bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive value of the neutrophil to lymphocyte ratio for disease deterioration and serious adverse outcomes in patients with COVID-19: a prospective cohort study
Authors: Zeng Zhi-Yong , Feng Shao-Dan , Chen Gong-Ping , Wu Jiang-Nan
Published: January 2021

Background: Early identification of patients who are at high risk of poor clinical outcomes is of great importance in saving the lives of patients with novel coronavirus disease 2019 (COVID-19) in the context of limited medical resources.Objective: To evaluate the value of the neutrophil to lymphocyte ratio (NLR), calculated at hospital admission and in isolation, for the prediction of the subsequent presence of disease progression and serious clinical outcomes (e.g., shock, death).Methods: We designed a prospective cohort study of 352 hospitalized patients with COVID-19 between January 9 and February 26, 2020, in Yichang City, Hubei Province. Patients with an NLR equal to or higher than the cutoff value derived from the receiver operating characteristic curve method were classified as the exposed group. The primary outcome was disease deterioration, defined as an increase of the clinical disease severity classification during hospitalization (e.g., moderate to severe/critical; severe to critical). The secondary outcomes were shock and death during the treatment.Results: During the follow-up period, 51 (14.5%) patients’ conditions deteriorated, 15 patients (4.3%) had complicated septic shock, and 15 patients (4.3%) died. The NLR was higher in patients with deterioration than in those without deterioration (median: 5.33 vs. 2.14, P <0.001), and higher in patients with serious clinical outcomes than in those without serious clinical outcomes (shock vs. no shock: 6.19 vs. 2.25, P <0.001; death vs. survival: 7.19 vs. 2.25, P <0.001). The NLR measured at hospital admission had high value in predicting subsequent disease deterioration, shock and death (all the areas under the curve > 0.80). The sensitivity of an NLR ≥ 2.6937 for predicting subsequent disease deterioration, shock and death was 82.0% (95% confidence interval, 69.0 to 91.0), 93.3% (68.0 to 100), and 92.9% (66.0 to 100), and the corresponding negative predictive values were 95.7% (93.0 to 99.2), 99.5% (98.6 to 100) and 99.5% (98.6 to 100), respectively.Conclusions: The NLR measured at admission and in isolation can be used to effectively predict the subsequent presence of disease deterioration and serious clinical outcomes in patients with COVID-19.
Detection of SARS-CoV-2 from Patient Fecal Samples by Whole Genome Sequencing
Authors: Papoutsis Andreas , Borody Thomas , Dolai Siba , Daniels Jordan , Steinberg Skylar , Barrows Brad , Hazan Sabine
Published: January 2021

Background

SARS-CoV-2 has been detected not only in respiratory secretions, but also in stool collections. Here were sought to identify SARS-CoV-2 by enrichment NGS from fecal samples, and to utilize whole genome analysis to characterize SARS-CoV-2 mutational variations in COVID-19 patients.

Results

Study participants underwent testing for SARS-CoV-2 from fecal samples by whole genome enrichment NGS (n = 14), and RT-PCR nasopharyngeal swab analysis (n = 12). The concordance of SARS-CoV-2 detection by enrichment NGS from stools with RT-PCR nasopharyngeal analysis was 100%. Unique variants were identified in four patients, with a total of 33 different mutations among those in which SARS-CoV-2 was detected by whole genome enrichment NGS.

Conclusion

These results highlight the potential viability of SARS-CoV-2 in feces, its ongoing mutational accumulation, and its possible role in fecal-oral transmission. This study also elucidates the advantages of SARS-CoV-2 enrichment NGS, which may be a key methodology to document complete viral eradication.
Early visual quality outcomes after small-incision lenticule extraction surgery for correcting high myopic astigmatism
Authors: Hou Xiangtao , Du Kaixuan , Wen Dan , Hu Shengfa , Hu Tu , Li Chenling , Tang Yanhui , Wu Xiaoying
Published: January 2021

Background: To evaluate early optical quality outcomes after small-incision lenticule extraction (SMILE) surgery for correcting high myopic astigmatism.Methods: This retrospective study enrolled 55 eyes from 37 patients who had preoperative myopic astigmatism of ≥2.00 diopters (D) who had been treated with SMILE surgery. Preoperatively, the mean cylinder was -2.41 ± 0.54 D (range, -2.00 D to -4.50 D). The preoperative and postoperative visual outcomes, refraction, and higher-order aberration (HOA) at 1 and 3 months were compared. Refractive astigmatism changes were analyzed by the Alpins vector method.Results: Three months after SMILE surgery, the average cylinder was -0.14 ± 0.31 D, and the average astigmatism vector was -0.09 D × 6.34°. The angle of error (AofE) was limited to within ±10°, and the magnitude of error was limited to within ±1.0 D in all patients. The correction index (CI) was 0.98 ± 0.07, the index of success (IOS) was 0.08 ± 0.13, and the flattening index (FI) was 0.97 ± 0.07. Significant positive correlations were found between IOS and |AofE| (P = 0.000); negative correlations were found between FI and |AofE| (P = 0.000). The postoperative total HOA, spherical aberration, vertical coma aberration, and trefoil 30° were increased significantly compared with preoperative measurements, and the increase in HOA was closely related to preoperative astigmatism (P < 0.05).Conclusions: SMILE has preferable outcomes for correcting high myopic astigmatism. Axis rotation during the surgery might influence the undercorrection of astigmatism. The increase of HOA after surgery is related to preoperative astigmatism.
Prediction of risk factors of bronchial mucus plugs in children with Mycoplasma pneumoniae pneumonia
Authors: Zhang Jiahui , Wang Ting , Li Rongrong , Ji Wei , Yan Yongdong , Sun Zhichao , Tan Jiahong , Wu Jinfeng , Huang Li , Chen Zhengrong
Published: January 2021

