bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing and Testing the Effectiveness of a Novel Online Integrated Treatment for Problem Gambling and Tobacco Smoking: A Protocol for an Open Label Randomized Controlled Trial
Authors: Bilevicius Elena , Single Alanna , Baumgartner Chris , Bui Van , Kempe Tyler , Schaub Michael , Stewart Sherry , MacKillop James , Hodgins David , Wardell Jeffrey , O'Connor Roisin , Read Jennifer , Hadjistavropoulos Heather , Sundstrom Christopher , Keough Matt
Published: September 2020

Background: Gambling and tobacco smoking are highly comorbid among North American adults. However, there is a paucity of treatment options that are integrated (i.e., targeting both gambling and tobacco smoking simultaneously), accessible, and evidence based. Methods: The aim of this two-arm open label randomized controlled trial is to examine the effectiveness of an online, self-guided integrated treatment for problem gambling and tobacco smoking. A target sample of 214 participants will be recruited and be randomized into either an eight-week integrated or gambling-only control condition. Both conditions will consist of seven online modules following cognitive behavioral therapy and motivational interviewing principles. Our three primary outcomes are (1) number of days gambled, (2) money spent on gambling activities, and (3) time spent in gambling activities. Secondary outcomes include gambling disorder symptoms, cigarette use, and nicotine dependence symptoms. Assessments will be completed at baseline, at completion (i.e., eight-weeks from baseline), and follow-up (i.e., 24-weeks from baseline). Generalized linear mixed modelling will be used to evaluate our primary and secondary outcomes. We expect that participants receiving online integrated treatment will show larger reductions in gambling relative to those receiving a control gambling only intervention. We further hypothesize that reductions in smoking will mediate these group differences. Discussion: The rates of problem gambling and tobacco smoking are high in North America; yet, the treatment options for both are limited, with no integrated treatments available. If supported, our pilot study will be a cost-effective and accessible way to improve treatments for co-occurring problem gambling and tobacco use. Trial registration: Clinicaltrials.gov; ID NCT03614884. Registered August 3, 2019; https://clinicaltrials.gov/ct2/show/NCT03614884?term=keough&rank=1
An Intelligent Loader-Digger Heat Balance System based on Simulation and Wireless Sensor Networks
Authors: Li Lei , Chen Xi , Liu Di , Zhou Honggen , Wu Haiyan
Published: September 2020

High temperature of the radiator group is harmful to the power system and hydraulic system. In order to improve the heat dissipation performance of the loader, the flow field characteristics of the cooling chamber are analyzed by simulation and heat balance test. Firstly, the mathematical model of heat flow is established. Secondly, the flow field in the cooling chamber under different speeds is simulated based on CFX. And then the influence of fan position and internal flow field distribution on radiator performance is studied. Through the simulation of four different distances, it is concluded that the optimal distance between cooling fan and radiator is 76mm. Finally, the heat balance test system based on wireless sensor network is established, and the simulation results are verified. The test results show that the heat dissipation performance of the whole machine meets the requirements after optimization. In this paper, the proposed scheme can dynamically adjust the heat dissipation performance and make the loader excavator in an efficient and energy-saving operation state.
N/OFQ modulates orofacial pain induced by tooth movement through CGRP-dependent pathways
Authors: Yan Xinyu , Han Han , Zhang Shizhen , Lu Yanzhu , Ren Linghuan , Tang Yufei , Li Xiaolong , Jian Fan , Wang Yan , Long Hu , Lai Wenli
Published: September 2020

Background: Nociceptin/orphanin FQ (N/OFQ) has been revealed to play bidirectional roles in orofacial pain modulation. Calcitonin gene-related peptide (CGRP) is a well-known pro-nociceptive molecule that participates in the modulation of orofacial pain. We aimed to determine the effects of N/OFQ on the modulation of orofacial pain and on the release of CGRP.Methods: Orofacial pain model was established by ligating springs between incisors and molars in rats for the simulation of tooth movement. The expression level of N/OFQ was determined and pain level scored in response to orofacial pain. Both agonist and antagonist of N/OFQ receptor were administered to examine their effects on pain and the expression of CGRP in trigeminal ganglia (TG). Moreover, gene therapy based on the overexpression of N/OFQ was delivered to validate the modulatory role of N/OFQ on pain and CGRP expression.Results: Tooth movement elicited orofacial pain and an elevation in N/OFQ expression. N/OFQ exacerbated orofacial pain and upregulated CGRP expression in TG, while UFP-101 alleviated pain and downregulated CGRP expression. N/OFQ-based gene therapy was successful in overexpressing N/OFQ in TG, which resulted in pain exacerbation and elevation of CGRP expression in TG.Conclusions: N/OFQ exacerbated orofacial pain possibly through upregulating CGRP.
Use Of Spinal Anaesthesia In Neonates And Infants In Antananarivo, Madagascar: A Retrospective Descriptive Study 
Authors: Randriamizao Harifetra Mamy Richard , Rakotondrainibe Aurelia , Razafindrabekoto Lova Dany Ella , Ravoaviarivelo Prisca Funken , Rajaonera Andriambelo Tovohery , Andriamanarivo Mamy Lalatiana
Published: September 2020

