bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment and management capacities for the child health screening and intervention initiative in Visakhapatnam, India
Authors: Pagolu Koteswara Rao , Rao T. Raghava
Published: October 2020

Background: Early detection and early intervention of diseases can significantly improve child quality of life. The most often a diagnosis of Developmental Delay (DDs) made by a doctor based on strict guidelines. The aim of present survey is to decide the commonness of the conditions screened and institutional facilities through the RBSK activity among the children going to the DEIC focus at Visakhapatnam, India. Methods: This observational study was conducted in Visakhapatnam, District Early Intervention Centre (DEIC) one of the north coastal district of India for one year period and 6572 children aged 2 months-18 years were taken in the study. Norms were developed by the Ministry of Health and Family Welfare, India to DEIC, according to the norms the pediatrician will examine the children who came to the center. Existing manpower analysis in the center was also done. Present study was done the multivariate logistic regression analysis were done to identify the predictors for DDs.Results: The examination of the 30 conditions screened under 4D's methodology, defects during childbirth were there in 255(3.88%), followed by deficiencies in 239 (3.63%) children, diseases during childhood were seen in 1277 (19.43%) children and disabilities and DDs were seen in 4801 (73.05%) children. From the diseases, dental caries were found in most elevated number of youngsters with 1219 (18.54%) cases. The mostly occurring DDs are language delay 941(14.31%) children had imperfections of these were observed. On analysis of deficiencies, most extreme number of 236 (3.59%) children was found with serious intense unhealthiness of severe acute malnutrition. Among the defects at birth, congenital deafness was the most frequently screened stipulation found in 84 (1.27%) children. The post of medical officer, Psychologist and DEIC manager stayed empty all through the examination time frame. Conclusion: In the present study we have undiagnosed that many curable diseases in children are not identified at all in a timely manner. Early intervention services on children's health are very useful and in future these services are extent for every individual child.
Clinicopathological features of Epstein-Barr virus infection, microsatellite instability, tumor mutation burden and PD-L1 status in Chinese patients with gastric cancer
Authors: Zhang Li , Wu Aiwen , Li Zhongwu
Published: October 2020

Objectives: Gastric cancer (GC) is the 4th most common type of cancer worldwide. Different GC subtypes exhibit unique molecular features that may potentially guide therapeutic decisions. The aim of the present study was to investigate Epstein-Barr virus (EBV) infection, microsatellite instability (MSI) status, the expression of programmed death-ligand 1 (PD-L1) and gene mutations in patients with surgically-treated GC. Methods: The data of 2,504 GC patients, who underwent potentially curative gastrectomy with lymphadenectomy at Peking University Cancer Hospital between 2013 and 2018, were reviewed from a prospectively collected medical database. We also analyzed the clinicopathological factors associated with the immunohistochemistry (IHC) profiles of these patients, and genetic alterations were analyzed using next generation sequencing (NGS). Results: Mismatch repair-deficient (d-MMR) GC patients were found to have a higher probability of expressing PD-L1 (p<0.001, PD-L1 cutoff value = 1%). In addition, 4 and 6.9% of the 2,504 gastric cancer patients were EBV-positive and d-MMR, respectively. The number of MLH1/PMS2-negative cases was 126 (6%), and the number of MSH2/MSH6-negative cases was 14 (0.9%). d-MMR status was associated with a diffuse/mixed group (p<0.05), but not with tumor differentiation. Furthermore, MSI and d-MMR GC status (detected by NGS and IHC, respectively) were consistently high, and the rate of MSI was higher in patients with d-MMR GC. A number of genes associated with DNA damage repair were detected in GC patients with MSI, including POLE, ETV6, BRCA and RNF43. In patients with a high tumor mutation burden, the most significantly mutated genes were LRP1B (79.07%), ARID1A (74.42%), RNF43 (69.77%), ZFHX3 (65.12%), TP53 (58.14%), GANS (51.16%), BRCA2 (51.16%), PIK3CA (51.16%), NOTCH1 (51.16%), SMARCA4 (48.84%), ATR (46.51%), POLE (41.86%) and ATM (39.53%). Conclusions: Using IHC and NGS, MSI status, protein expression, TMB and genetic alterations were identified in patients with GC, which provides a theoretical basis for the future clinical treatment of GC.
Membrane and lipid metabolism plays an important role in desiccation resistance in the yeast Saccharomyces cerevisiae
Authors: Ren Qun , Brenner Rebecca , Boothby Thomas C. , Zhang Zhaojie
Published: October 2020

