bluuebunny/crossref_metadata_2025 huggingface dataset:
Genotypic Variations of Mutans Streptococci Isolated from Dental Caries by REP-PCR
Authors: Salman Hamzah Abdulrahman , Senthilkumar R.
Published: December 2020

Mutans streptococci (MS) are a group of oral bacteria considered as the main cariogenic organisms. MS consists of several species of genus Streptococcus which are sharing similar phenotypes and genotypes. The aim of this study is to determine the genetic diversity of the core species of clinical strains of Streptococcus mutans, Streptococcus sobrinus and Streptococcus downei by using repitative extragenic palindromic (REP) primer. The DNA of the clinical strains of S. mutans (n=10), S. sobrinus (n=05) and S. downei (n=04) have been employed in the present study, which have been previously isolated from caries active subjects. The DNA of the clinical and reference strains was subjected to PCR amplification using REP primer. The phylogenetic dendrogram is constructed from the REP PCR banding profile by neighbour-joining method using PyElph 1.4 software. The size of the DNA amplicons generated by using REP primer were S. mutans (1500 bp to 250 bp), S. sobrinus (6000 bp to 250 bp) and S. downei (5000 bp to 400 bp). The results present common band at 480 bp in all the clinical strains of S. sobrinus. The current study is the first to demonstrate the genetic variety of S. sobrinus and S. downei by using REP primer. REP-PCR have been found to be a powerful method to study the molecular diversity of S. mutans, S. sobrinus and S. downei. Additionally, further studies are suggested to analyze the species specific bands and also to find the possibility to produce a new specific primer for S. sobrinus.
Morfología del empleo en las industrias de servicios intensivos en conocimiento. El caso de la Ciudad Autónoma de Buenos Aires
Authors: Martínez Ricardo Gabriel , Leone Julián Gabriel , Rodriguez-Repeti Juan Manuel
Published: December 2020

La Ciudad Autónoma de Buenos Aires se caracteriza por una estructura productiva intensiva en servicios, tanto en su absorción de mano de obra como en su participación en el producto. Los servicios intensivos en conocimiento (SIC) explican, a su vez, una buena parte de estos, de modo que merecen un cuidadoso análisis del tipo de demanda laboral asociada. Buena parte de la discusión académica redunda en la importancia de la oferta de capital humano para el desarrollo de la industria del conocimiento, por eso, entendido su rol en la proliferación del sector SIC, el objetivo principal de este trabajo es comprender este mecanismo, pero de forma inversa; es decir, entender la morfología de la demanda de empleo generada con base tanto en la calificación de la mano de obra como en sus tareas realizadas. Además de los controles habituales, se incorpora la precisión de la actividad laboral realizada, entendida bajo un específico esquema de tareas. El análisis permite concluir, entre otras cosas, que, aun con remuneraciones muy por encima del promedio, el control por tareas muestra una notoria disparidad salarial y en términos de creación de empleo. Al mismo tiempo, sobresale el sector SIC en la demanda laboral de puestos con mayor complementariedad tecnológica —intensidad en tareas cognitivas no rutinarias— y de calificación profesional y técnica.
What do we know about the impact of sexual violence on health and health behaviour of women in Estonia?
Authors: Lippus Hedda , Laanpere Made , Part Kai , Ringmets Inge , Karro Helle
Published: December 2020

Background: Sexual violence against women is a major public health issue and a breach of human rights. Although various consequences of sexual violence on health have been described in a large number of scientific publications, very little is known about this topic in Estonia. The aim of this study was to examine the prevalence of sexual violence and associations between exposure to sexual violence and risky health and sexual behaviours among women in Estonia.Methods: A population-based cross-sectional study was carried out in Estonia in 2014. Self-reported data regarding selected indicators of risky health and sexual behaviours were collected from 1670 women, aged 18–44 years, via a self-administered questionnaire. To measure the prevalence of sexual violence, questions from the NorVold Abuse Questionnaire were included. Chi-square and multivariate logistic regression were used to analyse the data.Results: Of the respondents, 22.7% (n=379) reported being exposed to sexual violence during their lifetime, and over half of these women had had these experiences before the age of 18. Statistically significant associations were found between sexual violence and smoking (adjusted odds ratio (AOR) 1.32, 95% CI 1.03–1.70), alcohol consumption (AOR 1.52, 95% CI 1.18–1.95), illicit drug use (AOR 2.21, 95% CI 1.70–2.89), sexual intercourse for money or other material reward (AOR 3.51, 95% CI 1.62–7.61), concurrent sexual relationships (AOR 2.64; 95% CI 1.80–3.86), and being diagnosed with sexually transmitted infections (AOR 1.48, 95% CI 1.09–2.01).Conclusions: In Estonia, sexual violence against women is widespread and is associated with several risky health and sexual behaviours. Efforts should be made, both among the general public and professionals, to raise awareness regarding the prevalence and negative impact of sexual violence. Women who have been exposed to sexual violence are in need of professional medical, legal and psychological help free from prejudice to help them recover from such traumatic events.
Genome-wide identification of the 14-3-3 gene family and its participation in floral transition by interacting with TFL1/FT in Apple
Authors: Zuo Xiya , Wang Shixiang , Xiang Wen , Yang Huiru , Tahir Muhammad Mobeen , Zheng Shangong , An Na , Han Mingyu , Zhao Caiping , Zhang Dong
Published: December 2020

