bluuebunny/crossref_metadata_2025 huggingface dataset:
Temperature niche difference and interspecific competition determine the parapatric distribution of two congeneric species in Diaphanosoma
Authors: Liu Ping , Pan Jiaying , Lin Jianhao , Wen Zhanming , Huang Qi , Pajk Franja , Dumont Henri , Han Bo-Ping
Published: September 2020

Background Diaphanosoma excisum and D. dubium are parapatrically distributed in tropical and subtropical waters, and rarely coexist at local communities in the transition between tropics and subtropics. According to Janzen’s hypothesis and the modern coexistence theory, the specific thermal adaptation and strong interspecific competition between the two congeneric species are assumed to result in their range limits. To explore the mechanisms underlying such parapatric distribution, we modeled their current geographic distribution, and compared temperature niche difference and fitness inequality in interspecific competition with their representative clones.Results The species distribution modeling showed that the two Diaphanosoma species had significantly divergent climate niches. Their life history parameters in monocultures also demonstrated as stable temperature niche difference, while D. excisum had higher fitness than D. dubium in dimension of food niche. The competition experiments revealed a strong exploitative competition between the two species, and D. excisum was the superior competitor, and excluded D. dubium in all the competition experiments within overlapping temperature niche regardless of food conditions.Conclusions Our results suggest that stable temperature niche difference overcoming interspecific competition for food plays a critical role in shaping Diaphanosoma species range.
Selecting contextually appropriate performance indicators for Northern maternity care systems: A modified Delphi approach
Authors: Rich Rebecca , D'Hont Thomsen , Murphy Kellie , Veillard Jeremy , Chatwood Susan
Published: September 2020

Background

Meaningful performance measurement requires indicators to be scientifically robust and strategically focused. For many circumpolar states, indicators aligned with national strategies may ignore the priorities of northern, remote, or Indigenous populations. The aim of this project was to identify contextually appropriate performance indicators for maternity care in Northern regions.
Methods

A scoping review generated a working list of indicators. Fourteen maternity care and health systems experts then participated in a modified Delphi consensus process. Participants rated proposed indicators according to importance, circumpolar relevance, validity, and reliability and suggested additional indicators for consideration.
Results

Consensus was achieved after two rounds. Eleven indicators were rated highly on all four criteria. Twenty-nine indicators, largely focused on social determinants of health, health care responsiveness, and accessibility, were identified for further research.
Conclusions

The Delphi approach was effective in identifying indicators for maternity care in Northern regions. Further research and collaboration with key stakeholders is necessary to further develop indicators of health system responsiveness and accessibility.
Identification and characterization of developmental, tissue, and evolutionary transcription start sites in Bos taurus indicus
Authors: Forutan Mehrnush , Ross Elizabeth , Chamberlain Amanda , Nguyen Loan , Mason Brett , Moore Stephen , Xiang Ruidong , Hayes Ben
Published: September 2020

To further the understanding of the evolution of transcriptional regulation, we profiled genome-wide transcriptional start sites (TSSs) in two sub-species, Bos taurus taurus and Bos taurus indicus, that diverged approximately 500,000 years ago. Evolutionarily divergent TSSs were observed in more than half of the genes expressed across the sub-species, ranging from extreme cases in which a TSS was observed only in one sub-species to intermediate situations in which a corresponding TSS had been translocated by > 50 nucleotides, to situations where the number of TSS differed between the sub-species. Fetal and adult stages not only had their own regulatory profile of active and inactive genes but also their own pattern of TSSs. Given indicus are more adapted to heat, we also specifically investigated TSSs for heat shock proteins. More variation was observed in number of TSSs for heat shock proteins in indicus than taurus. This study confirmed that most genes are regulated in a tissue-specific manner.
Stigmatization, psychological and emotional trauma among frontline health care workers treated for COVID-19 in Lagos State, Nigeria: A qualitative study
Authors: KWAGHE AYI VANDI , Ilesanmi Olayinka Stephen , Amede Peter Okpeh , Okediran James Olatunde , Utulu Rowland , Balogun Muhammad Shakir
Published: September 2020

Background
COVID-19 pandemic has resulted in global health and economic crisis. We investigated the experiences of frontline health care workers recovering from COVID-19 in Lagos State Nigeria.
Methods
We conducted a qualitative study among frontline health workers recovering from COVID-19 in Lagos State, Nigeria. We interviewed 12 respondents based on data saturation. We used a checklist of questions to guide the interview according to the phenomenon under study. Data obtained was analyzed using Colaizzi's phenomenological method.
Results
The study was summarized under five themes: knowledge of COVID-19, exposure, reactions, challenges and recommendations. The respondents were quite knowledgeable on COVID-19, their reactions when informed of their status were denial, anxiety, distress, disorientation, crying for fear of stigmatization, while some were psychologically prepared. Reactions from colleagues, family and friends were encouraging and provided solace for them with a few colleagues and families that had negative reactions. Challenges include anosmia, movement restriction, loneliness, worries about the state of their families, nondisclosure of status to family members, non-conducive isolation centre with limited space, insomnia, stigmatization by health workers at the isolation centre, extended duration of stay, delay in the release of test results and use of ambulance for evacuation to the isolation centres. Coping strategies were watching movies, phone calls, use of social media, listening to music, attending webinars, working on projects and reading spiritual books. Recommendations were early laboratory testing of samples and conveying of results, increase testing capacity, the need of health care workers to be more compassionate, better method of evacuation of people that tested positive to COVID-19, aside the use of ambulance that increases the likelihood of stigmatization and standard guideline for the case management of people recovering from COVID-19 in Lagos state.
Conclusions
Respondents felt stigmatized and psychologically and morally traumatized. Isolation is a difficult experience and some negative emotions as expressed by previous studies were experienced by the respondents. There is need for increased testing capacity, timely results, early evacuation and creation of more isolation centres in Lagos State due to the rising number of cases and shortage of bed space.
Health professional and patient perspectives of factors associated with potentially avoidable hospitalisations in a rural Australian setting: a qualitative study
Authors: Glenister Kristen , Archbold Tessa , Kidd David , Wilson Sue , Disler Rebecca
Published: September 2020

