bluuebunny/crossref_metadata_2025 huggingface dataset:
A Nomothetic Network Model Disclosing the Comorbidity of Depression and Unstable Angina: Effects of Atherogenicity, Insulin Resistance, Immune Activation, Antioxidants, the Endogenous Opioid System, Trace Elements, and Macrominerals
Authors: Mousa Rana , Smesam Hasan , Qazmooz Hasan , Al-Hakeim Hussein , Maes Michael
Published: September 2020

Background. There is strong comorbidity between atherosclerosis (ATS) and depression which is attributed to increased atherogenicity, insulin resistance (IR), and immune and oxidative stress.Aim of the study. To examine the role of the above pathways and mu opioid receptor (MOR), β-endorphin, zinc, copper, vitamin D3, calcium, and magnesium in depression due to ATS / unstable angina (UA).Methods. Biomarkers were assayed in 58 controls and 120 ATS patients divided into those with moderate and severe depression according to the Beck Depression Inventory (BDI)-II score > 19 and > 29, respectively. Results. Neural network and logistic regression models showed that severe depression due to ATS/UA was best predicted by IL-6, UA, MOR, zinc, β-endorphin, calcium and magnesium and that moderate depression was associated with IL-6, zinc, MOR, β-endorphin, UA, atherogenicity, IR, and calcium. These neural networks yielded a significant discrimination of severe and moderate depression with an area under the ROC curve of 0.831 and 0.931, respectively. Using Partial Least Squares analysis, 66.2% of the variance in a latent vector extracted from the ATS/UA clinical features, BDI-II scores, atherogenicity, and IR could be explained by the regression on IL-6, IL-10, zinc, copper, calcium, MOR, and age. The BDI-II scores increased from controls to ATS to UA class III to UA class IV.Conclusions. Depression due to ATS/UA is a reflective manifestation of increased atherogenicity and IR, which are modulated by immune activation, aberrations in the endogenous opioid system, antioxidants, trace elements, and macrominerals.
Enough is Enough, or More is More? Testing the Influence of Foraminiferal Count Size on Reconstructions of Paleo-Marsh Elevation
Authors: Kemp Andrew C. , Wright Alexander J. , Cahill Niamh
Published: September 2020

Salt-marsh foraminifera are sea-level proxies used to quantitatively reconstruct Holocene paleo-marsh elevations (PME) and subsequently relative sea level (RSL). The reliability of these reconstructions is partly dependent upon counting enough foraminifera to accurately characterize assemblages, while counting fewer tests allows more samples to be processed. We test the influence of count size on PME reconstructions by repeatedly subsampling foraminiferal assemblages preserved in a core of salt-marsh peat (from Newfoundland, Canada) with unusually large counts (up to 1595). Application of a single, weighted-averaging transfer function developed from a regional-scale modern training set to these ecologically-plausible simulated assemblages generated PME reconstructions at count sizes of 10–700. Reconstructed PMEs stabilize at counts sizes greater than ∼50 and counts exceeding ∼250 tests show little return for the additional time invested. The absence of some rare taxa in low counts is unlikely to markedly influence results from weighted-averaging transfer functions. Subsampling of modern foraminifera indicates that cross-validated transfer function performance shows only modest improvement when more than ∼40 foraminifera are counted. Studies seeking to understand multi-meter and millennial scale RSL trends should count more than ∼50 tests. The precision sought by studies aiming to resolve decimeter- and decadal-scale RSL variability is best achieved with counts greater than ∼75. In most studies seeking to reconstruct PME, effort is more productively allocated by counting relatively fewer foraminifera in more core samples than in counting large numbers of individuals. Target count sizes of 100–300 in existing studies are likely conservative and robust. Given the low diversity of salt-marsh foraminiferal assemblages, our results are likely applicable throughout and beyond northeastern North America.
Experimental Study of Heavy Oil Recovery Mechanisms during Cyclic Solvent Injection Processes
Authors: Plata Maria , Bryan Jonathan , Kantzas Apostolos
Published: September 2020

The cyclic solvent injection (CSI) process has recently shown to be a promising method for enhanced heavy oil recovery in Canada. Laboratory testing is often run before development of field pilots to assess the effect of parameters, such as solvent choice and process conditions, on the CSI response. However, differences between laboratory results vs. field applications have been observed. CSI laboratory studies work for only two to three cycles due to low incremental oil in subsequent cycles, whereas field pilots continue for years over multiple cycles. This experimental study is intended to capture the production mechanisms responsible for heavy oil production in CSI.