Objective: The aim of this study was to present the first cases of spinal anesthesia, in newborns and infants, preterm / ex-prematures, in order to determine its feasibility and its potential harmlessness, in Antananarivo – Madagascar. Indeed, spinal anesthesia is a low cost technique and can limit respiratory complications, postoperative apnea a contrario with pediatric general anesthesia which can lead to perioperative risks. Results: In a retrospective, descriptive, seven-year (2013 to 2019) period study, conducted in the University Hospital Joseph Ravoahangy Andrianavalona, 69 patients’ data files planned to have spinal anesthesia were recorded. These pediatric patients were predominantly male (sex ratio = 2.8) and 37 [28 - 52] days old. The smallest anesthetized child weighed 880g; the youngest was 4 days old. Twenty-seven (27) of them were premature and 20.3% presented respiratory diseases. They were mostly scheduled for hernia repair (90%). Spinal anesthesia was performed, with a Gauge 25 Quincke spinal needle, after 2 [1 - 2] attempts with hyperbaric bupivacaine of 4 [3.5 - 4] mg. Failure rate was 5.8%. The heart rate was stable throughout perioperative period and no complications were observed.
A single-centre retrospective study of systemic reactions to subcutaneous immunotherapy
Authors: Robertson Kara , Montazeri Nazanin , Shelke Urvashi , Jeimy Samira , Kim Harold
Published: September 2020

BackgroundSubcutaneous immunotherapy (SCIT) is the standard approach for treating patients with sensitizations to aeroallergens. However, immunotherapy can trigger severe systemic reactions if delivered inappropriately or to high risk patients. We sought to characterize and quantify SCIT systemic reactions requiring epinephrine administration during a 6-year period in a Canadian setting following the recommendations for components and dosages published in the 2010 Canadian Society of Allergy and Clinical Immunology (CSACI) Immunotherapy Manual. MethodsA single centre retrospective chart review was performed for all patients with systemic reactions to subcutaneous immunotherapy requiring intramuscular epinephrine injection between January 2011 and October 2017. Each systemic reaction requiring epinephrine was reviewed for baseline patient characteristics, details of the reaction, and reaction severity. Research ethics approval was obtained through McMaster University.Results28 of 380 patients experienced a systemic reaction requiring epinephrine administration, with an incidence rate of 1 per 1,047 injection visits (0.095%). 26 of the 28 reactions occurred within the mandatory 30-minute observation period post allergen immunotherapy. Of the 28 patients that experienced a systemic reaction to SCIT, 11 patients had asthma and 5 patients had a history of possible food allergy. All of the systemic reactions occurred during injections from vial number 4, and five patients reacted to their first shot of a re-ordered extract. 10 of the 28 patients required more than one intramuscular injection of epinephrine, and 20 of 28 patients were transferred to the hospital by ambulance.ConclusionsThis is the first Canadian study to review patients with systemic reactions to subcutaneous immunotherapy. Several best practice methods were employed throughout the study to optimize subcutaneous delivery of immunotherapy extract, and our recorded per injection incidence rate for systemic reactions was comparable or below the rate published in similar studies. The recommendations in the CSACI Immunotherapy Manual provide an approach to standardizing prescriptions for SCIT to maximize immunotherapy efficacy and reduce the risk of systemic reactions, though similar studies in larger multicenter settings are needed to confirm these observations. These observations provide important objective information to clinicians about the potential risks for systemic reactions in patients considering SCIT.
A One Health framework to estimate the cost of antimicrobial resistance.
Authors: Morel Chantal , Alm Richard , Ardal Christine , Bandera Alessandra , Bruno Giacomo , Carrara Elena , Colombo Giorgio , de Kraker Marlieke , Essack Sabiha , Frost Isabel , Gonzalez-Zorn Herman Bruno , Guardabassi Luca , Harbarth Stephan , Jørgensen Peter S. , Kanj Souha , Kostyanev Tomislav , Laxminarayan Ramanan , Leonard Finola , Hara Gabriel Levy , Mendelson Marc , Mikulska Malgorzata , Mutter Nico T. , Outterson Kevin , Baňo Jesus Rodriguez , Tacconelli Evelina , Scudeller Luigia
Published: September 2020

Objectives/Purpose The costs attributable to antimicrobial resistance (AMR) remain theoretical and largely unspecified. Current figures fail to capture the full health and economic burden caused by AMR across human, animal, and environmental health; historically many studies have considered only direct costs associated with human infection from a hospital perspective, primarily from high-income countries. The Global Antimicrobial Resistance Platform for ONE-Burden Estimates (GAP-ON€) network has developed a framework to help guide AMR costing exercises in any part of the world as a first step towards more comprehensive analyses for comparing AMR interventions at the local level as well as more harmonized analyses for quantifying the full economic burden attributable to AMR at the global level.Methods GAP-ON€ (funded under the JPIAMR 8th call (Virtual Research Institute) is composed of 19 international networks and institutions active in the field of AMR. For this project, the Network operated by means of Delphi rounds, teleconferences and face-to-face meetings. The resulting costing framework takes a bottom-up approach to incorporate all relevant costs imposed by an AMR bacterial microbe in a patient, in an animal, or in the environment up through to the societal level. Results The framework itemizes the epidemiological data as well as the direct and indirect cost components needed to build a realistic cost picture for AMR. While the framework lists a large number of relevant pathogens for which this framework could be used to explore the costs, the framework is sufficiently generic to facilitate the costing of other resistant pathogens, including those of other aetiologies. Conclusion In order to conduct cost-effectiveness analyses to choose amongst different AMR-related interventions at local level, the costing of AMR should be done according to local epidemiological priorities and local health service norms. Yet the use of a common framework across settings allows for the results of such studies to contribute to cumulative estimates that can serve as the basis of broader policy decisions at the international level such as how to steer R&D funding and how to prioritize AMR amongst other issues. Indeed, it is only by building a realistic cost picture that we can make informed decisions on how best to tackle major health threats.
Monochromatic green light stimulation during incubation shortened the hatching time via pineal function in White Leghorn eggs
Authors: Wang Panlin , Sun Yanyan , Li Yunlei , Fan Jing , Zong Yunhe , Isa Adamu Mani , Shi Lei , Wang Yuanmei , Ni Aixin , Ge Pingzhuang , Jiang Linlin , Bian Shixiong , Ma Hui , Yuan Zhengdong , Liu Xiaolin , Chen Jilan
Published: September 2020

