bluuebunny/crossref_metadata_2025 huggingface dataset:
Respiratory syncytial virus prophylaxis for prevention of recurrent childhood wheeze and asthma: a systematic review
Authors: Quinn Lauren , Shields Michael D , Sinha Ian , Groves Helen E
Published: October 2020

Background: Acute bronchiolitis caused by Respiratory Syncytial Virus (RSV) has been associated with greater risk of recurrent wheezing and asthma. However, it is unclear whether this association is causal. RSV-specific monoclonal antibodies have been shown to reduce RSV-related hospitalisations in high-risk infants, but the longer term follow-up has given conflicting evidence for prevention of recurrent wheeze or asthma.Objective: We performed a systematic review and meta-analysis to determine whether monoclonal antibody prophylaxis against RSV-bronchiolitis reduces the risk of subsequent recurrent wheeze or asthma. If so, this may support the hypothesis of causality. Methods: Studies were identified via an online database search using Embase, Medline, Pubmed, Web of Science and the Cochrane Library. Manufacturers of monoclonal antibodies were contacted directly for unpublished data. The intervention of interest was RSV monoclonal antibody prophylaxis and the primary outcome measure was recurrent wheeze and/or asthma. Studies were screened according to inclusion/exclusion criteria. Included studies were evaluated for quality and assessed for bias independently by 3 reviewers using the ‘Grading of Recommendations Assessment, Development and Evaluation’ (GRADE) approach. Results were extracted into 2x2 outcome tables and a meta-analysis carried out producing forest plots based on relative risk. Heterogeneity was assessed using the I2 statistic. Results: The search identified 141 articles, which, after screening resulted in eight studies (2 randomised controlled trials), thus including 11,195 infants in the meta-analysis. The overall result demonstrated a non-statistically significant reduction in relative risk of developing recurrent wheeze or asthma (RR 0.60; 95% CI 0.31 to 1.16). Study quality was generally low with evidence of publication bias and statistical heterogeneity. However, sub-group analysis excluding studies deemed to be ‘very low’ quality showed a relative risk of 0.42 (95% CI: 0.22 to 0.80, p = 0.008). A further sub-group analysis for infants aged 32 to <36 weeks showed a statistically significant relative risk of 0.35 (95% CI: 0.14 to 0.86, p = 0.02). Discussion: We did not identify an overall statistically significant benefit. However, our two subgroup analyses did find statistically significant benefits of monoclonal antibody therapy on the risk of recurrent wheeze and asthma. The main limitation of this study is the lack of high quality randomised controlled trials, highlighting the need for more research in this field.
Prevalence and Correlates of Maternal Early Stimulation Behaviors during Pregnancy in Northern Ghana: A Cross-Sectional Survey
Authors: Mackness Jessica , Gallis John A , Owusu Raymond Kofi , Ali Mohammed , Abubakr-Bibilazu Safiyatu , Adam Haliq , Aborigo Raymond , Awoonor-Williams John Koku , Lillie Margaret , McEwan Elena , Hembling John , Vasudevan Lavanya , Baumgartner Joy Noel
Published: October 2020

Background: Per UNICEF’s Nurturing Care Framework, early child development (ECD) begins during pregnancy and many lower-resource settings need data to inform their programs for optimal child development. The maternal-fetal relationship can be partly examined via a series of bonding activities called early stimulation behaviors (ESB). This study describes early stimulation behaviors and the associated correlates among pregnant women in Ghana. Methods: This cross-sectional study used data from a cluster-randomized trial in two districts of Northern Ghana. A total of 374 pregnant women were enrolled at baseline and administered a pre-intervention survey. Communication-related early stimulation behaviors was the primary outcome which was evaluated using three maternal-fetal bonding activities; did the woman self-report touching and/or talking, singing, and/or talking about family to her belly. A generalized estimating equation modified Poisson model was used for the bivariate and multivariable analysis.Results: About half of the participants reported performing communication-related ESB during pregnancy frequently or sometimes. Bivariate analysis revealed that negative life experiences including higher rates of emotional, physical and sexual intimate partner violence (IPV) and having moderate to severe depressive symptoms were associated with women performing early stimulation behaviors more often. In the multivariable model, physical intimate partner violence remained significantly associated with early stimulation behaviors. Conclusion: Research on early stimulation behaviors is still in a nascent phase. It is unclear why our results revealed an association between intimate partner violence and early stimulation behaviors; this could reflect a coping mechanism for the expectant mother. Further research is needed to better understand this association and explore potential long-term impacts of early stimulation behaviors during pregnancy on child development.Trial registration: Clinical Trials # NCT03665246, September 11, 2018
Executive dysfunctions mediate between altered sensory processing and daily activity performance in older adults
Authors: Yeger Batya Engel , Rosenblum Sara
Published: October 2020

