bluuebunny/crossref_metadata_2025 huggingface dataset:
Landscape Architecture and Framing to Psychological Well-Being in Schizophrenics
Authors: Chang Mei-Chung , Lung Pey , Lung For-Wey
Published: August 2020

Background: This study is to assess how the presence of landscape features influences the visit intention of users in different roles in a hospital setting. Method: Total of 94 patients with mental illness, including 71 schizophrenics and 23 borderline disorder who lived in a psychiatric hospital in southern Taiwan were recruited. Firstly, all participants were selected three pictures of hospital inside architecture design and another three outside landscape. Second, all of them need to choice each three favorite pictures from 12 of inside architecture design and 12 of outside landscape.Results: By structural equation modeling, patient who select card 8 in outside landscape, tend to better psychological well-being. Patients with higher level of emotional distress like to select card 10 in inside architecture design, then further reducing whose psychological well-being. In addition, who with higher level education like to select card 2 in inside architecture design, and then further increasing contributed to psychological well-being.Conclusions: There are several different outcomes to sex, education, diagnosis, mental illness, social adaption status, and psychological well-being in the effects of landscape architecture for patients with schizophrenia and borderline. Different individuals with different diagnosis mental symptoms, and psychological well-being have different preferences in landscape, but it just be a state of “here and now”. Hence, the longitudinal follow-up study should be consider in further studies. Moreover, the effects of landscape architecture how to play the role in the treatment of mental diseases and its clinical implication also need to consider in the future comprehensive studies.
Is routine X-ray pelvimetry of value to decide on mode of delivery for women with labor dystocia?
Authors: Kawakami Kaori , Tanaka Yuria , Ikeda Yuji , Komatsu Atsushi , Kobayashi Osamu , Nakajima Takahiro , Nakao Takehiro , Takeya Chiaki , Asai-Sato Mikiko , Chishima Fumihisa , Iwata Misako , Kawana Kei
Published: August 2020

Background: X-ray pelvimetry is used for evaluation of pelvic inlet generally to diagnose cephalopelvic disproportion (CPD) or contracted inlet. Cesarean section delivery (C/S) is often performed for labor dystocia without CPD or contracted inlet. Here, we examined whether X-ray pelvimetry is useful to decide on mode of delivery in women with dystocia.Method: A total of 1118 pregnant women received X-ray pelvimetry before or during labor. Overall, 205 women with cesarean deliveries for indications except for dystocia were excluded. The remaining 913 women undergoing induction/augmentation were retrospectively investigated. Obstetrical and maternal variables were analyzed by univariate, multivariate or ROC analysis.Results: Among 913 women, 37 (4%), including three with contracted inlet and seven with CPD, gave birth by C/S, whereas 876 gave birth by vaginal delivery. Low maternal height, older age, small obstetrical conjugate, large weight and infant head size were significantly associated with risk of C/S for dystocia. Multivariate analysis revealed that the obstetrical conjugate was an independent variable for risk of C/S. The area under the ROC curve (AUC) and the optimal cut-off values, respectively, were as follows: obstetrical conjugate: 0.68 and 11.7 cm (odds ratio=4.27), transverse diameter: 0.59 and 11.4 cm (odds ratio=1.82), maternal height: 0.70 and 155.5 cm (odds ratio=4.33), and maternal weight before pregnancy: 0.55 and 49.7 kg (odds ratio=1.98).Conclusion: The obstetrical conjugate was an independent variable associated with risk of C/S for dystocia. Additionally, maternal height was comparable to the conjugate in term of diagnostic ability. Our data suggested that routine X-ray pelvimetry was not beneficial to identify women at risk of C/S for dystocia.
Genome-wide identification and expression analysis of tomato ADK gene family during development and stress
Authors: Yang Lu , Cao Haohao , Zhang Xiaoping , Gui Liangxian , Chen Qiang , Qian Gui , Xiao Jiaxin , Li Zhengguo
Published: August 2020

Background: Adenylate kinase (ADK) is widely distributed in organisms and plays an important role in cellular energy homeostasis. In plants, ADK has important functions in plant growth and development regulation as well as adaptation to the environment. However, little information is available about the ADK genes in tomato (Solanum lycopersicum), an important economic crop.Results: To investigate the characteristics and functions of ADK genes in tomato, a total of 11 ADK genes were identified and named according to their chromosomal locations. The ADK family was divided into five groups and motif analysis revealed that each SlADK protein contained five to eight conserved motifs. Sequence analysis revealed 4-19 exons in all SlADKs and most members possessed four. The 11 SlADKs were randomly distributed on nine of the 12 tomato chromosomes. A cis-element analysis inferred that several stress response elements were found on the promoters of SlADKs. The online TomExpress platform prediction revealed that SlADKs were expressed in various tissues and organs, basically consistent with the data obtained from real-time quantitative PCR (qPCR). The qPCR verification was also used to determine the expression level of SlADKs and demonstrated that the genes responded to multiple abiotic stresses, such as drought, salt and cold. For example, almost all SlADKs contained two expression peaks at 9 and 48 h following salt treatment. The qPCR results showed that SlADK transcription was responsive to most of the applied hormone treatment: methyl jasmonate, ethylene, salicylic acid, indole 3-acetic acid and abscisic acid. Notably, SlADK2 and 4 exhibited significant changes under multiple stress treatments.Conclusions: These results provide valuable information for clarifying the evolutionary relationship of the tomato ADK family and in aiding functional characterization of SlADKs in further research.
Dissociation between 2-[18F]fluoro-2-deoxy-D-glucose Positron Emission Computer Tomography, Ultrasound and Clinical Assessments in Patients with non-severe Rheumatoid Arthritis including Remission
Authors: Rinkin Charline , Fosse Pacôme , Malaise Olivier , Chapelier Nathalie , Horrion Jil , Seidel Laurence , Adelin Albert , Hustinx Roland , Malaise Michel G.
Published: August 2020

