bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of patient safety culture and the leader coaching behaviour of nurses on the intention to report errors: A cross-sectional survey
Authors: Chegini Zahra , Kakemam Edris , Jafarabadi Mohammad Asghari , Janati Ali
Published: August 2020

Background: There is growing interest in examining the factors affecting the reporting of errors by nurses. However, little research has been conducted into the effects of perceived patient safety culture and leader coaching of nurses on the intention to report errors.
Methods: This cross-sectional study was conducted amongst 256 nurses in the emergency departments of 18 public and private hospitals in Tabriz, northwest Iran. Participants completed the Hospital Survey on Patient Safety Culture (HSOPSC), Coaching Behavior Scale and Intention to Report Errors questionnaires and the data was analyzed using multiple linear regression analysis.
Results: Overall, 43% of nurses had an intention to report errors; 50% of respondents reported that their nursing managers demonstrated high levels of coaching. With regard to patient safety culture, areas of strength and weakness were “teamwork within units” (PRR = 66.80%) and “non-punitive response errors” (PRR = 19.66%). Regression analysis findings highlighted a significant association between an intention to report errors and patient safety culture (B=0.123, CI 95%: 0.005 to 0.328, P = 0.026), leader coaching behavior (B=0.172, CI 95%: 0.066 to 0.347, P = 0.004) and nurses’ educational status (B=0. 787, 95% CI: -.064 to 1.638, P = 0.048).
Conclusions: Further research is needed to assess how interventions addressing patient safety culture and leader coaching behaviours might increase the intention to report errors.
Combined and interaction effect of Chlamydia pneumoniae infection and smoking on lung cancer: a case-control study in southeast China
Authors: Xu Xin , Liu Zhiqiang , Xiong Weimin , Qiu Minglian , Kang Shuling , Xu Qiuping , Cai Lin , He Fei
Published: August 2020

Background: This case-control study investigated the role of Chlamydia pneumoniae (Cpn) infection in the pathogenesis of lung cancer and the combined and interaction effect of Cpn infection, smoking, and various environmental factors.Methods: The study comprised 449 lung cancer patients and 512 age- and gender-matched healthy controls. All participants provided a 5 ml fasting peripheral venous blood sample for testing Cpn-specific IgG and IgA by using micro-immunofluorescence. Besides analyzing the associations between Cpn and lung cancer, combined effect analysis, logistic regression, and the Excel table made by Andersson were used to analyze the combined and interaction effects of Cpn and environmental factors on lung cancer.Results: Compared to those with no evidence of serum Cpn IgA or Cpn IgG, those with both Cpn IgG+ and IgA+ had 2.00 times the risk (95% CI: 1.34–3.00) of developing lung cancer. Cpn IgG+ or IgA+ was associated with a significantly increased risk of lung cancer among smokers; the adjusted odds ratio (OR) was 1.79 (95% CI: 1.10–2.91) and 2.27 (95% CI: 1.38–3.72), respectively. Those exposed to passive smoking with Cpn IgG+ or IgA+ also showed an increased risk of lung cancer; the adjusted OR was 1.82 (95% CI: 1.20–2.77) or 1.87 (95% CI: 1.22–2.87), respectively. Similar results were also observed among alcohol drinkers. Multiplicative and additive interactions were not observed between Cpn infection and environmental factors. The combined effects of Cpn IgG+ or IgA+ with smoking, passive smoking, and family history of cancer on lung cancer were determined.Conclusion: Cpn infection is potentially associated with primary lung cancer in the Chinese Han population and has combined effects with smoking, passive smoking, and family history of cancer.
Risk factors for hospital-acquired influenza A and patient characteristics: A matched case-control study
Authors: Yang Kui , Zhang Ni , Gao Chunchen , Qin Hongyan , Wang Anhui , Song Liqiang
Published: August 2020

Background: Hospital-acquired influenza A brings hospitalized patients an additional cost of care and considerable mortality, but risk factors for hospital-acquired influenza A are unknown. We aimed to describe the characteristics of patients vulnerable for hospital-acquired influenza A and to identify its risk factors. This knowledge would help clinicians to control hospital-acquired infection and reduce the burden of treatment.Methods: A case-control study was conducted in hospitalized patients aged ≥18 years in a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient who had no evidence of viral respiratory infection on admission. The controls without influenza were selected among patients exposed to the same setting during the same time period. We identified risk factors using conditional logistic regression and described characteristics of patients with hospital-acquired influenza A by comparing the clinical data of the influenza patients and the controls.Results: Of 412 hospitalized patients with influenza A from all departments of the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%) and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P=0.027), hypoalbuminemia (78.5% vs 57.0%, P=0.002) and pleural effusion (26.9% vs 9.7%, P=0.002) than matched controls. Notably, infected patients had a longer hospital stay (18 days vs 14 days, P=0.002), and higher mortality (10.8% vs 2.2%, P=0.017). Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P =0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P =0.027) and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P =0.014) were independently associated with hospital-acquired influenza A.Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion were independent risk factors that could help identify patients at high risk of hospital-acquired influenza A, which might extend hospital stay and is associated with a high mortality.
Changes in health-related quality of life before and after a 12-month enhanced primary care model among chronically ill primary care patients in Australia.
Authors: John James , Tannous W Kathy , Jones Amanda
Published: August 2020

Purpose

Evidence suggests that Patient-centred Medical Home (PCMH) model facilitates person-centred care and improves health-related quality of life for patients with chronic illness. This study aims to evaluate changes in health-related quality of life (HRQoL), before and after enrolment into a 12-month integrated care program called ‘WellNet’.