Background: Recently, many cases of pneumonia in children with Mycoplasma pneumoniae infection have been shown to have varying degrees of intrabronchial mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of patients with Mycoplasma infection are analyzed in this study. The risk factors for M. pneumoniae pneumonia (MPP) mucus plug formation in children are explored, and a risk factor scoring system is established.Methods: MPP patients treated with bronchoscopy were retrospectively enrolled in the study from February 2015 to December 2019. The children were divided into a mucus plug group and a control group according to the presence or absence of mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of the two groups of children were compared. Univariate and multivariate logistic regression models were used to identify the risk factors for MPP mucus plug formation. The receiver operating characteristic (ROC) curve was drawn to evaluate the regression model and establish the MPP mucous plug risk factor scoring system.Results: A univariate analysis showed that the children in the mucous group were older and had a longer fever duration, longer hospital stay, higher fever peak, more cases of wheezing symptoms and allergies, and azithromycin or corticosteroids were administered later. In addition, neutrophil, C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (DD), sputum MP-DNA copy number, and total immunoglobulin A (IgA) levels were higher, while prealbumin (PA) levels were lower. The ROC curve analysis showed that children with MPP had PA ≤144.5 mg/L, had used corticosteroids during the course of the illness of ≥4.5 days, CRP ≥12.27 mg/L, an LDH≥462.65 U/L, and there was a possibility of intra-airway mucus formation. The independent risk factors were scored according to their odds ratio (OR) value. Among the 255 children with MPP, the high-risk group had 44 (83.02%) mucus plugs out of 53; the middle-risk group had 35 (34.3%) mucus plugs out of 102; and the low-risk group had 11 (11%) mucus plugs out of 100.Conclusions: PA levels, timing of corticosteroid use (use in the first few days), CRP levels, and LDH levels were independent risk factors for MPP mucus plug formation. This provides a basis for the early identification of MPP in children combined with mucus plug formation.
Time trends in hospital admissions in very elderly patients (≥85 years-old) in Spain: data from the Spanish National Discharge Database (2000 - 2015)
Authors: Fernández Sergio Palacios , Salcedo Mario , Gonzalez-Alcaide Gregorio , Ramos-Rincon Jose-Manuel
Published: January 2021

Background The aging population is an increasing concern in Western hospital systems. The aim of this study was to describe the main characteristics and hospitalization patterns in very elderly inpatients (≥ 85 years) in Spain from 2000 to 2015.Methods Retrospective observational study analyzing data from the minimum basic data set, an administrative registry recording each hospital discharge in Spain since 1997. We collected administrative, economic and clinical data for all discharges between 2000 and 2015 in patients aged 85 years and older, reporting results in three age groups and four time periods to assess differences and compare trends.Results There were 4,387,326 admissions in very elderly patients in Spain from 2000 to 2015, representing 5.32% of total admissions in 2000–2003 and 10.42% in 2012–2015. The pace of growth was faster in older age groups, with an annual percentage increase of 6% in patients aged 85–89 years, 7.79% in those aged 90–94 years, and 8.06% in those aged 95 and older. The proportion of men also rose (37.3% to 39.7%, p<0.001), and they had a higher risk of hospitalization than women (385 discharges/1000 men versus 280 discharges/1000 women in 2012–2015).Mortality decreased from 14.64% in 2000–2003 to 13.83% in 2012–2015 (p<0.001), and mean length of stay from 9.98 days in 2000–2003 to 8.34 days in 2012–2015. Costs per hospital stay increased from 2000 to 2011, from EUR 4611 in 2000–2003 to EUR 5212 in 2008–2011, before dropping to EUR 4824 in 2012–2015. The 10 most frequent discharge diagnoses in the period 2000-2003 were: femoral neck fracture (8.07%), heart failure (7.84%), neoplasms (7.65%), ischemic encephalopathy (6.97%), pneumonia (6.36%), chronic obstructive pulmonary disease (4.23%), ischemic cardiomyopathy (4.2%), other respiratory diseases (3.87%), other alterations of urethra and the urinary tract (3.08%), and cholelithiasis (3.07%). Conclusions The very elderly population is growing in Spanish hospitals, and within this group, patients are getting older and more frequently male. M ean length of stay, cost of stay, and mortality are decreasing. Decompensation of chronic diseases, neoplasms and infections are the most common causes of admission.
CD9, a potential leukemia stem cell marker, regulates drug resistance and leukemia development in acute myeloid leukemia
Authors: Liu Yongliang , Wang Guiqin , Zhang Jiasi , Chen Xue , Xu Huailong , Heng Gang , Chen Jun , Zhao Yongchun , Li Jiatao , Ni Yuanli , Zhang Yingzi , Shan Juanjuan , Qian Cheng
Published: January 2021