Background Anhydrobiotes, such as the yeast Saccharomyces cerevisiae, are capable of surviving almost total loss of water. Desiccation tolerance requires an interplay of multiple events, including preserving the protein function and membrane integrity, preventing and mitigating oxidative stress, maintaining certain level of energy required for cellular activities in the desiccated state. Many of these crucial processes can be controlled and modulated at the level of organelle morphology and dynamics. However, little is understood about what organelle perturbations manifest in desiccation-sensitive cells as a consequence of drying or how this differs from organelle biology in desiccation-tolerant organisms undergoing anhydrobiosis.Results In this study, electron and optical microscopy was used to examine the dynamic changes of yeast cells during the desiccation process. Dramatic structural changes were observed during the desiccation process, including the diminishing of vacuoles, decrease of lipid droplets, decrease in mitochondrial cristae and increase of ER membrane, which is likely caused by ER stress and unfolded protein response. The survival rate was significantly decreased in mutants that are defective in lipid droplet biosynthesis, or cells treated with cerulenin, an inhibitor of fatty acid synthesis.Conclusion Our study suggests that the metabolism of lipid droplets and membrane may play an important role in yeast desiccation tolerance by providing cells with energy and possibly metabolic water. Additionally, the decrease in mitochondrial cristae coupled with a decrease in lipid droplets is indicative of a cellular response to reduce the production of reactive oxygen species.
Impact of Experienced HIV Stigma on Health is Mediated by Internalized Stigma and Depression: Results from the People Living with HIV Stigma Index in Ontario
Authors: Tian Jason Lo Hog , Watson James R , Ibáñez-Carrasco Francisco , Tran Billy , Parsons Janet A , Maunder Robert G , Card Kiffer G , Baral Stefan , Hui Christian , Boni Anthony R , Ajiboye Monisola , Lindsay Joanne D , Rourke Sean B
Published: October 2020

Background: Experiences of HIV stigma remain prevalent across Canada, causing significant stress and negatively affecting the health and wellbeing of people living with HIV. While studies have consistently demonstrated that stigma negatively impacts health, there has been limited research on the mechanisms behind these effects. This study aims to identify which dimensions of stigma have significant relationships with self-rated health and examine the mechanisms by which those types of stigma impact self-rated health and by extension, key real-life health outcomes.Methods: We recruited 724 participants to complete the People Living with HIV Stigma Index in Ontario, designed by people living with HIV to measure nuanced changes in stigma and discrimination. The present study utilizes data from externally validated measures of stigma and health risks that were included in the survey. First, we conducted multiple regression analyses to examine which variables had a significant impact on self-rated health. Results from the multiple regression guided the mediation analysis. A parallel mediation model was created with enacted stigma as the antecedent, internalized stigma and depression as the mediators, and self-rated health as the outcome. Results: In the multiple regression analysis, internalized stigma (coefficient = -0.20, p<0.01) and depression (coefficient = -0.07, p<0.01) were both significant and independent predictors of health. We found through mediation analyses that the relationship between enacted stigma and self-rated health is mediated in parallel by both internalized stigma [coefficient = -0.08, se = 0.03, 95% CI (-0.14, -0.02)] and depression [coefficient = -0.16, se = 0.03, 95% CI (-0.22, -0.11)].Conclusions: We developed a mediation model to explain how HIV stigma negatively impacts health. We found that that experiences of prejudice or discrimination (enacted stigma) can lead to internalization of negative thoughts regarding one’s HIV status (internalized stigma) and/or increased depressive symptoms which then may lead to worse overall health. Highlighting the importance of internalized stigma and depression has the potential to shape the development of targeted intervention strategies aimed at reducing the burden of stigma and improving the health and wellbeing of people living with HIV.
Riverbank Erosion and Migration Inter-Linkage: with special focus on Assam, India
Authors: Dekaraja Dimpal , Mahanta Ratul
Published: October 2020

Background: Riverbank erosion becomes a vulnerable phenomenon in the bank of the Brahmaputra river and its tributaries. Around 17 riverine districts of Assam are affected by riverbank erosion and lost a large plot of land. Due to riverbank erosion the victims’ loss their homestead and crop land as well as their survival strategy in the eroded areas. Moreover, farmers largely affected due to riverbank erosion as they loss their sources of income. This forces the farmer to migrate to another place for their survival. The paper examines the linkage between river bank erosion and migration based on secondary information. Method: To examine the linkage, information collected from government published sources ‘Census of India’ and ‘Statistical handbook of Assam’. On the basis of the information, 10 indicators constructed from 26 variables and then factor analysis method applied to examine the linkage between riverbank erosion and migration. Results: Four variables that are agricultural worker, industrial worker, cropped area and livestock population are loaded into the first factor, for which the first factor is labeled as the socio-economic indicator. In case of second factor the two variables i.e. Migrational Growth Index(MGI) and urban population are loaded. On the basis of the loaded variables this factor labeled as demographic indicator. In case of third factor also two variables are loaded that is, Natural Growth Index(NGI) and Literacy rate. The loaded variables indicate that both NGI and Literacy rate are positively related. Two variables are loaded in this fourth factor i.e. river bank eroded area and the district population growth. This factor labeled as environmental indicator on the basis of the variables loaded in this factor. The factor correlation matrix indicates the opposite relation between first and fourth factor. Conclusion: The results obtained from Factor component analysis reveals that the first and fourth factor component mainly established the linkage between riverbank erosion and migration. Besides this the component correlation matrix also reveals the inter-linkage between the variables. Thus we can say that there is positive relation between riverbank erosion and migration. However, it can be interpret that farmers mostly affected due to riverbank erosion and migrate more, because most of the inhabitants of the floodplain areas are the farmers.
Transcatheter arterial embolsation is efficient and safe for paediatric blunt torso trauma: a case-control study
Authors: Gakumazawa Masayasu , Toida Chiaki , Muguruma Takashi , Yogo Naoki , Shinohara Mafumi , Takeuchi Ichiro
Published: October 2020

