bluuebunny/crossref_metadata_2025 huggingface dataset:
Fracture fixation strategy and specific muscle tissue availability of neutrophilic granulocytes following mono- and polytrauma: intramedullary nailing vs. external fixation of femoral fractures
Authors: Greven Johannes , Horst Klemens , Qiao Zhi , Bläsius Felix Marius , Mert Ümit , Teuben Michel Paul Johan , Becker Nils Hendrik , Pfeifer Roman , Pape Hans-Christoph , Hildebrand Frank
Published: September 2020

Background: In the stabilization of femoral fractures in mono- and polytrauma, clinical practice has shown better care through intramedullary nailing. However, the reason why this is the case is not fully understood. In addition to concomitant injuries, the immunological aspect is increasingly coming to the fore. Neutrophil granulocytes (PMNL), in particular next to other immunological cell types, seem to be associated with the fracture healing processes. For this reason, the early phase after fracture (up to 72 h after trauma) near the fracture zone in muscle tissue was investigated in a pig model.Material and Methods: A mono- and polytrauma pig model (sole femur fracture or blunt thoracic trauma, hemorrhagic shock, liver laceration, and femur fracture) was used to demonstrate the immunological situation through muscle biopsies and their analysis by histology and qRT-PCR during a 72 h follow up phase. Two stabilization methods were used (intramedullary nail vs. external fixator) and compared to a non-traumatized sham group.Results: Monotrauma shows higher PMNL numbers in muscle tissue compared to polytrauma (15.52 ± 5.39 mono vs. 8.23 ± 3.36 poly; p = 0.013), regardless of the treatment strategy. In contrast, polytrauma shows a longer lasting invasion of PMNL (24 h vs. 72 h). At 24 h in the case of monotrauma, the fracture treated with external fixation shows more PMNL than the fracture treated with intramedullary nailing (p= 0.026). This difference cannot be determined in polytrauma probably caused by a generalized immune response. Both monotrauma and polytrauma show a delayed PMNL increase in the muscle tissue of the uninjured side. The use of intramedullary nailing in monotrauma resulted in a significant increase in IL-6 (2 h after trauma) and IL-8 (24 and 48 h after trauma) transcription.Conclusion: The reduction of PMNL invasion into the nearby muscle tissue of a monotrauma femur fracture stabilized by intramedullary nailing supports the advantages found in everyday clinical practice and therefore underlines the usage of nailing. For the polytrauma situation, the fixation seems to play a minor role, possibly due to a generalized immune reaction.
Association between haematological parameters and sickle cell genotypes in children with Plasmodium falciparum malaria resident in Kisumu County in western Kenya
Authors: Kosiyo Paul , Otieno Walter , Gitaka Jesse , Munde Elly O. , Ouma Collins
Published: September 2020

Background: Sickle cell disease (SCD) is a monogenic disorder due to point mutation in the β-globin gene resulting in substitution of Valine for Glutamic acid. The SCD is prevalent in P. falciparum endemic regions such as western Kenya. Carriage of different sickle cell genotypes may influence haematological parameter during malaria. Children resident in malaria holoendemic regions suffer more from malaria-related complications and this is moderated by the presence of the SCD. In the current study, we determined the association between sickle cell genotypes and haematological parameters in children with P. falciparum malaria resident in Kisumu County in Western Kenya.Methodology: Children (n=217, aged 1-192 months) with acute febrile condition were recruited at Jaramogi Oginga Odinga Teaching and Referral Hospital. Chi-square (c2) analysis was used to determine differences between proportions. Differences in haematological parameters were compared across groups using Kruskal Wallis test and between groups using Mann Whitney U test. Multivariate logistic regression analysis controlling for infection status was used to determine the association between sickle cell genotypes and haematological parameters. Results: Using HbAA as the reference group, multivariate logistic regression analysis revealed that carriage of HbSS was associated with reduced haemoglobin [OR=0.310, 95% CI=0.101-0.956, P=0.041], reduced haematocrit [OR=0.318, 95% CI=0.128-0.793, P=0.014], reduced RBC count [OR=0.124, 95% CI=0.045-0.337, P=0.001], reduced MCHC [OR=0.325, 95% CI=0.118-0.892, P=0.029], increased leucocytosis [OR=9.283, 95% CI=3.167-27.210, P=0.001] and reduced monocytosis [OR=0.319, 95% CI=0.123-0.830, P=0.019]. However, carriage of HbAS was only associated with increased micro-platelets [OR=3.629, 95% CI=1.291-8.276, P=0.012]. Conclusion: Results show that carriage of HbSS in children influence the levels of haemoglobin, haematocrit, RBC, MCHC, WBC and Monocytes. Therefore prior knowledge of HbSS should be considered to improve clinical management of haematological alterations during malaria in children.
An exploratory study to estimate cost-effectiveness threshold value for life saving treatments in western Iran
Authors: Moradi Najmeh , Woldemichael Abraha , Malekian Parisa , Rotavandi Delnia Moradi , Rezaei Satar
Published: September 2020