Background: 2-[18F]fluoro-2-deoxy-D-glucose Positron Emission Computer Tomography ([18F]FDG PET/CT) in rheumatoid arthritis (RA) visualizes and quantifies inflammation in joints of patients with severe disease activity but little is known on the metabolic status and its relationship with clinical and ultrasonography (US) metrology in patients with low/moderate activity or in remission.Methods: Clinical assessments (DAS28-CRP, CDAI), [18F]FDG PET/CT, US and X-ray were performed on 63 RA patients classified into remission, low/moderate or severe disease activity. PET/CT was analyzed visually, then semi-quantitatively by determining standardized uptake value (SUV) of positive joints. Results: Of the 1764 joints, 21.1% were tender only, 13.7% swollen only, 27.6% tender or swollen, 7.3% tender and swollen, 20.5% PET/CT-positive and 8.6% US-positive. PET and US-measurements correlated, albeit with poor concordance. Positive predictive value of PET/CT for clinical evaluation (tender and/or swollen) was low whereas its negative predictive value was high. Highly significant differences were found in the number of PET/CT-positive joints and in cumulative SUV between “severe and non-severe cases” (including remission and low/moderate activity together) only, but not between “remission and non-remission” or “remission and low/moderate activity”. Moreover, correlation between PET/CT measurements and clinical activity was positive only in CDAI severe disease group. In patients with remission or low/moderate activity, only 20-30% of joints were PET/CT-negative. In remission, PET/CT and US were positive in different joints and PET/CT-positive but US-negative joints mainly exhibited RA (38.1%) or normal (49.2%), and not osteoarthritis (12.7%), X-ray pattern.Conclusions: [18F]FDG PET/CT was effective at distinguishing patients with a severely active disease from the others. In non-severe RA, including remission, patients, PET/CT results disconnect from US and clinical observations. A longitudinal analysis is needed to explore the clinical relevance of such infra-clinical disease.
Moringa Oleifera Leaf Extracts Protect BMSC Osteogenic Induction Following Peroxidative Damage by Activating The PI3K/Akt /Foxo1 Pathway
Authors: Liu Meiling , Ding Haifeng , Wang Hongzhi , Wang Manfeng , Wu Xiaowei , Gan Lu , Cheng Luyang , Li Xianglu
Published: August 2020

Objective: We aimed to investigate the therapeutic effects of Moringa oleifera leaf extracts on osteogenic induction of rat bone marrow mesenchymal stem cells (BMSCs) following peroxidative damage and to explore the underlying mechanisms. Methods: Conditioned medium was used to induce osteogenic differentiation of BMSCs, which were treated with H2O2, Moringa oleifera leaf extracts-containing serum, or the phosphatidyl inositol-3 kinase (PI3K) inhibitor Wortmannin, alone or in combination. Cell viability was measured using the MTT assay. Cell cycle was assayed using flow cytometry. Expression levels of Akt, phosphorylated (p)Akt, Foxo1, and cleaved caspase-3 were analyzed using Western blot analysis. The mRNA levels of osteogenesis-associated genes, including alkaline phosphatase (ALP), collagen І, osteopontin (OPN), and Runx2, were detected using qRT-PCR. Reactive oxygen species (ROS) and malondialdehyde (MDA) levels, as well as superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), and ALP activity were detected using commercially available kits. Osteogenic differentiation capability was determined using alizarin red staining. Results: During osteogenic induction of rat BMSCs, H2O2 reduced cell viability and proliferation, inhibited osteogenesis, increased ROS and MDA levels, and decreased SOD and GSH-PX activity. H2O2 significantly reduced pAkt and Foxo1 expression, and increased cleaved caspase-3 levels in BMSCs. Additional treatments with Moringa oleifera leaf extracts partially reversed the H2O2-induced changes. Wortmannin partially attenuated the effects of Moringa oleifera leaf extracts on protein expression of Foxo1, pAkt, and cleaved caspase-3, as well as mRNA levels of osteogenesis-associated genes.Conclusion: Moringa oleifera leaf extracts ameliorate peroxidative damage and enhance osteogenic induction of rat BMSCs by activating the PI3K/Akt/Foxo1 pathway.
The Lack of an Association between Body Image Satisfaction and Self-Esteem in High School Students in Eastern Croatia: A Cross-Sectional Study
Authors: Bosnic Zvonimir , Miletic Maja , Volaric Nikola , Holik Dubravka , Volaric Mile , Majnaric Ljiljana Trtica
Published: August 2020