Background: It remains unclear whether transcatheter arterial embolisation (TAE) is as safe and effective for paediatric patients with blunt torso trauma as it is for adults in Japan, owing to few trauma cases and sporadic case reports. The study aimed to compare the efficacy and safety of TAE performed in paediatric (age ≤ 15 years) and adult patients with blunt torso trauma. Methods: This was a single-centre, retrospective chart review study that included blunt torso trauma patients who underwent TAE in the trauma centre from 2012 to 2017. The comparative study was carried out between a ‘paediatric patient group’ and an ‘adult patient group’. The outcome measures for TAE were the success of haemorrhage control and complications and standardised mortality ratio (SMR).Results: A total of 504 patients with blunt torso trauma were transported to the trauma centre, out of which 23% (N=114) with blunt torso trauma underwent TAE, including 15 paediatric and 99 adult patients. There was no significant difference between the use of TAE in paediatric and adult patients with blunt torso trauma (29% vs 22%, P=.221). The paediatric patients’ median age was 11 years (IQR 7–14). The predicted mortality rate (PMR) and SMR for paediatric patients were lower than those for adult patients (18.3% vs 25.9%, P=.026, and 0.37 vs 0.54). The rate of effective haemorrhage control without repeated TAE or additional surgical intervention was 93% in paediatric patients, which was similar to that in adult patients (88%). There were no complications in paediatric patients at our centre. There were no significant differences in the proportion of paediatric patients who underwent surgery before TAE or urgent blood transfusion (33% vs 26%, P=.566, or 67% vs 85%, P=.084).Conclusions: It is possible to provide an equal level of care related to TAE for paediatric and adult patients as it relates to TAE for blunt torso trauma with haemorrhage in the trauma centre. Alternative haemorrhage control procedures should be established as soon as possible whenever the patients reach a haemodynamically unstable state.
Development of the Equine Hindgut Microbiome in Semi-feral and Domestic Conventionally-Managed Foals
Authors: Tavenner Meredith , McDonnell Sue M , Biddle Amy S
Published: October 2020

Background: Early development of the gut microbiome is an essential part of neonate health in animals. It is unclear whether the acquisition of gut microbes is different between domesticated animals and their wild counterparts. In this study, fecal samples from ten domestic conventionally managed (DCM) Standardbred and ten semi-feral managed (SFM) Shetland-type pony foals and dams were compared using 16S rRNA sequencing to identify differences in the development of the foal hindgut microbiome related to time and management. Results: Gut microbiome diversity of dams was lower than foals overall and within groups, and foals from both groups at Week 1 had less diverse gut microbiomes than subsequent weeks. The core microbiomes of SFM dams and foals had more taxa overall, and greater numbers of taxa within species groups when compared to DCM dams and foals. The gut microbiomes of SFM foals demonstrated enhanced diversity of key groups: Verrucomicrobia (RFP12), Ruminococcaceae, Fusobacterium spp., and Bacteroides spp., based on age and management. Lactic acid bacteria Lactobacillus spp. and other Lactobacillaceae genera were enriched only in DCM foals, specifically during their second and third week of life. Predicted microbiome functions estimated computationally suggested that SFM foals had higher mean sequence counts for taxa contributing to the digestion of lipids, simple and complex carbohydrates, and protein. DCM foal microbiomes were more similar to their dams in week five and six than were SFM foals at the same age.Conclusions: This study demonstrates the impact of management on the development of the foal gut microbiome in the first 6 weeks of life. The higher numbers of taxa within and between bacterial groups found in SFM dams and foals suggests more diversity and functional redundancy in their gut microbiomes, which could lend greater stability and resiliency to these communities. The colonization of lactic acid bacteria in the early life of DCM foals suggests enrichment in response to the availability of dams’ feed. Thus, management type is an important driver of gut microbiome establishment on horses, and we may look to semi-feral horses for guidance in defining a healthy gut microbiome for domestic horses.
A physical activity coaching intervention can increase and maintain physical activity and health-related outcomes in adult ambulatory care patients in a regional hospital: the Healthy4U-2 randomised controlled trial
Authors: Barrett Stephen , Begg Steve , O'Halloran Paul , Kingsley Michael
Published: October 2020

