bluuebunny/crossref_metadata_2025 huggingface dataset:
The evolutionary landscape of primate longevity
Authors: Colchero Fernando , Aburto José , Archie Elizabeth , Boesch Christophe , Breuer Thomas , Campos Fernando , Collins Anthony , Conde Dalia , Cords Marina , Crockford Catherine , Thompson Melissa Emery , Fedigan Linda , Fichtel Claudia , Groenenberg Milou , Hobaiter Catherine , Kappeler Peter , Lawler Richard , Lewis Rebecca , Machanda Zarin , Manguette Marie , Muller Martin , Packer Craig , Parnell Richard , Perry Susan , Pusey Anne , Robbins Martha , Seyfarth Robert , Silk Joan , Staerk Johanna , Stoinski Tara , Stokes Emma , Strier Karen , Strum Shirley , Tung Jenny , Villavicencio Francisco , Wittig Roman , Wrangham Richard , Zuberbühler Klaus , Vaupel James , Alberts Susan
Published: December 2020

Is it possible to slow the rate of aging, or do biological constraints limit its plasticity? We test this ‘invariant rate of aging’ hypothesis with an unprecedented collection of 39 human and nonhuman primate datasets across seven genera. We first recapitulate, in nonhuman primates, the highly regular relationship between life expectancy and lifespan equality seen in humans. We next demonstrate that variation in the rate of aging within genera is orders of magnitude smaller than variation in pre-adult and age-independent mortality. Finally, we demonstrate that changes in the rate of aging, but not other mortality parameters, produce striking, species-atypical changes in mortality patterns. Our results support the invariant rate of aging hypothesis, implying biological constraints on how much the human rate of aging can be slowed.
Determining Intention, Fast Food Consumption and Their Related Factors Among University Students by Using A Behavior Change Theory
Authors: Didarloo Alireza , Khalili Surur , Aghapour Ahmad Ali , Mousavi Seyed Mortaza
Published: December 2020

Background Today, with the advancement of science, technology and industry, people's lifestyles such as the pattern of people's food, have changed from traditional foods to fast foods. The aim of this survey was to examine and identify factors influencing intent to use fast foods and behavior of fast food intake among students based on the theory of planned behavior (TPB). Methods A cross-sectional study was conducted among 229 university students. The study sample was selected and entered to the study using stratified random sampling method. Data were collected using a four-part questionnaire including Participants’ characteristics, knowledge, the TPB variables, and fast food consumption behavior. The study data were analyzed in SPSS software (version 16.0) using descriptive statistics (frequencies, Means, and Standard Deviation) and inferential statistics (t-test, Chi-square, correlation coefficient and multiple regressions). Results The monthly frequency of fast food consumption among students was reported 2.7 times. The TPB explained 35%, 23% variance of intent to use fast food and behavior of fast food intake, respectively. Among the TPB variables, knowledge (r=.340, p<0.001) and subjective norm (r=.318, p<0.001) were known as important predictors of intention to consume fast foods - In addition, based on regression analyses, intention (r=.215, p<0.05), perceived behavioral control (r=.205, p<0.05), and knowledge (r=.127, p<0.05) were related to fast food consumption, and these relationships were statistically significant. Conclusions The current study showed that the TPB is a good theory in predicting intent to use fast food and the actual behavior. It is supposed that health educators use from the present study results in designing appropriate interventions to improve nutritional status of students.
GR chaperone cycle mechanism revealed by cryo-EM: the GR-loading complex
Authors: Agard David , Wang Ray , Noddings Chari , Kirschke Elaine , Myasnikov Alexander , Johnson Jill
Published: December 2020

Maintaining a healthy proteome is fundamental for organism survival1. Integral to this are Hsp90 and Hsp70 molecular chaperones that together facilitate the folding, remodeling and maturation of Hsp90’s many “client” proteins. The glucocorticoid receptor (GR) is a model client strictly dependent upon Hsp90/Hsp70 for activity. Chaperoning GR involves a cycle of inactivation by Hsp70, formation of an inactive GR:Hsp90:Hsp70:Hop “loading” complex, conversion to an active GR:Hsp90:p23 “maturation” complex, and subsequent GR release. Unfortunately, a molecular understanding of this intricate chaperone cycle is lacking for any client. Here, we report the cryo-EM structure of the GR loading complex, in which Hsp70 loads GR onto Hsp90, revealing the molecular basis of direct Hsp90/Hsp70 coordination. The structure reveals two Hsp70s––one delivering GR and the other scaffolding Hop. Unexpectedly, the Hop cochaperone interacts with all components of the complex including GR, poising Hsp90 for subsequent ATP hydrolysis. GR is partially unfolded and recognized via an extended binding pocket composed of Hsp90, Hsp70 and Hop, revealing the mechanism of GR loading and inactivation. Together with the GR maturation complex (Noddings et al., 2020), we present the first complete molecular mechanism of chaperone-dependent client remodeling, establishing general principles of client recognition, inhibition, transfer and activation.
Rare coding variants in axonemal dynein heavy chain genes are associated with adolescent idiopathic scoliosis
Authors: Wang Yunjia , Liu Zhenhao , Yang Guanteng , Troutwine Benjamin , Gao Yang , Chen Hao , Xiao Lige , Li Jiong , Terune Elizabeth , Wethey Cambria , Guo Chaofeng , Tang Mingxing , Miller Nancy , Xu Shuhua , Xie Lu , Zhang Hongqi , Gray Ryan
Published: December 2020

