bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding user attitudes and economic aspects in a corporate multimodal mobility system: results from a field study in Germany
Authors: Günther Madlen , Jacobsen Benjamin , Rehme Marco , Götze Uwe , Krems Josef F.
Published: December 2020

The present study aims to investigate user attitudes and behaviour when users interact with a corporate multimodal mobility sharing system, consisting of battery electric vehicles (BEVs), pedelecs (i.e. electric bicycles) and public transport. We analysed participants’ attitudes towards BEVs, pedelecs, public transport, and the underlying service tools, as well as the economic impacts of the whole corporate multimodal mobility system. Ninety-three participants took part in the 22 months long naturalistic driving study and used the corporate multimodal mobility sharing system for their business travel. The attitudes towards BEVs and the keyless access were evaluated as the most positive components, and usage behaviour was related to a more positive attitude towards pedelecs, public transport, as well as the keyless access and the booking tool. The economic evaluation revealed the possibility of significant reductions in mobility costs when integrating different means of transport into a smart multimodal mobility system. The findings may help fleet owners to further improve existing mobility concepts for corporate travel.
Perception and attitudinal factors contributing to periodic deworming of preschool children in an urban slum, Nigeria
Authors: Eze Paul , Agu Ujunwa Justina , Aniebo Chioma Lynda , Agu Sergius Alex , Lawani Lucky Osaheni
Published: December 2020

Background

Over 20 million preschool-age children (PSAC) in Nigeria require periodic chemotherapy (PC) for soil-transmitted helminth (STH) infections. Persistently low coverage for this age group threatens the World Health Organization (WHO) 2030 target for eliminating STH infections. Current strategies for targeting PSAC have been largely ineffective. Hence, PSAC are mostly dewormed by their parents/caregivers. However, little is known of the perception and attitude of parents/caregivers of PSAC to deworming in this setting.

Methods

A mixed methods design, combining a community-based interviewer-administered questionnaire-survey (n = 433) and focus group discussions (FGD) (n = 43) was used to assess the perceptions and attitudes of mothers to periodic deworming of preschool children aged 2–5 years in Abakpa-Nike, Enugu, Nigeria.

Results

Coverage of periodic deworming in PSAC is 42% (95% CI: 37.3–46.8%). There is significant difference in the specific knowledge of transmission of STH (AOR = 0.62, 95% CI: 0.48–0.81, p = 0.000), complication of STH infections (AOR = 0.77, 95% CI: 0.61–0.98, p = 0.034), accurate knowledge of deworming frequency (AOR = 0.41, 95% CI: 0.18–0.90, p = 0.026), and knowledge of PC drug, mebendazole (AOR = 0.28, 95% CI: 0.09–0.90, p = 0.031), and pyrantel (AOR = 8.03, 95% CI: 2.22–29.03, p = 0.001) between mothers who periodically deworm their PSAC and those who do not. There is no significant difference in specific knowledge of the symptoms of STH infections (AOR = 0.76, 95% CI: 0.57–1.02, p = 0.069) and PC drug, Albendazole (AOR = 1.00, 95% CI: 0.46–2.11, p = 0.972). FGD revealed misconceptions that are rooted in stark ignorance of the disease. Overall attitude to deworming is positive and favourable.

Conclusions

Poor coverage of periodic deworming for STH infections in PSAC in this setting are primarily driven by poor specific knowledge of the risks and burden of the infection. Focused health education on the burden and transmission of STH infections could complement existing strategies to improve periodic deworming of PSAC in this setting.
Environmental sustainability in endodontics. A life cycle assessment (LCA) of a root canal treatment procedure
Authors: Duane Brett , Borglin Linnea , Pekarski Stephanie , Saget Sophie , Duncan Henry Fergus
Published: December 2020

Background

To analyse via life cycle analysis (LCA) the global resource use and environmental output of the endodontic procedure.

Methodology

An LCA was conducted to measure the life cycle of a standard/routine two-visit RCT. The LCA was conducted according to the International Organization of Standardization guidelines; ISO 14040:2006. All clinical elements of an endodontic treatment (RCT) were input into OpenLCA software using process and flows from the ecoinvent database. Travel to and from the dental clinic was not included. Environmental outputs included abiotic depletion, acidification, freshwater ecotoxicity/eutrophication, human toxicity, cancer/non cancer effects, ionizing radiation, global warming, marine eutrophication, ozone depletion, photochemical ozone formation and terrestrial eutrophication.

Results

An RCT procedure contributes 4.9 kg of carbon dioxide equivalent (CO2 eq) emissions. This is the equivalent of a 30 km drive in a small car. The main 5 contributors were dental clothing followed by surface disinfection (isopropanol), disposable bib (paper and plastic), single-use stainless steel instruments and electricity use. Although this LCA has illustrated the effect endodontic treatment has on the environment, there are a number of limitations that may influence the validity of the results.

