bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of international continuing education on neurorehabilitation for rehabilitation health workers in Honduras: a pretest-posttest design
Authors: Angarita-Fonseca Adriana , Lovo Stacey , Gomez-Diaz Isabel Cristina , Busch Angela J , Hijuelos-Cardenas Martha Liliana , Basualdo Maria Laura , Premkumar Kalyani , Bidonde Julia
Published: August 2020

BackgroundRehabilitation therapies are still in the early stages of development in Honduras. At the present time there are no formal training opportunities in Honduras to support the learning needs of health professionals and healthcare workers who specialize in neurological rehabilitation. Support and development of those delivering rehabilitation services from community engaged academic collaborations outside of Honduras can enhance the learning and knowledge of healthcare workers. The purpose of this study was to evaluate reaction and learning linked to two continuing educational workshops for rehabilitation workers in northern Honduras. MethodsThe study design was a pretest-posttest design. The workshops were conducted in a rehabilitation center and a family support organization located in northern Honduras in September 2017.Faculty from Canada and Colombia, together with health professionals from Honduras, facilitated two workshops. Seventeen participants attended the ‘Acquired brain injury/spinal cord injury workshop’ (adult workshop); 15 attended the ‘Rehabilitation for children with impaired neuromotor development workshop’ (pediatric workshop). Participants completed three questionnaires: sociodemographic, knowledge, and Modified Stages of Learning Questionnaires (MSLQ), and three after: Modified Kirkpatrick, knowledge, MSLQ. ResultsWorkshop participants were physiotherapists, physicians, nurses, educational professionals and other non-physiotherapists. Most agreed that the workshops had positive effects in reaction (engagement, relevance, satisfaction), and learning (skills, attitude, confidence and commitment). Stages of Learning changed from scanning/evaluation to learning/experience (p<0.05) in three out of six topics in the pediatric workshop. Three of the knowledge questions showed important learning effects. ConclusionsWorkshops offered to the neurological rehabilitation healthcare workers in Honduras through an international collaboration resulted in enhanced learning and knowledge of participants. This has the potential to improve quality of care for people with neurological conditions in the region.
Repercussions of The COVID-19 Pandemic on the Well-Being and Training of Medical Clerks: A Pan-Canadian Survey
Authors: Abbas Myriam , Dhane Malek , Beniey Michèle , Meloche-Dumas Léamarie , Eissa Mohamed , Guérard-Poirier Natasha , El-Raheb Myriam , Lebel-Guay Florence , Dubrowski Adam , Patocskai Erica
Published: August 2020

Background: The COVID-19 pandemic has been an unprecedented and potentially stressful event that inserted itself into the 2019-2020 Canadian medical curriculum. However, its impact on stress and subsequent professional pathways is not well understood. This study aims to assess the impact the COVID-19 pandemic on the mental well-being, training, and career choices of Canadian medical clerks within the first three months of the pandemic. It also aims to assess their use of university support systems and their appreciation of potential solutions to common academic stressors.Methods: An electronic survey composed of four sections: demographics, stressors experienced during the pandemic, World Health Organization (WHO) well-being index, and stress management and resources was distributed to Canadian clerks. Results: Clerks from 10 of the 17 Canadian medical faculties participated in this study (n=627). Forty-five percent of clerks reported higher levels of stress than usual; 22% reconsidered their residency choice; and 19% reconsidered medicine as a career. The factors that were most stressful among clerks were: the means of return to rotations; decreased opportunities to be productive in view of residency match; and taking the national licensing exam after the beginning of residency. The mean WHO well-being index was 14.8/25  4.5, indicating a poor level of well-being among a considerable proportion of students. Clerks who reconsidered their residency choice or medicine as a career had lower mean WHO well-being indices. Most clerks agreed with the following suggested solutions: training sessions on the clinical management of COVID-19 cases; being allowed to submit fewer reference letters when applying to residency; and having protected time to study for their licensing exam during residency. Overall, clerks were less concerned with being infected during their rotations than with the impact of the pandemic on their future career and residency match. Conclusion: The COVID-19 pandemic had a considerable impact on the medical curriculum and well-being of clerks. A number of student-identified solutions were proposed to reduce stress. The implementation of these solutions throughout the Canadian medical training system should be considered.
Artificial Intelligence-Based Nomogram for Small-Incision Lenticule Extraction
Authors: Park Seungbin , Kim Hannah , Kim Laehyun , Kim Jin-kuk , Lee In Sik , Ryu Ik Hee , Kim Youngjun
Published: August 2020