Primary production and CSI tests were conducted using sandpack models saturated with live heavy oil of 9530 mPa·s viscosity. The experiments were conducted in horizontal and vertical mode injection at high- and low-pressure depletion rates using two solvent mixtures of CH4 and C3H8. The sandpacks were scanned after every cycle to analyze the evolution of gas and oil saturations using computed tomography (CT). Three cores were used to study the effect of several parameters: gravity forces, pressure depletion rate, solvent composition, and initial oil saturation on the performance of CSI processes.

CSI cycles run after primary production in horizontal systems produced negligible incremental oil for both slow and fast drawdown rates due to the large void space and high free gas saturation inhibiting the pressure buildup to push the solvent-diluted oil. These CSI experiments were only initially successful in dead oil systems, in which the initial oil saturation was higher and appropriate pressure gradient was generated through fast depletion rates.

During the vertical alignment, CSI cycles exhibited higher incremental oil recovery per cycle. Slow depletion cycles were more efficient in terms of pressure and incremental recovery per cycle; however, faster depletion cycles performed better as a function of time. These results are more in line with the repeated recoveries measured over multiple cycles in field CSI pilot studies. More volume of diluted oil was drained out of the core when the solvent mixture with higher propane (C3H8) content was injected.

These results demonstrate the importance of gravity drainage in the CSI process and its significance on successful oil recovery rates. This study illustrates the limitations of previous horizontal laboratory tests and shows an improved test configuration for modeling and prediction of the improved response observed in CSI pilots.
The misdiagnosis of prolonged disorders of consciousness by a clinical consensus compared with repeated Coma-Recovery Scale-Revised assessment
Authors: Wang Jing , Hu Xiaohua , Hu Zhouyao , Sun Ziwei , Laureys Steven , Di Haibo
Published: September 2020

Background: Previous studies have shown that a single Coma-Recovery Scale-Revision (CRS-R) assessment can identify high rates of misdiagnosis by clinical consensus. The aim of this study was to investigate the proportion of misdiagnosis by clinical consensus compared to repeated behavior-scale assessments in patients with prolonged disorders of consciousness (DOC). Methods: Patients with prolonged DOC during hospitalization were screened by clinicians, and the clinicians formed a clinical-consensus diagnosis. Trained professionals used the CRS-R to evaluate the consciousness levels of the enrolled patients repeatedly (≥5 times) within a week. Based on the repeated evaluation results, the enrolled patients with prolonged DOC were divided into unresponsive wakefulness syndrome (UWS), minimally conscious state (MCS), and emergence from MCS (EMCS). Finally, the relationship between the results of the CRS-R and the clinical consensus were analyzed. Results: In this study, 137 patients with a clinical-consensus diagnosis of prolonged DOC were enrolled. It was found that 24.7% of patients with clinical UWS were actually in MCS after a single CRS-R behavior evaluation, while the repeated CRS-R evaluation results showed that the proportion of misdiagnosis of MCS was 38.2%. A total of 16.7% of EMCS patients were misdiagnosed with clinical MCS, and 1.1% of EMCS patients were misdiagnosed with clinical UWS. Conclusions: The rate of the misdiagnosis by clinical consensus is still relatively high. Therefore, clinicians should be aware of the importance of the bedside CRS-R behavior assessment and should apply the CRS-R tool in daily procedures.
The change of teeth color, whiteness variations and its psychosocial and self-perception effects when using low vs. high concentration bleaching gels: a one-year follow-up.
Authors: Estay Juan , Angel Pablo , Bersezio Cristian , R Mateus Tonetto , Jorquera Gilbert , Peña Manuel , Fernandéz Eduardo
Published: September 2020

Background: Dental bleaching in traditional concentrations generates greater sensitivity. In this respect, new systems of lower concentration of hydrogen peroxide for tooth bleaching appeared, with color stability unknown over time. The aim of this study was to compare the change and stability of color with low-concentration (6%) hydrogen peroxide gel in an in-office bleaching setting relative to conventional 37.5% gel, including their effects on psychosocial and esthetic self-perception, after one year. Methods: Patients (n=25) were assessed at 12 months post bleaching treatment (whitening with 6% chemo-activated alkaline formula gel versus 37.5% traditional concentration gel). Color changes were measured objectively using total variation in color (ΔE), and subjectively using Vita Classical and Vita Bleached scale (ΔSGU) by calibrated evaluators (Kappa=0.85). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Oral Health Impact Profile (OHIP-14) aesthetic questionnaires were used to measure the self-perception and the psychosocial impact of the bleaching protocols. Results: The effect (ΔE) of 37.5% HP (8.37 ± 2.73) was significantly better than that of 6% HP (5.27 ± 2.53) in terms of color rebound after one year of follow-up. There were significant differences in psychosocial impact and esthetic self-perception measurements prior to bleaching versus one-year post-whitening time points; positive effects were maintained. Conclusions: Low concentration (6%) achieved effective bleaching with good stability after one year, accompanied by a positive psychosocial impact and enhanced self-perception at follow-up. Trial registration: NCT03217994 (before enrollment of the first participant). Data register: July 14, 2017
Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study
Authors: Cailhol Johann , Khan Nichola
Published: September 2020

