bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and correlates of transactional sex among women of low socioeconomic status in Portland, Oregon
Authors: Menza Timothy W , Lipira Lauren , Bhattarai Amisha , Cali-DeLeon Victoria , Orellana Roberto
Published: October 2020

Background: Women who report transactional sex are at increased risk for HIV and other sexually transmitted infections (STIs). However, in the United States, social, behavioral, and trauma-related vulnerabilities associated with transactional sex are understudied and data on access to biomedical HIV prevention among women who report transactional sex are limited. Methods: In 2016, we conducted a population-based, cross-sectional survey of women of low socioeconomic status recruited via respondent-driven sampling in Portland, Oregon. We calculated the prevalence and, assessed the correlates of, transactional sex using generalized linear models accounting for sampling design. We also compared health outcomes, HIV screening, and knowledge and uptake of HIV pre-exposure prophylaxis (PrEP) between women who did and did not report transactional sex. Results: Of 334 women, 13.6% reported transactional sex (95% confidence interval [CI]: 6.8%, 20.5%). Women who reported transactional sex were older, more likely to identify as black, to identify as lesbian or bisexual, to experience childhood trauma and recent sexual violence, and to have been homeless. Six percent (95%CI: 1.8%, 10.5%) of women with no adverse childhood experiences (ACEs) reported transactional sex compared to 23.8% (95%CI: 13.0%, 34.6%) of women who reported eleven ACEs ( P <0.001). Transactional sex was strongly associated with combination methamphetamine and opiate use as well as condomless sex. Women who reported transactional sex were more likely to report being diagnosed with a bacterial STI and hepatitis C; however, HIV screening and pre-exposure prophylaxis knowledge and use were low. Conclusions: In a sample of women of low socioeconomic status in Portland, Oregon, transactional sex was characterized by marginalized identities, homelessness, childhood trauma, sexual violence, substance use, and sexual vulnerability to HIV/STI. Multi-level interventions that address these social, behavioral, and trauma-related factors and increase access to biomedical HIV prevention are critical to the sexual health of women who engage in transactional sex.
Global trends of antimicrobial susceptibility of ceftaroline and ceftazidime-avibactam: a surveillance study from the ATLAS program (2012-2016)
Authors: Zhang Hui , Xu Yingchun , Jia Peiyao , Zhu Ying , Zhang Ge , Zhang Jingjia , Duan Simeng , Kang Wei , Wang Tong , Jing Ran , Cheng Jingwei , Liu Yali , Yang Qiwen
Published: October 2020

Background:This study reports the global trends of antimicrobial susceptibility toceftaroline and ceftazidime-avibactam using data from the Antimicrobial Testing Leadership And Surveillance (ATLAS)programbetween2012and2016.Methods:For the 2012-2016 ATLAS program, 205 medical centers located in Africa-Middle East (n=12), Asia-Pacific (n=32), Europe (n=94), Latin America (n=26), North America (n=31), and Oceania (n=10) consecutively collected the clinical isolates. Theminimum inhibitory concentrations (MICs) andin vitro susceptibilities toceftarolineandceftazidime-avibactam were assessed using the Clinical andLaboratory Standards Institute (CLSI) 2019and European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2019 guidelines.Results:Between 2012 and 2016, 176,345 isolates were collectedfrom around the globeand included in theanalysis.Regarding Gram-negative bacteria, ceftazidime-avibactam demonstrated high susceptibility (>90%) against EnterobacteriaceaeandPseudomonas aeruginosa, with increasedantimicrobial activity observed from the addition of avibactam (4 mg/L) to ceftazidime.Regarding Gram-positive bacteria, ceftaroline showed >90% susceptibility againstStaphylococcus aureus, Streptococcus pneumoniae, α-and β-hemolytic Streptococcus.The antimicrobial susceptibilitiestoceftaroline and ceftazidime-avibactam were mostly stable from 2012 to 2016, but the susceptibilitiestoceftazidime-avibactam to carbapenem-resistant (CR)Klebsiella pneumoniae(88.4% to 81.6%) and to CR-Pseudomonas aeruginosa(89.6% to 72.7%) decreased over time. In terms of regional difference, the susceptibilities of methicillin-resistant Staphylococcus aureusto ceftaroline in Asia and of CR-Klebsiella pneumoniaeto ceftazidime-avibactam in Asia/Africa-Middle East were lowercompared with other regions,while the susceptibility of CR-Pseudomonas aeruginosa to ceftazidime-avibactam in North America was higher.Conclusion: The addition of avibactam improves the activity of ceftazidime against EnterobacteriaceaeandPseudomonas aeruginosa. The global antimicrobial susceptibilitiestoceftaroline and ceftazidime-avibactam were, in general, stable from 2012 to 2016, but a marked reduction in the susceptibilities of specific species andCR-Pseudomonas aeruginosa toceftazidime-avibactam was observed.
The inhibitory effect of curcumin via fascin suppression through JAK/STAT3 pathway on metastasis and recurrence of ovary cancer cells.
Authors: Kim Mi Ju
Published: October 2020