Methods

This study includes 616 eligible consented patients aged 40 years and above with one or more chronic conditions from six general practices across Sydney, Australia. The WellNet program included a team of general practitioners (GPs) and clinical coordinators (CCs) providing patient-tailored care plans configured to individual risk and complexity. HRQoL was recorded using the validated EuroQol EQ-5D-5L instrument at baseline and 12 months. Additionally, patients diagnosed with osteoarthritis also reported HRQoL using short versions of Knee and/or Hip disability and osteoarthritis outcome scores (KOOSjr and HOOSjr). A case-series study design with repeated measures analysis of covariance (ANCOVA) was used to assess changes in mean differences of EQ-5D index scores after controlling for baseline covariates. Additionally, backward stepwise multivariable linear regression models were conducted to determine significant predictors of EQ-5D index scores at follow-up.

Results

Out of 616 patients, 417 (68%) reported EQ-5D scores at follow-up. Almost half (48%) of the WellNet patients reported improved EQ-5D index scores at follow-up. After controlling for baseline covariates, the adjusted mean difference was statistically significant whilst also meeting the bare minimal clinically important difference (MCID) with a change of 0.03 (95% CI 0.01, 0.05). The multivariable regression models determined that baseline EQ-5D scores and positive diagnosis of a respiratory illness were significant predictors of HRQoL at follow-up. There were significant improvements across both KOOS and HOOS assessments, specifically, the pain and symptom scores in both scales met statistical significance in addition to meeting the MCID.

Conclusion

Patient-tailored CDM plans designed by team of GPs and CDM clinical coordinators could lead to better HRQoL among primary care patients.
Death Cafes for Prevention of Burnout in Intensive Care Unit Employees: Study Protocol for a Randomized Controlled Trial (STOPTHEBURN)
Authors: Bateman Marjorie E. , Hammer Rachel , Byrne Abigail , Ravindran Nithya , Chiurco Jennifer , Lasky Sasha , Denson Rebecca , Brown Margo , Myers Leann , Zu Yuanhao , Denson Joshua
Published: August 2020

Background: Burnout is an occupational syndrome that leads to mental health problems, job turnover, and patient safety events. Those caring for critically ill patients are especially susceptible due to high patient mortality, long hours, and regular encounters with trauma and ethical issues. Interventions to prevent burnout in this population are needed. Preliminary studies suggest debriefing sessions may reduce burnout. This study aims to assess whether participation in regular debriefing can prevent burnout in intensive care unit (ICU) clinicians.Methods: A randomized controlled trial will be conducted in two large academic medical centers. 200 ICU clinicians will be recruited with target enrollment of 100 physicians and 100 non-physicians (nurses, pharmacists, therapists). Participants must have worked in the ICU for the equivalent of at least 1 full time work week in the preceding 4 weeks. Enrolled subjects will be randomized to virtually attend biweekly debriefing sessions facilitated by a psychotherapist for 3 months or to a control arm without sessions. Our debriefs are modelled after Death Cafés, which are informal discussions focusing on death, dying, loss, grief and illness. These sessions allow for reflection on distressing events and offer community and collaboration among hospital employees outside of work. The primary outcome is clinician burnout as measured by the Maslach Burnout Inventory (MBI) Score. Secondary outcomes include depression and anxiety, as measured by the patient health questionnaire 8 (PHQ-8) and generalized anxiety disorder 7-item scale (GAD-7), respectively. Questionnaires will be administered prior to the intervention, at 1 month, at 3 months, and at 6 months after enrollment. These values will be compared between groups temporally. Qualitative feedback will also be collected and analyzed. This trial was registered prospectively with clinicaltrials.gov on April 15, 2020 (NCT04347811).Discussion: With ICU clinician burnout rates exceeding 50%, Death Café debriefing sessions may prove to be an effective tool to avert this debilitating syndrome. With COVID-19 limiting social interactions and overloading ICUs worldwide, the virtual administration of the Death Café for ICU clinicians provides an innovative strategy to potentially mitigate burnout in this vulnerable population.
Analysis of low-dose estrogen on callus BMD as measured by pQCT in postmenopausal women
Authors: Jäckle Katharina Blanka Dr. , Kolb Jan Philipp , Schilling Arndt F , Schlickewei Carsten , Amling Michael , Rueger Johannes M , Lehmann Wolfgang
Published: August 2020

Background: Osteoporosis affects elderly patients of both sexes. It is characterized by an increased fracture risk due to defective remodeling of the bone microarchitecture. It affects in particular postmenopausal women due to their decreased levels of estrogen. Preclinical studies with animals demonstrated that loss of estrogen had a negative effect on bone healing and that increasing the estrogen level led to a better bone healing. We asked whether increasing the estrogen level in menopausal patients has a beneficial effect on bone mineral density (BMD) during callus formation after a bone fracture.
Methods: To investigate whether estrogen has a beneficial effect on callus BMD of postmenopausal patients, we performed a prospective double-blinded randomized study with 76 patients suffering from distal radius fractures. A total of 31 patients (71.13 years ± 11.99) were treated with estrogen and 45 patients (75.62 years ± 10.47) served as untreated controls. Calculated bone density as well as cortical bone density were determined by peripheral quantitative computed tomography (pQCT) prior to and six weeks after the surgery. Comparative measurements were performed at the fractured site and at the corresponding position of the non-fractured arm.
Results: We found that unlike with preclinical models, bone fracture healing of human patients was not improved in response to estrogen treatment. Furthermore, we observed no dependence between age-dependent bone tissue loss and constant callus formation in the patients .
Conclusions: Transdermally applied estrogen to postmenopausal women, which results in estrogen levels similar to the systemic level of premenopausal women, has no significant beneficial effect on callus BMD as measured by pQCT, as recently shown in preclinical animal models.
Seismic Hazard Microzonation of Bengkulu City, Indonesia
Authors: Mase Lindung Zalbuin , Sugianto Nanang , Refrizon Refrizon
Published: August 2020