Background: The Healthy 4U-2 study sought to evaluate the effect of a twelve-week, physical activity (PA) coaching intervention for changes and maintenance in PA, anthropometrics and health-related outcomes in adults presenting to an ambulatory hospital clinic. Methods: One hundred and twenty insufficiently active adults were recruited from an ambulatory hospital clinic and randomised to an intervention group that received an education session and five 20-minute telephone sessions of PA coaching, or to a control group that received the education session only. ActiGraph GT3X accelerometers were used to measure moderate-to-vigorous physical activity (MVPA) at baseline, post-intervention (3-months) and follow-up (9-months). Secondary outcome measures (anthropometrics, PA self-efficacy, health-related and quality of life) were also assessed at the three time points. Results: At baseline, the mean age and body mass index of participants were 53 ± 8 years and 31 ± 4 kg/m 2 , respectively. Relative to control, the intervention group increased objectively measured MVPA at post-intervention (p<0.001) and 9 months follow-up (p<0.001). At the 9-month follow-up the intervention group completed 22 min/day of MVPA (95% CI: 20 to 25 min/day), which is sufficient to meet the recommended PA guidelines. The intervention group exhibited beneficial changes in body mass (p<0.001), waist circumference (p<0.001), body mass index (p<0.001), PA self-efficacy (p<0.001), and health-related quality of life (p<0.001) at the 9-month follow-up. Conclusions: This study demonstrates that a low contact PA coaching intervention results in beneficial changes in PA, anthropometrics and health-related outcomes in insufficiently active adults presenting to an ambulatory care clinic. The significant beneficial changes were measured at post-intervention and the 9-month follow-up, demonstrating a maintenance effect of the intervention. Trial registration: Prospectively registered on the Australian and New Zealand Clinical Trials Registry (ANZCTR). Trial registration number: ACTRN12619000036112. http://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376318 Keywords Physical activity; Exercise motivation; Accelerometry; Public health
Identification of metabolism-associated genes and construction of a prognostic signature in bladder cancer
Authors: Shen Chengquan , Liu Jing , Wang Liping , Liang Zhijuan , Niu Haitao , Wang Yonghua
Published: October 2020

Background: Bladder cancer (BC) is a commonly diagnosed malignant tumor in the urinary system, with a high morbidity and a high recurrence rate. Current studies indicated that metabolism-associated genes (MAGs) having critical roles in the etiology of BC. The present study aims to identify differentially expressed MAGs and construct a MAGs based prognostic risk signature for BC by using The Cancer Genome Atlas (TCGA) database and proteomics data. Methods: RNA-sequence data from the TCGA database and proteomics data from our BC samples were used to identify differentially expressed MAGs and construct a MAGs based prognostic signature in BC. Subsequently, survival analysis and nomogram were used to evaluate the prognostic and predictive value of the MAGs based signature in BC. RNA isolation and reverse transcription‑quantitative PCR (RT-qPCR) were further performed to investigate the expression levels of MAGs in BC cells and explore the relationship between MAGs and M2 tumor associated macrophages (TAMs) secreted transforming growth factor-β1 (TGF-β1) in BC cells.Results: A total of 23 differentially expressed MAGs were identified and five MAGs were finally used to construct a MAGs based signature. Survival analysis revealed that the MAGs based signature was closely correlated with the survival outcomes of patients with BC. A nomogram with the MAGs based signature risk score and clinical features was also constructed to facilitate the individualized prediction of BC patients. RT-qPCR showed that five MAGs were significantly differentially expressed and the expression levels of three MAGs were positively correlated with M2 TAMs secreted TGF-β1 in T24 cells.Conclusions: Our study identified novel prognostic MAGs and constructed a MAGs based signature, which can be used as an independent factor in evaluating the prognosis of patients with BC. Furthermore, M2 TAMs may promote the expression of MAGs via the TGF-β1 signaling pathway in the microenvironment of BC. Further clinical trials and experimental explorations are needed to validate our observations in BC.
Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States
Authors: Liu Xiaoshuang , Xu Xiao , Li Guanqiao , Xu Xian , Sun Yuyao , Wang Fei , Shi Xuanling , Li Xiang , Xie Guotong , Zhang Linqi
Published: October 2020

Background: The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs), such as non-essential business closures and gathering bans, to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is greatly needed to assist in guiding individualized decision making for adjustment of interventions in the US and around the world. However, the impacts of these approaches remain uncertain.Methods: Based on the reported cases, the effective reproduction number (Rt) of COVID-19 epidemic for 50 states in the US was estimated. Measurements on the effectiveness of nine different NPIs were conducted by assessing risk ratios (RRs) between R t and NPIs through a generalized linear model (GLM). Results: Different NPIs were found to have led to different levels of reduction in Rt. Stay-at-home contributed approximately 51% (95% CI 46%-57%), wearing (face) masks 29% (15%-42%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-14%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 7% (2%-11%).Conclusions: This retrospective assessment of NPIs on Rt has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.
Cost-effectiveness analysis of initial nonoperative management versus emergency laparoscopic appendectomy for acute complicated appendicitis
Authors: Sugiura Kiyoaki , Suzuki Keiichi , Umeyama Tomoshige , Omagari Kenshi , Hashimoto Takeo , Tamura Akihiko
Published: October 2020

