bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of Favorable Outcomes for Vertebrobasilar Artery Occlusion after Endovascular Therapy within 24 Hours of Symptom Onset
Authors: Jiang Changchun , Fan Yu , Li Yuechun , Hao Fei , Yang Junfeng , Wang Baojun , Zhang Tianyou , Li Xia , Liu Jiahui , Wang Shuguang
Published: August 2020

Objective
The aim of the present study was to describe our results of endovascular therapy (EVT) for vertebrobasilar artery occlusion (VBAO) within 24 h of symptom onset, and to evaluate prognostic factors associated with favorable outcomes.
Methods
The present study enrolled patients who underwent EVT for acute ischemic stroke (AIS) caused by VBAO. Inclusion criteria for EVT to treat VBAO were as follows: (1) computed tomography angiography (CTA) or magnetic resonance angiography (MRA) confirmed acute VBAO; (2) baseline National Institutes of Health Stroke Scale (NIHSS) score ≥ 2; (3) premorbid modified Rankin scale (mRS) score ≤ 2; (4) onset or last known time to puncture within 24 h; and (5) posterior-circulation Acute Stroke Prognosis Early CT score (pc-ASPECTS) ≥ 6. Favorable outcomes were defined as mRS scores of 0–3 at three months following EVT. The associations among baseline parameters, procedural parameters, and favorable outcomes were assessed.
Results
A total of 67 patients were recruited in this study, of which 40 patients (59.7%) had favorable outcomes. Of the 50 patients with a late-window (6–24 h), 29 patients (58%) had favorable outcomes. Univariate analysis revealed significant associations of the following parameters with favorable outcomes in the enrolled patients: age, sex, smoking status, baseline NIHSS score, baseline Glasgow coma scale (GCS) score, Pons-midbrain index (PMI), and intracranial atherosclerosis (ICAS). Multivariate logistic regression indicated that only age (OR 0.914, 95% CI: 0.849 to 0.984; p = 0.017), baseline GCS score (OR 1.234, 95% CI: 1.061 to 1.435; p = 0.006), and PMI (OR 0.448, 95% CI: 0.252 to 0.798; p = 0.006) were independently correlated with favorable outcomes at three months following EVT. After adjustments for confounding factors in patients with a late-window, only age (OR 0.879, 95% CI: 0.799 to 0.967; p = 0.008) was associated with favorable outcomes.
Conclusions
Younger age, lower PMI, and higher GCS scores in patients with VBAO-induced AIS were associated with more favorable outcomes. In late-window (6–24 h) patients, younger age correlated to favorable outcomes, and lower NIHSS scores and lower PMI each also had a tendency to correlate with favorable outcomes.
Evaluation of ustekinumab trough levels during induction and maintenance therapy with regard to disease activity status in difficult to treat Crohn Disease patients
Authors: Mechie Nicolae-Catalin , Burmester Merle , Mavropoulou Eirini , Pilavakis Yiannis , Kunsch Steffen , Ellenrieder Volker , Amanzada Ahmad
Published: August 2020

Background Ustekinumab (UST) is approved for the therapy of moderate and severe Crohn disease (CD). Therapeutic drug monitoring (TDM) helps to monitor the therapeutic effect of biologics. Therefore, the aim of this study was to evaluate clinical outcomes of UST treated CD patients and to determine UST trough level (USTTL) with clinical and corticosteroid-free remission.Methods This retrospective study of CD included patients with moderate and severe active disease treated with a weight adapted induction dose of UST intravenously. The maintenance therapy consisted of 90 mg UST subcutaneously at week 8 and thereafter every 8 or 12 weeks depending on the clinical response. Clinical and corticosteroid-free remission, Harvey-Bradshaw-Index (HBI), USTTL and further laboratory parameters were measured just before the injection of UST at each follow-up evaluation until week 40.Results 37CD patients with a median HBI of 9 at week 0 were included. Starting from 24% at the beginning of the monitoring period and 38% of patients at the end of it, were treated with an 8-week interval (p = 0.18). There was a significant improvement of clinical (p = 0.0004) and corticosteroid-free remission (p = 0.03) as well as in HBI (p < 0.0001) from week 0 until the end of the observation period, respectively.The serum USTTL decreased significantly from 2.0 at week 8 to 0.3 in the maintenance therapy and 0.4 µg/mL at the end of it (p < 0.0001), respectively. Neither USTTL nor levels of CRP or faecal calprotectin were associated with disease outcome. Concomitant immunomodulator therapy did not appear to affect the USTTL or the clinical course.Conclusions UST is an effective treatment option in difficult to treat CD patients. USTTL may not be associated with treatment efficacy or predict treatment outcomes in CD patients. Further prospective randomized trials should be conducted to evaluate if USTTL is associated with treatment outcomes in CD patients.
Fuelwood Use and Carbon Emission Reduction of Improved Biomass Cook Stoves; Evidence from Kitchen Performance Test in Tigray, Ethiopia
Authors: Manaye Ashenafi , Amaha Selemawit , Gufi Yirga , Tesfamariam Berihu , Worku Adefires , Abrha Haftu
Published: August 2020