It has been known that Bengkulu City (Indonesia) is vulnerable to undergo seismic damage. This study is initiated by measuring horizontal to vertical spectral ratio (H/V) to sites in Bengkulu City using microtremor. The inversion analysis is performed to generate shear wave velocity profile. A total of 218 sites is investigated in this study. The results show that observed H/V is consistent with the theoretical H/V. National Earthquake Hazard Reduction Program (NEHRP) code is adopted to classify the site class. The results also exhibit that Bengkulu City is dominated by Site Classes C and D. In general, this study could lead local government to reconsider seismic hazard mitigation for spatial plan.
RNA sequencing identifies transcriptional changes in the rabbit larynx in response to low humidity challenge
Authors: Bailey Taylor W , Santos Andrea , de Nascimento Naila Cannes , Sivasankar M. Preeti , Cox Abigail
Published: August 2020

Background
Voice disorders are a worldwide problem impacting human health, particularly for occupational voice users. Avoidance of surface dehydration is commonly prescribed as a protective factor against the development of dysphonia. The available literature inconclusively supports this practice and a biological mechanism for how surface dehydration of the laryngeal tissue affects voice has not been described. In this study, we used an in vivo male New Zealand white rabbit model to elucidate biological changes based on gene expression within the vocal folds from surface dehydration. Surface dehydration was induced by exposure to low humidity air (18.6% ± 4.3%) for 8 hours. Exposure to moderate humidity (43.0% ± 4.3%) served as the control condition. Ilumina-based RNA sequencing was performed and used for transcriptome analysis with validation by RT-qPCR.
Results
There were 103 genes identified through Cuffdiff with 64 genes meeting significance by both false discovery rate and fold change. Functional annotation enrichment and predicted protein interaction mapping showed enrichment of various loci, including cellular stress and inflammatory response, ciliary function, and keratinocyte development. Eight genes were selected for RT-qPCR validation. Matrix metalloproteinase 12 (MMP12) and macrophage cationic peptide 1 (MCP1) were significantly upregulated and an epithelial chloride channel protein (ECCP) was significantly downregulated after surface dehydration by RNA-Seq and RT-qPCR. Suprabasin (SPBN) and zinc activated cationic channel (ZACN) were marginally, but non-significantly down- and upregulated by RT-qPCR, respectively.
Conclusions
The data together support the notion that surface dehydration induces physiological changes in the vocal folds and justifies targeted analysis to further explore the underlying biology of compensatory fluid/ion flux and inflammatory mediators in response to airway surface dehydration.
The draft genome of the specialist flea beetle Altica viridicyanea (Coleoptera: Chrysomelidae) provides insight into host plant specialization
Authors: Xue Huai-Jun , Niu Yi-Wei , Segraves Kari A. , Nie Rui-E , Hao Ya-Jing , Zhang Li-Li , Cheng Xin-Chao , Zhang Xue-Wen , Li Wen-Zhu , Chen Run-Sheng , Yang Xing-Ke
Published: August 2020

Background
Altica (Coleoptera: Chrysomelidae) is a highly diverse and taxonomically challenging flea beetle genus that has been used as a model system in which to address questions related to host plant specialization, reproductive isolation, and ecological speciation. To further evolutionary studies in this important group, here we present a high-quality draft genome of a representative specialist, Altica viridicyanea, the first Alticinae genome and the fourth chrysomelid genome reported thus far.
Results
The genome is 864.8 Mb and consists of 4,490 scaffolds with a N50 size of 557 kb, which covered 98.6% complete and 0.4% partial insect Benchmarking Universal Single-Copy Orthologs. Repetitive sequences accounted for 62.9% of the assembly, and a total of 17,730 protein-coding gene models and 2,462 non-coding RNA models were predicted. To provide insight into host plant specialization of this monophagous species, we examined the key gene families involved in chemosensation, detoxification of plant secondary chemistry, and plant cell wall-degradation.
Conclusions
The high-quality genome assembled in this work provides an important resource for further studies on host plant adaptation and functionally affiliated genes. Moreover, this work also opens the way for comparative genomics studies among closely related Altica species, which may provide insight into the molecular evolutionary processes that occur during ecological speciation.
Evaluation of Functional Status Among Patients Undergoing Maintenance Treatments for Opioid use Disorders
Authors: Ruíz Juan Jesús Ruíz , Delgado José María Martínez , García Nuria , Baena Bartolomé
Published: August 2020