Background The evidence regarding the safety and efficacy of nonoperative management is growing. However, the best treatment strategy for acute complicated appendicitis remains controversial. We aimed to evaluate the cost-effectiveness of treatment strategies for complicated appendicitis patients. This study sought to determine the most cost-effective strategy from the health care-payer's perspectiveMethods The primary outcome was an incremental cost effectiveness ratio (ICER) using nonoperative management with or without interval laparoscopic appendectomy (ILA) as the intervention compared with operative management with emergency laparoscopic appendectomy (ELA) alone as the control. Model variables were abstracted from a literature review, and from data obtained from the hospital records of Tochigi Medical Center. Cost-effectiveness was evaluated using an ICER. We constructed a Markov model to compare treatment strategies for complicated appendicitis in otherwise-healthy adults, over a time horizon of a single year. Uncertainty surrounding model parameters was assessed via one-way- and probabilistic-sensitivity analyses. Threshold analysis was performed using the willingness-to-pay threshold set at the World Health Organization's criterion of $107,690.Results Three meta-analysis were included in our analysis. Operative management cost $6,075 per patient. Nonoperative management with interval laparoscopic appendectomy (ILA) cost $984 more than operative management and produced only 0.005 more QALYs, resulting in an ICER of $182,587. Nonoperative management without ILA cost $235 more than operative management, and also yielded only 0.005 additional QALYs resulting in an ICER of $45,123 per QALY. Probabilistic sensitivity analysis with 1,000 draws resulted in average ICER of $172,992 in nonoperative management with ILA and $462,843 in Nonoperative management without ILA. The threshold analysis demonstrated that regardless of willingness-to-pay, nonoperative management without ILA would not be most cost-effective strategyConclusions Nonoperative management with ILA and Nonoperative management without ILA were not cost-effective strategies compared with operative management to treat complicated appendicitis. Based on our findings, operative management remains the standard of care and nonoperative management would be reconsidered as a treatment option in complicated appendicitis from economic perspective.
Sub-thermionic, ultra-high-gain organic transistors and circuits
Authors: Luo Zhongzhong , Peng Boyu , Zeng Junpeng , Yu Zhihao , Zhao Ying , Xie Jun , Lan Longfang , Ma Zhong , Pan Lijia , Cao Ke , Lu Yang , He Daowei , Ning Hongkai , Meng Wanqing , Yang Yang , Chen Xiaoqing , Li Weisheng , Wang Jiawei , Pan Danfeng , Tu Xuecou , Huo Wenxing , Huang Xian , Shi Dongquan , Li Ling , Liu Ming , Shi Yi , Feng Xue , Chan Paddy Kwok Leung , Wang Xinran
Published: October 2020

The development of organic thin-film transistors (OTFTs) with low power consumption and high gain will advance many flexible electronics applications. Here, by combining solution-processed monolayer organic crystal, ferroelectric HfZrOx gating and van der Waals device fabrication, we realize flexible OTFTs that simultaneously deliver high transconductance and sub-60mV/dec switching, under one-volt operating voltage. The overall optimization of transconductance, subthreshold swing and output resistance leads to transistor intrinsic gain and amplifier voltage gain over 5.3×104 and 1.1×104, respectively, which outperform existing technologies using organics, oxides and low-dimensional nanomaterials. We further demonstrate battery-powered, integrated wearable electrocardiogram (ECG) and pulse sensors that can amplify human physiological signal by 900 times with high fidelity. The sensors are capable of detecting extremely weak ECG waves (undetectable even by clinical equipment) and diagnosing arrhythmia and atrial fibrillation. Our sub-thermionic OTFT is promising for battery/wireless powered yet performance demanding applications such as electronic skins, radio-frequency identification tags, among many others.
Characteristics and Outcomes of Acute Appendicitis Cases During the COVID-19 Pandemic
Authors: Başer Murat , Katar Mehmet Kağan
Published: October 2020

Background: Our aim in this study was to investigate the effects of the COVID-19 pandemic on acute appendicitis cases.Methods: This study was designed as a single-center, retrospective, and observational study. The patients were divided into three groups relative to the date of the first COVID-19 case in Turkey, which was March 10, 2020 (Group A: before the pandemic; Group B: pandemic period; Group C: the same period one year before the pandemic). A total of 413 patients were included in the study.Results: In terms of treatment modality, the rate of open appendectomy was significantly higher in group B (p<0.001). Rates of conversion to open surgery, as well as rates of complicated appendicitis were also significantly higher in group B (p=0.027, p=0.024, respectively). While there was no difference between the groups in terms of preoperative hospitalization duration (p=0.102), it was found that the duration of symptoms, operation time, and postoperative length of hospital stay were significantly higher in Group B (p<0.001, p=0.011, p=0.001, respectively). In addition, the complication rate in group B (8.9%) was also significantly higher than in the other two groups (p=0.023).Conclusion: We found that the rate of open surgery, the rate of conversion of laparoscopic surgery to open surgery, complication rates, mean operation time, and postoperative hospital stay were significantly higher in acute appendicitis patients that underwent surgery during the COVID-19 pandemic period. We believe that the main reason for this negative outcome is the late admission of the patients to the hospital.
Validity and Reliability of the Lederman Prenatal Self-Evaluation Questionnaire (Pseq) in Brazil
Authors: Silva Janiny Lima e , Mata Matheus de Sousa , Câmara Saionara Maria Aires , Costa Íris do Céu Clara , Medeiros Kleyton Santos de , Cobucci Ricardo Ney , Gonçalves Ana K.
Published: October 2020

