bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 Chest X-Ray Images Diagnosis: A Neutrosophic and Deep Transfer Learning Approach
Authors: M. Khalifa Nour Eldeen , Smarandache Florentin , Loey Mohamed
Published: April 2020

Coronavirus, also known as COVID-19, has spread to several countries around the world. It was announced as a pandemic disease by The World Health Organization (WHO) in 2020 for its devastating impact on humans. With the advancements in computer science algorithms, the detection of this type of virus in the early stages is urgently needed for the fast recovery of patients. In this paper, a neutrosophic with a deep learning model for the detection of COVID-19 from chest X-ray medical digital images is presented. The proposed model relies on neutrosophic theory by converting the medical images from the grayscale spatial domain to the neutrosophic domain. The neutrosophic domain consists of three types of images and they are, the True (T) images, the Indeterminacy (I) images, and the Falsity (F) images. Using neutrosophic images has positively affected the accuracy of the proposed model. The dataset used in this research has been collected from different sources as there is no benchmark dataset for COVID-19 chest X-ray until the writing of this research. The dataset consists of four classes and they are COVID-19, Normal, Pneumonia bacterial, and Pneumonia virus. After the conversion to the neutrosophic domain, the images are fed into three different deep transfer models and they are Alexnet, Googlenet, and Restnet18. Those models are selected as they have a small number of layers on their architectures and they have been used with related work. To test the performance of the conversion to the neutrosophic domain, four scenarios have been tested. The first scenario is training the deep transfer models with True (T) neutrosophic images only. The second one is training on Indeterminacy (I) neutrosophic images, while the third scenario is training the deep models over the Falsity (F) neutrosophic images. The fourth scenario is training over the combined (T, I, F) neutrosophic images. According to the experimental results, the combined (T, I, F) neutrosophic images achieved the highest accuracy possible for the validation, testing and all performance metrics such Precision, Recall and F1 Score using Resnet18 as a deep transfer model. The proposed model achieved a testing accuracy with 78.70%. Furthermore, the proposed model using neutrosophic and Resnet18 had achieved superior testing accuracy with a related work which achieved 52.80% with the same experimental environmental setup and the same deep learning hyperparameters.
The Successes and Failures of the Initial COVID-19 Pandemic Response in Romania
Authors: Dascalu Stefan
Published: April 2020

In the context of the COVID-19 pandemic, countries around the world varied in the strength and timeliness of their responses. In Romania, specific challenges were faced with regards to managing the spread and limiting the impact of the disease, ranging from healthcare infrastructure to demographic and sociocultural aspects. As the country has a sizeable diaspora, major difficulties were faced when large numbers of individuals from highly affected areas returned to Romania. However, the fast implementation of control measures successfully averted a surge in the number of COVID-19 cases. This delayed the overburdening of an already challenged healthcare system during the initial phases of the epidemic. Furthermore, early control was facilitated by the exploitation of communication channels that penetrated all layers of society, from ordinary citizens to governmental authorities and high-ranking religious figures. The management of the COVID-19 crisis in Romania illustrates the importance of a fast initial response which takes into account the role played by sociocultural aspects in the context of an epidemic. As the challenges faced by Romania are not unique, these results could inform future public health strategies worldwide.
The Dynamics of Humoral Immune Responses Following SARS-CoV-2 Infection and the Potential for Reinfection
Authors: Kellam Paul , Barclay Wendy
Published: April 2020

SARS-CoV-2 is a novel coronavirus that is the causative agent of Coronavirus infectious disease 2019 (COVD-19). As of the 17th April 2020, it has infected 2 114 269 people resulting in 145 144 deaths. The timing, magnitude and longevity of humoral immunity is not yet understood for SARS-CoV-2. Nevertheless, understanding this is urgently required to inform the likely future dynamics of the pandemic, to guide strategies to allow relaxation of social distancing measures and to understand how to deploy limiting vaccine doses when they become available to achieve maximum impact. SARS-CoV-2 is the seventh human coronavirus to be described. Four human coronaviruses circulate seasonally and cause common colds. Two other coronaviruses, SARS and MERS, have crossed from animal sources into humans but have not become endemic. Here we review what is known about the human humoral immune response to epidemic SARS CoV and MERS CoV and to the seasonal, endemic coronaviruses. Then we summarize recent, mostly non-peer reviewed studies into SARS-CoV-2 serology and reinfection in humans and non-human primates and summarize current pressing research needs.
Clues from the First Covid-19 Wave and Recommendations for Social Measures in the Future
Authors: Schlickeiser Reinhard , Kröger Martin
Published: April 2020

The Gauss model for the time evolution of the first corona pandemic wave allows to draw conclusions on the dark number of infections, the amount of heard immunization, the used maximum capacity of breathing apparati and the effectiveness of various non-pharmaceutical interventions in different countries. In Germany, Switzerland and Sweden the dark numbers are 7.4 +/- 6.1, 11.1 +/- 8.5 and 25 +/- 25, respectively. Our method of estimating dark numbers from modeling both, infection and death rates simultaneously spares these countries the laborious, time-consuming and costly medical testing for antibodies of large portions of the population. In Germany the total number of infected persons, including the dark number of infections by the first wave is estimated to be 1.06 +/- 0.60 million, corresponding to 1.28 +/- 0.72 percent of the German population. We work out direct implications from these predictions for managing the 2nd and further corona waves.
PENGEMBANGAN PERANGKAT PEMBELAJARAN ETNOMATEMATIKA PADA SITUS PURBAKALA PUGUNG RAHARJO
Authors: Choirudin Choirudin , Ningsih Eka Fitria , Anwar M. Saidun , Sari Intan Ratna , Amalia Suci
Published: April 2020

