bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of combining two individualized lung recruitment maneuvers at birth for very low gestational age infants: a retrospective cohort study
Authors: Kanaan Zalfa , Bloch-Queyrat Coralie , Boubaya Marouane , Lévy Vincent , Bolot Pascal , Waszak Paul
Published: March 2020

BACKGROUND
Lung recruitment at birth has been advocated as an effective method of improving the respiratory transition at birth. Sustained inflations (SI) and dynamic positive end-expiratory pressure (PEEP) were assessed in clinical and animal studies to define the optimal level. Our working hypothesis was that very low gestational age infants (VLGAI) < 32 weeks’ gestation require an individualized lung recruitment based on combining both manoeuvers.
METHODS
Between 2014 and 2016, 91 and 72 inborn VLGAI, requiring a respiratory support beyond a continuous positive airway pressure (CPAP) = 5 cmH2O, were enrolled before and after introducing these manoeuvers based on progressive increase in SI up to 15 seconds, with simultaneous gradual increase in PEEP up to 15 cmH2O, according to the cardiorespiratory response. Retrospective comparisons of the incidence of mechanical ventilation (MV) < 72h of life, short-term and before discharge morbidity were then performed.
RESULTS
Among extremely low gestational age infants (ELGAI) < 29 weeks’ gestation, the following outcomes decreased significantly: intubation (90% to 55%) and surfactant administration (54% to 12%) in the delivery room, MV (92% to 71%) and its mean duration < 72h of life (45h to 13h), administration of a 2nd dose of surfactant (35% to 12%) and postnatal corticosteroids (52% to 19%), and the rate of bronchopulmonary dysplasia (23 to 5%). Among VLGAI, all of these results were also significant. Neonatal mortality and morbidity were not different.
CONCLUSIONS
In our setting, combining two individualized lung recruitment maneuvers at birth was feasible and may be beneficial on short-term and before discharge pulmonary outcomes. A randomized controlled trial is needed to confirm these results.
Immune activation of murine RAW264.7 macrophages by sonicated and alkalized paramylon from Euglena gracilis
Authors: Guo Qingqing , Bi Decheng , Wu Mingcan , Yu Boming , Hu Lang , Liu Chenchen , Gu Liang , Zhu Hui , Lei Anping , Xu Xu , Wang Jiangxin
Published: March 2020

Background: Euglena is a new super health food resource that is rich in the natural polysaccharide paramylon, a linear β-1,3-glucan with various biological activities including activity on the immune system in different cell lines and animals. Despite these reports, the immune regulation mechanism of paramylon is still unclear. Results: We investigate the signaling pathways paramylon impacts in immune macrophages. In RAW264.7 macrophages, sonicated and alkalized paramylon oligomers up-regulated inducible nitric oxide synthase (iNOS) and increased secretion of nitric oxide (NO) , interleukin (IL)-6 and tumor necrosis factor (TNF)- α, in a concentration-dependent manner. In addition, paramylon activated the nuclear factor-κB(NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways and inhibiting these pathways attenuated the paramylon-induced secretion of the above immune-mediators. Conclusions: These results demonstrate that Euglena gracilis paramylon modulates the immune system via activation of the NF-κB and MAPK signaling pathways and thus has potential therapeutic benefits.
Ethanol-activated CaMKII signaling induces neuronal apoptosis through Drp1-mediated excessive mitochondrial fission and JNK1-dependent NLRP3 inflammasome activation.
Authors: Lim Jae Ryong , Lee Hyun Jik , Jung Young Hyun , Kim Jun Sung , Chae Chang Woo , Kim Seo Yihl , Han Ho Jae
Published: March 2020

Background: Neurodegeneration is a representative phenotype of patients with chronic alcoholism. Ethanol-induced calcium overload causes NLRP3 inflammasome formation and an imbalance in mitochondrial dynamics, closely associated with the pathogenesis of neurodegeneration. However, how calcium regulates this process in neuronal cells is poorly understood. Therefore, the present study investigated the detailed mechanism of calcium-regulated mitochondrial dynamics and NLRP3 inflammasome formation in neuronal cells by ethanol. Methods: In this study, we used the SK-N-MC human neuroblastoma cell line. To confirm the expression level of the mRNA and protein, real time quantitative PCR and western blot were performed. Co-immunoprecipitation and Immunofluorescence staining were conducted to confirm the complex formation or interaction of the proteins. Flow cytometry was used to analyze intracellular calcium, mitochondrial dysfunction and neuronal apoptosis. Results: Ethanol increased cleaved caspase-3 levels and mitochondrial reactive oxygen species (ROS) generation associated with neuronal apoptosis. In addition, ethanol increased PKA activation and CREB phosphorylation, which increased NMDA receptor (NMDAR) expression. Ethanol-increased NMDAR induced intracellular calcium overload and CaMKII activation leading to phosphorylation of dynamin-related protein 1 (Drp1) and JNK1. Drp1 phosphorylation promoted Drp1 translocation to the mitochondria, resulting in excessive mitochondrial fission, mitochondrial ROS accumulation, and loss of mitochondrial membrane potential, which was recovered by Drp1 inhibitor pretreatment. Ethanol-induced JNK1 phosphorylation activated the NLRP3 inflammasome that induced caspase-1 dependent mitophagy inhibition, thereby exacerbating ROS accumulation and causing cell death. Suppressing caspase-1 induced mitophagy and reversed the ethanol-induced apoptosis in neuronal cells. Conclusions: Our results demonstrated that ethanol upregulated NMDAR-dependent CaMKII phosphorylation which is essential for Drp1-mediated excessive mitochondrial fission and the JNK1-induced NLRP3 inflammasome activation resulting in neuronal apoptosis.
Targeted Imaging of Orthotopic Prostate Cancer by Using Clinical Transformable Photoacoustic Molecular Probe
Authors: Qiu Chen , Bai Yuanyuan , Yin Tinghui , Miao Xiaoyan , Gao Rongkang , Zhou Huichao , Ren Jie , Song Liang , Liu Chengbo , Zheng Hairong , Zheng Rongqin
Published: March 2020

