bluuebunny/crossref_metadata_2025 huggingface dataset:
Overcoming Barriers to Agriculture Green Technology Diffusion through Stakeholders in China: A Social Network Analysis
Authors: Wang Wenke , Wang Jue , Liu Kebei , Wu Yenchun Jim
Published: September 2020

It is crucial to actively encourage the development of agriculture green technology, which has been regarded as one of the most effective solutions to the environmental degradation caused by agricultural activities. However, agriculture green technology diffusion is indeed a challenging task and still faces numerous barriers. The stakeholders who can potentially deal with these barriers, however, have been overlooked by previous studies. To address these issues, social network analysis was performed to identify critical stakeholders and barriers. Their interactions in agriculture green technology diffusion were analyzed based on the literature, a questionnaire survey and expert judgments. A two-mode network and two one-mode networks were used to analyze the relationships among the identified 12 barriers and 14 stakeholders who can influence these 12 barriers identified. The results show that agricultural research institutes, universities, agribusiness, agencies of township promotion, the government and farmers’ relatives are key stakeholders and that the limited market demand for green technology and the high cost of its diffusion are two main barriers. However, poor green technology operability and farmer families in distress are factors that are not as important as previously perceived. Finally, some recommendations and suggestions are provided to promote agriculture green technology diffusion in China.
The Need for Universal Screening for Postnatal Depression in South Africa: Confirmation from a Sub-District in Pretoria, South Africa
Authors: Mokwena Kebogile , Masike Itumeleng
Published: September 2020

Although postnatal depression (PND) is a worldwide public health problem, it is relatively higher in developing countries, including countries in Sub-Saharan Africa. Postnatal depression is not routinely screened for in primary healthcare facilities in South Africa, despite its reported compromise on mother and child health. The purpose of this study was to determine the prevalence of, as well as factors associated with, postnatal depression in a sample of clinic attendees in a sub district in Tshwane, South Africa. A quantitative and cross-sectional survey was conducted in a sample of 406 women in three healthcare facilities. The Edinburgh Postnatal Depression Scale (EPDS) was used to collect data from women who had infants between the ages of 0 and 12 months. The cut-off point for the EPDS for the depressed category was a score of 13 out of a maximum of 30. The majority of the women (57.14%, n = 232) had scores of 13 and above, which is indicative of postnatal depressive symptoms. On logistic regression, postnatal depressive symptoms were significantly associated with lack of support in difficult times (p < 0.001, 95% CI 10.57–546.51), not having the preferred sex of the baby (p = 0.001, 95% CI 0.37–0.58), low household income (p < 0.001, 95% CI 1.23–1.67), and an older baby (p = 0.005, 95% CI 1.21–1.49). The results show the high proportion of women who have postnatal depression but remain undiagnosed and untreated, and therefore confirm the need for routine screening for postnatal depressive symptoms in primary healthcare facilities, which are used by the majority of women in South Africa.
The Predictive Role of Affectivity, Self-Esteem and Social Support in Depression and Anxiety in Children and Adolescents
Authors: Peñate Wenceslao , González-Loyola Melissa , Oyanadel Cristian
Published: September 2020

Background: This study analyzes the relationship between depression and anxiety levels and positive and negative affect, self-esteem, and perceived social support from family and friends in an early and middle adolescent sample. These are psychological variables that are often associated with the prediction of emotional disorders, especially depression. Methods: Participants (N = 467) were a representative sample of this group of adolescents and were recruited from schools in the city of Concepción, Chile. Part of the sample (N = 177) was assessed three additional times—at one-, two-, and four-month intervals. Results: Results showed a practical stability of all measures across the four intervals, with no significant differences between sexes. Anxiety and depression displayed a similar pattern of significant relationships with affectivity, self-esteem, and social support. Depression had a higher correlation coefficient (−0.47) with positive affect, and so did anxiety with negative affect (0.58). Conclusions: Taking into account 23 initial scores on affectivity, self-esteem, and social support in predicting both depression and anxiety scores at one-month, two-month, and four-month intervals, positive affect was present in three regression analyses, predicting depression scores; negative affect was present in anxiety scores. Results are discussed according to previous findings, as well as the tripartite model.
COVID-19 Pandemic and Mental Health: Prevalence and Correlates of New-Onset Obsessive-Compulsive Symptoms in a Canadian Province
Authors: Abba-Aji Adam , Li Daniel , Hrabok Marianne , Shalaby Reham , Gusnowski April , Vuong Wesley , Surood Shireen , Nkire Nnamdi , Li Xin-Min , Greenshaw Andrew J. , Agyapong Vincent I.O.
Published: September 2020

Background: This cross-sectional online survey investigates the prevalence of obsessive-compulsive disorder (OCD) symptoms at an early stage of the COVID-19 pandemic in Canada. Methods: OCD symptoms, moderate/high stress, likely generalized anxiety disorder (GAD) and likely major depressive disorder (MDD) were assessed with the Brief Obsessive-Compulsive Scale (BOCS), Perceived Stress Scale (PSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9) scale, respectively. Results: Out of 32,805 individuals subscribed to Text4Hope, 6041 completed an online survey; the response rate was 18.4%. Overall, 60.3% of respondents reported onset of OCD symptoms and 53.8% had compulsions to wash hands during the COVID-19 pandemic. Respondents who showed OCD symptoms only since the start of COVID-19 were significantly more likely to have moderate/high stress (z = 6.4, p < 0.001), likely GAD (z = 6.0, p < 0.001), and likely MDD (z = 2.7, p < 0.01). Similarly, respondents who engaged in compulsive hand washing were significantly more likely to have moderate/high stress (z = 4.6, p < 0.001) and likely GAD (z = 4.6 p < 0.001), but not likely MDD (z = 1.4, p = 0.16). Conclusion: The prevalence of OCD symptoms increased during the COVID-19 pandemic, at a rate significantly higher than pre-pandemic rates reported for the sample population. Presenting with OCD symptoms increased the likelihood of presenting with elevated stress, likely GAD, and likely MDD.
Relationship between Sprint Velocity and Peak Moment at Shoulder and Elbow in Elite Wheelchair Basketball Players
Authors: Villacieros Jorge , Pérez-Tejero Javier , Garrido Guadalupe , Grams Lena , López-Illescas África , Ferro Amelia
Published: September 2020