BackgroundSeine-Saint-Denis is a deprived departement (French administrative unit) in the North-East of Paris, France, hosting the majority of South Asian migrants in France. In recent years, the number of migrants from Pakistan, which has a high prevalence of hepatitis C globally, increased. As a corollary, this study addressed the high proportion of Pakistani patients in the infectious diseases clinic of a local hospital, diagnosed with hepatitis C, but also hepatitis B and Human Immunodeficiency Virus (HIV). It explored genealogies and beliefs about hepatitis and HIV transmission, including community, sexual and blood risk behaviours. The aim was to understand the ways these risk factors reduce or intensify both en route and once in France, in order to devise specific forms of community health intervention.MethodsThe study took place at Avicenne University-Hospital in Seine-Saint-Denis, and its environs, between July and September 2018. The design of the study was qualitative, combining semi-structured interviews, a focus group discussion, and ethnographic observations. The sample of Pakistani participants were selected from those followed-up for chronic hepatitis C, B, and/or HIV at Avicenne, and who had arrived after 2010 in Seine-Saint-Denis.ResultsThirteen semi-structured interviews were conducted, until saturation was reached. All participants were men from rural Punjab province. Most took the Eastern Mediterranean human smuggling route. Findings suggest that vulnerabilities to hepatitis and HIV transmission, originating in Pakistan, are intensified along the migration route and perpetuated in France. Taboo towards sexuality, promiscuity in cohabitation conditions, lack of knowledge about transmission were amongst the factors increasing vulnerabilities. Participants suggested a number of culturally-acceptable health promotion interventions in the community, such as outreach awareness and testing campaigns in workplaces, health promotion and education in mosques, as well as web-based sexual health promotion tool to preserve anonymity. ConclusionsOur findings highlight the need to look at specific groups at risk, related to their countries of origin. In-depth understandings of such groups, using interdisciplinary approaches such as were employed here, can allow for culturally adapted, tailored interventions. However, French colour-blind policies do not easily permit such kinds of targeted approach and this limitation requires further debate.
Comparative transcriptome analysis of root, stem, and leaf tissues of Entada phaseoloides reveals potential genes involved in triterpenoid saponin biosynthesis
Authors: Liao Weifang , Mei Zhinan , Miao Lihong , Liu Pulin , Gao Ruijie
Published: September 2020

Background

Entada phaseoloides (L.) Merr. is an important traditional medicinal plant. The stem of Entada phaseoloides is popularly used as traditional medicine because of its significance in dispelling wind and dampness and remarkable anti-inflammatory activities. Triterpenoid saponins are the major bioactive compounds of Entada phaseoloides. However, genomic or transcriptomic technologies have not been used to study the triterpenoid saponin biosynthetic pathway in this plant.

Results

We performed comparative transcriptome analysis of the root, stem, and leaf tissues of Entada phaseoloides with three independent biological replicates and obtained a total of 53.26 Gb clean data and 116,910 unigenes, with an average N50 length of 1218 bp. Putative functions could be annotated to 42,191 unigenes (36.1%) based on BLASTx searches against the Non-redundant, Uniprot, KEGG, Pfam, GO, KEGG and COG databases. Most of the unigenes related to triterpenoid saponin backbone biosynthesis were specifically upregulated in the stem. A total of 26 cytochrome P450 and 17 uridine diphosphate glycosyltransferase candidate genes related to triterpenoid saponin biosynthesis were identified. The differential expressions of selected genes were further verified by qPT-PCR.

Conclusions

The dataset reported here will facilitate the research about the functional genomics of triterpenoid saponin biosynthesis and genetic engineering of Entada phaseoloides.
A phase I study of a dual PI3-Kinase/mTOR inhibitor BEZ235 in adult patients with relapsed or refractory acute leukemia
Authors: Lang Fabian , Wunderle Lydia , Badura Susanne , Schleyer Eberhard , Brüggemann Monika , Serve Hubert , Schnittger Susanne , Gökbuget Nicola , Pfeifer Heike , Wagner Sebastian , Ashelford Kevin , Bug Gesine , Ottmann Oliver
Published: September 2020