Background: To obtain high-yield histological samples by targeted prostate cancer (PCa) biopsy is the current trend compared with transrectal ultrasound (TRUS)-guided systematic histological biopsy, which is regarded as the gold standard for prostate cancer (PCa) diagnosis. In this paper, we present a targeted PCa imaging strategy using a real-time molecular photoacoustic imaging system integrated with a handheld US probe (PAI/US) and synthesized an integrin αvβ3 targeted probe based on ICG (cRGD–ICG).Methods: To prepare cRGD–ICG, ICG-NHS was linked to cRGD through carboxyl-co-reaction. In vitro PA imaging ability of cRGD–ICG was tested. Orthotopic PCa-bearing rats were used as animal models. After injected with either cRGD–ICG or non-targeted probe, rats were implemented with PA imaging to confirm the specific accumulation of cRGD–ICG at tumor region. Moreover, pathological frozen slices were made to observe distribution of the probe in prostate tissue ex vivo. Results: A small molecular PAI probe was synthesized and exhibited excellent targeted imaging ability in vitro. In vivo photoacoustic imaging was carried out after intravenous injection of cRGD-ICG in orthotopic PCa-bearing rats under the facilitation of the PAI/US system. Maximum molecular photoacoustic signals were observed in the tumor area in vivo after the probe injection, which showed 3.8-fold higher signal enhancement than that in the control group (P < 0.05). Significantly higher cRGD-ICG accumulation was observed under confocal microscopy in the tumor region than in normal prostate tissue.Conclusions: All our results showed that the comprehensive strategy provided a high-yield and reliable method for PCa diagnosis and targeted prostate biopsy, with great clinical translation potential.
Subjective cognitive decline and subsequent dementia: a nationwide cohort study of 579,710 people aged 66 years in South Korea
Authors: Lee Yeong Chan , Kang Jae Myeong , Lee Hyewon , Kim Kiwon , Kim Soyeon , Yu Tae Yang , Lee Eun-Mi , Kim Clara Tammy , Kim Doh Kwan , Lewis Matthew , Won Hong-Hee , Jessen Frank , Myung Woojae
Published: March 2020

Background Subjective cognitive decline (SCD) is a potential risk factor for dementia. We aimed to investigate the association between SCD and subsequent dementia in a nationwide population-based cohort in South Korea. Methods This cohort included 579,710 66-year-old adults who were followed for a total of 3,870,293 person-years (average 6.68±1.33 years per person). All subjects completed a questionnaire about subjective memory impairment, the Pre-screening Korean Dementia Screening Questionnaire (KDSQ-P), which included a validated 5-item derivative, and were determined to have SCD based on a single question assessing memory decline. Depressive symptoms were assessed in all subjects using a 3-item modified geriatric depression scale. Hazard ratios were estimated using the Cox proportional hazards model and compared between subjects with and without SCD. Results Compared to subjects without SCD, those with SCD were more likely to develop dementia (incidence per 1,000 person-years: non-SCD: 5.66; SCD: 8.59). After adjusting for potential confounding factors, the risk of subsequent dementia significantly increased in subjects with SCD, with an adjusted hazard ratio (aHR) of 1.38 (95% confidence interval [CI] 1.34 to 1.41). The risk of subsequent dementia was greatly increased in subjects with higher KDSQ-P scores (aHR = 2.77, 95% CI 2.47 to 3.11). A significant association between SCD and dementia was observed in both depressive and non-depressive symptom groups (aHR = 1.50, 95% CI 1.42 to 1.57 in subjects with depressive symptoms; aHR = 1.33, 95% CI 1.29 to 1.37 in subjects without depressive symptoms; P = 0.001). Conclusions In this population of 66-year-old individuals, SCD was significantly associated with an increased risk of subsequent dementia. This association was found in both depressive and non-depressive groups, with an increased risk of dementia in the presence of depressive symptoms. Our findings suggest that SCD indicates a risk for dementia. Further studies are needed to delineate potential approaches to preventing the development of dementia in individuals with SCD.
Antibacterial effect of silver nanorings
Authors: González-Fernández Sara , Lozano-Iturbe Víctor , García Beatriz , Andrés Luis J. , Menéndez Mª Fe , Rodríguez David , Vazquez Fernando , Martín Carla , Quiros Luis M
Published: March 2020