Background: Apple (Malus domestica Borkh.) is one of the most popular cultivated fruit crops in China. Apple floral transition is an important process but liable to be affected by various environmental factors. The 14-3-3 proteins are involved in regulating diverse biological processes in plants, and some 14-3-3 members play vital roles in flowering. However, little information was available about the 14-3-3 members in apple.Results: In the current study, we identified eighteen 14-3-3 gene family members from the apple genome database, designated MdGF14a to MdGF14r. The isoforms possess a conserved core region comprising nine antiparallel α-helices and divergent N and C termini. According to their structural and phylogenetic features, Md14-3-3 proteins could be classified into two major evolutionary branches, the epsilon (ɛ) group and the non-epsilon (non-ɛ) group. Moreover, expression profiles derived from transcriptome data and quantitative real-time reverse transcription PCR analysis showed diverse expression patterns of Md14-3-3 genes in various tissues and in response to different sugars and hormone treatments during the floral transition phase. Four Md14‑3-3 isoforms (MdGF14a, MdGF14d, MdGF14i, and MdGF14j) exhibiting prominent transcriptional responses to sugars and hormones were selected for further investigation. Furthermore, yeast two-hybrid and bimolecular fluorescence complementation experiments showed that the four Md14-3-3 proteins interact with key floral integrators, MdTFL1 (TERMINAL FLOWER1) and MdFT (FLOWERING LOCUS T). Subcellular localization of four selected Md14-3-3 proteins demonstrated their localization in both the cytoplasm and nucleus.Conclusion: We identified the Md14-3-3s family in apple comprehensively. Certain Md14-3-3 genes are expressed predominantly during the apple floral transition stage, and may participate in the regulation of flowering through association with flower control genes. Our results provide a preliminary framework for further investigation into the roles of Md14-3-3s in floral transition.
Development and evaluation of a Japanese prediction model for low anterior resection syndrome after rectal cancer surgery
Authors: Paku Masakatsu , Miyoshi Norikatsu , Fujino Shiki , Hata Tsuyoshi , Ogino Takayuki , Takahashi Hidekazu , Uemura Mamoru , Mizushima Tsunekazu , Yamamoto Hirofumi , Doki Yuichiro , Eguchi Hidetoshi
Published: December 2020

Background: Low anterior resection syndrome (LARS) is the most common complication after rectal cancer resection. We aimed to identify predictive factors for LARS and to construct and evaluate a predictive model for LARS.Methods: This retrospective study included patients with rectal cancer more than one year after laparoscopic or robotic-assisted surgery. A questionnaire was administered to evaluate the degree of LARS. Clinical characteristics were examined with univariate and multivariate logistic regressions to identify predictive factors for major LARS. The obtained data was divided into learning set and validation set. A predictive model for major LARS was constructed using the learning set, and predictive accuracy of the validation set was assessed.Results: We reviewed a total of 160 patients with rectal cancer and divided them into a learning set (n = 115) and a validation set (n = 45). Univariate and multivariate analyses in the learning set showed that male (odds ratio [OR]: 2.88, 95% confidence interval [95%CI]: 1.11-8.09, p = 0.03), age <75 years (OR: 5.87, 95%CI: 1.14-47.25, p = 0.03) and tumors located <8.5 cm from the AV (OR: 7.20, 95%CI: 2.86-19.49, p <0.01) were significantly related to major LARS. A prediction model based on the patients in learning set was well calibrated.Conclusions: We found that sex, age and tumor location were independent predictors of major LARS in Japanese patients that underwent rectal cancer surgery. Our predictive model for major LARS could aid medical staff in educating and treating patients with rectal cancer before and after surgery.
A Medium for Facilitating Hepatitis B Virus Detection and Replication of the Virus
Authors: KARİPER İ. Afşin , Demir Tuğba , Caner Armağan , Gökahmetoğlu Selma , Tutar Yusuf , Bahar Dilek , önal Müge Gülcihan , HEPOKUR Ceylan , Bitgen Nazmiye
Published: December 2020

In this study, we tested a chemical mixture causing hepatitis virus to grow in excessive amounts. We obtained this chemical mixture by disintegrating albumin and invertase enzymes separately in supercritical environments, using acidic methanol as solvent. Then we used this mixture as a medium for hepatitis B virus. The chemical mixture caused the hepatitis B virus to multiply almost 80-100 times after 120 minutes. The real surprising result of the study occurred after carrying out bacterial tests with the same chemical mixture, its effect on cancer cells were also investigated. But no effect was observed neither on cancer cells, nor on bacteria. In other word, we developed a specific medium for the hepatitis virus. In this way, we decided that a method that can reduce the detection limit of PCR device to 1 IU/mL could be developed. This study will be an important milestone in developing vaccines against viruses as well.
Lipid-Lowering Drug, Fenofibrate Combined with si-HOTAIR Can Effectively Inhibit the Proliferation of Gliomas
Authors: Zhu Wei , Zhao Hongyang , Xu Fenfen , Huang Bin , Dai Xiaojing , Sun Jikui , Nyalali Alphonce , Zhang Kailiang , Ni Shilei
Published: December 2020