Specific wheelchair basketball (WB) skills on the court have been poorly analyzed in relation to improving players’ performance according to their functional class. The purpose of this study was to evaluate the associations between maximum velocity (Vmax) and peak moment (PM) in the shoulder and elbow joints in specific WB skills and to compare performance between the main two groups by functional class. Twelve male WB players, divided in categories A (functional classes 1.0–2.5) and B (class 3.0–4.5), performed a sprint test battery composed by four tests (with and without ball) and isokinetic tests. A significant relationship between PM of the internal and external shoulder rotation and the flexion and extension elbow with Vmax (p < 0.05) was found. During a 5 m backward sprint test, category B was faster in the last three meters than category A (p < 0.05) and also for the rest of the test but p = NS. Category B showed higher PM than category A for internal shoulder rotation (ISR) at 60 °/s and at 180 °/s on the dominant side (DS) (p < 0.05). In conclusion, ISR on the DS was found different for both groups and showed significant relationship with Vmax in all of the tests performed. Moreover, at higher speeds the elbow flexion and extension in DS were correlated with Vmax in all the actions with ball (passing, bouncing, and braking) reflected the importance of these joints movements in acquiring speed when performing sport specific WB skills.
Correlation between Oral Glucose Tolerance Test Abnormalities and Adverse Pregnancy Outcomes in Gestational Diabetes: A Cross-Sectional Study
Authors: Kalok Aida , Ong Ming Yean , Hasrori Aqilah , Chiang Ker Shing , Yazim Fatin , Baharuddin Salahuddin , Rahman Rahana Abdul , Shah Shamsul Azhar , Aziz Nor Haslinda Abd , Ahmad Shuhaila , Ismail Nor Azlin Mohamed
Published: September 2020

Gestational diabetes mellitus (GDM) is associated with maternal and neonatal complications. We aimed to evaluate the relationship between the abnormalities of the oral glucose tolerance test (OGTT) and adverse pregnancy outcomes. This was a retrospective study of GDM patients over a five-year period in a Malaysian tertiary center. The diagnosis of GDM was based on the National Institute for Health and Care Excellence (NICE) guideline. The data on patients’ demographics, OGTT results, GDM treatment, and pregnancy outcomes were analyzed. A total of 1105 women were included in the final analysis. The percentage of women with isolated abnormal fasting glucose, isolated two-hour abnormality, and both abnormal values were 4.8%, 87.1%, and 8.1%, respectively. Women with both OGTT abnormalities had a higher risk of preeclampsia (odds ratio (OR) 4.73; 95% confidence interval (CI) 1.45–15.41) and neonatal hypoglycemia (OR 8.78; 95% CI 1.93–39.88). Isolated postprandial abnormality was associated with an 80% lesser risk of neonatal hypoglycemia (OR 0.19; 95% CI 0.04–0.87). Both isolated fasting and multiple OGTT abnormalities were associated with insulin therapy. Multiple OGTT abnormalities were a positive predictor of adverse pregnancy outcomes, while isolated postprandial abnormality was associated with a lesser risk of neonatal complication. Further prospective study is essential to validate these findings.
Identification of Potential Biomarkers and Related Transcription Factors in Peripheral Blood of Tuberculosis Patients
Authors: Xie Longxiang , Chao Xiaoyu , Teng Tieshan , Li Qiming , Xie Jianping
Published: September 2020

Tuberculosis (TB), one major threat to humans, can infect one third of the worldwide population, and cause more than one million deaths each year. This study aimed to identify the effective diagnosis and therapy biomarkers of TB. Hence, we analyzed two microarray datasets (GSE54992 and GSE62525) derived from the Gene Expression Omnibus (GEO) database to find the differentially expressed genes (DEGs) of peripheral blood mononuclear cell (PBMC) between TB patients and healthy specimens. Functional and pathway enrichment of the DEGs were analyzed by Metascape database. Protein-protein interaction (PPI) network among the DEGs were constructed by STRING databases and visualized in Cytoscape software. The related transcription factors regulatory network of the DEGs was also constructed. A total of 190 DEGs including 36 up-regulated genes and 154 down-regulated genes were obtained in TB samples. Gene functional enrichment analysis showed that these DEGs were enriched in T cell activation, chemotaxis, leukocyte activation involved in immune response, cytokine secretion, head development, etc. The top six hub genes (namely, LRRK2, FYN, GART, CCR7, CXCR5, and FASLG) and two significant modules were got from PPI network of DEGs. Vital transcriptional factors, such as FoxC1 and GATA2, were discovered with close interaction with these six hub DEGs. By systemic bioinformatic analysis, many DEGs associated with TB were screened, and these identified hub DEGs may be potential biomarkers for diagnosis and treatment of TB in the future.
Recombinant Tissue Plasminogen Activator (r-tPA) Induces In-Vitro Human Neutrophil Migration via Low Density Lipoprotein Receptor-Related Protein 1 (LRP-1)
Authors: Liberale Luca , Bertolotto Maria , Minetti Silvia , Contini Paola , Verzola Daniela , Ameri Pietro , Ghigliotti Giorgio , Pende Aldo , Camici Giovanni G. , Carbone Federico , Montecucco Fabrizio
Published: September 2020