Background: The emergence and expansion of antibiotic resistance makes it necessary to have alternative anti-infective agents, among which silver nanoparticles (AgNPs) display especially interesting properties. AgNPs carry out their antibacterial action through various molecular mechanisms, and the magnitude of the observed effect is dependent on multiple, not fully understood, aspects, particle shape being one of the most important. In this article, we conduct a study of the antibacterial effect of a recently described type of AgNP: silver nanorings (AgNRs), making comparisons with other alternative types of AgNP synthesized in parallel using the same methodology. Results: When they act on planktonic forms, AgNRs produce a smaller effect on the viability of different bacteria than nanoparticles with other structures although their effect on growth is more intense over a longer period. When their action on biofilms is analyzed, AgNRs show a greater concentration-dependent effect. In both cases it was observed that the effect on inhibition depends on the microbial species, but not its Gram positive or negative nature. Growth patterns in silver-resistant Salmonella strains suggest that AgNRs work through different mechanisms to other AgNPs. The antibacterial effect is also produced to some extent by the conditioning of culture media or water by contact with AgNPs but, at least over short periods of time, this is not due to the release of Ag ions. Conclusions: AgNRs constitute a new type of AgNP, whose antibacterial properties depend on their shape, and is capable of acting efficiently on both planktonic bacteria and biofilms.
Cold priming uncouples light- and cold-regulation of gene expression in Arabidopsis thaliana
Authors: Bittner Andras , Buer Jörn van , Baier Margarete
Published: March 2020

Background

The majority of stress-sensitive genes responds to cold and high light in the same direction, if plants face the stresses for the first time. As shown recently for a small selection of genes of the core environmental stress response cluster, pre-treatment of Arabidopsis thaliana with a 24 h long 4 °C cold stimulus modifies cold regulation of gene expression for up to a week at 20 °C, although the primary cold effects are reverted within the first 24 h. Such memory-based regulation is called priming. Here, we show the effect of 24 h cold priming on cold regulation of gene expression on a transcriptome-wide scale and analyse if and how cold priming affects light regulation of gene expression.

Results

304 genes were differently regulated between cold-primed and non-primed plants after a second 24 h long 4 °C cold treatment. After triggering the plants with a heat-filtered high light stimulus (800 µmol quanta m -2 s -1 ), 1011 genes showed priming dependent regulation. Only 32 of the priming-sensitive genes responded similarly to cold and light triggering. The majority of the priming-sensitive genes were regulated in a stressor-specific manner. 29 genes were even inversely regulated by the two triggering stimuli.

Cold priming preferentially supported expression of genes involved in the defence against plant pathogens upon cold triggering. The regulation took place on the cost of the expression of genes involved in growth regulation and transport. On the contrary, cold priming resulted in stronger expression of genes regulating metabolism and development and weaker expression of defence genes in response to high light triggering. qPCR of several independently cultivated and treated samples confirmed the trends observed by RNA-Sequencing.

Conclusion

The 24 h long priming cold stimulus activates a several days lasting stress memory that controls cold and light regulation of gene expression and adjusts growth and defence regulation in a stressor-specific manner.
Children’s physical activity level and sedentary behavior in Norwegian early childhood education and care: effects of a staff-led cluster-randomized controlled trial
Authors: Andersen Eivind , Øvreås Steinar , Jørgensen Kari Anne , Borch-Jenssen Janne , Moser Thomas
Published: March 2020

A growing body of evidence suggest that the children’s physical activity (PA) level in early childhood education and care (ECEC) settings are insufficient. Since most children attend ECEC settings for many hours on most days of the week, and these institutions reach children across the socioeconomic spectrum, the ECEC settings may serve as an ideal avenue for increasing physical activity (PA) level, reduce sedentary time and enhance the overall health of young children. This paper investigates the effectiveness of the “Active Kindergarten – Active Children” study to increase children’s PA level and reduce sedentary time within the ECEC setting. Accelerometers were used to asses PA and sedentary time. A total of 116 three to four-year olds took part in a randomized controlled trial in 11 ECEC settings. Participants were cluster-randomized, by ECEC setting, to either a 12 week staff-led and expert-supported intervention or a waiting list control group. The intervention group increased time spent in moderate- and vigorous intensity PA by 10 min/day (95% CI = 3, 18; P=0.01), took 1909 more steps per day (95% CI = 1130, 2688; P˂0.01) and reduced sedentary time with 14min/day (95% CI = -27, -1; P=0.04) compared to the control group. The intervention group had a 2.4 higher odds (95% CI = 1.05, 5.7; P = 0.04) of meeting the PA recommendations compared to the control group at follow-up. Our results show that a flexible staff-led and expert-supported multicomponent PA intervention can increase total PA level, moderate- and vigorous intensity PA and reduce time spent sedentary in four-year-old children during their stay in ECEC settings.
Key words: ECEC; RCT; children; physical activity; sedentary time
Global dissection of the BAHD acyltransferase gene family in soybean: Expression profiling, metabolic functions, and evolution
Authors: Ahmad Muhammad Zulfiqar , Zeng Xiangsheng , Dong Qiang , Manan Sehrish , Jin Huanan , Li Penghui , Wang Xiaobo , Benedito Vagner A. , Zhao Jian
Published: March 2020