Background: Cost-effectiveness analysis provides a crucial means for evidence-informed decision-making on resource allocation. This study aims to elicit individuals' willingness to pay (WTP) for one additional quality-adjusted life-year (QALY) gained from life-saving treatment and associated factors in Kermanshah city, western Iran.Methods: We conducted a cross-sectional study on a total of 847 adults aged 18 years and above to elicit their WTP for one additional QALY gained by oneself and a family member using a hypothetical life-saving treatment. We used a multistage sampling technique to select the samples, and the Iranian version of EQ-5D-3L, and visual analogue scale (VAS) measures was used to obtain the participants’ health utility value. The Tobit regression model was used to identify the factors affecting WTP per QALY values.Results: The mean WTP value and standard deviation (SD) was US$ 862 (3,224) for the respondents and US$ 1,355 (3,993) for the family members. The mean utility values using EQ-5D-3L and VAS methods were 0.779 and 0.800, respectively. Besides, Tthe WTP for the additional QALY gained by the individual participants using the EQ-5D-3L and VAS methods were respectively US$ 1,202 and US$ 1,101, while the estimated value of the family members was US$ 1,355 (SD= 3,993). The Tobit regression models indicated that monthly income, education level, sex, and birthplace were statistically significantly associated (p < 0.05) with both the WTP for the extra QALY values using the EQ-5D-3L and the VAS methods. Besides, eEducational level and monthly income also showed statistically significant relationships with the WTP for the additional QALY gained by the family members (p < 0.05). Conclusion: Our findings indicated that the participants' WTP value of the additional QALY gained from the hypothetical life-saving treatment was in the range of 0.20 to 0.24 of the Iran’s gross domestic product (GDP) per capita of Iran. This value, which is far lower than the World Health Organization (WHO) recommended CE threshold value of one. This wide gap reflects the challenges the health system is facing and requires further research for defining the most appropriate CE threshold at the local level.
Improving the efficiency of nursing work for patients with severe COVID-19
Authors: Zhihui Mu , Meimei Luo , Ya Zhong , Min Li , Minghui Li , Yu Wang , Zhang Nan
Published: September 2020

Background

Exploring new ways to improve the efficiency of nursing work for patients with severe new coronavirus pneumonia.
Methods

A total of 372 clinical nursing shifts from February 9, 2020 to April 11, 2020 were analyzed in this study. Shifts were divided into a control group (186 shifts before reorganization) and an observation group (186 shifts after reorganization). Following improvements were applied: wearing the protective equipment, communication between inside and outside the contaminated area, and time needed to restock the bedside consumables.
Results

After the new method was applied, changing of protective equipment during worktime was reduced (5% (9/186) in the observation group vs. 15% (27/186) in the control group; P = 0.003). Moreover, the time needed to transfer items between inside and outside contaminated area and time for replenishment consumables for bedside treatment was shorter in the observation group compared to the control group (1.98 ± 1.41, 6.86 ± 2.25 vs. 2.52 ± 1.97, 10.81 ± 4.45, respectively; all P < 0.002).
Conclusion

The new applied measures have improved the nursing efficiency in patients with severe novel coronavirus pneumonia.
Adding Ursodeoxycholic Acid to the Endoscopic Treatment and Common Bile Duct Stenting for Large and Multiple Biliary Stones: Will it Improve the Outcomes?
Authors: Hormati Ahmad , Ghadir Mohammad Reza , Sarkeshikian Seyed Saeed , Alemi Faezeh , Moghaddam Majid , Ahmadpour Sajjad , Mohammadbeigi Abolfazl , Sivandzadeh Gholam Reza
Published: September 2020

Background and Objectives: The role of common bile duct (CBD) stenting in the establishment of bile stream in the elderly patients and the ones who are not good candidates for surgery due to not responding to treatments was well documented in previous studies. The current study aimed at investigating the effect of adding Ursodeoxycholic acid (UDCA) to CBD stenting alone in order to reduce the size or number of large and multiple CBD stones.Materials and Methods: Clinical outcomes including success rates in CBD stones clearance, incidence of pancreatitis, perforation, bleeding, as well as, decrease in size and number of stones and liver enzymes after a two-month period were assessed in the UDCA + CBD stenting group.Results: A total of 64 patients referring to Shahid Beheshti University Hospital in Qom, Iran with multiple or large CBD stones (above three or larger than 15 mm) received standard endoscopic therapies and UCDA + CBD stenting (group A) and controls only received standard endoscopic therapies + CBD stenting (group B). The mean reduction in the size of stones in group A was significantly higher than that of group B (3.22 ± 1.31 vs 4.09 ± 1.87 mm) (p =0.034). There was no difference in the incidence rate of complications including pancreatitis, cholangitis, bleeding, and perforation between the two groups (P >0.05).Conclusion: Adding UDCA to CBD stenting, due to decrease in the stone size and subsequently facilitation of the stones outlet, can be considered as the first-line treatment for patients with large and multiple CBD stones. Also, in the cases with large or multi stones may be effective in reducing size and subsequently stone retrieval. Trial registration number:The study protocol was approved by the Ethics Committee of Qom University of Medical Sciences (ethical code: IR.MUQ.REC.1397.075); the study was also registered in the Iranian Registry of Clinical Trials (No. IRCT20161205031252N8). This study adheres to CONSORT guidelines.
Over 65% sunlight absorption in a 1 μm Si slab with hyperuniform texture
Authors: Tavakoli Nasim , Spalding Richard , Koppejan Pepijn , Gkantzounis Georgio , Wang Chenglong , Röhrich Ruslan , Kontoleta Evgenia , Koenderink A. Femius , Sapienza Riccardo , Florescu Marian , Alarcon-Llado Esther
Published: September 2020