Penelitian ini bertujuan untuk 1) Mengidentifikasi benda-benda budaya (artefak) yang ada pada situs purbakala Pugung Raharjo di Lampung Timur sekaligus mengimplementasi potensi yang dapat dikembangkan sebagai bahan pembelajaran dalam pembelajaran matematika di perguruan tinggi. Penelitian ini merupakan Research and Development (R&D) yang melibatkan semua pihak yang relevan (stakeholder) dalam mengkaji tindakan yang sedang berlangsung, antara lain: 1) Badan Kesatuan Bangsa dan Poliliti (Kesbangpol) Pemerintah Kabupaten Lampung Timur sebagai pihak yang berwenang dalam bidang penelitian dan pengembangan, 2) Lembaga Pendidikan Ma’arif NU sebagai pemangku kebijakan di lingkungan pendidikan di bawah naungan NU provinsi Lampung, 3) Kepemerintahan Desa Pugung Raharjo selaku pemilik wilayah situs Purbakala. Penelitian ini menggunakan metode penelitian analisis deskriptif dengan pendekatan survei untuk mengembangkan buku ajar bagi mahasiswa pendidikan Matematika di IAIMNU Metro khususnya dan bagi para pecinta, pemerhati dan pemangku kebijakan di bidang budaya dan matematika
Peningkatan Hasil Belajar Matematika melalui Media Realia pada Siswa Kelas 2 SD
Authors: Sari Annisa Herlida
Published: April 2020

The aim of this research is to improve the results of learning math students second grade through the application of media realia. The research was implemented on SDN 1 Kalianda, South Lampung. This study used class action research conducted through two cycles, a cycle of comprising planning, action, observation and reflection. The subject of research is a whole number of second  grade student SDN 1 Kalianda having the mathematical value helpdown KKM totaled 12 student. Analysis of the percentage  data used in this study was based on an agreement with a researcher and collaborator is using percentage increase reched 71% atthe end of the cycle. Analysis of data obtained from the result of percentage increase at the end of the cycle reached 84,33%. The end result of a whole analysis percentage data is an inrease more than 71%. Based on an increase in the percentage of this research, all student have reached percentage inrease reahed 71%, the can be expressed that hypotesis accepted. It could be concluded that the use of the media realia can enchange the results of learning math student second grade of elementary school student.
Educação Profissional e a Produção do Conhecimento
Authors: De Almeida Danice , De Almeida Dionara
Published: April 2020

No texto que segue vislumbramos abordar a discussão do papel da tecnologia na formação profissional como ferramenta na construção do conhecimento, pensando na educação profissional na visão de Luckesi. O procedimento metodológico adotado foi revisão bibliográfica, que buscou explicar e discutir conteúdo científico sobre tema, como base em referências teóricas já publicadas em periódicos, revistas, livros e outros. O objetivo deste estudo é discutir o papel da tecnologia na formação profissional como ferramenta na construção do conhecimento, pensando na educação profissional. As tecnologias têm impactos imediatos no encurtamento do ciclo de vida do produto, na redefinição dos segmentos de mercado, no surgimento de novas fontes de concorrência, na mudança das relações com a força de trabalho. No artigo buscamos discutir o nosso tema de estudo dentro de uma concepção da abordagem sistêmica olhando cada elemento chave do nossotema de estudo como partes integrantes de um subsistema e a relação entre essas partes como um sistema maior. Compreendemos que tanto a educação profissional como as tecnologias são consideradas práticas sociais que agem em sociedades determinadas, reforçando ou colaborando com a transformação dos modelos e estruturas sociais. Mas, para que haja qualquer tipo de movimento, sejam estes transformadores ou, ainda, para tornar mais fortes os modelos e estruturas sociais presentes, é imprescindível socializar o que chamamos de conhecimento.
Competências para a transformação digital - Desafios para a Educação Superior
Authors: Moser Alvino , Kolbe Júnior Armando
Published: April 2020

A comunicação tem por objetivo tratar das competências necessárias para a educação do futuro no Ensino Superior. Na introdução apontamos que os professores se encontram em um ponto de mutação, no qual, as antigas referências para o Planejamento Pedagógico estão superadas. A exigir uma mente engenhosa para prever o que a Transformação Digital exige. Trata-se a seguir da Transformação Digital, seus conceitos básicos que a definem. É vista como disruptiva. Um caminho fundamental para a sobrevivência das empresas. A seguir, desenvolve-se alguns pontos a respeito da revolução cultural que deve acompanhar essa transformação. Assim, ver-se-á na sequência como será a transformação educacional, com a recalibragem de objetivos, nova programação de conteúdo curricular. Tendo como base as competências necessárias para essa Transformação Digital. Finalmente, apontamos as principais competências e habilidades para que os profissionais possam se adaptar às novas formas de trabalho como o uso de aplicativos novos, IoT, BIGDATA e robótica. Enfim, segue uma breve conclusão, na qual desponta a necessidade de operadores abertos à inovação constante e necessária flexibilidade.
Burden of stillbirths and associated factors in Yirgalem Hospital, Southern Ethiopia: a facility based cross-sectional study
Authors: Mengesha Sintayehu , Dangisso Mesay Hailu
Published: April 2020