In Ethiopia, biomass is the main form of fuel approximately for 92% of the population. Currently, several strategies were designed to reduce fuelwood consumption and greenhouse gases (GHG) emission by implementing improved cooking stoves (ICS). Nevertheless, the adoption of ICSs has been very slow. Therefore, this study were conducted to assess the performance of ICS (“Mirt” and Tikikil”) on fuelwood consumption and greenhouse gas emission (GHG) in the kitchens of real households using kitchen performance test (KPT) methods. To select the study households (HH), both cross-sectional and longitudinal study designs were used. The study indicated that there were significant differences (p < 0.05) between the use of improved and traditional cooking stoves in total and per capita wood consumption. The use of “Mirt” and “Tikikil” than the traditional stove reduced the household wood consumption by 35 % (438 kg/ year) and 18% (185 kg/ year), respectively. Likewise, adopting of these ICS stoves lead to decrease of 0.65 and 0.27 tons of carbon dioxide equivalents (CO2 e) per stove per year. This finding may have implication on adoption of ICS technology is important on reducing CO2 emission, forest degradation and household workloads.
Locking Compression Plate Distal Ulna Hook Plates as Alternative Fixation for Avulsion Fractures of the Tip of the Lateral Malleolus
Authors: Shui Wei , Luo Gang , Yang Youyin , Qiao Bo , Ni Weidong , Guo Shuquan
Published: August 2020

Background: Because of the fragment size and inferior location of the fracture lines, options are lacking for internal fixation to treat avulsion fractures of the tip of the lateral malleolus. Because the anatomical architecture of the distal malleolus is similar to that of the distal ulna metaphysis, the purpose of this study was to assess the effectiveness of 2.0-mm locking compression plate distal ulna hook plates in treating avulsion fractures of the tip of the lateral malleolus.Methods: Given the characteristics of the 2.0-mm locking compression plate distal ulna hook plate, cases in which the distance between the fracture lines and the distal end of the tip of the lateral malleolus was less than 6 mm were excluded. Seventeen patients (AO Foundation/Orthopaedic Trauma Association (AO/OTA) 44A fractures, 13 males, 4 females, median age 41 years range 18-73 years) with avulsion fractures of the tip of the lateral malleolus were included. All patients were treated with fixation of the fragment to the fibula using a 2.0-mm locking compression plate distal ulna hook plate. Clinical and radiological follow-up visits were conducted at 6 weeks and 3, 6, 12 and 24 months after the operation. Results: The mean American Orthopedic Foot and Ankle Society Ankle-Hindfoot score of the patients was 97.06±1.92 (range 94 to 100) at the 12-month postoperative follow-up and 97.71±1.54 (range 96 to 100) at the 24-month postoperative follow-up. The mean Karlsson score was 94.18±3.88 (range 90 to 100) at the 12-month postoperative follow-up and 96.43±2.34 (range 95 to 100) at the 24-month postoperative follow-up. Nonunion was not noted; 6 patients complained of lateral malleolar discomfort and foreign body sensation, and 3 of these patients underwent a hardware removal operation at 12 months postoperatively. All patients were clinically and radiographically stable.Conclusion: A 2.0-mm locking compression plate distal ulna hook plate achieved stable and anatomically suitable fixation and should be considered as an alternative treatment for avulsion fractures of the tip of the lateral malleolus.
Pore Texture Analysis in Automated 3D Breast Ultrasound Images for Implanted Lightweight Hernia Mesh Identification: A Preliminary Study
Authors: Yang Jiting , Li Haiyan , Wu Jun , Sun Liang , Xu Dan , Wang Yuanyuan , Zhang Yufeng , Chen Yue , Chen Lin
Published: August 2020

Background: Precise visualization of meshes and their position would greatly aid in mesh shrinkage evaluation, hernia recurrence risk assessment, and the preoperative planning of salvage repair. Lightweight (LW) meshes are able to preserve abdominal wall compliance by generating less post-implant fibrosis and rigidity. However, conventional 3D imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) cannot visualize the LW meshes. Patients sometimes have to undergo a second-look operation for visualizing the mesh implants. The goal of this work is to investigate the potential advantages of Automated 3D breast ultrasound (ABUS) pore texture analysis for implanted LW hernia mesh identification.Methods: In vitro, the appearances of four different flat meshes in both ABUS and 2D hand-held ultrasound (HHUS) images were evaluated and compared. In vivo, pore texture patterns of 87 hernia regions were analyzed both in ABUS images and their corresponding HHUS images.Results: In vitro studies, the imaging results of ABUS for implanted LW meshes are much more visualized and effective in comparison to HHUS. In vivo, the inter-class distance of 40 texture features was calculated. The texture features of 2D sectional plans (axial and sagittal plane) have no significant contribution to implanted LW mesh identification. Significant contribution was observed in coronal plane. However, since the mesh may have spatial variation such as shrinkage after implant surgery, the inter-class distance of 3D coronal plane pore texture features are bigger than 2D coronal plane, so the contribution of 3D coronal plane pore texture features are more valuable than 2D coronal plane for implanted LW mesh identification. The use of 3D pore texture features significantly improved the robustness of the identification method in distinguishing the LW mesh and fascia.Conclusions: An innovative new automated 3D breast ultrasound (ABUS) provides additional pore texture visualization, by separating the LW mesh from the fascia tissues. Therefore, ABUS having the potential to provide more accurate features to characterize pore texture patterns, and ultimately provide more accurate measures for implanted LW mesh identification.
Effects of Litchi on Systemic Low-Grade Inflammation and the Structure and Function of Gut Microbiota in HFA Mice
Authors: Sun Dongfang , Wang Chen , Sun Lijun , Hu Lianhua , Wang Yaling , Liu Ying , Fang Zhijia , Deng Qi , Xu Defeng , Zhao Jian
Published: August 2020