Conclusions

The endodontic team need to consider how they can reduce the environmental burden of endodontic care. One immediate area of focus might be to consider alternatives to isopropyl alcohol, and look at paper, single use instrument and electricity use. Longer term, research into environmentally-friendly medicaments should continue to investigate the replacement of current cytotoxic gold standards with possible natural alternatives. Minimally invasive regenerative endodontics techniques designed to stimulate repair or regeneration of damaged pulp tissue may also be one way of improving the environmental impact of an RCT.
Cost-utility analysis of hearing aid device for older adults in the community: a delayed start study
Authors: Kaur Palvinder , Chong Sheue Lih , Kannapiran Palvannan , Teo W.-S. Kelvin , Ling Charis Ng Wei , Weichen Chiang Win , Ruling Gan , Yin Lee Sing , Leng Tang Ying , Pei Soo Ying , Kang Then Tze , Han Lim Zhen , Peizhen Lin , Yee Lynne Lim Hsueh , George Pradeep Paul
Published: December 2020

Background

Hearing aids (HA) is the primary medical intervention aimed to reduce hearing handicap. This study assessed the cost-effectiveness of HA for older adults who were volunteered to be screened for hearing loss in a community-based mobile hearing clinic (MHC).

Methods

Participants with (1) at least moderate hearing loss (≥40 dB HL) in at least one ear, (2) no prior usage of HA, (3) no ear related medical complications, and (4) had a Mini-Mental State Examination score ≥ 18 were eligible for this study. Using a delayed-start study design, participants were randomized into the immediate-start (Fitted) group where HA was fitted immediately or the delayed-start (Not Fitted) group where HA fitting was delayed for three months. Cost utility analysis was used to compare the cost-effectiveness of being fitted with HA combined with short-term, aural rehabilitation with the routine care group who were not fitted with HA. Incremental cost effectiveness ration (ICER) was computed. Health Utility Index (HUI-3) was used to measure utility gain, a component required to derive the quality adjusted life years (QALY). Total costs included direct healthcare costs, direct non-healthcare costs and indirect costs (productivity loss of participant and caregiver). Demographic data was collected during the index visit to MHC. Cost and utility data were collected three months after index visit and projected to five years.

Results

There were 264 participants in the Fitted group and 163 participants in the Not Fitted group. No between-group differences in age, gender, ethnicity, housing type and degree of hearing loss were observed at baseline. At 3 months, HA fitting led to a mean utility increase of 0.12 and an ICER gain of S$42,790/QALY (95% CI: S$32, 793/QALY to S$62,221/QALY). At five years, the ICER was estimated to be at S$11,964/QALY (95% CI: S$8996/QALY to S$17,080/QALY) assuming 70% of the participants continued using the HA. As fewer individuals continued using their fitted HA, the ICER increased.

Conclusions

HA fitting can be cost-effective and could improve the quality of life of hearing-impaired older individuals within a brief period of device fitting. Long term cost-effectiveness of HA fitting is dependent on its continued usage.
Serological evidence of human infections with highly pathogenic avian influenza A(H5N1) virus: a systematic review and meta-analysis
Authors: Chen Xinhua , Wang Wei , Wang Yan , Lai Shengjie , Yang Juan , Cowling Benjamin J. , Horby Peter W. , Uyeki Timothy M. , Yu Hongjie
Published: December 2020

Background

Highly pathogenic avian influenza A(H5N1) virus poses a global public health threat given severe and fatal zoonotic infections since 1997 and ongoing A(H5N1) virus circulation among poultry in several countries. A comprehensive assessment of the seroprevalence of A(H5N1) virus antibodies remains a gap and limits understanding of the true risk of A(H5N1) virus infection.

Methods

We conducted a systematic review and meta-analysis of published serosurveys to assess the risk of subclinical and clinically mild A(H5N1) virus infections. We assessed A(H5N1) virus antibody titers and changes in titers among populations with variable exposures to different A(H5N1) viruses.

Results

Across studies using the World Health Organization-recommended seropositive definition, the point estimates of the seroprevalence of A(H5N1) virus-specific antibodies were higher in poultry-exposed populations (range 0–0.6%) and persons exposed to both human A(H5N1) cases and infected birds (range 0.4–1.8%) than in close contacts of A(H5N1) cases or the general population (none to very low frequencies). Seroprevalence was higher in persons exposed to A(H5N1) clade 0 virus (1.9%, range 0.7–3.2%) than in participants exposed to other clades of A(H5N1) virus (range 0–0.5%) (p < 0.05). Seroprevalence was higher in poultry-exposed populations (range 0–1.9%) if such studies utilized antigenically similar A(H5N1) virus antigens in assays to A(H5N1) viruses circulating among poultry.

Conclusions

These low seroprevalences suggest that subclinical and clinically mild human A(H5N1) virus infections are uncommon. Standardized serological survey and laboratory methods are needed to fully understand the extent and risk of human A(H5N1) virus infections.
Copy number gain of pro-inflammatory genes in patients with HBV-related acute-on-chronic liver failure
Authors: Sun Fengming , Tan Wenting , Dan Yunjie , Wang Xiuhua , Guo Yanzhi , Deng Guohong
Published: December 2020

Background

Host genetic factors such as single nucleotide variations may play a crucial role in the onset and progression of HBV-related acute-on-chronic liver failure (ACLF). However, the underlying genomic copy number variations (CNVs) involved in the pathology are currently unclear.

Methods

We genotyped two cohorts with 389 HBV-related ACLF patients and 391 asymptomatic HBV carriers (AsCs), and then carried out CNV-based global burden analysis and a genome-wide association study (GWAS).

Results

For 1874 rare CNVs, HBV-related ACLF patients exhibited a high burden of deletion segments with a size of 100–200 kb (P value = 0.04), and the related genes were significantly enriched in leukocyte transendothelial migration pathway (P value = 4.68 × 10–3). For 352 common CNVs, GWAS predicted 17 significant association signals, and the peak one was a duplication segment located on 1p36.13 (~ 38 Kb,P value = 1.99 × 10–4, OR = 2.66). The associated CNVs resulted in more copy number of pro-inflammatory genes (MST1L, DEFB, and HCG4B) in HBV-related ACLF patients than in AsC controls.