Background: Sensory processing is essential for the interaction with the environment and for adequate daily function. Sensory processing may be deteriorated in the elderly and restrict daily activity performance. Another factor impacted by aging which significantly affects daily activities is Executive functions (EF). Yet, most studies refer separately to the impacts of sensory processing or EF on daily activities and use clinical evaluations that do not necessarily reflect functional restrictions in real life. This study aims to describe the prevalence of altered sensory processing in the elderly as expressed in daily life scenarios and explore whether EF mediate between altered sensory processing and daily activity performance in older adults.Methods: This cross-sectional study included 167 healthy and independently functioning people living in the community and aged 65 years and older. Participants who had sufficient cognitive status and no symptoms of depression completed a demographic and health-status questionnaire, the Adolescent/Adult Sensory Profile, the Behavior Rating Inventory of Executive Function–Adult Version and the Daily Living Questionnaire.Results: Altered sensory processing, and mainly by the reduced ability to register and modulate sensory input from daily environment, are prevalent in older adults. Their impacts on daily activity performance are mediated by executive dysfunctions.Conclusions: Executive dysfunctions may worsen the negative effects of altered sensory processing on daily activity performance in older adults. The interaction between executive functions and sensory processing should receive growing attention in intervention and prevention programs for older adults, with the emphasis on their expressions in peoples’ real life context.
Dysregulated Bile Acid Receptor-mediated Signaling and IL-17A Induction are Implicated in Diet-associated Hepatic Health and Cognitive Function
Authors: JENA PRASANT KUMAR , Sheng Lili , Nguyen Michelle , Lucente Jacopo Di , Hu Ying , Li Yongchun , Maezawa Izumi , Jin Lee-way , Wan Yu-Jui
Published: October 2020

Background: Chronic consumption of high sugar and high fat diet associated with liver inflammation and cognitive decline. This paper tests a hypothesis that the development and resolution of diet-induced nonalcoholic fatty liver disease (NAFLD) has an impact on neuroplasticity and cognition. Methods: C57BL/6 wild-type mice were fed with either a healthy control diet (CD) or a fructose, palmitate, and cholesterol (FPC)-enriched diet since weaning. When mice were 3-months old, FPC diet-fed mice were randomly assigned to receive either FPC-enriched diet with or without 6% inulin supplementation. At 8 months of age, all three groups of mice were euthanized followed by analysis of inflammatory signaling in the liver and brain, gut microbiota, and cecal metabolites. Results: Our data showed that FPC diet intake induced hepatic steatosis and inflammation in the liver and brain along with elevated RORγ and IL-17A signaling. Accompanied by microglia activation and reduced hippocampal long-term potentiation, FPC diet intake also reduced postsynaptic density-95 and brain derived neurotrophic factor, whereas inulin supplementation prevented diet-reduced neuroplasticity and the development of NAFLD. In the gut, FPC diet increased Coriobacteriaceae and Erysipelotrichaceae, which are implicated in cholesterol metabolism, and the genus Allobaculum, and inulin supplementation reduced them. Furthermore, FPC diet reduced FXR and TGR5 signaling, and inulin supplementation reversed these changes. Untargeted cecal metabolomics profiling uncovered 273 metabolites, and 104 had significant changes due to FPC diet intake or inulin supplementation. Among the top 10 most affected metabolites, FPC-fed mice had marked increase of zymosterol, a cholesterol biosynthesis metabolite, and reduced 2,8-dihydroxyquinoline, which has known benefits in reducing glucose intolerance; these changes were reversible by inulin supplementation. Additionally, the abundance of Barnesiella, Coprobacter, Clostridium XIVa, and Butyrivibrio were negatively correlated with FPC diet intake and the concentration of cecal zymosterol but positively associated with inulin supplementation, suggesting their benefits. Conclusion: Taken together, the presented data suggest that diet alters the gut microbiota and their metabolites, including bile acids. This will subsequently affect IL-17A signaling, resulting in systemic impacts on both hepatic metabolism and cognitive function.
Resilience, Occupational Burnout, and Parenting Stress in Nurses Caring for COVID-2019 Patients
Authors: Bashirian Saeid , Bijani Mostafa , Borzou Seyed Reza , Khazaei Salman , Mohammadi Fateme
Published: October 2020

Background: Caring of patients with Corona Virus Infection Disease (COVID 2019) may have had an impact on the occupational burnout, resilience, and parenting of the nurses. Purpose: Evaluation occupational burnout, resilience, and parenting stress in nurses caring for COVID 2019patients.Methods: The present study is a cross-sectional study Base on Strengthening the Reporting of Observational Studies in Epidemiology Statement (STROBE). 420 nurses cared for COVID 2019 patients in 5 hospitals selected via convenience sampling. Each participant completed the scales online. Data were analyzed in SPSS v. 22.Results: Occupational burnout has a negative correlation with resilience and a positive correlation with parenting stress and can predict 61.32% of changes in the occupational burnout variance of nurses. Conclusion: the resilience, parenting stress, marital status, number of children, employment status, and gender predicated High percentage of the nurses’ occupational burnout variance. The nurse managers should use these findings to provide appropriate environments for nurses, that to develop more comprehensive plans for support of nurses for the current and future crises.
Validity and reliability of the Portuguese version of the modified Migraine Disability Assessment
Authors: Ferreira Pedro , Luzeiro Isabel , Lopes Margarida , Jorge André , Silva Bruno , Ferreira Lara
Published: October 2020