Adolescent idiopathic scoliosis (AIS) is the most common pediatric musculoskeletal disorder worldwide, characterized by atypical spine curvatures in otherwise healthy children. Human genetic studies have identified candidate genes associated with AIS, however, only a few of these genes have been shown to recapitulate adult-viable scoliosis in animal models. To further define susceptibility loci for AIS, we performed whole exome sequencing on a cohort of 195 Han Chinese AIS patients and 229 healthy controls. We identified members of the axonemal dynein family associated with both sporadic and familial AIS. We demonstrate that disruption of the dynein axonemal heavy chain 10 (dnah10) gene results in recessive adult-viable scoliosis in zebrafish. These dnah10 mutant zebrafish display reduced ependymal cilia beating and a disassembly of the Reissner fiber in the hindbrain and spinal canal, concurrent with the onset of body curvatures. Altogther, these results demonstrate that mutations in axonemal dynein genes are linked with human AIS and suggest that ependymal cell cilia function plays an essential role in maintaining spine alignment in humans.
Wafer-scale integration of stretchable semiconducting polymer microstructures via capillary gradient
Authors: Qiu Yuchen , Zhang Bo , Yang Junchuan , Gao Hanfei , Li Shuang , Wang Le , Wu Penghua , Feng Jiangang , Wu Yuchen , Jiang Lei
Published: December 2020

Organic semiconducting polymers have opened a new paradigm for soft electronics due to their intrinsic flexibility and solution processibility. However, the contradiction between the mechanical stretchability and electronic performances restricts the implementation of high-mobility polymers with rigid molecular backbone in highly deformable devices. Here, we report the realization of high electronic performance and high stretchability on curvilinear polymer microstructures fabricated by solution-processing capillary-gradient-mediated assembly method. Curvilinear polymer microstructure arrays are fabricated with highly ordered molecular packing, precisely controlled geometry and alignment, and wafer-scale homogeneity, leading to high hole mobilities of 4.3 and 2.6 cm2 V− 1 s− 1 under zero and 100% strain, respectively. Fully stretchable field-effect transistors and logic circuits can be integrated through all-solution process using assembled curvilinear microstructure semiconducting channels, organic dielectrics and carbon-nanotube electrodes. Based on these fully stretchable devices, 92% preservation of carrier mobility is realized after 1000 stretch-release cycle under 50% strain. Long-range homogeneity is demonstrated with the narrow distribution of height, width, mobility, on-off ratio and threshold voltage across a four-inch wafer. This solution-assembly method provides a platform for wafer-scale and reproducible integration of high-performance soft electronic devices and circuits based on conjugated organic semiconductors.
Landslide Susceptibility Zonation Using Geospatial Technologies and Multi Criteria Evaluation Techniques in Upper Didessa Sub-basin, Southwest Ethiopia
Authors: Mohammednur Redwan Sultan , Gemeda Dessalegn Obsi , Deribew Kiros Tsegay
Published: December 2020

Landslide is a serious geo-hazard that poses destruction and loses of life in different part of the world. The severity of the problem is higher in developing countries like Ethiopia. This study is aimed at assessing the spatial landslide susceptibility in the upper Didessa sub-basin using GIS and multi criteria evaluation (MCE) techniques. In order to reach this objective both primary (field survey) and secondary data (expert interview, literature, remote sensing data, digital soil map and geological map) were obtained from various source. Eleven landslide causative factor identified in this research are slope, aspect, drainage density, topographic wetness index (TWI), stream power index (SPI), topographic ruggedness index, hypsometric integral, lithology, LULC, soil texture, and distance from road. The analytical hierarchy process (AHP) method was employed to identify the weight of each indicator from the pairwise comparison matrix. The weighted linear combination was then used to generate landslide susceptibility map (LSM). Based on landslide susceptibility, the study area was classified into very high, high, moderate, low, and very low susceptibility zones. Finally, based on the eleven-landslide causative factor analysis, about 24% of the study area is moderately susceptible, while 12% and 6% were classified as high and very high susceptibility to landslides, respectively. The results of this study could help decision makers for future landslide hazardous preventions and mitigation strategies.
Perceptions of Oncology as a Career Choice Among the Early Career Doctors in Pakistan
Authors: Rehman Muhammad Aemaz , Farooq Hareem , Rehman Muhammad Ebaad , Ali Muhammad Mohsin , Zafar Amjad , Khokhar Muhammad Abbas
Published: December 2020

