bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular detection of Rickettsia in fleas from micromammals in Chile
Authors: Salas Lucila Moreno , Carniglia Mario Espinoza , Schmeisser Nicol Lizama , Fuentes Luis Gonzalo Torres , Fuente María Carolina Silva de la , Lareschi Marcela , Acuña Daniel González
Published: August 2020

BackgroundRickettsial diseases are considered important in public health due to their dispersal capacity determined by the particular characteristics of their reservoirs and / or vectors. Among the latter, fleas play an important role, since the vast majority of species parasitize wild and invasive rodents, so their detection is relevant to be able to monitor potential emerging diseases. The aim of this study was to detect, characterize, and compare Rickettsia spp. from the fleas of micromammals in areas with different human population densities in Chile.MethodsThe presence of Rickettsia spp. was evaluated by standard polymerase chain reaction (PCR) and sequencing in 1,315 fleas collected from 1,512 micromammals in 29 locations, with different human population densities in Chile. A generalized linear models (GLM) was used to identify the variables that may explain Rickettsia prevalence in fleas.ResultsDNA of Rickettsia spp. was identified in 13.2% (174 of 1,315) of fleas tested. Fifteen flea species were found to be Rickettsia-positive. The prevalence of Rickettsia spp. was higher in winter, semi-arid region and natural areas, and the infections in fleas varied between species of fleas. The prevalence of Rickettsia among flea species ranged from 0%–35.1%. Areas of lower human density have the highest prevalence of Rickettsia. The phylogenetic tree shows two well-differentiated clades. Rickettsia belli is positioned as basal in a clade. Another clade is subdivided into two subclades, and are related to Rickettsia of typhus group.ConclusionsTo our knowledge, this is the first report of the occurrence and molecular characterization of Rickettsia spp. in 15 species of fleas of micromammals in Chile. In this study, fleas were detected carrying Rickettsia DNA with zoonotic potential, mainly in villages and natural areas of Chile. Considering that there are differences in the prevalence of Rickettsia in fleas associated with different factors, more investigations are needed to further understand the ecology of Rickettsia in fleas and their implications for human health.
Molecular detection of drug resistant polymorphisms in Plasmodium falciparum isolates from Southwest, Nigeria
Authors: Tola Monday , Ajibola Olumide , Idowu Taiwo Emmanuel , Omidiji Olusesan , Awolola Samson Taiwo , Amambua-Ngwa Alfred
Published: August 2020

Objective: Nigeria bears 25% of global malaria burden despite concerted efforts towards its control and elimination. The emergence of drug resistance to first line drugs, artemisinin combination therapies (ACTs), indicates an urgent need for continuous molecular surveillance of drug resistance especially in high burden countries where drug interventions are heavily relied on. This study describes mutations in Plasmodium falciparum genes associated with drug resistance in malaria; Pfk13, Pfmdr1, PfATPase6 and Pfcrt in isolates obtained from 83 symptomatic malaria patients between 1-61 years old from Lagos, a Mega city in South-west Nigeria. Results: Two Pfmdr1, N86 and Y184 variants were present at a prevalence of 56% and 13.25% of isolates respectively. There was one synonymous (S679S) and two non-synonymous (M699V, S769M) mutations in the Pfatp6 gene, while Pfcrt genotype (CVIET), had a prevalence of 45%. The Pfk13 C580Y mutant allele was suspected by allelic discrimination in two samples with mixed genotypes. Our findings calls for robust molecular surveillance of antimalarial drug resistance markers in west Africa especially with increased use of antimalarial drugs as prophylaxis for covid-19.
Exogenous polyunsaturated fatty acids (PUFAs) promote changes in growth, phospholipid composition, membrane permeability and virulence phenotypes in Escherichia coli
Authors: Herndon Joshua , Peters Rachel , Hofer Rachel , Simmons Tim , Symes Steven , Giles David
Published: August 2020

Background: The utilization of exogenous fatty acids by Gram-negative bacteria has been linked to many cellular processes, including fatty acid oxidation for metabolic gain, assimilation into membrane phospholipids, and control of phenotypes associated with virulence. The expanded fatty acid handling capabilities have been demonstrated in several bacteria of medical importance; however, a survey of the polyunsaturated fatty acid responses in the model organism Escherichia coli has not been performed. The current study examined the impacts of exogenous fatty acids on E. coli. Results: All PUFAs elicited higher overall growth, with several fatty acids supporting growth as sole carbon sources. Most PUFAs were incorporated into membrane phospholipids as determined by ultra performance liquid chromatography-mass spectrometry, whereas membrane permeability was variably affected as measured by two separate dye uptake assays. Biofilm formation, swimming motility and antimicrobial peptide resistance were altered in the presence of PUFAs, with arachidonic and docosahexaenoic acids eliciting strong alteration to these phenotypes. Conclusions: The findings herein add E. coli to the growing list of Gram-negative bacteria with broader capabilities for utilizing and responding to exogenous fatty acids. Understanding bacterial responses to PUFAs may lead to microbial behavioral control regimens for disease prevention.
Consequences of the COVID-19 pandemic on the continuum of the care in a cohort of people living with HIV followed in a single center of Northern Italy
Authors: Quiros-Roldan Eugenia , Magro Paola , Carriero Canio , Chiesa Annacarla , Hamad Issa El , Tratta Elena , Fazio Raffaella , Formenti Beatrice , Castelli Francesco
Published: August 2020