Background: Certain foods are known as “heating” foods in Chinese medicine as over consumption of them can lead to symptoms known as “heating up”, which have been shown to be symptoms of systemic low-grade inflammation. However, the mechanism by which these foods cause inflammation is not clear. In this study, we investigated dysbacteriosis of gut microbiota as a possible cause of inflammation by litchi, a typical “heating” food. Human flora-associated (HFA) mice model was constructed by first sterilizing their guts by oral administration of antibiotics, and then transplantation of fecal microbial suspension from a healthy human adult. After gavaging the mice with litchi powder suspension at low, medium and high doses (400, 800, 1600 mg/kg·d-1 respectively) for 7 days, the serum level of inflammatory cytokines, gut microbiota and the integrity of intestinal mucosal barrier were measured.Result: The intervention of litchi significantly increased the diversity of mice gut flora. The ratio of Bacteroidetes/Firmicutes and the abundance of Actinobacteria increased significantly. At the genus level, the abundance of Phascolarctobacterium, Akkermansia, Megasomonas and Lactobacillus generally decreased, while the abundance of Prevotella and Bacteroides increased significantly, especially in the high litchi dose group. The abundance of Bilophila increased significantly only in high dose group. litchi intervention caused serum TNF-α level to increase by more than two times and LPS level to double, but a decrease in IL-1β and IL-6 levels. Medium and high dose litchi intervention caused a widening of intestinal epithelial cell junction complex, and general weakening of the intestinal mucosal barrier as well as reduced efficiency of gut microbiota in energy conversion. Conclusion: This study confirmed the notion in Chinese medicine that as a “heating” food, litchi when consumed excessively can lead to low degree systematic inflammation and demonstrated that this is linked to its ability to cause dysbacteriosis of the gut microbiota and weakening of the intestinal mucosal tissues.
Model-based reproduction and validation of the total spectrum of solar flare and their impact on the global environment at the X9.3 event of September 6, 2017
Authors: Watanabe Kyoko , Jin Hidekatsu , Nishimoto Shohei , Imada Shinsuke , Kawai Toshiki , Kawate Tomoko , Otsuka Yuichi , Shinbori Atsuki , Tsugawa Takuya , Nishioka Michi
Published: August 2020

We tried to reproduce the total electron content (TEC) variation in the Earth's atmosphere from the temporal variation of the solar flare spectrum of the X9.3 flare on September 6, 2017. The flare spectrum of the Flare Irradiance Spectral Model (FISM) which is most widely used and the flare spectrum from the 1D hydrodynamic model which considers the physics of plasma in the flare loop are used in the GAIA model which is a simulation model of the Earth's whole atmosphere and ionosphere, and calculate the difference of TEC. And then, we compared these results with the observed TEC. When we used the FISM flare spectrum, difference of TEC from the background was in a good agreement with the observation. On the other hand, when the flare spectrum of the 1D-hydro model was used, the result varied depending on the presence or absence of the background. This difference which depends on the models is thought to represent which EUV radiation is primarily responsible for increasing TEC. From the flare spectrum obtained from these models and the calculation result of TEC fluctuation using GAIA, it is considered that the enhancement in EUV emission about 15 to 35 nm is mainly contributes to increasing TEC rather than that of X-ray emission that has been thought to be mainly responsible for sudden ionospheric disturbance (SID). Also, from the altitude/wavelength distribution of the ionization rate of Earth's atmosphere by GAIA, it was found that EUV radiation of about 15–35 nm affects a wide altitude range of 120–300 km, and TEC enhancement is mainly caused by ionization of nitrogen molecules. (265 words)
Long Non-coding RNA PTPRG-AS1 Promotes Cell Tumorigenicity in Epithelial Ovarian Cancer by Decoying microRNA-545-3p and Consequently Enhancing HDAC4 Expression
Authors: Shi Juanjuan , Xu Xijian , Zhang Dan , Zhang Jiuyan , Yang Hui , Li Chang , Li Rui , Wei Xuan , Luan Wenqing , Liu Peishu
Published: August 2020