Background Stillbirth is an adverse pregnancy outcome of public health importance causing considerable psychosocial burden for parents and their family. Studies on stillbirth are scarce in southern Ethiopia. An assessment of stillbirths and associated factors in health care settings helps in devising strategies for tailored interventions. Therefore, we assessed the burden of stillbirths and associated factors in Yirgalem Hospital, southern Ethiopia Methods : A facility based cross-sectional study was conducted between 1 August 2015 and 30 July 2016. We randomly selected medical records of pregnant women from a hospital delivery registry. Bivariate analysis was employed to assess the association between independent and dependent variables using chi-square with significant p-value. Multivariate logistic regression was used to identify independent risk factors for stillbirths and to control for confounding.. Results : Of 374 reviewed records of pregnant women, 370 were included for the study. The magnitude of stillbirths was 92 per 1000 births. Fifteen, 15 (44.1%) of fetal deaths occurred after admission to the hospital. In multivariate logistic regression, stillbirths were higher among low birth-weight babies (<2500grams) (adjusted odds ratio (AOR): 10.70, 95% CI 3.18-35.97) than normal birth-weight babies (2500-<4000). Pregnant women who experienced a prolonged labour for more than 48 hours were 12 times (AOR: 12.15, 95% CI 1.76-84.12) more likely to have stillbirths than pregnant women without a prolonged labour. Pregnant women with obstetric complications were 19.8 times more likely to have stillbirths than pregnant women without obstetric complications. Similarly, pregnant women with at least 2 pregnancies were more likely to have stillbirths than pregnant women with less than two pregnancies (AOR: 4.39, 95% CI 1.21-15.85). Conclusion: We found a high burden of stillbirths in the study setting. Modifiable risk factors contributed to a higher risk of stillbirths; therefore, tailored interventions such as early identification and management of prolonged labour and obstetric complication at each level of health system could avert preventable stillbirths.
Wounds at risk of tetanus: unexpected level of underimmunization in a patient cohort
Authors: Piccini Gaia Bavestrello , Cavenaile Jean-Christophe , Bressan Maria Antonietta
Published: April 2020

Background: Tetanus is an acute and potentially fatal disease caused by Clostridium tetani, an extremely resilient pathogen. This bacterium can contaminate traumatic wounds which account for approximately 5.4% of all visits to the Emergency Department. According to several surveillance programs, the incidence of clinical tetanus in Italy is tenfold higher than in other industrialised countries. In 2010, Italy accounted for 57 of the 74 confirmed cases reported within the European Union.Methods: The study analysed data from 1094 patients who presented to the Emergency Department of the Fondazione IRRCS Policlinico San Matteo between April 2016 and November 2017 with wounds potentially at risk of infection with Clostridium tetani. Results: Data showed that, in conformity with the literature, the elderly (> 60 years old) constitute a high-risk category, with 219 unprotected individuals out of 238. Also, among patients aged more than 60 years old, there was a statistically significant difference between female and male patients. From the comparative analysis of the data however, it was surprisingly found that even younger patients are lacking protective immunity. Conclusions: When considering other medical systems, both European and non-European ones, and analysing their guidelines for the prevention of tetanus infection, the necessity of adopting a well-defined algorithm becomes evident. This, in order to avoid the excessive administration of prophylaxis, as well as to allow to put in place the necessary preventive measures for each patient. This study highlights the need for greater patient and clinician awareness, and for an improvement in record keeping and management of the documentation related to vaccinations. The analysed data also suggest the need for conducting awareness campaigns on the topic of vaccines and vaccine preventable infections. Patients should be made aware of the importance of keeping track of their own immunization status, and of remembering the date of the last administration of the vaccine or, of carrying around their vaccination card.
Patient’s travel distance to specialised cancer diagnostics and the association with the general practitioner’s diagnostic strategy and satisfaction with the access to diagnostic procedures: an observational study in Denmark
Authors: Virgilsen Line Flytkjær , Hvidberg Line , Vedsted Peter
Published: April 2020

Background: Research indicate that when general practitioners (GPs) refer their patients for specialist care, the patient often has long distance. This study had a twofold aim: in accordance to the GP’s suspicion of cancer, we investigated the association between: 1) cancer patient’s travel distance to the first specialised diagnostic facility and the GP’s diagnostic strategy and 2) cancer patient’s travel distance to the first specialised diagnostic facility and satisfaction with the waiting time and the availability of diagnostic investigations.Method: This combined questionnaire- and registry-based study included incident cancer patients diagnosed in the last six months of 2016 where the GP had been involved in the diagnostic process of the patients prior to their diagnosis of cancer (n=3,455). The patient’s travel distance to the first specialised diagnostic facility was calculated by ArcGIS Network Analyst. The diagnostic strategy of the GP and the GP’s satisfaction with the waiting times and the available investigations were assessed from GP questionnaires. Results: When the GP did not suspect cancer or serious illness, an insignificant tendency was seen that longer travel distance to the first specialised diagnostic facility increased the likelihood of the GP using ’wait-and-see’ approach and ’medical treatment’ as diagnostic strategies. The GPs of patients with travel distance longer than 49 kilometres to the first specialised diagnostic facility were more likely to report dissatisfaction with the waiting time for requested diagnostic investigations (PR: 1.98, 95% CI: 1.20-3.28).Conclusion: A insignificant tendency to use ‘wait-and-see’ and ‘medical treatment’ were more likely in GPs of patients with long travel distance to the first diagnostic facility when the GP did not suspect cancer or serious illness. Long distance was associated with higher probability of GP dissatisfaction with the waiting time for diagnostic investigations.
Quantitative proteomic analysis of Rett iPSC-derived neuronal progenitors
Authors: Varderidou-Minasian Suzy , Hinz Lisa , Hagemans Dominique , Posthuma Danielle , Altelaar Maarten , Heine Vivi M.
Published: April 2020