Background: Leukemia stem cells (LSCs) are responsible for the initiation, progression and relapse of acute myeloid leukemia (AML). Therefore, a therapeutic strategy targeting LSCs is a potential approach to eradicate AML. In this study, we aimed to identify LSC-specific surface markers and uncover the underlying mechanism of AML LSCs.Methods: Microarray gene expression data were used to investigate candidate AML-LSC-specific markers. CD9 expression in AML cell lines, patients with AML and normal donors was evaluated by flow cytometry (FC). The biological characteristics of CD9-positive (CD9+) cells were analyzed by in vitro proliferation, chemotherapeutic drug resistance, migration and in vivo xenotransplantation assays. The molecular mechanism involved in CD9+ cell function was investigated by gene expression profiling. The effects of alpha-2-macroglobulin (A2M) on CD9+ cells were analyzed with regard to proliferation, drug resistance and migration.Results: CD9, a cell surface protein, was specifically expressed on AML LSCs but barely detected on normal hematopoietic stem cells (HSCs). CD9+ cells exhibit more resistance to chemotherapy drugs and higher migration potential than do CD9-negative (CD9-) cells. More importantly, CD9+ cells possess the ability to reconstitute human AML in immunocompromised mice and promote leukemia growth, suggesting that CD9+ cells define the LSC population. Furthermore, we identified that A2M plays a crucial role in maintaining CD9+ LSC stemness. Knockdown of A2M impairs drug resistance and migration of CD9+ cells.Conclusion: Our findings suggest that CD9 is a new biomarker of AML LSCs and is a promising therapeutic target.
Molecular Detection, not Extended Culture Incubation, Contributes to Diagnosis of Fungal Infection
Authors: Zhu Alex , Qi Chao
Published: January 2021

Background. Despite its low sensitivity, fungal culture remains one of the key methods for diagnosis and treatment of fungal infections, as it identifies the etiology at the genus and species level and offers susceptibility testing. The Manual of Clinical Microbiology recommends that fungal culture screening for all pathogens should routinely be held for 4 weeks to maximize the recovery of slow-growing species. Information on the optimal fungal culture time in this era of expansion of immunocompromised populations is lacking. We reviewed our experience with fungal culture to determine the optimal culture incubation time. In addition, our experience of broad-range ITS PCR for diagnosis of culture-negative fungal infections was also reviewed.Method. Fungal culture and ITS PCR results from January 1, 2013, to December 31, 2017, were reviewed.Results. Ninety-six percent of positive cultures (4058) were detected in the first 7 days of incubation. During the second week of incubation, 2.8% of positives (111) were detected from day 8 to day 10, and 1.7% (71) were detected from day 11 to day 14. Only 0.1% of positive culture were detected in the third week of incubation, and no positive culture was detected in the fourth week of incubation. No clinically significant fungal isolates were recovered after 14 days. Clinically significant pathogens were detected in 0.2% of culture-negative samples by ITS PCR.Conclusion. Extending culture incubation beyond 2 weeks did not generate clinically relevant results. When culture failed to make a laboratory diagnosis, broad-range internal transcribed spacer (ITS) rRNA gene PCR followed by sequencing produced clinically significant results.
Hypothyroidism and Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer After Radiotherapy
Authors: Liu Chi-Hung , Chang Joseph Tung-Chieh , Lee Tsong-Hai , Chang Pi-Yueh , Chang Chien-Hung , Wu Hsiu-Chuan , Chang Ting-Yu , Huang Kuo-Lun , Lin Chien-Yu , Fan Kang-Hsing , Chang Yeu-Jhy
Published: January 2021

Background: Hypothyroidism (HT) and carotid artery stenosis (CAS) are complications of radiotherapy (RT) in patients with head and neck cancer (HNC). The impact of post-RT HT on CAS progression remains unclear.Methods: Between 2013 and 2014, HNC patients who had ever received RT and were under regular follow-up in our hospital were initially screened. Patients were categorized into euthyroid (EU) and HT groups. Details of RT and HNC were recorded. Total plaque scores and degrees of CAS were measured during annual extracranial duplex follow-up. Patients were monitored for CAS progression to >50% stenosis or ischemic stroke (IS). Cumulative time to CAS progression and IS between the 2 groups were compared. Data were further analyzed based on the use or nonuse of thyroxine of the HT group.Results: 333 HNC patients with RT history were screened. Finally, 216 patients were recruited (94 and 122 patients in the EU and HT groups). Patients of the HT group received higher mean RT doses (HT vs. EU; 7021.55 ± 401.67 vs. 6869.69 ± 425.32 centi-grays, p = 0.02). Multivariate Cox models showed comparable CAS progression (p = 0.24) and IS occurrence (p = 0.51) between the 2 groups. Moreover, no significant difference was observed in time to CAS progression (p = 0.49) or IS (p = 0.31) among patients with EU and HT using and not using thyroxine supplement.Conclusion: Our results did not demonstrate significant effects of HT and thyroxine supplementation on CAS progression and IS incidence in patients with HNC after RT.
Death in hospital following ICU discharge: insights from the LUNG SAFE study
Authors: Madotto Fabiana , McNicholas Bairbre , Rezoagli Emanuele , Pham Tài , Laffey John , Bellani Giacomo
Published: January 2021

Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge to the ward.Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted across 459 ICUs from 50 countries globally. This study aimed to understand the frequency and factors associated with death in hospital in patients who survived their ICU stay. We examined outcomes in the subpopulation discharged with no limitations of life sustaining treatments (‘treatment limitations’), and the subpopulations with treatment limitations.Results: 2,186 (94%) patients with no treatment limitations discharged from ICU survived, while 142 (6%) died in hospital. 118 (61%) of patients with treatment limitations survived while 77 (39%) patients died in hospital. Patients without treatment limitations that died in hospital after ICU discharge were older, more likely to have COPD, immunocompromise or chronic renal failure, less likely to have trauma as a risk factor for ARDS. Patients that died post ICU discharge were less likely to receive neuromuscular blockade, or to receive any adjunctive measure, and had a higher pre- ICU discharge non-pulmonary SOFA score. A similar pattern was seen in patients with treatment limitations that died in hospital following ICU discharge.Conclusions: A significant proportion of patients die in hospital following discharge from ICU, with higher mortality in patients with limitations of life-sustaining treatments in place. Non-survivors had higher systemic illness severity scores at ICU discharge than survivors.Trial Registration: ClinicalTrials.gov NCT02010073
Paludification reduces black spruce growth rate but does not alter tree water use efficiency in Canadian boreal forested peatlands
Authors: Beaulne Joannie , Boucher Étienne , Garneau Michelle , Magnan Gabriel
Published: January 2021

Background: Black spruce (Picea mariana (Mill.) BSP)-forested peatlands are widespread ecosystems in boreal North America in which peat accumulation, known as the paludification process, has been shown to induce forest growth decline. However, the ecophysiological mechanisms that lead to growth reductions in black spruce remain unexplored. Trees growing in paludified forests have to deal with continuously evolving environmental conditions (e.g., water table rise, increasing peat thickness) that may require growth mechanism adjustments over time. In this study, we investigated tree ecophysiological mechanisms along a paludification gradient in a boreal forested peatland of eastern Canada by combining peat-based and tree-ring analyses. Carbon and oxygen stable isotopes in tree rings were used to document changes in carbon assimilation rates, stomatal conductance, and water use efficiency. In addition, paleohydrological analyses were performed to evaluate the dynamical ecophysiological adjustments of black spruce trees to site-specific water table variations.Results: Increasing peat accumulation considerably impacted forest growth, but no significant differences in tree water use efficiency (iWUE) were observed between the study sites. Tree-ring isotopic analysis indicates no iWUE decrease over the last 100 years, but rather an important increase at each site up to the 1980s, before iWUE stabilized. Surprisingly, inferred basal area increments did not reflect such trends. Our results suggest that the slower growth rates observed at the most paludified sites are attributable, at least partially, to both lower carbon assimilation rates and stomatal conductance. These findings show that iWUE variations do not necessarily reflect tree ecophysiological adjustments required by changes in growing conditions. Local water table variations induced no changes in ecophysiological mechanisms, but the synchronous shift in iWUE observed at all sites in the mid-1980s suggests a tree response to regional or global factors, such as increasing atmospheric CO2 concentration.Conclusions: Our study shows that paludification induces black spruce growth decline without, however, altering tree water use efficiency in boreal forested peatlands. This is the first attempt in exploring the complex interactions between stem growth, ecophysiological mechanisms, and environmental conditions in paludified sites. Additional research on carbon allocation strategies is of utmost importance to understand the carbon sink capacity of these widespread ecosystems and better predict their response to future climate change.
Randomized Controlled Trial to Evaluate the Safety of Same-Day Discharge After Percutaneous Coronary Intervention (PCI)
Authors: gowani ambreen amir ali , Dhakam Sajid , Noor Ahmed , Iftikhar Imran , Ahmed Faisal , Tufail Mayera
Published: January 2021

Objective: Cardiovascular disease have a large disease burden in developing countries. Percutaneous coronary intervention (PCI) is one of the modalities used to restore the blood flow in atherosclerotic coronary vessels. The aim of this randomized controlled trial was to evaluate the safety of same-day discharge compared to overnight hospital stay after low-risk elective PCI in a tertiary care hospital in Pakistan.Results: From September 2014 to September 2015, a total of 210 patients who underwent low-risk PCI were randomized to overnight stay or same-day discharge. Primary endpoint of the study was a major adverse event, a composite of death, myocardial infarction, repeat revascularization, rehospitalization, and any access site complications (major bleeding or hematoma) after the procedure. No major adverse events were noted within 24 hours in either group. The only reported adverse event was myocardial infarction secondary to stent thrombosis on the third day after PCI in the same-day discharge group. No mortality or access site complications occurred in either group. In our cohort, same-day discharge after low-risk PCI was safe and should be considered for certain patients to eliminate the cost of an overnight hospital stay.clinical trial registry number: NCT02214082. Registered on 11th August 2014
Management of a hospital-wide vancomycin-resistant Enterococcus faecium outbreak in a Dutch general hospital, 2014-2017: successful control using a restrictive screening strategy
Authors: Weterings Veronica , Oosten Anita Van , Nieuwkoop Ellen , Nelson Jolande , Voss Andreas , Wintermans Bas , Lieshout Joris Van , Kluytmans Jan , Veenemans Jacobien
Published: January 2021