Background: Long non-coding RNA PTPRG antisense RNA 1 (PTPRG-AS1) deregulation has been reported in various human malignancies and identified as an important modulator of cancer development. Few reports have focused on the detailed role of PTPRG-AS1 in epithelial ovarian cancer (EOC) and its underlying mechanism. This study aimed to determine the physiological function of PTPRG-AS1 in EOC. A series of experiments were also done to identify the mechanisms through which PTPRG-AS1 exerts its function in EOC.Methods: Reverse transcription-quantitative polymerase chain reaction was used to determine PTPRG-AS1 expression in EOC tissues and cell lines. PTPRG-AS1 was silenced in EOC cells and studied with respect to cell proliferation, apoptosis, migration, invasion in vitro, and tumor growth in vivo. The putative miRNAs that target PTPRG-AS1 were predicted using bioinformatics analysis and further confirmed in luciferase reporter and RNA immunoprecipitation assays.Results: Our data verified the upregulation of PTPRG-AS1 in EOC tissues and cell lines. High PTPRG-AS1 expression was associated with shorter overall survival in patients with EOC. Functionally, EOC cell proliferation, migration, invasion in vitro and tumor growth in vivo were suppressed by PTPRG-AS1 silencing. In contrast, cell apoptosis was promoted by loss of PTPRG-AS1. For the mechanism part, PTPRG-AS1 could serve as a competing endogenous RNA in EOC cells by decoying microRNA-545-3p (miR-545-3p), thereby elevating histone deacetylase 4 (HDAC4) expression. Furthermore, rescue experiments revealed that PTPRG-AS1 knockdown-mediated effects on EOC cells were, in part, counteracted by the inhibition of miR-545-3p or restoration of HDAC4.Conclusions: PTPRG-AS1 functioned as an oncogenic lncRNA that aggravated the malignancy of EOC through the miR-545-3p/HDAC4 ceRNA network. Thus, targeting the PTPRG-AS1/miR-545-3p/HDAC4 pathway may be a novel strategy for EOC anticancer therapy.
Assessment of the Environmental Significance of Heavy Metals Pollution in Surficial Sediments of South Brittany Waters, France: An Ecological Risk Assessment Approach
Authors: ONG MENG CHUAN , Pan Hui-Juan , Shazili Noor Azhar Mohamed , Menier David , Dupont Virginie , Révillon Sidonie , Coynel Alexandra
Published: August 2020

Distribution patterns of selected heavy metals content in sediments from the Bay of Quiberon and Gulf of Morbihan were studied to understand the current heavy metals contamination due to urbanization and mariculture activities in the coastal area. Therefore, a survey was conducted and 196 sediments collected were characterized for heavy metals content using Inductively Coupled Plasma – Mass Spectrometry (ICP–MS) after mix acid digestion process. The distribution maps of the concentrations of the heavy metals studied were produced as an isopleth map based on data interpolation by the ArcGIS software application. The association with the adverse effects to on aquatic organisms were was determined by the classification of the sediment according to the sediment quality guidelines. Therefore, two approaches were employed namely; direct comparison with Sediment Quality Guidelines (SQGs) by USEPA and comparison with other numerical SQGs, threshold effect level/probable effect level, and effect range low /effect range medium. In order to estimate the effect of multiple contaminations of heavy metals, the mean–ERM–quotient was calculated at each sampling points.
Automatic Machine-Learning Classification of the Mode of Invasion of Oral Squamous Cell Carcinoma Using Digital Microscopic Images: A Retrospective Study
Authors: Yoshizawa Kunio , Ando Hidetoshi , Kimura Yujiro , Kawashiri Shuichi , Moroi Akinori , Ueki Koichiro
Published: August 2020

Background: The Yamamoto-Kohama criteria (YK), which are used to classify the morphology of the infiltrating protrusions of an oral squamous cell carcinoma (OSCC), are clinically useful for determining the mode of tumor invasion, especially in Japan. However, evaluations of the mode of OSCC invasion are based on subjective visual observations, and this approach has created considerable inter-evaluator and inter-facility differences. In this retrospective study, we aimed to develop an automatic method of determining the mode of invasion of OSCC based on the processing of digital medical images of the invasion front. Methods: Using 101 digitized photographic images of anonymized stained specimen slides from consecutive patients with OSCC at Kanazawa University, we created a classifier that allowed clinicians to introduce feature values and subjected the cases to machine learning using a random forest approach. We then compared the YK grades (1, 2, 3, 4C, 4D) determined by a human oral and maxillofacial surgeon with those determined using the machine learning approach. Results: The input of multiple test images into the newly created classifier yielded an overall F-measure value of 87%, (Grade 1: 93%, Grade 2: 67%, Grade 3: 89%, Grade 4C: 83%, Grade 4D: 94%). These results suggest that the output of the classifier was very similar to the judgments of the clinician. Conclusions: We successfully developed an automatic machine-learning method for discriminating the mode of invasion of OSCC. Our results suggest that a medical diagnostic imaging system could feasibly be used to provide an accurate determination of the mode of OSCC invasion.
The Infant Gut Resistome is Associated with E. coli and Early-life Exposures
Authors: Lebeaux Rebecca M. , Coker Modupe O. , Dade Erika F. , Palys Thomas J. , Morrison Hilary G. , Ross Benjamin D. , Baker Emily R. , Karagas Margaret R. , Madan Juliette C. , Hoen Anne G.
Published: August 2020