Background Rett syndrome (RTT) is a progressive neurodevelopmental disease that is characterized by abnormalities in cognitive, social and motor skills. RTT is often caused by mutations in the X-linked gene encoding methyl-CpG binding protein 2 (MeCP2). The mechanism by which impaired MeCP2 induces the pathological abnormalities in the brain is not understood. Both patients and mouse models have shown abnormalities at molecular and cellular level before typical RTT-associated symptoms appear. This implies that underlying mechanisms are already affected during neurodevelopmental stages.Methods To understand the molecular mechanisms involved in disease onset, we used an RTT patient induced pluripotent stem cell (iPSC)-based model with isogenic controls and performed time-series of proteomic analysis using in-depth high-resolution quantitative mass spectrometry during early stages of neuronal development. Results We provide mass spectrometry-based quantitative proteomic data, depth of about 7000 proteins, at neuronal progenitor developmental stages of RTT patient cells and isogenic controls. Our data gives evidence of proteomic alteration at early neurodevelopmental stages, suggesting alterations long before the phase that symptoms of RTT syndrome become apparent. Significant changes are associated with the GO enrichment analysis in biological processes cell-cell adhesion, actin cytoskeleton organization, neuronal stem cell population maintenance and pituitary gland development, next to protein changes previously associated with RTT, i.e. dendrite morphology and synaptic deficits. Differential expression increased from early to late neural stem cell phases, although proteins involved in immunity, metabolic processes and calcium signaling were affected throughout all stages analyzed. Limitations The limitation of our study is the number of RTT patients analyzed. As the aim of our study was to investigate a large number of proteins, only one patient was considered, of which 3 different RTT iPSC clones and 3 isogenic control iPSC clones were included. Even though this approach allowed the study of mutation-induced alterations due to the usage of isogenic controls, results should be validated on different RTT patients to suggest common disease mechanisms. Conclusions During early neuronal differentiation, there are consistent and time-point specific proteomic alterations in RTT patient cells carrying exon 3-4 deletion in MECP2. We found changes in proteins involved in pathway associated with RTT phenotypes, including dendrite morphology and synaptogenesis. Our results provide a valuable resource of proteins and pathways for follow up studies, investigating common mechanisms involved during early disease stages of RTT syndrome.
Hypoxia-challenged MSC-derived exosomes deliver miR-210 to attenuate post-infarction cardiac apoptosis
Authors: Cheng Hao , Chang Shufu , Xu Rende , Chen Lu , Song Xiaoyue , Wu Jian , Qian Juying , Zou Yunzeng , Ma Jianying
Published: April 2020

Background Myocardial infarction (MI) is a major cause of death worldwide. Although percutaneous coronary intervention and coronary artery bypass grafting can prolong life, cardiac damage persists. In particular, cardiomyocytes have no regenerative capacity. Mesenchymal stem cells (MSCs) are attractive candidates for the treatment of MI. The manner by which MSCs exert a beneficial effect upon injured cells is a source of continued study. Methods After the isolation and identification of exosomes from MSCs, the expression of miR-210 was determined by Microarray Chip. Subsequently, gain- and loss-function approaches were conducted to detect the role of exosomes and exosomal-miR-210 in cell proliferation and apoptosis of cardiomyocytes, as well as the MI in vivo . Dual-Luciferase Report Gene System was used to demonstrate the target gene of miR-210. Results We tested the hypothesis that MSC-derived exosomes transfer specific miRNA to protect cardiomyocytes from apoptotic cell death. Interestingly, direct cardiac injection of MSC exosomes reduced infarct size and improved heart function after coronary ligation. In vitro , the MSC exosomes enhanced cardiomyocyte survival to hypoxia. Confirmation of exosome uptake in myocytes was confirmed. Dual luciferase reporter assay implicated miR-210 as a mediator of the therapeutic effect and AIFM3 as a downstream target. Treatment with miR-210 overexpressing MSC exosomes improved myocyte protection to both in vitro and in vivo stress. Furthermore, the endogenous and exogenous miR-210 had the same therapeutic effects. Conclusion These results demonstrated that the beneficial effects offered by MSC-exosomes transplantation after MI are at least partially because of excreted exosome containing mainly miR-210.
Essential role of Salmonella Enteritidis DNA adenine methylase in modulating inflammasome activation
Authors: Guo Yaxin , Gu Dan , Huang Tingting , Cao Liyan , Zhu Xinyu , Zhou Yi , Wang Kangru , Kang Xilong , Meng Chuang , Jiao Xinan , Pan Zhiming
Published: April 2020