Background: Small-incision lenticule extraction (SMILE) is a surgical procedure for the refractive correction of myopia and astigmatism, which has been reported as safe and effective. However, over- and under-correction still occur after SMILE. The necessity of nomograms is emphasized to achieve optimal refractive results. Ophthalmologists diagnose nomograms by analyzing the preoperative refractive data with their individual knowledge which they accumulate over years of experience. Our aim was to predict the nomograms of sphere, cylinder, and astigmatism axis for SMILE accurately by applying machine learning algorithm. Methods: We retrospectively analyzed the data of 3,034 eyes composed of four categorical features and 28 numerical features selected from 46 features. The multiple linear regression, decision tree, AdaBoost, XGBoost, and multi-layer perceptron were employed in developing the nomogram models for sphere, cylinder, and astigmatism axis. The scores of the root mean square error (RMSE) and accuracy were evaluated and compared. Subsequently, the feature importance of the best models was calculated.Results: Adaboost achieved the highest performance with an RMSE of 0.1378, 0.1166, and 5.17 for the sphere, cylinder, and astigmatism axis, respectively. The accuracies of which error below 0.25 D for the sphere and cylinder nomograms and 25° for the astigmatism axis nomograms were 0.969, 0.976, and 0.994, respectively. The feature with the highest importance was pre-operative manifest refraction for all the cases of nomograms. For the sphere and cylinder nomograms, the following highly important feature was the surgeon. Conclusions: Among the diverse machine learning algorithms, Adaboost exhibited the highest performance in prediction of the sphere, cylinder, and astigmatism axis nomograms for SMILE. The study proved the feasibility of applying artificial intelligence (AI) to nomograms for SMILE. Also it may enhance the quality of the surgical result of SMILE by providing assistance in nomograms and preventing the misdiagnosis in nomograms.
Transcriptome differences between Cupriavidus necator NH9 grown with 3-chlorobenzoate and that grown with benzoate
Authors: Moriuchi Ryota , Dohra Hideo , Kanesaki Yu , Ogawa Naoto
Published: August 2020

Background
Aromatic compounds derived from human activities are often released into the environment. Many of them, especially halogenated aromatics, are persistent in nature and pose threats to organisms. Therefore, the microbial degradation of these compounds has been studied intensively. Our laboratory has studied the expression of genes in Cupriavidus necator NH9 involved in the degradation of 3-chlorobenzoate (3-CB), a model compound for studies on bacterial degradation of chlorinated aromatic compounds. In this study aimed at exploring how this bacterium has adapted to the utilization of chlorinated aromatic compounds, we performed RNA-seq analysis of NH9 cells cultured with 3-CB, benzoate (BA), or citric acid. The purpose of these analyses was to identify differentially expressed genes encoding products with various biological functions involved in the degradation of 3-CB and BA.
Results
Differential expression analysis confirmed strong induction of genes encoding enzymes in degradation pathways of 3-CB and BA (benABCD, cbnABCD, catA, catB, catDC, pcaIJF, and boxABCD). Genes involved in the degradation of 3-hydroxybenzoate and anthranilate were upregulated by 3-CB but not by BA, suggesting that transcriptional regulators of these degradative genes recognized 3-CB (or its intermediate metabolite) as an inducer. Four genes encoding MFS transporters were specifically induced by 3-CB or BA, and one cluster of genes encoding components of the ABC transporter system was significantly induced by 3-CB. Stress response genes encoding chaperones, proteases, the phosphate transporter PstBACS, and superoxide oxidase were upregulated in response to 3-CB and/or BA. Gene Ontology enrichment analysis revealed that genes encoding dioxygenases were upregulated by both 3-CB and BA. Intriguingly, the “cell motility,” “signal transduction,” and “chemotaxis” terms were significantly upregulated by BA compared with 3-CB. Consistent with this, in semi-solid agar plate assays, NH9 cells showed stronger chemotaxis to BA than to 3-CB.
Conclusions
Our results showed that the chemotaxis behavior of NH9 differs between 3-CB and BA. We inferred that NH9 has not fully adapted to the utilization of chlorinated benzoate, unlike its analogous aromatic compound BA, in nature.
Dysbiosis of gut microbiota and its correlation with dysregulation of cytokines in psoriasis patients
Authors: Zhang Xinyue , Guo Kun , Shi Linjing , Sun Ting , Geng Songmei
Published: August 2020

Background
Psoriasis is an inflammatory skin disease that is associated with multiple comorbidities and substantially diminishes patients’ quality of life. The gut microbiome has become a hot topic in psoriasis as it has been shown to have effect on both allergy and autoimmunity diseases in recent studies. Our objective was to identify differences in the faecal microbial composition of patients with psoriasis compared with healthy individuals in order to unravel the microbiota profiling in this autoimmune disease.
Results
We collected fecal samples from 30 psoriasis patients and 30 healthy controls and sequenced them by 16S rRNA high-throughput sequencing and identified the differences in the gut microbial composition between two groups through data analysis. Our results showed that different relative abundance of certain bacterial taxa between psoriasis patients and healthy individuals,including Faecalibacterium and Megamonas were increased in patients with psoriasis. It’s also implicated that many cytokines act as main effect molecules in the pathology of psoriasis. We selected the inflammation-related indicators that were abnormal in psoriasis patients and found the microbiome variations were associated with the level of them, especially interleukin-2 receptor showed a positive relationship with Phascolarctobacterium and a negative relationship with the Dialister. The correlation analysis based on microbiota and Inflammation-related indicators proved that microbiota dysbiosis might induce abnormal immune response in psoriasis.
Conclusions
We concluded that the gut microbiome composition in psoriasis patients has been altered markedly and provides evidence to understand the relationship between gut microbiota and psoriasis. More mechanistic experiments are needed to determine whether the differences observed in gut microbiota are the cause or consequences of psoriasis and whether the relationship between gut microbiota and cytokines was involved.
Changes in day/night activity in the 6-OHDA-induced experimental model of Parkinson´s disease: Exploring prodromal biomarkers
Authors: Requejo Catalina , de-Ipiña Karmele Lopez , Ruiz-Ortega José Ángel , Fernández Elsa , Calvo Pilar M. , Morera-Herreras Teresa , Miguelez Cristina , Cardona-Grifoll Laura , Cepeda Hodei , Ugedo Luisa , Lafuente José Vicente
Published: August 2020