Background: Fenofibrate is a fibric acid derivative known to have a lipid-lowering effect. Although fenofibrate-induced peroxisome proliferator-activated receptor alpha (PPARα) transcription activation has been shown to play an important role in the malignant progression of gliomas, the underlying mechanisms are poorly understood.Methods: In this study, we analyzed the TCGA database and found that there is a significant negative correlation between long non-coding RNA (lncRNA) HOTAIR and PPARα. Then we explored the molecular mechanism of lncRNA HOTAIR regulating PPARα from the level of in vitro cell lines and the level of nude mouse glioma model in vivo, and explored the effect of combined application of HOTAIR knocking down and fenofibrate treatment on glioma invasion.Results: For the first time, it was shown that after knocking down the expression of HOTAIR in gliomas, the expression of PPARα was significantly up-regulated, and the invasion and proliferation ability of gliomas were obviously inhibited. Then, glioma cells were treated with both PPARα agonist, fenofibrate and si-HOTAIR; results showed that proliferation and invasion of glioma cells were significantly inhibited.Conclusions: Our results suggest that HOTAIR can negatively regulate the expression of PPARα, and the combination of fenofibrate and si-HOTAIR treatment can significantly inhibit the progression of gliomas. This introduces new ideas for the treatment of gliomas.
Exploring the Mechanisms of Acupuncture-Induced Lowering of Blood Pressure Through Positron Emission Tomography and RNA Sequencing of the PVH
Authors: Li Jing , Peng Chong , Lai Dongjian , Fang Yajing , Luo Daihong , Zhou Zunming , Li Chenyun , Lai Xinsheng
Published: December 2020

Manual acupuncture (MA) can be used to manage high blood pressure, however, the underlying molecular mechanism remains unknown. To explore the mechanism of acupuncture in the treatment of hypertension, we used Wistar Kyoto rats (WKYs) and spontaneously hypertensive rats (SHRs) that were subject to either MA stimulation or the corresponding sham procedure as a negative control (sham-MA) for 1 week. Blood pressure was recorded regularly. After 7 days of treatment, PET-CT scans were used to detect brain areas where glucose metabolism was significantly regulated. Additionally, the differentially expressed genes(DEGs) of a specific brain region—the paraventricular hypothalamic nucleus (PVH)—were evaluated by transcriptomics, and verified with quantitative PCR (qPCR). Eight overlapping DEGs were found between the WKY, SHR, and MA groups. The DEGs were then annotated with the Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) databases. qPCR was used to verify the DEGs. These genes may lower blood pressure by regulating angiotensin, endothelial function and inflammation, ect. This study reveals MA regulates multiple biological processes and genes of the PVH, and provides a solid theoretical basis for exploring the mechanisms by which MA manages hypertension.
Evaluation and Diagnosis of Nonalcoholic Fatty Liver Disease/Steatohepatitis by K-Fold Validation Based on Pathology, Including Real-Time Shear Wave Elastography and Noninvasive Biomarkers
Authors: Zhou Jie , Yan Feng , Xu Jinshun , Lu Qiang , Zhu Xianglan , Gao Binyang , Zhang Huan , Yang Rui , Luo Yan
Published: December 2020

ObjectivesThis study aim to investigate the diagnostic accuracy of shear wave elastography (SWE) for diagnosing nonalcoholic steatohepatitis (NASH) and staging fibrosis in a cohort patients confirmed nonalcoholic fatty liver disease (NAFLD) by liver biopsy.MethodsA total of 86 NAFLD patients and 17 normal-control were enrolled. The performance of SWE to diagnose NASH and stage fibrosis was evaluated on the basis of histopathological inflammation grades and fibrosis stages according to Kleiner/Brunt et al.’s criteria classification, and compared to previous reported four noninvasive serum fibrotic scores, coupled with the k-fold-cross-validation and Delong test. Meanwhile, influence of steatosis on liver stiffness measurements (LSMs) of SWE was also studied.ResultsLSMs of SWE proved to be an excellent diagnostic indicator for detecting NASH (AUROC＝0.85), and fibrotic NASH: ≥F2 stage (AUROC＝0.92), ≥F3 stage (AUROC＝0.94) and =F4 stage (AUROC ＝0.94) with the cutoff values were 7.55, 7.65, 8.25 and 11.80 kPa, respectively. Compared with serum fibrotic scores, SWE had the highest AUROC for predicting ≥F2, ≥F3, =F4 by Delong test (all P＜0.05). No statistic differences of LSMs were found among different steatosis levels (P=0.29).ConclusionThe stiffness reconstructions based on SWE could be used to noninvasively identify NASH and stage fibrosis in NAFLD patients. Moreover, the diagnosis efficiency of LSMs on SWE could not be influenced by steatosis.
Prescription Patterns of Dentists in Primary Care in Bahrain During COVID-19: A Cross Sectional Study.
Authors: Sivaramakrishnan Gowri , Alsobaiei Muneera , AlSulaiti Fatema , Sridha Kannan
Published: December 2020