Background: Effect of monochromatic green light illumination on embryo development has been reported in chickens. The avian pineal is an important photo-endocrine organ formed by a mediodorsal protrusion during embryonic development. However, the involvement of pineal gland in the lighting transducing process remains to be elucidated. In the present study, we investigated the influence of monochromatic green light on hatching time and explored the possible mechanism via pineal function. Results: A total of 600 eggs of White Leghorn (Shaver strain) were incubated under photoperiods of either 12 h of light and 12 h of darkness using monochromatic green light (12L:12D group) or 24 h of darkness (0L:24D group) for 18 d. As compared to 0L:24D group, the green light stimulation shortened the hatching time without extending the hatch window or impairing hatchability. The liver of embryos incubated in the 12L:12D light condition was heavier than those of the 0L:24D group on d 21 post incubation. Meanwhile, the green light increased the serum concentration of insulin-like growth factor 1 (IGF-1), which is primarily secreted by the liver. Histological structure analysis of pineal gland demonstrated that the light stimulation increased follicle area, wall thickness and lumen area on d 10 and d 12 post incubation. Rhythmic function analysis demonstrated that three clock related genes (brain and muscle ARNT-like-1, BMAL1; circadian locomotor output cycles kaput, CLOCK; and cryptochrome-1, CRY1) and a melatonin rate-limiting enzyme related gene (Arylalkylamine N-acetyltransferase, AANAT) were rhythmically expressed in the pineal gland of the 12L:12D group, but not in that of the 0L:24D group. Simultaneously, the light stimulation also increased the concentration of melatonin (MT), which was linked to hepatocyte proliferation and IGF-1 secretion in previous studies. Conclusions: The 12L:12D monochromatic green light stimulation during incubation shortened hatching time without impairing hatching performance. Pineal gland’s early histological development and maturation of its rhythmic function were accelerated by the light stimulation. It may be the key organ in the photo-endocrine axis that regulates embryo development, and the potential mechanism could be that its higher secretion product of MT in the 12L:12D group promotes the secretion of IGF-1.
How Registered Nurses balance limited resources in order to maintain competence: A Grounded theory study
Authors: Rees Sharon , Farley Helen , Moloney Clint
Published: September 2020

BackgroundNurses have limited time outside of work for continuing professional development. Consequently, strategies need to be explored to enable them to better maintain their competence. This article describes recent research to ascertain how nurses used mobile technologies to determine if these behaviours could be leveraged for mobile learning. It addresses a gap in the existing literature around how nurses resource their own professional development in the absence of appropriate resourcing in the workplace.MethodsThe research employed a classic grounded theory methodology which was conducted with 27 registered nurses from Public and Private Hospitals in Queensland and external postgraduate nursing students from Victoria, South Australia and the Northern Territory enrolled at the University of Southern Queensland.ResultsThe Theory of Economising Learning describes how nurses maintain competence with limited resources. Unfavourable staffing levels and a fast-paced workplace mean that nurses rarely prioritise their professional learning while at work. Instead, it requires the nurse to contribute personal resources including time and money.Though the research revealed that nurses were unconcerned about using mobile technologies, they were concerned about maintaining competence with limited resources. To counter this, nurses economised their learning by balancing personal resources against their motivation to maintain competence. The process of economising learning begins and ends with the development of the nurse’s personal curriculum in response to what they identify as being the most significant knowledge deficits at work that jeopardise their competence. A learning opportunity that addresses the knowledge deficit is sought. Nurses balance the opportunity to address the deficit against the cost of personal resources, to decide if they will engage with the opportunity and update their personal curriculum accordingly.ConclusionsIt is suggested that workplaces need to create reasonable expectations within nurses to address knowledge deficits and provide the resources, including time, to allow them to do so without personal cost. It is also necessary for workplaces to moderate the flow of learning opportunities so as not to overwhelm and demotivate the nurses. Currently, nurses use several strategies to optimise their learning using mobile technologies which could be leveraged in the workplace.
Genetic diversity analysis of Chinese Leishmania isolates and development of L. donovani complex specific markers by RAPD
Authors: Yuan Dongmei , Qin Hanxiao , Chen Dali , Chen Jianping
Published: September 2020