Introduction: During the COVID-19 pandemic, hospitals faced increasing pressure, where people living with HIV risked to either acquire SARS-CoV-2 and to interrupt the HIV continuum of care.Methods: this is a retrospective, observational study. We compared the numbers of medical visits performed, antiretroviral drugs dispensed and the number of new HIV diagnosis and of hospitalizations in a cohort of people living with HIV (PLWH) followed by the Spedali Civili of Brescia between the bimester of the COVID-19 pandemic peak and the bimester of October-November 2019. Data were retrieved from administrative files and from paper and electronic clinical charts. Categorical variables were described using frequencies and percentages, while continuous variables were described using mean, median, and interquartile range (IQR) values. Means for continuous variables were compared using Student’s t-tests and the Mann-Whitney test. Proportions for categorical variables were compared using the χ2 test.Results: As of December 31st, 2019, a total of 3875 PLWH were followed in our clinic. Mean age was 51,4 ±13 years old, where 28% were females and 18.8% non-Italian. Overall, 98.9% were on ART (n=3834), 93% were viro-suppressed. A total of 1217 and 1162 patients had their visit scheduled at our out-patient HIV clinic during the two bimesters of 2019 and 2020, respectively. Comparing the two periods, we observed a raise of missed visits from 5% to 8% (p<0.01), a reduction in the number of new HIV diagnosis from 6.4 in 2019 to 2.5 per month in 2020 (p=0.01), a drop in ART dispensation and an increase of hospitalized HIV patients due to COVID-19. ART regimens including protease inhibitors (PIs) had a smaller average drop than ART not including PIs (16,6% vs 21,6%, p<0.05). Whether this may be due to the perception of a possible efficacy of PIs on COVID19 is not known. Conclusions: Our experience highlights the importance of a resilient healthcare system and the need to implement new strategies in order to guarantee the continuum of HIV care even in the context of emergency.
Ultrasound-guided versus Shikani optical stylet-aided tracheal intubation: a prospective randomized study
Authors: Ma Yuanyuan , Wang Yan , Shi Ping , Cao Xue , Ge Shengjin
Published: August 2020

Background: To compare ultrasound-guided tracheal intubation (UGTI) versus Shikani optical stylet (SOS)-aided tracheal intubation in patients with anticipated normal airway.Methods: Sixty patients aged 18-65 years old who presented for elective surgery under general anesthesia were recruited in this prospective randomized study. They were assigned into two equal groups, either an ultrasound-guided group (Group UG, n=30) or an SOS-aided group (Group SOS, n=30). After the induction of anesthesia, the tracheal intubation was performed by a specified skilled anesthesiologist. The number of tracheal intubation attempt and the duration of successful intubation on the first attempt were recorded. Complications relative to tracheal intubation including desaturation, hoarseness and sore throat were also recorded.Results: The first-attempt success rate is 93.3% (28/30) in Group UG and 90% (27/30) in Group SOS (P=0.640). The second-attempt was all successful for the 2 and 3 patients left in the two groups, and the overall success rate of both groups was 100%. The duration of successful intubation on the first attempt of Group UG was not significantly different from that of Group SOS (34.0±20.8s vs 35.5±23.2s, P=0.784). One patient in Group SOS had desaturation (P=0.313), and there was none hoarseness in the two groups. Sore throat was detected in both group (4 in Group UG, 5 in Group SOS, P= 0.718).Conclusion: Ultrasound-guided tracheal intubation was as effective as Shikani optical stylet-aided tracheal intubation in adult patients with anticipated normal airway.Trial registration: Chinese Clinical Trial Registry, ChiCTR-IIC-17010875. Date of Registration: 15 March 2017.
What is the impact of the COVID-19 Pandemic on Emergency Medicine Residency Training: An observational study
Authors: Lo Hsiang-Yun , Lin Shen-Che , Chaou Chung-Hsien , Chang Yu-Che , Ng Chip-Jin , Chen Shou-Yen
Published: August 2020