Background Combined inhibition of phosphatidylinositol 3-kinase (PI3K) and the mammalian target of rapamycin (mTOR) complexes may be an efficient treatment for acute leukemia. The primary objective of this phase I single center open label study was to determine the maximum tolerated dose (MTD) and recommended phase II dose (RP2D) of the dual pan-class I PI3K and mTOR inhibitor BEZ235 in patients with advanced leukemia. Methods Herein patients > 18 years of age who had relapsed or showed refractory leukemia were treated with BEZ235 (orally at 300-400 mg BID (cohort -1/1)) to assess safety, tolerability, preliminary efficacy and pharmacokinetic (PK). Adverse events data and serious adverse events were analyzed and haematological and clinical biochemistry toxicities were assessed from laboratory test parameters. Response was assessed for the first time at the end of cycle 1 (day 29) and after every subsequent cycle. Pharmacokinetic and pharmacodynamic analyses of BEZ235 were also included (BEZ235 plasma levels, phosphorylation of AKT, S6 and 4EBP1). On statistics this trial is a multiple ascending dose study in which a following variant of the 3+3 rule (“Rolling Six”), a minimum of 6 and a maximum of 12 patients was recruited for the dose escalation and another 5 were planned for the expansion phase.Results Twenty-four patients with ALL (n=11) or AML (n=12) or CML-BP (n=1) were enrolled. All patients had failed one (n=5) or more lines of therapy (n=5) and 14 patients were in refractory / refractory relapse. No formal MTD was defined, stomatitis and gastrointestinal toxicity at 400 mg BID dose was considered incompatible with prolonged treatment. The RP2D of BEZ235 was defined as 300 mg BID. Four of 24 patients showed clinical benefit. Twenty-two of 24 patients discontinued because of progression, (median time to progression 27 days (4d-112d). There was no association between PK parameters and efficacy or tolerability. Conclusions Combined inhibition of PI3K and mTOR inhibits a clinically meaningful driver pathway in a small subset of patients with ALL, with no benefit in patients with AML.Trial registration ClinicalTrials.gov, identifier NCT01756118. registered 19th December 2012, https://clinicaltrials.gov/ct2/show/NCT01756118
Effect of Resilience on Infertile Couples’ Quality of Life: An Actor–Partner Interdependence Model Approach
Authors: Ha Ju-Young , Ban Seonhwa
Published: September 2020

BackgroundInfertility is an emerging socioeconomic issue affecting an individual’s life and the nation. However, only few studies have examined the influence of resilience on the quality of life (QoL) of spouses as actors and partners. Hence, this study aimed to analyze the influence of resilience, a positive factor that infertile couples may have, on QoL using the actor–partner interdependence model (APIM).MethodsBy the analyses of couples’ data, we analyzed the effect of resilience on the QoL of infertile couples as actors and partners. This cross-sectional study included 150 infertile couples. The Fertility Quality of Life and Resilience Scale was used to measure couples’ QoL and resilience. APIM was applied to analyze QoL.ResultsIn terms of actor effects, the resilience of both wives (β = 0.201, p < 0.001) and husbands (β = 0.713, p < 0.001) had a significant effect on individual QoL. With regard to partner effects, husbands’ resilience (β = 0.351, p < 0.001) had a significant impact on wives’ QoL and the wives’ resilience (β = 0.219, p = 0.009) had a significant impact on husbands’ QoL.ConclusionsThe resilience of an infertile actor was found to affect both his/her own QoL and his/her partner’s QoL. In the future, if a program is to be developed to improve couples’ QoL, both spouses should work together to improve their resilience, thereby improving their QoL.
Nursing and midwifery students’ experiences and perception of their clinical learning environment in Malawi: A mixed method study
Authors: Mbakaya Balwani Chingatichifwe , Kalembo Fatch Welcome , Zgambo Maggie , Konyani Alice , Lungu Florence , Tveit Bodil , Kaasen Anne , Simango Modesta , Bvumbwe Thokozani
Published: September 2020

Background

The clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. The aim of this study was to assess the experiences and perception of nursing and midwifery students of their clinical learning environment in Malawi.

Methods

A mixed-methods approach was used to collect data from nursing and midwifery students. Data were collected using a questionnaire and focus group discussions. Questionnaire data were collected using the Clinical Learning Environment Inventory (CLEI). Data from focus group discussions were collected using an interview guide which had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression while qualitative data were analysed by thematic analysis

Results

A total of 126 participants completed the questionnaire data while 30 students participated in the focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while Individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed statistically significant association between Satisfaction with clinical learning environment and Personalization (β = 0.50, p = < 0.001), and Task orientation (β =0.16 p= < 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment.