The authors have withdrawn this preprint due to author disagreement.
Morphological study of vastus medialis oblique in recurrent patellar dislocation based on magnetic resonance images
Authors: Shu Lei , Yang Xu , He Hangyuan , Chen Biao , Chen Liaobin , Ni Qubo
Published: August 2020

Purpose To investigate the morphological parameters of the vastus medialis obliquus (VMO) muscle and delineate its importance in the maintenance of patellofemoral joint stability.Methods The magnetic resonance imaging (MRI) data of 75 knees (54 patients) with recurrent lateral patella dislocation (LPD) and 75 knees (70 patients with similar age, gender and body mass index) were retrospectively analyzed. Five morphological parameters related to VMO (elevation on sagittal plane and coronal plane, cross-sectional area ratio, craniocaudal extent, muscle-fiber angulation,) and two parameters of patella tilt (patella tilt angle, bisect offset ratio) were measured in MRI images, and the types of trochlear in each patient were recorded. Finally, the differences of these parameters between the two groups were analyzed.Results Compared with the control group, the patients with recurrent LPD showed significantly higher in sagittal VMO elevation (10.4 ± 2.3 mm vs 4.1 ± 1.9 mm), coronal VMO elevation (15.9 ± 5.7 mm vs 3.9 ± 3.7 mm), muscle-fiber angulation (35.4 ± 8.0° vs 27.9 ± 6.3°), patella tilt angle (25.9 ± 10.7° vs 9.1 ± 5.2°), and bisect offset ratio values (0.9 ± 0.3 vs 0.5 ± 0.1), and significantly lower in craniocaudal extent (13.7 ± 5.3mm vs 16.7 ± 5.1 mm) and cross-sectional area ratio values (0.07 ± 0.02 vs 0.05 ± 0.02).Conclusions The results showed that the abnormality of VMO were clearly present in recurrent LPD patients compared with normal people, which may be an important factor of patella tilt in LPD patients, so it is necessary to focus on injury condition of VMO during preoperative evaluation.
Bibliometric Analysis of the Global Research on Precision Medicine
Authors: Zhang Baoyue , Ali Sajid , Xuan Tianhui , Zhao Yajie , Ao Bo , Lu Xinyue , Chen Junbai , Bao Pengfei , Yang Shuang , Huang Qian , Li Ruifeng , Hou Zhongwei , Huang Youliang
Published: August 2020

Background: Precision medicine provides medical solutions to stratified patients with personalised forecasting outcome as an important method of treatment in the medical field. This study aims at delivering a structured overview to carry out a bibliometric analysis of precision medicine retrospectively. Methods: The compilation of data and the use of bibliometric methods based on academic databases (Science Citation Index-Expanded and PubMed) from January 1, 2010, to December 31, 2019. Research outputs, countries, institutions, authors, major journals, cited papers, hot subject areas were analysed. Results: 8,566 papers related were identified (98.728% in English) covering 1,975 different journals. The papers were originated from 109 countries; the USA held the predominant contributors with 4,635 papers, China was on second with 925 papers. Conclusions: Precision medicine serves important purposes in clinical treatment, and widely used in the oncology, biochemistry, molecular biology field. The study summarised existing work and provided guidance for future research in this promising precision medicine area.
Viral and Atypical Pathogens Epidemiology of a Large Cohort of Patients with Acute Respiratory Tract Infections in Shaanxi Province, Northwest China
Authors: Li Meng , Liu Xinyu , Yang Tian , He Ruiqing , Guo Xuan , Chen Mingwei
Published: August 2020

Purpose To analyze and summarize the etiological and epidemiological characteristics of acute respiratory tract infections (ARIs) in northwest China for improving the clinical management and prevention of local ARIs. Methods Patients with ARIs in the Shaanxi Province from January 2014 to December 2018 were retrospectively analyzed, indirect immunofluorescence assay (IFA) was used to detect IgM antibody of eight respiratory pathogens. Results A total of 15543 eligible patients was included in this study. Overall, 36.01% patients (5597/15543) were positive for at least one of eight pathogens, among which single and mixed infections was accounted for 74.65% (4178/5597) and 25.35% (1419/5597), respectively. Mycoplasma (MP) showed the highest detection rate (18.12%), followed by influenza virus B (Flu B, 11.65%), chlamydia (CP, 7.00%), respiratory syncytial virus(RSV, 4.18%), parainfluenza virus (PIV, 2.83%), influenza virus A(Flu A, 1.69%), legionella (LP, 1.00%) and adenovirus (ADV, 0.70%). Flu B (17.54 %, 759/4327) was the most prevalent virus in patients aged less than 18 years. In addition, this group were more likely to have mixed infections. Autumn and winter were the high-occurrence season for ARIs. Conclusion These findings serve as a reference for local health authorities to develop further plans for the prevention and control of ARIs.
Powering Jobs: the Employment Footprint of Clean Cooking Solutions in Kenya
Authors: LEE CHIH-JUNG , Shirley Rebekah , Otieno Maureen , Nyambura Hope
Published: August 2020