Thrombolysis is the gold standard treatment for acute ischemic stroke. Besides its fibrinolytic role, recombinant tissue plasminogen activator (r-tPA) holds several non-fibrinolytic functions. Here, we investigated the potential role of r-tPA on human primary neutrophil migration in vitro. By means of modified Boyden chamber migration assay and checkerboard analysis we showed a dose-dependent chemotactic effect of r-TPA with a maximum effect reached by 0.03 mg/mL (0.003–1 mg/mL). Pre-incubation with MAP kinases inhibitors allowed the identification of PI3K/Akt, but not ERK1/2 as the intracellular pathway mediating the observed effects. Furthermore, by means of real-time PCR, immunocytochemistry and cytofluorimetry we demonstrated that the r-tPA receptor low density lipoprotein receptor-related protein 1 (LRP-1) is synthetized and expressed by neutrophils in response to r-tPA and TNF-α. Inhibition of LRP-1 by receptor-associated protein (RAP), prevented r-tPA-mediated F-actin polymerization, migration and signal through Akt but not ERK1/2. Lastly, also neutrophil degranulation in response to r-tPA seems to be mediated by LRP-1 under adhesion conditions. In conclusion, we show that r-tPA induces neutrophil chemotaxis through LRP-1/Akt pathway. Blunting r-tPA-mediated neutrophil activation might be beneficial as an adjuvant therapy to thrombolysis in this setting.
Mapping TRPM7 Function by NS8593
Authors: Chubanov Vladimir , Gudermann Thomas
Published: September 2020

The transient receptor potential cation channel, subfamily M, member 7 (TRPM7) is a ubiquitously expressed membrane protein, which forms a channel linked to a cytosolic protein kinase. Genetic inactivation of TRPM7 in animal models uncovered the critical role of TRPM7 in early embryonic development, immune responses, and the organismal balance of Zn2+, Mg2+, and Ca2+. TRPM7 emerged as a new therapeutic target because malfunctions of TRPM7 have been associated with anoxic neuronal death, tissue fibrosis, tumour progression, and giant platelet disorder. Recently, several laboratories have identified pharmacological compounds allowing to modulate either channel or kinase activity of TRPM7. Among other small molecules, NS8593 has been defined as a potent negative gating regulator of the TRPM7 channel. Consequently, several groups applied NS8593 to investigate cellular pathways regulated by TRPM7. Here, we summarize the progress in this research area. In particular, two notable milestones have been reached in the assessment of TRPM7 druggability. Firstly, several laboratories demonstrated that NS8593 treatment reliably mirrors prominent phenotypes of cells manipulated by genetic inactivation of TRPM7. Secondly, it has been shown that NS8593 allows us to probe the therapeutic potential of TRPM7 in animal models of human diseases. Collectively, these studies employing NS8593 may serve as a blueprint for the preclinical assessment of TRPM7-targeting drugs.
Fused in Sarcoma (FUS) in DNA Repair: Tango with Poly(ADP-ribose) Polymerase 1 and Compartmentalisation of Damaged DNA
Authors: Sukhanova Maria V. , Singatulina Anastasia S. , Pastré David , Lavrik Olga I.
Published: September 2020

The fused in sarcoma (FUS) protein combines prion-like properties with a multifunctional DNA/RNA-binding domain and has functions spanning the regulation of RNA metabolism, including transcription, pre-mRNA splicing, mRNA transport and translation. In addition to its roles in RNA metabolism, FUS is implicated in the maintenance of DNA integrity. In this review, we examine the participation of FUS in major DNA repair pathways, focusing on DNA repair associated with poly(ADP-ribosyl)ation events and on how the interaction of FUS with poly(ADP-ribose) may orchestrate transient compartmentalisation of DNA strand breaks. Unravelling how prion-like RNA-binding proteins control DNA repair pathways will deepen our understanding of the pathogenesis of some neurological diseases and cancer as well as provide the basis for the development of relevant innovative therapeutic technologies. This knowledge may also extend the range of applications of poly(ADP-ribose) polymerase inhibitors to the treatment of neurodegenerative diseases related to RNA-binding proteins in the cell, e.g., amyotrophic lateral sclerosis and frontotemporal lobar degeneration.
Spontaneous Right Ventricular Pseudoaneurysms and Increased Arrhythmogenicity in a Mouse Model of Marfan Syndrome
Authors: Steijns Felke , Renard Marjolijn , Vanhomwegen Marine , Vermassen Petra , Desloovere Jana , Raedt Robrecht , Larsen Lars E. , Tóth Máté I. , De Backer Julie , Sips Patrick
Published: September 2020