Background: Antibiotic resistance is an increasing threat to human health. The human gut microbiome harbors a collection of bacterial antimicrobial resistance genes (ARGs) known as the resistome. The factors associated with establishment of the resistome in early life are not well understood and clarifying these factors would inform strategies to decrease antibiotic resistance. We investigated the early-life exposures and taxonomic signatures associated with resistome development over the first year of life in a large, prospective cohort in the United States. Shotgun metagenomic sequencing was used to profile both microbial composition and ARGs in stool samples collected at 6 weeks and 1 year of age from infants enrolled in the New Hampshire Birth Cohort Study. Negative binomial regression and statistical modeling was used to examine infant factors such as sex, delivery mode, feeding method, gestational age, antibiotic exposure, and infant gut microbiome composition in relation to the diversity and relative abundance of ARGs.Results: Metagenomic sequencing was performed on paired samples from 195 full term (at least 37 weeks’ gestation) and 15 late preterm (33-36 weeks’ gestation) infants. 6-week samples compared to 1-year samples had 4.37 times (95% CI: 3.54-5.39) the rate of harboring ARGs. The majority of ARGs that were at a greater relative abundance at 6 weeks (chi-squared p < 0.01) worked through the mechanism of antibiotic efflux (i.e., by pumping antibiotics out of the cell). The overall relative abundance of the resistome was strongly correlated with Proteobacteria (Spearman correlation = 78.9%) and specifically E. coli (62.2%) relative abundance in the gut microbiome. Among infant characteristics, delivery mode was most strongly associated with the diversity and relative abundance of ARGs. Infants born via cesarean delivery had a higher risk of harboring unique ARGs [relative risk = 1.12 (95% CI: 0.97 – 1.29)] as well as a having an increased risk for overall ARG relative abundance [relative risk = 1.43 (95% CI: 1.12 – 1.84)] at 1 year compared to infants born vaginally. Additionally, 6 specific ARGs were at a greater relative abundance in infants delivered by cesarean section compared to vaginally delivered infants across both time points. Conclusions: Our findings suggest that the developing infant gut resistome may be alterable by early-life exposures. Establishing the extent to which infant characteristics and early-life exposures impact the resistome can ultimately lead to interventions that decrease the transmission of ARGs and thus the possibility of antibiotic resistant life threatening infections.
Assessing Traumatic Experiences of Justice-Involved Latinx Youth A Systematic Review
Authors: Hoskins David
Published: August 2020

Background: Traumatic experiences have been linked to the unmet behavioral health needs of justice-involved youth. Unmet behavioral health needs are some of the most salient predictors of initial justice involvement and recidivism. Latinx youth are one of the most overrepresented ethnic and racial minority groups in the Juvenile Justice System in the United States. The primary aim of this systematic review was focused on justice-involved, Latinx youth in order to compare traumatic experiences and PTSD rates by race/ethnicity and gender. Methods: To ensure methodological rigor and reduce bias, a protocol was developed to outline criteria for study inclusion and to identify relevant data for extraction. For inclusion in this systematic review, studies had to be (a) observational or randomized controlled trials, (b) assess either trauma exposure or symptoms of justice-involved Latinx youth 13 to 18 years of age, (c) sample detained youth in the juvenile justice system, and (d) compare Latinx trauma experience or symptoms by gender and/or by ethnicity/race. A librarian at the University of California, San Francisco assisted to identify seminal articles in the field of juvenile justice and to identify subject headings and keyword terms from titles and abstracts. Results: Seven peer-reviewed articles were collected from PsycINFO, PubMed, and EMBASE, analyzed, and summarized. Themes from the literature were organized into the following sections: (a) participant characteristics, (b) measurement of trauma experience and PTSD, (c) types of studies, (d) trauma rates, (e) trauma exposure by race/ethnicity and Latinx gender, and (f) PTSD by race/ethnicity and gender. There were differences in the number and types of traumatic experiences that the youth were asked about, which precluded allowing direct data comparisons across studies. Most of the studies varied in their measurement of PTSD. Trauma exposure rates by race/ethnicity and Latinx gender was mixed. Latinx youth disclosed PTSD symptoms at a statistically significant higher rate than did White and Black youth. Conclusion: Trauma rate differences varied by study, presumably related to a lack of construct equivalence and variability in the number and types of traumatic experiences assessed by the measures. Further research is needed to inform appropriate assessment and treatment of justice-involved Latinx youth.
Video Analysis and Verification of Direct Head Impacts Recorded by Wearable Sensors in Junior Rugby League Players
Authors: Carey Lauchlan John , Terry Douglas P , McIntosh Andrew , Stanwell Peter , Iverson Grant L , Gardner Andrew J
Published: August 2020

Background: Rugby League is a high-intensity collision sport that carries a risk of concussion. Youth athletes are considered to be more vulnerable and take longer to recover from concussion than adult athletes. Purpose: To review head impact events in elite level junior representative rugby league and to verify and analyze x-patchTM recorded impacts via video analysis.Study Design: Observational case series.Methods: The x-patchTM was used on twenty-one adolescent players (thirteen forwards and eight backs) during a 2017 junior representative rugby league competition. Game day footage, recorded by a trained videographer from a single camera, was synchronized with accelerometer timestamps. Impacts were double verified by video review. Impact rates, playing characteristics, and game play situations were described.Results: The x-patchTM recorded 624 impacts 20g between game start and finish, of which 564 (90.4%) were verified on video. Upon video review, 413 (73.2%) of all verified impacts 20g where determined to be direct head impacts. Direct head impacts 20g occurred at a rate of 5.2 impacts per game hour; 7.6 for forwards and 3.0 for backs (range=0-18.2). A defender’s arm directly impacting the head of the ball carrier was the most common event, accounting for 21.3% (n=120) of all impacts, and 46.7% of all “hit-up” impacts. There were no medically diagnosed concussions during the competition.Conclusion: The majority (90.4%) of impacts 20g recorded by the x-patchTM sensor were verified by video. Double verification of direct head impacts in addition to cross-verification of sensor recorded impacts using a secondary source such as synchronized video review can be used to ensure accuracy and validation of data.
Prevalence of Opportunistic Infections and Associated Factors Among HIV-infected Patients on Antiretroviral Therapy in Eastern Zone of Tigray, Ethiopia:A Cross-sectional Study
Authors: Hailu Tsegu , Hagos Haftea , Gemechu Kbrom , Tesfay Haftom , Tadesse Beyene
Published: August 2020