Background
Migraine Disability Assessment Scale (MIDAS) is a useful tool to measure headache-related disability. Modified MIDAS with 4-week recall period reduces recall bias and improves accuracy of the results. This study aimed at validating mMIDAS in Portuguese.
Methods
Studied population consisted of adult migraine patients attending a headache outpatient clinic. Reliability was assessed by internal consistency and reproducibility in a 3-week test-retest. Content validity was evaluated by two expert panels. Construct validity was tested by comparing mMIDAS-P index in socioeconomic and clinical patient groups and scale unidimensionality was evidenced by factor analysis. Criterion validity was tested using EQ-5D-5L and HADS.
Results
92 patients, 88% female, mean age of 44 years, participated. They had, in average, 9.7 headache days in previous month, pain averaging 7.5/10. About 69.9% were on a migraine prophylactic treatment, and 42.4% had severe disability; 29.4% and 13.0% showed, respectively, moderate/severe anxiety and depression. Content validity showed that mMIDAS-P is simple and clinically useful. It did not show to be determined by patient’s sociodemographic characteristics and it was correlated with depression scale and EQ-5D-5L. Test-retest demonstrated high reproductive reliability and good internal consistency.
Conclusion
mMIDAS-P is valid and reliable. We strongly recommend it for clinical and research use.
CellRank for directed single-cell fate mapping
Authors: Lange Marius , Bergen Volker , Klein Michal , Setty Manu , Reuter Bernhard , Bakhti Mostafa , Lickert Heiko , Ansari Meshal , Schniering Janine , Schiller Herbert , Pe'er Dana , Theis Fabian
Published: October 2020

Computational trajectory inference enables the reconstruction of cell-state dynamics from single-cell RNA sequencing experiments. However, trajectory inference requires that the direction of a biological process is known, largely limiting its application to differentiating systems in normal development. Here, we present CellRank (https://cellrank.org) for mapping the fate of single cells in diverse scenarios, including perturbations such as regeneration or disease, for which direction is unknown. Our approach combines the robustness of trajectory inference with directional information from RNA velocity, derived from ratios of spliced to unspliced reads. CellRank takes into account both the gradual and stochastic nature of cellular fate decisions, as well as uncertainty in RNA velocity vectors. On data from pancreas development, we show that it automatically detects initial, intermediate and terminal populations, predicts fate potentials and visualizes continuous gene expression trends along individual lineages. CellRank also predicts a novel dedifferentiation trajectory during regeneration after lung injury, which we follow up experimentally by confirming the existence of previously unknown intermediate cell states.
Evidence-informed decision about (de-)implementing return-to-work coordination – a case study
Authors: Tikka Christina , Verbeek Jos , Hoving Jan , Kunz Regina
Published: October 2020

BackgroundCoordination of return-to-work (RtW) with the aim to decrease sick leave in many countries. Compared to usual care, a Cochrane review found RtW coordination to have no considerable effect on sick leave. The aim of the study is to find out how the evidence from this review can be used for decisions about (de-)implementing RtW coordination in a country specific setting, using Finland as an example. MethodsWe conducted a systematic literature search and online survey with two groups of experts to collect data on the similarity of RtW interventions in Finland and those evaluated in the Cochrane review. Using content analysis methods we analysed how comparable the interventions in the Cochrane review are to Finish practice. We modelled the costs of RtW coordination compared to usual care for Finland. We used the criteria of the evidence-to-decision framework to draw conclusions about (de-)implementing RtW coordination in Finland. ResultsWe included 7 documents from the literature search and received survey data from 10 survey participants. RtW coordination included, both in Finland and in the review, at least one face-to-face meeting between the physician and the worker, a workers’ needs assessment, and an individual RtW plan and its implementation. Usual care focuses on medical treatment and may include general RtW advice. RtW coordination would be cost saving if it decreases sick leave with at least two days compared to usual care. The evidence in the Cochrane review was mainly of low certainty and the effect sizes had relatively wide confidence intervals. Only a new, high quality and large RCT can decrease the current uncertainty but this is unlikely to happen. The evidence-to-decision framework did not provide arguments for further implementation nor for de-implementation of the intervention. ConclusionsInterventions evaluated in the Cochrane review are similar to RtW coordination and usual care interventions in Finland. Considering all EtD framework criteria, including certainty of the evidence and costs, de-implementation of RtW coordination interventions in Finland seems unnecessary. Better evidence about the costs and stakeholders’ values regarding RtW coordination is needed to improve decision making.
Radiological and Long-Term Patient-Reported Outcome after Stabilization of Traumatic Thoraco-Lumbar Spinal Fractures using an Expandable Vertebral Body Replacement Implant.
Authors: Lang Siegmund , Neumann Carsten , Schwaiger Christina , Voss Andreas , Alt Volker , Loibl Markus , Kerschbaum Maximilian
Published: October 2020