Background The coronavirus disease 2019 (COVID-19) pandemic has engendered difficulties for health systems globally; however, the effect of the pandemic on emergency medicine (EM) residency training programs is unknown. The pandemic has caused reduced volumes of emergency department (ED) patients, except for those with COVID-19 infections, and this may reduce the case exposure of EM residents. The primary objective of this study was to compare the clinical exposure of EM residents between the prepandemic and pandemic periods. Methods This was a retrospective study of EM resident physicians’ training in a tertiary teaching hospital with two branch regional hospitals in Taiwan. We retrieved data regarding patients seen by EM residents in the ED between September 1, 2019, and April 30, 2020. The first confirmed COVID-19 case in Taiwan was reported on January 11, so the pandemic period in our study was defined as spanning from February 1, 2020, to April 30, 2020. The number and characteristics of patients seen by residents were recorded. We compared the data between the prepandemic and pandemic periods.Results The mean number of patients per hour (PPH) seen by EM residents in the adult ED decreased in all three hospitals during the pandemic. The average PPH of critical area of medical ED was 1.68 in the pre-epidemic period and decreased to 1.33 in the epidemic period (p value < 0.001). The average number of patients managed by residents decreased from 1.24 to 0.82 in the trauma ED (p value= 0.01) and 1.56 to 0.51 in the pediatric ED (p value=0.003) during the pandemic, respectively. The severity of patient illness did not change significantly between the periods. Conclusions The COVID-19 pandemic engendered a reduced ED volume and decreased EM residents’ clinical exposure. All portion of EM residency training were affected by the pandemic, with pediatric EM being the most affected. The patient volume reduction may persist and in turn reduce patients’ case exposure until the pandemic subsides. Adjustment of the training programs may be necessary and ancillary methods of learning should be used to ensure adequate EM residency training.
Structural and functional analysis of LIM domain-dependent recruitment of paxillin to focal adhesions
Authors: Ripamonti Marta , Liaudet Nicolas , Wehrle-Haller Bernhard
Published: August 2020

The LIM domain-dependent localization of the adapter protein paxillin to focal adhesions (FAs) is not mechanistically understood. Here, by combining molecular biology with photoactivation and FA-isolation experiments, we demonstrate a specific contribution of each LIM domain and reveal the existence of multiple paxillin docking sites in the FA-complex. Mutation of β3 integrin at a putative paxillin binding site leads to rapid inward sliding of FAs, correlating with enhanced paxillin dissociation rates. Mechanical coupling of paxillin to integrins or the plasma membrane arrests the FAs sliding, thereby disclosing an essential structural function of the LIM-array for the maturation of integrin/talin clusters. Moreover, via bimolecular fluorescence complementation, we determine a precise spatial orientation of the paxillin LIM domains, juxtaposing the positively charged LIM4 to the plasma membrane and the extremity of the β3 integrin tail, providing structural insights into the molecular organization of FAs.
Psychiatric Disorders in Female Psychosexual Disorders—A Nationwide, Cohort Study in Taiwan
Authors: Lin Iau-Jin , Tzeng Nian-Sheng , Chung Chi-Hsiang , Wu-chien Chien
Published: August 2020

Background: We aimed to investigate whether females with psychosexual disorders (PSD) were associated with the risk of affective and other psychiatric disorders. Methods: A total of 2,240 enrolled individuals, with 560 PSD patients and 1,680 non-PSD subjects (1:3) matched for age and index year, from the Longitudinal Health Insurance Database, retrieved from the National Health Insurance Research Database, between 2000-2015 in Taiwan. The multivariate Cox regression model was used to compare the risk of developing psychiatric disorders during the 15 years of follow-up. Results: There were 98 in the PSD cohort (3444.66 per 100,000 person-year) and 119 in the non-PSD cohort (736.07 per 100,000 person-year) that developed psychiatric disorders. The multivariate Cox regression model revealed that, after the adjustment of age, monthly income, urbanization level, geographic region, and comorbidities, the adjusted hazard ratio (HR) was 9.848 (95% CI= 7.298 — 13.291, p < 0.001). Sexual dysfunctions (adjusted HR = 6.448), paraphilia (adjusted HR = 33.366), and gender identity disorders (adjusted HR = 12.286) were associated with the overall psychiatric disorders. Conclusions: Female patients with PSD were associated with the risk of psychiatric disorders. This finding could be a refiner for clinicians about the mental health problems in the PSD patients.
WITHDRAWN: LncRNA DSCAM-AS1 Promotes Proliferation, Migration and Invasion of Colorectal Cancer Cells via Modulating miR-144-5p/CDKL1
Authors: Pei Jiaping , Deng Xiaozhao
Published: August 2020

Background LncRNA DSCAM-AS1 is oncogenic in several cancers. However, DSCAM-AS1 expression and function in colorectal cancer (CRC) remain far from being fully elucidated. Methods Paired CRC tissues/adjacent tissues were collected, and the expression levels of DSCAM-AS1, miR-144-5p and CDKL1 were examined by qRT-PCR; DSCAM-AS1 shRNA was transfected into HCT-116 and SW480 cell lines to establish cell models. The proliferation was detected through CCK-8 assay and plate colony formation assay. Transwell assay was used to evaluate the migration and invasion. QRT-PCR and western blot were adopted to analyze changes in miR-144-5p and CDKL1; luciferase reporter gene assay was performed to determine the regulatory relationship between miR-144-5p and DSCAM-AS1, miR-144-5p and CDKL1. Results DSCAM-AS1 was notably up-regulated in CRC samples, positively correlated with CDKL1 expression, while negatively correlated with miR-144-5p. After the transfection of DSCAM-AS1 shRNAs into cancer cells, the proliferative and metastatic ability of cancer cells were impeded. DSCAM-AS1 could reduce the expression level of miR-144-5p by binding with it. Additionally, CDKL1 was also validated as a target gene of miR-144-5p, and DSCAM-AS1 was proved to indirectly regulate CDKL1 expression. Conclusion DSCAM-AS1 was aberrantly up-regulated in CRC, and it can modulate the cells proliferative and metastatic ability. It has the ability to be the “ceRNA” to regulate CDKL1 expression via sponging miR-144-5p.
Parents' and medical staff's experience of adolescents with suicide-related behaviors admitted to a general hospital in China: qualitative study
Authors: Fu Xi , Yang Jiaxin , Liao Xiaoli , Shen Yidong , Ou Jianjun , Li Yamin , Chen Runsen
Published: August 2020