Background: Leishmaniasis is one of the most neglected tropical diseases in the world and is still endemic in some underdeveloped regions including western of China. The phylogeny and classification of Chinese Leishmania has not yet been clarified, especially within Leishmania (L.) donovani complex, although phylogenetic analyses based on a series of gene markers were carried out. More different analytic method and data still be needed. Random amplified polymorphic DNA (RAPD) technology could identify slight intraspecific differences sensitively, and it always be a powerful tool to seek the species-specific markers. This work aimed to identify Chinese Leishmania isolates from diverse geographic regions at genomic level. Meanwhile, the specific markers of L. donovani complex were also developed by RAPD.Methods: The RAPD was applied on 14 Chinese Leishmania isolates from diverse geographic regions and 3 WHO reference strains. The polymorphic sites of amplification were transformed into data matrix, based on which genetic similarity were calculated and UPGMA dendrogram were constructed to analyze genetic diversity of these Leishmania isolates. Meanwhile, the specific amplification loci of L. donovani complex were TA-cloned, sequenced and converted into sequence characterized amplified regions (SCAR) markers, which were validated preliminarily in available 17 Leishmania strains in this study and analyzed by bioinformatics.Results: The cluster analyses showed that the three Leishmania sp. isolates SC10H2, SD and GL clustered together and apart from others, and the strains of L. donovani complex clearly divided into two clades and the three isolates Cy, WenChuan and 801 formed a subclade. Three specific SCAR markers of L. donovani complex, i.e. 1-AD17, 2-A816 and 3-O13, were successfully obtained and validated on available 17 Leishmania strains in this study. Through bioinformatics analyses, Marker 1-AD17 may have more specificity on PCR detection of VL and Marker 3-O13 has the potential of encoding protein.Conclusions: The RAPD result verified that the undescribed Leishmania species causing visceral Leishmaniasis (VL) in China was a unique clade distinguished from L. donovani, and revealed that there was genetic differentiation among Chinese L. donovani. The development of L. donovani specific markers may provide the foundation for developing new specific diagnostic markers of VL and the research of specific gene function.
Performance Evaluation of Fifth-Generation Ultra-High-Resolution SPECT System with Two Stationary Detectors and Multi-Pinhole Imaging
Authors: Hoffmann Jan V , Janssen Jan P , Kanno Takayuki , Shibutani Takayuki , Onoguchi Masahisa , Lapa Constantin , Grunz Jan Peter , Buck Andreas , Higuchi Takahiro
Published: September 2020

Background: Small-animal single-photon emission computed tomography (SPECT) systems with multi-pinhole collimation and large stationary detectors have advantages compared to systems with moving small detectors. These systems benefit from less labour-intensive maintenance and quality control as fewer prone parts are moving, higher accuracy for focused scans and maintaining high resolution with increased sensitivity due to focused pinholes on the field of view. This study aims to investigate the performance of a novel ultra-high-resolution scanner with two-detector-configuration (U-SPECT5-E) and to compare its image quality to a conventional micro-SPECT system with three stationary detectors (U-SPECT+).Methods: The new U-SPECT5-E with two stationary detectors was used for acquiring data with 99mTc-filled point source, hot-rod and uniformity phantoms to analyse sensitivity, spatial resolution, uniformity and contrast-to-noise ratio (CNR). Three dedicated multi-pinhole mouse collimators with 75 pinholes each and 0.25-, 0.60- and 1.00-mm pinholes for extra ultra-high resolution (XUHR-M), general-purpose (GP-M) and ultra-high sensitivity (UHS-M) imaging were examined. For CNR analysis, four different activity ranges representing low- and high-count settings were investigated for all three collimators. The experiments for the performance assessment were repeated with the same GP-M collimator in the three-detector U-SPECT+ for comparison. Results: Peak sensitivity was 237 cps/MBq (XUHR-M), 847 cps/MBq (GP-M), 2054 cps/MBq (UHS-M) for U-SPECT5-E and 1710 cps/MBq (GP-M) for U-SPECT+. In the visually analysed sections of the reconstructed mini Derenzo phantom, rods as small as 0.35 mm (XUHR-M), 0.50 mm (GP-M) for the two-detector as well as the three-detector SPECT and 0.75 mm (UHS-M) were resolved. Uniformity for maximum resolution recorded 40.7% (XUHR-M), 29.1% (GP-M, U-SPECT5-E), 16.3% (GP-M, U-SPECT+) and 23.0% (UHS-M), respectively. UHS-M reached highest CNR values for low-count images; for rods smaller than 0.45 mm, acceptable CNR was only achieved by XUHR-M. GP-M was superior for imaging rods sized from 0.60-1.50 mm for intermediate activity concentrations. U-SPECT5-E and U-SPECT+ both provided comparable CNR.Conclusions: While uniformity and sensitivity are negatively affected by the absence of a third detector, the investigated U-SPECT5-E system with two stationary detectors delivers excellent spatial resolution and CNR comparable to the performance of an established three-detector-setup.
Lacrimal Sac Bacteriology and Susceptibility Pattern in Infants with Congenital Nasolacrimal Duct Obstruction in the 1st Year of Life: A Cross-Sectional Study 
Authors: Zheng Xiaoyu , Choy Bonnie Nga Kwan , Zhou Mingming , Shi Caiping , Zhao Zhengyan
Published: September 2020