Conclusions

Our results suggested that the impact of host CNV on HBV-related ACLF may be through decreasing natural immunity and enhancing host inflammatory response during HBV infection. The findings highlighted the potential importance of gene dosage on excessive hepatic inflammation of this disease.
CSN8 is a key regulator in hypoxia-induced epithelial–mesenchymal transition and dormancy of colorectal cancer cells
Authors: Ju Songwen , Wang Feng , Wang Yirong , Ju Songguang
Published: December 2020

Hypoxic stress plays a pivotal role in cancer progression; however, how hypoxia drives tumors to become more aggressive or metastatic and adaptive to adverse environmental stress is still poorly understood. In this study, we revealed that CSN8 might be a key regulatory switch controlling hypoxia-induced malignant tumor progression. We demonstrated that the expression of CSN8 increased significantly in colorectal cancerous tissues, which was correlated with lymph node metastasis and predicted poor patient survival. CSN8 overexpression induces the epithelial-mesenchymal transition (EMT) process in colorectal cancer cells, increasing migration and invasion. CSN8 overexpression arrested cell proliferation, upregulated key dormancy marker (NR2F1, DEC2, p27) and hypoxia response genes (HIF-1α, GLUT1), and dramatically enhanced survival under hypoxia, serum deprivation, or chemo-drug 5-fluorouracil treatment conditions. In particular, silenced CSN8 blocks the EMT and dormancy processes induced by the hypoxia of 1% O2 in vitro and undermines the adaptive capacity of colorectal cancer cells in vivo. The further study showed that CSN8 regulated EMT and dormancy partly by activating the HIF-1α signaling pathway, which increased HIF-1α mRNA expression by activating NF-κB and stabilized the HIF-1α protein via HIF-1α de-ubiquitination. Taken together, CSN8 endows primary colorectal cancer cells with highly aggressive/metastatic and adaptive capacities through regulating both EMT and dormancy induced by hypoxia. CSN8 could serve as a novel prognostic biomarker for colorectal cancer and would be an ideal target of disseminated dormant cell elimination and tumor metastasis, recurrence, and chemoresistance prevention.
Rapid evidence review of harm reduction interventions and messaging for people who inject drugs during pandemic events: implications for the ongoing COVID-19 response
Authors: Wilkinson Rebecca , Hines Lindsey , Holland Adam , Mandal Sema , Phipps Emily
Published: December 2020

Background

People who inject drugs are at increased health risk in a pandemic due to their greater susceptibility to severe disease and as a consequence of the restrictions put in place to halt the spread of infection. Harm reduction (HR) services, which aim to reduce the negative effects of drug use on health, are likely to be diminished in a pandemic. However, innovative HR interventions and messaging may also develop in response to such a crisis. It is vital to understand the most effective ways to deliver HR in pandemic situations so that guidance can be provided for current and future disruptions to service provision.

Methods

A rapid evidence review was conducted with the aim of exploring what HR interventions and messaging are most effective during a pandemic-type situation. Ten health databases were systematically searched using terms relevant to the research aim. A search was also made of grey literature, including a targeted search of HR messaging from key national and service provider websites.

Results

In the initial search, 121 pieces of evidence were identified which, after screening and de-duplication, resulted in 60 for inclusion. The included evidence consists mainly of non-peer reviewed, pre-publication or expert opinion pieces. The rapid findings suggest that HR services should be deemed essential during a pandemic, with staff supported to work safely and social distancing adaptations implemented. Services should be encouraged to operate more flexibly; for instance, in deciding the amounts of take-home supplies of injecting equipment and medications. The evidence on HR communication was very limited but key messages on infection control, uncertain drug supply and accessing services were identified.

Conclusions

This rapid evidence review identifies implications for national policy makers, commissioners and HR service providers. A person-centred rather than disease-centred approach to HR delivered by collaborating partners, as well as prioritizing tailored HR messaging, is recommended. Further research evaluating the delivery of HR services and messaging, particularly focusing on health inequalities, is urgently needed.
Psychometric evaluation of a Canadian version of the Seattle Angina Questionnaire (SAQ-CAN)
Authors:   for the APPROACH Investigators, Lawal Oluwaseyi A. , Awosoga Oluwagbohunmi , Santana Maria J. , James Matthew T. , Southern Danielle A. , Wilton Stephen B. , Graham Michelle M. , Knudtson Merrill , Lu Mingshan , Quan Hude , Ghali William A. , Norris Colleen M. , Sajobi Tolulope
Published: December 2020

Background

The Seattle Angina Questionnaire (SAQ) is a widely-used patient-reported outcomes measure in patients with heart disease. This study assesses the validity and reliability of the SAQ in a Canadian cohort of individuals with stable angina.