Background: Salmonella Enteritidis (SE) is one of the major foodborne zoonotic pathogens of worldwide importance which can induce activation of NLRC4 and NLRP3 inflammasomes during infection. Given that the inflammasomes play an essential role in resisting bacterial infection, Salmonella has evolved various strategies to regulate activation of the inflammasome, most of which largely remain unclear.Results: A transposon mutant library in SE strain C50336 was screened for the identification of the potential factors that regulate inﬂammasome activation. We found that T3SS-associated genes invC, prgH, and spaN were required for inﬂammasome activation in vitro. Interestingly, C50336 strains with deletion or overexpression of Dam were both defective in activation of caspase-1 and secretion of IL-1β. Transcriptome sequencing (RNA-seq) results suggest that the absence and overexpression of Dam had similar effects on infected cells, as high overlapping rates of differentially expressed genes and enriched pathways were found between the C50336-VS-C50336Δdam and C50336-VS-C50336::dam groups, including multiple signaling pathways related to the inﬂammasome. Moreover, overexpression of Dam in macrophages by lentiviral infection could specifically promote the activation of the NLRP3 inflammasome independently.Conclusions: These data indicate that Dam was essential for modulating inflammasome activation during SE infection, there are complex and dynamic interplays between Dam and the inflammasome under different conditions. New insights were provided about the battle between SE and host innate immunological mechanisms.
Utilization of Reproductive Health Services and associated factors among secondary school students in Woldia Town, Northeast Ethiopia, 2020
Authors: Gebremeskel Teshome , Beletew Biruk
Published: April 2020

Background: Despite policy actions and strategic efforts made reproductive health service uptake of youths in Ethiopia, its utilization remains low. Local evidence about the utilization of reproductive health service among adolescents and associated factors are relevant to design age-appropriate intervention strategies. Objective: The main aim of this study was to assess the utilization of reproductive health service and associated factors among adolescents in Woldia town secondary schools, Amhara, Ethiopia, 2019.Methods: Institutional based descriptive cross-sectional study was conducted on 420 secondary school students in Woldia Town from January - June 2019. A self-administered, structured questionnaire was used to collect the data. The samples were distributed proportionally and participants in each school were selected by systematic sampling technique. Bivariate and multivariable logistic regression was carried out to asses’ association between dependent and independent variables. Result: Two hundred seventy (64.3%) respondents utilize reproductive health service. Residence, educational status of the partner, presence of RHS facility in school, good knowledge level on RHS were significantly associated with the reproductive health services utilization. Conclusion and Recommendations: Knowledge of respondents on reproductive health issues in the study area was found to be low. This low service utilization might make students disposed to different reproductive health risks; STI, HIV, and unwanted pregnancy; which in turn can increase the school dropout rate, and have an impact on an individual’s future life.
Expression of Type II Toxin/Antitoxin systems and ClpP protease of Methicillin-Resistant Staphylococcus aureus under stress condition
Authors: Karimaei Samira , Kalani Behrooz Sadeghi , Shahrokhi Nader , Mashhadi Rahil , Pourmand Mohammad Reza
Published: April 2020

BackgroundStaphylococcus aureus is a major human pathogen causing chronic to persistent infections. Amongst diverse factors of pathogenesis in bacteria, toxin-antitoxin (TA) systems have a potential to be presented as an antibacterial target due to their participation in cell physiology including stress responses. This study was conducted to determine the effects of thermal and oxidative stresses on expression of type II Toxin/Antitoxin systems and ClpP protease in Methicillin-Resistant Staphylococcus aureus (MRSA).Materials/methodsExpression of type II TA genes (mazF, relE1, relE2 and immA) and clpP gene in MRSA strain were evaluated following thermal and oxidative stresses by qRT-PCR techniques.ResultsThe cell viability was constant across thermal stress, whereas oxidative stress induction resulted in a significant reduction in the growth of MRSA strain. The result of RT-qPCR revealed that TA genes were expressed in stress conditions and expression of mazF gene increased under both thermal and oxidative stresses in MRSA strain.ConclusionsBased on our results, the MRSA strain responded to stress by altering the expression level of TA genes. In overall, TA system could be an antibacterial target in S. aureus that can revitalize the research on TA systems in this pathogen.
Tibiotalocalcaneal arthrodesis in osteoarthritis deformation of ankle and subtalar joint – evaluation of treatment results
Authors: Stołtny Tomasz , Dugiełło Bogdan , Pasek Jarosław , Szyluk Karol , Pyda Michał , Spyrka Daniel , Białek Michał , Czuma Przemysław , Pijet Bartłomiej , Werner Krystian , Cieślar Grzegorz , Littner Roman , Pleva Leopold , Koczy Bogdan
Published: April 2020