Background

Potentially avoidable hospitalisations are a proxy measure of effective primary care at a population level. Hospitalisations for the chronic health conditions of diabetes, congestive cardiac failure and chronic obstructive pulmonary disease account for half of the potentially avoidable hospitalisations for chronic diseases. These hospitalisations are higher in rural areas and socioeconomically disadvantaged areas. Scarce qualitative research has focussed on the identification of factors associated with potentially avoidable hospitalisation from the perspectives of health professionals or patients. This study sought to identify factors associated with potentially avoidable hospitalisations in a rural context from the perspectives of patients and health professionals.
Methods

Patients with chronic obstructive pulmonary disease, congestive cardiac failure or type 2 diabetes, admitted to a rural hospital in Australia, and health professionals involved in the care of patients with these conditions, were invited to participate in interviews between September and October 2019. Conversations were recorded, transcribed verbatim and analysed using thematic analysis.
Results

Nine patients and 16 health professionals participated in semi-structured interviews. Five themes were identified (representing factors associated with potentially avoidable hospitalisation); namely General Practitioner involvement, individual patient factors, the influence of the rural locality, medication awareness and health service access. Within these themes, inter-related subthemes emerged including sub-optimal disease management plans, barriers to accessing general practice, poor mental health, patients living alone, healthcare costs, sub-optimal communication and poor connectivity between patients and beneficial services.
Conclusion

Factors associated with potentially avoidable hospitalisation in this rural area were complex and inter-related. These factors encompassed health service access and disease management, as well as socioeconomic disadvantage. Results suggest that improved indicators of access to effective health services, including primary care, are necessary to address potentially avoidable hospitalisation.
Predictors of Patient Safety Activities among Registered Nurses and Nurse Aides in Long-term Care Facilities
Authors: Lee Youran , Cho Eunhee
Published: September 2020

Background

In Korea, registered nurses (RNs) and nurse aides (NAs) are legally permitted as substitutes for long-term care (LTC) facilities, even though they have very different levels of education and standards of qualifications. This study aimed to explore the factors that influence patient safety activities of the RNs and NAs working in LTC facilities and to identify the relationship between patient safety culture (PSC) and patient safety activities.
Methods

This was a cross-sectional, descriptive study. The study participants were 88 RNs and 71 NAs who worked at 33 LTC facilities for more than three months. The questionnaires were collected by e-mail or mobile application and kept confidential. Data were analyzed using SPSS version 25.0.
Results

The mean scores of PSC and patient safety activities were 4.03 ± 0.51 points, 4.29 ± 0.49 points out of 5, respectively. There was significant correlation between PSC and patient safety activities (r = .23, p = .004). Factors influencing patient safety activities among RNs and NAs in LTC facilities were registered nurse (β = .377, p < .001), organizational system of PSC (β = .314, p < .010), and work sift type (fixed night shift, on-call, 24-hour shift) (β = − .264, p = .004), which explained about 36.0% of total variance (F = 5.69, p < .001).
Conclusion

The findings indicate the need for the mandatory placement of RNs by improving current domestic regulations that can be replaced without distinctions between the level of education and qualifications of RNs and NAs to strengthen patient safety activities at LTC facilities. Additionally, the importance of an organizational safety system and effective working shift types to prevent residents’ safety accidents in LTC facilities is indicated.
Edge states of Floquet-Dirac semimetal in a laser-driven
semiconductor quantum-well
Authors: Zhang Boyuan , Maeshima Nobuya , Hino Ken-ichi
Published: September 2020

Band crossings observed in a wide range of condensed matter systems are recognized as a key to understand low-energy fermionic excitations that behave as massless Dirac particles. Despite rapid progress in this field, the exploration of non-equilibrium topological states remains scarce and it has potential ability of providing a new platform to create unexpected massless Dirac states. Here we show that in a cw-laser driven semiconductor quantum-well, the optical Stark effect conducts bulk-band crossing, and the resulting Floquet-Dirac semimetallic phase supports an unconventional edge state in the projected one-dimensional Brillouin zone. Further, we reveal that this edge state mediates a transition between topological and non-topological edge states that is caused by tuning the laser intensity. The existence of the respective edge states and the related topological numbers are understood in a
unified manner in terms of the laser-induced polarization reflecting parity hybridization in the bulk Brillouin zone.
Extraction and detection of guanosine 5'-diphosphate-3'-diphosphate in Clavibacter michiganensis cells
Authors: Bai Kaihong , Chen Xing , Jiang Na , Lyu Qingyang , Li Jianqiang , Luo Laixin
Published: September 2020