BackgroundA combined posterior and anterior stabilization was found to offer a better restoration of the sagittal profile of thoracolumbar fractures in comparison to posterior-only stabilization. Data on restoring the bisegmental kyphotic endplate angle (BKA) and on patient-reported outcome measures (PROM) is sparse.Patients and Methods136 patients with traumatic thoraco-lumbar spinal fractures were treated with an expandable VBR implant (Obelisc™, Ulrich Medical, Germany). in our trauma department between 2001 and 2015. Radiological data acquisition was completed pre- and postoperatively, after at least six months and approximately two years after surgery. The BKA was measured at each follow-up. The patient related outcome was evaluated prospectively.Results117 (31 female, 86 males; age: 52.7 ± 16.5 years) patients were included in the study. 64 patients (54.7% of included patients; age: 53.2 ± 14.8 years) completed the PROM questionnaires and therefore were assigned to the study group. An A4 fracture was seen in 99 cases (84.6%) and 85 (72.6%) fractures were located at the lumbar spine. Intraoperative reduction of the BKA in 117 patients was 6.6 ± 8.2° (p < 0.01). A significant loss of reduction of 2.6 ± 4.2° at the first follow-up (t1) and of 4.4 ± 6.6° at the second follow-up (t2) was measured (each p < 0.05). The consolidation rate was 95.7%. The total revision rate was 5.1%. 64 patients (54.7% of included patients; age: 53.2 ± 14.8 years) completed the PROM questionnaires and therefore were assigned to the study group. Mean time between index surgery and completion of the PROM questionnaire was 109.4 ± 44.6 months. Mean ODI of was 28.4 ± 17.6, the mean EQ-5D VAS reached 57.9 ± 2.5 points. The cohort showed significantly lower SF-36 values compared to a healthy reference population (each p < 0.05).ConclusionTreatment of traumatic thoraco-lumbar spinal fractures using an expandable VBR implant is an effective and safe procedure. A significant operative correction of the BKA could be achieved. Although the initial reconstruction of the BKA did not consist over time in the study group, satisfactory PROMs were found.
Bridging scales in disordered porous media by mapping molecular dynamics onto intermittent Brownian motion
Authors: Bousige Colin , Levitz Pierre , Coasne Benoit
Published: October 2020

Owing to their complex pore morphology and strong surface heterogeneity, disordered nanoporous media possess a rich underlying diffusion landscape that gives rise to specific transport phenomena. The unique diffusion mechanisms in such heterogeneous, ultra-confining solids stem from restricted pore relocation and blurred, i.e. ill-defined, pore/surface boundaries. As a result, while the fundamentals of diffusion and transport in simple pore geometries are well-established, the case of fluids confined in such complex porous materials still challenges existing frameworks. Here, we invoke the intermittent surface/pore diffusion formalism to map molecular dynamics onto random walk in disordered nanoporous media. Our hierarchical strategy allows quantitatively bridging microscopic and mesoscopic dynamics with parameters obtained from simple physical laws. In more detail, the surface residence and relocation times - t_A, t_B - are shown to derive from pore size p and temperature-rescaled surface interaction ε/k_BT. On the one hand, t_A obeys a transition state theory with an adsorption free energy barrier ~ε/k_BT and a prefactor ~1ps corrected for pore curvature p. On the other hand, t_B scales with p which is rationalized through a cutoff in the relocation first passage distribution. Beyond fundamental implications, the present approach provides a robust formalism to predict diffusion for any fluid in complex nanoporous media using fluid and material parameters available to simple experiments.
WAKMAR2, a Prognosis-related Enhancer RNA in Gastric Cancer
Authors: Zhang Yankai , Yan Yichao , Ning Ning , Shen Zhanlong , Ye Yingjiang
Published: October 2020

Purpose An increasing number of long non-coding RNAs (lncRNAs) are thought to be associated with gastric cancer (GC). A lncRNA subclass that promotes enhancer function is called enhancer RNA (eRNA). We aimed to identify an eRNA that can predict GC prognosis and response to immune checkpoint inhibitors (ICIs).Methods Kaplan–Meier survival analysis was utilized to screen eRNA which can predict the prognosis of GC (P <0.05). The method of Spearman correlation analysis was employed in the filtration of target genes related to eRNA (r> 0.4, P <0.001). According to the median of WAKMAR2 expression, the patients were subdivided into low expression group and high expression group. Subsequently, differences of immune checkpoint-related genes and immune cell infiltration between the two groups were further explored. Furthermore, we analyzed the correlation of WAKMAR2 with tumor mutation burden (TMB) and microsatellite instability (MSI) in GC and other types of cancer.Results WAKMAR2 and its target gene TNFAIP3 entered the subsequent analysis. Patients with high-WAKMAR2 expression had a favorable prognosis compared to patients with low-WAKMAR2 expression (P = 0.048). Immune checkpoint-related genes (PD-L1, CTLA4, PDCD1, LAG3) in the WAKMAR2 high-expression group were also highly expressed, except for B7-H3. In addition, infiltration levels of B cells naive, T cells CD8, T cells CD4 memory activated, as well as Macrophages M1 in high-WAKMAR2 group were greater than in low-WAKMAR2 group. Last, the expression of WAKMAR2 in GC was significantly correlated with TMB and MSI.Conclusion WAKMAR2, a new eRNA, is a promising biomarker that can be used to predict the overall survival (OS) of GC patients, and WAKMAR2 expression can be utilized to identify ICB responders in GC, providing new insights for immunotherapy strategies.
MicroRNA-mediated Extracellular Matrix Remodeling in Squamous Cell Carcinoma of the Oral Cavity
Authors: Menderico Gilberto Mendes , Theodoro Thérèse Rachell , Pasini Fatima Solange , Ishikawa Marina de Menezes , Santos Nayara Stephânie Sousa , de Mello Evandro Sobroza , Pinhal Maria Aparecida da Silva , Moyses Raquel Ajub , Kulcsar Marco Aurelio Vamondes , Dedivitis Rogério Aparecido , Cernea Claudio Roberto , Kowalski Luiz Paulo , de Matos Leandro Luongo
Published: October 2020