Methods and results

Data are from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) registry, a population-based registry of patients who received cardiac catheterization in Alberta, Canada. The cohort consists of 4052 patients undergoing cardiac catheterization for stable angina and completed the SAQ within 2 weeks. Exploratory factor analysis and confirmatory factor analysis (CFA) were used to assess the factorial structure of the SAQ. Internal and test–retest reliabilities of a new measure (i.e., SAQ-CAN) was measured using Cronbach α and intraclass correlation coefficient, respectively. CFA model fit was assessed using the root mean square error of approximation (RMSEA) and comparative fit index (CFI). Construct validity of the SAQ-CAN was assessed in relation to Hospital Anxiety and Depression Scales (HADS), Euro Quality of life 5 dimension (EQ5D), and original SAQ. Of the 4052 patients included in this analysis, 3281 (80.97%) were younger than 75 years old, while 3239 (79.94%) were male. Both exploratory and confirmatory factor analyses revealed a four-factorial structure consisting of 16 items that provided a better fit to the data (RMSEA = 0.049 [90% CI = (0.047, 0.052)]; CFI = 0.975). The 16-item SAQ demonstrated good to excellent internal reliability (Cronbach’s α range from 0.77 to 0.90), moderate to strong correlation with the Original SAQ and EQ5D but negligible correlations with HADS.

Conclusion

The SAQ-CAN has acceptable psychometric properties that are comparable to the original SAQ. We recommend its use for assessing coronary health outcomes in Canadian patients with Coronary Artery Disease.
miR-29c-3p regulates proliferation and migration in ovarian cancer by targeting KIF4A
Authors: Feng Songwei , Luo Shanhui , Ji Chenchen , Shi Jia
Published: December 2020

Background

Increasing evidence suggested that microRNA and kinesin superfamily proteins play an essential role in ovarian cancer. The association between KIF4A and ovarian cancer (OC) was investigated in this study.

Methods

We performed bioinformatics analysis in the GEO database to screen out the differentially expressed miRNAs (DEmiRNAs) associated with ovarian cancer prognosis. Upstream targeting prediction for KIF4A was acquired by using the mirDIP database. The potential regulatory factor miR-29c-3p for KIF4A was obtained from the intersection of the above all miRNAs. The prognosis of KIF4A and target-miRNA in OC was obtained in the subsequent analysis. qRT-PCR and Western blot detected KIF4A expression level in IOSE80 (human normal ovarian epithelial cell line). In the meantime, the gene expression level was detected in A2780, HO-8910PM, COC1, and SKOV3 cell lines (human ovarian carcinoma cell line). MTT and colony formation assays were used to detect cell proliferation of SKOV3 cell line. The following assays detected cell migration through the use of transwell and wound heal assays. Targeted binding relationship between KIF4A and miRNA was detected by using the dual-luciferase reporter assay.

Results

Both high expression of KIF4A and lower expression of miR-29c-3p could be used as biomarkers indicating poor prognosis in OC patients. Cellular function tests confirmed that when KIF4A was silenced, it inhibited the proliferation and migration of OC cells. In addition, 3′-UTR of KIF4A had a direct binding site with miR-29c-3p, which indicated that the expression of KIF4A could be regulated by miR-29c-3p. In subsequent assays, the proliferation and migration of OC cells were inhibited by the overexpression of miR-29c-3p. At the same time, rescue experiments also confirmed that the promotion of KIF4A could be reversed by miR-29c-3p.

Conclusion

In a word, our data revealed a new mechanism for the role of KIF4A in the occurrence and development of OC.
Ranking of meal preferences and interactions with demographic characteristics: a discrete choice experiment in young adults
Authors: Livingstone Katherine M. , Lamb Karen E. , Abbott Gavin , Worsley Tony , McNaughton Sarah A.
Published: December 2020

Background

The diet of young adults is poor, yet little is known about the relative importance of influences on healthy eating in a decision-making context. The aim of this exploratory study was to understand the relative ranking of influences on meal choices in young adults and to investigate interactions between meal preferences and demographic and health characteristics.

Methods

Adults aged 18–30 years (n = 92, mean age: 23.9 (SD 3.4) years) completed an online discrete choice experiment. Participants were presented with 12 choice sets reflecting a typical weekday meal and were asked to choose between four meal options. Each meal consisted of a combination of five meal attributes (preparation time, cost, taste, familiarity and nutrition content) that each had three attribute levels. Data were analysed using conditional logit models. Subgroup analyses were performed by sex, education, income, weight status and meeting fruit and vegetable recommendations.

Results

Comparing the highest and lowest attribute levels, meal preferences were higher for better taste (B = 0.38; 95% CI: 0.12, 0.63), familiarity (B = 0.37; 95% CI: 0.21, 0.54) and nutrition content (B = 1.11; 95% CI: 0.81, 1.41) and lower for increased preparation times (B = −0.33; 95% CI: − 0.53, − 0.12) and cost (B = −0.50; 95% CI: − 0.75, − 0.24). Nutrition content was the most important influence on meal choice. Cost was the second most important, followed by taste, familiarity and preparation time. Compared to males, females had a higher preference for better nutrition content, taste and familiarity and a lower preference for increased cost. Higher educated participants had a higher preference for better nutrition content, familiarity and taste compared to lower educated participants. Young adults who met recommendations for fruit and vegetable intake had a higher preference for better nutrition content compared to participants who did not meet recommendations.

Conclusion

Nutrition content was the most important influence on young adults’ meal choices, followed by cost, taste, familiarity and preparation time. Preferences varied by demographics and health characteristics, suggesting that the focus of dietary interventions may benefit from being tailored to specific young adult groups.
Validation of Dietary Antioxidant Index (DAI) and investigating the relationship between DAI and the odds of gastric cancer
Authors: Vahid Farhad , Rahmani Diana , Davoodi Seyed Hossein
Published: December 2020

Background

Gastric cancer (GC) incidence and mortality are rapidly growing worldwide. It is estimated that more than 1,000,000 new cases are diagnosed each year, and more than 78,000 people lose their lives due to GC. The association between dietary antioxidants and GC has been shown in some studies. However, because of the discrepancy between the findings and the lack of a valid indicator, it seems necessary to design and validate the Dietary Antioxidant Index (DAI) to examine the diet's total antioxidant content. The present study aimed to survey the validity of DAI and its association with the odds of GC.