Objective﻿ Methadone and buprenorphine are the most prevalent types of opioid maintenance programs in Andalusia. The main objective is comparing the functional and health status of patients with pharmacological opioid maintenance treatments according to different socio-demographic characteristic, disabilities and sexual functioning difficulties. Methods A total of 593 patients from the Andalusia community, 329 were undergoing methadone treatment and 264 were undergoing buprenorphine treatment. The patients were interviewed by socio-demographic and opioid-related variables, assessed by functional disability and health variables ( WHODAS 2.0. ) and for sexual dysfunction ( PRSexDQ-SALSEX ). Results We found significant differences in the socio-demographic and the opioid-related variables as the onset of opioid use, being on previous maintenance programs, opioid intravenous use, the length of previous maintenance programs, polydrug use and elevated seroprevalence rates (HCV and HIV) between the methadone group and the buprenorphine group. There were differences in the Understanding and communication domain, Getting around domain, Participation in society domain and in the WHODAS 2.0. simple and complex score, favoring buprenorphine-treated patients. The methadone group had elevated sexual dysfunction than the buprenorphine group. Opioid-related variables as seroprevalence rates, other previous lifetime maintenance program, the daily opioid dosage and the daily alcohol use are the most discriminative variables between both groups. Participation in society variables and sexual problems were the most important clinical variables in distinguishing the methadone group from the buprenorphine group. Conclusions The methadone group showed higher prevalence in opioid dependence-related variables, elevated disabilities in participation in society activities and sexual problems compared with the buprenorphine group.
Sap Flow Dynamics and Responses to Grazing and Seasonal Changes in Soil Moisture for Acacia Ancistroclada and Comberatum Molle in a Kenyan Savanna
Authors: Ondier Joseph , Otieno Dennis , Okach Daniel , Onyango John
Published: August 2020

The Kenyan savanna, which is dominated by Acacia ancistroclada and Comberatum molle, has experienced notable changes in rainfall patterns and increased livestock grazing. A significant decrease in trees spread from 5 % to less than 1 % has been documented for the ecosystem and could be linked to the increased livestock grazing and changes in rainfall patterns, however, scientific evidence is lacking. We utilized sap flow to analyze the hydraulic responses of the prevailing trees to livestock grazing and seasonal changes in soil moisture. Environmental factors including precipitation, air temperature, soil moisture at - 0.3 m, and vapor pressure deficit were simultaneously measured. The results showed that the diurnal variation in sap flux density exhibited a single peak curve at around midday and correlated strongly with vapor pressure deficit and air temperature. Sap flux density was higher in the grazed (27.47 ± 8.65 g m-2s-1) than the fenced plots (20.17 ± 7.27 g m-2s-1). In all the plots, sap flux density followed seasonality in rainfall patterns, increasing and decreasing in wet and dry seasons respectively. The higher crown projected area was responsible for higher sap flow in the grazed plots. The diurnal variation in sap flux density showed that sap flow was coupled to the atmosphere with relatively low boundary layer resistance and the seasonal variation in sap flow was controlled by stomatal regulation. These findings point to the possibility that the dominant tree species in Lambwe are isohydric species. However, additional measurements need to be conducted on the eligibility of the species to confirm the conclusion.
The Effects of Workplace Smoke-free Policies on Individual Smoking and Quitting-related Behaviours in China: Evidence From Repeated Cross-sectional Survey Data
Authors: LIN Haoxiang , Chang Chun , LIU Zhao
Published: August 2020

Objective

Our study aims to determine the coverage of workplace Smoke-free (SF) policies in mainland China, and to assess the relationship between workplace SF policies and Second-hand smoke (SHS) exposure, smoking prevalence, smoking harm awareness, and quitting intention among smokers.
Methods

The Logistic regression with year fixed effects is applied to the Asia Best Workplace Mainland China study, a repeated cross-sectional dataset including approximately 14,195 employees from the 2018 survey and 14,953 employees from the 2019 survey.
Results

21,275 participants (73.0%) reported working under SF policies. The overall prevalence of smoking and SHS exposure were 20.3% and 52.5%. The workplace SF policy was significantly associated with lower SHS exposure (OR: 0.501, 95% CI: 0.473–0.530), lower smoking prevalence (OR: 0.813, 95% CI: 0.761–0.869) and higher awareness of smoking harm (OR: 1.756, 95% CI: 1.612–1.913). However, workplace SF policy was not significantly associated with quitting intention (OR: 0.984, 95% CI: 0.837–1.158).
Conclusion

Our study identified that although most companies have established workplace SF policy,the overall prevalence of SHS exposure remains very high. The findings supports the existence of spill-over effects of SF workplace policies. Regarding to triggering strong quitting intentions, the SF policies should consider provided in combination with available smoking cessation services. These findings provide valuable evidence to promote such policies in all workplaces.
Performance Characteristics of the TaqMan Array PCR on Repository Stool Specimens and Smears on Whatman® FTA Elute Cards
Authors: Tisdale Michele , Mitra Indrani , McCoy Andrea J , Simons Mark P , Reynolds Nathanael D , Swierczewski Brett E , Liu Jie , Houpt Eric R , Fraser Jamie A , Riddle Mark S , Tribble David R , Lalani Tahaniyat
Published: August 2020