Guanosine 5’-diphosphate-3’-diphosphate (ppGpp) is a small molecule nucleotide alarmone that can accumulate under the amino acid starvation state and trigger the stringent response. This study reported the extraction of ppGpp from the Gram-positive bacteria Clavibacter michiganensis (Cm) through methods using formic acid, lysozyme, or methanol. Following extraction, ppGpp was detected through ultra-high-performance liquid chromatography (UHPLC) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). The methanol method showed the highest extraction efficiency for ppGpp among the three methods tested. Amino acid starvation was induced in C. michiganensis cells during logarithmic phase using serine hydroxamate (SHX). ppGpp was extracted and detected at 0 min, 15 min, 30 min and 1 h. When using the methanol extraction method, the results show that ppGpp concentrations in SHX-treated samples were 15.645 nM, 17.656 nM, 20.372 nM and 19.280 nM at 0 min, 15 min, 30 min and 1 h, respectively, when detected using LC-MS/MS. This is the first report on ppGpp extraction and detection in Clavibacter providing a new idea and approach for nucleotide detection and extraction in bacteria.
Utility of Platelet Indices in Assessing the Risk of Coronary Artery Disease in Patients of Diabetes Mellitus
Authors: Khatoon Ayesh , Yadav Shakti Kumar , Singh Sompal , Singh Harsh Vardhan , Sarin Namrata
Published: September 2020

Background: Platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR), are the indicators of increased platelet activity which may play a role in development of vascular complications in diabetic patients. This study was performed to evaluate and compare the platelet volume indices such as MPV, PDW, P-LCR in patients of type 2 diabetes mellitus (DM) with and without manifested coronary artery disease in order to identify their usefulness in determining the risk for development of coronary complications.Methods: Analytical cross - sectional study included 150 patients of which 100 patients were diagnosed as type 2 DM and 50 apparently healthy controls. The study cases were divided into two groups based on presence or absence of coronary artery disease. Group A included 50 cases of type 2 DM without manifested coronary artery disease and group B included 50 cases of type 2 DM with manifested coronary artery disease. PVI was obtained using automated cell counter.Results: MPV, PDW, P-LCR were significantly higher in diabetics as compared to controls subjects (P < 0.001 for all). However, no statistically significant difference was found between diabetics with and without manifested coronary artery disease.Conclusions: The study showed higher PVI in diabetic subjects when compared to control subjects, but no difference between patients with and without manifested coronary artery disease suggesting that various other factors might be associated with the pathogenesis of CAD in patients of DM.
Unravelling the modes of transmission of SARS-CoV-2 during a nursing home outbreak: looking beyond the church super-spread event
Authors: Voeten Helene ACM , Sikkema Reina S , Damen Marjolein , Munnink Bas B Oude , Arends Carla , Stobberingh Ellen , Hoogervorst Ellen , Koopmans Marion P.G. , Fanoy Ewout
Published: September 2020

BackgroundAn outbreak of COVID-19 in a nursing home in the Netherlands, following an on-site church service held on March 8, 2020, triggered an investigation to unravel sources and chain(s) of transmission.MethodsEpidemiological data were collected from registries and through a questionnaire among church visitors. Symptomatic residents and healthcare workers (HCWs) were tested for SARS-CoV-2 by RT-PCR and subjected to whole genome sequencing (WGS). Sequences from a selection of people from the same area were included as community reference.ResultsAfter the church service, 30 of 39 visitors (77%) developed symptoms; 14 were tested and were positive for COVID-19 (11 residents and 3 non-residents). In the following five weeks, 62 of 300 residents (21%) and 30 of 640 HCWs (5%) tested positive for COVID-19; 21 of 62 residents (34%) died. The outbreak was controlled through a cascade of measures. WGS of samples from residents and HCWs identified a diversity of sequence types, grouped into eight clusters. Seven resident church visitors all were infected with distinct viruses, four of which belonged to two larger clusters in the nursing home.ConclusionsAlthough initial investigation suggested the church service as source of the outbreak, detailed analysis showed a more complex picture, most consistent with widespread regional circulation of the virus in the weeks before the outbreak, and multiple introductions into the nursing home before the visitor ban. The findings underscore the importance of careful outbreak investigations to understand SARS-CoV-2 transmission to develop evidence-based mitigation measures.
Comparative Analysis of the Diagnostic Value of Several Methods for the Diagnosis of Patent Foramen Ovale
Authors: liu Fangfang , Kong Qingyu , Zhang Xiaojun , Li Yan , Liang Shimin , Han Shuang , Li guishuang
Published: September 2020