Thin, flexible and invisible solar cells will be an ubiquitous technology in the near future. Ultrathin crystalline silicon (c-Si) cells capitalise on the success of bulk silicon cells while being light-weight and mechanically flexible, but suffer from poor absorption and efficiency. Here we present a new family of surface texturing, based on correlated disordered hyperuniform patterns, capable of efficiently coupling the incident spectrum into the silicon slab optical modes. We experimentally demonstrate 66.5% solar light absorption in free-standing 1 µm c-Si layers by hyperuniform nanostructuring. The absorption equivalent photocurrent derived from our measurements is 26.3 mA/cm2, which is far above the highest found in literature for Si of similar thickness. Considering state-of-the-art Si PV technologies, the enhanced light trapping translates to a record efficiency above 15%. The light absorption can potentially be increased up to 33.8 mA/cm2 by incorporating a back-reflector and improved anti-reflection, for which we estimate a photovoltaic efficiency above 21% for 1 µm thick Si cells.
Efficacy and safety of Misoprostol vaginal insert to induce labor beyond 40 + 0 weeks of gestation
Authors: Krause Catharina , Rudlowski Christian , Erices-Leclercq Melanie , Tenckhoff David , Lubig Sabine
Published: September 2020

IntroductionOne of the most common reasons for inducing labor are pregnancies beyond 40 + 0 weeks. Prostaglandins have been proven to induce labor whilst not increasing the rate of caesarean delivery. As a vaginal insert Misoprostol was available in Germany from 2014 to 2019. Studies show that Misoprostol vaginal insert (MVI) reduces induction to delivery time as well as active labor time. But it is also known to increase uterine tachysystole. This study aimed to clarify whether MVI is safe and efficient for women with pregnancies past 40 + 0 to 42 + 0 weeks since there is a lack of studies focussing on this particular group of women.MethodsThis single centre prospective cohort study was performed between December 2014 and September 2019 at a tertiary academic centre at the Presbyterian Hospital Bergisch Gladbach, Germany. A total of 304 women between 40 + 0 to 42 + 0 weeks of gestation have been induced to labor with MVI. MVI was placed in the posterior vaginal fornix to release to release 200 μg synthetic prostaglandin E1 in a controlled manner. Time from insertion of MVI to delivery was documented for each patient. In addition, we recorded all kinds of intervention, CTG alterations and fetal outcome. We recorded mode of delivery, the need of epidural anaesthesia as well as the rate of tocolysis to treat signs of fetal distress due to pathological heart rates. And thirdly we had an interest in fetal outcome reflected by cord blood pH-levels or admission to a neonatal clinic.Results75.7 % (n = 230) of women gave birth within 24 hours which means time from insertion to delivery. After MVI insertion 72.2 % (n = 140) nulliparous women and 81.8 % (n = 90) multiparous women gave birth within 24 hours. Subgroup analyses revealed that within 24 hours after removal of MVI 259 women out of 304 (85.2 %) delivered their babies. 67.8 % (n = 206) of women induced with MVI delivered vaginal. ConclusionMVI is an efficient and safe method to induce labor for women with pregnancies beyond 40 + 0 weeks. ISRCTN No. 14702259 date of registration: 21.08.2020URL: http://www.isrctn.com/ISRCTN14702259
Unexpected changes in learned task contingencies trigger sharp wave ripples in the primate hippocampus during virtual navigation
Authors: McIntosh Mary , Corrigan Benjamin , Gulli Roberto , Doucet Guillaume , Martinez-Trujillo Julio , Levy Ron
Published: September 2020

The hippocampi and mesial temporal lobes play a central role in episodic memory and associative learning. It is unclear how unexpected experience influences learning. Hippocampal sharp wave ripples (SWR) are an electrical biomarker of memory consolidation. We tracked when and where SWR occur during 2 tasks. Local field potentials were recorded in the hippocampi, entorhinal cortices and amygdalae of non-human primates (NHP; n=3) performing reversal and associative learning tasks in a 3D virtual environment. Our results show hippocampal SWR occurred when learned task contingencies were unexpectedly altered. Surprise rewards and reward denial were associated with SWR rates 9.8x and 8.0x greater than expected rewards. The highest density of SWR occurred in zones where errors were made. SWR were preceded by event-related potentials in the amygdala but not entorhinal cortex. Our results suggest that SWR generation in primates may prioritize behaviourally relevant experience for commitment to memory to allow flexible learning.
Exploring the breastfeeding knowledge level of pregnant women with gestational diabetes mellitus and its influencing factors
Authors: Wang Yan , You Hua-xuan , Luo Bi-ru
Published: September 2020

Background
Studies revealed that promoting the breastfeeding knowledge level help to improve breastfeeding behaviors. Promoting breastfeeding knowledge was a simple and economical way to increase breastfeeding rates. However, there were no studies focus on the level of breastfeeding knowledge and its influencing factors in GDM women. Thus, the objective of this study was to investigate the breastfeeding knowledge level of GDM pregnant women and explore its influence factors.
Methods
Cross-sectional survey and convenience sampling was conducted in this study. The sociodemographic characteristics, caregivers in pregnancy, knowledge source, breastfeeding status and breast status information of participants were collected. Breastfeeding Knowledge Scale was used to assess the breastfeeding knowledge level of pregnant women with GDM. Multiple linear regression was used to analyze the influence factors of breastfeeding knowledge level in this study.
Results
A total of 226 questionnaires were issued and finally 212 valid questionnaires were collected. Some misconceptions still existed (e.g. ’breastfeeding cannot prevent your baby from being overweight’ and ‘it is advisable to breastfeed 3–4 times per day within 2–3 days after delivery’), although women with GDM had a good score of breastfeeding knowledge (mean score: 103.5 ± 10.4). Multiple linear regression analysis found that gestational age, family per capita monthly income, educational level, knowledge source were the independent protective factors for breastfeeding knowledge and minority nationality was the independent risk factor. The educational level had the greatest influence on the breastfeeding knowledge level of GDM pregnant women (β = 0.210, t = 2.978, P = 0.003).
Conclusion
GDM pregnant women with insufficient gestational age, low educational level, low family per capita monthly income and single access to knowledge should be included in the focus of health education on breastfeeding. In-depth and systematic health education should be conducted for pregnant women with GDM to improve their breastfeeding rate.
Serum lnc34a is a Potential Prediction Biomarker for Bone Metastasis in Hepatocellular Carcinoma Patients
Authors: Zhang Li , Niu Hao , Yang Ping , Ma Jie , Yuan Bao-Ying , Zeng Zhao-Chong , Xiang Zuo-Lin
Published: September 2020