Introduction: The research objectives are to examine the degree of satisfaction of students in two high schools in Eastern Croatia, regarding their physical appearance and self-esteem based on their gender and type of school - Grammar school or Vocational school. Furthermore, it aims to determine the correlation between degree of satisfaction regarding physical appearance and self-esteem and examines the differences in socio-economic status among the students of the two schools.Methods: The study is designed as a cross-sectional research performed in the Secondary Health and Veterinary School and Grammar School in Vinkovci. The study includes 278 participants. The data were collected in three ways. First, by using a survey on socio-economic status of the participants. Second, a modified test consisting of fourteen questions was used to examine the level of body image satisfaction. Third, a test consisting of ten questions was used to examine the level of self-esteem. Results: Median age of participants is 18 years. The research established a linear correlation between the body image satisfaction and gender of the students in both schools. An association between level of body image satisfaction and self-esteem was not established. Conclusion: To conclude with, adolescents in this region of Croatia are not overly concerned about their physical appearance despite relatively decreased self-esteem. A lack of association between reduced self-esteem and self-assessment of appearance may also be a consequence of later sexual maturation and tradional development which promote the traditional values of family, youth life and marriage
Personalized Single-Cell Networks: A Framework to Predict The Response of Any Gene To Any Drug For Any Patient
Authors: Harikumar Haripriya , Quinn Thomas P , Rana Santu , Gupta Sunil , Venkatesh Svetha
Published: August 2020

Background: The last decade has seen a major increase in the availability of genomic data. This includes expert-curated databases that describe the biological activity of genes, as well as high-throughput assays that measure the gene expression of bulk tissue and single cells. Integrating these heterogeneous data sources can generate new hypotheses about biological systems. Our primary objective is to combine population-level drug-response data with patient-level single-cell expression data to predict how any gene will respond to any drug for any patient. Methods: We use a “dual-channel” random walk with restart algorithm to perform 3 analyses. First, we use glioblastoma single cells from 5 individual patients to discover genes whose functions differ between cancers. Second, we use drug screening data from the Library of Integrated Network-Based Cellular Signatures (LINCS) to show how a cell-specific drug-response signature can be accurately predicted from a baseline (drug-free) gene co-expression network. Finally, we combine both data streams to show how we can predict how any gene will respond to any drug for each of the 5 glioblastoma patients. Conclusions: Our manuscript introduces two innovations to the integration of heterogeneous biological data. First, we use a “dual-channel” method to predict up-regulation and down-regulation separately. Second, we use individualized single-cell gene co-expression networks to make personalized predictions. These innovations let us predict gene function and drug response for individual patients. When applied to real data, we identify a number of genes that exhibit a patient-specific drug response, including the pan-cancer oncogene EGFR.
Anesthesia Management in Patients With Central Airway Stenosis Undergoing Bronchoscopy Treatments - Safety Application of Muscle Relaxants and the Traditional Low-frequency Ventilation : A Retrospective Observational Study
Authors: Li Jing-Jin , Li Nan , Ma Wei-Jia , Bao Ming-Xue , Chen Zi-Yang , Ding Zheng-Nian
Published: August 2020

Background: Bronchoscopy treatments of central airway stenosis (CAO) under general anesthesia are high-risky procedures, and posing a giant challenge to the anesthesiologists. The aim of this research was to estimate the safety application of muscle relaxants and the traditional Low-frequency ventilation in patients with central airway stenosis undergoing bronchoscopy treatments under general anesthesia by summarizing our clinical experience.Methods: Clinical data of 375 patients with CAO who underwent urgent endoscopic treatments from January 2016 to October 2019 were retrospectively reviewed. The use ratio of skeletal muscle relaxants, dose of fentanyl and skeletal muscle relaxants used between rigid bronchoscopy compared with flexible bronchoscopy therapy, the incidence of perioperative adverse events, adequacy of ventilation and gas exchange, post-operative recovery and risk factors for postoperative ICU admission were evaluated. Results: There was a high usage rate (96.5%) of skeletal muscle relaxants in patients with CAO who underwent either flexible bronchoscopy or rigid bronchoscopy therapy and there is a higher dosage of analgesic and skeletal muscle relaxants used in rigid bronchoscopy compared with flexible bronchoscopy therapy. This procedure had a low incidence of perioperative adverse events, with no significant difference between flexible bronchoscopy and rigid bronchoscopy therapy. Sufficient ventilation was successfully established using the traditional Low-frequency ventilation both in flexible and rigid bronchoscopy group. There was a low mortality (0.8%) during the post-operative recovery, and the higher grade of ASA and obvious dyspnea or orthopnea were the independent risk factors for postoperative ICU admission. Conclusion: The use of proper dosage of muscle relaxants is indispensable and safe in patients with CAO undergoing bronchoscopy treatments and the traditional Low-frequency ventilation also can be used in this procedure safely.
Overlapping syndrome mimicking infectious meningoencephalitis in a patient with MOG and GFAP IgG
Authors: Ji Su-qiong , Liu Chen-chen , Bu Bi-tao
Published: August 2020

The authors have withdrawn this preprint due to erroneous posting.
Mapping and validation of quantitative trait loci that confer resistance to rice black-streaked dwarf virus disease in rice (Oryza sativa)
Authors: zhang honggen , Wang Ruixuan , Xu Zuopeng , Liu Jiangning , Lan Guofang , Chen Zhiai , Gu Minghong , Tang Shuzhu
Published: August 2020