Background: In recent years, patent foramen ovale (PFO) has been reported to be strongly associated with embolic strokes of undetermined source (ESUS), including cryptogenic stroke, transient ischemic attack (TIA), migraine, and so on.The aim of this research was to compare the sensitivity and positive predictive value of contrast transcranial Doppler (c-TCD), contrast- transthoracic echocardiography (c-TTE) versus contrast- transesophageal echocardiography (c-TEE), to find which is the best method to diagnose patent foramen ovale (PFO), provides reference for the further improvement of clinical. Methods: We investigated 161 patients who suffered from migraine, cryptogenic stroke, TIA, and cerebral infarction of unknown cause, all patients underwent the transcatheter examination, and put the results of the right heart catheterization (RHC) as the gold standard for PFO diagnosis. A chi-square test was used to compare the sensitivity and specificity between the three methods. A P value of <0.05 indicated statistical significance. Results: The present study revealed that c-TTE with the Valsalva maneuver yielded a higher sensitivity in detecting PFO-RLS, but the rate of misdetection might be higher than c-TCD. Conclusions: For the suspected patients, can examine with c-TCD first, if we get the positive results, then c-TTE and c-TEE should be taking to further confirmed. These findings may be helpful in the diagnosis of patent foramen ovale in practice.
The Intensive Care Outcome of Patients with a Solid Malignancy in a Tertiary Hospital in Saudi Arabia: A prospective Intensive Care Unit Registry Study
Authors: Rugaan Asia , Iqbal Masood , Almadani Asma , Bugis Elham , Rawah Ahlam , Radi Rwan , Radwan Enshrah , Damanhouri Elaf , Alhazmi Maher
Published: September 2020

Aim: There is a paucity of research on the factors predicting mortality and prolonged stay in the Intensive Care Unit (ICU) in critically ill patients with a solid malignancy. We aimed to assess the characteristics and outcomes of these patients who admitted to a medical ICU in a tertiary hospital in Saudi Arabia, and determine the predictors of ICU mortality and ICU prolonged stay. Method: Clinical data from patients with solid tumors extracted from a comprehensive prospective ICU registry. We used logistic regression analysis to identify the predictors influencing ICU mortality and ICU prolonged stay. Results: Of 2883 patients admitted to the ICU, 364 patients identified with solid tumor were enrolled in this study. The most common solid tumor types were: breast (15.9%), colorectal (11.5%) and lung (9.9%) cancers. The ICU mortality rate was (32.4%), and there were 50 (13.7%) patients had a prolonged stay of ≥ 21 days. In the multivariate analysis, three factors were the independent predictors for the ICU mortality: Sequential Organ Failure Assessment (SOFA) score (P <.001), mechanical ventilation (P=.004) and inotropic/vasopressor agents (P=.018), and four variables were independent predictors for the prolonged stay in ICU: ICU acquired infection (P<.001), SOFA score (P <.001), mechanical ventilation (P<.001) and bilirubin (P=.049).Conclusion: In patients with solid tumour the ICU mortality is 32.4%, and 13.7% had a prolonged ICU stay. The reported outcome in this study indicate benefit from ICU care in this category of cases The identified predictors of ICU mortality and prolonged stay of patients would help in assessing the potential benefit of ICU admission, and prognostication.
Relationship between miR-92b expression and hypertension, the degree of heart disease and cerebral hemorrhage
Authors: Tang Zi-Jun , Zhang Jing , Zeng Jun-yi , Zheng Ze-qi , Zhang Wan , Ding Lu , Wen Tong , Yi Da-Song
Published: September 2020

Objective: To delve into the correlation between miR-92b expression in peripheral plasma and hypertension, heart disease and cerebral hemorrhage. Methods: We enrolled 204 patients hospitalized in our institution from March 2016 to May 2017, including patients with hypertension (group B), hypertensive left ventricular hypertrophy (HTN-LVH) (group C), HTN-LVH complicated heart failure (group D), with 68 cases each group, and recruited another 60 healthy volunteers as control group (group A). Our team compared miR-92b level in peripheral plasma, and ultrasound indexes among the four groups and inquired into their correlation. The patients were followed up to assay miR-92b level in the peripheral plasma, cerebral edema volume and cerebral hematoma volume before and after treatment. Results: (1) In contrast to group B, the LVDs and LVMI in group C, D waxed, whereas LVEF and E/A waned (P<0.05). In contrast to group C, group D owned increased LVDs and LVMI, and decreased LVEF (all P<0.05). (2) In contrast to group A, miR-92b expression decreased in groups B, C and D, among which group D were the lowest and group B were the highest (all P<0.05). (3) miR-92b held negative relationship with SBP, DBP, LVDd and LVMI (all P<0.001), and had positive link with LVEF (r=0.649, P<0.001). (4) In contrast to before treatment, miR-92b expression in plasma was up-regulated after treatment (P<0.05). miR-92b level in plasma after treatment possessed negative association with brain edema volume and hematoma volume (P<0.001), and no correlation with the edema/hematoma ratio. Conclusion: miR-92b expression in peripheral plasma of patients with hypertension, myocardial hypertrophy and cerebral hemorrhage is down-regulated. miR-92b probably harbors a defensive impact and participates in the pathophysiological process of hypertension, heart disease and cerebral hemorrhage.
Drivers learn city-scale dynamic equilibrium
Authors: Zhang Ruda , Ghanem Roger
Published: September 2020