Background: It has been demonstrated that for oral cavity squamous cell carcinoma (SCC) as tumor thickness increases, there are lower rates of survival. Several molecular factors have been studied to determine this invasive behavior, including microRNAs, that play a role in the tumor microenvironment. Methods: The aim of this study is evaluate the role of extracellular matrix remodeling, as well as the involvement of microRNAs, in the process of oral cavity SCC carcinogenesis. This was a retrospective study with patients operated on for SCC of the oral cavity, in addition to a group of oral mucosa samples from paired patients. RNA extraction was performed, followed by complementary DNA amplification of microRNAs related to adhesion, migration, cell proliferation, apoptosis, and constituents of the extracellular matrix. We also performed immunohistochemical reactions for markers involved in the same biological processes. Results: High expression of miR-21-5p and miR-106-5p and low expression of miR-320a and miR-222-3p were predictors of malignancies and mir21-5p, individually, showed the best differentiation between the groups (AUC = 0.972). Regarding the immunohistochemical markers, there was greater expression of p53, EGFR, metalloproteinase-2 (MMP-2), laminin beta, Ki-67 and CD34 in the tumor cells than in the healthy mucosa. Furthermore, increased expression of MMP-2, metalloproteinase-9 (MMP-9), laminin alpha and laminin beta in tumor-related fibroblasts and lower continuity of type IV collagen in the basement membrane were observed. Conclusions: These results demonstrate the biological effects of microRNAs on the carcinogenesis of SCC of the oral cavity as well as the intense modification of the tumor microenvironment.
Multiple role of diazotrophs in coupling nitrogen and iron biogeochemical processes through vertical soil profiles of different paddy soil types
Authors: Wang Xiaomi , Teng Ying , Ren Wenjie , Li Yuntao , Yang Teng , Chen Yan , Zhang Huimin , Kuramae Eiko E.
Published: October 2020

Background: Soil microbiota exert fundamental functions in maintaining ecosystem functioning and services, including pedogenesis, biogeochemical processes and plant productivity, especially for agriculture system. Despite their ubiquitousness from the epipedon to deep soil, the vertical characteristics of microbiomes (especially for functional microorganisms) and their contribution to soil element cycling when considering soil developmental features are poorly understood. Here, nine profiles (0~135 cm) of two canonical paddy soil types (Fe-accumuli- and Hapli-stagnic anthrosols; 111 samples in total) at a local scale were collected, which represented relative long- and short-term water flooding history, respectively. The vertical variations in edaphic characteristics and assemblies of soil bacterial and diazotrophic communities, and microbial contribution to element cycling were explored. Results: Across soil profiles, Hapli-stagnic anthrosol was characteristic of higher concentrations in free iron oxides and total iron in the epipedon, and contained higher amounts of ammonia along the subsurface layers, as compared with acidic Fe-accumuli-anthrosol. Community assemblies of bacteria and diazotrophs, as well as edaphic properties, were mainly shaped by soil depths, followed by soil types. Furthermore, random forest analysis revealed that, for Fe-accumuli-anthrosol, available Fe could best predict nitrogen cycling index and nitrogen status was significantly related to iron cycling index; while in Hapli-stagnic anthrosol, available sulfur was the most important variable in predicting nitrogen and iron cycling indices. Among the dominant genera, some distinctive biomarkers that varied remarkably between the two soil types were noticeable for their contributions to both nitrogen and iron transformation, including iron-reducing diazotroph Geobacter and iron-oxidizing bacterium Rhodanobacter that characterized Fe-accumuli type, and sulfur reducing diazotroph Desulfobacca as main discriminant clades for Hapli-stagnic type.Conclusions: A novel perspective was proposed on the vertical characteristics of edaphic properties and bacterial and diazotrophic communities in the two paddy soil types. The findings indicated the nitrogen-iron cycling processes for Fe-accumuli-anthrosol and nitrogen-iron-sulfur coupling interaction for Hapli-stagnic anthrosol, advancing our understanding of the significant multiple role played by soil microorganisms, especially for diazotrophs, in element biogeochemical cycles.
Multi-spectral and Thermography Imaging Techniques for the Investigation of a 15th Century Wall Painting
Authors: Ricci Marco , Laureti Stefano , Malekmohammadi Hamed , Sfarra Stefano , Melis Marcello , Agresti Giorgia , Lanteri Luca , Colantonio Claudia , Calabrò Giuseppe , Pelosi Claudia
Published: October 2020