Background: Rice black-streaked dwarf virus (RBSDV) disease is one of the most destructive viral diseases that threatens rice production in China. Breeding of resistant cultivars through multi-gene pyramiding is considered to be an effective way to control the disease, but few resistance genes have been characterized to date.Results; In the present study, we identified T1012, a BC2F6 line from a cross of the japonica variety ‘Wuyujing3’ (recipient) and the indica variety ‘Dular’ (donor), that had improved resistance to RBSDV disease in a field test, and 140 chromosome segment substitution lines (CSSLs) derived from a cross of between T1012 and ‘Wuyujing3’ were developed using marker-assisted selection. Genetic analysis showed that the resistance of T1012 to RBSDV disease was controlled by quantitative trait loci (QTLs). Two QTLs for RBSDV disease resistance located on chromosomes 1 and 4, qRBSDV-1 and qRBSDV-4, were identified, and qRBSDV-4 was repeatedly detected in two environments. Compared to ‘Wuyujing3’, the CSSL containing only the substitution segment covering qRBSDV-4 exhibited significantly decreased disease incidence, indicating that qRBSDV-4 is a reliable resistance QTL with a high breeding value. Furthermore, two linked QTLs, qRBSDV-4-1 and qRBSDV-4-2, were identified within the interval containing qRBSDV-4.Conclusions: The QTLs identified here will provide a useful resource for breeding RBSDV-resistant rice cultivars through marker-assisted selection and establish a foundation for the cloning of RBSDV disease resistance genes.
Total Knee Arthroplasty in Patients with Rheumatoid Arthritis, Severe Osteoporosis, and Genu Valgum
Authors: Zhang Tao , Zhou Yong , Zhang Rui , Li Mi , Zhang Dapeng , Hu Naiwu
Published: August 2020

Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by symmetric, relapsing, or chronic destructive synovitis. The aim of this retrospective study was to assess the clinical benefits of TKA in patients with severe osteoporosis and moderate genu valgum.Methods: This was a retrospective study of patients with RA, osteoporosis, and genu valgus treated using TKA at the Fourth Affiliated Hospital of Harbin Medical University between 05/2016 and 05/2019. Posterior stable prostheses were used in all patients. The Knee Society Scoring System (KSS) was used.Results: There were eight males with 10 knees involved and 24 females with 34 knees involved. Healing by first intention was achieved in all patients. All patients received follow-up, with the mean follow up time of 2.9 (1-4) years. At the last follow-up, the KSS clinical score was improved from 32.1±9.8 to 82.0±5.8, (P<0.001). The KSS functional score of the patients was improved from 38.3±9.3 to 88.1±10.7 (P<0.001). The flexion-extension ROM of the knee joint was improved from 81.8°±27.9° to 105.8°±17.0° (P<0.001). The femorotibial angle (FTA) was changed from 23.1°±2.8° to 6.8°±1.9° (P<0.001). Common peroneal nerve paralysis and periarticular infection each occurred in one patient.Conclusion: TKA via the medial parapatellar approach with proper osteotomy and soft tissue balancing could restore the knee function in patients with RA, severe osteoporosis, and genu valgum.
Capacity of National Malaria Control Programs to implement vector surveillance: A global analysis
Authors: Russell Tanya L , Farlow Robert , Min Myo , Espino Effie , Mnzava Abraham , Burkot Thomas R.
Published: August 2020

Background
Solving the problem of malaria requires a highly skilled workforce with supporting infrastructure, financial backing and sound program management coordinated by a strategic plan. Here the capacity of NMCPs was analysed to identify the strengths and weaknesses underpinning implementation of vector surveillance and control activities by the core elements of program capacity, being strategic frameworks, financing, human resources, logistics and infrastructure, and information systems.
Results
Across nearly every country surveyed, the vector surveillance programs were hampered by a lack of capacity and capability. Only 8% of NMCPs reported having sufficient capacity to implement vector surveillance. In contrast, 57%, 56% and 28% of NMCPs had the capacity to implement LLINs, IRS and LSM activities, respectively. Largely underlying this was a lack of up-to-date strategic plans that prioritise vector surveillance and include frameworks for decision making and action.
Conclusions
Strategic planning and a lack of well-trained entomologists most heavily limited vector surveillance. Eliminating countries generally had more operational/field staff compared to controlling countries, and also were more likely to have an established system for staff training and capacity building. It is unlikely that controlling countries will make significant progress unless huge investments also go towards increasing the number and capacity of programmatic staff.
Pharmacokinetics and Dialytic Clearance of Apixaban During In Vitro Continuous Renal Replacement Therapy
Authors: Andrews Lauren , Benken Scott , Tan Xing , Wenzler Eric
Published: August 2020