Background Delivering clean cooking access to 1.2 billion people who cook with charcoal, kerosene and firewood may have a strong localized employment impact. With the challenge of a rapidly expanding youth population and growing job scarcity in sub-Saharan Africa, understanding the impact of clean cooking on employment as well as the skills gap is timely. However, there is little definitive data on clean cooking jobs. Recognizing this data gap, we sought to conduct a study focused specifically on employment from the clean cooking sectors in Kenya, covering liquefied petroleum gas (LPG), bioethanol, biogas and electric cooking solutions. This study provides an initial baseline and early estimate of clean cooking sectors’ direct formal and informal employment based on one year of company survey data, expert interviews, available literature, and local focus group discussion.Results In Kenya, the clean cooking sector provided about 19,000 direct, formal jobs and potentially 15,000 to 35,000 direct, informal jobs in 2019. While the clean cooking sector provided many jobs, the level of compensation and retention is low. In the LPG and electric cooking sector, sales and distribution are the biggest part of the workforce, while for bioethanol and biogas, manufacturing and assembling is important. The majority of the direct, formal workforce is reported to be skilled. Management, finance and legal, and product development and research are the most difficult skills to recruit for. Women’s participation is lower than 30% in the clean cooking sectors. Managerial positions have higher women’s participation than non-managerial ones. Conclusion This research exercise establishes a baseline for understanding the employment impact of the clean cooking sectors. However, a massive data gap persists. Our study shows that while the clean cooking sectors, especially LPG, are already providing tens of thousands of jobs, further studies are critically needed to map the employment impact of delivering universal clean cooking access.
An AIDS Patient With Recurrent Multiple Skin Crusted Ulcerations
Authors: Wang Yu , Wen Ying
Published: August 2020

Background:Malignant syphilis is considered a rare disease, more commonly affecting individuals with poor immunity. We report a case of acquired immune deficiency syndrome with Repeated crusted ulcerations. Our report shows the typical skin lesions of malignant syphilis and a reinfection with the same rashes. Case presentation:A 22-year-old homosexual male was admitted to hospital for fever and ulcerations with overlying brown–black rupioid crusts. Then he was confirmed human immunodeficiency virus infection. Malignant syphilis was diagnosed by positive markers and biopsy pathology. After application of benzathine penicillin for 3 weeks, the symptoms improved and rapid plasma regain (RPR) decreased from 1:64 to 1:4 in 8 months. But the patient appeared with rashes that was accurately the same with rashes before 13 months later，and RPR rose to 1:128, that was likely to be re-infection after frequent sexual activity. And he responded well to doxycycline treatment. Conclusion: Malignant syphilis is a rare form of secondary syphilis, but tends to occur in acquired immune deficiency syndrome patients because of poor immunity. Although the clinical manifestations of malignant syphilis are severe, the response to the therapy of penicillin and doxycycline are excellent, even with repeated infection.
Health Literacy and Health Outcomes in Patients with Back Pain – A Scoping Review
Authors: See Clarence Ye King , Smith Helen Elizabeth , Car Lorainne Tudor , Protheroe Joanne , Wong Wei Cong , Bartlam Bernadette
Published: August 2020

BACKGROUND: The World Health Organisation highlights back pain as a leading and growing cause of disability worldwide. In the field of chronic pain, higher health literacy is linked to lower pain intensity and better pain control. However, there remains a paucity of evidence, with a recent systematic review finding only three studies meeting its inclusion criteria. OBJECTIVES: This scoping review had two objectives in exploring research in chronic pain, which were to identify:1) The health literacy measures currently employed. 2) The back-pain health outcomes included in such work and the extent to which these reflect the core outcome set for clinical trials in non-specific low back pain.METHODS: The search broadened the search strategy used in the systematic review. It was conducted using thirteen bibliographic databases, employing medical subject heading (MeSH) terms for back pain and health literacy, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A thematic framework approach was used for analysis.RESULTS: The search yielded ten relevant studies for inclusion, amongst which a total of nine health literacy measures and 50 health outcome measures were used. The health outcomes assessed by the included studies could be broadly categorised into: Pain, Disability, Behaviour, Knowledge and Beliefs, and Resource Utilisation. Most outcome measures employed (36 out of 50) were not directly relevant to addressing the core outcome set for clinical trials in non-specific low back pain.CONCLUSIONS: A dearth of studies in this field of research was noted, especially in Asia and low-middle income countries. Methodological limitations were identified, including in study design and outcome measures. To allow for comparison across findings and the development of a rigorous evidence base, future work should include the core outcome set for clinical trials in non-specific low back pain. Furthermore, research thus far has focused on a narrow range of populations and there is an urgent need to broaden the evidence-base to include those with characteristics known to be moderators in health outcomes. Such work demands the incorporation of comprehensive measures of health literacy that have both generic and culturally sensitive components.
Changes in Quantitative Muscle Ultrasound for Diagnosis of Intensive Care Unit-Acquired Weakness in Critically Ill Patients
Authors: Zhang Weiqing , Wu Jun , Gu Qiuying , Gu Yanting , Zhao Yujin , Ge Xiaoying , Sun Xiaojing , Zeng Qian
Published: August 2020