Understanding collective human behavior and dynamics at urban-scale has drawn broad interest in physics, engineering, and social sciences. Social physics often adopts a statistical perspective and treats individuals as interactive elementary units, while the economics perspective sees individuals as strategic decision makers. Here we provide a microscopic mechanism of city-scale dynamics, interpret the collective outcome in a thermodynamic framework, and verify its various implications empirically. We capture the decisions of taxi drivers in a game-theoretic model, prove the existence, uniqueness, and global asymptotic stability of Nash equilibrium. We offer a macroscopic view of this equilibrium with laws of thermodynamics. With 870 million trips of over 50k drivers in New York City, we verify this equilibrium in space and time, estimate an empirical constitutive relation, and examine the learning process at individual and collective levels. Connecting two perspectives, our work shows a promising approach to understand collective behavior of subpopulations.
Individuals With Upper Limb Loss Require Minimal Training to Achieve Robust Motion Classification Using Sonomyography
Authors: Engdahl Susannah , Dhawan Ananya , Bashatah Ahmed , Diao Guoqing , Mukherjee Biswarup , Monroe Brian , Holley Rahsaan , Sikdar Siddhartha
Published: September 2020

Background: Although surface electromyography is commonly used as a sensing strategy for upper limb prostheses, it remains difficult to reliably decode the recorded signals for controlling multi-articulated hands. Sonomyography, or ultrasound-based sensing of muscle deformation, overcomes some of these issues and allows individuals with upper limb loss to reliably perform multiple motion patterns. The purposes of this study were to determine 1) the effect of training on classification performance with sonomyographic control and 2) the effect of training on the underlying muscle deformation patterns.Methods: A series of motion pattern datasets were collected from five individuals with transradial limb loss. Each dataset contained five ultrasound images corresponding each of the following five motions: power grasp, wrist pronation, key grasp, tripod, point. Participants initially performed the motions for the datasets without receiving feedback on their performance (baseline phase), then with visual and verbal feedback (feedback phase), and finally again without feedback (retention phase). Cross-validation accuracy and metrics describing the consistency and separability of the muscle deformation patters were computed for each dataset. Changes in classification performance over the course of the study were assessed using linear mixed models. Associations between classification performance and the consistency and separability metrics were evaluated using Pearson correlations.Results: The average cross-validation accuracy for each phase was 92% or greater and there was no significant change in cross-validation accuracy throughout training. Misclassifications of one motion as another did not persist systematically across datasets. Few of the correlations were significant, although many were moderate or greater in strength and showed a positive association between accuracy and improved consistency and separability metrics.Conclusions: Participants were able to achieve high classification rates upon their initial exposure to sonomyography and training did not affect their performance. Thus, motion classification using sonomyography may be highly intuitive and is unlikely to require a structured training protocol to gain proficiency.
Association between social capital and loneliness among older adults: A cross-sectional study in Anhui Province, China
Authors: Bai Zhongliang , Wang Zijing , Shao Tiantai , Qin Xia , Hu Zhi
Published: September 2020

Background
Although the relationship between social capital and loneliness in later life has been widely researched in western countries, this evidence is largely lacking in China. We aimed to examine the association between social capital and experienced loneliness in Anhui Province, China.
Methods
Data were collected from a cross-sectional study using a multi-stage stratified cluster sampling strategy. Data on demographic characteristics, socioeconomic factors, social capital, and loneliness in 1810 older adults (aged 60 years and older) were used for analysis. Binary logistic regression models and a classification and regression tree model were performed.
Results
Our results indicated that social capital in terms of social participation (AOR = 1.38; 95% CI: 1.10–1.74), social connection (AOR = 1.51; 95% CI: 1.18–1.93), and reciprocity (AOR = 1.47; 95% CI: 1.13–1.90) were associated with loneliness. We noted the interactive effect of different social capital dimensions on loneliness, suggesting that the risk for suffering loneliness was greatest in older people limited in functional ability, with less trust, less social connection, and less social participation.
Conclusions
Our findings show that social capital is associated with loneliness in older adults. This implies that social capital, especially in terms of trust, social connection, and social participation may be significant for alleviating loneliness among older adults.
One-day combined botulinum toxin injections and pulsed radiofrequency of greater occipital nerve for treatment refractory chronic migraine
Authors: Voloshin Alexey , Moiseeva I.V.
Published: September 2020

Background. The aim of this study was to evaluate the potential of combined the greater occipital nerve’s (GON) pulsed radiofrequency (PRF) with botulinum toxin therapy procedures for treatment the refractory chronic migraine.Methods. We had 6 patients, all female, from 33 to 57 years old suffering from refractory chronic migraine (RCM) according to the European Headache proposed criteria. All patients had migraine from 5 to 44 years and refractory migraine from 1 to 10 years. Simultaneous one-day treatments were undertaken: first step - botulinum toxin type A injections in accordance with the PREEMPT protocol. Second step - the PRF stimulation on the bilateral GONs was performed under the guidance of ultrasound. The follow-up duration after the procedure was 6 months.Results. We had a positive response to treatment from all patients. As a result, we observed a dramatic reduction of pain intensity from 7±1 to 2±2 on NRS scale and, most importantly, a significant decrease in the number of days with headache from 22±5 to 4±4 during first month after treatment, with two patients (30% of patients) recording a complete regression of migraine attacks. None of the patients had any adverse effects.Conclusion. The simultaneous one-day use of PRF GON with botulinum toxin therapy may be a useful option for the treatment of refractory chronic migraine. The combined interventional procedures are effective, minimally invasive, inexpensive, safe, well tolerated and can be performed on an outpatient basis.
TNF-α expression ratio of M1/M2 macrophages is a potential adjunctive tool for the diagnosis of autism spectrum disorder
Authors: Yamauchi Takahira , Makinodan Manabu , Toritsuka Michihiro , Okumura Kazuki , Kayashima Yoshinori , Ishida Rio , Kishimoto Naoko , Takahashi Masato , Komori Takashi , Yamaguchi Yasunari , Takada Ryohei , Yamamuro Kazuhiko , Kimoto Sohei , Yasuda Yuka , Hashimoto Ryota , Kishimoto Toshifumi
Published: September 2020