Background: Currently, there is increasing awareness of suicide-related behaviors. Mental health services are a key location for assisting people with suicide-related behaviors. However, few studies focused on the evaluation and experience of the mental health care system from families and the medical staff’s perspective in China. The study is aim to explore parents' and the front-line medical staff's experience of an adolescent with suicide-related behaviors admitted to the psychiatry department of a general hospital in China.Design: Qualitative study was employed in the study. Participants were recruited from a general hospital in China characterized by high levels in the Chinese mental health system.Methods: Semi-structured in-depth interviews were conducted exploring their experience and perceptions when an adolescent admitted to the hospital. The theme analysis method is used for data analysis.Results: Participants expressed dissatisfaction in the psychiatric department. Other barriers in their work were identified, such as the shortage of staff and difficulties in caring or communicating with patients. Besides, the imperfect treatment system also contributes to the low satisfaction of patients and their families. Four themes were identified for medical staff’s experience:1) Perception of working in psychiatry; 2) The challenges of working in psychiatry; 3) The advice to the health care service. Two themes for parents: 1) The evaluation for hospitalization treatment; 2) The advice to the health care service.Conclusion: This study found that insufficient staffing and lacking of systematic professional treatment models are the major challenges. We suggest increasing the input of mental health resources to expand and train the mental health service team and establish a complete set of a treatment model for SRBs.
Surgical Outcomes for the Thoracic Ossification of Ligamentum flavum: A Retrospective Analysis of 61 Cases
Authors: Yamada Tsuyoshi , Shindo Shigeo , Yoshii Toshitaka , Ushio Shuta , Kusano Kazuo , Miyake Norihiko , Arai Yoshiyasu , Otani Kazuyuki , Okawa Atsushi , Nakai Osamu
Published: August 2020

Background: Thoracic ossification of ligamentum flavum (T-OLF), as one of the causes of thoracic myelopathy, is often combined with other spinal disorders. Concurrent lumbar spinal canal stenosis (LCS) is often abstruse by symptoms due to T-OLF, leading to difficulty in identifying the origin of these neurological findings. It is common to be misdiagnosed or delayed diagnosis due to the complicated nature. We evaluated the prevalence, distribution, and clinical characteristics of OLF, especially in patients with LCS.Methods: The authors performed a retrospective analysis of the outcomes of 61 patients who underwent thoracic surgeries performed for symptomatic T-OLF. In all the patients, whole spine lesions were evaluated preoperatively. We examined the factors related to poor outcomes (the recovery rate of the Japanese Orthopedic Association score for thoracic myelopathy is less than 40%) following OLF surgeries. We further compared the clinical outcomes according to whether there is concurrent LCS, and determined the optimal surgical approach.Results: The prevalence of T-OLF increased in an age-dependent manner. Forty-six cases (75.4%) were considered to be tandem T-OLF and LCS (LCS group). An advanced age, and concurrent LCS were associated with a poor outcome after the surgery, rather than type of surgical procedure, the local T-OLF size, configuration, the number of OLF lesions, or radiographic cervical stenosis. The LCS group significantly included a greater number of elderly, and more light-weighted patients with Modic change in thoracic spine and a greater SVA, resulting in the lower neurological recovery. Additional lumbar surgery (13cases) effectively improved both the T-JOA and L-JOA scores (from 6.5 ± 2.0 points to 8.0 ± 1.8 points, p=0.0406, and from 14.5 ± 4.7 points to 20.7 ± 2.6 points, p=0.001, respectively) in OLF patients with LCS.Conclusions: T-OLF was highly combined with other spinal disorders. Poor outcomes in T-OLF surgery could be associated with age and concurrent LCS, and an additional surgery for another lumbar lesion significantly improved neurological findings in T-OLF patients.
Parameter Optimization of Gas Metal Arc Welding Process on AISI: 430 Stainless Steel Using Meta Heuristic Optimization Techniques
Authors: Ravichandran P. , B Meenakshipriya , Parameshwaran R. , Maheswari C. , Priyanka E.B. , Sivapathasekaran P.
Published: August 2020