Conclusion

The findings of this study show that although satisfaction with clinical learning environment had the highest scores, students encountered multifaceted challenges in their clinical learning environment. A collaborative effort from training institutions and hospitals is needed to better support students with their clinical learning.
New vectors in northern Sarawak, Malaysian Borneo, for the zoonotic malaria parasite, Plasmodium knowlesi
Authors: De Joshua Ang Xin , Kadir Khamisah Abdul , Mohamad Dayang Shuaisah Awang , Matusop Asmad , Divis Paul Cliff Simon , Yaman Khatijah , Singh Balbir
Published: September 2020

Background: Plasmodium knowlesi is a significant cause of human malaria in Sarawak, Malaysian Borneo. Only one study has been previously undertaken in Sarawak to identify vectors of P. knowlesi , where Anopheles latens was incriminated as the vector in Kapit, central Sarawak. A study was therefore undertaken to identify malaria vectors in a different location in Sarawak. Methods: Mosquitoes found landing on humans and resting on leaves over a 5-day period at two sites in the Lawas District of northern Sarawak were collected and identified. DNA samples extracted from salivary glands of Anopheles mosquitoes were subjected to nested PCR malaria-detection assays. The small subunit ribosomal RNA ( SSU rRNA) gene of Plasmodium was sequenced, and the internal transcribed spacer 2 (ITS2) and mitochondrial cytochrome c oxidase subunit 1 ( cox 1) gene of the mosquitoes were sequenced from the Plasmodium -positive samples for phylogenetic analysis. Results: Totals of 65 anophelines and 127 culicines were collected. By PCR, 6 An. balabacensis and 5 An. donaldi were found to have single P. knowlesi infections while 3 other An. balabacensis had either single, double or triple infections with P. inui , P. fieldi , P. cynomolgi and P. knowlesi . Phylogenetic analysis of the Plasmodium SSU rRNA gene confirmed 3 An. donaldi and 3 An. balabacensis with single P. knowlesi infections, while 3 other An. balabacensis had two or more Plasmodium species of P. inui , P. knowlesi , P. cynomolgi and some species of Plasmodium that could not be conclusively identified. Phylogenies inferred from the ITS2 and/or cox 1 sequences of An. balabacensis and An. donaldi indicate that they are genetically indistinguishable from An. balabacensis and An. donaldi , respectively, found in Sabah, Malaysian Borneo. Conclusions: Previously An. latens was identified as the vector for P. knowlesi in Kapit, central Sarawak, Malaysian Borneo, and now An. balabacensis and An. donaldi have been incriminated as vectors for zoonotic malaria in Lawas, northern Sarawak.
Factors Associated with Current and Severe Pain Among People Living with HIV: Results From a Statewide Sample
Authors: Joseph Verlin , Jones Abenaa , Canidate Shantrel , Mannes Zachary , Lu Huiyin , Ennis Nicole , Ibanez Gladys , Somboonwit Charurut , Cook Robert
Published: September 2020

Background: People living with HIV (PLHIV) are more likely to suffer from pain compared to the general public. Pain often clusters with mental health symptoms and substance use. This study sought to evaluate mental health and substance use factors associated with any pain and severe pain intensities among PLHIV. Methods: Data were derived from HIV+ adults (N=733) recruited from community health centers across Florida who completed questionnaires regarding demographics, chronic pain, HIV clinical outcomes, mental health symptoms, and substance use information. Pain was assessed using the Brief Pain Inventory (BPI) short form. Multivariate logistic regression analysis was utilized to assess the relationship between selected covariates and pain. Results: Approximately half (45.0%) of participants reported having any current pain while 16.1% reported severe pain. The odds of having any current pain were 2.49 (CI 95% 1.48, 4.18, p<0.01) times greater among PLHIV reporting anxiety and 1.69 (CI 95% 1.11, 2.57, p=0.01) times greater among PLHIV reporting PTSD compared to those without those factors. The odds of having severe pain were 2.03 (CI 95% 1.03, 4.01, p=0.04) times greater among PLHIV reporting anxiety and 2.02 (CI 95% 1.26, 3.24, p<0.01) times greater among female participants compared to PLHIV without those factors respectively. Factors including depression, alcohol consumption, and marijuana use were not statistically associated with any current pain nor with severe pain.Conclusion: The relationship between pain and mental health is complex. Thus, future research is needed to determine if pain treatments may reduce mental health symptoms or if treatments can be targeted to address both issues simultaneously.
Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports
Authors: Yamada Tomoko , Fukuoka Hidenori , Hosokawa Yusei , Odake Yukiko , Yoshida Kenichi , Matsumoto Ryusaku , Bando Hironori , Okada Yuko , Hirota Yushi , Iguchi Genzo , Ogawa Wataru , Takahashi Yutaka
Published: September 2020

Background Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA).Methods In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n =18), SCS (n =18), and NFA (n =31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled.Results PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3~2.8) vs. 0.7 (0.5~1.8) and 0.9 (0.6~1.4) ng/mL/h; p =0.018 and p =0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5~79.5) vs. 156.0 (92.9~194.5) and 114.9 (90.1~153.4); p =0.001 and p <0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA >1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR <95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA.Conclusions ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC. Trial registration This study was not registered because of the retrospective analysis.
Proteomic and metabolic profile analysis of low-temperature storage responses in Ipomoea batata Lam. tuberous roots
Authors: Cui Peng , Li Yongxin , Cui Chenke , Huo Yanrong , Lu Guoquan , Yang Huqing
Published: September 2020