Methods

In this hospital-based case–control study, 82 patients with GC and 95 healthy controls were examined. We used a 168-item food frequency questioner to assess dietary intakes. The DAI was calculated based on the intake of vitamin A, C, E, and selenium, manganese, and zinc. We standardized each of the six vitamins and minerals by subtracting the global mean and dividing by the global standard deviation to calculate DAI. We then calculated the DAI by summing up the standardized intakes of these vitamins and minerals of the individuals with equal weight.

Results

We observed a significant correlation between DAI and total antioxidant capacity (TAC) after controlling for age, body mass index (BMI), energy intake, smoking and fasting blood sugar, education, total fat intake, helicobacter pylori infection, total cholesterol, and saturated fatty acid (SFA) intakes. Results obtained from modeling DAI as a continuous variable in relation to GC showed a negative association after adjustment for age and in the multivariable analysis (OR = 0.64,CI = 0.43–0.95).

Conclusion

DAI is a valid indicator of dietary antioxidants assessments, and it can be used as a predictor of antioxidant status due to its correlation with serum antioxidant levels. The results showed that dietary antioxidants have a significant relationship with GC, which indicates the importance of antioxidants in this cancer's etiology.
The role of knee arthroscopy in managing common soft tissue complications after total knee arthroplasty: a retrospective case series study
Authors: Hou Yunfei , Gao Jiaxiang , Chen Jian , Lin Jianhao , Ni Lei , Sun Tiezheng , Jiang Jun
Published: December 2020

Background

To investigate the feasibility, safety and therapeutic efficacy of arthroscopy in managing the 3 most common soft tissue complications, peripatellar impingement (PI), arthrofibrosis (AF) and generalized synovitis (GS), after total knee arthroplasty (TKA).

Methods

A retrospective review of patients undertaking arthroscopy for PI, AF and GS was conducted. Outcome measures included complications, postoperative range of motion (ROM), Knee Society Score (KSS) and rates of symptom recurrence, prosthesis revision. Intraoperative findings and surgical procedures were also recorded. Pairedttest, Fisher’s exact test, Kruskal-Wallis test and post hoc analysis with Bonferroni correction were used for statistical evaluation.

Results

A total of 74 patients, including 35 patients with peripatellar impingement, 25 patients with arthrofibrosis and 14 patients with generalized synovitis, with a mean age of 66.1 ± 7.9 years, were analysed. The mean follow-up (FU) duration was 81.3 ± 40.6 months. All patients underwent arthroscopic surgery safely without intraoperative complications. However, there were 4 postoperative complications, including 1 acute myocardial infarction and 3 periprosthetic joint infections. Overall, patients acquired improvements in ROM from 81.7 ± 23.1° to 96.8 ± 20.5° (p< 0.05), in KSS knee score from 64.2 ± 9.6 to 78.7 ± 12.1 (p< 0.05) and in KSS function score from 61.1 ± 7.4 to 77.3 ± 12.2 (p< 0.05) postoperatively. Patients in all 3 groups had improvements in ROM (p< 0.05), KSS knee score (p< 0.05) and KSS function score (p< 0.05). The overall recurrence rate was 22.9% (95% confidence interval (CI) 15.1–34.9%), and the overall revision rate was 14.9% (95% CI 8.6–25.6%). There were significant differences in both the symptom recurrence and prosthesis revision rates among the groups (p< 0.05). The PI group had a significantly lower symptom recurrence rate (11.4%, 95% CI 4.5–28.7%) and revision rate (8.6%, 95% CI 2.9–25.3%) (p< 0.017), while the GS group had a significantly higher recurrence rate (42.9%, 95% CI 23.4–78.5%) and revision rate (35.7%, 95% CI 17.6–72.1%) (p< 0.017).

Conclusions

In the setting of symptomatic TKA, although carrying certain risks for PJI and other complications, arthroscopic intervention could be feasible and provide clinical improvement in most cases at an average of 81.3 months follow-up. Patients with PI had the best outcomes, while patients with GS had the worst outcomes.

Level of evidence

Level IV
Development of machine learning models to predict RT-PCR results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with influenza-like symptoms using only basic clinical data
Authors: Langer Thomas , Favarato Martina , Giudici Riccardo , Bassi Gabriele , Garberi Roberta , Villa Fabiana , Gay Hedwige , Zeduri Anna , Bragagnolo Sara , Molteni Alberto , Beretta Andrea , Corradin Matteo , Moreno Mauro , Vismara Chiara , Perno Carlo Federico , Buscema Massimo , Grossi Enzo , Fumagalli Roberto
Published: December 2020

Background

Reverse Transcription-Polymerase Chain Reaction (RT-PCR) for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) diagnosis currently requires quite a long time span. A quicker and more efficient diagnostic tool in emergency departments could improve management during this global crisis. Our main goal was assessing the accuracy of artificial intelligence in predicting the results of RT-PCR for SARS-COV-2, using basic information at hand in all emergency departments.