Background: A common occurrence in severe illness is muscle wasting, which is defined as intensive care unit acquired weakness (ICU-AW) and characterized by flaccid tetraparesis with areflexia or hyporeflexia. Many studies revealed the tendency of changes in quantitative muscle ultrasound parameters in critical illnesses; however, the relation between those changes in muscle parameters and intensive care unit acquired weakness was unknown.Objectives: Using the Medical Research Council Criteria, test the accuracy in diagnosis of changes in quantitative muscle ultrasound for diagnosing intensive care unit acquired weakness.Methods: Patients who were conscious and positively responded to verbal commands with facial muscles were subjected to quantitative muscle ultrasonography including measuring thickness and cross-sectional area of biceps brachii (BB) muscle, vastus intermedius (VI) muscle, and rectus femoris (RF) muscles for 4 times in the next 10 days after assessing their muscle strength using the Medical Research Council score. Assessment of the diagnostic accuracy of changes in cross-sectional area and thickness of different muscle groups was made using area under the curve of the receiver operating characteristic curve (ROC–AUC). We also calculated specificity, sensitivity, negative predictive value, positive predictive value, and diagnostic accuracy of 15% threshold for reduction of thickness and 12% threshold for reduction of cross-sectional area.Results: 37 patients underwent muscle ultrasonography for 4 times and 24 were found to have ICW-AW. ROC–AUC of changes in muscle parameters were acceptable and ranged from 0.647 to 0.727. The changes in the thickness of vastus intermedius muscle on both sides while the change in thickness and cross-sectional area of rectus femoris muscle on the right side showed good diagnostic accuracy and ranged from 75.7% to 78.4%.Conclusions: Ultrasonography of the changes in muscle parameters with good diagnostic accuracy is an alternative approach for making a diagnosis of intensive care unit acquired weakness. Particularly, changes in the thickness of vastus intermedius muscle on both sides and changes in thickness and cross-sectional area of rectus femoris muscle on the right side have diagnostic potential.
Predicting Hyperoxia-Induced Lung Injury from Associated Intestinal and Lung Dysbiosis in Neonatal Mice
Authors: Chen Chung-Ming , Chou Hsiu-Chu , Yang Yu-Chen , Su Emily Chia-Yu
Published: August 2020

Background: Newborns with respiratory disorders often require supplemental oxygen. Preclinical studies have demonstrated that hyperoxia disrupts the intestinal barrier, impairs intestinal function, and injures the lungs of newborn animals. The effects of neonatal hyperoxia on intestinal and lung microbiota and the role of the intestinal microbiota in the pathogenesis of hyperoxia-induced lung injury have not been investigated.Results: In this study, we evaluated the effect of neonatal hyperoxia on intestine and lung microbiota alterations in neonatal C57BL/6N mice reared in either room air (RA) or hyperoxia (85% O2) from postnatal days 1 to 7. On postnatal day 7, lung and intestinal microbiota were sampled from the left lung and lower gastrointestinal tract for 16S ribosomal RNA gene sequencing. Tissue from the right lung and terminal ileum were harvested for Western blot and histology analysis. Hyperoxia decreased body weight, induced intestinal injury, decreased intestinal tight junction expression, impaired lung alveolarization and angiogenesis, and increased lung cytokines in neonatal mice. Hyperoxia also altered intestinal and lung microbiota and promoted bacterial translocation from the intestine to the lung as evidenced by the presence of intestinal bacteria in the lungs of hyperoxia-exposed neonatal mice. The relative abundance of these bacterial taxa was significantly positively correlated with lung cytokines. Intestinal and lung microbiota combined with cytokines were incorporated into machine learning algorithms to develop prediction models for the classification of RA- or hyperoxia-reared mice. The experiment results demonstrated that a Bayes network achieved the best predictive performance, attaining accuracy, sensitivity, specificity, and area under the curve values of 94.4%, 88.9%, 100%, and 0.963, respectively. Selected discriminative features included lung cytokines (interleukin-1β, macrophage inflammatory protein-2, and tumor necrosis factor-α), lung microbiota (Ruminococcaceae_UCG-010, CAG-56, and Enterobacter), and intestinal microbiota (Peptococcaceae_ge, Muribaculum, Enterobacter, and Ruminococcaceae_UCG-010). Conclusions: Neonatal hyperoxia exposure during the first week of life induced intestinal and lung dysbiosis and promoted bacterial translocation from the intestine to the lung. These findings suggest that changes in the composition of the intestinal microbiota contribute to hyperoxia-induced lung injury and that the combination of intestinal and lung microbiota may indicate hyperoxia-induced lung injury in neonatal mice.
Self-Reported Taste and Smell Disorders in Patients with COVID-19: Distinct Features in China
Authors: Song Jia , Deng Yi-Ke , Wang Hai , Wang Zhi-Chao , Liao Bo , Ma Jin , He Chao , Pan Li , Liu Yang , Alobid Isam , Wang De-Yun , Zeng Ming , Mullol Joaquim , Liu Zheng
Published: August 2020