Background: Sweetpotato (Ipomoea batatas L.) is one of the seven major food crops grown worldwide, with 70-75% of production in China. Cold stress often can cause protein expression pattern and substance contents variations for tuberous roots of sweetpotato during low-temperature storage. Recently, we developed proteometabolic profiles of the fresh sweetpotatoes (cv. Xinxiang) in an attempt to discern the cold stress-responsive mechanism of tuberous root crops during post-harvest storage. Results: For roots stored under 4℃ condition, the CI index, REC and MDA content in roots were significantly higher than them at control temperature (13℃). The activities of SOD, CAT, APX, O2.- producing rate, proline and especially soluble sugar contents were also significantly increased. Most of the differentially expressed proteins (DEPs) were implicated in pathways related to metabolic pathway (~22%), especially phenylpropanoids (~10%) and followed by starch and sucrose metabolism (~3%). Proteins including L-ascorbate peroxidase 3 and catalase were down-regulated during low temperature (4℃) storage. α-amylase, sucrose synthase and fructokinase were significantly up-regulated in starch and sucrose metabolism, while β-glucosidase, glucose-1-phosphate adenylyl-transferase and starch synthase were opposite. Furthermore, metabolome profiling revealed that glucosinolate biosynthesis, tropane, piperidine and pyridine alkaloid biosynthesis as well as protein digestion and absorption played a leading role in metabolic pathways of sweetpotato roots. More importantly, leucine, tryptophan, tyrosine, isoleucine and valine were all significantly up-regulated in glucosinolate biosynthesis. Data are available via ProteomeXchange with identifier PXD017728.Conclusions: Our proteomic and metabolic profile analysis of sweetpotato roots stored at low temperature reveal that the antioxidant enzymes activities, proline and especially soluble sugar content were significantly increased. Most of the DEPs were implicated in phenylpropanoids and followed by starch and sucrose metabolism. The discrepancy between proteomic (L-ascorbate peroxidase 3 and catalase) and biochemical (APX/CAT enzyme activity) data may be explained by higher H2O2 levels and increased glutathione and ascorbate redox states, which enhanced the CAT/APX enzyme activity indirectly. Glucosinolate biosynthesis played a leading role in metabolic pathways of sweetpotao roots. More importantly, leucine, tryptophan, tyrosine, isoleucine and valine were all significantly up-regulated in glucosinolate biosynthesis.
Back protection of canvas paintings
Authors: Padfield Tim , Padfield Nicolas , Lee Daniel Sang-Hoon , Thøgersen Anne , Nielsen Astrid Valbjørn , Andersen Cecil Krarup , Scharff Mikkel
Published: September 2020

In this paper different scenarios for back protection of a canvas painting and their effect on the stability of the relative humidity behind the painting are tested. A painting on canvas, stretched on a wooden frame, was fitted with various styles of back protection and then exposed to a cycle of temperature variation at the back, with the front exposed to a constant room temperature. The painting was also exposed to a constant wall temperature and varying room temperature. The space between the canvas and the back

board was fitted with temperature and relative humidity (RH) sensors. The sensors were used to provide the essential single-point data of temperature and RH at the given locations. For more comprehensive understanding of the rather confined space, further numerical simulation (computational fluid dynamics) was adopted as part of the investigation. The computational fluid dynamics was used to understand the natural convection within the microclimate through the depictions of temperature distribution, as well as the corresponding air flow.

The unprotected painting sffered a large RH variation at its back, because of the varying canvas temperature interacting with the constant room air moisture content.

Effective stabilisation of the RH behind the canvas against temperature variation was provided by a shiny aluminium alloy sheet sealed against the frame. The non-absorbent back board experienced a strong variation in RH, because of humidity bu ering of the space by the painting canvas at a different temperature. Either a space or insulation between this back plate and the wall reduced the risk of condensation on the inner surface of the back plate. Insulation will however increase the risk of condensation on the wall surface behind the painting. An absorbent back board de-stabilised the RH at the painting canvas surface by providing a competing humidity bu er at a different temperature. To provide protection against moisture exchange with an unsuitable room RH, extra humidity bu er was placed 3 mm behind the painting canvas, kept close to the painting temperature by insulation between this bu er and the back board. This stabilised RH at the canvas surface but increased both the temperature and the RH variation at the back board and thus increased the risk of condensation on the inner surface of the back board. The RH and the temperature in the narrow spaces between the painting canvas and the wooden stretcher frame were always more nearly constant than in the open canvas area, which suggests an explanation for the widely observed better condition of the areas of canvas paintings which lie close over the support structure.