The superiority and profile of the weld obtained through Gas Metal Arc Welding (GMAW) are not only depends on the chemical configuration of the flux, but also on the choice of welding parameters. Since variety of process parameters influence the results, a proper empathetic of process performance and identification of suitable welding conditions (i.e. optimum setting of process parameters) are indeed essential to enhance quality. The present work highlights the application and comparison of single-response optimization using Response Surface Methodology (RSM) with Meta Heuristic Optimization techniques namely Particle Swarm Optimization (PSO) and Firefly Algorithm (FA). The experimental analysis is conducted by optimizing the input parameters like Current Rating (Amp), Feed Rate (m/min), Welding Speed (mm/sec) and Gas Flow (l/m). An attempt has been made in the present research work by taking AISI: 430 stainless steel specimens to compare and analyse the performance in terms of weld bead geometry (Bead Width (mm), Bead Height (mm) and Depth of Penetration (mm)), Hardness (VHN) and Tensile Strength (N/mm²) using IRB 1410 Industrial manipulator. The effect of process parameters on ferritic stainless steel of series 400 (AISI: 430) grade has been analysed using Response Surface Methodology (RSM) method. Further, Meta Heuristic Optimization techniques namely Particle Swarm Optimization (PSO) and Firefly Algorithm (FA) have been developed further to minimize the bead width, bead height and maximize the depth of penetration. While fairly similar results were achieved with the implementation of Particle Swarm Optimization (PSO) and Firefly Algorithm (FA) were computationally efficient. Experimental validation of the single-objective as well as multi-objective optimization results indicates that the empirical models for the quality prediction with proposed optimization results are better for the GMAW process by IRB 1410 Industrial manipulator.
Enhancing Positron Production using Front Surface Target Structures
Authors: Jiang Sheng , Link Anthony , Canning Dave , Fooks Julie , Kempler Paul , Kerr Shaun , Kim J , Krieger Michael , Lewis Nathan , Wallace Russell , Williams G. Jackson , Yalamanchili Sisir , Chen Hui
Published: August 2020

We report the first experimental results and simulations that demonstrate a substantial effect of large-scale front-surface target structures on high-intensity laser-produced positrons. Specifically, as compared to a flat target under nominally the same laser conditions, an optimized Si microwire array target yielded a near 100% increase in the laser-to-positron conversion efficiency and produced a 10 MeV increase in positron energy. Full-scale particle-in-cell simulations that modeled the entire positron production and transport process starting from laser-plasma interactions provided additional insight into the beneficial role of target structuring. The agreement between experimental and simulated spectra suggests future target structure optimization for desired positron sources.
Effects of Adding Respiratory Exercises to the Therapeutic Routine in Smartphone Users With Forward Head Posture and Non-Specific Chronic Neck Pain: A Randomised Controlled Trial
Authors: Dareh-deh Hamid Rezaee , Hadadnezhad Malihe , Letafkar Amir , Peolsson Anneli
Published: August 2020

Background: Neck pain and forward head posture are common in prolonged smartphone users and need to be targeted for treatment. We aimed to compare the effect of adding respiratory exercises to the therapeutic routine in smartphone users with forward-head posture and non-specific chronic neck pain.Mehods: Sixty patients (aged 24.7±2.1 years), were randomly assigned to the therapeutic routine (n=20), combined respiratory-exercises with therapeutic routine (n=20), or control groups (n=20). Each programme was implemented three times a week for 8 weeks. Forward head angle, pain, electromyographic activity, and respiratory patterns were measured at baseline and at 8-weeks’ post-treatment. Results: There were significant improvements in the combined group compared with the therapeutic routine group (p=0.03) for diaphragm muscle activation, (p=0.03), neck erector spinae activity (p=0.04), respiratory balance (p=0.04), and number of breaths (p=0.02). There were significant within-group changes from baseline to post-treatment in the combined group for all outcomes above, but no changes in the therapeutic exercise routine group. Outcomes for the combined group were superior to the control group in every variable. Conclusion: Combination treatment is more effective than the standard therapeutic routine. These results could be strengthened by more studies with longer follow-up assessments.Trial registration: Current Controlled Trials using the IRCT website with ID number of, IRCT20200212046469N1 “Prospectively registered” at 2020/03/04.
Spatial-temporal patterns of malaria incidence in Uganda using HMIS data from 2015 to 2019
Authors: Kigozi Simon , Kigozi Ruth N , Sebuguzi Catherine M , Cano Jorge , Rutazaana Damian , Opigo Jimmy , Bousema Teun , Yeka Adoke , Gasasira Anne , Sartorius Benn , Pullan Rachel L
Published: August 2020

Background: As global progress to reduce malaria transmission continues, it is increasingly important to track changes in malaria incidence rather than prevalence. Risk estimates for Africa have largely underutilized available health management information systems (HMIS) data to monitor trends. This study uses national HMIS data together with environmental and geographical data, to assess spatial-temporal patterns of malaria incidence at facility catchment level in Uganda over a recent 5-year period.Methods: Data reported by 3446 health facilities in Uganda, between July 2015 and September 2019 was analysed. To assess the geographic accessibility of the health facilities network, AccessMod was employed to determine a three-hour cost-distance catchment around each facility. Using confirmed malaria cases and total catchment population by facility, an ecological Bayesian conditional autoregressive spatial-temporal Poisson model was fitted to generate monthly posterior incidence rate estimates, adjusted for caregiver education, rainfall, land surface temperature, night-time light (an indicator of urbanicity), and vegetation index.Results: An estimated 38.8 million (95% Credible Interval [CI]: 37.9–40.9) confirmed cases of malaria occurred over the period, with a national mean monthly incidence rate of 20.4 (95% CI: 19.9–21.5) cases per 1000, ranging from 8.9 (95% CI: 8.7–9.4) to 36.6 (95% CI: 35.7–38.5) across the study period. Strong seasonality was observed, with June-July experiencing highest peaks and February-March the lowest peaks. There was also considerable geographic heterogeneity in incidence, with health facility catchment relative risk during peak transmission months ranging from 0 to 50.5 (95% CI: 49.0–50.8) times higher than national average. Both districts and health facility catchments showed significant positive spatial autocorrelation; health facility catchments had global Moran’s I = 0.3 (p < 0.001) and districts Moran’s I = 0.4 (p < 0.001). Notably, significant clusters of high-risk health facility catchments were concentrated in Acholi, West Nile, Karamoja, and East Central – Busoga regions.Conclusion: Findings showed clear countrywide spatial-temporal patterns with clustering of malaria risk across districts and health facility catchments within high risk regions, which can facilitate targeting of interventions to those areas at highest risk. Moreover, despite high and perennial transmission, seasonality for malaria incidence highlights the potential for optimal and timely implementation of targeted interventions.
Pre- and Post-operative Pain Catastrophizing and Resilience of Patients With Total Knee Arthroplasty: A Cohort Study
Authors: Nwankwo Vesta , Jiranek William A. , Green Cynthia L. , Allen Kelli D. , George Steven Z.
Published: August 2020