Background: Opportunistic infections are diseases that cause infections in people whose immune systems are weakened. It is the most public health problem and the leading cause of morbidity and mortality of AIDS-related infections in developing countries. Identification of opportunistic infections is the core for developing a specific intervention. Despite this fact, information about the burden of opportunistic infections is lacking in the particular study. Therefore, this study aimed to assess the prevalence and associated factors of opportunistic infections among HIV-infected patients in Eastern zone of Tigray, northern Ethiopia. Methods: An institutional-based cross-sectional study was done among HIV/AIDS patients taking antiretroviral therapy in Northern Ethiopia. A total of 394 study subjects was selected using a systematic random sampling method. Data was collected using a structured questionnaire. The collected data was entered and analyzed by SPSS version 22. Bivariate and multivariable logistic regression analysis with 95% confidence interval were used to find factors associated with opportunistic infections. The adjusted odds ratio was calculated to show the strength of the association. Variables with p-value of < 0.05 were considered statically significant. Results: The mean age of the respondents was 41 (± 10). Of the study participants, about 52% (95% CI: 47.5-57.1) developed opportunistic infections. Being housewife occupation (AOR = 0.17; 95% CI: 0.07-0.46), CD4+ count < 200 cells/µl (AOR = 2.38; 95% CI: 1.3-4.67), poor adherence (AOR = 4; 95% CI: 1.95-8.2), and bedridden functional status (AOR = 13.9; 95% CI: 5.2-37) were independently associated with opportunistic infections. Conclusion: This study stated the prevalence of opportunistic infections among HIV-infected patients is high. Being housewife occupation, poor ART adherence, low CD4+ count, and bedridden functional status were found to be associated with development of opportunistic infections. Therefore, health care providers must give continuous health education on primary prevention of opportunistic infections.
Does Cystic Fibrosis Constitute an Advantage in COVID-19 Infection?
Authors: Bezzerri Valentino , Lucca Francesca , Volpi Sonia , Cipolli Marco
Published: August 2020

The Veneto region is one of the most affected Italian regions by COVID-19. Chronic lung diseases, such as chronic obstructive pulmonary disease (COPD), may constitute a risk factor in COVID-19. Moreover, respiratory viruses were generally associated with severe pulmonary impairment in cystic fibrosis (CF). We would have therefore expected numerous cases of severe COVID-19 among the CF population. Surprisingly, we found that CF patients were significantly protected against infection by SARS-CoV-2. We discussed this aspect formulating some reasonable theories.
Patient-Reported Maternal Care Quality Measures: A Scoping Review Protocol
Authors: Brown Kyrah K , Boateng Godfred O , Ossom-Williamson Peace , Haygood Laura
Published: August 2020

Background
Despite the global decline in maternal mortality ratio, the burden of this global health problem differs considerably by a country’s economic development status and geographic region. Research suggests that ensuring high-quality maternal care services is crucial for significantly reducing the global maternal mortality ratio. Health practitioners and researchers must be able to measure and assess maternal care quality in facilities; yet, there are many challenges such as lack of consensus on definitions and measures that may not be practical in facility settings. Whereas previous work has focused on clinical indicators used to measure maternal care quality in developing countries, this scoping review will be the first to address the ways in which patient-reported maternal care quality is defined, conceptualized, and measured across low-, middle-, and high-income countries; and to identify, evaluate, and summarize existing patient-reported measures of maternal care quality.
Methods
For this scoping review, we will conduct searches for peer-reviewed studies from Ovid MEDLINE, Embase, Amed, WHO Global Index Medicus, and grey literature sources. Published studies in English until August 31, 2020 focused on the measurement of maternal care quality will be included. Screening and data extraction will be completed independently by two members of the review team. We will analyze the evidence using a critical appraisal tool and best practice guideline for developing and validating scales.
Discussion
The review will provide researchers and practitioners with a summary of existing definitions, frameworks, and measures for assessing maternal care quality along with associated psychometric evidence. The review will also lay the groundwork for developing a comprehensive patient-reported maternal care quality measure.
Neuropsychiatric symptoms herald metabolic decline in Alzheimer’s disease
Authors: Ng Kok Pin , Pascoal Tharick A. , Mathotaarachchi Sulantha , Chan Yiong Huak , Jiang Lai , Therriault Joseph , Benedet Andrea L. , Shin Monica , Kandiah Nagaendran , Greenwood Celia M.T. , Rosa-Neto Pedro , Gauthier Serge
Published: August 2020