Our conclusion is that a non-absorbent, impermeable back plate gives good RH stability against a changing temperature gradient between wall and canvas painting surface.
How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.
Authors: Sim Sai Zhen - , Koh Hui Li , Lee Sabrina Poay Sian , Young Doris Yee Ling , Lee Eng Sing
Published: September 2020

Background: Multimorbidity is of increasing prevalence and importance. It has been negatively associated with health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity for the middle-aged population, defined as those between 40-64 years old, there is a paucity of research investigating the impact of multimorbidity in this population. This study aimed to investigate the association between multimorbidity and HrQoL in the middle-aged primary care population in Singapore.Methods: A cross-sectional study was conducted at a primary care centre in Singapore. Interviewer-administered questionnaires were used to collect data regarding the participants’ sociodemographic characteristics, chronic conditions, and HrQoL, as measured by the EuroQol five dimensions 3-levels questionnaire (EQ5D). We defined multimorbidity as the presence of three or more conditions, out of a list of 14 chronic conditions. The associations between multimorbidity and the components of the EQ5D were assessed using multivariable regression analyses.Results: The study included 297 participants, aged 40-64 years, of which 124 (41.7%) had multimorbidity. After adjusting for sociodemographic factors, participants with multimorbidity had significantly lower EQ5D UI, (β-coefficient -0.064 (C.I -0.125, -0.003), p = 0.04), but not significantly lower EQ5D VAS, (β-coefficient -0.045 (C.I 0.102, 0.012), p = 0.12). Additionally, participants with multimorbidity had higher odds (OR = 2.41, p = 0.01) of reporting problems due to pain/discomfort.Conclusion: Multimorbidity was not significantly associated with the overall health state, as measured by the EQ5D VAS, in middle-aged primary care patients. However, it was associated with the EQ5D UI which is a composite measure of five specific domains of HrQoL. Specifically, there was a statistically significant association between multimorbidity and the pain domain. Further studies are required to understand the relationship between multimorbidity and pain to enable physicians to better manage pain and HrQoL in this population.
Validation of the Moroccan arabic version of the low anterior resection syndrome score
Authors: Essangri Hajar , Majbar Mohammed Anass , Benkabbou Amine , Amrani Laila , Mohsine Raouf , Amine Souadka
Published: September 2020

Background: Sphincter sparing surgery is oftentimes associated with bowel dysfunction complaints, namely the low anterior resection syndrome (LARS). The LARS questionnaire is widely used to assess this syndrome. The aim of this observational study is to translate this tool into arabic and test its psychometric properties in rectal cancer patients, in order to ease its use in clinical practice and future research.Methods: The LARS questionnaire was translated to arabic and administered to a total of 143 patients. A subgroup of 42 patients took the test twice for test-retest reliability. Internal consistency was examined through cronbach’s alpha. The score results were correlated to the EORTC QLQ-C30 questionnaire for convergent validity assessment, while discriminant validity was established through the ability of the LARS score to differentiate patients with different clinical and pathological criteria.Results: The Moroccan Arabic version of the LARS score was completed by 143 patients. The internal consistency was demonstrated through a cronbach alpha score of 0.66. The agreement between the test and retest was established by a Bland Altman plot with 95% limits of agreement. 85.6% of patients remained in the same LARS category. The LARS score showed negative correlation with all five of the QLQ-C30 functional scales as well as positive correlation to the diarrhea symptom scale. The questionnaire score differed between patients according to their tumor location, chemoradiotherapy, type of mesorectal excision and anastomosis. Conclusion: The Moroccan Arabic version of the LARS score shows good psychometric properties and can be used for bowel dysfunction assessment in clinical and research settings.
Trends in the utilization of youth primary healthcare services and psychological distress
Authors: Potrebny Thomas , Wiium Nora , Haugstvedt Anne , Sollesnes Ragnhild , Wold Bente , Thuen Frode
Published: September 2020

Background Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need.Methods This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time. Results We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 300 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16-66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.Conclusions Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.
Using practical wisdom to facilitate ethical decision-making: a major empirical study of phronesis in the decision narratives of doctors.
Authors: Conroy Mervyn , Malik Aisha Y , Hale Catherine , Weir Catherine , Brockie Alan , Turner Chris
Published: September 2020