BackgroundThe emergence of vancomycin resistant enterococci poses a major problem in healthcare settings. Here we describe a hospital-wide outbreak of vancomycin-resistant Enterococcus faecium in a general hospital in The Netherlands in the period December 2014 – February 2017. Due to late detection of the outbreak, a large cohort of approximately 25,000 (discharged) patients was classified as ‘VRE suspected’. Hereupon a mitigated screening and isolation policy, as compared with the national guideline, was implemented to control the outbreak. MethodsAfter the outbreak was identified, a screening policy consisting of a single rectal swab culture (with enrichment broth) to discontinue isolation and removing ‘VRE suspected’ label in the electronic patient files for readmitted VRE suspected patients, was implemented. In addition to the on admission screening, periodic hospital-wide point prevalence screening, measures to improve compliance with standard infection control precautions and enhanced environmental cleaning were implemented to control the outbreak.ResultsBetween September 2014 and February 2017, 140 patients were identified to be colonised by vanA mediated vancomycin-resistant Enterococcus faecium (VREfm). Two of these patients developed bacteraemia. AFLP typing showed that the outbreak was caused by a single clone. Extensive environmental contamination was found in multiple wards. Within nine months after the detection of the outbreak no new VRE cases were detected.ConclusionWe implemented a control strategy based on targeted screening and isolation in combination with implementation of general precautions and environmental cleaning. The strategy was less stringent than the Dutch national guideline for VRE control. This strategy successfully controlled the outbreak, while it was associated with a reduction in the number of isolation days and the number of cultures taken.
Perceived walking difficulties in Parkinson’s disease – predictors and changes over time
Authors: Lindh-Rengifo Magnus , Jonasson Stina B. , Ullén Susann , Mattsson-Carlgren Niklas , Nilsson Maria H.
Published: January 2021

Background: People with Parkinson’s disease (PD) have described their walking difficulties as linked to activity avoidance, social isolation, reduced independence and quality of life. There is a knowledge gap regarding predictive factors of perceived walking difficulties in people with PD. Such knowledge could be useful when designing intervention studies. This study aimed to investigate how perceived walking difficulties evolve over a 3-year period in people with PD. A specific aim was to identify predictive factors of perceived walking difficulties.Methods: 148 people with PD (mean age 67.9 years) completed the Walk-12G questionnaire (which assesses perceived walking difficulties) at both baseline and the 3-year follow-up. Paired samples t-test was used for comparing baseline and follow-up mean scores. Multivariable linear regression analyses were used to identify predictive factors of perceived walking difficulties. Results: Perceived walking difficulties increased after 3 years: mean Walk-12G score 14.8 versus 18.7, p <0.001. Concerns about falling was the strongest predictor (β=0.445) of perceived walking difficulties, followed by perceived balance problems while dual tasking (β=0.268) and pain (β=0.153). Perceived balance problems while dual tasking was the strongest predictor (β=0.180) of a change in perceived walking difficulties, followed by global cognitive functioning (β=-0.107). Conclusions: Perceived walking difficulties increase over time in people with PD. Both personal factors (i.e. concerns about falling) and motor aspects (i.e. balance problems while dual tasking) seem to have a predictive role. Importantly, our study indicates that also non-motor symptoms (e.g. pain and cognitive functioning) seem to be of importance for future perceived walking difficulties. Future intervention studies that address these factors need to confirm their preventative effect on perceived walking difficulties.
Changes in PCSK 9 and Apolipoprotein B100 in Niemann-Pick Disease After Enzyme Replacement Therapy with Olipudase Alfa
Authors: Garside Bethanie , Ho Jan Hoong , Kwok See , Liu Yifen , Dhage Shaishav , Donn Rachelle , Iqbal Zohaib , Jones Simon A. , Soran Handrean
Published: January 2021

Background: Enzyme replacement therapy (ERT) with olipudase alfa, a recombinant human acid sphingomyelinase (rhASM), is being developed to treat patients with ASM deficiency (ASMD), commonly known as Niemann-Pick Disease (NPD) types A or B. This study assessed the effect of ERT on lipid parameters and inflammatory markers. Methods: Serum and plasma samples from five adults with NPD type B (NPD-B) who received olipudase alfa ERT for 26 weeks were analysed. We also collected fasting blood samples from fifteen age- and sex-matched participants as reference and comparison group. We measured fasting lipid profile, apolipoproteins B48 and B100 (apoB48 and apoB100), apolipoprotein A1 (apoA1), proprotein convertase subtilisin/klexin type 9 ( PCSK9) mass, oxidised low-density lipoprotein (oxLDL), small dense low-density lipoprotein cholesterol (sdLDL-C) and tumour necrosis factor α (TNF-α). Results: Patients with NPD-B, compared with age and sex matched reference group, had higher triglycerides, PCSK9, apoB48, oxLDL and TNF-α and lower high density lipoprotein cholesterol (HDL-C) and apoA1. Treatment with ERT was associated with improved lipid parameters including total cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), sdLDL-C, oxLDL and apoB100. Though there was an increase in apoA1, HDL-C was slightly reduced. TNF-α showed a reduction. ApoB100 decreased in parallel with a decrease in total serum PCSK9 mass after ERT. Conclusion: This study demonstrated that patients with NPD-B had a proatherogenic lipid profile and higher circulating TNF-α compared to reference group. There was an improvement in dyslipidaemia after olipudase alfa. It was possible that reductions in LDL-C and apoB100 were driven by reductions in TNF-α and PCSK9 following ERT.
Joint effects of ethnic enclave residence and ambient volatile organic compounds exposure on risk of gestational diabetes mellitus among Asian/Pacific Islander women in the United States
Authors: Williams Andrew D , Ha Sandie , Shenassa Edmond , Messer Lynne , Kanner Jenna , Mendola Pauline
Published: January 2021