Background: The Lederman Prenatal Self-Evaluation Questionnaire (PSEQ) is used to assess psychosocial adaptation to pregnancy, labor, childbirth, and maternity. The PSEQ is a tool used in various countries and has been translated into Portuguese; however, it needs to be validated in Brazil. This study aimed to analyze the validity and reliability of the PSEQ for Brazilian pregnant women. Method: This methodological validity study investigated the internal consistency and reliability using Cronbach’s alpha and intraclass correlation coefficient, respectively. Construct validity was assessed using Pearson’s correlation between the domains and confirmatory factor analysis. To assess the concurrent validity, the Pearson’s correlation between the PSEQ and Prenatal Psychosocial Profile-Portuguese Version (PPP-VP) was determined. Results: This study included 399 pregnant women from the northeastern region of Brazil. The internal consistency and reliability of the total PSEQ score were high (Cronbach's alpha = 0.89; intraclass correlation coefficient = 0.95). Validity analysis showed positive and significant correlations between all PSEQ domains, ranging from 0.14 to 0.56. Confirmation factor analysis demonstrated the following values of goodness of fit: RMSEA = 0.05, SRMR = 0.08, CFI = 0.61, x²/df = 1.77. The discriminant and concurrent validities of the PSEQ were confirmed. The level of significance was set at 5%. Conclusions: The Portuguese version of the PSEQ has adequate psychometric properties and is a valid and reliable tool to evaluate the psychosocial adaptation to pregnancy in Brazilian pregnant women.
Healthcare Professionals’ Perspectives on the Cross-sectoral Treatment Pathway for Women with Gestational Diabetes During and After Pregnancy – A Qualitative Study
Authors: Timm Anne , Nielsen Karoline Kragelund , Christense Ulla , Maindal Helle Terkildsen
Published: October 2020

Background: Gestational diabetes increases the risk of complications during and after pregnancy, including a long-term risk of type 2 diabetes. Women with gestational diabetes have to navigate a complex treatment pathway during pregnancy, which they often experience as incoherent. These women also report a lack of preventive care after pregnancy. The objective of this study is to investigate healthcare professionals’ views on the cross-sectoral treatment pathway for women with gestational diabetes – under and after pregnancy. Methods: Nine healthcare professionals handling women with gestational diabetes before and after pregnancy in Denmark were interviewed (two general practitioners, four midwives, two obstetricians and one diabetes nurse). Further, eight health visitors participated in focus group discussions. The data material was analysed using systematic text condensation. Results: Three major themes emerged: 1) professional identity which varied across the healthcare professionals and consequently shaped care practices; 2) lack of priority in the area of gestational diabetes contributed to uncertainty of tasks and responsibilities across the treatment pathway; and 3) cross-sectoral collaboration relied heavily on knowledge transfer between hospitals, general practitioners, and the local municipality. Conclusion: Knowledge transfer was fragmented as guidelines for treatment in the postpartum period were unclear to healthcare professionals outside the hospital. More awareness should be given to structures that ease clear and transparent guidelines and tailored communication strategies for healthcare professionals who provide care to women with gestational diabetes under and after pregnancy.
Production, Optimization and Characterization of an Acid Protease From Filamentous Fungi by Solid-state Fermentation
Authors: Usman Abdilbar , Mohammed Said , Mamo Jermen
Published: October 2020

Acid proteases represent an important group of enzymes, extensively used in food and beverage industries. There are a diversification of food industries and thus an increasing demand for biocatalysts capable of adapting the industrial extreme environments. These demands can be covered by a plant and animal proteases; however there is a shortage to meet the present industrial demands. This necessitates the search for an alternative acid protease sources from fungi. The fungal isolates were recovered from grape and dairy farm soil using potato-dextrose Agar. The fungi were further screened for protease production based on the hydrolysis of clear-zone on skim-milk agar media. The potential fungi were then subjected to secondary screening under solid-state fermentation. After primary and secondary screening, the potential fungus (isolate Z1BL1) was identified to the genus level by combination of macroscopic and microscopic morphological study. The growth condition and media composition for potential fungal isolate (Z1BL1) was further optimized under solid-state fermentation. The crude enzyme produced from isolate Z1BL1 was characterized after partial purification by acetone and ammonium sulphate precipitation. A total of 9 fungal isolates were showed protease production in primary and secondary screening, however 1 potential isolate (Z1BL1) was selected for further study based on its protease activity. The potential fungus, isolate Z1BL1 was identified to the genus Aspergillus based on their morphological features. The optimization of media composition and growth conditions for acid protease production from Z1BL1 were slightly increased the protease activity. The acetone precipitated enzyme exhibited the maximum activity at 50 0C and pH 5 with stability at pH 4-6 and temperature 40-60 0C. Thus based on the above findings, the acid protease produced from Aspergillus was shown suitable enzyme characteristics required in industry and could be a candidate to be applicable in food industry after further purification by high resolution techniques.
Complementarity of Raman and Infrared Spectroscopy for Rapid Characterization of Fucoidan Extracts
Authors: Ptak Signe , Sanchez Lee , Frette Xavier , Kurouski Dmitry
Published: October 2020