Background: Medical ethics has recently seen a drive away from multiple prescriptive approaches, where physicians are inundated with guidelines and principles, towards alternative, less deontological perspectives. This represents a clear call for theory building that does not produce more guidelines. Phronesis (practical wisdom) offers an alternative approach for ethical decision-making based on an application of accumulated wisdom gained through previous practice dilemmas and decisions experienced by practitioners. Phronesis, sometimes referred to as the ‘executive virtue’, offers a way to navigate the practice virtues for any given case to reach a final decision on the way forward. However, very limited empirical data exist to support the theory of phronesis -based medical decision-making, and what does exist tends to focus on individual practitioners rather than practice-based communities of physicians.Methods: The primary research question was: What does it mean to medical practitioners to make ethically wise decisions for patients and their communities? A three-year ethnographic study explored the practical wisdom of doctors (n=131) and used their narratives to develop theoretical understanding of the concepts of ethical decision-making. Data collection included narrative interviews and observations with hospital doctors and General Practitioners at all stages in career progression. The analysis draws on neo-Aristotelian and MacIntyrean concepts of practice- based virtue ethics and was supported by an arts-based film production process.Findings: We found that individually doctors conveyed many different practice virtues and those were consolidated into fifteen virtue continua that convey the participants’ collective practical wisdom, including the phronesis virtue. This study advances the existing theory on phronesis as a decision-making approach because only now a theoretical ‘collective practical wisdom’ exists. Conclusion: Given the arguments that doctors feel professionally and personally vulnerable in the context of ethical decision-making, our contribution in the form of a moral debating resource can support before, during and after decision-making reflection. The potential implications are that these theoretical findings can be used by educators and practitioners as a non-prescriptive alternative to improve ethical decision-making, thereby addressing the call in the literature, and benefit patients and their communities, as well.
Learning Attention for Object Tracking with Adversarial Learning Network
Authors: Cheng Xu , Song Chen , Gu Yongxiang , Chen Beijing , Zhou Lin , Zhang Yifeng
Published: September 2020

Artificial intelligence has been widely studied on solving intelligent surveillance analysis and security problems in recent years. Although many multimedia security approaches have been proposed by using deep learning network model, there are still some challenges on their performances which deserve in-depth research. On one hand, high computational complexity of current deep learning methods makes it hard to be applied to real-time scenario. On the other hand, it is difficult to obtain the specific features of a video by fine-tuning the network online with the object state of the first frame, which fails to capture rich appearance variations of the object. To solve above two issues, in this paper, an effective object tracking method with learning attention is proposed to achieve the object localization and reduce the training time in adversarial learning framework. First, a prediction network is designed to track the object in video sequences. The object positions of the first ten frames are employed to fine-tune prediction network, which can fully mine a specific features of an object. Second, the prediction network is integrated into the generative adversarial network framework, which randomly generates masks to capture object appearance variations via adaptively dropout input features. Third, we present a spatial attention mechanism to improve the tracking performance. The proposed network can identify the mask that maintains the most robust features of the objects over a long temporal span. Extensive experiments on two large-scale benchmarks demonstrate that the proposed algorithm performs favorably against state-of-the-art methods.
Violence –related injuries in a rapidly developing Middle Eastern country: A Retrospective Study from a Level 1Trauma Center
Authors: Mollazehi Monira , El-Menyar Ayman , Mekkodathil Ahammed , Consunji Rafael , Al-Thani Hassan
Published: September 2020

Background : Violence is a global public health problem leading to injuries, long-term physical, sexual or mental health problems and mortality. The burden of violence-related injuries remains understudied in the Arabian Gulf region. The present study aimed to describe the epidemiology of hospitalized violence-related injuries in Qatar. Methods : A retrospective analysis of trauma registry data from a level 1 trauma center was conducted by including all patients presented to the hospital following violence-related injuries in the duration between June 2010 and June 2017. We analyzed and compared the hospitalized interpersonal and self-inflicted violence groups. Results : The hospitalization rate of violence-related injuries was 4.6 per 100,000 population per year; it was significantly higher in males (5.5/100,000 males/year vs. 1.8/100,000 females/year) and in younger population, specifically in the 25-34 years age-group (41%). South Asians constituted 55% of the affected study population. Interpersonal violence (76.7%) was the commonest type of violence. Significant differences between interpersonal and self-inflicted violence were evident especially the type of trauma (i.e. blunt or penetrating), injured body regions, alcohol use, injury severity, intubation and psychiatric referrals (p<0.05). Overall in-hospital mortality was 6.4%; higher rate was reported in females (16% vs.5%, p=0.001). Outcomes including length of hospital stay and mortality were comparable regardless of the type of violence. Multivariable analysis showed that male gender and Blood Alcohol Concentration (BAC) positivity were predictors for interpersonal violence whereas Injury Severity Score and Glasgow Coma Scale were predictors of mortality among violence patients. Conclusions : The rate of hospitalization for violence-related injuries in Qatar is low; however, its burden on the trauma system is of concern. Although it comprised only 9.6% of the study population, females are more likely to get hospitalized following self-inflicted injuries when compared to interpersonal violence. Disproportionate burden of violence in the South Asians and young population warrants an evidence-based public health approach in violence prevention to well address the risk factors.