BackgroundPatients undergoing total knee arthroplasty (TKA) have psychological comorbidities that influence recovery and functional outcomes. Resilience is a psychological construct defined as an individual's ability to adapt to adversity. Pain catastrophizing encompasses rumination, magnification, and helplessness that patients feel toward their pain. Pain catastrophizing is associated with poor function following surgery. Studies assessing the influence of resilience on postoperative outcomes have shown inconsistent findings and have not accounted for the influence of pain catastrophizing. We sought to identify (1) whether baseline pain catastrophizing and resilience are predictive of postoperative knee function, general physical health, and general mental health three months after TKA and (2) whether baseline pain catastrophizing and resilience are associated with preoperative knee function, general physical health, and general mental health.MethodsPatients undergoing TKA between January 2019 and November 2019 were included in this longitudinal cohort study. Demographics and questionnaires [Brief Resilience Scale (BRS), Pain Catastrophizing Scale (PCS), Knee injury and Osteoarthritis Outcome Score, Junior (KOOS, JR.) and Patient-Reported Outcomes Measurement Information System Physical and Mental Health (PROMIS PH and MH, respectively)] were collected preoperatively and 3 months postoperatively. Multivariable regression was used to test associations of preoperative BRS and PCS with postoperative outcomes.ResultsThe study cohort included 117 patients with a median age of 67.0 years (Q1-Q3: 59.0-72.0). Fifty-three percent of patients were women and 70.1% were white. In multivariable linear regression analyses, baseline pain catastrophizing did not demonstrate a significant association with postoperative 3-month knee function, (β = -0.08, p = 0.543), general physical health (β = -0.11, p = 0.313), or general mental health (β = 0.01, p = 0.919). Baseline resilience positively associated with postoperative knee function (β = 0.24, p = 0.019) and general physical health (β = 0.24, p = 0.013).ConclusionsOur prospective analysis suggests that resilience predicts postoperative knee function and general physical health in patients undergoing TKA. Given the inconsistent findings in this area of research, future studies should continue to delineate preoperative constructs that impact patients following surgery. Exploring interventions targeting the preoperative mental health of patients undergoing TKA may improve outcomes in this cohort.
Pan-resistome insights into the multidrug resistance of Acinetobacter baumannii
Authors: Rodrigues Diego Lucas Neres , Morais-Rodrigues Francielly , Hurtado Raquel , Santos Roselane Gonçalves dos , Costa Daniela Camargos , Barh Debmalya , Ghosh Preetam , Soares Siomar C , Ramos Rommel , Góes-Neto Aristóteles , Azevedo Vasco , Aburjaile Flavia
Published: August 2020

BACKGROUND
Acinetobacter baumannii is an important Gram-negative opportunistic pathogen, which is responsible for many nosocomial infections. This etiologic agent has acquired, over the years, multiple mechanisms of resistance to a wide range of antimicrobials and the ability to survive in different environments. In this context, our study aims to elucidate the resistome from the A. baumannii strains based on phylogenetic, phylogenomic, and comparative genomics analyses. In silico analysis of the complete genomes of A. baumannii strains was carried out to identify genes involved in resistance mechanisms and the phylogenetic relationships and grouping of the strains based on the sequence type.
RESULTS
The strains belonging to the same sequence type (ST) were phylogenomically closer than from distinct STs, and the most prevalent ST was ST 2. The presence of genomic islands containing most of the resistance gene repertoire indicated high genomic plasticity, which probably enabled the acquisition of resistance genes and the formation of a robust resistome. A. baumannii displayed an open pan-genome and revealed a still constant genetic permutation among their strains, similarly to the genera Escherichia, Klebsiella, and Pseudomonas.
CONCLUSIONS
Our study is the first one to evaluate the resistome of the species A. baumannii using comparative multi-omics methods. Furthermore, the resistance genes suggest a specific profile within the species throughout its evolutionary history. Moreover, the current study performed the screening and characterization of the main genes present in the resistome, which can be used in applied research for the development of new therapeutic methods to control this important bacterial pathogen.
A Novel Device for Accurate Guide wire Placement in Cannulated Screw Fixation of Femoral Neck Fracture:A Pilot Study
Authors: ren bu-fang , Ma quan-ping , lv xin
Published: August 2020