Background: The lack of oncologists is a growing global concern. In Pakistan the scarcity of oncologists compared to the growing cancer burden is alarming, with approximately only 125 trained oncologists available for a population above 201 million. Furthermore, oncology is a lower ranked professional field of choice among Pakistani medical students. This study aims to determine the opinions of young doctors regarding oncology and the factors affecting their preferences in order to devise strategies to attract more doctors into the field.Methods: A cross-sectional study using non-probability sampling technique was conducted across various public and private sectors hospitals of Lahore, Pakistan, from March to November 2019. 300 doctors were interviewed via a close-ended, pre-validated questionnaire, which included demographic details as well as assessment of perception regarding oncology on the basis of workplace environment, financial and emotional aspects, nature of work and scope of field. Data was analyzed by SPSS 23 with quantitative variables presented as mean ± S.D, and qualitative variables presented as frequency and percentages. The influence of perceptions on ‘Oncology as a Career Choice’ was determined by binary logistic regression analysis.Results: Out of 300, a huge majority of 72.7% chose not to prefer oncology as a career if given a chance to decide. The positive perceptions about oncology in descending order were: progressive field (85.3%), gender-neutral specialty (77%), stable working hours (61%), financially healthy specialty (47.7%) and work-family balance (46.7%). Among the top negative perceptions were: lack of oncologic facilities in Pakistani hospitals (70%), radiation exposure (66%), need for private practice (60.7%), poor patient prognosis (56.7%), high patient load (55.7%) and depression (54.3%). The most influential factors in favor of/against the choice were late presentation of patients leading to poor prognosis, cancer survivor/ death in the family, already having an oncologist in the family, type of medical school attended, stage of medical career and future plan to settle abroad.Conclusion: Alignment of the environment in oncology with the preferences of young doctors and addressing their concerns are key to attracting doctors to this field. This can minimize the doctor-population discrepancy in this field in our country.
Feasibility of a High-Pitch Protocol for Transcatheter Aortic Valve Replacement Evaluation in Patients not Suitable for ECG-Gated CT
Authors: Shnayien Seyd , Bressem Keno , Beetz Nick , Vahldiek Janis , Hamm Bernd , Niehues Stefan
Published: December 2020

High-Pitch CT for TAVR Evaluation in Patients not Suitable for ECG-GatingThe use of transcatheter aortic valve replacement (TAVR) has been established to be non-inferior to surgical aortic valve replacement (SAVR). As a result, in the United States, more patients now undergo TAVR than SAVR. It is recommended that preprocedural CT imaging for aortic valve evaluation and optimal sizing should include an ECG-gated scan of, at least, the aortic root. However, many patients suffer from concomitant tachyarrhythmias such as atrial fibrillation, which may seriously degrade the diagnostic accuracy of ECG-gated scans. The aim of the present study is to explore whether a high-pitch non-ECG-gated computed tomography angiography (CTA) of the entire aorta can render similar diagnostic preprocedural images as a standard ECG-gated scan. 108 patients were included. Objective image quality parameters such as image noise, CNR and SNR as well as subjective image quality analysis by two different readers were compared. The results showed a significant increase in image noise at the level of the aortic root with use of the high-pitch protocol (p = 0.001). Otherwise, our study revealed no significant differences in subjective and objective image quality. Diagnostic image quality was achieved in all patients without a record of inaccurate sizing in the surgical reports or subsequent patient histories.
Novel structure of active platinum-bismuth site for oxidation of carbon monoxide
Authors: Nan Bing , Fu Qiang , Shu Miao , Zhou Lulu , Wang Wei-Wei , Jia Chun-Jiang , Ma Chao , Chen Jun-Xiang , Li Lina , Si Rui
Published: December 2020

As the technology development, the future advanced combustion engines must be designed to perform at a low temperature. Thus, it is a great challenge to synthesize high active and stable catalysts to resolve exhaust below 100 °C. Here, we report that bismuth as a dopant added to form platinum-bismuth cluster on silica for CO oxidation. The highly reducible oxygen species provided by surface metal-oxide (M-O) interface could be activated by CO at low temperature (~ 50 °C) with a high CO2 production rate of 487 µmolCO2·gPt−1·s− 1 at 110 °C. Experiment data combined with density functional calculation (DFT) results demonstrate that Pt cluster with surface Pt−O−Bi structure is the active site for CO oxidation via providing moderate CO adsorption and activating CO molecules with electron transformation between platinum atom and carbon monoxide. These findings provide a novel and general approach towards design of potential outstanding performance catalysts for redox reaction.
ICG Fluorescence Imaging in Colorectal Surgery: A Snapshot from the ICRAL Study Group
Authors: Baiocchi Gian Luca
Published: December 2020

BackgroundFluorescence-guided visualization represents a recently proposed technology in colorectal surgery. Possible uses include perfusion evaluation, lymph node navigation and search for hepatic metastases and peritoneal spread. Despite the absence of high-level evidence, this technique gained considerable popularity among colorectal surgeons, due to its significant reliability, easy and safe use and the relatively low cost. However, the actual use of this technique in daily clinical practice has not been reported to date.MethodsThe survey was conducted on April 2020 among 44 centres dealing with colorectal diseases, participating to the Italian ColoRectal Anastomotic Leakage (iCral) study group. Surgeons were about equally divided on the basis of a geographical criterion from multiple Italian regions, with a large proportion of public (89.1%) and non-academic (75.7%) centres. They were invited answering to an online survey in order to make a snapshot of their current behaviours regarding the use of fluorescence-guided visualization in colorectal surgery. Questions about technological availability, indications and techniques, personal approach and feeling were collected in a 23-item questionnaire.ResultsQuestionnaire replies were received from 37 institutions, and partially answered by 8 of them, who don’t have the fluorescence technology (21.6%). Out of the remaining 29 centres (78,4%), fluorescence is utilized in all laparoscopic colorectal resections by 72.4% of surgeons and only in selected cases in the remaining 27.6%, while 62.1% of respondents don’t use fluorescence in open surgery (unless the perfusion is macroscopically doubtful with the naked eye for 41.4% of them). The survey also suggests that there is no agreement on dilution, dosing and timing, as many different practices are adopted, based on personal belief. Only about half of surgeons reported reduced leak rate with fluorescence perfusion assessment, but 65.5% of them strongly believe that this technique will become a minimum requirement in colorectal surgery in the future. ConclusionThe survey confirms that fluorescence is becoming a widely used technique in colorectal surgery. However, both the indications and methods still vary considerably; furthermore, the surgeons' perception of results is still not enough to consider this technology essential. This survey emphasizes the need for further research to reach recommendations based on solid scientific evidences.
The Force Effects of Two Types of Polyethylene Terephthalate Glyc-olmodified Clear Aligners Immersed in Artificial Saliva
Authors: Xiang Biao , Wang Xingxing , Wu Gang , Xu Yichen , Wang Menghan , Yang Yanjing , Wang Qingyu
Published: December 2020