BackgroundFucoidans are sulfated polysaccharides from the cell-wall of brown algae. They have a wide range of applications in medicine, including regenerative medicine, ophthalmology, cancer, and autoimmune disease. Biological activity of fucoidans directly depends on their structure, which remains poorly understood. This is primarily because the polymeric nature of these molecules limits the use of nuclear magnetic resonance and mass spectrometry, classical tools of structural biology for their structural characterization. Raman and Infrared spectroscopies are non-invasive and non-destructive techniques that can be used to probe the structural organization of biological specimens. In this study, we investigate the potential of Raman and Infrared spectroscopy for structural analysis of several fucoidan extracts. ResultsOur results show that Infrared and Raman provide different but complimentary information about the structure of crude extracts of fucoidans, revealing the presence of minor impurities from co-extractants. We also found that at high extraction temperatures acidic conditions limit formation of melanoidins, while also yielding relatively high sulfate ester fucoidan. However, at high temperatures, water extraction may potentially result in formation of advanced glycation end products. Their presence could be problematic for fucoidan extracts intended for medicinal use, as advanced glycation end products have been linked to endocrine interruption mechanisms in vivo by crosslinking to and permanently altering extracellular matrix proteins. ConclusionRaman and Infrared can be used as complementary tools for rapid screening of crude fucoidan extracts, which can be a valuable tool for assessing impurities that remain after extraction.
Deployment of a Lorawan Network and Evaluation of Tracking Devices in the Context of Smart Cities
Authors: Camargo Edson , Spanhol Fabio , Souza Alvaro
Published: October 2020

Recent public cooperation between the Federal University of Technology Paraná and Toledo Municipality plans to implement the concept of smart cities in this city. In this context, one of the applications under development intends to track the recyclable garbage collector trucks in real time over the Internet. Actually, fleet vehicle tracking is one of the main applications for smart cities. LoRaWAN stands out among network technologies for smart cities due to operating in an open frequency range, covering long distances with low power consumption and low equipment cost. However, the coverage and performance of LoRaWAN is directly affected by both the environment and configuration parameters. In addition, tracking devices must be able to send its coordinates to the Internet even when the vehicle goes through zones where there are obstacles for electromagnetic waves, such as elevated buildings or valleys. In this paper we perform experimental investigations to evaluate four LoRaWAN tracking devices, two out of the box commercial and two assembled and programmed. The behavior of each tracking device is analyzed when moving through three representative urban areas. As the devices depend on the quality of the signal offered by the network, we also present the results of the development and evaluation of the LoRaWAN network, planning its coverage throughout the city. Results of tracking devices were analyzed under quantitative and qualitative aspects, including the received signal strength indication (RSSI), signal-to-noise ratio (SNR), package delivery ratio (PDR), and spreading factor (SF) for the geographic coordinates received.
Novel Nomograms to Predict of Overall Survival and Cancer-specific Survival of Patients of Metaplastic Breast Cancer
Authors: Li Yongfeng , Chen Daobao , Xuan Haojun , Dragomir Mihnea P. , Calin George A. , Yang Hongjian , Chen Meng , Jin hongchuan
Published: October 2020

Background Metaplastic breast cancer (MBC) is a rare type of breast cancer with an increasing incidence, we aim to develop clinical nomograms to predict the overall survival and cancer-specific survival for patients with MBC.MethodsPatients data were collected from the SEER database between 1973 and 2015. All included patients were randomly assigned into the training and validation sets. Univariate and multivariate Cox analysis were performed to identify independent prognostic factors of MBC. These essential prognostic variables were combined to construct nomogram models to predict overall survival (OS) and cancer-specific survival (CSS) in patients with MBC. Model performance was evaluated by concordance index (C-index) and calibration plots.ResultsA total of 1835 patients were collected and divided into the training (1223) and validation (612) groups. The multivariate Cox model identified age, TNM stage, T stage, and N stage, chemotherapy and radiotherapy as independent covariates associated with OS, while these variables except for age and chemotherapy were independent prognostic factors of CSS. The nomogram constructed based on these covariates demonstrated excellent accuracy in estimating 3-, and 5-year OS and CSS, with a C-index of 0.759 (95% CI, 0.746-0.772) for OS and 0.766 (95% CI, 0.751-0.781) for CSS in the training cohort. In the validation cohort, the nomogram-predicted C-index was 0.754 for OS (95%CI, 0.734-0.774) and 0.752 (95%CI, 0.728-0.776) for CSS. All calibration curves exhibited good consistency between predicted and actual survival.ConclusionsThese nomogram models established in this study can help to enhance the accuracy of prognostic prediction, which may thereby improve individualized assessment of survival risks and facilitate to provide constructive therapeutic suggestions.
Gene expression profiling to explore the protective effect of Antrodia cinnamomea compound decoction on PM2.5-induced lung inflammation in rats
Authors: Wang Guishu , Chen Weicheng , Meng Yufeng , Zhang Caijuan , Zheng Jiakun , Liu Yaqian , Zhu Changle , Shi Liangtian , Wei Yongjie , Kuo Jenhua , Feng Cuiling
Published: October 2020