BackgroundEarly screening and intervention therapies are crucial to improve the prognosis of hepatocellular carcinoma (HCC) patients with bone metastasis. We aimed to identify serum lncRNA as a prediction biomarker in HCC bone metastasis.MethodsThe expression levels of lnc34a in serum samples from 157 HCC patients were detected by quantitative real-time PCR. Univariate analysis and multivariate analysis were performed to determine statistically significant variables.ResultsExpression levels of lnc34a in serum from HCC patients with bone metastasis were significantly higher than those without bone metastasis. And high expression of lnc34a, vascular invasion and BCLC stage were associated with bone metastasis by analysis. Moreover, lnc34a expression was specifically associated with bone metastasis rather than lung or lymph node metastasis in HCC.Conclusions﻿High serum lnc34a expression was a independent risk factor for developing bone metastasis in HCC.
A Modified Lung Ultrasound Score for Assessing Oxygenation Status and Predicting the Need for Invasive Ventilation in Preterm Neonates with RDS
Authors: Szymański Piotr , Kruczek Piotr , Hożejowski Roman , Wais Piotr
Published: September 2020

PurposeWe propose a modified lung ultrasound score (LUS) in neonates with respiratory distress syndrome (RDS), which includes posterior instead of lateral lung fields, and a 5-grade rating scale instead of a 4-grade rating scale. The LUS was evaluated for validity, interrater agreement and prognostic power in relation to the need for respiratory support on day of life (DOL) 3. The hypothesis of the dominant weight of posterior scans in the LUS was also verified.Materials and methodsA total of 647 serial lung scans were performed in 70 preterm infants <32 weeks gestation and birth weight <1500 g. Assessments were performed within 24 hours of birth (LUS0) and on days 2, 3, 5, 7, 10, 14, 21 and 28. LUS was correlated to oxygen saturation over fraction of inspired oxygen (SpO2/FiO2) and mode of respiratory support. Probabilities of the need for respiratory support on DOL 3 were assessed with ordinal logistic regression.ResultsThe LUS correlated significantly with SpO2/FiO2 (Spearman rho = -0.635; p<0.0001) and had excellent interrater agreement (Cronbach’s alpha = 0.99). Posterior fields had dominant weight over the anterior fields (ls mean [confidence level]) 4.0 [3.8–4.1] vs 2.2 [2.0–2.4]; p<0.0001. Significant predictors of ventilation requirements on DOL 3 were LUS0 (p<0.016) and birth weight (BW) (p<0.0001); invasive ventilation was the most likely option with LUS0 ≥7 (BW 900 g), ≥10 (BW 1050 g) and ≥15 (BW 1280 g).Conclusion﻿Postbirth LUS predicts the need for mechanical ventilation on DOL 3. Posterior fields play a dominant role in sonographic assessment of lungs in neonatal RDS.
Clinical Aspects for Recognitions of Kawasaki Disease Shock Syndrome in The COVID-19 Pandemic Era: A Case Control Study
Authors: Park Woo Young , Lee Sang-Yun , Kim Gi Beom , Song Mi Kyoung , Kwon Hye Won , Bae Eun Jung , Choi Eunhwa , Park June Dong
Published: September 2020

Background As the COVID-19 pandemic continues, there have been reports of sudden increase of multi-system inflammatory syndrome in children (MIS-C) that shares clinical features with Kawasaki disease (KD). Recognition of sudden increase of severe Kawasaki-like disease is alarming the differential diagnosis of KD, Kawasaki disease shock syndrome (KDSS), septic shock, and toxic shock syndrome (TSS). To help clinicians distinguish KD, KDSS, septic shock, and TSS earlier, we suggest differential diagnosis and treatment guideline.Methods Medical records of immunocompetent patients who were admitted to the pediatric department with a diagnosis of KDSS, septic shock or TSS (SS group) were retrospectively reviewed. In addition, KD patients were selected by seasonal matching to each case of KDSS patient by date of admission (± 2 weeks).Results There were 13 patients with KDSS, 35 patients with SS group, and 93 patients with KD. In comparison between KDSS and septic shock group, KDSS group had significantly higher rate of higher incidence of coronary aneurysm, and higher left ventricle dysfunction rate. In comparison between KDSS and TSS, patients with KDSS had a significantly higher erythrocyte sedimentation rate (ESR) and significantly lower Creatinine. Receiver operation characteristic curve revealed that the optimal ESR cut off value for determining the KDSS was 56.0 (sensitivity 75.0%, specificity of 100.0%) and the optimal Creatinine cut off value for determining the TSS was 0.695 (sensitivity 76.9%, specificity 84.6%)Conclusions Clinical symptoms, laboratory finding, echocardiography, and culture studies can be used to differentiate KD, KDSS, septic shock, TSS and MIS-C.
Fermi Blockade of the Electron-phonon Interaction: Why Strong Coupling Effects May Not Be Seen in Optimally Doped High Temperature Superconductors
Authors: Mishchenko Andrey , Nagaosa Naoto , Prokof'ev Nikolay
Published: September 2020