Numerous factors can influence the force exerted by clear aligners teeth. This study aimed to investigate the stability of the force delivered by two different material appliances. 90 clear aligners with 2 materials and three different activations were designed and fabricated. Then, a device was employed to measure the force generated by the two types of PET-G material appliances immersed in artificial saliva for 0, 3, 7, 10, 14 days. Scanning electron microscopy was applied to observe the morphologic alterations on the aligner surfaces, respectively. The forces generated by different activation appliance exhibited differently, 0.0 mm < 0.1 mm < 0.2 mm. In addition, increasing the immersion times and the orthodontic force also decreased , but the forces decreased differently. Compared with the forces of conventional PETG appliances with 0.20 mm activation, the modified PETG appliances with the same activation exhibited significantly higher mean force. When comparing the mean force for modified PETG appliances after 10 and 14 days with conventional PETG appliances, the delivery forces exhibited significant differences (P<0.05). The force delivered by both materials decreased obviously following artificial saliva immersion, and the force generated by modified aligners exhibited better stability than conventional aligners.
Multimorbidity Clustering of the Emergency Department Patient Flow: Impact Analysis of New Unscheduled Care Clinics
Authors: Wartelle Adrien , Mourad-Chehade Farah , Yalaoui Farouk , Questiaux Hélène , Monneret Thomas , Solivau Ghilain , Chrusciel Jan , Duclos Antoine , Laplanche David , Sanchez Stéphane
Published: December 2020

Background: In France, the number of admissions to emergency departments doubled between 1996 and 2016, leading to overcrowding. To cope with the resultant overcrowding, redirecting patients to new healthcare services is a viable solution, to spread demand more evenly across available healthcare delivery points, and render care more efficient. The goal of this study was to analyse the impact of opening new unscheduled care services on variations in patient attendance at a large emergency department. Methods: We performed a before-and-after study investigating the use of unscheduled care services in the Aube Department (Eastern France), focusing on emergency department attendance of Troyes Hospital. We applied a hierarchical clustering based on co-occurrence of diagnoses, to divide the population into different multimorbidity profiles and study their temporal trends. A multivariate logistic regression model was constructed to adjust the period effect for appropriate confounders. Results: In total, 120,718 visits to the emergency department were recorded over a 24-month period (2018-2019), and 14 clusters were identified accounting for 94.76% of all visits. The before-and-after analysis showed a decrease of 57.95 visits per week in 7 specific clusters, while the consumption of unscheduled health care services increased by 328.12 visits per week.Conclusions: Using an innovative and reliable methodology to evaluate changes in patient flow through the emergency department, our results could help to inform public health policy regarding the implementation of unscheduled care services, to ease pressure on emergency departments.
Comparative Effectiveness of and Maternal Acceptability with Cervical Ripening uSing cErvicaL Massage vErsuS Membrane Sweep (CEASELESS): A Randomized Controlled Trial
Authors: Madugalle T.M.S.S.B , Jayasundara D.M.C.S
Published: December 2020

Methods-This randomized controlled non-blinded clinical trial conducted at a leading tertiary obstetric care unit in Colombo, Sri Lanka, compared the maternal acceptability and effectiveness of membrane sweep (MS) and cervical massage (CM) in ripening uterine cervix to avoid formal induction of labour. MS, CM and control (C) groups had 104, 106 and 102 women after randomization. Primiparous women underwent either MS or CM at 39th and 40th weeks while multiparous women underwent at 40th week of gestation only. All were followed up until 24 hours postpartum. 100, 102 and 101 women in MS, CM and C groups respectively were included in the analysis. Results- Overall, MS significantly improved Modified Bishop’s Score (MBS) to ≥7 compared to C (p=0.0310) but not compared to CM (p=0.2639). There was no significant improvement of MBS after CM compared to C (p=0.2795). Among primiparous (p=0.047) and multiparous (p=0.038) women separately, mean survival times without going into labour (MBS ≥7) were significantly shorter after MS compared to C but not compared to CM. Hospital stay for delivery was less overall after both MS (p=0.0015) and CM (p=0.0197). There were no significant differences between MS, CM and C groups with regards to synthetic oxytocin use, uterine hyperstimulation during labour, emergency cesarean section rate in labour, postpartum hemorrhage, maternal fever and APGAR score at 5 minutes. Maternal acceptability was assessed using a validated questionnaire consisting of 4 Likert scale items (S-CVI = 0.875; Cronbach’s Alfa = 0.876). Maternal acceptability score of CM was significantly higher than that of MS during overall analysis as well as during subgroup analysis according to parity (p=0.0011). Conclusions- MS is an effective adjunct to induction which ripens cervix, prevents formal induction of labour (NNT = 7), significantly reduces the duration of pregnancy and shortens hospital stay for delivery overall. Although CM is more acceptable than MS and shortened hospital stay for delivery overall, it is not an effective method to ripen the uterine cervix or to prevent formal induction labour regardless of parity. This trial was self-funded. Trial Registration No - SLCTR/2020/003, Universal Trial Number - U 1111-1244-8026.
Preoperative C-Reactive Protein to Albumin Ratio and Oral Health in Oral Squamous Cell Carcinoma Patients
Authors: Keinänen Arvi , Uittamo Johanna , Marinescu-Gava Magdalena , Kainulainen Satu , Snäll Johanna
Published: December 2020