Background The etiology of autism spectrum disorder (ASD) is complex. Its pathobiology is characterized by enhanced inflammatory activities; however, the exact ASD pathobiology remains unclear. Some cases of ASD are difficult to diagnose using existing psychological assessments because the careful exclusion of other psychiatric disorders is challenging. To distinguish between the appropriate targets for interventions and research, the demand for identifying efficient diagnostic biomarkers is increasing. This study aimed to find an inflammatory indicator beneficial for the diagnosis of ASD.Methods Cytokine mRNA expression, including tumor necrosis factor-α (TNF-α), was measured in the differentiated M1 and M2 macrophages of ASD patients (n = 29) and typically developed (TD) individuals (n = 30). TNF-α expression was also measured in the monocytes of ASD patients (n = 7) and TD individuals (n = 6).Results TNF-α expression in M1 macrophages and TNF-α expression ratio of M1/M2 macrophages were markedly higher in ASD patients than in TD subjects; however, this difference was not observed in M2 macrophages (M1: p < 0.01; ratio of M1/M2: p < 0.0001; M2: p > 0.05), suggesting that this indicator could be a useful tool for diagnosing ASD (M1: sensitivity = 34.5%, specificity = 96.7%, area under the curve (AUC) = 0.74, positive likelihood ratio (PLR) = 10.34; ratio of M1/M2: sensitivity = 55.2%, specificity = 96.7%, AUC = 0.79, PLR = 16.55). However, there was no significant difference in the TNF-α expression in monocytes between ASD and TD individuals (p > 0.05).Conclusion These findings suggest that TNF-α expression in differentiated macrophages represents a novel adjunctive tool for the diagnosis of ASD.
The Skeleton Key Group: The Impact of Fellow Led Education in Nephrology
Authors: Yau Amy A , Topf Joel , Norouzi Sayna
Published: September 2020

BackgroundThe Skeleton Key Group (SKG) is an online collective of trainees working to generate free, open-access medical education (FOAMed) focusing on electrolyte disorders. Trainee created and edited materials include a case report supplemented by visual abstracts, tweetorials, and quizzes. MethodsThe group formed in September 2019, and members were continually added. In May 2020, anonymous surveys were sent to SKG members and readers to assess educational impact.ResultsMember response rate was 62.5% (n=20) with 13 nephrology fellows and 4 residents. 85% (n=17) of respondents reported improved medical knowledge, and 70-80% (n=14-16) noted improved manuscript construction. Members’ primary goal of joining was to learn (n=18), and 60% (n=12) met all and 30% (n=6) met some of their goals with similar rates among low-engagement members (n=10).Of the 130 audience responses, the majority were nephrology fellows (41, 32%) and residents (42, 32%). Case reports were considered high quality, scoring 91±15.5 (0, low to 100, high). Tweetorials were the most useful and reported utility increased compared to the case report as training level progressed. 79% (n=103) confirmed their educational experience was impacted by the COVID-19 pandemic, and 90% (n=116) found the SKG an effective educational tool during this period.ConclusionsThe SKG is an innovative collaborative experience and valuable educational resource. Involvement led to positive changes in members’ reported medical knowledge and writing skills. Our data also reinforces the ability of FOAMed to cater to different learning styles and to complement traditional medical education specifically during periods of social distancing.
Nutritional Status and Associated Factors Among Children Below Five Years of Age in Somali Region, Ethiopia: Evidence From 2016 Ethiopian Demographic and Health Survey
Authors: Kebede Damitie , Aragaw Hayat , Worku Eyerusalem
Published: September 2020

Background: Childhood under-nutrition is far-reaching in low and middle-income nations. Under-nutrition is one of the major open wellbeing concerns among newborn children and youthful children in Ethiopia. This study aimed to assess the prevalence of under-nutrition and its related variables among under-five children in Somali Region, Ethiopia.Methods: The data for this study was extricated from the Ethiopian Demographic and Health Survey (EDHS) 2016. The data collected from 1339 children born 5 years before was considered within the analysis. A multivariable binary logistic regression analysis was utilized at a 5% level of significance to decide the individual and community-level variables related to childhood malnutrition.Results: the incidences of stunting, underweight and wasting were 27.4%, 28.7% and 22.7%, respectively. About 16.1% of children were both stunted and underweight; the extent of both being underweight and wasted was 11.7%, the prevalence of both stunted and wasted children was 5.5%, and all three malnutrition conditions were 4.7% children. Among the variables considered in this study, age of the child in months, type of birth, anemia level, size child at birth, sex of the child, mothers’ BMI and sources of drinking water were significantly related to stunting, underweight and wasting in Somali Region.Conclusions: The prevalence of stunting, underweight and wasting was relatively high. Under-nutrition is one of the major open wellbeing concerns among children in Somali region. The impact of these variables ought to be considered to develop strategies for decreasing the lack of healthy sustenance due to malnutrition in the study areas. Hence, intercession should be centered on making strides the under-nutrition determinant variables of the children to be solid, to improve the child’s wholesome status, and decrease child mortality quickly.
A quintessence dynamical dark energy model
Authors: Liu Jackie
Published: September 2020