Objective
Stool repositories are a valuable resource for retrospective analyses including quantitative PCR assays to distinguish between asymptomatic shedding and clinical disease. The suitability of archival specimens for this purpose is unclear and requires assessment. We conducted a pilot study to evaluate pathogen detection by TaqMan Array Card (TAC) in travelers’ diarrhea (TD) stool specimens stored for 1–13 years, as well as, the impact of transporting specimens on Whatman FTA Elute cards (FTA Cards) on detection.
Results
The positive percent agreement (PPA) for TAC on stool vs. microbiologic testing was lower than our a priori PPA estimate of 80% for most pathogens: Shigella spp. (100% [95%CI: 69–100%]), enterotoxigenic E coli (ETEC) (63 [49–75%]), Campylobacter spp. (66 [43–85%]) and Norovirus (37 [16–61%]). Use of the FTA card resulted in a further reduction of PPA. Our findings suggest that archival specimens may lead to insensitive detection on quantitative PCR assays due to degradation of nucleic acid with prolonged storage, although our limited sample size precluded us from evaluating the impact of storage duration on nucleic acid yield. Additional studies are needed to understand the impact of storage duration on quantitative PCR data.
The technique of 3D reconstruction combining with biochemistry to build an equivalent formula of indocyanine green (ICG) clearance test to assess the liver reserve function
Authors: Zheng JinLi , Xie Wei , Huang Yang , Zhu Yunfeng , Jiang Li
Published: August 2020

Background: The indocyanine green(ICG) clearance test is the main method of evaluating the liver reserve function before hepatectomy. However, some patients may be allergic to ICG or the equipment of ICG clearance test was lack, leading to be difficult to evaluate liver reserve function. We aim to find an alternative tool to assist the clinicians to evaluate the liver reserve function for those who were allergic to the ICG or lack of equipment before hepatectomy.Methods: We retrospected 300 patients to investigate the risk factors affecting the liver reserve function and to build an equivalent formula to predict ICG 15 minutes retention rate (ICG-R15) value.Results: We found that the independent risk factors affecting ICG clearance test were total bilirubin, albumin, and spleen-to-non-neoplastic liver volume ratio (SNLR). The equivalent formula of the serological index combining with SNLR was: ICG-R15 = 0.36 × TB (umol/L)- 0.78 × ALB(g/L) + 7.783 × SNLR + 0.794 × PT (s) − 0.016 × PLT(/109) − 0.039 × ALT (IU/L) + 0.043 × AST (IU/L) + 23.846. The equivalent formula of serum index was: ICG-R152 = 24.6650.382 × TB (umol/L) − 0.799 × ALB(g/L) − 0.025 × PLT(/109) + 0.048 × AST(IU/L) − 0.045 × ALT(IU/L). And the area under the ROC curve (AUC) of predicting ICG-R15 ≥ 10% was 0.861 and 0.857, respectively.Conclusion: We found that SNLR was an independent risk factor affecting liver reserve function. Combining with SNLR to evaluate the liver reserve function was better than just basing on serology.
Effect of PTH and corticotomy on implant movement under mechanical force
Authors: Kim Jiyeon , Kim Heon-Young , Kim Won-Ho , Kim Jin-Woo , Kim Minji
Published: August 2020

Background Osseointegrated implants are considered as clinically non-movable. Parathyroid hormone (PTH) is known to play a significant role in the regulation of bone remodeling and in intermittent, low doses, result in osteoanabolic effects. This study aimed to investigate the effects of PTH and corticotomy, both under traction force, on osseointegrated implants. Methods Four implants—two in each hemimandible—were placed in each of the three study mongrels. Each mongrels were designated as control, normal dose PTH (PTH-1), and high dose PTH (PTH-2) groups, with each groups further subdivided into non-surgery and surgery groups. After osseointegration, mechanical force with NiTi closed coil springs (500g) was applied around each implants. Corticotomy was performed around one of four implants in each mongrels. Parathyroid hormone was administered locally on a weekly basis for 20 weeks. Clinical movement of the implants were evaluated with the superimposed 3D- scanned data, bone- microarchitectural and histologic examinations Results Superimposition analysis showed continuous movement of the implants in PTH-1 group. Movement was further justified with lowest bone implant contact (adjusted BIC; 44.77%) in histomorphometric analysis. Upregulation of bone remodeling around the implant was observed in the normal dose PTH group. In the surgery subgroups, the remarkably higher adjusted BIC compared to the non-surgery subgroups indicated increased bone formation around the implant surface. Conclusion The results indicate that the balance of osseointegrated implants in bone remodeling can be shifted via various interventions. Clinical Relevance Upregulated bone remodeling by PTH and corticotomy under continuous mechanical force showed the possible implications on the clinical implant movement.
Sleep Quality and Athletic Performance According to Chronotype
Authors: Lim Seung-Taek , Kim Do-Yoon , Kwon Hyeong-Tae , Lee Eunjae
Published: August 2020