Methods

This is a retrospective study carried out between February 22, 2020 and March 16, 2020 in one of the main hospitals in Milan, Italy. We screened for eligibility all patients admitted with influenza-like symptoms tested for SARS-COV-2. Patients under 12 years old and patients in whom the leukocyte formula was not performed in the ED were excluded. Input data through artificial intelligence were made up of a combination of clinical, radiological and routine laboratory data upon hospital admission. Different Machine Learning algorithms available on WEKA data mining software and on Semeion Research Centre depository were trained using both the Training and Testing and the K-fold cross-validation protocol.

Results

Among 199 patients subject to study (median [interquartile range] age 65 [46–78] years; 127 [63.8%] men), 124 [62.3%] resulted positive to SARS-COV-2. The best Machine Learning System reached an accuracy of 91.4% with 94.1% sensitivity and 88.7% specificity.

Conclusion

Our study suggests that properly trained artificial intelligence algorithms may be able to predict correct results in RT-PCR for SARS-COV-2, using basic clinical data. If confirmed, on a larger-scale study, this approach could have important clinical and organizational implications.
The intracellular bacterium Rickettsia rickettsii exerts an inhibitory effect on the apoptosis of tick cells
Authors: Martins Larissa Almeida , Palmisano Giuseppe , Cortez Mauro , Kawahara Rebeca , de Freitas Balanco José Mario , Fujita André , Alonso Beatriz Iglesias , Barros-Battesti Darci Moraes , Braz Gloria Regina Cardoso , Tirloni Lucas , Esteves Eliane , Daffre Sirlei , Fogaça Andréa Cristina
Published: December 2020

Background

Rickettsia rickettsii is a tick-borne obligate intracellular bacterium that causes Rocky Mountain spotted fever, a life-threatening illness. To obtain an insight into the vector–pathogen interactions, we assessed the effects of infection with R. rickettsii on the proteome cells of the tick embryonic cell line BME26.

Methods

The proteome of BME26 cells was determined by label-free high-performance liquid chromatography coupled with tandem mass spectrometry analysis. Also evaluated were the effects of infection on the activity of caspase-3, assessed by the hydrolysis of a synthetic fluorogenic substrate in enzymatic assays, and on the exposition of phosphatidyserine, evaluated by live-cell fluorescence microscopy after labeling with annexin-V. Finally, the effects of activation or inhibition of caspase-3 activity on the growth of R. rickettsii in BME26 cells was determined.

Results

Tick proteins of different functional classes were modulated in a time-dependent manner by R. rickettsii infection. Regarding proteins involved in apoptosis, certain negative regulators were downregulated at the initial phase of the infection (6 h) but upregulated in the middle of the exponential phase of the bacterial growth (48 h). Microorganisms are known to be able to inhibit apoptosis of the host cell to ensure their survival and proliferation. We therefore evaluated the effects of infection on classic features of apoptotic cells and observed DNA fragmentation exclusively in noninfected cells. Moreover, both caspase-3 activity and phosphatidylserine exposition were lower in infected than in noninfected cells. Importantly, while the activation of caspase-3 exerted a detrimental effect on rickettsial proliferation, its inhibition increased bacterial growth.

Conclusions

Taken together, these results show that R. rickettsii modulates the proteome and exerts an inhibitory effect on apoptosis in tick cellsthat seems to be important to ensure cell colonization.

Graphical Abstract
Clinical comparisons between previously diagnosed SLE and newly diagnosed SLE by kidney biopsy
Authors: Tonsawan Pantipa , Sawanyawisuth Kittisak
Published: December 2020

Background

Lupus nephritis is a type of major organ involvement in systemic lupus erythematosus (SLE) patients that leads to higher rates of morbidity and mortality and may present initially in 28% of SLE patients. However, there are limited data available on clinical differences or predictors for biopsy-proven lupus nephritis in established versus newly diagnosed SLE cases.

Methods

Adult patients undergoing kidney biopsy for the first time with a diagnosis of lupus nephritis were eligible for inclusion. Patients were categorized into two groups: those with previously diagnosed SLE and those with newly diagnosed SLE by kidney biopsy. Factors associated with newly diagnosed SLE were determined using logistic regression analysis.

Results

There were 68 patients diagnosed with lupus nephritis by kidney biopsy. Of those, 31 cases (45.58%) were newly diagnosed. The newly diagnosed SLE group was significantly older (36.87 vs 30.95 years) and had a lower proportion of females (74.19% vs 91.89%) than the previously diagnosed group. A new-onset hypertension was the only factor independently associated with newly diagnosed SLE by kidney biopsy. The adjusted odds ratio (95% CI) was 5.152 (1.046, 25.363).

Conclusions

Nearly half of the biopsy-proven lupus nephritis cases in this study were patients with newly diagnosed SLE. Patients with previously diagnosed SLE and newly diagnosed SLE by kidney biopsy had clinical differences.
Lower trapezius myocutaneous flap repairs adjacent deep electrical burn wounds
Authors: Meng Chengying , Liu Yuyao , Wang Huan , Sun Youjun , Lu Shiping , Zhou Yan , Hu Jiayan , Yu Youxin , Fang Linsen , Sun Yexiang , Hu Delin
Published: December 2020

Background

Local tissue damage caused by electrical burns is often deep and severe. High-voltage electrical burns are common in the head, neck and torso areas. These are mostly caused by direct contact with the power supply and are often accompanied by deep injuries of the nerve, blood vessel, muscle, tendon, and bone. We must pay great attention to the clinical treatment of these parts injured by electrical burn.