Background: Dentists have always been attributed to the ever rising global problem of antibiotic resistance. The recent pandemic due to COVID-19 has caused greater concern and primary dental care practices were suspended in the Ministry of Health in Bahrain between February to August 2020. Dental emergencies were addressed using a triage system and dentists were advised on avoiding invasive and aerosol generating procedures. This means that many dentists opted to prescribe medications without undertaking the necessary dental intervention. Aim: To identify the prescription and drug utilization of primary care dental practitioners during the temporary suspension of routine dental practices due to COVID-19.Method: Anonymized data from out-patient dental prescriptions from February 2020 to August 2020 were collected. Necessary data regarding the number, type and indication for prescription were collected and analyzed using appropriate statistical tests.Results: An average of two medications were prescribed for each patient, that included systemic and local analgesics and anti-microbials. 33.4% of patients were only prescribed medications without any dental intervention. Approximately 35% of the records showed inappropriate diagnosis and their rationale for prescription could not be determined. 100% of the patients with acute or chronic periapical abscess and 41% with gingivitis or periodontitis were prescribed medications without any dental intervention. Amoxicillin and amoxicillin/clavulanic acid amongst the antimicrobial class; and ibuprofen and acetaminophen amongst the analgesics accounted for 90% of prescribed drugs. Chlorhexidine mouth rinse seemed to be on the regular list for any diagnoses, prescribed between 7 and 14 days, twice or thrice daily. Conclusion: Suspension of dental practices can cause more harm in terms of overuse and unindicated prescription practices in primary dental care. The awareness of the recent guidelines is important to prevent unintended use. Effective infection control practices based on guideline should be in place to contain COVID-19 transmission rather than suspension of dental care.
Adherence Of Facemask During COVID Pandemic Among South Asian Countries-An Observational Study
Authors: Abid Khadijah , Imran Abira , Bari Yashfika , Ziadi Tooba , Khambati Zainab , Younus Maryam , Billah Abul Hasan Baki , Khura Bikash , Jabbar Abdul
Published: December 2020

Background: The novel coronavirus outbreak, caused by SARS-CoV-2, has proven to be an attack on the global healthcare system, demanding utmost attention from both the healthcare and government officials around the world. The use of face masks is so pivotal in lowering the risk of contracting respiratory viruses, it is crucial to know how many people are actually complying with this protective healthcare policy and what socio-demographic factors (if any) are influencing it. So, the aim was to investigate the adherence rate of face masks among the people of South Asian countries namely Pakistan, Bangladesh, and India, and also to examine correlations between face mask adherence and socio-demographic factors.Methodology: This was an observational study conducted from 15 July 2020 to 15 September 2020. Individuals of age more than 14 years of either gender, who had accessibility to the internet and understood English participated in the study. The three South-Asian countries such as Pakistan, India, and Bangladesh were targeted. The online survey form included questions regarding socio-demographics and the type of face mask they wore. Face mask adherence was classified as “yes” when any type of face mask was worn and “no” when no face mask was used. Statistical software SPSS version 25 was used to analyze data.Results: The mean age of the participants was 31.32±9.83 years. Out of all these participants, there were 826 (46.3%) males and 959 (53.7%) were females. Univariate analysis showed that females, Muslims, education level till graduate, employed, monthly income and Bangladeshi participants had higher odds of face mask adherence (p<0.05). The multivariate analysis showed that females, Muslims, urban residents, secondary level education, employed, monthly income $100 - $300, and Bangladeshi were strongly associated with face mask adherence (p<0.05).Conclusion: Among all three countries, Bangladeshi had high face mask adherence than Pakistan and India. The socio-demographic factors associated with facemask usage were gender, religion, locality, education, employment status, monthly income, and nationality.
OB Nest Randomized Controlled Trial: A Cost Comparison of Reduced Visit Compared to Traditional Prenatal Care
Authors: Theiler Regan , Tobah Yvonne Butler , Hathcock Matthew , Famuyide Abimbola
Published: December 2020

BackgroundTraditional prenatal care includes up to 13 in person office visits, and the cost of this care is not well-described. Alternative models are being explored to better meet the needs of patients and providers. OB Nest is a telemedicine-enhanced program with a reduced frequency of in-person prenatal visits. The cost implications of connected care services added to prenatal care packages are unclear.MethodsUsing data from the OB Nest randomized, controlled trial we analyzed the provider and staff time associated with prenatal care in the traditional and OB Nest models. Fewer visits were required for OB Nest, but given the compensatory increase in connected care activity and supplies, the actual cost difference is not known.Nursing and provider staff time was prospectively recorded for all patients enrolled in the OB Nest clinical trial. Published 2015 national wages for healthcare workers were used to calculate the actual labor cost of providing either traditional or OB Nest prenatal care in 2015 US dollars. Overhead expenses and opportunity costs were not considered.ResultsTotal provider cost was decreased caring for the OB Nest participants, but nursing cost was increased. OB Nest care required an average of 160.8 (+/- 45.0) minutes provider time and 87.8 (+/- 25.1) minutes nursing time, compared to 215.0 (+/- 71.6) and 99.6 (+/- 29.7) minutes for traditional prenatal care (P<0.01). This translated into decreased provider cost and increased nursing cost (P<0.01). Supply costs increased, travel costs declined, and overhead costs declined in the OB Nest model. ConclusionsIn this trial, labor cost for OB Nest prenatal care was 34% higher than for traditional prenatal care. The increased cost is largely attributable to additional nursing connected care time, and in some practice settings may be offset by decreased overhead costs and increased provider billing opportunities. Future efforts will be focused on development of digital solutions for some routine nursing tasks to decrease the overall cost of the model. Trial Registrations: ClinicalTrials.gov Identifier: NCT02082275
What A Disaster! The Hydrofluoric Acid Leak in Gumi City in 2012: Lessons What We Have Earned From Review of the Past Hospital’s Disaster Response
Authors: Shin Heejun , Oh Se Kwang , Lee Han You , Chung Heajin , Yoon Seong Yong , Choi Sung Yong , Kim Jae Hyuk
Published: December 2020