Background: Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of patients. The aim of this study was to evaluate the microbiology of lacrimal sac (LS) in Chinese children with CNLDO in their first year of life.Methods: Patients with CNLDO between May 1, 2017 and August 31, 2018 at a tertiary care children’s hospital were enrolled. The study recruited infants who received lacrimal probing under 1 year old, and refluxed discharge from LS was collected. Samples were cultured and susceptibility test was performed for positive culture.Results: Thirty-two patients with CNLDO were included. The ratio of male to female was 23:9. The mean age was 6.7 ± 2.4 (1.7-12) months. Positive cultures was identified in 87.5% of the sample, and presented 38 strains of bacteria. Mixed infection was identified in 10 (31.3%) children. Gram-positive bacteria accounted for 60.5% of all the strains, with Streptococcus (50%) being the most frequent species, whereas Haemophilus (21.1%) and Neisseriae (13.2%) were most common isolates for Gram-negative organisms. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 2 infants whose symptoms resolved by a routine probing. No difference of bacteriology pattern was detected between patients under 6 months old and those beyond. The pathogens were highly sensitive to chloramphenicol (88%) and levofloxacin (84%), but resistant to erythromycin (40%) and sulfamethoxazole (32%).Conclusions: Infants with CNLDO under 1 year of age presented predominance of Streptococcus as Gram-positive organism, and Haemophilus as Gram-negative organism. Levofloxacin was an active topical antibiotic agent with few chance of resistance especially for Chinese children. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments.
Psychological Distress in Nepalese Residents during COVID-19 Pandemic: A Community Level Survey 
Authors: Shrestha Dhan Bahadur , Thapa Bikash Bikram , Katuwal Nagendra , Shrestha Bikal , Pant Chiranjibi , Basnet Bina , Mandal Pankaj , Gurung Amol , Agrawal Ankita , Rouniyar Ramhari
Published: September 2020

BackgroundCOVID-19 pandemic has created unprecedented health and economic impact. Psychological stress, anxiety and depression are affecting not only COVID-19 patients but also health professionals, and general population. Fear of contracting COVID-19, forced restrictive social measures, and economic hardship are causing mental trauma. Nepal is a developing country from South Asia where the COVID-19 pandemic is still evolving. This online survey has been carried out to understand impact of COVID- 19 on mental health of Nepalese community dwellers.MethodsThe COVID-19 Peritraumatic Distress Index (CPDI) questionnaire adapted from the Shanghai Mental Health Centre was used for online data collection from 11 April-17 May 2020. Collected data were extracted to Microsoft excel-13 and imported and analyzed using SPSS (Statistical Package for Social Sciences) version-22. An initial univariate analysis was conducted for all variables to assess the distribution. Logistic regression analyses were done to estimate the odds ratios of relevant predicting variables.ResultsA total of 410 participants completed the self-rated questionnaires. Mean age of study participants was 34.8 ±11.7 years with male preponderance. 88.5% of the respondents were not in distress (score less than 28) while, 11% had mild to moderate distress and 0.5% had severe distress. The prevalence of distress is higher among age group >45 years, female gender, and post-secondary education group. Health professional were more likely to get distressed. Respondents with post-secondary education had higher odds (OR= 3.32; p=0.020) of developing distress as compared to respondents with secondary education or lower.ConclusionThere is lower rate of psychological distress in city dwellers and people with low education. Adequate intervention and evaluation into mental health awareness, and psychosocial support focused primarily on health care workers, female and elderly individuals is necessary.
The relationship between health-related quality of life, acceptance of illness and characteristics of pregnant women with hyperglycemia
Authors: Iwanowicz-Palus Grażyna , Zarajczyk Marta , Bień Agnieszka
Published: September 2020

Background: The study was performed to evaluate the association between socio-demographic factors on the one hand, and quality of life and illness acceptance on the other, in pregnant women with hyperglycemia.Methods: The study was performed in the years 2016–2017 in south-eastern Poland. The study included 676 women: 339 pregnant women with hyperglycemia in the case group, and 337 healthy pregnant women in the control group. The research instruments applied included the WHOQOL-BREF quality of life questionnaire, the Acceptance of Illness Scale (AIS), and a general questionnaire.Results: Factors associated with quality of life in women with hyperglycemia include: relationship status, residence, professional activity, living conditions, number of pregnancies, self-reported knowledge of diabetes treatment and lifestyle and also of the potential pregnancy complications and fetal health impact associated with the disease, as well as the type of diabetes treatment (p < 0.05).The mean illness acceptance score among the patients is near the lower boundary of “moderate”, 31.37 points. Factors associated with illness acceptance in women with hyperglycemia include: professional activity, living conditions, and self-reported knowledge of diabetes treatment and lifestyle and of the potential pregnancy complications and fetal health impact associated with the disease (p < 0.05).Conclusion: Better overall quality of life, general perceived health, and quality of life in all specific domains was found among healthy pregnant women compared to those with hyperglycemia. A higher level of illness acceptance has a positive effect on overall quality of life, general perceived health, and quality of life in all specific domains. General Quality of Life is positively correlated with reported living conditions and self-reported knowledge on glucose tolerance disorder treatment and lifestyle recommendations. AIS is positively correlated with living conditions, self-reported knowledge on glucose tolerance disorder treatment and lifestyle recommendations, and self-reported knowledge on possible pregnancy complications and infant health impact associated with glucose tolerance disorders.
Auxin, abscisic acid and jasmonate are the central players in rice sheath rot caused by Sarocladium oryzae and Pseudomonas fuscovaginae
Authors: Peeters Kaat , Ameye Maarten , Demeestere Kristof , Audenaert Kris , Hofte Monica
Published: September 2020