Background
Tibiotalocalcaneal arthrodesis (TTCA) is an increasingly used method of stiffening the ankle and subtalar joints in advanced degenerative deformities.
Material and methods
The study group consisted of 19 men who were subjected to intramedullary and intra-osseous arthrodesis using an intramedullary nail. The average age of patients was 46 years (19–68). The main indication for surgical treatment was post-traumatic arthrosis 11 (58%). In the studied group of patients, clinical condition was assessed using the AOFAS classification, quality of life using the SF-12 scale, and assessment of pain intensity using the VAS scale. The above parameters were evaluated before surgery in the early (under 2 years), intermediate (from 2–5 years) and late (over 5 years) postoperative period.
Results
Analysis of the results showed that the assessed clinical condition on the AOFAS scale improved from an average of 20.6 points before TTCA to 63.5 points after the procedure. The result was statistically significant (p < 0.0001). Analyzing the results obtained using the SF-12 quality of life scale, a statistically significant increase was found. In the physical sphere of quality of life PCS-12 increased from 26.5 points to 44.2 points (p = 0.0004) and in the mental sphere of quality of life MCS-12 from 46.1 points to 52.6 points (p = 0.030). The intensity of pain ailments, assessed in the VAS scale, decreased in all three periods of postoperative observation (in the early period p < 0.05, in the intermediate period p = 0.23, and in the late period p < 0.05), with the strongest analgesic effect (reduction of pain intensity by 4.3 points on the VAS scale) was observed in the early post-operative follow-up period.
Conclusions
Tibiotalocalcaneal arthrodesis using an intramedullary nail causes a significant improvement in the clinical condition according to the AOFAS classification, enabling most patients to move independently, a significant improvement in the physical and mental quality of life assessed in the SF-12 scale and a significant reduction in the intensity of pain ailments assessed in the VAS scale, especially in the early postoperative period.
Lesions of the Lumbar Region in Asymptomatic Young Soccer Players: A Cross-Sectional Study
Authors: Junior Charbel Jacob , Amorim Gabriel Donato , Vidal Pâmela Reis , Lourenço Rafael Burgomeister , Junior Marcos Rosa , Hochhegger Bruno , Mattiello Rita
Published: April 2020

Purpose

To assess abnormalities frequency of the lumbar region in asymptomatic young soccer players.
Methods

Cross-sectional study. Male adolescents from schools of grassroots soccer clubs and non-practicing activity controls were included by convenience. The abnormalities frequency of the lumbar region was evaluated by magnetic resonance imaging (MRI), performed using 1.5T devices with multi-channel coils in model equipment models. The types of lesions evaluated were general, warning signs, instituted, anterior and posterior, and of the column. Comparisons between groups and the relative percentage of each lesion type were compared by Pearson’s chi-squared test and Fischer’s exact test. The inter and intra-observer analyses were compared by the Kappa test.
Results

Forty-five adolescents were included, of whom 25 (56%) were soccer-practicing teenagers. No significant differences were identified between the variables age (P = 0.960) and the body mass index (BMI) Z-score (P = 0.540) between the group of soccer players and the controls. However, the percentages of lesions (general, instituted, anterior and posterior, and in the spinal column) were significantly higher in the practicing football group than in the control group (P = 0.002, P < 0.001, P = 0.012, and P = 0.006, respectively).
Conclusion

Young adolescent asymptomatic soccer players have more lumbar spine lesions than less active controls who do not practice sports regularly.
Histone methyltransferase EHMT2 degradation by propionate derived from Bacteroides thetaiotaomicron induced colon cancer apoptosis via epigenetic regulation of TNFAIP1
Authors: Ryu Tae Young , Kim Kwangho , Han Tae-Su , Lee Mi-Ok , Lee Jinkwon , Choi Jinhyeon , Jeong Eun-Jeong , An Da Mi , Jung Cho-Rok , Jung Jaeeun , Park Kunhyang , Park Doo-Sang , Kim Dae-Soo , Son Mi-Young , Cho Hyun-Soo
Published: April 2020

BackgroundBacteroides thetaiotaomicron (BT) is the second most commonly isolated bacterium in the human microbiome after B. fragilis and is involved in the hydrolysis of glycosidic bonds in dietary carbohydrates. Although the human microbiome has recently been shown to affect colorectal cancer (CRC) treatment, the mode of action (MOA) between the microbiome and CRC is still unclear.MethodsTo assess the colon cancer apoptosis, we performed western blot, qRT-PCR and FACS analysis using BT supernatant (Sup), sodium propionate (SP), and EHMT2 specific siRNA. Using RNA-seq analysis and ChIP-seq analysis, we identified HECTD2 (E3 ligase) and TNFAIP1 (EHMT2 target) genes. The antitumor activity of EHMT2 was determined by an in vivo xenograft model.ResultsWe selected propionate derived from BT and showed that it suppressed CRC growth by promoting proteasomal degradation of EHMT2 through HECTD2 upregulation. Moreover, downregulation of EHMT2 reduced the level of H3K9me2 on the promoter region of TNFAIP1, and subsequently, upregulation of TNFAIP1 induced apoptosis of CRC cells. Finally, we performed an in vivo study using BIX01294 to inactivate EHMT2 and observed a reduction in the tumor size of the CRC xenograft models.ConclusionsWe suggest anticancer effects of BT and EHMT2 as therapeutic targets for colon cancer treatment, and we will provide the possibility for synergistic effects of an EHMT2 inhibitor and BT in CRC treatment.*Authors share co-first authorship
Patients’ perceptions of frequent hospital admissions: A qualitative study with older people above 65 years
Authors: Huang Miaolin , Borght Carolien Van der , Leithaus Merel , Flamaing Johan , Goderis Geert
Published: April 2020