Patients with Marfan syndrome (MFS), a connective tissue disorder caused by pathogenic variants in the gene encoding the extracellular matrix protein fibrillin-1, have an increased prevalence of primary cardiomyopathy, arrhythmias, and sudden cardiac death. We have performed an in-depth in vivo and ex vivo study of the cardiac phenotype of Fbn1mgR/mgR mice, an established mouse model of MFS with a severely reduced expression of fibrillin-1. Using ultrasound measurements, we confirmed the presence of aortic dilatation and observed cardiac diastolic dysfunction in male Fbn1mgR/mgR mice. Upon post-mortem examination, we discovered that the mutant mice consistently presented myocardial lesions at the level of the right ventricular free wall, which we characterized as spontaneous pseudoaneurysms. Histological investigation demonstrated a decrease in myocardial compaction in the MFS mouse model. Furthermore, continuous 24 h electrocardiographic analysis showed a decreased heart rate variability and an increased prevalence of extrasystolic arrhythmic events in Fbn1mgR/mgR mice compared to wild-type littermates. Taken together, in this paper we document a previously unreported cardiac phenotype in the Fbn1mgR/mgR MFS mouse model and provide a detailed characterization of the cardiac dysfunction and rhythm disorders which are caused by fibrillin-1 deficiency. These findings highlight the wide spectrum of cardiac manifestations of MFS, which might have implications for patient care.
BMP-2/β-TCP Local Delivery for Bone Regeneration in MRONJ-Like Mouse Model
Authors: Mikai Akihiro , Ono Mitsuaki , Tosa Ikue , Nguyen Ha Thi Thu , Hara Emilio Satoshi , Nosho Shuji , Kimura-Ono Aya , Nawachi Kumiko , Takarada Takeshi , Kuboki Takuo , Oohashi Toshitaka
Published: September 2020

Medication-related osteonecrosis of the jaw (MRONJ) is a severe pathological condition associated mainly with the long-term administration of bone resorption inhibitors, which are known to induce suppression of osteoclast activity and bone remodeling. Bone Morphogenetic Protein (BMP)-2 is known to be a strong inducer of bone remodeling, by directly regulating osteoblast differentiation and osteoclast activity. This study aimed to evaluate the effects of BMP-2 adsorbed onto beta-tricalcium phosphate (β-TCP), which is an osteoinductive bioceramic material and allows space retention, on the prevention and treatment of MRONJ in mice. Tooth extraction was performed after 3 weeks of zoledronate (ZA) and cyclophosphamide (CY) administration. For prevention studies, BMP-2/β-TCP was transplanted immediately after tooth extraction, and the mice were administered ZA and CY for an additional 4 weeks. The results showed that while the tooth extraction socket was mainly filled with a sparse tissue in the control group, bone formation was observed at the apex of the tooth extraction socket and was filled with a dense connective tissue rich in cellular components in the BMP-2/β-TCP transplanted group. For treatment studies, BMP-2/β-TCP was transplanted 2 weeks after tooth extraction, and bone formation was followed up for the subsequent 4 weeks under ZA and CY suspension. The results showed that although the tooth extraction socket was mainly filled with soft tissue in the control group, transplantation of BMP-2/β-TCP could significantly accelerate bone formation, as shown by immunohistochemical analysis for osteopontin, and reduce the bone necrosis in tooth extraction sockets. These data suggest that the combination of BMP-2/β-TCP could become a suitable therapy for the management of MRONJ.
Docosahexaenoic Acid-Loaded Polylactic Acid Core-Shell Nanofiber Membranes for Regenerative Medicine after Spinal Cord Injury: In Vitro and In Vivo Study
Authors: Liu Zhuo-Hao , Huang Yin-Cheng , Kuo Chang-Yi , Kuo Chao-Ying , Chin Chieh-Yu , Yip Ping K. , Chen Jyh-Ping
Published: September 2020

Spinal cord injury (SCI) is associated with disability and a drastic decrease in quality of life for affected individuals. Previous studies support the idea that docosahexaenoic acid (DHA)-based pharmacological approach is a promising therapeutic strategy for the management of acute SCI. We postulated that a nanostructured material for controlled delivery of DHA at the lesion site may be well suited for this purpose. Toward this end, we prepare drug-loaded fibrous mats made of core-shell nanofibers by electrospinning, which contained a polylactic acid (PLA) shell for encapsulation of DHA within the core, for delivery of DHA in situ. In vitro study confirmed sustained DHA release from PLA/DHA core-shell nanofiber membrane (CSNM) for up to 36 days, which could significantly increase neurite outgrowth from primary cortical neurons in 3 days. This is supported by the upregulation of brain-derived neurotropic factor (BDNF) and neurotrophin-3 (NT-3) neural marker genes from qRT-PCR analysis. Most importantly, the sustained release of DHA could significantly increase the neurite outgrowth length from cortical neuron cells in 7 days when co-cultured with PLA/DHA CSNM, compared with cells cultured with 3 μM DHA. From in vivo study with a SCI model created in rats, implantation of PLA/DHA CSNM could significantly improve neurological functions revealed by behavior assessment in comparison with the control (no treatment) and the PLA CSNM groups. According to histological analysis, PLA/DHA CSNM also effectively reduced neuron loss and increased serotonergic nerve sprouting. Taken together, the PLA/DHA CSNM may provide a nanostructured drug delivery system for DHA and contribute to neuroprotection and promoting neuroplasticity change following SCI.
Distributed Simulation Using Agents for the Internet of Things and the Factory of the Future
Authors: Basingab Mohammed , Nagadi Khalid , Rahal Ahmad , Bukhari Hatim , Alasim Fahad
Published: September 2020