Sheath rot is an emerging rice disease that causes severe yield losses worldwide. The main causal agents are the toxin producers Sarocladium oryzae and Pseudomonas fuscovaginae. The fungus S. oryzae produces helvolic acid and cerulenin and the bacterium P. fuscovaginae produces cyclic lipopeptides. Helvolic acid and the lipopeptide, fuscopeptin, inhibit membrane-bound H+-ATPase pumps in the rice plant. To manage rice sheath rot, a better understanding of the host response and virulence strategies of the pathogens is required. This study investigated the interaction of the sheath rot pathogens with their host and the role of their toxins herein. Japonica rice was inoculated with high- and low-helvolic acid-producing S. oryzae isolates or with P. fuscovaginae wild type and fuscopeptin mutant strains. During infection, cerulenin, helvolic acid and the phytohormones abscisic acid, jasmonate, auxin and salicylic acid were quantified in the sheath. In addition, disease severity and grain yield parameters were assessed. Rice plants responded to high-toxin-producing S. oryzae and P. fuscovaginae strains with an increase in abscisic acid, jasmonate and auxin levels. We conclude that, for both pathogens, toxins play a core role during sheath rot infection. S. oryzae and P. fuscovaginae interact with their host in a similar way. This may explain why both sheath rot pathogens cause very similar symptoms despite their different nature.
Evaluation of a genetic risk score for severity of COVID-19 using human chromosomal-scale length variation. 
Authors: Toh Chris , Brody James
Published: September 2020

Introduction.The course of COVID-19 varies from asymptomatic to severe in patients. The basis for this range in symptoms is unknown. One possibility is that genetic variation is partly responsible for the highly variable response. We evaluated how well a genetic risk score based on chromosomal-scale length variation and machine learning classification algorithms could predict severity of response to SARS-CoV-2 infection. Methods.We compared 981 patients from the UK Biobank dataset who had a severe reaction to SARS-CoV-2 infection before 27 April 2020 to a similar number of age matched patients drawn for the general UK Biobank population. For each patient, we built a profile of 88 numbers characterizing the chromosomal-scale length variability of their germ line DNA. Each number represented one quarter of the 22 autosomes. We used the machine learning algorithm XGBoost to build a classifier that could predict whether a person would have a severe reaction to COVID-19 based only on their 88-number classification.Results. We found that the XGBoost classifier could differentiate between the two classes at a significant level (I as measured against a randomized control and (n as measured against the expected value of a random guessing algorithm (AUC=0.5). However, we found that the AUC of the classifier was only 0.51, too low for a clinically useful test.Conclusion.Genetics play a role in the severity of COVID-19, but we cannot yet develop a useful genetic test to predict severity.
Tobacco Smoking is Positively Associated with Hepatocellular Carcinoma Due to the p53 Mutation at Serine 249
Authors: Wang Huai , Chen Lu , Zhou Tong , Zhang Zhongwei , Zeng Canwei
Published: September 2020

Background The major risk factors for hepatocellular carcinoma (HCC) are known to be hepatitis b virus (HBV) infection and aflatoxin B1(AFB1) exposure. However, there is still controversy about whether smoking is related to HCC.Methods A binary unconditional logistic regression was used for the data about a total of 300 cases and 612 controls. The approach of functional analysis of separated alleles in yeast (FASAY) was applied to analyze p53 status in HCC group. The relationship between p53 mutation at Serine 249 (p53-RS) and smoking was assessed. Quantitative reverse-transcription PCR (qRT-PCR) was employed for the evaluation to transcriptional activity of p53 and p53-RS. Results Smoking was linked to the risk of HCC with an increased dose-response effect. Moreover, among subjects without alcohol drinker, the risks of HCC were significantly increased for smokers between HCC and controls. Besides, there was an increase in the number of HCC in smokers compared to non-smokers after exclusion of HBV and/or HCV infection. Also, a significant difference was observed about p53-RS between smokers and nonsmokers. Furthermore, the p53-RS transcriptional activity was significantly increased in tumor tissues.Conclusions It demonstrated that tobacco smoking is positively and independently associated with HCC, which may be attributed to p53-RS and its gain of function.
Long-term Outcomes of Intervention between Open Repair and Endovascular Aortic Repair for Descending Aortic pathologies: A Propensity-Matched Analysis
Authors: Son Shin-Ah , Jung Hanna , Cho Joon Yong
Published: September 2020