Background: Last December 2019, a cluster of viral pneumonia cases identified as coronavirus disease 2019 (COVID-19), was reported in Wuhan, China. We aimed to explore the frequencies of nasal symptoms in patients with COVID-19, including loss of smell and taste, as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19.Methods: In this retrospective study, 1,206 laboratory-confirmed COVID-19 patients were included and followed-up by telephone call one month after discharged from Tongji Hospital, Wuhan. Demographic data, laboratory values, comorbidities, symptoms, and numerical rating scale scores (0-10) of nasal symptoms were extracted from the hospital medical records, and confirmed or reevaluated by the telephone follow-up. Results: From COVID-19 patients (N = 1,172) completing follow-up, 199 (17%) subjects had severe COVID-19 and 342 (29.2%) reported nasal symptoms. The most common nasal symptom was loss of taste (20.6%, median score = 6), while 11.4% had loss of smell (median score = 5). The incidence of nasal symptom including loss of smell and loss of taste as the first onset symptom was <1% in COVID-19 patients. Loss of smell or taste scores showed no correlation with the scores of other nasal symptoms. Loss of taste scores, but not loss of smell scores, were significantly increased in severe vs. non-severe COVID-19 patients. Interleukin (IL)-6 and lactose dehydrogenase (LDH) serum levels positively correlated with loss of taste scores. About 80% of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks.Conclusions: In the Wuhan COVID-19 cohort, only 1 out of 10 hospital admitted patients had loss of smell while 1 out 5 reported loss of taste which was associated to severity of COVID-19. Most patients recovered smell and taste dysfunctions in 2 weeks.
Vertical Equity in Access to Health Insurance Services: a Qualitative Analysis of Perceptions and Enrollment in the Jirapa Municipality, North-Western Ghana.
Authors: Domapielle Maximillian Kolbe , Akurugu Constance Awinpoka , Derbile Emmanuel Kanchebe
Published: August 2020

Background: Given concerns about the spiralling cost of health services in Low and Middle Income Countries (LMICs), this study draws on a framework for assessing poverty and access to health services to ascertain progress towards achieving vertical equity in the National Health Insurance Scheme (NHIS) in a rural setting in northern Ghana. Rural-urban disparities in financial access to NHIS services are seldom explored in equity-related studies although there is a knowledge gap of progress and challenges of implementing the scheme’s vertical equity objectives to inform social health protection planning and implementation. Methods: A qualitative approach was used to collect and analyse the data. Specifically, in-depth interviews and observation provided the needed data to critically analyse the relationship between location, livelihoods and ability to pay for health insurance services. Results: The article found that flat rate contributions for populations in the informal sector of the economy and lack of flexibility and adaptability of timing premium collections to the needs of rural residents make the cost of membership disproportionately higher for them, and this situation contradicts the vertical equity objectives of the NHIS. Conclusion: The study concludes that the current payment arrangements serve as important deterrence to poor rural residents enrolling in the scheme. Based on this, we advocate strict adherence and implementation of the scheme’s vertical equity measures through the adoption of the Ghana National Household Register (GNHR) as a tool for ensuring that contributions are based on income and also collection is well-timed.
Implications of Liver Injury in Risk-Stratification and Management of Patients with COVID-19
Authors: Shao Jiaofang , Liang Yuan , Li Yan , Ding Rong , Zhu Mengyan , You Wenhua , Wang Ziyu , Huang Bing , Wu Min , Zhang Tingting , Li Kening , Wu Wei , Wu Lingxiang , Wang Qianghu , Xia Xinyi , Wang Shukui , Lu Ling
Published: August 2020

BackgroundInfection with SARS-CoV-2 has been associated with liver dysfunction, aggravation of liver burden, and liver injury. This study aimed to assess the effects of liver injuries on the clinical outcomes of patients with COVID-19.MethodsA total of 1,564 patients with severe or critical COVID-19 from Huoshenshan Hospital, Wuhan, were enrolled. Chronic liver disease (CLD) was confirmed by consensus diagnostic criteria. Laboratory test results were compared between different groups. scRNA-seq data and bulk gene expression profiles were used to identify cell types associated with liver injury.ResultsA total of 10.98% of patients with severe or critical COVID-19 developed liver injury after admission that was associated with significantly higher rates of mortality (21.74%, p<0.001) and intensive care unit admission (26.71%, p<0.001). A pre-existing CLD was not associated with a higher risk. However, fatty liver disease and cirrhosis were associated with higher risks, supported by evidences from single cell and bulk transcriptome analysis that showed more TMPRSS2+ cells in these tissues. By generating a model, we were able to predict the risk and severity of liver injury during hospitalization.ConclusionWe demonstrate that liver injury occurring during therapy in patients with COVID-19 is significantly associated with the severity of disease and mortality, but the presence of CLD is not associated. We provide a risk-score model that can predict whether patients with COVID-19 will develop liver injury or proceed to higher risk stages during subsequent hospitalizations. These findings may prove beneficial for the clinical management of patients infected with SARS-CoV-2.
A global assessment of the impact of school closure in reducing COVID-19 spread
Authors: Wu Joseph T. , Mei Shujiang , Luo Sihui , Leung Kathy , Liu Di , Lv Qiuying , Liu Jian , Li Yuan , Weng Jianping , Feng Tiejian , Zheng Xueying , Leung Gabriel M
Published: August 2020