Background: Members of the BAHD acyltransferase (ACT) family play important roles in plant defence against biotic and abiotic stresses. A better understanding of the functions that specific members of this family play in stress defence can lead to better breeding strategies for stress tolerance. Previous genome-wide studies explored other acyltransferase families, but so far not a single study has been published on genome-wide or positive selection analyses of the BAHD genes in Glycine max . Results: A total of 103 genes of the BAHD family (GmACT genes) were identified from the soybean genome, which could be grouped into four phylogenetic clades (I-IV). Clade III was further divided into two sub-clades (IIIA and IIIB). In each clade, the gene structure and functional motifs were relatively well conserved. These ACT genes were unequally distributed on all 20 chromosomes, and 16 paralogous pairs were found within the family. Positive selection analysis revealed amino acids under strong positive selection, which suggests that the evolution of this gene family modulated soybean domestication. Some GmACT genes showed expression specific under specific conditions, while others showed constitutive expression in all soybean tissues or conditions analysed. Most of the expression of ACT genes in soybean was repressed with Al 3+ and fungal elicitor exposure, except for GmACT84 , which expression increased in these conditions 2- and 3-fold, respectively. The promoter of GmACT84 contains the maximum number of stress-responsive elements among all GmACT genes and it is especially enriched in MYB-related elements. Conclusions: This study provides a genome-wide analysis of the BAHD gene family and assessed their expression profiles in soybean. We found evidence of a strong positive selection of GmACT genes. Our findings will help efforts of functional characterisation of ACT genes in soybean in order to discover their involvement in growth, development, and defence mechanisms.
Myelination- and immune mediated MR-based brain network correlates
Authors: Cerina Manuela , Muthuraman Muthuraman , Gallus Marco , Koirala Nabin , Dik Andre , Wachsmuth Lydia , Hundehege Petra , Schiffler Patrick , Tenberge Jan-Gerd , Fleischer Vinzenz , Gonzalez-Escamilla Gabriel , Narayanan Venu , Krämer Julia , Faber Cornelius , Budde Thomas , Groppa Sergiu , Meuth Sven G
Published: March 2020

Background: Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS), characterized by inflammatory and neurodegenerative processes. Despite demyelination being a hallmark of the disease, how it relates to neurodegeneration has still not been completely unraveled, and research is still ongoing into how these processes can be tracked non-invasively. Magnetic resonance imaging (MRI) derived brain network characteristics, which closely mirror disease processes and relate to functional impairment, recently became important variables for characterizing immune-mediated neurodegeneration, however their histopathological basis remains unclear. Methods: In order to determine the MRI-derived correlates of myelin dynamics and to test if brain network characteristics derived from diffusion tensor imaging reflect microstructural tissue reorganization, we took advantage of the cuprizone model of general demyelination in mice and performed longitudinal histological and imaging analyses with behavioral tests. By introducing cuprizone into the diet, we induced targeted and consistent demyelination of oligodendrocytes, over a period of 5 weeks. Subsequent myelin synthesis was enabled by reintroduction of normal food. Results: Using specific immune-histological markers, we demonstrated that two weeks of cuprizone diet induced a 52% reduction of myelin content in the corpus callosum (CC) and a 35% reduction in the neocortex. An extended cuprizone diet increased myelin loss in the CC, while remyelination commenced in the neocortex. These histologically determined dynamics were reflected by MRI measurements from diffusion tensor imaging. Demyelination was associated with decreased fractional anisotropy (FA) values and increased modularity and clustering at the network level. MRI-derived modularization of the brain network and FA reduction in key anatomical regions, including the hippocampus, thalamus and analyzed cortical areas, were closely related to impaired memory function and anxiety-like behavior. Conclusion: Network specific remyelination, shown by histology and MRI metrics, determined amelioration of functional performance and neuropsychiatric symptoms. Taken together, we illustrate the histological basis for the MRI-driven network responses to demyelination, where increased modularity leads to evolving damage and abnormal behavior in MS. Quantitative information about in vivo myelination processes is mirrored by diffusion based imaging of microstructural integrity and network characteristics.
Diagnosis performance of ultrasonography, dual-phase 99mTc-MIBI scintigraphy, early SPECT/CT and delayed SPECT/CT in preoperative localization of parathyroid gland in secondary hyperparathyroidism
Authors: Author) Rongqin Zhang(Former Corresponding , Zhang Zhanwen , Huang Pinbo , Li Zhi , Hu Rui , Zhang Jie , Qiu Wanglin , Author) Ping Hu(New Corresponding
Published: March 2020

Background: Secondary hyperparathyroidism (SHPT) usually need parathyroidectomy when drug regimens fail. However, obtaining an exact preoperative map of the locations of the parathyroid glands is a challenge. The purpose of this study was to compare the diagnostic performance of ultrasonography, dual-phase 99m Tc-MIBI scintigraphy, early SPECT/CT and delayed SPECT/CT in patients with SHPT. Methods: Sixty patients with SHPT who were undergoing dialysis were evaluated preoperatively with ultrasonography, dual-phase 99m Tc-MIBI scintigraphy, early SPECT/CT and delayed SPECT/CT. Postoperative pathology served as the gold standard. The sensitivity, specificity, and accuracy rate were determined for each method. Spearman correlation analysis was used to analyze the correlation of the hyperplastic parathyroid calcification with serum alkaline phosphatase (AKP) and parathyroid hormone (PTH). Results: 229 lesions in 60 patients were pathological confirmed to be parathyroid hyperplasia with 209 lesions in typical sites, 15 lesions in upper mediastinum and 5 lesions in the thyroid. 88.33% (53/60) patients had four lesions. US, early and delayed SPECT/CT had significantly higher sensitivity and accuracy rate (P < 0.001) than did dual-phase 99m Tc-MIBI scintigraphy. Furthermore, early SPECT/CT had significantly higher sensitivity (χ2 = 17.521, P < 0.001, χ2 = 35.027, P < 0.001) and accuracy rate (χ2 = 11.076, P = 0.001, χ2 = 16.289, P < 0.001) than did US and delayed SPECT/CT. In ectopic hyperplastic parathyroid, the sensitivity of early SPECT/CT (90%) was significantly higher than US (55%) and dual-phase planar (50%) (P = 0.039 and P = 0.039). Spearman correlation results showed a significant linear association between the calcification and serum PTH (r = 0.398, P = 0.002) and AKP (r = 0.415, P = 0.002). Conclusion: The ability of early SPECT/CT to detect hyperplastic parathyroid in patients with SHPT is superior to US, 99m Tc-MIBI scintigraphy and delayed SPECT/CT, and dual-phase SPECT/CT is not essential. Calcification of parathyroid gland is related to the levels of PTH and AKP and may help provide an evidence for the identification of SHPT.
Genome-wide identification of the peptide transporter family in rice and analysis of the PTR expression modulation in two near-isogenic lines with different nitrogen use efficiency
Authors: Yang Xinghai , Xia Xiuzhong , Zeng Yu , Nong Baoxuan , Zhang Zongqiong , Wu Yanyan , Tian Qinglan , Zeng Weiying , Gao Ju , Zhou Weiyong , Liang Haifu , Li Danting , Deng Guofu
Published: March 2020