Background The C-reactive protein to albumin (CRP/alb) ratio can predict early mortality of a hospitalized patient. We evaluated factors that influence the preoperative CRP/alb ratio in oral squamous cell carcinoma (OSCC) patients and in particular clarified the role of oral health to this ratio. Materials and Methods Data from surgically treated OSCC patients were collected retrospectively. Patient 3-month mortality was recorded. The outcome variables were preoperative CRP/alb ratio, CRP level, and alb level. The studied predictors were total number of teeth, periodontal stability, marginal bone loss, tumour stage, T-class, lymph node status, and site. The statistical significance of age, sex, comorbidity combination of age and disease history (Charlson Comorbidity Index [CCI]), smoking, and alcohol history for outcome variables were evaluated.Results A total of 159 patients were included in the study. The early mortality was 3.8%. CRP/alb was higher in these patients than in those who survived. The only independent variables for CRP/alb changes were CCI and heavy alcohol use. The CRP/alb ratio was significantly lower in non-heavy alcohol users (odds ratio [OR] 0.114, 95% confidence interval [CI] 0.024-0.541; adjusted p=0.006) than in other patients. Patients with CCI 0-1 were more likely to have a lower CRP/alb ratio than patients with CCI ≥5 (OR 0.033, 95% CI 0.004-0.284; adjusted p=0.002). Conclusions The CRP/alb ratio was high in OSCC patients with combined comorbities of age and disease history and in patients with heavy alcohol use. Oral health or tumour-related variables did not independently affect the CRP/alb ratio. The CRP/alb ratio appears suitable for prediction of OSCC patient early survival.
Assessment of Macular Function in Patients With Non-Vascularized Pigment Epithelial Detachment
Authors: Asaoka Ryo , Inoue Tatsuya , Amari Tatsuaki , Komatsu Kayoko , Yamamoto Motoshi , Ogawa Asako , Aoki Nobuyori , Yamanari Masashiro , Sugiyama Satoshi , Aihara Makoto , Kato Satoshi , Azuma Keiko , Maruyama-Inoue Maiko , Kadonosono Kazuaki , Obata Ryo , Kitano Marie , Fujita Asahi
Published: December 2020

Non-vascularized pigment epithelial detachments (PED) are usually associated with dry age-related macular degeneration (AMD). In this study, we aimed to investigate the correlation between visual function and morphologic parameters. Seventeen eyes of eleven patients with non-vascularized AMD were enrolled. In addition to conventional optical coherence tomography (OCT), polarization-sensitive optical coherence tomography (PS-OCT) measurements were performed by evaluating the regularity of retinal pigment epithelium (RPE) entropy within the PED area. Retinal sensitivity was measured with MP-3 microperimetry, and retinal sensitivities within (RSin) and outside (RSout) the PED area were calculated. The relationship between OCT parameters and visual function was analyzed. As a result, there was a significant difference between the RSin and RSout (p < 0.001, Wilcoxon signed rank test). Moreover, RSin was significantly related to logMAR VA (p = 0.033, linear mixed model). The regularity of RPE entropy was significantly related to visual acuity and RSin (p = 0.00038, p = 0.031, linear mixed model), although neither the height nor area of PED correlated with visual function. Our results suggest that retinal sensitivity is significantly deteriorated within the PED area and RPE entropy measured with PS-OCT was closely related to visual function in eyes with non-vascularized PED.
Malnutrition Concerning Geriatric Depression and Associated Risk Factors: A Community-based Case-control Study in Rural Elderly of Bangladesh
Authors: Islam Md Ziaul , Disu Tasnim , Farjana Shatmin , Rahman Mohammad
Published: December 2020