BackgroundAlthough frequent flyers represent barely three to eight percent of the total patient population in a hospital, they are responsible for a disproportionately high percentage (12 to 28 percent) of all admissions. Moreover those hospital admissions are an important contributor to healthcare costs and overpopulation in various hospitals. The aim of this research is to get a deeper insight into the phenomenon of the frequent flyer. Our objectives were to understand the patients’ perspectives on the cause of their frequent hospital admissions and to identify the perceived consequences of the frequent flyer status.Design and methodsThis qualitative study took place at the University Hospital of Leuven. The COREQ guidelines were followed to provide rigor to the study. Patients were included when they had at least four overnight admissions in the past 12 months, an age above 65 and an hospital admission at the time of the study. Data was collected via semi-structured interviews and encoded in NVivo.ResultsThirteen interviews were collected. A total of 17 perceived causes for frequent hospital admission were identified which could be divided into six themes namely patient, drugs, primary care, secondary care, home and family. Most of the causes were preventable or modifiable. The perceived consequences of being a frequent flyer were divided into six themes namely body, daily life functioning, social participation, mental status and spiritual dimension. Negative experiences were linked to frequent flying and could be situated mainly in the categories of social participation, mental status and spiritual dimensions.ConclusionsThis study offered an in-depth insight into the patients’ perceived causes of frequent admissions and identified the experiences of frequent flyers.Relevance to clinical practiceFew qualitative studies have been published in this field of research, while they can provide added value for understanding the phenomenon of frequent flying.Impact statementWhat does this paper contribute to the wider global clinical community?● This article offers in-depth understanding of patients’ perspectives of the cause(s) of their frequent hospital admissions.● This article shows how patients experience the consequences of being a frequent flyer on their current state.
miRNA Identification from Jatropha curcas L. whole genome shotgun assembly sequences
Authors: Vishwakarma Nutan Prakash
Published: April 2020

miRNAs are 20-25 nucleotide in length, endogenous in origin, and noncoding RNA molecules found in all the eukaryotic organism and takes part in the regulation of gene expression. Jatropha curcas L. oil has drawn attention as one of the most potential biofuels that can be a substitute of never-ending fuel crisis. Six miRNA candidates, each belonging to different miRNA families were predicted after screening of 41,790 whole genome shotgun assembly sequences by using the comparative genomics approach. The targets of identified miRNA were also predicted, the predicted target genes are belonging to diverse functions like in metabolism, transport, and genes involved in fatty acid metabolism. The predicted miRNAs show their targets which involve in the fatty acid metabolism, like miR414 targets the gene of acetyl-CoA carboxylase and O-acyltransferase WSD1, miR846 targets gene of FAD omega-3 fatty acid, FAD plastid fatty acid desaturase, miR5658 have the target gene long chain acyl-CoA synthetase 1, and miR407 have the target gene Trigalactosyldiacylglycerol 2, miR2938 GDSL esterase/lipase, glycolipid transfer protein 1.
Challenges assessing personality disorders with the SCID-5-PD in psychiatric patients
Authors: Boberg Mateo , Felding Simon , Jansson Lennart Bertil , Nordgaard Julie
Published: April 2020

Background: The SCID-5-PD is frequently used to diagnose personality disorders. The aim of this study is to compare the diagnostic outcomes of the SCID-5-PD with expert clinical assessment in an ICD-10 setting. Methods: A random sample of a total of 30 psychiatric in- and outpatients (mean age = 34 ± 16, 17 males and 13 females) went through a comprehensive clinical assessment conducted by experts. Subsequently, the patients were assessed with the SCID-5-PD by specifically trained novice raters. Results: 55% (n=11) of patients with clinical diagnosis within the schizophrenia spectrum were allocated one or more diagnoses of personality disorder according to the SCID-5-PD, primarily borderline personality disorder (n=6). In contrast, of all patients with a clinical diagnosis outside the schizophrenia spectrum, only one patient qualified for a diagnosis of personality disorder with the SCID-5-PD. Meanwhile, 70% (n=7) of patients with a clinical diagnosis of ICD-10 schizotypal disorder did not meet the criteria for this disorder when assessed with the SCID-5-PD. Conclusions: When considering a differential diagnosis within the schizophrenia spectrum, outcomes from the SCID-5-PD should be interpreted cautiously.
Is it the time to implement the routine use of distress thermometer among Egyptian patients with newly diagnosed cancer?
Authors: Aziz Nashwa Abd El- , Khallaf Salah , Abozaid Waleed , Elgohary Ghada , El-Fattah Ola Abd , Elhawary Mai , Khaled Safaa , El-Haffez Azza Abd , Kamel Ehab , Mohamed Sherif
Published: April 2020

Background
The distress thermometer (DT) is an effective tool for identifying distress among cancer patients worldwide. However, DT has not been studied in Egyptian patients. We aimed to study the prevalence of distress among Egyptian patients with different types of cancers using DT.
Methods
A total of 550 patients with newly diagnosed hematological and solid cancers who followed at 3 Oncology Centers in Egypt were enrolled. They completed a sociodemographic and clinical status questionnaire, the DT and the Problem List (PL) scale.
Results
At a DT cut off score of ≥ 4, 46% of patients had significant distress, which was related to the tumor site and stage. The most frequent problems reported were treatment decision (64.4%), worry (47%), and fears (44.5%). Univariate analysis showed that participants who had significant distress described 26 out of 36 problems in the practical, family, emotional, spiritual/religious and physical areas. Multivariate analysis confirmed only advanced cancer stage, depression, fear, nervousness, sadness, worry, loss of interest in usual activity, appearance, fatigue, feeling swollen, fever, getting around, indigestion, nausea, pain, and sleep as independent factors associated with significant distress in cancer patients.
Conclusions
Almost half of Egyptian patients newly diagnosed with cancer suffered from significant distress. Patients who had significant distress described extra problems in the practical, family, emotional, spiritual and physical areas. We recommend the routine use of DT for screening Egyptian patients with cancer, as well as the involvement of the psycho-oncology service and palliative care for pain control, at the time of their initial diagnosis.
Does a lower self-concept explain mental health disparities of diverse immigrant youth from middle childhood to late adolescence?
Authors: Busch Julian , Claus Carola , Schneider Silvia , Siefen Rainer Georg
Published: April 2020