Background: Nitrogen (N) is a major nutrient element for crop growth. In plants, the members of the peptide transporter (PTR) gene family are involved in nitrate uptake and transport. Here, we identied PTR gene family in rice and analyzed their expression level in near-isogenic lines.
Results: We identified 96, 85 and 78 PTR genes in Nipponbare, R498and Oryza glaberrima , and the phylogenetic were similar in Asian cultivated rice and African cultivated rice. The number of PTR genes was higher in peanuts (125) and soybeans (127). The 521 PTR genes in rice, maize, sorghum, peanut, soybean and Arabidopsis could be classified into 4 groups, and their distribution was different between monocots and dicots. In Nipponbare genome, the 25 PTR genes were distributed in 5 segmental duplication regions on chromosome 1, 2, 3, 4, 5, 7, 8, 9, and 10. The PTR genes in rice have 0-11 introns and 1-12 exons , and 16 of them have the NPF (NRT1/PTR family) domain. The results of RNA-Seq showed that the number of differentially expressed genes (DEGs) between NIL15 and NIL19 at three stages were 928, 1467, and 1586, respectively. Under low N conditions, the number of differentially expressed PTR genes increased significantly. The RNA-Seq data was analyzed using WGCNA to predict the potential interaction between genes. We classified the genes with similar expression pattern into one module, and obtained 25 target modules. Among these modules, three modules may be involved in rice nitrogen uptake and utilization, especially the brown module, in which hub genes were annotated as protein kinase that may regulate rice N metabolism.
Conclusions: In this study, we comprehensively analyzed the PTR gene family in rice. 96 PTR genes were identified in Nippobare genome and 25 of them were located on five large segmental duplication regions. The Ka/Ks ratio indicated that many PTR genes had undergone positive selection. The RNA-seq results showed that many PTR genes were involved in riceNUE, and protein kinases might play an important role in this process. These results provide a fundamental basis to improve the rice NUE via molecular breeding.
Gaining favorable identities of Iranian EFL teachers: A single case study of transition from elementary schools to universities
Authors: Rostami Farzad , Yousefi Mohammad Hossein - , Amini Davood
Published: March 2020

Having adapted the self-concept framework as a lens and intrinsic case study as a methodological tool, the present study set out to examine how the professional identity of an elementary school teacher is socially (re) constructed while his transition from teaching at elementary schools to teaching at universities. The design of the study was the intrinsic case study. The focal participant was an assistant professor of TEFL who has been teaching in elementary, middle and high schools prior to starting his academic work ten years ago. For the purpose of the data collection, in-depth interview was conducted. Another source of the data was the participant's stories as well as the diaries he had kept over the years. For the data analysis, thematic analysis was employed. Results indicate that the transition was seen to be in parallel with the transition from lower identity perception to higher identity perception. The transitions can be best expressed in terms of identity promotion. The results indicate that the transitions were two main and noticeable ones. The data analyses also indicate that three themes including personal-self, social self, and learners were the driving forces for the case's professional identity development. The study has a number of implications for teacher education, policymakers, and teachers.
Fatty liver index and development of cardiovascular disease in Koreans without pre-existing myocardial infarction and ischemic stroke: a large population-based study
Authors: Kim Jun Hyung , Moon Jin Sil , Byun Seok Joon , Lee Jun Hyeok , Kang Dae Ryong , Sung Ki Chul , Kim Jang Young , Huh Ji Hye
Published: March 2020

Background: Despite the known association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD), whether NAFLD predicts future CVD events, especially CVD mortality, remains uncertain. We evaluated the relationship between fatty liver index (FLI), a validated marker of NAFLD, and risk of major adverse cardiac events (MACEs) in a large population-based study. Methods: We identified 3,011,588 subjects in the Korean National Health Insurance System cohort without a history of CVD who underwent health examinations from 2009 to 2011. The primary endpoint was a composite of cardiovascular deaths, non-fatal myocardial infarction (MI), and ischemic stroke. A Cox proportional hazards regression analysis was performed to assess association between the FLI and the primary endpoint. Results: During the median follow-up period of 6 years, there were 46,010 cases of MACEs (7,148 cases of cardiovascular death, 16,574 of non-fatal MI, and 22,288 of ischemic stroke). There was a linear association between higher FLI values and higher incidence of the primary endpoint. In the multivariable models adjusted for factors, such as body weight and cholesterol levels, the hazard ratio for the primary endpoint comparing the highest vs. lowest quartiles of the FLI was 1.99 (95% confidence interval [CIs], 1.91–2.07). The corresponding hazard ratios (95% CIs) for cardiovascular death, non-fetal MI, and ischemic stroke were 1.98 (1.9-2.06), 2.16 (2.01-2.31), and 2.01 (1.90-2.13), respectively (p<0.001). The results were similar when we performed stratified analyses by age, sex, use of dyslipidemia medication, obesity, diabetes, and hypertension. Conclusions: Our findings indicate that the FLI, which is a surrogate marker of NAFLD, has prognostic value for detecting individuals at higher risk for cardiovascular events.
Assessing The Youth-Friendliness Of Youth Clinics In Northern Sweden: A Survey Analyzing The Perspective Of The Youth
Authors: Waenerlund Anna-Karin , Sebastian Miguel San , Hurtig Anna-Karin , Wiklund Maria , Christianson Monica , Goicolea Isabel
Published: March 2020