Background: Malnutrition and depression are highly prevalent in the elderly and can lead to disparaging outcomes. Analytical studies on malnutrition concerning geriatric depression (GD) are very scarce in Bangladesh, although the size of the elderly population is increasing fast in the country. The current study aimed to assess the association between malnutrition and depression and associated risk factors in the rural elderly.Methods: A case-control study was conducted in 600 elderly residents (aged ≥60 years) of three rural communities of Bangladesh from January to October 2019. Three hundred depressed elderly people were enrolled as cases and 300 non-depressed elderly individuals were included as community controls by matching the age and living area of the cases. We used a semi-structured questionnaire based on the Geriatric Depression Scale-15 and the Bangla version of Mini-Nutritional Assessment-Short Form to collect data through face-to-face interviews. Measures included baseline and personal characteristics, malnutrition, GD, and associated risk factors. A binary logistic regression model was fitted to identify variables associated with the risk of GD.Results: The study found no significant difference in gender (male Vs. female) between cases (44.0% Vs. 56.0%) and controls (46.0% Vs. 54.0%). The study revealed that malnutrition was significantly (p<0.01) higher in cases (56.0%) than in controls (18.0%). The malnourished elderly had around three times AOR=3.155; 95% CI: 1.53-6.49, p=0.002) more (risk of having depression than the controls. The unemployed elderly (AOR=4.964; 95% CI: 2.361-10.440; p=0.0001) and the elderly of the lower and middle class (AOR=3.654; 95% CI: 2.266-7.767; p=0.001) were more likely to experience depression. The elderly having a poor diet were more likely to experience depression (AOR=3.384; 95% CI: 1.764-6.703; p=0.0001). The single elderly (AOR=2.368; 95% CI: 1.762-6.524; p=0.001) and the elderly tobacco users (AOR=2.332; 95% CI: 1.663-5.623; p=0.003) were more likely to experience depression.Conclusions: A significant association between malnutrition and depression is evident in the rural elderly individuals of Bangladesh. It will be a prolific initiative if policymakers merge malnutrition and the risk factors associated with geriatric depression in the provision of universal health care for better health and well-being of the rural elderly populations.
Missed Care in Neonatal Intensive Care Unit: Effect of Eletronic Reminders  
Authors: Bahrami Fereshteh , Forouzi Mansooreh Azizzadeh , Nematollahi Monirsadat , J. Beatrice Kalisch , Bagherian Behnaz
Published: December 2020

Background: Missed nursing care is a newly defined concept and refers to any aspect of required patient care that is omitted or delayed. This study aimed to determine the effectiveness of electronic reminders on missed care in NICU.Methods: This is a two groups (before and after) quasi experimental study. A random sampling technique was employed to collect a sample of 70 nurses among two NICUs in an educational hospital in the south east of Iran. Miss care questionnaire was used to determine Missed care before, immediate, and one month after the intervention. The study intervention includes sending electronic reminders regarding nursing care of NICU hospitalized neonate. Data were analyzed using SPSS20 software, descriptive (frequency, percentage, mean, and standard deviation), and analytical statistics. The level of significance was considered as 0.05.Results: The results showed that the mean score of missed care was decreased after intervention in the intervention group (6.74±8.47) rather than the control group (18.57±14.59) (P=0.001). The highest and the lowest mean score of missed care before and after the intervention was in general care and oxygen therapy domains in both groups. The second time intervention was one month after did not show any significant differences in the two groups. But decreasing in missed care was shown in both groups.Conclusion: using information technologies like whatsApp is an easy, low cost and available method which could help nurses decrease missed nursing care.
Validation of Claims-based Definitions for Identifying Rheumatoid Arthritis: A Hospital-based Cross-sectional Study Conducted in 64 Hospitals in Japan
Authors: Kubota Kiyoshi , Yoshizawa Masaki , Takahashi Satoru , Fujimura Yoshiaki , Nomura Hiroko , Kohsaka Hitoshi
Published: December 2020

BackgroundAn administrative database covering a whole population such as the national database in Japan may be used to estimate the nationwide prevalence of diseases including rheumatoid arthritis (RA) when a well-validated definition of the disease is available. In Japan, the record-linkage between the administrative database and medical charts in hospitals is strictly prohibited. A “hospital-based” validation study is one of few possible validation studies where claims kept inside the study hospital are rearranged into the database structure. MethodsRandom samples of 19,734 patients were selected from about 1.6 million patients who received medical care between February 2018 and January 2019 in one of the 64 hospitals of the Tokushukai Medical Group. We excluded patients whose observation period was less than 365 days and identified 334 patients who met the definition of “possible cases of RA” whose medical chart was then evaluated by two rheumatologists independently. In a sensitivity analysis, we evaluated bias due to misclassifying some patients with RA who did not meet the definition of “possible cases of RA” as a patient with no RA.ResultsThe kappa coefficient between two rheumatologists was 0.80. The prevalence of RA in the study population was estimated as 0.56%. We found [condition code of RA] and ([any disease-modifying antirheumatic drug] or [oral corticosteroid with no systemic autoimmune diseases (other than RA) and no polymyalgia rheumatica]) had a relatively high sensitivity (around 73%) and a high positive predictive value (around 80%). In a sensitivity analysis, we found that when some patients with RA who did not meet the definition of “possible cases of RA” were misclassified as a patient with no RA, then this would lead to underestimation of the prevalence of the definition-positive patients and the adjusted prevalence.ConclusionsWe recommend using the claims-based definition of RA (found in the current validation study in the 64 hospitals) to estimate the prevalence of RA in Japan. We also recommend estimating the adjusted prevalence using the quantitative bias analysis method because the prevalence of the disease in the “hospital-based” validation study is different from that in the administrative database.Trial registration: The current study is not a clinical trial and thus is not subject to trial registration.
Factors Affecting of Road Traffic Injuries in the Lower Southern Region of Thailand: A Content Analysis of Road Traffic Investigation Reports, 2006-2019
Authors: Klinjun Nuntaporn , Kelly Matthew , Praditsathaporn Chanita , Petsirasan Rewwadee
Published: December 2020