Background: Asian/Pacific Islander (API) communities in the United States often reside in metropolitan areas with distinct social and environmental attributes. Residence in an ethnic enclave, a socially distinct area, is associated with lower gestational diabetes mellitus (GDM) risk, yet exposure to high levels of air pollution, including volatile organic compounds (VOCS), is associated with increased GDM risk. We examined the joint effects of ethnic enclaves and VOCs to better understand GDM risk among API women, the group with the highest prevalence of GDM.Methods: We examined 9,069 API births in the Consortium on Safe Labor (19 hospitals, 2002-2008). API ethnic enclaves were defined as areas ≥66th percentile for percent API residents, dissimilarity (geographic dispersal of API and White residents), and isolation (degree that API individuals interact with another API individual). High levels of 14 volatile organic compounds (VOC) were defined as ≥75th percentile. Four joint categories were created for each VOC: Low VOC/Enclave (reference group), Low VOC/No Enclave, High VOC/Enclave, High VOC/No Enclave. GDM was reported in medical records. Hierarchical logistic regression estimated odds ratios (OR) and 95% confidence intervals (95%CI) between joint exposures and GDM, adjusted for maternal factors and area-level poverty. Risk was estimated for 3-months preconception and first trimester exposures.Results: Enclave residence was associated with lower GDM risk regardless of VOC exposure. Preconception benzene exposure was associated with increased risk when women resided outside enclaves [High VOC/No Enclave (OR:3.45, 95%CI:1.77,6.72)], and the effect was somewhat mitigated within enclaves, [High VOC/Enclave (OR:2.07, 95%:1.09,3.94)]. Risks were similar for 12 of 14 VOCs during preconception and 10 of 14 during the first trimester.Conclusions: API residence in non-enclave areas is associated with higher GDM risk, regardless of VOC level. Ethnic enclave residence may mitigate effects of VOC exposure, perhaps due to lower stress levels. The potential benefit of ethnic enclaves warrants further study.
Assessment of surveillance core and support functions regarding neglected tropical diseases in Kenya
Authors: Ng'etich Arthur Kipkemoi Saitabau , Voyi Kuku , Mutero Clifford Maina
Published: January 2021

Background: Effective surveillance and response systems are vital to achievement of disease control and elimination goals. Kenya adopted the revised guidelines of the integrated disease surveillance and response system in 2012. Previous assessments of surveillance system core and support functions in Africa are limited to notifiable diseases with minimal attention given to neglected tropical diseases amenable to preventive chemotherapy (PC-NTDs). The study aimed to assess surveillance system core and support functions relating to PC-NTDs in Kenya.Methods: A mixed method cross-sectional survey was adapted involving 192 health facility workers, 50 community-level health workers and 44 sub-national level health personnel. Data was collected using modified World Health Organization generic questionnaires, observation checklists and interview schedules. Descriptive summaries, tests of associations using Pearson’s Chi-square or Fisher’s exact tests and mixed effects regression models were used to analyse quantitative data. Qualitative data derived from interviews with study participants were coded and analysed thematically.Results: Surveillance core and support functions in relation to PC-NTDs were assessed in comparison to an indicator performance target of 80%. Optimal performance reported on specimen handling (84%; 100%), reports submission (100%; 100%) and data analysis (84%; 80%) at the sub-county and county levels respectively. Facilities achieved the threshold on reports submission (84%), reporting deadlines (88%) and feedback (80%). However, low performance reported on case definitions availability (60%), case registers (19%), functional laboratories (52%) and data analysis (58%). Having well-equipped laboratories (3.07, 95% CI: 1.36, 6.94), PC-NTDs provision in reporting forms (3.20, 95% CI: 1.44, 7.10) and surveillance training (4.15, 95% CI: 2.30, 7.48) were associated with higher odds of functional surveillance systems. Challenges facing surveillance activities implementation revealed through qualitative data were in relation to surveillance guidelines and reporting tools, data analysis, feedback, supervisory activities, training and resource provision.Conclusion: There was evidence of low-performing surveillance functions regarding PC-NTDs especially at the peripheral surveillance levels. Case detection, registration and confirmation, reporting, data analysis and feedback performed sub-optimally at the facility and community levels. Additionally, support functions including standards and guidelines, supervision, training and resources were particularly weak at the sub-national level. Improved PC-NTDs surveillance performance sub-nationally requires strengthened capacities.
Improve Management of Mental Well-being and Empathy in Chinese Medical Students: A Randomized Controlled Study
Authors: Rong Rong , Chen Wei , Dai Zihao , Gu Jingli , Chen Weiying , Zhou Yanbin , Xiao Haipeng , Kuang Ming
Published: January 2021