We study how manifestations of strong electron-phonon interaction (EPI) depend on the carrier concentration by solving the two-dimensional Holstein model for the spin-polarized fermions using an approximation free bold-line diagrammatic Monte Carlo (BDMC) method. We show that the strong EPI, obviously present at very small Fermion concentration, is masked by the Fermi blockade effects and Migdal's theorem to the extent that it manifests itself as moderate one at large carriers densities. Suppression of strong EPI fingerprints is in agreement with experimental observations in doped high temperature superconductors.
Exploring Entrepreneurial Culture and Its Socio-Cultural Determinants: In Case of Woldia University Graduating Students
Authors: Engidaw Abriham Ebabu
Published: September 2020

The purpose of this study was exploring entrepreneurial culture and its determinants: in the case area’s University graduating students. To achieve its objectives, the study employed a descriptive and explanatory research design and in the study cross-sectional study was conducted through mixed research method. The target population of the study was 223 first degree regular 2018 University graduating students of management department and their instructors in the study area. And sample size was 143 respondents. The study result showed that majority of respondents did not plan to start their own knowledge based business. This was essentially due to lack of competence in transforming ideas in to practice and commercializing it to create their own business. Correspondingly, prodigious attention should be given to have an entrepreneurial orientation in the contents and methods of teaching at all levels of education systems primary, secondary and higher educational institutions and use different awareness raising mechanisms.
Organic Complementary Inverters Based on Vertical-Channel Dual-Base Thin-Film Transistors with Time Constants < 10ns
Authors: Wu Zhongbin , Guo Erjuan , Xing Shen , Dollinger Felix , Hübner René , Wang Shu-Jen , Leo Karl , Kleemann Hans
Published: September 2020

Lateral-channel dual-gate organic thin-film transistors (OTFTs) are utilized in organic pseudo-CMOS inverters to realize switching voltage control. However, the relatively long channel length will slow the inverter operation. Vertical-channel dual-gate OTFTs are an attractive alternative due to the short channel length. In this work, controllable and reliable complementary inverters are presented using vertical n-channel organic permeable dual-base transistors (OPDBTs) and vertical p-channel organic permeable base transistors (OPBTs). With operating voltages < 2.0 V, the threshold voltages of the n-type OPDBTs are changed across a wide range from 0.12 to 0.82 V by varying the voltage of the additional base. The fabricated tunable organic complementary inverter features switching voltage shift and gain enhancement. In addition, the inverters show very small switching time constants (< 10 ns) at 10 MHz. Our work represents a significant step towards the application of vertical dual-gate/base transistors in power-efficient organic complementary inverters, offering the capability to easily tune the switching voltage of organic complementary inverters. This facilitates the development of high-performance and complex organic digital integrated circuits.
Phosphorous and Nitrogen Dual-Doped Carbon as a Highly Efficient Electrocatalyst for Sodium-Oxygen Batteries
Authors: Guo Haipeng , Zheng Zhi , Shu Chaozhu , Hu Zhe , Gebert Florian , Gu Qinfen , Konstantinov Konstantin , Chou Shulei , Liu Huakun , Wang Jiazhao
Published: September 2020

Sodium-oxygen batteries have been regarded as promising energy storage devices due to their low overpotential and high energy density. Its applications, however, still face formidable challenges due to the lack of understanding about the influence of electrocatalysts on discharge products. Here, a phosphorous and nitrogen dual-doped carbon (PNDC) based cathode is synthesized to increase the electrocatalytic activity and to stabilize the NaO2 nanoparticle discharge products, leading to enhanced cycling stability when compared with the nitrogen-doped carbon (NDC). The PNDC air cathode exhibits a quite low overpotential (0.36 V) and long cycling stability for 120 cycles. The reversible formation/decomposition and stabilize ability of NaO2 discharge products are clearly proven by in-situ synchrotron X-ray diffraction and ex-situ X-ray diffraction. Based on the density functional theory calculation, the PNDC has much stronger adsorption energy (-2.85 eV) for NaO2 than that of NDC (-1.80 eV), which could efficiently stabilize the NaO2 discharge products.
HIV Prevalence and Sexual Behaviour Risk Among Male Regular Partners of Female Sex Workers. A Mixed- Methods Study at a Peri-urban Clinic in Kampala, Uganda
Authors: Namale Gertrude , Kamacooko Onesmus , Kawuma Rachel , Bagiire Daniel , Mayanja Yunia , Ssali Agnes , Kiwanuka Thadeus , Mbonye Martin , Seeley Janet
Published: September 2020