When planning the restoration of an artwork, the good practice involves the evaluation of the item healthiness before starting the common operation of cleaning, consolidation, etc., possibly through non-invasive techniques that supply meaningful information about the whole item. Motivated by this need, a plethora of imaging techniques are used in cultural heritage diagnostic typically borrowed from other applications – e.g. medical diagnostics, nondestructive testing, etc., and then tailored for inspecting cultural heritage objects. In the inspection of a painting, hyper- and multi- spectral techniques are commonly used to analyze the outer layers (varnish, pictorial and drawing) while X-ray, tomography, and many other can be employed to investigate its inner structure. Although highly desirable, a single technique providing all the info about a painting is still not available, thus it is of great interest defining protocols that could optimally exploit the complementarities of a limited number of techniques. To this aim, the present paper shows the combined use of the Hypecolorimetric Multispectral Imaging (HMI) and that of the Pulse-Compression Thermography (PuCT) on a 15th century wall painting attributed to the Italian artist Antonio del Massaro, also known as Pastura, and representing the Madonna with the Child and the Saints Jerome and Francis. In particular, HMI is a multispectral imaging method working from the ultraviolet to the near infrared region, exploiting advanced processing based on artificial intelligence to define hypercolorimetric coordinates. Such approach guarantees a thorough analysis of the outer layers, underlining previous restorations, varnish alterations and allowing the pigments to be classified from a comparison with a large database. The PuCT method adopted here has been tailored for the specific needs of artworks’ inspection and it allows for a safe imaging of the multilayer structure of paintings, and hence the stratigraphy analysis, through a suitable processing of the time-domain thermal response. The capabilities and the complementarities of the two techniques, whose info can also be fused through postprocessing techniques, are illustrated in detail in this paper. A false-color imaging approach is also proposed to improve the readability and analysis of the thermography results.
Prevalence of Advance Care Planning Practices Among People with Chronic Diseases in Hospital and Community Settings: A Quasi-Experimental Design
Authors: Jeong Sarah Yeun-Sim , Barrett Tomiko , Ohr Se Ok , Cleasby Peter , Davey Ryan
Published: October 2020

Background: Advance Care Planning (ACP) enables healthcare professionals to embrace the important process where patients think about their values in life and goals for health care, and discuss their future health care preferences with family members for a time when they are not able to make health care decisions. Despite the promotion of ACP last two decades, and well-known benefits of ACP and a written Advance Care Directive (ACD), they are still underutilised in Australia and across the world. Previous studies have provided some insights, however, an uptake of ACP and prevalence of ACDs in community setting is rarely reported.Methods: The aim of this study was to determine the uptake of ACP and prevalence of ACDs among people with chronic diseases in hospital and community settings. A retrospective medical record audit of eligible patients looking for evidence of ACP was conducted in 16 research sites (eight intervention and eight control) in hospital and community care settings. Participants included those who were admitted to one of the research sites, and who were aged 18 years and over with at least one of nine nominated chronic diseases. The primary outcome measures included the number of patients with evidence of ACP through the following practices: completion of an ACD, appointment of an Enduring Guardian (EG), or completion of a resuscitation plan. Results: The overall prevalence of ACD was 2.8% (n=28) out of 1006 audited records, and only 10 of them were legally binding. The number of EGs legally appointed was 39 (3.9%) across the sites. A total of 151 (15.4%) resuscitation plans were found across the eight hospital sites. 95% (n=144) of the resuscitation plans advised ‘Not-for-resuscitation’. Conclusions: The uptake of ACP is very low. Current medical recording system reveals the challenges in ACP lie in the process of storage, access and execution of the ACDs. Given that having an ACD or EG in place is only useful if the treating physician knows how and where to access the information, it has implications for policy, information system, and healthcare professionals’ education. Trial registration: The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12618001627246). The URL of the trial registry record http://www.anzctr.org.au/trial/MyTrial.aspx
Comparison of the Reductions in LDL-C and Non-HDL-C Induced by the Red Yeast Rice Extract Xuezhikang Between Fasting and Nonfasting States in Patients With Coronary Heart Disease
Authors: Zhu Li-Yuan , Wen Xing-Yu , Xiang Qun-Yan , Guo Li-Ling , Xu Jin , Zhao Shui-Ping , Liu Ling
Published: October 2020

Background: Xuezhikang, an extract of red yeast rice, effectively lowers fasting blood lipid levels. However, the influence of Xuezhikang on nonfasting levels of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) has not been explored in Chinese patients with coronary heart disease (CHD).Methods: Fifty CHD patients were enrolled and randomly divided into two groups (each n = 25) to receive 1200 mg/d Xuezhikang or not for six weeks as routine therapy. Blood lipids were measured repeatedly before and after six weeks of treatment at 0, 2, 4 and 6 hours (h) after a standard breakfast containing 800 kcal and 50 g fat.Result: Serum LDL-C levels significantly decreased, from a fasting level of 3.88 mmol/L to nonfasting levels of 2.99, 2.83 and 3.23 mmol/L at 2, 4 and 6 h, respectively, after breakfast (P<0.05), while there was no significant difference in total cholesterol (TC) levels between the fasting value and the values at any nonfasting time-points. The serum non-HDL-C level mildly increased from a fasting level of 4.29 mmol/L to nonfasting levels of 4.32, 4.38 and 4.34 mmol/L at 2, 4 and 6 h postprandially, respectively, and the difference reached statistical significance only at 4 and 6 h after breakfast (P < 0.05). There was no difference in fasting and nonfasting blood lipids between the two groups at baseline. After six weeks of Xuezhikang treatment, patients had significantly lower fasting and nonfasting serum levels of LDL-C and HDL-C (P < 0.05) than they did pretreatment. LDL-C levels were reduced by 27.8%, 28.1%, 26.2% and 25.3% at 0, 2, 4 and 6 h, respectively, and non-HDL-C levels were reduced by 27.6%, 28.7%, 29.0% and 28.0% at 0, 2, 4 and 6 h, respectively, after breakfast. There was no significant difference in the percent reductions in LDL-C and non-HDL-C levels among the four different time-points.Conclusions: A six-week Xuezhikang (1200 mg/d) treatment significantly decreased LDL-C and non-HDL-C levels, with similar percent reductions in fasting and nonfasting states in CHD patients. This may indicate that nonfasting blood lipids detected at the same time point after a standard meal could replace fasting blood lipids when evaluating the efficacy of cholesterol control in CHD patients who are unwilling or unable to fast.
The anti-oxidative Effect of Chrysanthemum Extract on Retinal- light Damage of Mice
Authors: Gong YiBo , Wang Xuechun , Wang Yuchuan , Hao Peng , Guo Yatu , Zhang Wei
Published: October 2020