Background: Sweden has nearly 300 youth clinics that have been offering services since the 1970s. However, no evaluation has been done to assess their youth-friendliness. This study aims to assess: i) to what extent youth clinics are perceived as youth-friendly by the young people using them; and ii) if the level of youth friendliness is equally perceived across different sociodemographic groups of users.
Methods: The four northernmost counties of Sweden were included in the study. Of the total identified 22 youth clinics, 20 participated by giving out questionnaires to the youth after their visits to the respective youth clinics. In total 1,110 youth participated in the study and answered questions according to the World Health Organization’s criteria of accessibility, equity, respect, privacy and confidentiality, no judgement, and quality. Means and frequencies were calculated, and t-test and ANOVA were used to compare means by sociodemographic variables.
Results: Participants perceived the youth clinics as very youth friendly across the measured domains, with scores as high as 4.8 and 4.9 (of a maximum of 5).Youth clinics were perceived in a similar way regardless of gender, but other sociodemographic factors influenced some of the domains, especially ethnic background.
Conclusions: The perception of youth friendliness in youth clinics was very high. Nonetheless, younger users; users who did not categorize themselves as either heterosexual, homosexual, or bisexual; users with trans-experiences; and users with non-Swedish backgrounds gave youth clinics lower scores for certain domains.
Keywords: youth clinic, Sweden, youth friendly, health services, health service accessibility, youth, questionnaire
Clinical implication of plasma exchange on life-threatening antineutrophil cytoplasmic antibody-associated vasculitis
Authors: Park Pil Gyu , Yoo Byung-Woo , Song Jason Jungsik , Park Yong-Beom , Lee Sang-Won
Published: March 2020

Background We assessed the rate of and the predictor for all-cause mortality in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients receiving plasma exchange (PLEX) and evaluated the survival-benefit of PLEX for diffuse alveolar haemorrhage (DAH) between AAV patients receiving PLEX and those not receiving. Methods We retrospectively reviewed the medical records of 212 AAV patients. Demographic, clinical and laboratory data at the time of PLEX was collected from both 9 patients receiving PLEX and 10 AAV patients with DAH. The follow-up duration was defined as the period from the time of PLEX or DAH occurrence to death for the deceased patients and as that to the last visit for the survived patients. Results The median age of 9 AAV patients receiving PLEX was 71.0 years and 5 patients were men. Four of 9 patients receiving PLEX died at a median follow-up duration of 92.0 days. Three died of sepsis and one died of no response to PLEX. When patients with DAH receiving PLEX and those not receiving were compared, there were no significant differences in variables between the two groups. The cumulative patients’ survival rate between patients with DAH receiving PLEX and those not receiving were also compared using the Kaplan-Meier survival analysis but no survival-benefit of PLEX for DAH was observed. Conclusion The rate of all-cause mortality in 9 AAV patients receiving PLEX was assessed as 44.4% and it was controversial that PLEX is beneficial for the improvement of prognosis of AAV-related DAH.
Lack of Sexual Behavior Disclosure May Distort STI Testing Outcomes
Authors: Kumar Navin , Forastiere Laura , Zhang Tiange , Yang Fan , Li Katherine T , Tang Weiming , Tucker Joseph D , Christakis Nicholas A , Alexander Marcus
Published: March 2020

Background. To evaluate whether Chinese men who have sex with men (MSM) selectan STI test (rectal vs urethral) appropriate for their sexual behavior (insertive and/orreceptive).Methods. We studied uptake of gonorrhea and chlamydia testing among ChineseMSM (N=431) in a multi-site randomized controlled trial (RCT) (December 2018 toJanuary 2019). We collected socio-demographics, relevant medical and sexual history,and disclosure of sexual behavior (outness). Drawing data from the RCT, we estimatedthe decision to test and test choice, and the extent to which disclosure plays a role indecision-making. Results. Among 431 MSM, mean age was 28 years (SD=7.10) and 65% were outto someone. MSM who indicated versatile sexual behavior and were out to someone hada 26.8% (95%CI=6.1, 47.5) increased likelihood for selecting the rectal test vs the ure-thral test, compared to those versatile and not out. Versatile MSM out to their healthprovider outside of the study context had a 29.4% (95%CI=6.3, 52.6) greater likelihoodfor selecting the rectal STI test vs the urethral test, compared to versatile MSM not outto their health provider. Conclusions. Sexual behavior and outness may affect gonorrhea and chlamydia test-ing provision. Apart from clinicians, community-based efforts may reduce stigma-basedbarriers to testing. Keywords. MSM; Sexual Health; Sexual Behavior Disclosure; China
Comparison of Hand-sewn and Modified Mechanical Anastomosis in Esophageal Cancer Patients Undergoing Transhiatal Esophagectomy: An Iranian Retrospective Cohort Study
Authors: Rasihashemi Seyed Ziaeddin , Ramouz Ali , Beheshtirouy Samad , Amini Hassan
Published: March 2020