Prolonged school closure has been adopted worldwide to control COVID-19. Such preemptive implementation was predicated on the premise that school children are a core group for COVID-19 transmission. Using surveillance data from the Chinese cities of Shenzhen and Anqing, we inferred that children aged 18 or below are only around half as susceptible to COVID-19 infection as adults. Using transmission models parameterized with synthetic contact matrices for 152 jurisdictions around the world, we showed that the lower susceptibility of school children substantially limited the effectiveness of school closure in reducing COVID-19 transmissibility. Our results, together with recent findings that clinical severity of COVID-19 in children is lower, suggest that school closure may not be ideal as a sustained, primary intervention for controlling COVID-19.
Variability in Reaction to Root and Crown Rot Caused by Rhizoctonia Solani Among Table Beet Cultivars, Breeding Lines, and Plant Introductions in Controlled Environment Conditions
Authors: Wigg Katharina S. , Goldman Irwin L.
Published: August 2020

Table beet (Beta vulgaris ssp. vulgaris) is adversely affected by the soilborne fungus, Rhizoctonia solani, which greatly decreases root quality. There are no reports of breeding efforts designed to improve resistance to this fungus in table beet. A collection of table beet PIs, cultivars, and publicly available inbreds were characterized for their response to inoculation with R. solani in three replicated greenhouse experiments conducted between 2017 and 2019. An isolate of AG 2-2 IIIB was used to inoculate 8-week old plants, and both susceptible and resistant sugar beet genotypes were used for comparison. Plants were evaluated for internal and external disease characteristics 3 and 5 weeks postinoculation. Compared with uninoculated controls, PI accessions ranged from 2% to 44% infection, whereas cultivars and inbred lines ranged from 16% to 53% and 22% to 52%, respectively. No commercial cultivar outperformed the resistant sugar beet genotype; however, several PI accessions exhibited lower mean diseased tissue percentages than the resistant sugar beet. This suggests that resistance to R. solani may exist in table beet germplasm. PI accessions exhibited greater resistance on average than did cultivars. Inbred lines exhibited the least amount of variation. Ordinal regression allowed for prediction of infection response, which may be helpful in future selection efforts. ‘Badger Flame’, Ames 22164, PI 502294, PI 169015, ‘Long Season’, ‘Red Cloud’, and ‘Albina Vereduna’ were some of the most resistant accessions in our screens. The findings from this study can be used to inform decisions for breeding for host plant resistance in table beet.
Growth and Nutritional Responses of Cowpea (cv. Soronko) to Short-term Elevated Temperature
Authors: Nevhulaudzi Thalukanyo , Ntushelo Khayalethu , Kanu Sheku Alfred
Published: August 2020

Short-term variations in temperature associated with climate change have been noted to affect the physiological processes and metabolite profile of plants, including the nutritional status, ultimately affecting their growth and development. An evaluation of the effects of elevated temperatures on the growth and nutritional quality of cowpea was performed during this experiment. The main objective was to evaluate the effects of short-term elevated temperatures on the nutritional quality of cowpea at different growth stages. Surface-sterilized seeds of cowpea (cv. Soronko) were germinated in pots in the glasshouse. At different growth stages (preflowering, flowering, and postflowering), plants were incubated in growth chambers set at three different temperature regimes (25, 30, and 35 °C) for a period of 7 days. Compared with control (25 °C), exposure to both elevated temperatures (30 and 35 °C) reduced the whole plant fresh weight and dry weight by 30% and 52% and 42% and 29%, respectively, at the preflowering stage, and by 31 and 60% and 47 and 63%, respectively, at the flowering/anthesis stage. However, no significant difference in whole plant biomass was noted between elevated temperatures (35%) and the control temperature at the postflowering stage. Short-term exposure to an elevated temperature (35 °C) increased the shoot crude protein content (5.59 N%) of cowpea compared with control (3.77 N%) and preflowering stage. In contrast, at the flowering stage, an elevated temperature (35 °C) reduced the crude protein content (1.77%) of the shoot compared with control (5.59%). At an elevated temperature (35 °C), the preflowering and flowering stages of cowpea were most affected compared with control. These results suggest that the preflowering and flowering stages of cowpea compared with the postflowering stage are more susceptible to elevated temperatures (30 to 35 °C).
Regional Variation in the Index of Absorbance Difference as an Indicator of Maturity and Predictor of Storage Disorders in Apples
Authors: Moran Renae , DeEll Jennifer , Tong Cindy B.S.
Published: August 2020

We evaluated regional variation in the Delta Absorbance Meter® index of absorbance difference (IAD) as a measure of harvest maturity and for predicting the occurrence of storage disorders in ‘McIntosh’ apples [Malus ×sylvestris (L.) var. domestica (Borkh.) Mansf.] in 2016 and ‘Honeycrisp’ apples in 2016 and 2017. Apples were grown in Maine (ME), Minnesota (MN), and Ontario (ON), and they were harvested from one orchard in each region, and two to three times each year, followed by cold storage at 0.5 °C for 2 months in 2016 and 4 months in 2017. In 2016, ‘Honeycrisp’ IAD values were similar in ME and ON, but lower than in MN. In 2017, IAD was greater in ME than in the other two regions during the first harvest, and it similar to MN in the latter two harvests and lower in ON than in the other regions. In ‘Honeycrisp’ apples, IAD was more strongly related to starch pattern index (SPI), internal ethylene concentration, and fruit peel blush than to chlorophyll or soluble solids concentration. Soft scald incidence (SSI) of ‘Honeycrisp’ fruit was greater in ME than in MN and ON in both years. In ME, SSI was related to IAD at harvest in both years, but with an inverse relationship with the first harvest and a positive relationship in the second harvest. A positive relationship also occurred in ON in 2017. SSI was not related to IAD at harvest in MN in both years and ON in 2016. Regional similarities in patterns of change in ‘Honeycrisp’ fruit IAD were not consistent from year to year, and this indicates that a single IAD standard should not be used to assess fruit maturity in different regions. In ‘McIntosh’, IAD values were variable among the three regions and were not related to other maturity indicators. IAD was not useful for measuring maturity in ‘McIntosh’ apples, but it was weakly related to core browning incidence.
For Young Consumers Farm-to-fork Is Not Organic: A Cluster Analysis of University Students
Authors: Torres Ariana
Published: August 2020