Case presentation

The first case involved a migrant worker who touched a 6-kV high-tension wire when welding steel; this electric shock caused burns in many places. Deep electrical burn wounds were mainly located on the left shoulder and back, characterized by widespread skin and soft tissue defect and bone necrosis. We utilized a lower trapezius myocutaneous flap to repair these wounds in the neck and back caused by deep electrical burns. The flap survived completely and the wound was effectively repaired. The function and shape of the shoulder and back after the restoration were satisfactory. The second case involved a 29-year-old who accidentally touched a high-voltage wire while working and was burned by a 30,000-V electric shock. His wounds were mainly located on the left head, neck, back and left upper limbs. We designed a 30 cm × 12 cm right trapezius myocutaneous flap which completely covered the wound surface; the electrical burn wounds on the neck and back were effectively repaired. After the electrical burn wound was repaired, the neck function returned to normal with a satisfactory shape.

Conclusion

The authors report two cases of patients who were burned by high voltage. We used lower trapezius myocutaneous flaps to repair their wounds, which achieved satisfactory clinical results. This study has provided a reliable surgical method for the clinical treatment of deep electrical burn wounds in the neck, shoulders and back.
Multi-omics-data-assisted genomic feature markers preselection improves the accuracy of genomic prediction
Authors: Ye Shaopan , Li Jiaqi , Zhang Zhe
Published: December 2020

Background

Presently, multi-omics data (e.g., genomics, transcriptomics, proteomics, and metabolomics) are available to improve genomic predictors. Omics data not only offers new data layers for genomic prediction but also provides a bridge between organismal phenotypes and genome variation that cannot be readily captured at the genome sequence level. Therefore, using multi-omics data to select feature markers is a feasible strategy to improve the accuracy of genomic prediction. In this study, simultaneously using whole-genome sequencing (WGS) and gene expression level data, four strategies for single-nucleotide polymorphism (SNP) preselection were investigated for genomic predictions in theDrosophilaGenetic Reference Panel.

Results

Using genomic best linear unbiased prediction (GBLUP) with complete WGS data, the prediction accuracies were 0.208 ± 0.020 (0.181 ± 0.022) for the startle response and 0.272 ± 0.017 (0.307 ± 0.015) for starvation resistance in the female (male) lines. Compared with GBLUP using complete WGS data, both GBLUP and the genomic feature BLUP (GFBLUP) did not improve the prediction accuracy using SNPs preselected from complete WGS data based on the results of genome-wide association studies (GWASs) or transcriptome-wide association studies (TWASs). Furthermore, by using SNPs preselected from the WGS data based on the results of the expression quantitative trait locus (eQTL) mapping of all genes, only the startle response had greater accuracy than GBLUP with the complete WGS data. The best accuracy values in the female and male lines were 0.243 ± 0.020 and 0.220 ± 0.022, respectively. Importantly, by using SNPs preselected based on the results of the eQTL mapping of significant genes from TWAS, both GBLUP and GFBLUP resulted in great accuracy and small bias of genomic prediction. Compared with the GBLUP using complete WGS data, the best accuracy values represented increases of 60.66% and 39.09% for the starvation resistance and 27.40% and 35.36% for startle response in the female and male lines, respectively.

Conclusions

Overall, multi-omics data can assist genomic feature preselection and improve the performance of genomic prediction. The new knowledge gained from this study will enrich the use of multi-omics in genomic prediction.
The legal sustainability of energy substitution in Nigeria’s electric power sector: renewable energy as alternative
Authors: Olujobi Olusola Joshua
Published: December 2020

Non-renewable fuel sources have been the predominant energy sources and a significant source of foreign exchange income for Nigeria, while at the same time there is a severe problem of electricity inconsistency and persistent power blackouts in Nigeria. The research aims to end the concern for deficient energy use, and to encourage energy efficiency and sustainability. Nigeria has not maximized the advantages of renewable energy after the denationalisation of its electricity industry despite the current transformation in the power industry and the rising demand for renewable energy supply. The research adopts a doctrinal legal approach with a library-based legal research technique with a comparative legal method. It reveals that the absence of a comprehensible legal regime with encouragement for the use of renewable energy is the fundamental element causing the slow utilization of renewable energy as a substitute source of energy in Nigeria. It is suggested that, among other reforms, there is a need for a comprehensible legal regime on renewable energy and the encouragement of strict implementation of energy regulatory strategies and policies with incentives for the application of renewable energy sources in Nigeria.
Sensitivity and mathematical model analysis on secondhand smoking tobacco
Authors: Fekede Birliew , Mebrate Benyam
Published: December 2020

In this paper, we are concerned with a mathematical model of secondhand smoker. The model is biologically meaningful and mathematically well posed. The reproductive number $$R_{0}$$

R
0

is determined from the model, and it measures the average number of secondary cases generated by a single primary case in a fully susceptible population. If $$R_{0}<1,$$

R
0

<
1
,

the smoking-free equilibrium point is stable, and if $$R_{0}>1,$$

R
0

>
1
,

endemic equilibrium point is unstable. We also provide numerical simulation to show stability of equilibrium points. In addition, sensitivity analysis of parameters involving in the dynamic system of the proposed model has been included. The parameters involving in reproductive number measure the relative change in $$R_{0}$$

R
0

when the value of the parameter changes.
Spectrum of HRCT findings among asymptomatic and recovered COVID-19 patients: how did they impact the clinical decision?
Authors: Samir Ahmed , Abdelgawad Mohamed Saied , Baess Ayman Ibrahim , Hassan Hebatallah Hassan Mamdouh
Published: December 2020

Background

Decisions about asymptomatic COVID-19 patients are always critical, either during initial screening or during recovery. Spread of infection will be inevitable if those patients were left non-isolated. This study aimed not only to survey spectrum of HRCT findings of COVID-19 among asymptomatic and recovered patients but also to record unexpected results and document their impact upon the clinical decision.