Background: In Uganda, female sex workers (FSWs) and their male partners are estimated to contribute 16% to new HIV infections. We assessed HIV prevalence and associated sexual behaviour risk among male regular partners of FSWs attending a peri-urban clinic in Kampala, Uganda.Methods: Between June 2012 - June 2017, we conducted a mixed methods cross-sectional study among male regular partners (aged ≥18 years old) of FSWs. The men were enrolled through FSWs attending a routine three monthly visit at a research clinic. Eligible and interested men were consented and counselled for parallel rapid HIV testing (Determine, Statpak, Unigold) on a serum sample. HIV-positive men were assessed and enrolled into HIV care and 3 monthly follow up. Data on socio-demographic, sexual behaviour (sexual relationships, condom and alcohol use), and clinical characteristics were collected. Multivariable logistic regression was used to identify factors associated with HIV sero-positivity. In-depth interviews were conducted to elicit information on participants’ knowledge of HIV and its prevention as well as sexual risk practices. Qualitative data was analysed using NVIVO 12.0 following thematic approach.Results: One hundred and sixty-two men were included in the analysis; mean age was 35 years old (SD± 8.43). The overall HIV sero-positivity was 65/162 (40%), of these 57/65 (88%) men were initiated on ART from the clinic. Ninety percent had no signs of sexually transmitted infections (STI), 119/162 (73%) reported not using a condom during last sexual intercourse. At adjusted analysis, HIV sero-positivity was less likely among men with no STI (aOR= 0.21; 95% CI: 0.06-0.70) and using a condom during last sexual intercourse (aOR = 0.39 (95% CI: 0.18-0.85). HIV sero-positivity was more likely among uncircumcised men (aOR=3.10; 95%CI: 1.49-6.45), those with multiple sexual relationships (two or more sexual partners] (aOR= 3.45; 95% CI: 1.59-7.51). Qualitative findings highlight that most participants were not consistently using condoms with FSWs; the main reason given was that they “trusted” their steady FSWs.Conclusions: HIV prevalence among male regular partners was associated with high risk sexual behaviour. Interventions targeting FSWs should be extended to their male regular partners, to enable their access to HIV care and support.
Identification of Susceptibility Loci for Cardiovascular Disease in Adults With Hypertension, Diabetes and Dyslipidemia 
Authors: Song Youhyun , Choi Ja-Eun , Kwon Yu-Jin , Chang Hyuk-Jae , Kim Jung Oh , Park Da-Hyun , Park Jae-Min , Kim Seong-Jin , Lee Ji Won , Hong Kyung-Won
Published: September 2020

Background: Hypertension (HTN), diabetes mellitus (DM), and dyslipidemia (DL) are well-known risk factors of cardiovascular disease (CVD), but not all patients develop CVDs. Studies have been limited investigating genetic risk of CVDs specific to individuals with metabolic diseases. This study aimed to identify disease-specific and/or common genetic loci associated with CVD susceptibility in chronic metabolic disease patients.Methods: We conducted a genome-wide association study (GWAS) of a multiple case-control design with data from the City Cohort within Health EXAminees subcohort of the Korean Genome and Epidemiology Study (KoGES_HEXA). KoGES_HEXA is a population-based prospective cohort of 173,357 urban Korean adults that had health examinations at medical centers. 42,393 participants (16,309 HTN; 5,314 DM; 20,770 DL) were analyzed, and each metabolic disease group was divided into three CVD case-controls: coronary artery disease (CAD), ischemic stroke (IS), and cardio-cerebrovascular disease (CCD). GWASs were conducted for each case-control group with 7,975,321 imputed single nucleotide polymorphisms using Phase 1/2 Asian panels from 1000 Genomes Project, by logistic regression and controlled for confounding variables. Genome-wide significant levels were implemented to identify important susceptibility loci.Results: Totaling 42,393 individuals, this study included 16,309 HTN (mean age [SD], 57.28 [7.45]; 816 CAD, 398 IS, and 1,185 CCD cases), 5,314 DM (57.79 [7.39]; 361 CAD, 153 IS, and 497 CCD cases), and 20,770 DL patients (55.34 [7.63]; 768 CAD, 295 IS, and 1,039 CCD cases). Six genome-wide significant CVD risk loci were identified, with relatively large effect sizes: 1 locus in HTN (HTN-CAD: 17q25.3/CBX8-CBX4 [OR, 2.607; P = 6.37 × 10−9]), 2 in DM (DM-IS: 4q32.3/MARCH1-LINC01207 [OR, 5.587; P = 1.34 × 10−8], and DM-CCD: 17q25.3/RPTOR [OR, 3.511; P = 1.99 × 10−8]), and 3 in DL (DL-CAD: 9q22.2/UNQ6494-LOC101927847 [OR, 2.282; P = 7.78 × 10−9], DL-IS: 3p22.1/ULK4 [OR, 2.162; P = 2.97 × 10−8], and DL-CCD: 2p22.2/CYP1B1-CYP1B1-AS1 [OR, 2.027; P = 4.24 × 10−8]).Conclusions: This study identified 6 susceptibility loci and positional candidate genes for CVDs in HTN, DM, and DL patients using an unprecedented study design. 1 locus (17q25.3) was commonly associated with CAD. These associations warrant validation in additional studies for potential therapeutic applications.
Important Dispersal Capacity of One Main Species Vector of Bluetongue and Schmallenberg Viruses Culicoides Obsoletus (Diptera: Ceratopogonidae) Revealed by Landscape Genetic Analyses 
Authors: Mignotte Antoine , Garros Claire , Dellicour Simon , Jacquot Maude , Gilbert Marius , Gardès Laetitia , Balenghien Thomas , Duhayon Maxime , Rakotoarivony Ignace , de Wavrechin Maïa , Huber Karine
Published: September 2020