Background

fascin is an actin-binding protein and highly expressed in ovarian cancer cells. It is associated with metastasis of cancer and may be a useful prognostic factor. Anticancer activity of curcumin is related to its effect on several signaling mechanisms. Although there have been many reports regarding the anticancer properties of curcumin, its inhibitory effects on migration and invasion of ovarian cancer cells, particularly in the context of fascin expression, have not been reported. The purpose of this study was to investigate the effect of curcumin on fascin expression in ovarian cancer cells and to propose a possible mechanism for the anticancer activity of curcumin through reduced fascin expression.

Methods

SKOV3, human epithelial ovary cancer cell line, was cultured with curcumin at various dose and duration. The fascin was quantified using cell viability test and Western blot. To determine the effect of curcumin on the upstream pathway of fascin expression, the signal transducer and activator of transcription 3 (STAT3) was analyzed by sandwich-ELISA. Attachment assay, migration assay and invasion assay were analyzed to approve the change of cellular invasiveness of ovary cancer after curcumin. To determine the morphological changes of ovarian cancer cells by curcumin, immunofluorescence was performed.

Results

MTS assays showed that cell viability was different at various concentration of curcumin, and as concentration increased, cell viability tended to decrease. Curcumin appears to suppress fascin expression, even with a minimal concentration and short exposure time. Also, curcumin may suppress fascin expression in ovarian cancer cells through STAT3 downregulation. The attachment assay, migration assay and invasion assay of the ovarian cancer cells exhibited a statistically significant decrease. Immunofluorescence revealed a change of cell shape from a typical form of uninfluenced cells to a more polygonal appearance, with a significant reduction in filopodia formation.

Conclusions

Curcumin reduces fascin expression through JAK/STAT3 pathway inhibition, which interferes with the cellular interactions essential for the metastasis and recurrence of ovarian cancer cells. Higher curcumin concentrations and longer exposure times concomitantly decreased fascin expression.
Long noncoding RNA UPK1A-AS1 indicates poor prognosis of hepatocellular carcinoma and promotes cell proliferation through interacting with EZH2
Authors: Zhang Dong-Yan , Sun Qing-Can , Zou Xue-Jing , Song Yang , Li Wen-Wen , Guo Ze-Qin , Liu Shan-Shan , Liu Li , Wu De-Hua
Published: October 2020