Background: The Chinese medical students suffer from high prevalent mental health-related issues and low empathy. Effective strategies to improve the situations are lacking. This study aims to investigate the efficacy of the well-designed interventional courses to enhance the mental health and empathy of the senior Chinese medical students. Methods: A total of 146 3rd and 4th year medical students were randomized to intervention group (n=74) and control group (n=72). A pilot study including 5 pre-clinical students and 5 interns was first carried out to determine the themes and contents of the interventional courses. The designed courses were delivered in the intervention group once a month for three times, while the control group had no specific intervention. Five self-assessment questionnaires including the General Self-Efficacy (GSE), Medical Outcomes Study Short Form 8 (SF-8), Patient Health Questionnaire-9 (PHQ-9), Maslach Burnout Inventory (MBI), and Jefferson Scale of Empathy-Health Care Provider Student version (JSE-HPS) that separately evaluated the level of self-efficacy (SE), quality of life (QoL), depression, burnout, and empathy were completed by the students before and one month after the courses. Qualitative data were collected via e-mails two year after the intervention.Results: Compared to the control group, the interventional group showed significantly higher scores of the empathy (111.0 [IQR 102.0, 118.0] vs 106.0 [IQR 93.0, 111.5]; P = .01) and QoL (32.0 [IQR 28.0, 35.0] vs 29.5 [IQR 26.0, 34.0]; P = .04). The rate of depression was significantly decreased in the interventional group compared to that in the control group (13.5% vs 29.2%; Chi-square test, P = .02). However, no significant differences of self-efficacy (25.6 ± 4.8 vs 24.3 ± 6.3; P = .16) and burnout (27.0% vs 34.7%; Chi-square test, P = .31) were observed between the two groups.Conclusions: The well-designed interventional courses had a positive impact on the mental well-being and empathy in senior Chinese medical students, which may help provide novel information for incorporation into the medical school curriculum.
Phages from Ganges River curtail in vitro biofilms and planktonic growth of drug resistant Klebsiella pneumoniae in a zebrafish infection model
Authors: Sundaramoor Niranjana Sri , Thothathri Subramanian , Bhaskaran Muthu Meenakshi , GaneshPrasad ArunKumar , Nagarajan Saisubramanian
Published: January 2021

Bacteriophages are a promising alternative for curtailing infections caused by multi drug resistant (MDR) bacteria. The objective of the present study is to evaluate phage populations from water bodies to inhibit planktonic and biofilm mode of growth of drug resistant Klebsiella pneumoniae in vitro and curtail planktonic growth in vivo in a zebrafish model. Phage specific to K. pneumoniae (MTCC 432) was isolated from Ganges River (designated as KpG). One-step growth curve, in vitro time kill curve study and in vivo infection model were performed to evaluate the ability of phage to curtail planktonic growth. Crystal violet assay and colony biofilm assay were performed to determine the action of phages on biofilms. KpG phages had a greater burst size, better bactericidal potential and enhanced inhibitory effect against biofilms formed at liquid air and solid air interfaces. In vitro time kill assay showed a 3 log decline and a 6 log decline in K. pneumoniae colony counts, when phages were administered individually and in combination with streptomycin, respectively. In vivo injection of KpG phages revealed that it did not pose any toxicity to zebrafish as evidenced by liver/brain enzyme profiles and by histopathological analysis. The muscle tissue of zebrafish, infected with K. pneumoniae and treated with KpG phages alone and in combination with streptomycin showed a significant 77.7% and 97.2 % decline in CFU/ml, respectively, relative to untreated control. Our study reveals that KpG phages has the potential to curtail plantonic and biofilm mode of growth in vivo in higher animal models.
Evaluation of Automated Microvascular Flow Analysis Software AVA 4: A Validation Study
Authors: Guay Christian S. , Khebir Mariam , Shahiri Shiva , Szilagyi Ariana , Cole Erin Elizabeth , Bracco David , Simoneau Gabrielle , Badawy Mohamed
Published: January 2021

BACKGROUND: Real-time automated analysis of videos of the microvasculature is an essential step in the development of research protocols and clinical algorithms that incorporate point-of-care microvascular analysis. In response to the call for validation studies of available automated analysis software by the European Society of Intensive Care Medicine, and building on a previous validation study in sheep, we report the first human validation study of AVA 4.METHODS:Two retrospective perioperative datasets of human microcirculation videos (P1 and P2) and one prospective healthy volunteer dataset (V1) were used in this validation study. Video quality was assessed using the modified Microcirculation Image Quality Selection (MIQS) score. Videos were initially analyzed with (1) AVA software 3.2 by two experienced investigators using the gold standard semi-automated method, followed by an analysis with (2) AVA automated software 4.1. Microvascular variables measured were perfused vessel density (PVD), total vessel density (TVD), and proportion of perfused vessels (PPV). Bland-Altman analysis and intraclass correlation coefficients (ICC) were used to measure agreement between the two methods. Each method’s ability to discriminate between microcirculatory states before and after induction of general anesthesia was assessed using paired t-tests. RESULTS: Fifty-two videos from P1, 128 videos from P2 and 26 videos from V1 met inclusion criteria for analysis. Correlational analysis and Bland Altman analysis revealed poor agreement and no correlation between AVA 4.1 and AVA 3.2. Following the induction of general anesthesia, TVD and PVD measured using AVA 3.2 increased significantly for P1 (p < 0.05) and P2 (p < 0.05). However, these changes could not be replicated with the data generated by AVA 4.1. CONCLUSIONS: AVA 4.1 is not a suitable tool for research or clinical purposes at this time. Future validation studies of automated microvascular flow analysis software should aim to measure the new software’s agreement with the gold standard, its ability to discriminate between clinical states and the quality thresholds at which its performance becomes unacceptable.
Transcriptome dynamics in early in vivo developing and in vitro produced porcine embryos
Authors: Weijden Vera A van der , Schmidhauser Meret , Kurome Mayuko , Flöter Veronika L , Knubben Johannes , Wolf Eckhard , Ulbrich Susanne
Published: January 2021