Background: In the last two decades, recurrent epizootics of bluetongue virus and Schmallenberg virus have been reported in the western Palearctic region. These viruses affect domestic cattle, sheep, goats and wild ruminants and are transmitted by native hematophagous midges of the genus Culicoides (Diptera: Ceratopogonidae). Culicoides dispersal is known to be stratified, i.e. due to a combination of dispersal processes occurring actively at short distances and passively or semi-actively at long distances, allowing individuals to jump hundreds of kilometers. Methods: Here, we aim to identify the environmental factors that promote or limit gene flows of Culicoides obsoletus, an abundant and widespread vector species in Europe using an innovative framework integrating spatial, population genetics and statistical approaches. A total of 348 individuals were sampled in 46 sites in France and have been genotyped using 11 newly-designed microsatellite markers. Results: We found a low genetic differentiation and population structure for C. obsoletus across the country. Using three complementary inter-individual genetic distances, we did not detect any significant isolation-by-distance, but a significant anisotropic isolation-by-distance on a North-South axis. We have employed a multiple regression approach on distance matrices to investigate the correlation between genetic and environmental distances. Among all the environmental factors that have been tested, only cattle density seems to have an impact on C. obsoletus gene flow. Conclusions: Such a high dispersal capacity of C. obsoletus over land territories calls for a re-evaluation of the impact of Culicoides on virus dispersal and highlights the urgent need to better integrate molecular, spatial and statistical information to guide vector-borne diseases control.
Efficacy of a single oral dose artesunate plus sulfalene/pyrimethamine versus praziquantel in the treatment of Schistosoma mansoni in Kenyan children: randomised, exploratory, open-label trial
Authors: Muok Erick M.O , Were Vincent O. , Obonyo Charles O.
Published: September 2020

Background: The global control strategy for schistosomiasis is the periodic administration of praziquantel. Schistosomes have developed reduced susceptibility to praziquantel. Artemisinin-based drug combinations are promising alternatives to praziquantel, but it is unclear whether a single dose of an artemisinin-based drug combination is as effective and safe as praziquantel. We assessed the efficacy and safety of a single oral dose of artesunate plus sulfalene/pyrimethamine in the treatment of schistosomiasis. Methods: An exploratory, open-label randomized trial, was carried out in Rarieda sub-County, western Kenya to compare the efficacy of a single oral dose of artesunate plus sulfalene/pyrimethamine (12mg/kg of artesunate) to a standard single dose of praziquantel (40mg/kg) in the treatment of school children (aged 6 to 15 years) with S. mansoni infection. The primary outcomes were cure and egg reduction rates on day 28 after treatment in the per-protocol population.Results: A total of 73 S. mansoni infected children were included and randomized to receive either artesunate plus sulfalene/pyrimethamine (n=39) or praziquantel (n=34). 67 children completed the study. The cure rate was 69.4% (25/36) in the artesunate plus sulfalene/pyrimethamine group and 80.6% (25/31) in the praziquantel group (p=0.294). Egg reduction rates were 96.2% in the artesunate plus sulfalene/pyrimethamine group and 82.9% in the praziquantel group (p=0.339). Ten children treated with praziquantel developed adverse events compared with four in the artesunate plus sulfalene/pyrimethamine group. There was no serious adverse event. Conclusion: A single oral dose of artesunate plus sulfalene/pyrimethamine was safe and as efficacious as praziquantel in the treatment of S. mansoni in Kenyan children. These results should be confirmed in larger randomized controlled trials. Combination treatment with praziquantel plus artemisinin-based combination therapies may be a potential alternative for improving praziquantel efficacy and transmission control. Trial Registration: ClinicalTrials.gov, number NCT01054651.
Mortality, Severity, and Hospital Admission Among COVID-19 Patients with ACEI/ARB Use: A Meta-analysis Stratifying Countries Based on Response to the First Wave of the Pandemic
Authors: Alamer Ahmad , Almulhim Abdulaziz , Alrashed Ahmed , Abraham Ivo
Published: September 2020

BackgroundThe use of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) is controversial for treating COVID-19 patients. We aimed to estimate pooled risks of mortality, disease severity, and hospitalization associated with ACEI/ARB use and stratify them by country and country clusters. MethodsWe conducted a search in various databases through 7/4/2020 and then applied random-effects models to estimate pooled risks (ORp) across stratifications by country cluster. Clusters were chosen to reflect outbreak times (China followed by Korea/Italy, others subsequently) and mobility restrictions (China and Denmark/France/Spain with stricter lockdowns than the UK/US). ResultsOverall analysis showed no increase in mortality; however, a statistical increase in mortality was seen in the US/UK cluster with ORp=1.28[95%CI=1.04; 1.56] and a decrease in China with ORp=0.65[95%CI=0.43; 0.96] and France with OR=0.31[95%CI=0.14; 0.69]. Severity and hospitalization were not statistically significant in the analysis; however, several associations were seen in specific countries but not in country clusters. ConclusionThe country-cluster meta-analysis provided a reasonable explanation for COVID-19 mortality among ACEI/ARB users. The analysis did not explain differences in severity and suggested the involvement of other factors. Hospitalization findings may be considered informative as they may have been subjected to clinical decisions and hospital-bed availability.
Review of Type III Non-Hereditary Angioedema Patients in Manitoba.
Authors: Hinther Kelsey , Kalicinsky Chrystyna
Published: September 2020