Objective: This study aimed to analyze the characteristics of hydrogen fluoride–exposed patients (HFEPs) treated at an emergency department (ED) at a local university hospital, and to review the hospital's disaster response according to staff, stuff, space, and system (4Ss).Method: This is retrospective observational chart review and descriptive study included 199 HFEPs among 2628 of total ED patient who visited a local university emergency medical center for treatment between September 27 and October 20, 2012, following an HF leak at the Hub Globe factory in Gumi City, Republic of Korea. Descriptive results concerning 4Ss were obtained from interview with ED specialist staff physician on duty during the study period. According to the criteria of the American Burn Association, patients requiring burn center referral were assigned to the major burn group (MBG) as severe condition. Result: During the first 24 h after the accident, 161 (80.9%) HFEPs were treated in the ED. Among the 55 (27.6%) patients in the MBG, 8 (4% of the HFEPs) came to the ED during the acute phase (within the first 8 h after the leak began). During the acute phase, the ED was staffed with three doctors and three nurses. Among the total 2628 patients in the ED during the study period, 262 (9.97%) patients, including 167 (83.92%) of the 199 HFEPs, were there during the subacute phase, defined as the 24 h after the acute phase. During the subacute phase, the ED staff consisted of six doctors and 10 nurses. No concepts according to 4Ss that allowed for the expansion of ED space with securing disaster reserve beds or an increase in manpower with duty time adjustments or duty relocation for ED working personnel were in place as well as reinforcement of logistics such as antidote or PPE or disaster related measures of administration department or decontamination zone setup or decontamination or disaster related diagnostic testing measures or unification and management of the entrances and exits of hospital or implementation of previously designated disaster triage.Conclusion: Hospital disaster response was insufficient for all aspects of 4Ss. Detailed guidance for hospital disaster management plan establishment is required.
Using a Distribution-Based Approach and Systematic Review Methods to Derive Minimum Clinically Important Differences
Authors: Watt Jennifer , Veroniki Areti Angeliki , Tricco Andrea , Straus Sharon
Published: December 2020

Background Clinical interpretation of changes measured on a scale is dependent on knowing the minimum clinically important difference (MCID) for that scale: the threshold above which clinicians, patients, and researchers perceive an outcome difference. Until now, approaches to determining MCIDs were based upon individual studies or surveys of experts. However, the comparison of meta-analytic treatment effects to a MCID derived from a distribution of standard deviations (SDs) associated with all trial-specific outcomes in a meta-analysis could improve our clinical understanding of meta-analytic treatment effects. Methods We approximated MCIDs using a distribution-based approach that pooled SDs associated with baseline mean or mean change values for two scales (i.e. Mini-Mental State Exam [MMSE] and Alzheimer Disease Assessment Scale – Cognitive Subscale [ADAS-Cog]), as reported in parallel randomized trials (RCTs) that were included in a systematic review of cognitive enhancing medications for dementia (i.e. cholinesterase inhibitors and memantine). We excluded RCTs that did not report baseline or mean change SD values. We derived MCIDs at 0.4 and 0.5 SDs of the pooled SD and compared our derived MCIDs to previously published MCIDs for the MMSE and ADAS-Cog.Results We showed that MCIDs derived from a distribution-based approach approximated published MCIDs for the MMSE and ADAS-Cog. For the MMSE (51 RCTs, 12449 patients), we derived a MCID of 1.6 at 0.4 SDs and 2 at 0.5 SDs using baseline SDs and we derived a MCID of 1.4 at 0.4 SDs and 1.8 at 0.5 SDs using mean change SDs. For the ADAS-Cog (37 RCTs, 10006 patients), we derived a MCID of 4 at 0.4 SDs and 5 at 0.5 SDs using baseline SDs and we derived a MCID of 2.6 at 0.4 SDs and 3.2 at 0.5 SDs using mean change SDs. Conclusion A distribution-based approach using data included in a systematic review approximated known MCIDs. Our approach performed better when we derived MCIDs from baseline as opposed to mean change SDs. This approach could facilitate clinical interpretation of outcome measures reported in RCTs and systematic reviews of interventions. Future research should focus on the generalizability of this method to other clinical scenarios.
Winter Wonderland Cave, Utah, USA: A Natural Laboratory for the Study of Cryogenic Cave Carbonate and Thawing Permafrost
Authors: Munroe Jeffrey , Kimble Kristin , Spötl Christoph , Marks Gabriela Serrato , McGee David , Herron David
Published: December 2020