Young consumers value healthy foods and are willing to pay for them. As young consumers transition into higher paying jobs, their influence in the food system will compound. This study used a convenient sample of university students to understand how young consumers value attributes for fresh produce. With the proliferation of food labels, this study takes a step back to identify four consumer segments with regard to their values on explicit (i.e., organic and local) and implicit (i.e., small-family farms and sustainable) attributes: committed, farm-to-fork, unattached, and skeptic. The study also investigated the impact of personal motives on cluster membership. Although committed consumers placed high value on all attributes, farm-to-fork consumers valued local, sustainable, and small-family farm systems, but did not have positive valuation toward organic. Our findings suggest increasing access to local foods and farmers market patronage is likely to increase consumers’ valuing foods with local, organic, sustainable, and small-family farms attributes.
The Cosmic Lithium Story
Authors: Lodders Katharina
Published: August 2020

Lithium’s story spans the history of the universe and is one that links to all its largest-scale processes: big bang nucleosyntheses, the evolution of stars, and galactic chemical evolution. Lithium was the only metal produced in the big bang, alongside the gases H and He. Stars destroy both stable isotopes of Li easily, yet we still have Li today, even after generations of stars have come and gone. Ongoing production of Li by galactic cosmic rays and by a limited number of Li-producing nuclear reactions and transport processes in some rare types of stars keeps lithium present in the universe.
Interdisciplinary approach to the management of patients with chronic gout
Authors: Tsurko V. V. , Gromova M. A. , Malysheva N. V.
Published: August 2020

Gout, one of the most common forms of inflammatory arthritis, is characterized by severe joint pain, which often interferes with daily activities. In recent years, further research on its causes and on improving diagnosis, treatment and prevention has been ongoing. It is known that gout usually occurs due to the accumulation of sodium monourate crystals in joints due to high levels of serum uric acid. In 2019, the Annals of the Rheumatic Diseases journal published new data on imaging and clinical diagnostics methods based on the principles of evidence-based medicine. Formulated by experts, they were adopted as a consensus of the European League Against Rheumatism (EULAR). The American College of Rheumatology (ACR) has now developed new strategies to treat and prevent gout. On May 11, 2020, the Arthritis & Rheumatology Journal presented guidelines for the management of gout patients, including the treatment of acute gout attack, indications for urate-lowering therapy and instructions for its optimal use, as well as recommendations on lifestyle and drugs that are often prescribed to patients with comorbidity. The purpose of this review is to summarize current knowledge with a focus on recent advances in the algorithm for managing acute and chronic gout patients.
Occurrence and Characteristics of the Extended-spectrum Beta-lactamase-producing Enterobacterale in a Hospital Setting
Authors: Elsafi Salah H.
Published: August 2020

Objectives:

Infectious diseases caused by ESBL-producingEnterobacteraleare an emerging problem worldwide, which increase hospital costs, empirical treatment failure, together with rates of morbidity and mortality. The aims of this study were to determine the antibiotic-resistant patterns and the frequency ofblaTEM,blaCTX-M andblaSHV genes amongEnterobacterale.

Methods:

A total of 239 non-repeated clinical isolates of theEnterobacteralefamily, including 202 (84.5%)Escherichia coliandKlebsiella pneumoniae25 (12.3%) were collected. Identification and susceptibility tests were carried out on 60 (25.9%) ESBL phenotypes using biomérieux VITEK®2 compact system. Isolates showing ESBL positivity by the phenotypic method were all screened forblaTEM,blaCTX-M andblaSHV genes by PCR.

Results:

The prevalence of ESBL-producingEnterobacteraleisolates was found to be 25.9%. These ESBL-producing isolates displayed an increasing rate of resistance for aminopenicillins (ampicillin) (96.3%), followed by piperacillin-tazobactam (54.2%), amoxicillin/clavulanic acid (45.8), the cephalosporin groups, ceftriaxone (52.4%), ceftazidime (46.7%), and fluoroquinolone (ciprofloxacin) (42.7%). Both the organisms showed a higher susceptibility to the carbapenems (Imipenem) and aminoglycosides (Amikacin). Out of the 62 ESBL positive isolates, 11 (17.7%) carried the TEM gene, 22 (35.5%) carried the CTX-M gene alone, 8 (12.9%) carried both TEM and CTX-M genes, 1(1.6%) carried both SHV and CTX-M genes, and 20 (32.3%) carried the TEM, SHV, and CTX-M genes. SHV gene alone was not reported in any of the isolates.

Conclusion:

The study indicated a moderate occurrence of ESBL-producingEnterobacteralewith CTX-M being the most dominant gene. The co-existence of all three genes on many occasions suggested the carriage of multiple plasmids with three resistance genes that might pose a serious epidemiological, clinical and public health threat.