Background: There are controversies over the efficacy of mechanical stapler when compared with the hand-sewn (HS) technique in patients who underwent esophagogastric anastomosis in terms of efficacy and post-operative advantages. The purpose of the present study is to compare the clinical outcomes of manual and a modified mechanical stapled (MMS) anastomosis (double stapled technique) during esophagectomy for esophageal cancer.Methods: A retrospective cohort study was conducted on 409 patient’s medical records who underwent transhiatal esophagectomy for esophageal cancer between March 2010 and March 2016. All patients were operated using HS technique or MMS technique. All cases were visited in two weeks, four, eight and twelve months after surgery and were evaluated in terms of postoperative complications including anastomotic leakage, regurgitation, anastomotic stricture, dysphagia and need for anastomotic dilatation.Results: 259 (63.3%) patients were operated using HS technique and 150 patients (36.7%) were operated by MMS technique. The mean operative time was 211.45± 82.25 min for the MMS anastomosis group, whereas for the manual group it was 251.42±52.81 min, respectively (P = 0.023). Postoperatively, 38 (14.67%) anastomotic leakage were detected in the HS group compared to 8 (5.33%) the MMS group (P= 0.002). The results showed lesser anastomotic stricture in patients who underwent MMS anastomosis (P= 0.004). However, during the one-year follow-up period, patients with HS anastomosis required more anastomotic dilatation (P= 0.021).Conclusions: Using a MMS anastomosis may reduce operation time and lead to lower rates of anastomotic leak, decrease anastomotic stricture and anastomotic dilatation.
High Level of Vaccination and Protection Against Hepatitis B with Low Rate of Hepatitis C HCV infection Markers among Hospital Health Care Personnel in North of Iran: A cross-Sectional study.
Authors: Saffar Hiva , Khoshayand Negar , Parsaei Mohammad-Reza , Ghorbani Gholam-Reza , Aarabi Mohsen , Ghara Ali-Asghar Nadi , Saffar mohammed-Jafar
Published: March 2020

Background: hepatitis B virus (HBV) and C virus (HCV) are among the leading causes of mortality worldwide. Health care personnel (HCP) are subjected to increased risk of these infections. Therefore, HBV vaccination and post-vaccination serologic testing (PVST) are recommended for them. Our Objectives in this study were investigate how well the vaccination guidelines for hospital HCPs were implemented. Moreover, the prevalence rates of HBV and HCV infections were calculated. To determine the presence of immunological memory, vaccinated personnel negative to antibody against HB surface antigen with one dose of HB vaccine were boosted.
Methods: From 1 July to 30 November 2017, a cross-Sectional study among HCPs working in public hospitals were conducted. All HCPs from various professional categories potentially at risk of exposure to contaminated sources were included. The information was gathered via interview and self-administered questionnaire. The questions were focused on the demographic characteristics, HB vaccination and immunity status and time elapsed since initial vaccination series, and frequency of needelstick injuries during the past 12 months of their work. Moreover, the prevalence rate of HBV and HCV infections were calculated. To determine the presence of immunological memory, subjects negative to HBV seromarkers received a booster dose of the vaccine.
Results: A total of 186 out of 766 participants were male and nurses comprised 71% of personnel. Although all HCP were vaccinated, 84% of them completed the course and less than 5% of them received PVST. According to the results, 0.78%, 4.6%, and 83% were serologically positive to HBV surface antigen, antibodies against HBV core, and S antigens, respectively. Approximately, 91% of seronegative participants responded to a booster dose and only 0.91% of the personnel had HCV was Anti-HCV positive.
Conclusion: Most HCP received full HBV vaccination course. Although a minority did PVST, the HBV vaccine-induced long-term protection and HBV booster were not required. Therefore, policies should be made to increase the rate PVST after immunization. According to the results, the HCV infection rate was low and thus pre-recruitment screening was not necessary.
Effects of gonadotropin-releasing hormone analog (GnRHa) immunization on the gonadal transcriptome and proteome of tilapia (Oreochromis niloticus)
Authors: Wang Rui , Wen Luting , Ma Huawei , Yang Huizan , Lv Min , Chen Zhong , Du Xuesong , Zeng Lan , Lin Yong , Huang Liming , Chen Tao
Published: March 2020

Background: Gonadotropin releasing hormone (GnRH) plays an important role in the regulation of vertebrate reproduction. Studies have shown that immunization against GnRHa can induce sexually sterile tilapia. To explore the mechanism behind this, in this study, RNA-seq and data-independent acquisition (DIA) techniques were used to study the transcriptome and proteome of the gonad of tilapia immunized with GnRHa. Results : 644 differentially expressed genes (80 upregulated and 564 downregulated) and 1150 differentially expressed proteins (351 upregulated and 799 downregulated) were identified. There were 209 genes with consistent differential expression patterns in the transcriptomic and proteomic analyses, of which 9 were upregulated and 200 downregulated, indicating that the gonad gene expression was inhibited by GnRHa immunization. The downregulated genes were particularly involved in the functions of single-organism process, binding, cellular process, metabolic process and catalytic activity, and associated with the pathways including ECM–receptor interaction, focal adhesion, cardiac muscle contraction and oxidative phosphorylation. The expression of six differentially expressed genes involved in the GnRH signaling pathway was all downregulated. In addition, several important functional genes related to gonadal development after GnRHa immunization were screened. Conclusions: This study confirmed the expression of corresponding genes was affected by GnRHa on the gonad development in tilapia at the molecular level, and laid a foundation for elucidating the mechanism of GnRHa immunization.
Bone-targeted extracellular vesicles from mesenchymal stem cells for osteoporosis therapy
Authors: Wang Yayu , Yao Jie , Cai Lizhao , Liu Tong , Wang Xiaogang , Zhang Ye , Zhou Zhiying , Li Tingwei , Liu Minyi , Lai Renfa , Liu Xiangning
Published: March 2020