Background: The transcriptional changes around the time of embryonic genome activation in pre-implantation embryos indicate that this process is highly dynamic. In vitro produced porcine blastocysts are known to be less competent than in vivo developed blastocysts. To understand the conditions that compromise developmental competence of in vitro embryos, it is crucial to evaluate the transcriptional profile of porcine embryos during pre-implantation stages. In this study, we investigated the transcriptome dynamics in in vivo developed and in vitro produced 4-cell embryos, morulae and hatched blastocysts. Results: In vivo developed and in vitro produced embryos displayed largely similar transcriptome profiles during development. Enriched canonical pathways from the 4-cell to the morula transition that were shared between in vivo developed and in vitro produced embryos included oxidative phosphorylation and EIF2 signaling. The shared canonical pathways from the morula to the hatched blastocyst transition were 14-3-3-mediated signaling, xenobiotic metabolism general signaling pathway, and NRF2-mediated oxidative stress response. The in vivo developed and in vitro produced hatched blastocysts were compared to identify molecular signaling pathways indicative of lower developmental competence of in vitro produced hatched blastocysts. A higher metabolic rate and expression of the arginine transporter SLC7A1 were found in in vitro produced hatched blastocysts. Conclusions: Our findings suggest that embryos with compromised developmental potential are arrested at an early stage of development, while embryos developing to the hatched blastocyst stage display largely similar transcriptome profiles, irrespective of the embryo source. The hatched blastocysts derived from the in vitro fertilization-pipeline showed an enrichment in molecular signaling pathways associated with lower developmental competence, compared to the in vivo developed embryos.
Photoelectronic Properties of End-bonded InAsSb Nanowire Array Detector under Weak Light
Authors: Yao Xiaomei , Zhang Xutao , Kang Tingting , Song Zhiyong , Sun Qiang , Wei Dongdong , Zou Jin , Chen Pingping
Published: January 2021

A simple fabrication of end-bonded contacts InAsSb NW (nanowire) array detector to weak light is demonstrated in this study. The detector is fabricated using InAsSb NW array grown by molecular beam epitaxy on GaAs substrate. The MIGS (metal-induced gap states) is induced by the end-bonded contact which suppresses the dark current at various temperatures. The existence of the interface dipole due to the interfacial gap states enhances the light excitation around the local field, thus upgrade the photo responsivity and photo detectivity to the weak light. The light intensity of the infrared light source in this report is 14 nW/cm2 which is about 3 to 4 orders of magnitude less than the laser source. The responsivity of the detector has reached 28.57 A/W at room temperature with the light (945 nm) radiation, while the detectivity is 4.81×1011 cm·Hz1/2 W−1. Anomalous temperature-dependent performance emerges at the variable temperature experiments, and we discussed the detailed mechanism behind the non-linear relationship between the photoresponse of the device and temperatures. Besides, the optoelectronic characteristics of the detector clarified that the light trapping effect and photogating effect of the NWs can enhance the photoresponse to the weak light across ultraviolet to near-infrared. These results highlight the feasibility of the InAsSb NW array detector to the infrared weak light without a cooling system.
NEGOSIASI IDENTITAS PEREMPUAN MUSLIM HIJABERS COMMUNITY: STUDI KASUS PADA BRAND RIA MIRANDA
Authors: Saraswati Listya Ayu
Published: January 2021

The rise of pious lifestyle among the middle class in Indonesia has emerged various expressions of pious identity. City areas with modern and dynamic lifestyles are now the contestation for urban identities. Middle class and urban living Muslim in Indonesia are the most active agent of representation in both production and consumption of culture and cultural products, such as fashion, and consequently become the trend setter for national and international Muslim living. By putting the focus on Muslim women in Hijabers Community, one of the most popular Muslim women organization in social media, I discuss the identity negotiation of Muslim women that is shaped and represented in Ria Miranda fashion brand. Ria Miranda, made by one of Hijabers Community founders, has been part of the community since its beginning in 2011. Ethnography study and in-depth interviews with Hijabers Community, Ria Miranda brand, and the consumers were conducted in Hijab Day events created by Hijabers Community from 2016 to 2019. Qualitative data were gathered and analyzed. In the result, I argue that Indonesia middle class urban Muslim women’s identity is continuously in ﬂux and negotiated in between the urban identity of becoming trendy, individualistic, and modern, and the pious Islamic identity of modest, communal accepted, and pious.
Penggunaan Metode QFD Menerjemahkan Suara Konsumen Untuk Pengembangan Lip Product Lavine Beaute
Authors: Kurniawan Shelvy , Nahdi Nabila Dian
Published: January 2021

This study aims to bridge the literature gap to examine factors that influence customers in buying a beauty product especially product quality.  The type of research used is descriptive. The use of the method in this study is the quality function deployment (QFD) method which has 6 parts namely; customer needs, technical attributes, relationship matrix, technical assessment, correlation matrix, and competitive assessment. The findings of this study are the attributes that meet BPOM standards, ingredients performance, and the probability of failure become one of the attributes that have the highest value on the part of customer needs that can meet customer satisfaction in product development.