Objective: To evaluate the transmembrane clearance (CLTM) of apixaban during modeled in vitro continuous renal replacement therapy (CRRT), assess protein binding and circuit adsorption, and provide initial dosing recommendations. Design: In vitro pharmacokinetic (PK) study.Setting: University research laboratory.Subjects: Not applicable. Interventions: Apixaban was added to the CRRT circuit and serial, undiluted pre-filter bovine blood samples were collected along with analogous post-filter blood and effluent samples. All experiments were performed in duplicate using continuous veno-venous hemofiltration (CVVH) and hemodialysis (CVVHD) modes, with varying filter types (M150 and HF1400), flow rates (2 and 4 L/h), and point of CVVH replacement fluid dilution (pre, post, and pre/post filter). Concentrations of apixaban and urea were quantified via liquid chromatography-tandem mass spectrometry. Plasma PK parameters for apixaban were estimated via noncompartmental analysis in WinNonlin. CLTM was calculated via the estimated area under the curve (AUC) and by the product of the sieving/saturation coefficient (SC/SA) and flow rate. Two and three-way ANOVA models were built to assess the effects of mode, filter type, flow rate, and point of dilution on CLTM by each method. Optimal doses were suggested by matching the AUC observed in vitro to the systemic exposure demonstrated in Phase 2/3 studies of apixaban. Linear regression was then utilized to provide dosing estimations for flow rates from 0.5-5 L/h. Measurements and Main Results: Mean adsorption to the HF1400 and M150 filters differed significantly at 38% and 13%, respectively, while mean (±SD) percent protein binding was 70.81±0.01%. Effect of CVVH point of replacement fluid dilution did not differ across filter types, although CLTM was consistently significantly higher during CRRT with the HF1400 filter compared to the M150. The three-way ANOVA demonstrated improved fit when CLTM values calculated by AUC were used (adjusted R2 0.87 vs. 0.52), and therefore, these values were used to generate optimal dosing recommendations. Linear regression revealed significant effects of filter type and flow rate on CLTM by AUC, suggesting doses of 5-10 mg BID may be needed for flow rates ranging from 0.5-5 L/h respectively. Conclusion: CLTM of apixaban during CRRT resulted in estimated dosing recommendations ranging from 5 mg BID for flow rates ≤3 L/h up to 7.5-10 mg BID for rates >3 L/h, depending on filter type, in order to match target systemic exposure thresholds. The safety and efficacy of these proposed dosing regimens warrants further investigation in clinical studies.
Intrathymic differentiation of natural antibody-producing plasma cells in human neonates
Authors: Cordero Hector , King Rodney , Dogra Pranay , Dufeu Chloe , See Sarah , Chong Alexander , Uhlemann Anne-Catrin , Ho Siu-Hong , Kalfa David , Bacha Emile , Kearney John , Zorn Emmanuel
Published: August 2020

The thymus is a central lymphoid organ responsible for the development of T cells. Here, we show that the thymus of human neonates also contains a consistent contingent of CD138+ plasma cells, producing all classes and subclasses of immunoglobulins with the exception of IgD. These antibody-secreting cells (ASC) are comprised within a larger subset of B cells lacking expression of the complement receptors CD21 and CD35 and sharing the expression of signature genes defining mouse B1 B cells. Single-cell transcriptomic analyses supported the intrathymic differentiation of CD138+ plasma cells alongside other B cell subsets with distinctive molecular phenotypes. Neonatal thymic plasma cells also included clones reactive to pathogenic bacteria that commonly infect children born with antibody deficiency. Thus, our findings point to the thymus as a source of innate humoral immunity in human neonates.
The Patient, Investigator, Nurse, Carer Questionnaire (PINC-Q): A Cross-Sectional, Retrospective, Non-Interventional Study Exploring the Impact of Less Frequent Medication Administration with Paliperidone Palmitate 3-Monthly as Maintenance Treatment for Schizophrenia
Authors: Wooller Annette , Pungor Katalin , Attal Jerome , Leopold Karolina , Pappa Sofia , Sanchez Pedro , Steegen Geertie , Vita Antonion , Marsella Carol , Verrijcken Caroline , Lahaye Marjolein
Published: August 2020

BackgroundTo understand the implications of switching from paliperidone palmitate 1-monthly (PP1M) to paliperidone palmitate 3-monthly (PP3M) treatment of schizophrenia from the perspective of four key stakeholders: patients, physicians, nurses and carers. Methods PINC-Q was a cross-sectional, retrospective, non-interventional study comprising a one-time questionnaire for adult patients (aged ≥18 years) with schizophrenia (International Classification of Diseases; ICD-10) and their physician, nurse and carer. Questionnaires were developed in association with patient and carer advocacy groups (GAMIAN and EUFAMI) and following an advisory board formed of psychiatrists and nurses. The degree of alignment between stakeholders was also examined.ResultsResponses were received from a total of 224 evaluable patients. For most patients (88.4%), responses were received from at least two other stakeholders. Patients were moderately ill with mild-to-moderate lack of insight and had received PP1M for a mean (standard deviation [SD]) of 23.9 (21.28) months before switching to PP3M (duration mean [SD] 12.8 [3.72] months). The most frequently reported reasons to switch from PP1M to PP3M were ‘to live life as normally as possible’ and ‘patient convenience’. Over 79% of responses within each stakeholder group stated that PP3M helped the patients, with increased patient activity and social involvement, improved frequency and quality of physician–patient and nurse–patient communication and decreased perceived stigma.ConclusionsThe results of the PINC-Q study add to the increasing body of evidence supporting the benefits of PP3M in a population of patients with schizophrenia representative of real-world clinical practice.
Urine CA-2 as a biomarker for diagnosis urinary stone and prediction of its complications
Authors: Leng Yuan-jing , Zhou Hai-bin , Fu Jiang-ling , Wang Wen-juan
Published: August 2020