BackgroundAntrodia cinnamomea compound decoction (ACCD), a Chinese herbal extract composed of Antrodia cinnamomea, Rhinacanthus nasutus (L.) Kurz and Phellinus igniarius (L. ex Fr.), were widely used with anti-inflammatory activity. However, the effects and mechanisms of ACCD on the lung inflammation induced by PM2.5 are not fully understood. This study aims to reveal the effect of ACCD on PM2.5-induced lung inflammation and analyze the possible mechanisms through gene chip expression profiling. MethodsMale Wistar rats were subjected to lung damage by stimulation with 10% PM2.5, with/without ACCD (0.67g/kg/d) intervention. The HE, AB-PAS staining and IL-1β were performed to evaluate the effect of ACCD in the treatment of lung inflammation caused by PM2.5. In addition, the extracted lung genes were detected based on the gene chip expression profile. Bioinformatics analysis and quantitative real-time polymerase chain reaction assay (Q-PCR) were used to analysis and verify the related differentially expressed genes (DEGs). ResultsResults showed that instillation of PM2.5 increased the inflammatory cells immersion in the airways and the acid mucus content in the tracheal epithelium compared with the sham group, and it increased the IL-1β levels in Bronchoalveolar lavage fluid (BALF). ACCD reduced inflammatory cell immersion in airways, alleviated goblet cell metaplasia in tracheal epithelium and reduced IL-1β levels in BALF. A total of 99 genes with significant differential expression were identified (p < 0.05) after ACCD treatment compared with the model group, including 48 up-regulated and 51 down-regulated genes. Bioinformatics analysis showed that these DEGs were mainly related to inflammatory response and significantly enriched in cancer signaling pathway. Five of the DEGs were subjected to Q-PCR and three of them (Plcβ-1, Axin2, Ccbe1) were significant difference (p < 0.05). ConclusionOur study suggests that ACCD may exert anti-inflammatory effects on PM2.5-induced lung inflammation via the cancer pathway, and that Plcβ-1, Axin2, and Ccbe1 may be key targets of ACCD action on PM2.5-induced lung inflammation. This work could provide genomic clues for the continued study of ACCD for the therapy of PM2.5-induced lung inflammation.
Association of Serum Antibodies Against the Mycobacterium Avium Complex and Hemoptysis: A Cross-Sectional Study
Authors: Ogata Hiroaki , Moriwaki Atsushi , Nakagawa Taisuke , Sakoda Soichiro , Ishimatsu Akiko , Taguchi Kazuhito , Aso Hiroshi , Nogami Hiroko , Kadowaki Masako , Tateshi Yuko , Yoshida Makoto
Published: October 2020

Background: Hemoptysis is very common and can be life threatening in clinical practice for nontuberculous mycobacteria. The serum antibody against the Mycobacterium avium complex (MAC-Ab), the majority of nontuberculous mycobacteria species, is well known to reflect the activity of MAC lung disease; however, there is no study investigating the association between the MAC-Ab and hemoptysis in MAC patients. Therefore, we assessed whether the MAC-Ab is a good biomarker for hemoptysis among subjects with MAC lung disease. Methods: This study was conducted as a five-year retrospective survey at the National Hospital Organization Fukuoka National Hospital. A total of 155 patients aged ≥ 20 years with MAC lung disease were enrolled and separated into seropositive and seronegative groups using the cutoff for MAC-Ab levels of 0.7 U/ml. The prevalence of hemoptysis and odds ratios for the presence of hemoptysis were estimated and compared between the groups. To investigate the linear trends in the relationship between MAC-Ab levels and hemoptysis, the subjects were classified into three groups using the tertile distribution of the MAC-Ab. Results: The prevalence of hemoptysis was twice as high in the seropositive group than in the seronegative group (42.2% and 21.7%, respectively, P = 0.02). The multivariable-adjusted risk of hemoptysis was elevated in the seropositive group as compared with the seronegative group (odds ratio = 2.79 (95% confidence interval 1.15–7.44)). Likewise, when categorizing the subjects into three groups, the risk of hemoptysis increased parallel to higher MAC-Ab levels (P = 0.03 for trend). Conclusions: A positive MAC-Ab level was a significant risk factor for hemoptysis among patients with MAC lung disease. There were also positive trends in the association between the MAC-Ab titer and the likelihood of hemoptysis. MAC patients who tested positive for the MAC-Ab should be carefully followed up for the potential development of hemoptysis.
Low Expression of Mas1 Receptor in Pancreas Related with Acute Pancreatitis
Authors: Cui Tianyu , Yu Xiaozheng , Li Chunyun , Li Tianhe , Liu Ruixia , Yin Chenghong
Published: October 2020

Background：Acute pancreatitis (AP) continues to be one of the most common causes of hospitalization among all gastrointestinal disease. There is a lack of therapies directed to its molecular pathogenesis. The aim of this study was to investigate the role and major mechanisms of Mas1 receptor in AP. Methods: AP was induced in C57BL/6 mice by administration of caerulein and lipopolysaccharide. The effects of intervening Mas1 receptor on the severity of AP, trypsinogen activation peptide (TAP), zymogens distribution and autophagy activity were detected in vivo. Then Mas1-lentivirus transfected AR42J cell and incubated with caerulein. TAP, autophagy activity and co-location of trypsin and autophagic were further detected in vitro. Human pancreas tissue from patients with AP and without AP were also used for Mas1 receptor protein and mRNA expression levels.Results: Mas1 receptor proteins were down-regulated in AP mice pancreas tissue as well as in human patients with AP. Compared with Mas1 receptor inhibited in AP mice, AP mice with Mas1 receptor activated decreased severe pathological changes in pancreata, lower levels of trypsinogen activation concomitant with zymogens basolateral distribution, and autophagy down-regulation. Mas1 receptor knockdown and over-expression further verified those results in vitro and showed Mas1 receptor knockdown in AR42J cells had an increased colocalization of LC3II with trypsin.Conclusions: Mas1 receptor decreased expresssion in pancreas may promote zymogens premature activation relating to AP.