Background – Thailand has the second highest rates of road traffic mortality globally. Detailed information on the combination of human, vehicle and environmental risks giving rise to each incident is important for addressing risk factors holistically. This paper presents the result of forensic road traffic investigation reports in Thailand and determines risk factor patterns for road traffic injuries.Methods – Detailed forensic reports were extracted for 25 serious traffic accident events. For each report, accidents were characterized by the number of vehicles, number and type of injuries and deaths, road user types, involvement of roadside hazards, medical care provided, and human, vehicular and environmental influences on the incident. The Haddon matrix was used to analyse risk factors in three phases (pre-event, event, post-event) stratified by four agents (human, vehicle, physical and socio-economic environment).Results - The 25 events analyzed involved 407 victims and 47 vehicles. 65.8% of victims were injured, including 22.0% who died. Median age of those injured was 27 years, and 28 years for fatalities. Vehicles crashing with fixed objects, and pickup-related crashes, accounted for the majority of accidents and deaths. Head or neck trauma was the main cause of death. The majority (61%) of deaths occurred at the scene. Human error-related factors included speeding, and drowsiness from night and long-distance driving. Passenger risks included not using seat belt, sitting in cargo area and the cab of pickups. Not having anyone trained in first aid on the scene, first aid being provided by bystanders, and delayed calls to Emergency Medical Services increased injury risk. Overloaded vehicles, unsafe car modifications, no occupant safety equipment, and having unfixed seats were vehicular risks. Environmental risks included fixed objects on the roadside, no traffic lights, no guard rails, no traffic sign, road accident black spots, and hazardous objects roadside.Conclusions - Thailand must address all three temporal phases of the Haddon model and all three factors – human, vehicle and environment. At present traffic accidents cause much avoidable severe injury and death. The Haddon matrix is useful to structure road traffic investigations, revealing multi-level factors common on Thai roads. Keywords: Road traffic injury, Risk factor, Road traffic investigation, Haddon matrix
In Vitro Anti-Trypanosoma Cruzi Activity of Halophytes From Southern Portugal Reloaded: A Special Focus on Sea Fennel (Crithmum Maritimum L.)
Authors: Pereira Catarina , Moraes Carolina , Franco Caio , Grougnet Raphaël , Barbosa Euzébio , Panciera Michele Michele , Correiae Carlos Roque , Rodrigues Maria João , Custódio Luísa
Published: December 2020

Marine halophytes are an outstanding reservoir of natural products and several species have anti-infectious traditional uses. However, little is known about their potential against neglected tropical ailments, such as Chagas disease. This work evaluated for the first time the in vitro anti-Trypanosoma cruzi activity of extracts from the aromatic and medicinal species Helichrysum italicum subsp. picardii (Boiss. & Reut.) Franco (Asteraceae, everlasting) and Crithmum maritimum L. (Apiaceae, sea fennel). For that purpose, decoctions, tinctures and essential oils from everlasting’s flowers and sea fennel’s stems, leaves and flowers were tested against intracellular amastigotes of two T. cruzi strains. Sea fennel’s flowers decoction displayed significant anti-trypanosomal activity and no toxicity towards the host cell (EC50 = 17.7 µg/mL, selectivity index > 5.65). This extract was partitioned using liquid-liquid extraction affording 5 fractions that were re-tested in the same model of anti-parasitic activity. Fraction 1 was the most active and selective (EC50 = 0.47 μg/mL, selectivity index = 59.6) and was submitted to preparative thin layer chromatography. The major compound present, likely responsible for the observed anti-trypanosomal activity, was identified as falcarindiol. Target fishing studies showed falcarindiol as a ligand of T. cruzi spermidine synthase, pointing to a potential enzyme-inhibiting anti-trypanosomal mechanism of action.
Global, Regional, and National Burden of Multiple Myeloma from 1990 to 2019: Estimates from the 2019 Global Burden of Disease study
Authors: Zhou Linghui , Yu Qin , Wei Guoqing , Wang Linqin , Huang Yue , Hu Kejia , Hu Yongxian , Huang He
Published: December 2020

BackgroundMultiple myeloma (MM) is a major health concern. Understanding the different burden and tendency of MM in different regions is crucial for formulating specific local strategies. Therefore, we evaluated the epidemiologic patterns and explored the risk factors for MM death.MethodsData on MM were collected from the 2019 Global Burden of Disease study. We used incidence, mortality, and disability adjusted life-years to estimate the global, regional, and national burden of MM. ResultsIn 2019, there were 155,688 (95% UI, 136,585 – 172,577) MM cases worldwide, of which 84,516 (54.3%, 70,924 – 94,910) were of men. The age-standardized incidence rate (ASIR) was 1.72/100,000 persons (95% UI, 1.59 – 1.93) in 1990 and 1.92/100,000 persons (95% UI, 1.68 - 2.12) in 2019. The number of MM deaths increased 1.19-fold from 51,862 (95% UI, 47,710–58,979) in 1990 to 113,474 (95% UI, 99,527 – 121,735) in 2019; the age-standardized death rate (ASDR) was 1.42/100,000 persons (95% UI, 1.24 - 1.52) in 2019. Countries with high social-demographic indexes exhibited a higher ASIR and ASDR. Australasia, North America, and Western Europe had the highest ASIR and ASDR, with 46.3% incident cases and 41.8% death cases. Monaco had the highest ASIR and ASDR, which was almost half as high as the second highest country Barbados. In addition, United Arab Emirates and Qatar had the largest growth multiple in ASIR and ASDR, which was twice the third country Djibouti.ConclusionsGlobally, incident and death MM cases have more than doubled over the past 30 years. The increasing global burden may continue with population aging, whereas mortality may continue to decrease with the progression of medical technology. The global burden pattern of MM was diverse, therefore specific local strategies based on different burden patterns for MM are necessary.
High Cell Density and Antimicrobial Persistence in Streptococcus Pyogenes 
Authors: Martini Caroline , Coronado Amada , Melo Maria Celeste , Gobbi Clarice , Lopez Úrsula , Mattos Marcos , Amorim Thais , Botelho Ana Maria , Vasconcelos Ana Teresa , Almeida Luiz Gonzaga , Planet Paul , Zingali Russolina , Figueiredo Agnes Marie , Ferreira-Carvalho Bernadete
Published: December 2020