Winter Wonderland Cave contains perennial ice associated with two types of cryogenic cave carbonate (CCC) formed during the freezing of water. CCCfine is characterized by relatively enriched δ13C values, whereas CCCcoarse exhibits notably depleted δ18O values indicating precipitation under (semi)closed-system conditions in a pool of residual water beneath an ice lid. Previous work has concluded that CCCcoarse forms during permafrost thaw, making the presence of this precipitate a valuable indicator of past cryospheric change. Available geochronologic evidence indicates that CCC formation in this cave is a Late Holocene or contemporary process, and field observations suggest that the cave thermal regime recently changed in a manner that permits the ingress of liquid water. This is the first documented occurence of CCCcoarse in the Western Hemisphere and one of only a few locations where these minerals have been found in association with ice. Winter Wonderland Cave is a natural laboratory for studying CCC genesis.
Comparison of Changes in 2015 to 2019 for Socioeconomic Inequalities and Inequities in Health Services Utilization Among Patients With Hypertension in Pearl River Delta Region of China
Authors: Liu Yan , Cheng Mengjiao , Peng Xin , Huang Junxuan , Liu Nan , Ma Jinxiang , Wang Pei-Xi
Published: December 2020

BackgroundAssessing inequities in health services utilization contributes to build effective strategies for promotion of health equity. This study aimed to evaluate the socioeconomic inequalities and inequities in health services utilization among hypertensive patients and explore the changes between 2015 and 2019 in Pearl River Delta region of China. MethodsThe cross-sectional surveys were conducted using the questionnaire. In total, 830 and 1166 hypertensive patients in 2015 and 2019 were interviewed, respectively. The concentration index (CI) and the horizontal inequity (HI) were used to access the socioeconomic inequalities and inequities in health services use. The contribution of influential factors to the overall unfairness was estimated via the concentration index decomposition. Oaxaca-type decomposition technique was utilized to measure the changes in socioeconomic inequalities between the observation periods. ResultsFrom 2015 to 2019, the CIs for outpatient and inpatient utilization decreased from 0.1498 to 0.1198, 0.1982 to 0.1648, respectively, and the HIs for outpatient and inpatient utilization decreased from 0.1478 to 0.1078, 0.1956 to 0.1390, respectively, i.e. obvious pro-rich inequities in utilization of health services by hypertensive patients existed in Pearl River Delta Region even after controlling different needs, but they decreased over time. The inequities in inpatient utilization were higher compared with that in outpatient utilization. Economic status contributed the maximum ratio of the socioeconomic inequalities in the use of health services in these two years (107.54% in 2015, 106.92% in 2019). Oaxaca decomposition revealed that factors such as residential location, registration, health insurance and time to the nearest health facilities, employment status and educational level, etc. made positive contributions to decline the inequalities. While factors pushed the equalities toward deterioration included health needs, economic status and household size. Conclusion﻿There were certain decline in the socioeconomic inequalities and inequities in health services utilization by hypertensive patients in Pearl River Delta Region of China by comparison of 2015 and 2019. Although the pro-rich inequities persists, it does suggest that government policies have improved health equity over time.
The Impact of Illness Awareness on the Difference in the Economic Burden of Disease Among Middle-Aged and Elderly Diabetic Patients in Rural Areas
Authors: Liu Li , Deng Jing , Yu Xue
Published: December 2020

BackgroundThere are many explorations in China on the awareness of diabetes and the economic burden of disease, but the impact of awareness of illness on the economic burden of disease has not yet been empirically studied. We aim to explore the status of illness awareness and its influencing factors in rural middle-aged and elderly diabetic patients, and to further explore the impact of illness awareness on the economic burden of patients.MethodsTaking rural middle-aged and elderly diabetes as the object, the multiple regression model was used to analyze the patient's economic burden of disease and illness awareness, the propensity score matching method (PSM) was used to solve the influence of sample selection bias, and to explore the economic burden of disease awareness on patients Impact.ResultsIllness awareness is an important factor affecting the economic burden of disease in middle-aged and elderly diabetes in rural areas. Illness awareness increased the economic burden of disease by 94.3%; the number of other chronic diseases, education level, location, self-rated health status, and smoking are Influencing factors of patients' awareness of illness.ConclusionIn the short term, awareness of illness increases the overall treatment costs of patients, but from the perspective of long-term development, changes in lifestyle and medical behavior based on awareness of illness can help improve the health of patients and effectively reduce the risk of middle-aged and elderly diabetic patients in rural areas. The economic burden of disease.
Lung Diffusion Capacity Affects Stroke Volume in Systemic Sclerosis
Authors: Someya Fujiko , Mugii Naoki
Published: December 2020