Background: When studying the quality of sleep in relation to athletic performance, the athlete's chronotype and habitual time were considered important factors. We aimed to investigate the sleep quality and athletes’ performance according to chronotype in elite athletes. Methods: Three hundred forty elite athletes (males = 261, females = 79) were recruited for the present study. All participants were screened for chronotype. Measurements of the Korean versions of the Morningness - Eveningness Questionnaire (MEQ-K), Pittsburgh Sleep Quality Index (PSQI), and Wingate Anaerobic Test (WAnT). Results: PSQI global score, PSQI sleep quality, PSQI sleep onset latency, PSQI sleep disturbance, and PSQI daytime dysfunction were significantly difference in among the groups. Mean power, and peak power were significantly difference in among the groups. A negative correlation was found between PSQI score and mean power (W), mean power (W/kg), peak power (W), and peak power (W/kg). Conclusions: This study indicates that related poor sleep quality and late type of chronotype may reduce the athletes’ performance in elite athletes. In additional, significant better sleep quality in early type of chronotype more than late type of chronotype. Moreover, also significant higher athletic performance in early type of chronotype more than late type of chronotype.
Reliability of genomic variants across different next-generation sequencing platforms and bioinformatic processing pipelines
Authors: Gerber Susanne , Weißbach Stephan , Sys Stanislav Jur`Evic , Hewel Charlotte , Todorov Hristo , Schweiger Susann , Winter Jennifer , Pfenninger Markus , Torkamani Ali , Evans Doug , Burger Joachim , Everschor-Sitte Karin , May-Simera Helen
Published: August 2020

Background Next Generation Sequencing (NGS) is the fundament of various studies providing insights into questions from biology and medicine. Nevertheless, integrating data from different experimental backgrounds can introduce strong biases. In order to methodically investigate the magnitude of systematic errors, we performed a cross-sectional observational study on a genomic cohort of 99 subjects each sequenced via (i) Illumina HiSeq X, (ii) Illumina HiSeq and (iii) Complete Genomics. Consequently, we systematically analyzed the heterogeneity between the sequencing cohorts with respect to genomic annotation and common filter criteria like minimum allele frequency (MAF). Results The number of detected variants/variant classes per individual was highly dependent on the sequencing technology. We observed a statistically significant overrepresentation of variants uniquely called by a single platform which indicates potential systematic biases. These variants were enriched in low complexity genomic regions and simple repeats. Furthermore, estimates of allele frequency were highly discrepant for a subset of variants in pairwise comparisons between different sequencing platforms. Applying common filters – such as MAF 5% and HWE- greatly reduced the heterogeneity between cohorts but still left discrepancies of several thousand variants after filtering.Conclusion We provide empirical evidence of systematic heterogeneity in variant calls between alternative experimental and data analysis setups. Our results highlight the potential benefit of reprocessing genomic data with harmonized pipelines when integrating data from different studies.
Mental Health and HIV-related Risky Sexual Behaviors Among Cisgender, Transgender, and Gender Non- Conforming MSM in China
Authors: Duan Zhizhou , Wang Liyin , Guo Menglan , Ding Changmian , Huang Danqin , Yan Hong , Wilson Amanda , Li Shiyue
Published: August 2020

Background
The new recognition of sub-groups among gender minorities (i.e transgender and gender non-conforming) who also identify as men who have sex with men (MSM) play a considerable role in new HIV infections in China. However, while research focuses on the prevalence of MSM, it ignores the diversity of gender minorities within the MSM population. Furthermore, information on the mental health and HIV-related risky sexual behavior also requires consideration to understand the prevalence and new rates of infection both of MSM and within these gender minority sub-groups.
Methods
From September 2017 to December 2017, MSM were recruited in Wuhan, Nanchang, and Changsha cities in China. Participants were asked to fill out a structured self-designed questionnaire to assess depression, perceived social support, resilience, identify concealment, and HIV-related risky sexual behaviors.
Results
A total of 715 MSM completed the structured questionnaire, the number of gender minorities identifying as MSM were 63 and accounted for 8.8% of the population. Compared with the cisgender MSM population, transgender MSM had a significantly lower likelihood of identity concealment (P = 0.016, 95%CI = 0.16, 5.79), were more likely to have one-night stand/occasional partner in the past six months (AOR = 3.90, 95% CI = 1.17–13.03), have sex after drug use (AOR = 2.84, 95%CI = 1.18–6.79), and engage in commercial sexual behavior in the past six months (AOR = 6.09, 95%CI = 1.003–36.94). In terms of gender non-conforming MSM, the differences were not significant for mental health and HIV-related risky sexual behaviors in comparison to the cisgender MSM population.
Conclusions
It is critical to create targeted interventions tailored towards the different gender minority identities among the MSM population. Further research is necessary to understand the relationship between gender identity, mental health, and HIV-related risky sexual behaviors.
Plasmacytoid urothelial carcinoma of renal pelvis with positive zinc finger E–box–binding homeobox 1: a case report
Authors: Takada-Owada Atsuko , Nozawa Yumi , Onozaki Masato , Noda Shuhei , Jamiyan Tsengelumaa , Nakazato Yoshimasa , Tokura Yuumi , Kamai Takao , Ishida Kazuyuki
Published: August 2020

BackgroundThe tumor transformation mechanism of a plasmacytoid urothelial carcinoma remains unexplained. We describe the case of a plasmacytoid urothelial carcinoma of the renal pelvis in which the expression of zinc finger E–box–binding homeobox 1 (ZEB1), a key nuclear transcription factor in an epithelial–mesenchymal transition, is involved in tumor transformation.Case presentationThe patient had a left nephrectomy with the clinical diagnosis of left pelvic renal cancer. The resected specimen showed that the tumor surface comprised a noninvasive papillary urothelial carcinoma with the carcinoma in situ, and the invasive area comprised a plasmacytoid urothelial carcinoma characterized by the presence of single dyscohesive malignant cells that resembled plasma cells in a loose myxoid stroma. The noninvasive urothelial carcinoma was positive for cytokeratin and E–cadherin, and negative for vimentin and ZEB1. In contrast, the invasive plasmacytoid urothelial carcinoma was positive for cytokeratin and also vimentin and ZEB1, and negative for E–cadherin. Additionally, this component was immunoreactive for CD138 and CD38 that are immunohistochemical markers for plasma cells.ConclusionWe suggest that ZEB1 is involved in the plasmacytoid transformation by repressing the E–cadherin in a plasmacytoid urothelial carcinoma.
The association of interpregnancy interval and mode of delivery with outcomes among a cohort of Guatemalan women with a history of prior cesarean
Authors: Harrison Margo , Garces Ana , Figueroa Lester , Westcott Jamie , Hambidge Michael , Krebs Nancy F
Published: August 2020