The adoption of the Internet of Things (IoT) and its related technologies has transformed the manufacturing industry and has significantly changed the traditional linear manufacturing supply chains into dynamic and interconnected systems. However, the lack of an approach to assess the economic feasibility and return uncertainties of an IoT system implementation, is blamed as the culprit for hindering its adoption rate. Using two distinctive case studies, this research investigates the use of distributed simulation of agent-based model (ABM) to address such gap in the literature. The first involves the economic feasibility of an IoT implementation in a very large retail warehouse facility, while the second case study proposes a framework able to generate and assess ideal or near-ideal manufacturing configurations and capabilities, and in establishing appropriate information messaging protocols between the various system components by using ABM in distributed simulation.
Social Representations of Insects as Food: An Explorative-Comparative Study among Millennials and X-Generation Consumers
Authors: Fasanelli Roberto , Galli Ida , Riverso Roberta , Piscitelli Alfonso
Published: September 2020

The aim of the research here presented is to describe and compare the social representations of entomophagy co-constructed and circulating among different groups of consumers. Social representations theory (SRT) allows us to understand a social reality that the individual builds based on his own experience in everyday life symbolic exchanges, whose primary function is to adapt concepts and abstract ideas using objectification and anchoring processes. We carried out this research within the structural approach methodological framework. We explored the structure (central core and peripheral schemes) and the content (information, opinions, attitudes, and beliefs) of the social representations of entomophagy by using mixed methodological strategies (hierarchized evocations, validated scales, check-list, projective tool, open-ended questions). Data were processed employing different R packages. The main results show an essential role played by generative processes (objectification and anchoring) as well as cognitive polyphasia and thémata in the co-construction of the social representations of entomophagy. Data could help in understanding the sensory characteristics of “insects as food” that should be used or avoided, for example, in communication aimed to promote entomophagy.
Precision Medicine to Treat Advanced Gastroesophageal Adenocarcinoma: A Work in Progress
Authors: Gambardella Valentina , Fleitas Tania , Tarazona Noelia , Papaccio Federica , Huerta Marisol , Roselló Susana , Gimeno-Valiente Francisco , Roda Desamparados , Cervantes Andrés
Published: September 2020

Gastroesophageal adenocarcinoma (GEA) represents a heterogeneous disease and, when diagnosed as locally advanced or metastatic, it is characterized by poor prognosis. During the last few years, several molecular classifications have been proposed to try to personalize treatment for those patients diagnosed with advanced disease. Nevertheless, despite the great effort, precision medicine is still far from being a reality. The improvement in the molecular analysis due to the application of high throughput technologies based on DNA and RNA sequencing has opened a novel scenario leading to the personalization of treatment. The possibility to target epidermal growth factor receptor (HER)2, Claudine, Fibroblast Growth Factor Receptors (FGFR), and other alterations with a molecular matched therapy could significantly improve clinical outcomes over advanced gastric cancer patients. On the other hand, the development of immunotherapy could also represent a promising strategy in a selected population. In this review, we sought to describe the novel pathways implicated in GEA progression and the results of the molecular matched therapies.
The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia
Authors: Ofori-Asenso Richard , Liew Danny , Mårtensson Johan , Jones Daryl
Published: September 2020

Background: Limited available evidence suggests that a small proportion of inpatients undergo prolonged hospitalization and use a disproportionate number of bed days. Understanding the factors contributing to prolonged hospitalization may improve patient care and reduce the length of stay in such patients. Methods: We undertook a retrospective cohort study of adult (≥20 years) patients admitted for at least 24 h between 14 November 2016 and 14 November 2018 to hospitals in Victoria, Australia. Data including baseline demographics, admitting specialty, survival status and discharge disposition were obtained from the Victorian Admission Episode Dataset. Multivariable logistic regression analysis was used to identify factors independently associated with prolonged hospitalization (≥14 days). Cox proportional hazard regression model was used to examine the association between various factors and in-hospital mortality. Results: There were almost 5 million hospital admissions over two years. After exclusions, 1,696,112 admissions lasting at least 24 h were included. Admissions with prolonged hospitalization comprised only 9.7% of admissions but utilized 44.2% of all hospital bed days. Factors independently associated with prolonged hospitalization included age, female gender, not being in a relationship, being a current smoker, level of co-morbidity, admission from another hospital, admission on the weekend, and the number of admissions in the prior 12 months. The in-hospital mortality rate was 5.0% for those with prolonged hospitalization compared with 1.8% in those without (p < 0.001). Prolonged hospitalization was also independently associated with a decreased likelihood of being discharged to home (OR 0.53, 95% CI 0.52–0.54). Conclusions: Patients experiencing prolonged hospitalization utilize a disproportionate proportion of bed days and are at higher risk of in-hospital death and discharge to destinations other than home. Further studies are required to identify modifiable factors contributing to prolonged hospitalization as well as the quality of end-of-life care in such admissions.
Characterization of Fetal Thyroid Levels at Delivery among Appalachian Infants
Authors: Crank Madison N. , Cottrell Jesse N. , Mitchell Brenda L. , Valentovic Monica A.
Published: September 2020