Objective: In our previous cross-sectional study, we reported impaired stroke volume in patients with systemic sclerosis; however, no cardiac parameter using echocardiography was found to be related to stroke volume reduction. As few studies have focused on the hemodynamic clinical course, the patients were re-evaluated in a median interval of 18 months, and correlations between stroke volume and cardiopulmonary parameters were analyzed.Results: Seventeen patients who were able to complete the 6-minute walk test wearing a non-invasive impedance cardiograph device were assigned for re-evaluation, and individual changes in the stroke volume were noted. The stroke volume was not related to cardiac parameters, but it was significantly related to the diffusion capacity of the lung for carbon monoxide after walking in the first evaluation (r = 0.63, p = 0.006), and at rest in the re-evaluation (r = 0.72, p = 0.001). Significant relation was also found between the distance walked and the stroke volume after walking in the first evaluation and re-evaluation, and at rest in the re-evaluation. Thus, a limited lung diffusion capacity may affect stroke volume due to the exercise intolerance in systemic sclerosis without pathological heart involvement.
Effect of Ambient Fine Particulate (PM2.5) on Hospital Admissions for Respiratory and Cardiovascular Diseases in Wuhan, China
Authors: Ren Zhan , Liu Xingyuan , Liu Tianyu , Chen Dieyi , Jiao Kuizhuang , Wang Xiaodie , Suo Jingdong , Yang Haomin , Liao Jingling , Ma Lu
Published: December 2020

Background: The positive associations between ambient PM2.5 and cardiorespiratory disease have been well demonstrated during the past decade. However, few studies have examined the adverse effects of PM2.5 based on an entire population of megalopolis. In addition, due to the lack of accurate methods of assessing individual PM2.5 exposure, further studies are still necessary to be launched in China.Methods: The study was conducted in Wuhan, a megacity in central China with about 10.8929 million population. Daily hospital admission records, from October 2016 to December 2018, were obtained from Wuhan Information center of Health and Family Planning, which administrates all the hospitals in Wuhan. The daily air pollution concentration and weather variable in Wuhan during the study period were collected. We developed Land use regression model (LUR) to assess individual PM2.5 exposure. Time-stratified case-crossover design and conditional logistic regression models were adopted to estimate cardiorespiratory hospitalization risks associated with short-term exposures to PM2.5. We also conducted stratification analyses by age, sex and season.Results: A total of 2,806,115 hospital admissions records were collected during the study period, from which we identified 332,090 for total cardiovascular diseases and 159,365 for total respiratory diseases. We found short-term PM2.5 exposure was associated with increased risk of cardiorespiratory hospital admission in Wuhan. Per 10 μg/m3 increase of PM2.5 at lag0~2 days was associated with 1.23% (95%CI: 1.01–1.45%) and 1.95% (95%CI: 1.63–2.27%) elevated risk of admission from cardiovascular and respiratory diseases respectively. The elderly were at higher PM-induced risks. The associations appeared to be more evident in the cold season than in the warm season.Conclusions: This study contributed evidence to support the short-term effects of PM2.5 on cardiorespiratory hospital admission, which may be helpful for air pollution control and disease prevention in Wuhan.
A Novel Landmark Based on Nutrient Foramen for Pedicle Screw Insertion in the Battlefield Emergency 
Authors: Lu Lantao , Zhu Jian , Sun Kaiqiang , Sun Jingchuan , Shi Jiangang
Published: December 2020

Background: Spinal injuries is with high frequency in the modern wars and some patients with severe spinal injures have to accept the emergency spinal surgery. Nutrient foramen is easy to identify intraoperatively. The purpose of this study was to investigate the feasibility and reliability of using the nutrient foramen to guide the pedicle screw placement.Methods: Nine dried human vertebral bone were involved in this study. The anatomical association to the pedicles and bony landmarks were measured in the vertebrae for C6-T6. We also determined the frequency with which the nutrient foramina were present in 86 cadaveric vertebrae. We identified the pedicle location, base of the superior articular process, base of inferior articular process, base of transverse process, and the posterior median line with respect to the nutrient foramenResults: The overall presence of the nutrient foramina was 63% in the specimens. The nutrient foramina located cranially and laterally on the lamina, and the nutrient foramen was located near to the pedicle. Conclusion: The location of nutrient foramen can be used for identifying the entry point for pedicle screws in the cervicothoracic junction. The nutrient foramen is easy to identify during operation and with a high frequency of occurrence. Therefore, the nutrient foramen could be used as a reliable landmark to guide the entry point localization in emergency spinal surgeries in the battlefield.
NaCl-Related Weathering of Stone: The Importance of Kinetics and Salt Mixtures in Environmental Risk Assessment
Authors: Godts Sebastiaan , Orr Scott Allan , Desarnaud Julie , Steiger Michael , Wilhelm Katrin , De Clercq Hilde , Cnudde Veerle , De Kock Tim
Published: December 2020

Salt weathering is one of the most important causes of deterioration in the built environment. Two crucial aspects need further investigation to understand the processes and find suitable measures: the impact of different climatic environments and the properties of salt mixture crystallization. We demonstrate the importance of kinetics in quantifying crystallization and dissolution cycles by combining droplet and capillary laboratory experiments with climate data analysis. The results proved that dissolution times for pure NaCl were much slower than crystallization, while thermodynamic modelling showed a lower RHeq of NaCl (65.5%) in a salt mixture (commonly found in the built heritage) compared to its RHeq as a single salt (75.5%). Following the results, a minimum time of 0.5 hour is considered for dissolution and the two main RHeq thresholds could be applied to climate data analysis. The predicted number of dissolution/crystallization cycles was significantly dependent on the measurement frequency (or equivalent averaging period) of the climatic data. An analysis of corresponding rural and urban climate demonstrated the impact of spatial phenomena (such as the urban heat island) on the predicted frequency cycles. The findings are fundamental to improve appropriate timescale windows and to illustrate a methodology with specific points of interest to quantify salt crystallization cycles in realistic environments as a risk assessment procedure that can be applied to climate data. The results are the basis for future work to improve the accuracy of salt risk assessment by including the kinetics of salt mixtures. This will improve the understanding of past and future salt weathering mechanisms and enable scientifically informed conservation strategies.
IPDfromKM: Reconstruct Individual Patient Data from Published Kaplan-Meier Survival Curves
Authors: Liu Na , Zhou Yanhong , Lee J. Jack
Published: December 2020