Background: Dysregulations of lncRNA are responsible for cancer initiation and development, positioning lncRNAs as not only biomarkers but also promising therapeutic targets for cancer treatment. Growing number of lncRNAs have been reported in HCC but their functional and mechanistic roles remain unclear. Methods: Gene Set Enrichment Analysis was used to investigate the molecular mechanism of lncRNA UPK1A antisense RNA 1 (UPK1A-AS1). CCK-8 assay, EdU assay, flow cytometry, western blot, and xenograft assay were used to confirm the role of UPK1A-AS1 in the proliferation of HCC cells both in vitro and in vivo. Bioinformatics analysis and qRT-PCR were performed to explore the interplay between UPK1A-AS1 and Enhancer of Zeste Homologue 2 (EZH2). RNA immunoprecipitation (RIP), RNA-pull down assay, western blot, qRT-PCR, and were conducted to confirm the interaction between UPK1A-AS1 and EZH2. The interaction between UPK1A-AS1 and miR-138-5p was examined by luciferase reporter and RIP assays. Finally, the expression level and prognosis value of UPK1A-AS1 in HCC were analyzed using RNA-seq data from TCGA datasets.Results: We showed that UPK1A-AS1, a newly identified lncRNA, promoted cellular proliferation and tumor growth by accelerating cell cycle progression. Cell cycle related genes including CCND1, CDK2, CDK4, CCNB1 and CCNB2 were significantly upregulated in HCC cells with UPK1A-AS1 overexpression. Furthermore, overexpression of UPK1A-AS1 could protect HCC cells from cis-platinum toxicity. Mechanistically, UPK1A-AS1 interacted with EZH2 to mediate its nuclear translocation and reinforce its binding to SUZ12, leading to the increasing trimethylation of H27K3. Targeting EZH2 with specific siRNA impaired UPK1A-AS1-mediated upregulation of proliferation and cell cycle progression related genes. Moreover, miR-138-5p was identified as a direct target of UPK1A-AS1. Additionally, UPK1A-AS1 was significantly upregulated in HCC, and upregulation of UPK1A-AS1 predicted poor prognosis for patients with HCC. Conclusions: Our study reveals that UPK1A-AS1 promotes HCC development by accelerating cell cycle progression via interacting with EZH2 and sponging miR-138-5p, suggesting that UPK1A-AS1 possesses substantial potential as a novel biomarker for HCC prognosis and therapy.
Guidance for overviews of reviews continues to accumulate, but important challenges remain: A scoping review
Authors: Gates Michelle , Gates Allison , Guitard Samantha , Pollock Michelle , Hartling Lisa
Published: October 2020

Background. Overviews of reviews (overviews) provide an invaluable resource for healthcare decision-making by combining large volumes of systematic review (SR) data into a single synthesis. The production of high-quality overviews hinges on the availability of practical evidence-based guidance for conduct and reporting.Objectives. Within the broad purpose of informing the development of a reporting guideline for overviews, we aimed to provide an up-to-date map of existing guidance related to the conduct of overviews, and to identify common challenges that authors face when undertaking overviews.Methods. We updated a scoping review published in 2016 using the search methods that had produced the highest yield: ongoing reference tracking (2014 to March 2020 in Pubmed, Scopus, and Google Scholar), hand-searching conference proceedings and websites, and contacting authors of published overviews. Using a qualitative meta-summary approach, one reviewer extracted, organized, and summarized the guidance and challenges presented within the included documents. A second reviewer verified the data and synthesis.Results. We located 28 new guidance documents, for a total of 77 documents produced by 34 research groups. The new guidance helps to resolve some earlier identified challenges in the production of overviews. Important developments include strengthened guidance on handling primary study overlap at the study selection and analysis stages. Despite marked progress, several areas continue to be hampered by inconsistent or lacking guidance. There is ongoing debate about whether, when, and how supplemental primary studies should be included in overviews. Guidance remains scant on how to extract and use appraisals of quality of the primary studies within the included SRs and how to adapt GRADE methodology to overviews. The challenges that overview authors face are often related to the above-described steps in the process where evidence-based guidance is lacking or conflicting.Conclusion. The rising popularity of overviews has been accompanied by a steady accumulation of new, and sometimes conflicting, guidance. While recent guidance has helped to address some of the challenges that overview authors face, areas of uncertainty remain. Practical tools supported by empirical evidence are needed to assist authors with the many methodological decision points that are encountered in the production of overviews.
Molecular characteristics of rotavirus genotypes circulating in the south of Benin, 2016-2018
Authors: Agbla Jijoho Michel , Esona Mathew D , Agbankpé Alidéhou Jerrold , Capo-Chichi Annick , Gautam Rashi , Dougnon Tamègnon Victorien , Razack Osseni , Bowen Michael D , Bankolé Honoré Sourou
Published: October 2020