PURPOSECarbonic anhydrase-2 (CA-2) plays a role in mineralization and calcification in organism. Strong evidence suggests that CA-2 is associated with urolithiasis. However, the relationship between CA-2 and urinary stone remains unclear. The study aimed to assess the association of urine CA-2 (uCA-2) level and the potential risk of urinary stone.METHODSFrom March 2017 to November 2019, a prospective cohort study was conducted on patients with urinary stones and healthy subjects to determine the pretreatment uCA-2 level detection by Enzyme linked immunosorbent assay (ELISA). The difference of uCA-2 level between patients with urinary stones and healthy subjects was compared. Then comparison between stone patients with complications and without complications was carried out as well as correlation analysis to detect factors associated with biomarker expression.RESULTS118 patients with urinary stones were into urinary stones group and 42 healthy subjects were into healthy control group. The mean pretreatment uCA-2 level was significantly higher in patients with urinary stones group than healthy controls group (P=0.028). Furthermore, The uCA-2 level was positive correlation with urinary stones complications (R=0.379, P=0.000), especially pain complications (R=0.524, P=0.000) and hematuria complications (R=0.374, P=0.000). Receiver operating characteristic curve (ROC) analysis that a uCA-2 level threshold of 10.94 ng/mL had 83.67% sensitivity and 68.12% specificity for predicting urinary stones complications. CONCLUSIONSExcessive uCA-2 excretion is a major risk factor for urinary stone. Our findings suggested that uCA-2 may be used as an unappreciated biomarker for the diagnosis urinary stone in patients and to predict its complications.
Recurrent wheezing after respiratory syncytial virus infection in children under 3 years of age: a 1-year follow-up study
Authors: Zhou Li , Li Jing , Hu Fang , Zhang Lin , Xiang Hua , Ren Juan
Published: August 2020

Background: Wheezing in infancy is very common. RSV infection can cause recurrent wheezing. The aim of this study was to explore the risk factors of recurrent wheezing in children under 3 years of age after RSV infection. Methods：We chose children with initial wheezing before 3 years of age who were hospitalized for medical treatment. Wheezing frequency was determined by follow-up at 1 week, 1 month, 3 months, 6 months, and 1 year. Information such as birth status, age, sex, preterm, mode of delivery, birth order, eczema history, personal allergy history, family allergy history, passive smoking, and place of residence (urban/rural) was collected. Total serum IgE level, serum allergen testing, routine blood tests, C-reactive protein level, procalcitonin level, respiratory pathogens tests, sputum culture, chest radiography or computed tomography were performed in all patients. The correlation between each factor and wheezing recurrence was evaluated. Results: A total of 259 children were included in the study. They were divided into single recurrence, multiple recurrences, and no recurrence groups. There were significant differences between the single recurrence and multiple recurrences groups in terms of personal allergy history, passive smoking, total serum IgE level, age, hospital stay duration, and wheezing duration (p<0.05). The percentage of children with a personal allergy history in the multiple recurrences group was significantly higher than that of children in the single recurrence and no recurrence groups (p=0.031 and 0.008, respectively). The age of children in the multiple recurrences group was significantly lower than that of children in the single recurrence group (p=0.000). The cost of re-hospitalization in the multiple recurrences group was significantly higher than that in the single recurrence and no recurrence groups (p=0.000 and 0.000, respectively). Conclusions: Children with a personal allergy history were more likely to have wheezing episodes. The frequency of wheezing in children under 3 years of age within 1 year of a respiratory syncytial virus infection was related to age. The younger the age at the time of the onset of wheezing, the more wheezing recurrences in the following year.
Elite Rugby and COVID-19: Protecting the Wellbeing of Rugby Players and Support Staff from an Occupational Safety and Health Perspective
Authors: Chen Yanbing , Buggy Conor , Kelly Seamus
Published: August 2020

Background: The contact nature of rugby with its’ intensive physical interaction often exposes players to a high risk of injury and illness. Compliance with prescribed safety guidelines when returning to play during the COVID-19 pandemic is important for both rugby players and their support staff’s health and wellbeing. However, elite rugby has an inherent level of risk acceptance that has been a cultural norm in the game for decades. This paper aims to identify risk factors that influence players’ awareness and actions in relation to the highly communicable disease COVID-19, and provide rugby clubs and associations with practical return to play solutions from a health and safety perspective. Methods: This study thematically analysed interviews with 15 senior rugby support staff employed in elite rugby union that explored key factors impacting health-and-safety in elite rugby. With the emphasis on rugby players’ health-and-safety awareness (e.g. illness/injury reporting awareness) and rugby environment micromanagement (e.g. player hygiene) and rugby physical contact nature, analysing the factors that may be normalised in elite sporting settings in the context of managing return to play during the COVID-19 pandemic.Results: Due to physical contact nature of rugby, players are exposed to the risk of trauma resulting in skin abrasions and lacerations etc. which may aggregate the risk of infectious diseases. A level of micromanagement practices such as player hygiene management and health condition surveillance that builds on the current situation are effective and essential, considering rugby players in a high level of fitness condition and at a relatively young age can be overly confident with their ability to deal with the risk of illness. Furthermore, player awareness such as symptom reporting and return-to-play (RTP) after unwellness is due to improve for ensuring their health and wellbeing and of their fellow players as well as support staff during the back to field process in the context of COVID-19.Conclusions: Returning to rugby practice and competition will require a level of micromanagement and player safety awareness education in order to achieve the goal of optimally protecting the players from potential illness and / or spreading it to fellow players and support staff. Rugby rituals such as the New Zealand haka could be considered for keeping social distance between players while affirming the rugby nature of aggression exhibition.
A Revealed Preference Analysis to Develop Composite Scores Approximating Lung Allocation Policy in the U.S.
Authors: Stewart Darren , Wood Dallas , Alcorn James , Hayes Michael , Hauber Brett , Goff Rebecca
Published: August 2020