Thyroid disorders are a frequently encountered issue during pregnancy and a cause of maternal and fetal morbidity. In regions like Appalachia that are particularly susceptible to health disparities, descriptive studies are needed to assist in identifying pathologic derangements. We sought to characterize fetal thyroid hormone levels at delivery and investigate whether or not maternal demographic characteristics affect the prevalence of neonatal thyroid disease. A cross-sectional analysis was conducted on 130 pregnant women recruited from the Tri-State region, incorporating areas of Kentucky, Ohio, and West Virginia. Total triiodothyronine (T3) (p = 0.4799), free T3 (p = 0.6323), T3 uptake (p = 0.0926), total thyroxine (T4) (p = 0.8316), free T4 (p = 0.0566), and Thyroid stimulating hormone (TSH) (p = 0.8745) levels were comparable between urban and rural newborns. We found no effect of hypertension status or nicotine levels on fetal umbilical cord thyroid hormone levels. Maternal diabetic status was associated with lower T4 (p = 0.0099) and free T4 (p = 0.0025) levels. Cotinine affected levels of T4 (p = 0.0339). In regard to maternal Body Mass Index (BMI), there was an increase in total T3 as BMI increased (p = 0.0367) and no significant difference in free T3, T3 uptake, T4, free T4, or TSH. There was a negative correlation between TSH and 1 min Apgar scores (p = 0.0058). Lead and cadmium have been implicated to alter TSH levels, but no correlation was found in our study (r2 = 0.0277). There were no differences in cord blood between urban (37.3 ± 10.3 fmol/ug DNA) and rural (70.5 ± 26.8 fmol/ug DNA) benzo(a)pyrene DNA adducts (p = 0.174). Thyroid disorders present a unique opportunity for the prevention of perinatal morbidity and mortality, since maternal treatment, as well as maternal demographic characteristics, can have direct fetal effects.
Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects
Authors: Niederer Daniel , Engel Tilman , Vogt Lutz , Arampatzis Adamantios , Banzer Winfried , Beck Heidrun , Moreno Catalá María , Brenner-Fliesser Michael , Güthoff Claas , Haag Thore , Hönning Alexander , Pfeifer Ann-Christin , Platen Petra , Schiltenwolf Marcus , Schneider Christian , Trompeter Katharina , Wippert Pia-Maria , Mayer Frank
Published: September 2020

Low-to-moderate quality meta-analytic evidence shows that motor control stabilisation exercise (MCE) is an effective treatment of non-specific low back pain. A possible approach to overcome the weaknesses of traditional meta-analyses would be that of a prospective meta-analyses. The aim of the present analysis was to generate high-quality evidence to support the view that motor control stabilisation exercises (MCE) lead to a reduction in pain intensity and disability in non-specific low back pain patients when compared to a control group. In this prospective meta-analysis and sensitivity multilevel meta-regression within the MiSpEx-Network, 18 randomized controlled study arms were included. Participants with non-specific low back pain were allocated to an intervention (individualized MCE, 12 weeks) or a control group (no additive exercise intervention). From each study site/arm, outcomes at baseline, 3 weeks, 12 weeks, and 6 months were pooled. The outcomes were current pain (NRS or VAS, 11 points scale), characteristic pain intensity, and subjective disability. A random effects meta-analysis model for continuous outcomes to display standardized mean differences between intervention and control was performed, followed by sensitivity multilevel meta-regressions. Overall, 2391 patients were randomized; 1976 (3 weeks, short-term), 1740 (12 weeks, intermediate), and 1560 (6 months, sustainability) participants were included in the meta-analyses. In the short-term, intermediate and sustainability, moderate-to-high quality evidence indicated that MCE has a larger effect on current pain (SMD = −0.15, −0.15, −0.19), pain intensity (SMD = −0.19, −0.26, −0.26) and disability (SMD = −0.15, −0.27, −0.25) compared with no exercise intervention. Low-quality evidence suggested that those patients with comparably intermediate current pain and older patients may profit the most from MCE. Motor control stabilisation exercise is an effective treatment for non-specific low back pain. Sub-clinical intermediate pain and middle-aged patients may profit the most from this intervention.
Effect of Instrument Design and Technique on the Precision and Accuracy of Objective Refraction Measurement
Authors: Domínguez-Vicent Alberto , Al-Soboh Loujain , Brautaset Rune , Venkataraman Abinaya Priya
Published: September 2020

Background: To evaluate the precision and accuracy of objective refraction measurement obtained with combinations of instrument design and technique. We also compared the performance of the instruments with subjective refraction measurements. Method and analysis: The objective refraction was measured in 71 subjects with three autorefractometers that have different designs and measurement principles (binocular with fogging, binocular without fogging, and monocular with fogging). Repeatability and reproducibility metrics were calculated for the objective refraction measurements. The agreement of the objective refraction measurements between the three instruments and the agreement with the subjective refraction measurements were evaluated. Results: All three autorefractometers had repeatability and reproducibility limits smaller than 0.70D. The smallest difference (0.10D) in the spherical equivalent was seen between the two binocular instruments. Compared with the subjective refraction, the binocular without fogging technique had the smallest mean difference in spherical equivalent (<0.20D) whereas the binocular fogging technique had the smallest limit of agreement interval (1.00D). For all comparisons, the mean difference and limit of agreement interval for the cylindrical components were lower than 0.10D and 0.75D, respectively. Conclusion: All three instruments evaluated had good repeatability and reproducibility. The binocular fogging technique provided the best agreement with subjective refraction.
Hospital Caseload Demand in the Presence of Interventions during the COVID-19 Pandemic: A Modeling Study
Authors: Hayashi Katsuma , Kayano Taishi , Sorano Sumire , Nishiura Hiroshi
Published: September 2020