Background Osteoporosis (OP) is one of the most common chronic diseases, but the drugs used to treat OP have strong side effects. Recently, bone regeneration in stem cell derivatives represented by extracellular vesicles (EVs) has provided a new strategy for the prevention and treatment of OP. EVs derived from mouse mesenchymal stem cells (mMSCs) have a positive effect on bone regeneration, yet their clinical application has been hampered by the lack of bone-targeting. Alendronate (Ale) has a specifically affinity for bone tissue through a high affinity with hydroxyapatite. Herein, we used copper-free "click chemistry” to combine EVs with Ale together for OP targeted therapy. Bone targeting was facilitated via Ale binding to hydroxyapatite, which is highly expressed on the bone surface. Methods In vitro, bone targeting of Ale-EVs was confirmed by flow cytometry. Also, Ex vivo ﬂuorescent imaging data revealed strong ﬂuorescent signals in bone tissues in mice treated with Ale-EVs-DiD compared to bone tissues of mice treated with EVs-DiD. Importantly, the modified EVs were well tolerated and showed no evidence of nonspecific side effects or immune response. Besides, our results showed that Ale-EVs could promote the proliferation and differentiation of mouse mesenchymal stem cells in vitro. And it had the antiosteoporotic effects in ovariectomy (OVX)-induced osteoporosis rat model. Conclusions A novel bone-targeting nanoparticle delivery system was developed for osteoporosis therapy. We used the Ale-N3 to modify mMSCs derived EVs by copper-free "click chemistry” to generate a Ale-EVs system. The Ale-EVs had a high affinity for bone and have great potential for clinical applications in osteoporosis therapy with low systemic toxicity.
Making a case for preconception care—the pregnancy experiences of women with pre-existing medical conditions in Ibadan, Nigeria
Authors: Ojifinni Oludoyinmola Omobolade , Ibisomi Latifat
Published: March 2020

BackgroundFactors that predispose to poor maternal and child health outcomes in most low and middle income countries include the presence of pre-existing medical conditions that are amenable to preconception care (PCC). Nigeria has an increasing pool of women of reproductive age with pre-existing medical conditions but PCC services are not provided routinely in the maternal and child health framework. This study explores the pregnancy experiences of women with pre-existing medical conditions to make a case for PCC as a routine service.MethodsNine women purposively selected because they has pre-existing medical conditions participated in in-depth interviews (IDIs) in this qualitative study. The IDIs were held in the obstetric outpatient clinics and lying-in wards of two referral hospitals for maternal and child health services in Ibadan North LGA of Oyo State, southwest Nigeria. The interviews lasted an average of 30 minutes, were digitally recorded and transcribed verbatim. Thematic analysis using a hybrid of inductive and deductive coding was done using MAXQDA 2018.ResultsAmong the nine participants, seven were pregnant and two non-pregnant with pre-existing medical conditions including hypertension, diabetes mellitus, sickle cell disorder, chronic hepatitis, HIV, previous pregnancy loss of unknown cause and secondary infertility. None of the participants were aware of PCC and although they all desired their current pregnancy, there was no active preparation. None of the pregnant participants notified their health care providers about their desire for pregnancy and their medications were not adjusted or changed till after pregnancy. All except one of the participants believed they could have benefitted from PCC if they had been aware before pregnancy.ConclusionThe regular contact with the health system afforded by their pre-existing medical conditions is an opportunity for them to have been adequately prepared for pregnancy through counselling and adjustment or change in treatment regimen to prevent complications. This opportunity was missed among the study participants. Health care providers need to be proactive and ask women of reproductive age about their pregnancy desires during routine clinic visits in order to make adequate preparation.
Free Vaccination and Immunization Coverage of Uninsured Children: The Case of the Vaccines for Children Program in the United States
Authors: Kawase Akihiro
Published: March 2020

Objective : Vaccines against contagious diseases have strong positive externalities as immunization protects not just the immunized but those around them. Out-of-pocket immunization costs are a common barrier to obtaining vaccines, especially for low-income families or those without health insurance in the United States. The Vaccines for Children (VFC) Program, initiated in October 1994, allows all uninsured children in the United States to receive free vaccinations. Despite its importance, few studies have focused on the effectiveness of this program. Using data from the National Immunization Survey (NIS) from 1995–1997 (N=51902), this study investigates how the introduction of this program affected the immunization coverage of uninsured children aged 19–35 months.Results : Accounting for variation in a child’s exposure to the program, I found that providing free vaccination correlated with an increase in the uptake of the entire spectrum of recommended vaccines, which included hepatitis B (Hep b) vaccine added to the recommended immunization schedule at the time. Further, despite the introduction of the program, uninsured children continue to have low immunization coverage. These findings suggest that improving immunization coverage for uninsured children by only reducing out-of-pocket vaccination costs may be insufficient and other factors may still influence vaccination decisions.