causes of mortality are chemotherapy toxicity, infection and relapse. The Guangdong(GD)-2008-ALL collaborative protocol was carried out to study the effect of reduced intensity on treatment related mortality(TRM) based on Berlin-Frankfurt-Münster (BFM) 2002 backbone treatment. The study was designed to elucidate whether the reduced intensity is effective and safe for children with ALL. Methods The clinical data was obtained from February 28, 2008 to June 30, 2016. A total of 1,765 childhood ALL cases from 9 medical centers were collected and data was retrospectively analyzed. Patients were stratified into 3 groups according to bone marrow morphology, prednisone response, age, genotype, and karyotype information: standard risk (SR), intermediate risk (IR) and high risk (HR). For SR group, daunorubicin was decreased in induction IA while duration was reduced in Induction Ib (2 weeks in place of 4 weeks). Doses for CAM were same in all risk groups - SR patients got one CAM, others got two CAMs. Results The 5-year and 8-year overall survival (OS), event-free survival (EFS) and cumulative incidence of relapse (CIR) were 83.5±0.9% and 83.1±1.0%, 71.9±1.1% and 70.9±1.2%, and 19.5±1.0% and 20.5±1.1%, respectively. The 2-year treatment-related mortality (TRM) was 5.2±0.5%. The 5-year and 8-year OS were 90.7±1.4% and 89.6±1.6% in the SR group, while the 5-year and 8-year EFS were 81.5±1.8% and 80.0±2.0%. In the SR group, 74 (15.2 %) patients measured minimal residual disease (MRD) on Day 15 and Day 33 of induction therapy. Among them, 7 patients (9.46%) were MRD positive (≥ 0.01%) on Day 33. The incidence of relapse in the MRD Day33 positive group (n=7) was 28.6%, while in the MRD Day33 negative group (n=67) was 7.5% (p=0.129). Conclusions The results of GD-2008-ALL protocol are outstanding for reducing TRM in childhood ALL in China with excellent long term EFS. This protocol provided the evidence for further reducing intensity of induction therapy in the SR group according to the risk stratification. MRD levels on Day 15 and Day 33 are appropriate indexes for stratification.
Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India
Authors: Mungai Isaac Gikandi , Baghel Sumit Singh , Soni Suchi , Vagela Shailja , Sharma Megha , Diwan Vishal , Tamhankar Ashok J. , Lundborg Cecilia Stålsby , Pathak Ashish
Published: August 2020

Background: More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods: A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to study association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice. Results: Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean±SD score achieved was 22.3±7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75 th and q90 th ) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90 th ). Conclusions: The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon in future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population and to improve neonatal care services.
Evaluation of the effects of Vitamin C on Epithelialization of Burn Wounds: A Randomized Clinical Trial
Authors: Haddadi Mohammd , Jaghouri Elaheh , Sarpooshi Davood Robat , Ghobadi Fateme , Sarpooshi Hamid Robat
Published: August 2020

Objectives The purpose of this study is to determine the effect of topical vitamin C on second-degree burn wounds restoration. This was a clinical trial. The sample size was determined as 30. Participants were selected from patients suffering from second-degree burns who visited the Burn Center of Vaseei Hospital in Sabzevar. Both intervention and control groups targeted one patient.Dressing was changed in a daily manner after cleansing. A topical vitamin C solution was administered on the wounds. The Bates-Jensen Wound Assessment Tool was used to evaluate burn wound parameters in the 1 st , 3 rd , 7 th , and 14 th days of treatment. Data was analyzed using SPSS v.16 and ‘’repeated measures ANOVA. Results The average age of participants was 43.33 ± 11.9 years and 60% of the participants were males and 40% of them were females. The results of repeated measures ANOVA showed a statistically significant difference in mean scores of the wound between the two treatments (P = 0.047), wound healing significantly differed in the two groups and topical vitamin C solution had a significant effect on the acceleration of wound Epithelialization. The administration of topical vitamin C is recommended for epithelialization of second-degree burns.