Background:Apoptosis of photoreceptor cells and oxidative stress of RPE in age-related macular degeneration (AMD) could be promoted by photopic oxidative stress. In our study we are aim to study the protective effect of chrysanthemum extract on light damaged retina of mice.Methods:In vitro, ARPE-19 cells are incubated and divided into four groups: the control, the light damaged, the low and high dose-chrysanthemum extract groups. The last three groups were dropped in zero, low and high concentration of chrysanthemum extract separately before exposing to light. Cellular viability and Reactive Oxygen Species(ROS) production were measured by MTT and immunofluorescence. In vivo, C57BL/6J mice were divided into four groups as above mentioned. Low and high concentration of chrysanthemum extract were given by continuous intragastric administration before being exposed to white light. Retinal function was evaluated by electroretinogram. Optical coherence tomography and Fluorescein fundus angiography were used to observe the morphology and vessels. HE staining and TUNEL immunofluorescence for presenting morphology and apoptosis of isolated retina.Results:Viability of ARPE-19 cells decreased and ROS production increased after the light damaged. However, treatment with chrysanthemum extract, viability improved and ROS declined. After light injury, dysfunctional retina, destroyed morphology and increased apoptosis rate were observed in mice especially in RPE and photoreceptor layer. Treatment with chrysanthemum extract, retina function improved as well as structure of RPE and photoreceptor layers. Rate of apoptosis decreased via the raised concentration of anti-oxidative enzyme superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px). Conclusions:Preventive administration of chrysanthemum extract reduces the oxidative-stress induced by light damage, which indicating Chrysanthemum have a potential of preventive measure for AMD.
Diversifying a Resource Dependent Economy: Private-Public Relationships in the Kuwaiti Economy
Authors: GELAN AYELE , He Geoffrey J.D. , AlAwadhi Ahmad
Published: October 2020

The Kuwaiti economy is characterized by two major structural imbalances – heavy dependence on oil and dominance of the public sector. Kuwait has struggled over the years to implement a two-pronged development strategy – diversifying the country’s economic base away from oil and promoting private sector development. This paper will explore the economic impact of some options currently being considered by using a unique set of input-output tables, derived from supply-use tables, that distinguish transactions made by private and public enterprises as well as providing a matrix of imports by sector. The public-private sector interdependence analysis revealed interesting results regarding sectoral differences in strengths of forward and backward linkages. For instance, the findings indicated that the strength of the publicly owned oil sectors lie in their forward linkages, supplying other sectors with their outputs but their backward linkages is weak. On the other hand, the chemicals industry is identified as one of the few sectors, which have balanced and relatively strong forward and backward linkages in both public and private sector. The policy analyses conducted in this paper are highly relevant to the ongoing policy debate in Kuwait over the design of the economic reform programs. The public-private sector linkage analysis has revealed insights into policy synergies through which one instrument can affect more than one policy target.
Sensitivity Analysis for Interpretation of Machine Learning Based Segmentation Models in Cardiac MRI
Authors: Ankenbrand Markus J , Shainberg Liliia , Hock Michael , Lohr David , Schreiber Laura M
Published: October 2020

Background Image segmentation is a common task in medical imaging e.g. for volumetry analysis in cardiac MRI. Artificial neural networks are used to automate this task with performance similar to manual operators. However, this performance is only achieved in the narrow tasks networks are trained on. Performance drops dramatically when data characteristics differ from the training set properties. Moreover, neural networks are commonly considered black boxes, because it is hard to understand how they make decisions and why they fail. Therefore, it is also hard to predict whether they will generalize and work well with new data. Results We show that sensitivity analysis is a suitable approach to answer practical questions regarding use and functionality of segmentation models. We also provide an open source Python library (misas), that facilitates the use of this method with arbitrary data and models. By enabling a better understanding of neural networks through sensitivity analysis it also assists in decision making. We demonstrate this in two case studies on cardiac magnetic resonance imaging.Conclusions Sensitivity analysis is a useful tool for deep learning developers as well as users such as clinicians. It extends their toolbox with a new tool that makes segmentation models more interpretable. Although demonstrated only on cardiac magnetic resonance images this approach and software are much more broadly applicable.
Maternal and neonatal outcomes of preeclamptic and normotensive women who underwent cesarean section under spinal Anesthesia: Systematic review and Meta-Analysis
Authors: Abate semagn , Mergia Getachew , Basu Bivash
Published: October 2020