Background: Accurate placement of cannulated screws is the key to stable fixation of the femoral neck fracture. A novel device was developed to improve the accuracy of screw placement.Methods: 20 synthetic femoral bones were divided into conventional technique group and the experimental group. Three Kirschner wire were inserted into the femoral neck fracture by conventional technique or by the simple guide device. The operative time, total drilling times and fluoroscopic frequency were evaluated.Results: By using the guide device, the fluoroscopy and operation time of the experimental group were shorter that of the conventional method. The total drilling times with the simple guide device were significantly lower than the conventional technique group.Conclusions: This device can help trauma surgeons shorten the surgical time and reduce radiation exposure time. The use of this guide device can make screw fixation for femoral neck fracture easier.
Genome-wide identification, characterization, and expression analysis of tea plant autophagy-related genes (CsARGs) reveals diverse roles during development and abiotic stress
Authors: Qian Wenjun , Wang Huan , Ding ZhaoTang , Gou Mengjie , Hu Jianhui , Wang Yu , Wang Lu , Wang Yuchun , Di Taimei , Zhang Xinfu , Hao Xinyuan , Wang Xinchao , Yang Yajun
Published: August 2020

Background
Autophagy, meaning ‘self-eating’, is required for degradation and recycling of cytoplasmic constituents under stressful or non-stressful conditions, thereby contributing to maintaining cellular homeostasis, delaying aged and longevity in eukaryotes. So far, the functions of autophagy have been intensively studied in yeast, mammals and model plants, but few studies have focused on economic crops, especially for tea plants, the roles of autophagy in coping with different environment stimuluses have not yet been detailed. Therefore, exploring the functions of autophagy related genes in tea plant would contribute to further understanding the mechanism of autophagy in response to stresses in woody plants.
Results
Here, we totally identified 35 CsARGs in tea plant. Each CsARG is highly conserved with its homologues stemmed from other plant species, except for CsATG14. Tissue-specific expression analysis revealed that the abundances of CsARGs were varied with different tissues, but CsATG8c/i showed a certain degree of tissue specificity, respectively. Under hormones and abiotic stress conditions, most of CsARGs were up-regulated at different treatment time points. In addition, the transcriptions of 10 CsARGs were higher in cold-resistance cultivar ‘Longjing43’ than the cold-susceptible cultivar ‘Damianbai’ during CA periods, however, CsATG101 showed a contrary tendency.
Conclusions
We comprehensively analyzed the bioinformatics and physiological roles of CsARGs in tea plant, and these results provide the basis for deepen exploring the molecular mechanism of autophagy involved in tea plant growth and development and stress responses. Meanwhile, some CsARGs would be served as putative molecular markers for cold-resistance breeding of tea plant in future.
Multiple anatomical brain networks for self-esteem related analysis among young adults
Authors: Peng Bo , Pang Gaofeng , Saxena Aditya , Liu Yan , Hu Baohua , Wang Suhong , Dai Yakang
Published: August 2020

Background: Self-esteem is the individual evaluation of oneself. People with high self-esteem have mental health and can bravely cope with the threats from the environment. With the development of neuroimaging techniques, researches on the cognitive neural mechanisms of self-esteem are increased. Existing methods based on brain morphometry and single-layer brain network cannot characterize the subtle structural differences related to self-esteem. Method: To solve this issue, we proposed multiple anatomical brain network framework based on multi-resolution ROI template to study the cognitive neuroscience mechanism of self-esteem. Multiple anatomical brain network consist of high-resolution ROI features extracted from structural MRI and hierarchal brain network features. For each layer, we calculated the correlation relationship between pairs of ROIs. In order to solve the high-dimensional problem caused by the large amount of multiple network features, combined feature selection methods are adopted to reduce the number of features while retaining discriminative information to the maximum extent. Multi-kernel SVM is employed to combine the two types of features by appropriate weight coefficient. Result: Our experimental results show that the proposed method can improve classification accuracy to 97.26% compared with single-layer brain network. Conclusions: This article reveals the cognitive neural mechanism of self-esteem and provides foundation for positive and healthy self-esteem.
Adherence to Antipsychotic Drugs by Medication Possession Ratio for Schizophrenia and Similar Psychotic Disorders in the Republic of Korea: A Retrospective Cohort Study
Authors: Cho Sung Joon , Kim Jungmee , Lee Jin Yong , Sohn Jee Hoon
Published: August 2020