Background: The patient ranking process for donor lung allocation in the United States is carried out by a classification-based, computerized algorithm, known as the match system. Experts have wondered whether a continuous, points-based allocation framework would better serve waiting list candidates by removing hard boundaries and increasing transparency into the relative importance of factors used to order candidates. We applied discrete choice modeling to match run data to determine the feasibility of approximating current lung allocation policy by one or more composite scores. Our study aimed to demystify the points-based approach to allocation; quantify the relative importance of factors used in allocation under current policy; and provide a viable policy option that adapts the current, classification-based system to the continuous allocation framework.Methods: Rank ordered logistic regression models were estimated using 6,466 match runs for 5,913 adult donors and 534 match runs for 488 pediatric donors from 2018. Four primary attributes are used to rank candidates and were included in the models: (1) medical priority, (2) candidate age, (3) candidate’s transplant center proximity to the donor hospital, and (4) blood type compatibility with the donor.Results: Two composite scores were developed, one for adult and one for pediatric donor allocation. Candidate rankings based on the composite scores were highly correlated with current policy rankings (Kendall’s Tau ~0.80, Spearman correlation >90%), indicating both scores strongly reflect current policy. In both models, candidates are ranked higher if they have higher medical priority, are registered at a transplant center closer to the donor hospital, or have an identical blood type to the donor. Proximity was the most important attribute. Under a points-based scoring system, candidates in further away zones are sometimes ranked higher than more proximal candidates compared to current policy. Conclusions: Revealed preference analysis of match runs produced composite scores that capture the essence of current policy while removing hard boundaries of the current classification-based system. A carefully crafted, continuous version of lung allocation policy has the potential to make better use of the limited supply of donor lungs in a manner consistent with the priorities of the transplant community.
A Multicenter Prospective Double Blinded Randomized Controlled Pilot Trial of Intravenous Iron (Ferric Derisomaltose (FDI)) in Iron Deficient but not Anemic Patients with Chronic Kidney Disease on Functional Status.
Authors: Bhandari Sunil , Allgar Victoria , Lamplugh Archie , Macdougall Iain , Kalra Philip
Published: August 2020

Background Iron deficiency (ID) is common in patients with chronic kidney disease (CKD). Intravenous (IV) iron in heart failure leads to improvement in exercise capacity and improvement in quality of life measurements; however, data in patients with CKD are lacking.Methods The Iron and the Heart Study was a prospective double blinded randomized study in non-anemic CKD stages 3b-5 patients with ID which investigated whether 1000 mg of IV iron (ferric derisomaltose (FDI) ) could improve exercise capacity in comparison to placebo measured at 1 and 3 months post infusion. Secondary objectives included effects on hematinic profiles and hemoglobin, safety analysis and quality of life questionnaires (QoL).Results We randomly assigned 54 patients mean (SD) age for FDI (n=26) 61.6 (10.1) years vs placebo (n=28; 57.8 (12.9) years) and mean eGFR (32.1 (9.6) vs. 29.1 (9.6) ml/min/1.73m2) at baseline, respectively. Adjusting for baseline measurements, six-minute walk test (6MWT) showed no statistically significant difference between arms at 1 month (p=0.736), or 3 months (p=0.741). There were non-significant increases in 6MWT from baseline to 1 and 3 months in the FDI arm. Hemoglobin (Hb) at 1 and 3 months remained stable. There were statistically significant increases in ferritin (SF) and transferrin saturation (TSAT) at 1 and 3 months (p<0.001). There was a modest numerical improvement in QoL parameters. There were no adverse events attributable to IV iron. Conclusion This study demonstrated a short-term beneficial effect of FDI on exercise capacity, but it was not significant despite improvements in parameters of iron status, maintenance of Hb concentration, and numerical increases in functional capacity and quality of life scores. A larger study will be required to confirm if intravenous iron is beneficial in iron deficient non-anemic non-dialysis CKD patients without heart failure to improve the 6MWT.Trial Registration: European Clinical Trials Database (EudraCT) No: 2014-004133-16https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-004133-16/GBREC no: 14/YH/1209Date First Registered: 2015-02-17 and date of end of trail 2015-05-23Sponsor ref R1766 and Protocol No: IHI 141
A Mixed-Methods Feasibility Study of an Arts-Based Intervention for Patients Receiving Maintenance Haemodialysis.
Authors: Carswell Claire , Reid Joanne , Walsh Ian , Johnston William , McAneney Helen , Mullan Robert , Lee Jenny Baxley , Nelson Hugh , Matthews Michael , Weatherup Elizabeth , Spencer Andrea , Michelo Jean , Quail Anne , Kielty Grainne , Elliott Jenny , Mackenzie Alistair , Arbuckle Nicola , Wilson Anna , Noble Helen
Published: August 2020