Design: Our objectives were to analyze how interpregnancy interval (IPI) was associated with delivery mode and how outcomes varied by these characteristics.Methods: This secondary analysis used data from a prospective study conducted in Chimaltenango, Guatemala from January 2017 through April 2020.Results: Of 26,465 Guatemalan women, 3,170 (12.0%) had a history of prior cesarean. 560 (20.1%) women delivered by vaginal birth after cesarean with the remaining 2,233 (79.9%) delivered by repeat cesarean delivery. Repeat cesarean reduced the risk of needing a dilation and curettage compared to vaginal birth after cesarean, but this association did not vary by IPI (AOR 0.01 – 0.03, p < 0.001). Repeat cesarean delivery, as compared to vaginal birth after cesarean, significantly reduced the likelihood a woman breastfeeding within one hour of birth (AOR 0.009 – 0.10, p < 0.001), but IPI was not associated with the outcome. Regarding stillbirth, repeat cesarean birth reduced the likelihood of stillbirth as compared to vaginal birth (AOR 0.2, p = 0.001 – 0.002), but again IPI was not associated with the outcome.Conclusion: Outcomes by mode of delivery among a Guatemalan cohort of women with a history of prior cesarean birth do not vary by IPI.
Health Professionals Perception And Beliefs About Drug- Related Problems on Polymedicated Older Adults- A Focus Group Study
Authors: Plácido Ana Isabel , Herdeiro Maria Teresa , Simões João Lindo , Amaral Odete , Figueiras Adolfo , Roque Fátima
Published: August 2020

Background: Polymedicated older patients are at greater risk of suffering adverse events. For this reason, the detection of both inappropriate polypharmacy and polypharmacy-associated drug-related problems (DRPs) are essential to improve the health and wellbeing of older adults and to reduce healthcare costs. This work aims to explore health professionals’ perceptions and opinions about polypharmacy and the handling of medicines by polymedicated older adults.Methods: Thirteen focus groups with 94 health professionals (20 community pharmacists, 40 general practitioners and 34 nurses) were conducted in primary healthcare centers of the region center of Portugal. Participants were asked to discuss their perceptions and beliefs in relation to DRPs in polymedicated older adults. The sessions were audiotaped. After the transcription and coding of focus group sessions, a thematic analysis was done.Results: The following four main themes emerged f﻿rom the 13 focus group sessions: poor compliance and polypharmacy- a vicious cycle perpetuated by the behaviour of older adults, organization of the healthcare system, communication among health professionals, and strategies to prevent inappropriate polypharmacy.Conclusion: The lack of both an efficient network of information and communication among health professionals makes the detection and/ or prevention of polypharmacy in older adults difficult. The implementation of new models to manage and/or prevent polypharmacy based on health professional perception and beliefs is essential to prevent DRPs and improve compliance among older adults.
District-led Malaria Surveillance and Response as an Effective way to Manage Malaria Upsurges Following the Withdrawal of Indoor Residual Spraying: A Case Study from Nwoya District, Northern Uganda
Authors: Nuwa Anthony , Oola Janet , Obonyo Sam Okot , Feldman Mitra , Karungi Shirah Christine , Kertho Edmound , Odong David Salandini , Kimera Isaac , Magumba Godfrey , Beinomugisha Geofrey , Chitty Alexandra , Tibenderana James Kananura , Opigo Jimmy , Abwaimo Francis
Published: August 2020

BackgroundMalaria remains the number one cause of morbidity and mortality in Uganda. In 2009, an indoor residual spraying (IRS) programme was implemented in 10 Northern districts, resulting in marked reductions in the malaria burden, and a prevalence of just 7 percent. IRS was withdrawn after five years and malaria prevalence among children subsequently increased dramatically from 2014-2016. This upsurge led to an increased focus on training district malaria programme staff on malaria surveillance, epidemic preparedness, and response. An increase in malaria cases was detected again in 2018 in Nwoya district. MethodsIn response to the increase in malaria cases, the District Health Team (DHT) set up multi-sectoral management taskforce and technical rapid response team (RRT). The RRT was responsible for a rapid assessment, mapping exercises and identifying possible causes. The DHT informed all relevant stakeholders of the findings, mobilised resources and developed a comprehensive response plan. Interventions were categorised as immediate (to treat cases and avert deaths), intermediate (to bring down the epidemic) and long-term (to sustain the gains achieved). Health workers from the affected areas were trained on integrated management of malaria, village health team (VHT) members were mentored on malaria epidemic response and their role in the response plan, and health facilities conducted test, treat and track outreach activities. Social behaviour change and communication (SBCC) played a key role, and the RRT monitored and ensured that there were enough malaria commodities at the facilities and for the VHTs.ResultsThe Nwoya DHT was able to detect the 2018 upsurge from the district records, raise awareness, and respond effectively in a timely manner. This district-led response led to a reduction in routinely reported malaria cases from an average of 2,513 cases per week to 1,335 cases between week 43 in 2018 and week 10 in 2019.ConclusionsMalaria upsurges usually have early warning signals and surveillance is a key health intervention to reducing their impact. Malaria surveillance and response, with precisely targeted multipronged activities, when led by local health authorities is an effective, efficient, and sustainable approach to managing such upsurges.
Gut Microbiota: Effect of Pubertal Status
Authors: Yuan Xin , Chen Ruimin , Zhang Ying , Lin Xiangquan , Yang Xiaohong
Published: August 2020