Streptococcus pyogenes (group A Streptococcus-GAS) is an important pathogen for humans. GAS has been associated with severe and invasive diseases. Despite the fact that these bacteria remain universally susceptible to penicillin, therapeutic failures have been reported in some GAS infections. Many hypotheses have been proposed to explain these antibiotic-unresponsive infections, however none of them has fully elucidated this phenomenon. In this study, antimicrobial persistence emerged when GAS strains were grown at high cell density. Strong efflux activity was detected, and gene expression assays by real-time qRT-PCR showed upregulation of some genes associated with efflux pumps in persistent cells arising in the presence of penicillin. Subsequent phenotypic reversion and whole-genome sequencing indicated that this event was due to non-inherited resistance mechanisms. The tiny persistent colonies showed downregulation of genes associated with protein biosynthesis and cell growth, as demonstrated by gene expression assays. Moreover, proteomic analyses showed that susceptible cells express higher levels of ribosome proteins. The generation of persistent cells due to high bacterial load might be an important mechanism of clinical resistance in GAS invasive infections that has been overlooked. The phenomenon described here might shed some light on the origin of therapeutic failures in S. pyogenes infections.
Comparison of the Mutation Profiles of Triple-Negative Breast Cancers and Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Breast Cancers at the T2N0-1M0 Stage
Authors: Lee Seungju , Kim Hyun Yul , Jung Youn Joo , Paik Hyun-June , Jung Chang Shin , Kim Jee Yeon , Lee Sun Min , Oh Seung Hwan
Published: December 2020

BackgroundTriple-negative breast cancer (TNBC) has higher loco-regional recurrence and visceral metastasis compared to other breast cancer subtypes; however, little is known about the molecular pathogenesis and therapeutic targets of TNBC. Therefore, we compared the mutation profiles of early TNBC with those of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2) breast cancer using a customized next-generation sequencing capture panel.MethodsDNA was obtained from the primary tumor tissues of 34 patients diagnosed with pT2N0-1M0 HR+/HER2 breast cancer or TNBC. To enrich the 48 breast cancer-associated genes, 21,192 probes were designed using the SureSelect design tool. After library preparation using the SureSelect XT kit (Agilent), paired-end DNA sequencing was performed on a HiSeq platform (Illumina). The mean depth of the target regions was 1,766 (×). The subsequent output containing genetic variation was analyzed using a pipeline of bioinformatics tools. Significant mutations with allele frequencies of more than 30% were checked for their germline counterparts in the peripheral blood. Circulating cell-free nucleic acids were extracted and analyzed with a therascreen® PIK3CA RGQ PCR kit (QIAGEN).ResultsSignificant mutations were found in TP53, PIK3CA, AR, BRCA1, PTEN, BRCA2, BRIP2, KIT, MET, AKT1, ALK, BARD1, BRAF, CD274, ERBB2, FGFR1, IDH2, NOTCH1, RET, and STK11 (in descending order of occurrence). TP53 mutations were identified in the TNBC group more frequently than in the HR+/HER2 group (p=0.003). The presence of TP53 mutations was associated with a higher tumor grade (p=0.008), p53 positivity (p<0.0001), and a higher (≥15) Ki-67 index (p=0.004). PIK3CA was the most frequently mutated gene in HR+/HER2 breast cancer (8/22, 36.4%), but not in TNBC (1/12, 8.3%). However, circulating cell-free PIK3CA mutations were not detected in either group. ConclusionsThe TP53 mutation is associated with higher tumor grade and Ki-67 expression in both groups, and with larger tumor size in TNBC, but not in HR+/HER2– breast cancer. In the foundation of TP53 mutation, concomitant mutation numbers are proportional to tumor size, reflecting clonal progression. Breast cancer-associated mutations such as those in TP53 and PIK3CA have different biological implications for the proliferation and clonal diversification of these two distinct groups of breast cancer.
Actions to Align Energy Projects With the Sustainable Development Goals
Authors: de Almeida Constança Martins Leite , Bergqvist Elin , Thacker Scott , Nerini Francesco Fuso
Published: December 2020

The 2030 Agenda is an aspiring set of goals and targets that aims to prompt humanity towards a sustainable development by 2030. In order to achieve this, actions that mitigate trade-offs and enhance synergies within the Sustainable Development Goals (SDGs) need to be identified. However, for the energy sector these actions are dispersed across the scientific literature, which is a clear barrier to encourage practitioners to have a proactive and pragmatic approach towards the SDGs. For this reason, a set of actions for energy projects was compiled. This compilation addresses the synergies and trade-offs identified in the Sustainable Development Goals Impact Assessment Framework for Energy Projects (SDG-IAE). One case study was used to test the actions, the lighthouse Project VARGA. Subsequently, an analysis was conducted to understand how possible actions can impact different technologies, project stages, actors and SDG targets. In this way, enabling policymakers and project developers to define areas of action when evaluating policies or considering specific intervention. This article aims to be the starting point of stakeholder discussions that consistently frame energy projects within the achievement of the SDGs.