We develop a mechanism to generate dynamical dark energy - a quintessence field coupled with gravity. Such model causes the dark energy behaving differently in early and late time universe. In the radiation-dominated-era and matter-dominated-era, the related analytical solutions of the quintessence field have an interesting property - starting as a constant field, then oscillating as the universe expands. By Markov Chain Monte Carlo search of the parameter space with the local measurement (Type Ia supernovae) in the Bayesian framework, the probed range of H0 (within 1σ) overlaps the H0 value inferred from Planck CMB dataset by ΛCDM model.
Proteomic signatures of innate immunity in immunotherapy naïve melanomas correlate with anti-CTLA-4 immunotherapy responsiveness
Authors: Taylor Erin Michelle , Koss Brian , Washam Charity L , Shalin Sara C , Barreto Juan C , Graw Stefan , Byrum Stephanie D , Mackintosh Samuel G , Edmondson Rick D , Tackett Alan
Published: September 2020

Background Factors that determine responsiveness to immune checkpoint inhibitors (ICIs) in metastatic melanoma are not completely understood. Failure to respond to ICI therapy can result from primary resistance or the development of secondary resistance to treatment. Understanding the mechanisms that contribute to primary and secondary resistance may help direct which immune checkpoint blockade agents a patient should receive or allow for the development of therapeutics which could be used in combination with immune checkpoint blockade to boost responsiveness.Methods Formalin-fixed, paraffin embedded, metastatic melanoma tumors were collected from 17 patients prior to receiving anti-CTLA-4 monotherapy. After monotherapy, 5 patients had complete response and 12 had disease progression. The samples were processed for proteomic analysis using filter aided sample preparation and Thermo Tandem Mass Tag (TMT)-labeling of resulting peptides. TMT-labeled samples were fractionated off-line and combined into super fractions. The super fractions were then analyzed by mass spectrometry using an in-line ultra-performance liquid chromatography (UPLC) coupled to a Thermo Orbitrap Fusion Tribrid instrument.Results Proteomic analysis of metastatic melanoma patient tumors prior to treatment with anti-CTLA-4 therapy identified a total of 4,776 proteins across all patient samples. A random forest model was used to identify the most important proteomic features that could predict responsiveness to treatment. The random forest model had a sensitivity of 80% and specificity of 67% for predicting patient response to therapy. A large portion of the proteins elevated in tumors from patients that had complete response to the treatment were associated with innate immunity, particularly pathways involving complement cascade and neutrophil degranulation.Conclusions Proteomic analysis of immunotherapy naïve metastatic melanoma tissue from patients subsequently treated with anti-CTLA-4 therapy suggests that preexisting innate immune response may be important in responsiveness to treatment. Specifically, elevation of complement cascade or neutrophil degranulation proteins in the tumor microenvironment may increase responsiveness to anti-CTLA-4 monotherapy. Assessing a patient’s innate immune status prior to treatment may aid in predicting whether a patient would respond to immune checkpoint inhibition with anti-CTLA-4 monotherapy.
Predictors of Skin and Soft Tissue Infections Among Sample of Rural Residents Who Inject Drugs
Authors: Baltes Amelia , Akhtar Wajiha , Birstler Jen , Olson-Streed Heidi , Eagen Kellene , Seal David , Westergaard Ryan , Brown Randall
Published: September 2020

Introduction: Skin and soft tissue infections (SSTIs) are among the leading causes of morbidity and mortality for people who inject drugs (PWID). Studies demonstrate that certain injection practices correlate with SSTI incidence among PWID. The opioid epidemic has particularly affected rural communities, where access to prevention and treatment presents unique challenges. This study aims to understand current injection practices and SSTI history among a rural-dwelling PWID.Methods: Thirteen questions specific to SSTIs and injection practices were added to a larger study assessing unmet health care needs among PWID and were administered at six needle exchange programs in rural Wisconsin between May and July 2019. SSTI history prevalence was estimated based on infections reported within one-year prior of response and was compared to self-reported demographics and injection practices. Results: Eighty responses were collected and analyzed. Respondents were white (77.5%), males (60%), between the ages 30-39 (42.5%), and have a high school diploma or GED (38.75%). Females were over three times more likely to report SSTI history (OR=3.07, p=0.038) compared to males. Water sources for drug dilution (p=0.093) and frequency of injecting on first attempt (p=0.037), but not proper skin cleaning method (p = 0.378), were significantly associated with a history of SSTI. Injecting into skin (p=0.038) or muscle (p=0.001) significantly associated with a history of SSTI whereas injection into veins did not (p=0.333).Conclusion: Higher-risk injection practices were common among participants reporting a history of SSTIs in this rural sample. Studies exploring socio-demographic factors influencing risky injection practices and general barriers to safer injection practices to prevent SSTIs are warranted. Dissemination of education materials targeting SSTI prevention and intervention among PWID not in treatment are warranted.
Analyzing inherent biases in SARS-CoV-2 PCR and serological epidemiologic metrics
Authors: Makhoul Monia , Abou-Hijleh Farah , Seedat Shaheen , Mumtaz Ghina R , Chemaitelly Hiam , Ayoub Houssein , Abu-Raddad Laith J.
Published: September 2020