Background: preeclampsia is very challenging for anesthetists due to the heterogeneous clinical spectrum of the disease characterized by hypertension, risk of hypotension, high risk of aspiration, and difficult airway. Therefore, the Meta-Analysis is intended to provide evidence on maternal and neonatal outcomes of preeclamptic parturient. Methods: A comprehensive strategy was conducted in PubMed/Medline, Science Direct, and Cochrane from January 2000 to May 2020 without language restriction. The Heterogeneity among the included studies was checked with forest plot and I2 test. Observational and experimental studies reporting maternal and neonatal outcomes among preeclamptic and normotensive women were included. Results: The Meta-Analysis revealed that pooled incidence of hypotension was reduced by thirty-eight percent in preeclamptic as compared to normotensive parturient, RR=0.62(95% confidence interval (CI): 0.52 to 0.75)Conclusion: The Meta-Analysis revealed that the incidence of hypotension was lower in preeclamptic women when compared to normotensive women. The included studies were low to a very low quality of evidence which entails further randomized controlled trials.Registration: This systematic review and meta-analysis was registered in Open science Network on June 6, 2020, and the registration is available at https://osf.io/jcedt/.
Analysis of Leaf Trait and Differentially Expressed Genes of Leaf Development in Eucommia ulmoides Oliver after Ultraviolet-B (UV-B) Radiation
Authors: Dewen Li , Ying Liu , Dandan Du , Yuangang Zu , Zhonghua Tang , Yusen Zhao
Published: October 2020

Background Eucommia ulmoides Oliver (EUO) has a great medicinal value in China. The using leaf model of Eucommia planting (ULMEP) is a promising approach to resolve the shortage of EUO resources. We focused on leaf responses and differentially expressed genes (DEGs) for transcriptome profiling after ultraviolet-B radiation (UV-B) in the east-north China. ResultsThe leaf traits were significantly affected after UV-B treatment, and the leaf area, leaf thickness and total leaf fresh/dry weight significantly increased (p<0.05). Anatomical results showed that cells from the leaf epidermal and palisade tissue were larger than those of control. Two transcriptome databases were assembled and integrated, the transcriptome databases comparative analysis revealed 1,826 up-regulated and 1,872 down-regulated genes. Among them, the up-regulated unigenes were mainly participated in Signal transduction mechanisms, and Cell wall/membrane biogenesis by the KOG database, and up-regulated genes were analyzed in plant hormone signal transduction and phenylpropanoid metabolic pathways by KEGG pathway. Furthermore, randomly 10 candidate unigenes expression were examined using RT-qPCR, the two libraries exhibited differential expression and were same as those obtained by sequencing. Conclusions This study was helpful to clarify the cause of leaf enlargement after UV-B treatment, the differentially expressed genes (DEGs) from plant auxin and phenylpropanoid biosynthesis signal pathways were focused on after UV-B treatment. This study provided a valuable reference for the ULMEP in the east-north China.
History of severe hypoglycemia in type II diabetes mellitus unmasked significant atherosclerotic coronary artery disease: a matched case-control study
Authors: Raffali Mohd Asyiq Al-Fard bin Mohd , Muhammad Syawal Faizal , Sukor Norlela , Hamid Hamzaini Abdul , Jyung Tiau Wei , Govindaraju Shathishkumar , Farouk Noor Diyana Mohamad , Nawi Azmawati Mohammed , Hassan Hamat Hamdi Che , Kamaruddin Nor Azmi
Published: October 2020

BackgroundHistory of severe hypoglycemia (SH) has been associated with cardiovascular (CV) events among patients with type II diabetes mellitus (T2DM). In this study, we screened patients with SH for atherosclerotic coronary artery disease (ACAD) .MethodsWe conducted a matched case-control study involving 28 T2DM patients with SH within the last 5 years with no documented ACAD and matched them with 28 T2DM patients with no SH. All subjects underwent coronary artery calcium scoring (CACS) followed by CT coronary angiography (CCTA) if indicated.ResultsHistory of SH in T2DM was associated with 78% (22 out of 28) incidence of significant ACAD compared to 46% (13 out of 28) in those without SH, based on either CACS≥400, or at least one coronary artery with ≥50% stenosis from CCTA, ( P =0.026).ConclusionThis study supported that SH in T2DM is associated with ACAD compared to T2DM without SH.
Laparoscopic Fixation of Biological Mesh at Hiatus with Glue and Suture During Hiatal Hernia Repair
Authors: Nie Yusheng , Yang Huiqi , Xiong Yao , Guan Lei , Yuan Xin , Chen Fuqiang , Chen Jie
Published: October 2020

Aim: Laparoscopic paraesophageal hernia repair is associated with higher recurrence rate. Mesh is used to reduce the recurrence rate. This retrospective study is to review our experience of biological mesh fixed with suture and medical glue in hiatal hernias repairs.Methods: A retrospective chart review was conducted for a consecutive series of patients undergoing laparoscopic hiatal herniorrhaphy between January 2018 and January 2019. After hiatus closure, a piece of biological prosthesis was fixed with medical glue and suture for reinforcement of the crural closure. Clinical outcomes were reviewed, and data were collected regarding operative details, complications, symptoms, and follow-up imaging. Radiological evidence of any size of hiatal hernia was considered to indicate a recurrence.Results: Thirty-six patients underwent surgery uneventfully without any serious complication. There was no mortality. The follow-up was, on average, 18.4 months, and there was no symptomatic recurrence. There was one anatomical recurrence without any related presentation. The method of mesh fixation with medical glue and suture took 12 mins on average, and the handling was fairly easy.Conclusions: Biological mesh fixed with suture and medical glue was safe and effective for repairing large hiatal hernias. Of course, a longer follow-up is still needed for determining long-term outcomes.