Background: Pharmacotherapy is considered as an essential element in the treatment of schizophrenia and other psychotic disorders. Discontinuation of antipsychotic drugs increases medical use and economic burden, such as worsening of symptoms, recurrence, and hospitalization. Therefore, maintenance of drug treatment is essential to reduce the social burden caused by schizophrenia and SSP, and hence, it is important to analyze not only the incidence rate of the disorders, but also investigate the rate at which pharmacotherapy is maintained. Therefore, this study aimed to examine the current status of drug compliance using national health insurance data. Methods: This was a retrospective cohort study, which analyzed data from the nationwide insurance claims database. A total of 343,134 patients who were newly diagnosed with schizophrenia and schizophrenia similar psychosis (SSP) during 2011−2015. The adherence to antipsychotic drugs was assessed by medication possession ratio (MPR) and the risk factors of poor adherence were defined as MPR <40%.Results: The average of the MPRs among these patients was 45.8%, and the proportion of patients with less than 40% of MPR was 50.8%. It was found that female patients, the experience of “psychiatric hospital outpatient,” the experience of “psychiatric hospital admission,” the experience of “general hospital admission,” and patients receiving “medical aid” showed less risk of having statistically significant low MPR (< 40%).Conclusions: In this study, the drug adherence of schizophrenia and SSP patients currently under treatment, as estimated by MPR, was very low. However, it was also found that the MPR was high among patients receiving medical aid, with less medical expenses that they have to pay for themselves. Thus, it is possible to consider an institutional mechanism in which schizophrenia and SSP patients can be treated with less economic burden.
MiR-106B Represents an Innovative Bio-marker in Cholangiocarcinoma Detection
Authors: Wang Ning , Li Yanni , Zheng Yanfang , Chen Huoming , Wen Xiaolong , Li Zhaoxia
Published: August 2020

Background

Cholangiocarcinoma (CCA) is one of the most aggressive malignancies. Late diagnosis may be responsible for the high mortality. MicroRNA-106b (MiR-106b) is accepted as an important regulator in various human malignancies. The current study was aimed to investigate the diagnostic value of miR-106b in CCA.
Methods

Serum levels of miR-106b in CCA patients and healthy control were evaluated by quantitative real-time polymerase chain reaction (qRT-PCR). Chi-square test was used to analyze the association of miR-106b with the clinicopathological features. To evaluate the diagnostic value of miR-106b in CCA, the ROC curve was constructed.
Results

The expression of miR-106b was significantly increased in CCA samples compared with the healthy controls (P < 0.001). The overexpression of miR-106b was remarkable correlated with the lymphatic node metastasis (P = 0.038), clinical stage (P = 0.017) and differentiation (P = 0.009). ROC curve suggested that miR-106b was an effective diagnostic biomarker in CCA with the AUC of 0.913. The optimal cutoff value was 2.525, with the sensitivity of 89.7% and the specificity of 79.3%.
Conclusions

MiR-106b functions as an oncogene in CCA, which may be an potential diagnostic biomarker for CCA.
Measuring coverage of WHO recommended Essential Newborn Care practices in the squatter settlements of Islamabad Capital Territory in Pakistan.
Authors: Hassan Rameeza , Hamid Saima , Raza Tahira Ezra , Hanif Kauser , Blanchard James , Emmanuel Faran
Published: August 2020

Background: Pakistan has shown significant progress in reducing child mortality, however, significant challenges exist in reducing neonatal mortality rate. WHO recommends a package of “essential newborn care” practices based on effective coverage to improve newborn survival. This study assessed the level of effective coverage of newborn care in the squatter settlements of Islamabad Capital Territory (ICT) and also determined if the care received is within the parameters of essential newborn care as defined by WHO guidelines.Methods: A cross-sectional survey was conducted to gather community-based data on newborn care practices from 416 mothers who delivered a live baby in the past twelve months within a randomly selected squatter population of ICT. Three composite outcomes (safe cord care, optimal thermal care and good neonatal feeding) were generated by combining individual practices from a list of essential newborn care practices recommended by WHO. All International ethical standards were followed including informed consent and confidentiality of respondents. Ethical clearance was obtained from the ethical review board of Health Services Academy (HSA).Results: Despite a very high number of institutional deliveries, the study showed that only 2.9% of newborns received all components of WHO recommended essential newborn care. Only 17.1% of the newborns received essential elements of safe cord care, 40.4% received recommended optimal thermal care and 28.8% followed WHO guidelines of good neonatal feeding practice. This low uptake of essential practices was due to the application of various substances on the cord, delayed skin to skin contact and feeding of pre-lacteals to the newborn.Conclusion: The study highlighted that the current level of effective essential newborn care is extremely low in the country. We found multiple cultural and societal misconceptions, that translate into harmful practices for newborns. Interventions such as educating mothers through front line workers, updating health care staff on WHO recommended guidelines for newborn care and declaring widespread harmful traditional practices hazardous for the health of newborn, can help improve essential newborn care in Pakistan.
Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States
Authors: Liu Xiaoshuang , Xu Xiao , Li Guanqiao , Xu Xian , Sun Yuyao , Wang Fei , Shi Xuanling , Li Xiang , Xie Guotong , Zhang Linqi
Published: August 2020

The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs) to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is in great need to assist in guiding the individualized decision making for adjustment of interventions in the US and around the world. However, the impact of these approaches remain uncertain. Based on the reported cases, the effective reproduction number of COVID-19 epidemic for 50 states in the US was estimated. The measurement on the effectiveness of eight different NPIs was conducted by assessing risk ratios (RRs) between and NPIs through a generalized linear model (GLM). Different NPIs were found to have led to different levels of reduction in. Stay-at-home contributed approximately 51% (95% CI 46%-57%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-13%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 6% (2%-11%). This retrospective assessment of NPIs on has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.