Background The long-term complication rates of open repair and thoracic endovascular aortic repair (TEVAR) have not yet been determined. Therefore, this study aimed to compare the long-term outcomes and aortic reintervention rates between open repair and TEVAR in patients with descending thoracic aortic pathologies. Methods Between January 2002 and December 2017, 230 patients with descending thoracic aortic pathologies underwent surgery. Of these, 136 patients were included in this retrospective study: 45 patients (10, 2, and 33 with dissection, penetrating atherosclerotic ulcer, and pseudoaneurysm, respectively) underwent open repair and 91 patients (27, 1, and 63 with dissection, penetrating atherosclerotic ulcer, and pseudoaneurysm, respectively) underwent TEVAR. The primary end points were in-hospital mortality, and short-term complications. The secondary end points were long-term mortality and reintervention rates. Based on the propensity score matching (PSM), 35 patients who underwent open repair were matched to 35 patients who underwent TEVAR (ratio= 1:1). Results The mean follow-up period was 70.2 ± 51.9 months. Shorter intensive care unit and hospital stay were seen in the TEVAR group than in the open repair group before and after PSM (p < 0.001 and p < 0.001, respectively). However, in-hospital mortality, and spinal cord ischemia were not significantly different among the two groups (before PSM: p = 0.068 and p = 0.211, respectively; after PSM: p = 0.303 and p = 0.314, respectively). The cumulative all-cause death and aorta-related death showed no significant differences between the two groups (before PSM: p = 0.709 and p = 0.734; after PSM: p = 0.888 and p = 0.731, respectively). However, aortic reintervention rates were higher in the TEVAR group than in the open repair group before and after PSM (p = 0.006 and p = 0.013, respectively). Conclusion The TEVAR group was superior in short-term recovery outcomes but had higher reintervention rates compared to the open repair group. However, there were no significant differences in long-term survival between the two groups.
Characteristics and diversity of mutations in regulatory genes of resistance-nodulation-cell division efflux pumps in association with drug-resistant clinical isolates of Acinetobacter baumannii
Authors: Salehi Bahare , Ghalavand Zohreh , Yadegar Abbas , Eslami Gita
Published: September 2020

Background: This study aimed to characterize the regulation and expression of three putative resistance-nodulation-cell division (RND)-type efflux systems and their contribution to multidrug efflux in clinical isolates of Acinetobacter baumannii. Methods: Antimicrobial susceptibility testing (AST) of 95 A. baumannii isolates was determined by Kirby-Bauer disk diffusion for 18 antibiotics and minimum inhibitory concentration (MIC) of colistin was determined by broth microdilution method. Moreover, MIC of five classes of antibiotics was assessed using E-test strips in the presence and absence of phenylalanine-arginine beta-naphthylamide (PAβN). Regulatory genes of RND efflux pumps (AdeRS, AdeL, AdeN and BaeSR) were subjected to sequencing. The relative expression of adeB. adeG and adeJ genes was determined by quantitative real-time PCR (RT-PCR).Results: Overall, majority of isolates (93%) were extensively drug-resistant (XDR). In the phenotypic assay, efflux pump activity was observed in 40% of isolates against multiple antibiotics mainly tigecycline, but not to imipenem. Several amino acid substitutions were detected in the regulatory genes; except in AdeN. Of note, A136V in AdeR and G186V in AdeS were found to be associated with overexpression of their relative efflux pumps. No insertion sequences (ISs) were detected. Conclusions: Our findings outline the role of RND efflux pumps in resistance of A. baumannii against multiple antibiotics particularly tigecycline, and point out importance of a variety of single mutations in the corresponding regulatory systems. Even though it has been concluded that multidrug resistance occurs as a result of a complex sets of different resistant mechanisms
Loop electrosurgical excision procedure combined with cold coagulation for cervical intraepithelial neoplasia and adenocarcinoma in-situ: A feasible treatment with a low risk of residual/recurrent disease
Authors: Yang Eun Jung , Kim Nae Ry , Choi Ji Yeon , Kim Wook Youn , Lee Sun Joo
Published: September 2020

Objective This study was performed to evaluate the significance of positive resection margins (RMs) with the loop electrosurgical excision procedure combined with cold coagulation (LEEP with CC) as a definitive treatment for patients with cervical intraepithelial neoplasia (CIN) and adenocarcinoma in-situ . Methods We retrospectively reviewed 467 patients who underwent LEEP with CC. A right-angled triangular loop in a single pass followed by a CC (120°C) to the cone bed for 10 to 20 seconds was used. Pathology reports and clinical data were obtained and evaluated. Results Histopathology evaluation of LEEP tissue samples revealed the presence of CIN 1 in 69, CIN 2/3 in 366, AIS in 5 and invasive carcinoma in 16 (microinvasive squamous cell carcinoma (SCC) and invasive SCC, 13 and 3) patients. Margins were positive in 66 (14.5%) cases: 0 in CIN 1, 54 in CIN 2/3 (12.4%), 1 in AIS (20.0%) and 11 in microinvasive/invasive SCC (68.8%). Although 54 CIN2/3 patients with positive RMs did not undergo additional treatment, 1 of these (1.9%) was confirmed to have residual CIN3 at the first follow-up. Two of 8 (25.0%) microinvasive SCC patients with positive RMs were confirmed to have residual diseases (1 microinvasive SCC and 1 invasive SCC) after hysterectomy. Four out of 360 (1 positive RM, 3 negative RM) CIN cases recurred during the study period. Conclusions These results suggest that CIN patients with positive RMs after LEEP with CC may be followed up without additional treatment.
Broad Spectrum Epidemiological Contribution of Cannabis and Other Substances to the Teratological Profile of Northern New South Wales: Geospatial and Causal Inference Analysis 
Authors: Reece Albert Stuart , Hulse Gary Kenneth
Published: September 2020