BackgroundWhen applying secondary analysis on published survival data, it is critical to obtain each patient’s raw data, because the individual patient data (IPD) approach has been considered as the gold standard of data analysis. However, researchers often lack access to the IPD. We aim to propose a straightforward and robust approach to help researchers to obtain IPD from published survival curves with a friendly software platform. ResultsImproving upon the existing methods, we proposed an easy-to-use, two-stage approach to reconstruct IPD from published Kaplan-Meier (K-M) curves. Stage 1 extracts raw data coordinates and Stage 2 reconstructs IPD using the proposed method. To facilitate the use of the proposed method, we develop the R package IPDfromKM and an accompanied web-based Shiny application. Both the R package and Shiny application can be used to extract raw data coordinates from published K-M curves, reconstruct IPD from data coordinates extracted, visualize the reconstructed IPD, assess the accuracy of the reconstruction, and perform secondary analysis on the IPD. We illustrate the use of the R package and the Shiny application with K-M curves from published studies. Extensive simulations and real world data applications demonstrate that the proposed method has high accuracy and great reliability in estimating the number of events, number of patients at risk, survival probabilities, median survival times, as well as hazard ratios. ConclusionsIPDfromKM has great flexibility and accuracy to reconstruct IPD from published K-M curves with different shapes. We believe that the R package and the Shiny application will greatly facilitate the potential use of quality IPD data and advance the use of secondary data to make informed decision in medical research.
Malaria Vector Survivorship Linked to Irrigated Sugarcane Plantation Scheme in Ethiopia
Authors: Hawaria Dawit , Kibret Solomon , Demissew Assalif , Tsegaye Arega , Bitew Denekew , Yan Guiyun , Yewhalaw Delenasaw
Published: December 2020

Background: To ensure food security, the sub-Saharan Africa has initiated massive water resource development projects in recent years. However, such environmental modifications affect the survivorship and development of mosquitoes that are vectors of different diseases. This study aimed at determining the effects of irrigation practices on development and survivorship of Anopheles gambiae s.l in Ethiopia. Methods: Life-table experiment was conducted to examine the effect of environmental modification on survivorship of both immature and adults An. gambiae s.l. in irrigated and non-irrigated areas. The pupation rate and development time of the immatures and adult longevity and fecundity were compared between the two settings.Results: The estimated mean survival time of female An. gambiae s.l. in irrigated and non-irrigated area was 37.9 and 31.3 days, respectively. A survival analysis showed that adult females of An. gambiae s.l. placed in irrigated area lived significantly longer than those at the non-irrigated area (χ2 = 18.3, df = 1, p <0.001) and An. gambiae s.l. females lived significantly longer than males in both areas (p < 0.05). Conclusions: Adult An. gambiae s.l. survivorship was found to be enhanced in irrigated area compared to non-irrigated area. Longer survival of adult mosquito in irrigated area could have important implications in vectorial capacity and hence malaria transmission.
Decomposition of High-Frequency Electrical Conductivity into Extracellular and Intracellular Compartments based on Two-Compartment Model using Low-to-High Multi-b Diffusion MRI
Authors: Lee Mun Bae , Kim Hyung Joong , Kwon Oh-In
Published: December 2020

Background: As an object's electrical passive property, the electrical conductivity is proportional to the mobility and concentration of charged carriers that reflect the brain micro-structures. The measured Mb-DWI data by controlling the degree of applied diffusion weights can quantify the apparent mobility of water molecules within biological tissues. Without any external electrical stimulation, magnetic resonance electrical properties tomography (MREPT) techniques have successfully recovered the conductivity distribution at a Larmor-frequency. Methods: This work provides a non-invasive method to decompose the high-frequency conductivity into the extracellular medium conductivity based on a two-compartment model using multi-b diffusion-weighted imaging (Mb-DWI). To separate the intra- and extracellular micro-structures from the recovered high-frequency conductivity, we include higher b-values DWI and apply the random decision forests to stably determine the micro-structural diffusion parameters. Results: To demonstrate the proposed method, we conducted human experiments by comparing the results of reconstructed conductivity of extracellular medium and the conductivity in the intra-neurite and intra-cell body. Human experiments verify that the proposed method can recover the extracellular electrical properties from the high-frequency conductivity using a routine protocol sequence of MRI scan. Conclusion: We have proposed a method to decompose the electrical properties in the extracellular, intra-neurite, and soma compartments from the high-frequency conductivity map, reconstructed by solving the electro-magnetic equation with measured B1 phase signals.