BackgroundHaemodialysis can negatively impact quality of life and mental health. Arts-based interventions used successfully in other settings to improve health and well-being, could help address the impact of haemodialysis. This study aimed to evaluate the feasibility and acceptability of conducting a randomised controlled trial (RCT) of an arts-based intervention for patients receiving haemodialysisMethodsA parallel convergent mixed-methods design was used, including a pilot cluster RCT and qualitative process evaluation. Phase 1 evaluated recruitment and retention rates through a pilot cluster RCT at a single haemodialysis unit in Northern Ireland. Participants included patients who received haemodialysis for ESKD, were over the age of 18 and had the capacity to consent. These participants were randomised to the intervention or control group according to their haemodialysis shift. The intervention involved six one-hour, one-to-one facilitated arts sessions during haemodialysis. Phase 2 explored intervention and trial acceptability through a qualitative process evaluation using semi-structured interviews based on the RE-AIM framework. Participants included 13 patients who participated in phase 1 of the study, including 9 participants from the experimental group and four participants from the control group, and nine healthcare professionals who were present on the unit during implementation. ResultsOut of 122 outpatient haemodialysis patients, 94 were assessed as eligible for participation. Twenty-four participants were randomised, meaning 80% of the target sample size was recruited and the attrition rate at 3 months was 12.5% (n=3). Participants viewed the arts as more accessible and enjoyable than anticipated following implementation. All participants who started the intervention (n=11) completed the full six sessions. Qualitative benefits of the intervention suggest improvements in mental well-being. Patient choice and facilitation were important factors for successful implementation. ConclusionAn arts-based intervention for patients receiving haemodialysis is acceptable for both patients and healthcare professionals, and a definitive trial is feasible. The intervention may help improve mental-wellbeing in patients receiving haemodialysis, but this requires further investigation in a definitive trial.Trial registrationThe trial was prospectively registered on clinicaltrials.gov on 14/8/2018, registration number NCT03629496.
Diagnosis and management of Adenosine Deaminase 2 Deficiency children: the experience from China
Authors: Wang Wei , Zhang Tiannan , Zheng Wenjie , Zhong Linqing , Wang Lin , Li Ji , Liu Qian , Dong Yanqing , Song Hongmei
Published: August 2020

BACKGROUND: Deficiency of adenosine deaminase 2 (DADA2) is a rare autoinflammatory disease caused by mutations in the ADA2 gene. Few Chinese cases have been reported. We describe and compare the clinical features, genotypes, and treatments of Chinese DADA2 patients and non-Chinese patients.METHODS: Primary immunodeficiency disease panel or whole-exome sequencing was performed for suspected cases, and assays for adenosine deaminase 2 (ADA2) enzyme activity were also carried out for the patients and their parents. Case reports of Chinese and non-Chinese patients with DADA2 were searched in PubMed and Chinese national databases.RESULTS: Seven unrelated children from China with DADA2 were included in our study. Five were identified at Peking Union Medical College Hospital, and two had been reported previously (1 on PubMed and 1 in Chinese literature). Fourteen mutations in ADA2 were identified, 7 of which have not previously been reported in non-Chinese patients. Four children who underwent enzymatic analysis had lower ADA2 activity compared with their parents. Phenotypic manifestations included fever, skin symptoms, vasculitis, and neurologic involvement. Treatments varying from steroids, immunosuppressants, and tocilizumab, anti-TNF therapy and hematopoietic stem cell transplantation (HSCT) were effective depending on phenotype and severity.CONCLUSION: This study includes the largest number of Chinese DADA2 patients to date. We recommend the combination of enzymatic analysis with gene screening to confirm the diagnosis. Different genotypes were observed among Chinese DADA2 patients; most phenotypes were similar to those of non-Chinese DADA2 patients, except for growth retardation. Disease remission might not be achieved with anti-IL-6 therapy.
Suprainguinal Fascia Iliaca Block Accelerates General Anesthesia Recovery and Relieves Postoperative Pain in Elderly Patients After Total Hip Arthroplasty: A Retrospective Study
Authors: Wang Yali , Liu Yunqing , Ni Hua , Zhang Xinlei , Ding Li , Tong Fei , Chen Hongye , Zhang Xinhua , Kong Mingjian
Published: August 2020

Background: Peripheral regional block combined with general anesthesia might be a preferable anesthetic regimen for elderly patients receiving total hip arthroplasty. To investigate whether suprainguinal fascia iliaca block accelerates recovery after general anesthesia and relieves early postoperative pain in elderly patients undergoing total hip arthroplasty. Methods: Patients who underwent total hip arthroplasty under general anesthesia in 2015 or 2019 at the Second Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. The patients were grouped based on whether preoperative suprainguinal fascia iliaca block was performed. The time to tracheal extubation and spent in the post anesthesia care unit (PACU), intraoperative remifentanil dosage, fentanyl consumption in PACU, postoperative cumulative fentanyl consumption within 48 h after operation, visual analog scale (VAS) at rest and during movement on the first and second days after surgery, and adverse reactions were compared.Results: Thirty-one patients were included in the study (block group:16, no-block group: 15). The VAS at rest and during movement on the first and second days were significantly lower in the block group than in the no-block group (all P<0.05). The intraoperative remifentanil dosage, fentanyl consumption given in PACU, and postoperative cumulative fentanyl consumption in 48 h after operation were lower in the block group (all P<0.01). The time to tracheal extubation and the time spent in PACU in the block group were shorter (all P<0.01). Conclusion: Suprainguinal fascia iliaca block led to faster recovery after general anesthesia and early postoperative pain relief in elderly patients undergoing total hip arthroplasty.