A surge in hospital admissions was observed in Japan in late March 2020, and the incidence of coronavirus disease (COVID-19) temporarily reduced from March to May as a result of the closure of host and hostess clubs, shortening the opening hours of bars and restaurants, and requesting a voluntary reduction of contact outside the household. To prepare for the second wave, it is vital to anticipate caseload demand, and thus, the number of required hospital beds for admitted cases and plan interventions through scenario analysis. In the present study, we analyzed the first wave data by age group so that the age-specific number of hospital admissions could be projected for the second wave. Because the age-specific patterns of the epidemic were different between urban and other areas, we analyzed datasets from two distinct cities: Osaka, where the cases were dominated by young adults, and Hokkaido, where the older adults accounted for the majority of hospitalized cases. By estimating the exponential growth rates of cases by age group and assuming probable reductions in those rates under interventions, we obtained projected epidemic curves of cases in addition to hospital admissions. We demonstrated that the longer our interventions were delayed, the higher the peak of hospital admissions. Although the approach relies on a simplistic model, the proposed framework can guide local government to secure the essential number of hospital beds for COVID-19 cases and formulate action plans.
The PANDEMYC Score. An Easily Applicable and Interpretable Model for Predicting Mortality Associated With COVID-19
Authors: Torres-Macho Juan , Ryan Pablo , Valencia Jorge , Pérez-Butragueño Mario , Jiménez Eva , Fontán-Vela Mario , Izquierdo-García Elsa , Fernandez-Jimenez Inés , Álvaro-Alonso Elena , Lazaro Andrea , Alvarado Marta , Notario Helena , Resino Salvador , Velez-Serrano Daniel , Meca Alejandro
Published: September 2020

This study aimed to build an easily applicable prognostic model based on routine clinical, radiological, and laboratory data available at admission, to predict mortality in coronavirus 19 disease (COVID-19) hospitalized patients. Methods: We retrospectively collected clinical information from 1968 patients admitted to a hospital. We built a predictive score based on a logistic regression model in which explicative variables were discretized using classification trees that facilitated the identification of the optimal sections in order to predict inpatient mortality in patients admitted with COVID-19. These sections were translated into a score indicating the probability of a patient’s death, thus making the results easy to interpret. Results. Median age was 67 years, 1104 patients (56.4%) were male, and 325 (16.5%) died during hospitalization. Our final model identified nine key features: age, oxygen saturation, smoking, serum creatinine, lymphocytes, hemoglobin, platelets, C-reactive protein, and sodium at admission. The discrimination of the model was excellent in the training, validation, and test samples (AUC: 0.865, 0.808, and 0.883, respectively). We constructed a prognostic scale to determine the probability of death associated with each score. Conclusions: We designed an easily applicable predictive model for early identification of patients at high risk of death due to COVID-19 during hospitalization.
Innovative Technology Based Interventions for Psychological Treatment of Common Mental Disorders
Authors: Donker Tara , Kleiboer Annet
Published: September 2020

The present Special Issue of Journal of Clinical Medicine includes a series of important papers that aim to further the evidence base of innovative technological advances in the screening and treatment of mental health, and to further our understanding of their implications for mental health care [...]
Guideline-Based Statin Eligibility, Coronary Artery Stenosis and Cardiovascular Events in Patients with Stable Chest Pain: A Secondary Analysis of the PROMISE Randomized Clinical Trial
Authors: Pursnani Amit , Taron Jana , Mayrhofer Thomas , Lu Michael T. , Ferencik Maros , Ladapo Joseph A. , Douglas Pamela S. , Hoffmann Udo
Published: September 2020

Background: Recommendations for preventive statin treatment in patients with stable chest pain may be difficult as symptoms can be unspecific. It is unclear if coronary CT angiography (CTA)-detected coronary artery disease (CAD) can optimize statin prescription. Methods: In stable chest pain patients randomized to CTA in the PROMISE trial, statin eligibility was defined per 2018 American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Primary outcome was a composite of death, myocardial infarction or unstable angina over 26 months median follow-up. Hazard ratios (HR) of non-obstructive (1–69% stenosis) and obstructive (≥70% stenosis) CAD for events were determined using Cox proportional hazard models. Calculated HR were then incorporated into the ACC/AHA pooled cohort equation (PCE) to revised ASCVD risk and assess re-classification of statin eligibility. Results: Among 3986 patients (60.5 ± 8.2 years; 51% female), 72.9% (2904/3986) were statin eligible. Event rates in statin-eligible vs. ineligible patients were 3.3% vs. 2.3% (HR = 1.4 (95% CI 0.9–2.2), p = 0.142). Although the proportion of statin-eligible patients increased with CAD severity, 54% without CAD were statin eligible. Incorporating information on CAD into PCE reclassified 12.7% of patients (1.3% towards statin, 11.4% towards no statin). Similar results were found in stratified analysis of statin naïve patients (reclassification of 13.9%, 1.0% towards statin, and 12.9% towards no statin). As a result, revised ASCVD risk improved model discrimination in all patients (c-statistic: 0.59 (95 %CI 0.55–0.62) vs. 0.52 (95 %CI 0.49–0.56); p 0.001), while reducing statin use by 10.1% (62.7% vs. 72.9% statin eligible, p 0.001). Conclusion: In stable chest pain patients, integration of CAD into guideline recommendations was associated with greater accuracy to reclassify those at increased risk for incident events and a more efficient use of statins.
Comparative Analysis of Thrombin Calibration Algorithms and Correction for Thrombin-α2macroglobulin Activity
Authors: Chang William C. , Jackson Joseph W. , Machlus Kellie R. , Wolberg Alisa S. , Ovanesov Mikhail V.
Published: September 2020