Background:
Neuropsychiatric symptoms (NPS) are increasingly recognized as early non-cognitive manifestations in the Alzheimer’s disease (AD) continuum. However, the role of NPS as an early marker of pathophysiological progression in AD remains unclear. Dominantly inherited AD (DIAD) mutation carriers are young individuals who are destined to develop AD in future due to the full penetrance of the genetic mutation. Hence, the study of DIAD mutation carriers enables the evaluation of the associations between pure AD pathophysiology and metabolic correlates of NPS without the confounding effects of co-existing pathologies. In this longitudinal study, we aim to identify regional brain metabolic dysfunctions associated with NPS in cognitively intact DIAD mutation carriers.
Methods:
We stratified 221 cognitively intact participants from the Dominantly Inherited Alzheimer’s Network according to their mutation carrier status. Regression mixed effect models with family-level random effects evaluated the interactions of NPS measured by the Neuropsychiatric Inventory-Questionnaire (NPI-Q), age and estimated years of onset (EYO) as a function of metabolism measured by [18F]flurodeoxyglucose ([18F]FDG) positron emission tomography in DIAD mutation and non-mutation carriers. An exploratory factor analysis was performed to identify the neuropsychiatric subsyndromes in DIAD mutation carriers using the NPI-Q sub-components. Regression mixed effect models then evaluated the interactions of specific neuropsychiatric subsyndromes with EYO and age on metabolism.
Results:
119 mutation and 102 non-mutation carriers were studied. The interaction of higher NPI-Q and shorter EYO was associated with greater global and regional [18F]FDG uptake decline in the posterior cingulate and ventromedial prefrontal cortices, bilateral parietal lobes and right insula in DIAD mutation carriers. The neuropsychiatric subsyndrome of agitation, disinhibition, irritability and depression interacted with EYO to drive [18F]FDG uptake decline in the DIAD mutation carriers. The interaction of NPI and EYO was not associated with [18F]FDG uptake in DIAD non mutation carriers.
Conclusions:
NPS in cognitively intact DIAD mutation carriers are clinical indicators of subsequent metabolic decline in brain networks vulnerable to AD. Our findings further advanced the emerging conceptual framework that NPS represent early manifestations of neuronal injury in AD.
Metastatic solitary vaginal nodule from a primary rectal tumor.
Authors: Alawneh Fade , Chaar Mohamad K. Abou , Rabah Lara , Shatnawi Qais , Gharaibeh Azza , Jaber Omar , Daoud Faiez
Published: August 2020

Introduction: An isolated vaginal metastasis from a primary colorectal adenocarcinoma is extremely rare. Based on meticulous literature review, only seven cases were reported from 1956 – 2013. Case Presentation: We present a case of a 52-year-old female patient diagnosed with rectal adenocarcinoma, underwent low anterior resection of the primary tumor, and then was found to have an asymptomatic isolated vaginal metastasis that was completely excised. Conclusion: Isolated vaginal metastatic disease is one of the rarest entities in surgical oncology with only limited cases being reported in the literature. A diagnosis can be challenging if the metastatic lesion is small and asymptomatic even with the most advanced radiological assessment tools. A meticulous examination should be done pre-operatively in order to rule out such diagnosis.
Chest wall and diaphragm reconstruction; a technique not well established in literature
Authors: Jalil Riad Abdel , Kakish Hanna , Chaar Mohamad K. Abou , Al-Qudah Obada
Published: August 2020

Introduction: The treatment for most primary chest wall tumors is wide excision. After radical chest wall resection, skeletal reconstruction, when appropriate to preserve the reconstruction, is the essential element for successful management. Case presentation: We describe a case of a 27-year-old male patient who had chest wall and diaphragm reconstruction for a recurrent chest wall tumor, using a single patch of Polytetrafluoroethylene (PTFE) mesh with diaphragm implanted into the middle of the mesh. There were no operative complications. The patient received post-operative radiotherapy with good functional and cosmetic results. Conclusion: We present a novel and safe technique resulting in stable results after full-thickness multi-rib chest wall resections involving the diaphragm.
The 100 top-Cited Studies on Ebola: A Bibliometric Analysis
Authors: Kawuki Joseph , Musa Taha Hussein , Papabathini Shireen Salome , Ghimire Upama , Obore Nathan , Yu Xiao-Jin
Published: August 2020

Background: The achievements in Ebola virus disease (EVD) prevention and control can be reflected by scientific studies, particularly in the top-cited studies. The study thus aimed to identify and characterise the 100 top-cited studies of Ebola.Methods: The study used a retrospective bibliometric analysis, which was performed in January 2020. Studies were searched from the Web of Science using the keywords: “Ebola” or “Ebola virus” or “Ebola virus disease” to identify the 100 top-cited ebola studies. Studies were analysed for the number of citations, authorship, and journal, year of publication, country and institution. The analyses were carried out using SPSS, HistCite and VOSviewer.Results: The 100 top-cited studies were published between 1977 and 2017, were cited from 169 to 808 times and had an average citation of 290.5, and 8 studies were cited more than 500 times. They were published in 31 journals, and Journal of Virology published most of the studies (n=14). They were produced by 33 countries, and the USA published most of the studies (63), followed by Germany (8) and Gabon (6). Centre for Disease prevention and Control-USA (26) was the leading institution, while Geisbert TW and Sanchez A were the most productive authors.Conclusions: This study provides insights into the historical advancements reflected by the top-cited studies and has highlighted the leading roles played by various stakeholders in addressing EVD. However, the contribution of African countries is not sufficiently reflected among these studies, and so more focus, funding and involvement in clinical research is needed for effective prevention and control of EVD in Africa.
An ultra-low magnetic field thermal demagnetizer for high-precision paleomagnetism
Authors: Qin Huafeng , Zhao Xiang , Liu Shuangch , Paterson Greig , Jiang Zhaoxia , Cai Shuhui , Li Jinhua , Liu Qingsong , Zhu Rixiang
Published: August 2020