Background: The make-up of gut microbiota at different puberty stages has not been reported. This cross-sectional study analyzed the bio-diversity of gut microbiota at different puberty stages. Methods: The fecal microbiome was determined in 89 Chinese subjects aged 5-15 years. Subjects were grouped as non-pubertal (n=42) or pubertal (n=47) according to Tanner stages. Gut colonization patterns were determined by 16S rDNA microbiome profiling.Results: The subjects were divided into non-pubertal (n=42, male%: 66.7%) or pubertal groups (n=47, male%:44.68); in both groups, Firmicutes, Bacteroidetes and Proteobacteria were the dominant phylum. There was no difference of alpha- and beta-diversity among disparate puberty stages. Non-pubertal subjects had significantly higher members of the genus Turicibacter and lower members of genus Sutterella than pubertal subjects. Of note, the proportion of genus Sutterella increased gradually with the pubertal status and independent of BMI-Z. In the pubertal subjects, the abundance of genus Adlercreutzia, Dorea, Clostridium and Parabacteroides was associated with the level of testosterone.Conclusion: This is the first report of the diversity of gut microbiota at different puberty stages. The various species of gut microbiota changed gradually associated with puberty stages. Differences in gut microflora at different pubertal status may be related to androgen levels.
Predicting Outcomes of Abdominal Surgical Emergencies in the Elderly Population Using a CT Muscle Gauge
Authors: Tee Yu-San , Cheng Chi-Tung , Wu Yu-Tung , Hsu Chih-Po , Kang Shih-Ching , Hsieh Chi-Hsun , Derstine Brian A. , Su Grace L. , Wang Stewart C. , Fu Chih-Yuan , Liao Chien-Hung
Published: August 2020

Background: Frailty has been shown to be an independent negative predictor of surgical outcomes in geriatric patients. Traditional measurements of frailty are impractical in emergency settings, and computed tomography (CT)-measured skeletal muscle mass has been proposed as an alternative. However, the cutoff values of these CT metrics for frailty are still unknown, and their impact on abdominal emergencies in the elderly population is unclear.Study Design: A total of 462 young trauma patients aged 18-40 years were analyzed to establish sex-specific reference cutoff values for the CT-measured muscle index (MI) and muscle gauge (MG) values. The impacts of low MI and MG values were investigated in 1192 elderly patients (aged ≥ 65 years) undergoing abdominal surgery.Results: The sex-specific cutoff values for MI and MG were determined by adopting European Working Group on Sarcopenia in Older People (EWGSOP) guidelines. The correlation between MG and ageing was significantly stronger than that between MI and ageing. With regard to the MG, the L4 psoas muscle gauge (L4 PMG) was further investigated in an elderly cohort owing to its high predictive value and ease of use in the clinical setting. A low L4 PMG value was an independent risk factor for overall complications and mortality in elderly patients with abdominal emergencies.Conclusion: The current study was the largest study investigating the correlations between MG values and ageing in the Asian population. Frailty, as indicated by a low L4 PMG value, may help surgeons during preoperative decision making regarding geriatric patients with abdominal emergencies.
Insoluble proteins catch heterologous soluble proteins into inclusion bodies by intermolecular interaction of aggregating peptides
Authors: Carratalá Jose Vicente , Cisneros Andrés , Hellman Elijah , Villaverde Antonio , Ferrer-Miralles Neus
Published: August 2020

Background
Protein aggregation is a biological event observed in expression systems in which the recombinant protein is produced under stressful conditions surpassing the homeostasis of the protein quality control system. In addition, protein aggregation is also related to conformational diseases in animals as transmissible prion diseases or non-transmissible neurodegenerative diseases including Alzheimer, Parkinson's disease, amyloidosis and multiple system atrophy among others. At the molecular level, the presence of aggregating-prone domains in protein molecules act as seeding igniters to induce the accumulation of protein molecules in protease-resistant clusters by intermolecular interactions.
Results
In this work we have studied the aggregating-prone performance of a small peptide (L6K2) with additional antimicrobial activity and we have elucidated the relevance of the accompanying scaffold protein to enhance the aggregating profile of the fusion protein. Furthermore, we demonstrated that the fusion of L6K2 to highly soluble recombinant proteins directs the protein to inclusion bodies (IB) in E. coli through stereospecific interactions in the presence of an insoluble protein displaying the same aggregating-prone peptide (APP).
Conclusions
These data suggest that the molecular bases of protein aggregation are related to the net balance of protein aggregation potential and not only to the presence of aggregation-prone stretches. This is then presented as a generic platform to generate hybrid protein aggregates in microbial cell factories for biopharmaceutical and biotechnological applications.