Background. Whilst cannabis commercialization is occurring rapidly guided by highly individualistic public narratives, evidence that all congenital anomalies (CA) increase alongside cannabis use in Canada, a link with 21 CA’s in Hawaii, and rising CA’s in Colorado indicate that transgenerational effects can be significant and impact public health. It was therefore important to study Northern New South Wales (NNSW) where cannabis use is high.Methods. Design: Cohort. 2008-2015. Setting: NNSW and Queensland (QLD), Australia. Participants. Whole populations. Exposures. Tobacco, alcohol, cannabis. Source: National Drug Strategy Household Surveys 2010, 2013. Main Outcomes. CA Rates. NNSW-QLD comparisons. Geospatial and causal regression. Results. Cardiovascular, respiratory and gastrointestinal anomalies rose with falling tobacco and alcohol but rising cannabis use rates across Queensland. Maternal age NNSW-QLD was not different (2008-2015: 4265/22084 v. 96473/490514 >35 years/total, Chi.Sq.=1.687, P=0.194). A higher rate of NNSW cannabis-related than cannabis-unrelated defects occurred (prevalence ratio (PR)=2.13, 95%C.I. 1.80-2.52, P=3.24x10-19). CA’s rose more potently with rising cannabis than with rising tobacco or alcohol use. Exomphalos and gastroschisis had the highest NNSW:QLD PR (6.29(2.94-13.48) and 5.85(3.54-9.67)) and attributable fraction in the exposed (84.11%(65.95-92.58%) and 82.91%(71.75-89.66%), P=2.83x10-8 and P=5.62x10-15). In multivariable geospatial models cannabis was significantly linked with cardiovascular (atrial septal defect, ventricular septal defect, tetralogy of Fallot, patent ductus arteriosus), genetic (chromosomal defects, Downs syndrome), gastrointestinal (small intestinal atresia), body wall (gastroschisis, diaphragmatic hernia) and other (hypospadias) (AVTPCDSGDH) CA’s. In linear modelling cannabis use was significantly linked with anal stenosis, congenital hydrocephalus and Turner syndrome (ACT) and was significantly linked in borderline significant models (model P<0.1) with microtia, microphthalmia, and transposition of the great vessels. At robust and mixed effects inverse probability weighted multivariable regression cannabis was related to 18 defects. 16/17 E-Values in spatial models were >1.25 ranging up to 5.2x1013 making uncontrolled confounding unlikely.Conclusions. These results suggest that population level CA’s react more strongly to small rises in cannabis use than tobacco or alcohol; cardiovascular, chromosomal, body wall and gastrointestinal CA’s rise significantly with small increases in cannabis use; that cannabis is a bivariate correlate of AVTPCDSGDH and ACT anomalies, is robust to adjustment for other substances; and is causal.
Liver Resection for Colorectal Liver-limited Metastases in Elderly Patients: A Propensity Score Matching Analysis
Authors: Jin Ke-Min , Wang Kun , Bao Quan , Wang Hong-Wei , Xing Bao-Cai
Published: September 2020

Background: Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients. Methods: From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥70 years of age) were matched to 128 younger patients (＜70 years of age) to obtain two balanced groups with regards to demographic, therapeutic and prognostic factors.Results: There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score Ⅲ and comorbidities, and lower proportion of more than 3 liver metastases and postoperative chemotherapy (p<0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175ml vs. 200ml, p=0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p=0.020) and a higher readmission rate (4.7% vs.0%, p=0.036). The EG also had longer disease-free survival (DFS), overall survival (OS) and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant (p>0.05). Old age was not an independent factor for DFS, OS and CSS by Cox multivariate regression analysis (p>0.05). Conclusions: Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS and CSS.
High Triglyceride-Glucose Index is Associated with Poor Cardiovascular Outcomes in Non-Diabetic ACS Patients with LDL-C Below 1.8mmol/L
Authors: Zhang Yue , Ding Xiaosong , Hua Bing , Liu Qingbo , Gao Hui , Chen Hui , Zhao Xue-Qiao , Li Weiping , Li Hongwei
Published: September 2020

Background: To evaluate the prognostic value of triglyceride glucose (TyG) index in non-diabetic acute coronary syndrome (ACS) patients with low-density lipoprotein cholesterol (LDL-C) below 1.8mmol/L.Methods: A total of 1655 non-diabetic ACS patients with LDL-C below 1.8mmol/L were included in the analysis. Patients were stratified into 2 groups. Incidence of acute myocardial infarction (AMI), infarct size in patients with AMI, and major adverse cardiac and cerebral event (MACCE) during a median of 35.6-month follow-up were determined and compared between the 2 groups. The TyG index was calculated using the following formula: ln [fasting triglycerides (mg/dL) ×fasting plasma glucose (mg/dL)/2].Results: Compared with the TyG index <8.33 group, the TyG index ≥8.33 group had significantly higher incidence of AMI (21.2% vs. 15.2%, p =0.014) and larger infarct size in patients with AMI (pTNI: 10.4 vs. 4.8 ng/ml, p =0.003; pCKMB: 52.8 vs. 22.0 ng/ml, p =0.006; pMyo: 73.7 vs. 46.0 ng/ml, p =0.038). Although there was no significant difference in mortality between the 2 groups, the incidence of revascularization of TyG index ≥8.33 group was significantly higher than that of TyG index <8.33 group (8.9% vs. 5.0%, p =0.035). Multivariable Cox regression revealed that the TyG index was positively associated with revascularization [HR (95% CI): 1.67 (1.02,2.75), p=0.043].Conclusion: In non-diabetic ACS patients with LDL-C below 1.8mmol/L, the high TyG index level was associated with higher incidence of AMI, larger infarct size, and higher incidence of revascularization. The high TyG index level might be a valid predictor of subsequent revascularization.Trial registration: retrospectively registered.