Thermal demagnetization furnaces are widely used paleomagnetic facilities for progressive removal of naturally acquired magnetic remanence or the imparting of well controlled laboratory magnetization. An ideal thermal demagnetizer should maintain “zero” magnetic field in the sample chamber during thermal treatments. However, magnetic field noises, including the residual magnetic fields of the construction material and the induced fields caused by the alternating current (AC) in the heating element are always present, which often greatly contaminate the paleoamgnetic results at the elevated temperatures or for the magnetically weak samples. Here, we designed a new structure of heating wire named named straight core solenoid to develop a new demagnetization furnace with ultra-low magnetic field noise. Simulation and practical measurement show that the heating current magnetic field can be greatly reduced by using the new technology. Thermal demagnetization experiments demonstrate that the new demagnetizer can yield low noise results even for weakly magnetic samples.
An integer programming model to assign patients based on mental health impact for tele-psychotherapy intervention during the Covid–19 emergency
Authors: Trujillo Andrés Miniguano , Salazar Fernanda , Torres Ramiro , Arias Patricio , Sotomayor Koraima
Published: August 2020

The Covid–19 pandemic challenges healthcare systems worldwide while severely impacting mental health. As a result, the rising demand for psychological assistance during crisis times requires early and effective intervention. This contributes to the well-being of the public and front-line workers and prevents mental health disorders. Many countries are offering diverse and accessible services of tele-psychological intervention; Ecuador is not the exception. The present study combines statistical analyses and discrete optimization techniques to solve the problem of assigning patients to therapists for crisis intervention with a single tele-psychotherapy session. The statistical analyses showed that professionals and healthcare workers in contact with Covid–19 patients or with a confirmed diagnosis had a significant relationship with suicide risk, sadness, experiential avoidance, and perception of severity. Moreover, some Covid–19-related variables were found to be predictors of sadness and suicide risk as unveiled via path analysis. This allowed categorizing patients according to their screening and grouping therapists according to their qualifications. With this stratification, a multi-periodic optimization model and a heuristic are proposed to find an adequate assignment of patients to therapists over time. The integer programming model was validated with real-world data, and its results were applied in a volunteer program in Ecuador.
Computational Fluid Dynamic Models as Tools to Predict Aerosol Distribution in Tracheobronchial Airways
Authors: Atzeni Claudia , Lesma Gianluca , Dubini Gabriele , Masi Maurizio , Rossi Filippo , Bianchi Elena
Published: August 2020

Background: Aerosol and pollutants, in form of particulates 5 – 8 um in main size face every day our respiratory system as natural suspension in air or forced to be inhaled as a coadjutant in a medical therapy for respiratory diseases. This inhalation happens in children to elderly, women and men, healthy or sick and disable people. In this paper we analyzed the inhalation of aerosol in conditions assimilable to the thermal therapy, in a model of patient representing an adult man. Results: We use a computational fluid dynamic 3D model to compute and visualize the trajectories of aerosol (3-7-10-25 µm) down to the sixth generation of bronchi, in a steady and dynamic condition (7 µm) set as breath cycle at rest. Results, compared to a set of milestones experimental studies published in literature, allow the comprehension of particles behavior during the inhalation from mouth to bronchi sixth generation, the visualization of jet at larynx constriction and vortices, in a characteristic geometrical model including tracheal rings. Conclusions: Results on trajectories and deposition show the importance of the including transient physiological breath cycle on aerosol deposition analyses. Furthermore results indicate that vorticity in the glottides and trachea sections mix the trajectories on the transversal plane, excluding meaningful relation between position of the inhalation across the mouth and the deposition lobe. Numerical and graphical results, usable from researchers, technicians and medical doctors, may enable the design of medical devices and protocols to make the inhalations more effective in all the users’ population.
Hospitalized COVID-19 Patients Treated With Convalescent Plasma in a Mid-size City in The Mid West
Authors: Hartman William R , Hess Aaron S , Connor Joseph P
Published: August 2020

BackgroundSARS-CoV-2 and its associated disease, COVID-19, has infected over seven million people world-wide, including two million people in the United States. While many people recover from the virus uneventfully, a subset of patients will require hospital admission, some with intensive care needs including intubation, and mechanical ventilation. To date there is no cure and no vaccine is available. Passive immunotherapy by the transfusion of convalescent plasma donated by COVID-19 recovered patients might be an effective option to combat the virus, especially if used early in the course of disease. Here we report our experience of using convalescent plasma at a tertiary care center in a mid-size, midwestern city that did not experience an overwhelming patient surge.MethodsHospitalized COVID-19 patients categorized as having Severe or Life-Threatening disease according to the Mayo Clinic Emergency Access Protocol were screened, consented, and treated with convalescent plasma collected from local donors recovered from COVID-19 infection. Clinical data and outcomes were collected retrospectively.Results31 patients were treated, 16 severe patients and 15 life-threatened patients. Overall mortality was 27% (4/31) but only patients with life-threatening disease died. 94% of transfused patients with severe disease avoided escalation to ICU care and mechanical ventilation. 67% of patients with life-threatening disease were able to be extubated. Most transfused patients had a rapid decrease in their respiratory support requirements on or about day 7 following convalescent plasma transfusion.ConclusionOur results demonstrate that convalescent plasma is associated with reducing ventilatory requirements in patients with both severe and life-threatening disease, but appears to be most beneficial when administered early in the course of disease when patients meet the criteria for severe illness.