Background Prospective observational data show that infected persons with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain polymerase chain reaction (PCR) positive for a prolonged duration, and that detectable antibodies develop slowly with time. We aimed to analyze how these effects can bias key epidemiological metrics used to track and monitor SARS-CoV-2 epidemics.Methods An age-structured mathematical model was constructed to simulate progression of SARS-CoV-2 epidemics in populations. PCR testing to diagnose infection and cross-sectional surveys to measure seroprevalence were also simulated. Analyses were conducted on simulated outcomes assuming a natural epidemic time course and an epidemic in presence of interventions.Results The prolonged PCR positivity biased the epidemiological measures. There was a lag of 10 days between the true epidemic peak and the actually-observed peak. Prior to epidemic peak, PCR positivity rate was 2-fold higher than that based only on current active infection, and half of those tested positive by PCR were in the prolonged PCR positivity stage after infection clearance. Post epidemic peak, PCR positivity rate poorly predicted true trend in active infection. Meanwhile, the prolonged PCR positivity did not appreciably bias estimation of the basic reproduction number R0. The time delay in development of detectable antibodies biased measured seroprevalence. The actually-observed seroprevalence substantially underestimated true prevalence of ever infection, with the underestimation being most pronounced around epidemic peak.Conclusions Caution is warranted in interpreting PCR and serological testing data, and any drawn inferences need to factor the effects of the investigated biases for an accurate assessment of epidemic dynamics.
Transcriptomic Response of Daphnia Magna to Nitrogen or Phosphorus Limited Diet
Authors: Xu Zhimeng , Li Yingdong , Li Meng , Liu Hongbin
Published: September 2020

Background: Effects of nutrient-imbalanced diet on the growth and fitness of zooplankton were widely reported. However, little is known about the molecular mechanisms driving the physiological changes of zooplankton under nutrient stress.Results: In this study, we investigated the physiological fitness and transcriptomic response of Daphnia magna when exposed to nitrogen (N)-limited or phosphorus (P)-limited algal diet (Chlamydomonas reinhardtii) compared to regular algae (N and P saturated). D. magna showed higher ingestion rates and over expression of genes encoding digestive enzymes when fed with either N-limited or P-limited algae, reflecting the compensatory feeding. Under P-limitation, both growth rate and reproduction rate of D. magna were greatly reduced, which could be attributed to the downregulated genes within the pathways of cell cycle and DNA replication. Growth rate of D. magna under N-limitation was similar to normal group, which could be explained by the high methylation level (by degradation of methionine) supporting the body development.Conclusions: Phenotypic changes of D. magna under nutrient stress were explained by gene and pathway regulations from transcriptome data. Generally, D. magna invested more on growth under N-limitation but kept maintenance (e.g. cell structure and defense to external stress) in priority under P-limitation. Post-translational modifications (e.g. methylation and protein folding) were important for D. magna to deal with nutrient constrains. This study reveals the fundamental mechanisms of zooplankton in dealing with elemental imbalanced diet and shed light on the transfer of energy and nutrient in aquatic ecosystems.
The β- Amylase Gene Family in Brassica Napus: Genome Wide Analysis and Expression Profiles in Response to Abiotic Stresses
Authors: Lv Yan , Luo Dan , Jia Ziqi , Cheng Yong , Zou Xiling
Published: September 2020

Background: The β amylase (BAM) gene family, known for their property of catalytic ability to hydrolyze starch to maltose units, has been recognized to play critical roles in metabolism and gene regulation. To date, BAM genes have not been characterized in oil crops.Results: In this study, the genome wide survey revealed the identification of 30 BnaBAM genes in Brassica napus (B. napus), 11 BraBAM genes in Brassica rapa (B. rapa), 20 BoBAM genes in Brassica oleracea (B. oleracea), which were divided into 4 subfamilies according to the sequence similarity and phylogenetic relationships. All the BAM genes identified in the allotetraploid genome of B. napus, as well as two parental related species (B. rapa and B. oleracea), were analyzed for the gene structures, chromosomal distribution and collinearity, the sequence alignment of the core glucosyl hydrolase domains was further applied. 30 BnaBAMs, 11 BraBAMs and 17 BoBAMs exhibited uneven distribution on chromosomes of Brassica crops. The similar structural compositions of BAM genes in the same subfamily suggested that they were relatively conserved. Abiotic stresses pose one of the major constraints to plant growth and productivity worldwide. Thus, the responsiveness of BnaBAM genes under abiotic stresses were analyzed in B. napus. The expression patterns revealed a stress responsive behavior of all members, of which BnaBAM3s were more prominent. These differential expression patterns suggested an intricate regulation of BnaBAMs elicited by environmental stimuli. Conclusion: Altogether, the present study provides first insights into the BAM gene family of Brassica crops, which lays the foundation for investigating the roles of stress--responsive BnaBAM candidates in B. napus.