Background: Three out of ten children in Germany have an immigrant background and this proportion will increase further. While immigrant youth has been found more vulnerable to developing symptoms of depression and anxiety, the underlying mechanisms of how such disparities develop across youth development are still understudied. Some previous research has found that immigrant youth are at risk of experiencing a less positive self-concept compared to non-immigrant youth. We investigated whether the self-concept is a mediator for such mental health disparities. Moreover, we explored variability in such associations from middle childhood to late adolescence.Methods: Overall 1907 children and adolescents aged 5-18 years (M=14 years, SD=3.03, 49.8% female, n=782 with immigrant status) participated in a cross-sectional self-report survey in school settings using scales from the Beck’s Youth Inventories II [1] to assess self-concept and symptoms of depression and anxiety. Links between the immigrant status, age, self-concept and symptom levels of depression as well as anxiety were examined in univariate regression models and moderated mediation models.Results: Immigrant youth reported higher symptom levels of depression and anxiety than their non-immigrant counterparts but did not differ in their self-concepts. Across age groups, self-concept was a significant predictor for symptom levels of depression as well as anxiety, with stronger associations in adolescents. However, the overall hypothesized moderated mediation models were not supported as self-concept neither mediated the link between immigrant status and depression nor anxiety.Conclusions: Our study substantiates previous findings that immigrant youth have increased levels of mental health problems compared to non-immigrant youth. However, our findings also show that immigrant youth do not have a more negative self-concept. The self-concept moreover does not seem to represent a mediator for internalizing mental health disparities. Findings from our study hence suggest that psychosocial interventions for immigrant youth do not require a specific emphasis on self-concept-related components. As our evidence suggests age-moderation of the self-concept on depression and anxiety, psychosocial interventions should consider developing a positive attitude towards the self especially for adolescents. Further research is needed to deepen the understanding of the mediating processes between migration status and mental health variables.
Transposable element abundance correlates with mode of transmission in microsporidian parasites
Authors: de Albuquerque Nathalia Rammé Medeiros , Ebert Dieter , Haag Karen Luisa
Published: April 2020

The extreme genome reduction and physiological simplicity of some microsporidia has been attributed to their intracellular, obligate parasitic lifestyle. Although not all microsporidian genomes are small–the known size range goes from about 2 to 50 MB–it is widely accepted that microsporidian genome size has been streamlined by natural selection. We explore an alternative hypothesis for microsporidian genome diversification, i.e ., that vertical transmission in microsporidia likely produces population bottlenecks, reducing the effectiveness of natural selection. We compared the transposable element (TE) content of 47 microsporidian genomes, and showed that genome size is positively correlated with the amount of TEs, and that species that experience vertical transmission have larger genomes with higher proportion of TEs. Our findings are consistent with earlier studies inferring that nonadaptive processes play an important role in microsporidian evolution.
Clinical Evaluation of Patients with Mixed Low-and-High Grade Non-muscle Invasive Bladder Cancer with EORTC Risk Scores
Authors: Lan Tianjie , Li Yuhong , Lu Yi , Liu Chuanfeng , Lin Gaoteng , Niu Yuanjie , Wang Xiaoming , Li Gang
Published: April 2020

Background: To evaluate the recurrence and progression rate of patients with mixed low-and-high grade (MG) non-muscle invasive bladder cancer (NMIBC), and compare these outcomes with the European Cancer Research and Treatment Organization (EORTC) prognostic risk scores.Methods: A retrospective analysis was performed based on the data from 68 MG NMIBC patients undergoing transurethral resection of bladder treatment (TUR-BT) from October 2013 to November 2018 in our hospital. The patients received intravesical treatment, and the follow-up protocols, including cystoscopy, ultrasound and urinary cytology, for the mean follow-up period of 33±10.7 months. The patients were divided into 4 groups according to the EORTC risk scores, and the recurrence rate and progression scores of tumors in each group were calculated and compared with the estimated rates based on EORTC risk scores. The log-rank test and multivariable analysis were used to analyze the possible differences between the risk groups and to identify independent prognostic factors.Results: Among the 68 patients, averagely 67.6 years (32-86 years), 42 patients were of Stage Ta and 26 were of Stage T1; the tumor recurrence was noted in 15 patients (22.1%), 11 as LG (low grade) and 4 as HG (high grade); and tumor progression in 4 patients (5.9%), 2 stages of progression. The Kaplan-Meier curve showed a real recurrence-free survival (RFS) difference rates between Group 1-4 and Group 5-9 (P=0.0362<0.05, log-rank test); while for Group 0, Group 2-6 and Group 7-13, the real progression-free survival (PFS) was statistically different (P=0.0077<0.01, log-rank test)． Conclusions: The pathology and clinical behavior of MG are “benign” prior to LG even if the patients did not receive overly aggressive intravesical instillations. The EORTC risk scores can be applied to the short-term prognostic assessment of recurrence and progression risk in MG patients of the cohort. However, the value and applicability of long-term prognosis assessment are to be confirmed in further studies in the future.