Background: The thrombin generation (TG) test is useful for characterizing global hemostasis potential, but fluorescence substrate artifacts, such as thrombin-α2macroglobulin (T-α2MG) signal, inner filter effect (IFE), substrate consumption, and calibration algorithms have been suggested as sources of intra- and inter-laboratory variance, which may limit its clinical utility. Methods: Effects of internal vs. external normalization, IFE and T-α2MG on TG curves in normal plasma supplemented with coagulation factors, thrombomodulin, and tissue factor were studied using the Calibrated Automated Thrombinography (CAT; Diagnostica Stago, Parsippany, NJ, USA) and in-house software. Results: The various calibration methods demonstrated no significant difference in producing TG curves, nor increased the robustness of the TG assay. Several TG parameters, including thrombin peak height (TPH), produced from internal linear calibration did not differ significantly from uncalibrated TG parameters. Further, TPH values from internal linear and nonlinear calibration with or without T-α2MG correction correlated well with TPH from external calibration. Higher coefficients of variation (CVs) for TPH values were observed in both platelet-free and platelet-rich plasma with added thrombomodulin. Conclusions: Our work suggests minimal differences between distinct computational approaches toward calibrating and correcting fluorescence signals into TG levels, with most samples returning similar or equivalent TPH results.
Effect of Limosilactobacillus reuteri LRE02–Lacticaseibacillus rhamnosus LR04 Combination on Antibiotic-Associated Diarrhea in a Pediatric Population: A National Survey
Authors: Drago Lorenzo , Meroni Gabriele , Chiaretti Antonio , Laforgia Nicola , Cucchiara Salvatore , Baldassarre Maria ,   on behalf of the Surveyflor Group
Published: September 2020

Probiotics are living microorganisms, which, upon oral ingestion, may prevent antibiotic-associated diarrhea (AAD) through the normalization of an unbalanced gastrointestinal flora. The objective of this study was to evaluate the benefits of a probiotic combination (Limosilactibacillus reuteri LRE02-DSM 23878 and Lacticaseibacillus rhamnosus LR04-DSM 16605) on the prevention of AAD in an outpatient pediatric setting. Questionnaires were delivered to pediatricians by each patient/parent during the visits after antibiotics and probiotics treatment to monitor physiological parameters. The primary outcome of both groups (probiotics and no probiotics treated) was the evaluation of the prevalence of AAD between the two groups. Evaluation of stool consistency using the Bristol Stool Scale (BSS) score was performed, as well as the evaluation of AAD duration, frequencies of daily evacuation, and the beginning of diarrhea and weight loss during AAD in both groups and related to antibiotic categories. Results indicated that probiotics, at the recommended dosage of 1.2 × 109 CFU (Colony Forming Unit) per day for 30 days, are associated with lower rates of AAD and a decreased number of days with diarrhea, independent of the type of antibiotic used. Moreover, the use of probiotics resulted in a normal stool consistency in a shorter time period, as evaluated by the BSS.
The Use of a Vibro-Acoustic Based Method to Determine the Composite Material Properties of a Replicate Clavicle Bone Model
Authors: Goossens Quentin , Vancleef Sanne , Leuridan Steven , Pastrav Leonard Cezar , Mulier Michiel , Desmet Wim , Vander Sloten Jos , Denis Kathleen
Published: September 2020

Replicate bones are widely used as an alternative for cadaveric bones for in vitro testing. These composite bone models are more easily available and show low inter-specimen variability compared to cadaveric bone models. The combination of in vitro testing with in silico models can provide further insights in the evaluation of the mechanical behavior of orthopedic implants. An accurate numerical representation of the experimental model is important to draw meaningful conclusions from the numerical predictions. This study aims to determine the elastic material constants of a commonly used composite clavicle model by combining acoustic experimental and numerical modal analysis. The difference between the experimental and finite element (FE) predicted natural frequencies was minimized by updating the elastic material constants of the transversely isotropic cortical bone analogue that are provided by the manufacturer. The longitudinal Young’s modulus was reduced from 16.00 GPa to 12.88 GPa and the shear modulus was increased from 3.30 GPa to 4.53 GPa. These updated material properties resulted in an average natural frequency difference of 0.49% and a maximum difference of 1.73% between the FE predictions and the experimental results. The presented updated model aims to improve future research that focuses on mechanical simulations with clavicle composite bone models.
A Survey of Resource Management for Processing-In-Memory and Near-Memory Processing Architectures
Authors: Khan Kamil , Pasricha Sudeep , Kim Ryan Gary
Published: September 2020

Due to the amount of data involved in emerging deep learning and big data applications, operations related to data movement have quickly become a bottleneck. Data-centric computing (DCC), as enabled by processing-in-memory (PIM) and near-memory processing (NMP) paradigms, aims to accelerate these types of applications by moving the computation closer to the data. Over the past few years, researchers have proposed various memory architectures that enable DCC systems, such as logic layers in 3D-stacked memories or charge-sharing-based bitwise operations in dynamic random-access memory (DRAM). However, application-specific memory access patterns, power and thermal concerns, memory technology limitations, and inconsistent performance gains complicate the offloading of computation in DCC systems. Therefore, designing intelligent resource management techniques for computation offloading is vital for leveraging the potential offered by this new paradigm. In this article, we survey the major trends in managing PIM and NMP-based DCC systems and provide a review of the landscape of resource management techniques employed by system designers for such systems. Additionally, we discuss the future challenges and opportunities in DCC management.