Introduction: Non-hereditary angioedema with normal C1 esterase inhibitor level and function (NHAE-nC1INH) is a novel entity. The diagnosis of NHAE-nC1INH requires a high index of suspicion, given that there are no laboratory tests to confirm the diagnosis. There is limited evidence on the treatment efficacy for short- and long-term prophylaxis, and acute attacks. The aim of the study is to describe a cohort of NHAE-nC1INH in Manitoba, including an estimate of prevalence, as well as to analyze the response to plasma derived C1esterase inhibitor (pdC1INH), and a bradykinin-2 receptor antagonist (Icatibant).Methods: A retrospective chart review of patients diagnosed with normal C1 esterase level and function angioedema seen at the Clinical Immunology and Allergy Clinic at the Health Sciences Centre in Winnipeg, Manitoba, was done. Inclusion criteria included the following: (1) Reside within Manitoba (2) Aged 18 years and older (3) Angioedema without urticaria (4) Normal C1-INH antigenic level and function (5) No symptom resolution with antihistamines, epinephrine or corticosteroids. (6) No family history. Five patients were included in the study who met the above inclusion criteria. The five patients charts were reviewed. Response to pdC1INH and Icatibant were defined as time to improvement of angioedema symptoms.Results: Four out of five patients had an effective response to pdC1INH for prophylactic treatment and for on-demand treatment for angioedema episodes. pdC1INH was ineffective in 1 patient for prophylaxis and on-demand treatment; tranexamic acid was successful for prophylactic treatment in 1 patient who did not respond to pdC1INH for prophylaxis and for on-demand treatment. 3 of 5 patients have tried Icatibant. All three patients were not responsive to Icatibant.Conclusion: This study suggests that pdC1INH may be an efficacious treatment option for NHAE-nC1INH patients. Larger studies are required to better elucidate the effectiveness of on-demand and prophylactic treatment for NHAE-nC1INH.
Switching First-Line Targeted Therapy After Not Reaching Low Disease Activity Within Six Months is Superior to Conservative Approach: A Propensity Score Matched Analysis From The ATTRA Registry
Authors: Nekvindova Lucie , Vencovský Jiří , Pavelka Karel , Horák Pavel , Křístková Zlatuše , Závada Jakub
Published: September 2020

Background: Treat-to-target (T2T) is a widely accepted strategy for patients with rheumatoid arthritis (RA). It recommends attaining a goal of at least low disease activity (LDA) within six months; otherwise, the current therapy should be modified. We aimed to investigate whether switching a first-line targeted therapy (TT) in patients not reaching LDA within six months leads to a higher probability of meeting LDA at 12‑month visit in daily clinical practice using data from Czech registry ATTRA.Methods: We included patients with RA starting the first-line TT from 1 January 2012 to 31 January 2017 with at least one-year follow-up. We created four mutually exclusive cohorts based on 1) switching to another TT within the first year and 2) reaching a treatment target (DAS28-ESR ≤ 3.2) at the 6‑month visit. The primary outcome was the comparison of odds for reaching remission (REM) or LDA at the 12-month visit between patients switching and not switching TT after not reaching treatment target at six months. Before using logistic regression to estimate the odds ratio, we employed the propensity score to match patients at the 6-month visit.Results: A total of 1275 patients were eligible for the analysis. Sixty-two patients switched within the first five months of the treatment before evaluating treatment response at the 6-month visit (C1); 598 patients reached the treatment target within six months of therapy (C2); 124 patients did not reach treatment response at 6-month visit and switched to another therapy (C3), and 491 patients continued with the same treatment despite not reaching LDA at the 6‑month visit (C4). We matched 75 patients from cohort C3 and 75 patients from C4 using the propensity score. Patients following T2T principle (C3) showed 2.8 (95% CI 1.4–5.8; p=0.005) times increased likelihood of achieving REM/LDA at 12‑month visit compared to patients not following T2T strategy (C4).Conclusions: In daily clinical practice, the application of T2T strategy is underused. Switching TT after not reaching REM/LDA within the first six months leads to a higher probability of achieving REM/LDA in RA patients at the 12-month visit.
Identification of a Novel Nonsense Homozygous Mutation of LINS1 Gene in Two Sisters With Moderate Intellectual Disability, Schizophrenia, and Anxiety Disorders and Review of the Literature
Authors: Chen Chia-Hsiang , Huang Yu-Shu , Fang Ting-Hsuan
Published: September 2020

Background: The human LINS1 gene is located at 15q26.3 and encodes the lines homolog 1 protein that contains the Drosophila lines homologous domain. Mutations in the LINS1 gene have been reported to cause a rare recessive form of intellectual disability. A total of seven mutations in six studies have been reported in the literature to our knowledge. Results: Using whole genome sequencing analysis, we identified a novel homozygous nonsense mutation in the LINS1 gene in these two sisters who presented moderate intellectual disability, schizophrenia symptoms, and severe anxiety. The mutation was a C-to-T substitution at the cDNA nucleotide position 274 that changed the amino acid glutamine at the codon 92 to stop codon (Gln92X), resulting in the truncation of LINS1 protein after amino acid 91. This mutation was transmitted from their unrelated parents who were heterozygous carriers. Conclusions: Our findings not only add to the allelic heterogeneity of the LINS1-associated intellectual disability but also expand the spectrum of clinical phenotypes of patients with LINS1 mutations. Our study suggests that the human LINS1 gene mutation may play a role in the pathogenesis of psychosis and anxiety in addition to the intellectual disability.
Effect of porcine immature oocyte vitrification on oocyte-cumulus cell gap junctional intercellular communication.
Authors: Casillas Fahiel , Ducolomb Yvonne , López Alma , Betancourt Miguel
Published: September 2020

Vitrification may severely affect cumulus cells and oocyte morphology and viability, limiting their maturation and developmental potential. The aim of this study was to evaluate the gap junction intercellular communication (GJIC) integrity after the vitrification of porcine immature cumulus-oocyte complexes (COCs). Fresh COCs were randomly distributed in two groups: untreated (control) and vitrified (vitrification), then subjected to in vitro maturation (IVM). Oocyte viability and IVM were measured in both groups. The evaluation of GJIC was expressed as relative fluorescence intensity (RFI). Vitrification significantly decreased oocyte viability and maturation after 44 h of culture compared to control. Also, significantly reduced RFI was observed in vitrified COCs at 4 and 8 h of culture compared to control. This study demonstrates that porcine oocyte viability and maturation after 44 h of culture were compromised after vitrification. GJIC was also affected after the vitrification of GV oocytes, being the possible mechanism by which oocyte maturation decreased.