Results

The study was retrospectively conducted, during June and July 2020, on 120 patients proved with COVID-19, during initial HRCT screening or delayed following announcement of recovery. All patients were completely asymptomatic. They included 72 males and 48 females (60%:40%). Their age ranged from 10 to 58 years (mean 35.95 ± 12.25 SD). HRCT was analyzed by three expert consultant radiologists in consensus. Among asymptomatic initially screened COVID-19 patients, additional to GGOs, bilateral consolidative changes were unexpectedly found together with secondary fibrosis (23.3% and 10%). HRCT results significantly impacted the clinical decision (P < 0.0001); PCR had to be repeated with home isolation (43.3%). Infected health care providers had to stop their duty immediately (20%). Isolated hospitalization replaced routine ward admission (25%). Cautious surgical interference was performed using full personal protective equipment (PPE) (8.3%). Among asymptomatic recovered COVID-19 patients, unexpected large lesions (> 3 cm) were found (70%). Near 50% of lung volume was persistently affected (10%). Secondary fibrosis was striking (33%). Encysted hydro-pneumothorax persisted for a whole month (1.7%). “No-isolation” decision remained unchanged because of clinical and laboratory stability; however, steroids were prescribed to speed lung recovery.

Conclusion

HRCT findings among asymptomatic and recovered COVID-19 patients can be unexpected and can definitely impact the clinical decision.
Risk factors for in-patient admission among adults with intellectual disability and autism: investigation of electronic clinical records
Authors: Sheehan Rory , Mutch Jennifer , Marston Louise , Osborn David , Hassiotis Angela
Published: December 2020

Adults with intellectual disability or autism are at risk of psychiatric admission which carries personal, social and economic costs. We identified 654 adults with intellectual disability or autism in the electronic clinical records of one mental health trust. We investigated the demographic and clinical factors associated with admission and readmission after discharge. Young male patients with intellectual disability, schizophrenia and previous admissions are most at risk of the former, whereas affective and personality disorders predict the latter. Both community intellectual disability services and mental health crisis care must focus on providing effective support for those patients.
Mitochondria control mTORC1 activity-linked compartmentalization of eIF4E to regulate extracellular export of microRNAs
Authors: Chatterjee Susanta , Chakrabarty Yogaditya , Banerjee Saikat , Ghosh Souvik , Bhattacharyya Suvendra N.
Published: December 2020

Defective intracellular trafficking and export of microRNAs (miRNAs) have been observed in growth-retarded mammalian cells having impaired mitochondrial potential and dynamics. Here, we found that uncoupling protein 2 (Ucp2)-mediated depolarization of mitochondrial membrane also results in progressive sequestration of miRNAs within polysomes and lowers their release via extracellular vesicles. Interestingly, the impaired miRNA-trafficking process in growth-retarded human cells could be reversed in the presence of Genipin, an inhibitor of Ucp2. Mitochondrial detethering of endoplasmic reticulum (ER), observed in cells with depolarized mitochondria, was found to be responsible for defective compartmentalization of translation initiation factor eIF4E to polysomes attached to ER. This caused a retarded translation process accompanied by enhanced retention of miRNAs and target mRNAs within ER-attached polysomes to restrict extracellular export of miRNAs. Reduced compartment-specific activity of the mammalian target of rapamycin complex 1 (mTORC1), the master regulator of protein synthesis, in cells with defective mitochondria or detethered ER, caused reduced phosphorylation of eIF4E-BP1 and prevented eIF4E targeting to ER-attached polysomes and miRNA export. These data suggest how mitochondrial membrane potential and dynamics, by affecting mTORC1 activity and compartmentalization, determine the subcellular localization and export of miRNAs.
ESCRT recruitment by the S. cerevisiae inner nuclear membrane protein Heh1 is regulated by Hub1-mediated alternative splicing
Authors: Capella Matías , Martín Caballero Lucía , Pfander Boris , Braun Sigurd , Jentsch Stefan
Published: December 2020

Misassembled nuclear pore complexes (NPCs) are removed by sealing off the surrounding nuclear envelope (NE), which is conducted by the endosomal sorting complexes required for transport (ESCRT) machinery. Recruitment of ESCRT proteins to the NE is mediated by the interaction between the ESCRT member Chm7 and the inner nuclear membrane protein Heh1, which belongs to the conserved LEM family. Increased ESCRT recruitment results in excessive membrane scission at damage sites but its regulation remains poorly understood. Here, we show that Hub1-mediated alternative splicing of HEH1 pre-mRNA, resulting in production of its shorter form Heh1-S, is critical for the integrity of the NE in Saccharomyces cerevisiae. ESCRT-III mutants lacking Hub1 or Heh1-S display severe growth defects and accumulate improperly assembled NPCs. This depends on the interaction of Chm7 with the conserved MSC domain, which is only present in the longer variant Heh1-L. Heh1 variants assemble into heterodimers, and we demonstrate that a unique splice segment in Heh1-S suppresses growth defects associated with the uncontrolled interaction between Heh1-L and Chm7. Together, our findings reveal that Hub1-mediated splicing generates Heh1-S to regulate ESCRT recruitment to the NE.

This article has an associated First Person interview with the first author of the paper.