Objective Rotavirus remains the main causative agent of gastroenteritis in young children in countries that have not yet introduced the vaccine. In Benin, rotavirus vaccine was introduced late December 2019 into the EPI. This study aims to provide pre-vaccination era rotavirus genotyping data in Benin. These data can supplement data from the surveillance system of Ministry of Health of Benin which is supported by the World Health Organization (WHO). Results Of the 420 diarrheal stool samples, actively collected in southern Benin from July 2016 through November 2018 from children under five years old and suffering from gastroenteritis, 167 (39.8%) samples were rotavirus EIA positive. 186 (44.3%) samples contained amplifiable rotavirus RNA detected by qRT-PCR method and were genotyped using one-step RT-PCR multiplex genotyping method. G1P[8] represents the predominant genotype (32%) followed by the G2P[4] (26%), G3P[6] (16%), G12P[8] (13%) and mixed G and P types (1%). Four samples (2%) could not be assigned both G and P type speciﬁcity.
Effects of the socio-economic transition on health professions education: The case of Mongolia
Authors: Amgalan Nomin , Shin Jwa-Seop , Lee Seung-Hee , Badamdorj Oyungoo , Ravjir Oyungerel , Yoon Hyun Bae
Published: October 2020

BackgroundFormer socialist countries have undergone a socio-economic transition in recent decades. New challenges for the healthcare system have arisen in the transition economy, leading to demands for better management and development of the health professions. However, few studies have explored the effects of this transition on health professions education. Thus, we investigated the effects of the socio-economic transition on the three levels of health professions education system in Mongolia, a transition economy country. The changing requirements of three levels, including input, process, and output levels of health professions education system were explored. The input level refers to planning and management, the process level refers to the actual delivery of educational services, and the output level refers to issues related to the health professionals, produced by the system. This study utilized a qualitative research design, including document review and interviews with local representatives. Content analysis and the constant comparative method were used for data analysis. ResultsWe explored tensions in the three levels of the health professions education system. First, medical schools attained academic authority for planning and management without proper regulation and financial support. The government sets tuition fees, which are the only financial resource of medical schools; thus, medical schools attempt to enroll more students in order to adapt to the market environment. Second, the quality of educational services varies across institutions due to the absence of a core curriculum and differences in the learning environment. After the transition, the number of private medical schools rapidly increased without quality control, while hospitals started their own specialized training programs. Third, health professionals are struggling to maintain their professional values and development in the market environment. Fixed salaries lead to a lack of motivation, and quality evaluation measures more likely reflect government control than quality improvement.ConclusionMongolia continues to face the consequences of the socio-economic transition. Medical schools’ lack of financial authority, the varying quality of educational services, and poor professional development are the major adverse effects. Finding external financial support, developing a core curriculum, and introducing performance-based payments are recommended.
Lactic acidosis associated with metformin in diabetic patients with chronic kidney disease: a multicentre case-control study using electronic health records
Authors: Ávila Mónica , Videla Sebastian , Gómez-Lumbreras Ainhoa , Manriquez Marcela , Prat Oriol , Morros Rosa , Pedrós Consuelo
Published: October 2020

Background: Several studies have assessed the risk of lactic acidosis with metformin use. However, data of this association in patients with renal impairment are still scarce and controversial. Our aim was therefore to assess the association between metformin and lactic acidosis in Spanish type 2 diabetic patients with chronic kidney disease.Methods: A case-control study (ALIMAR-C2) was performed using the electronic health records from hospitals linked to their corresponding primary healthcare regions. The cases were adult (≥18 years) diabetic patients with chronic kidney disease, admitted to seven Spanish hospitals from 2010 to 2016. Ten controls (≥18 years, diabetic patients with chronic kidney disease) per case were selected from the population within the same primary healthcare region of the hospital cases. The patients’ hospital health records were linked to their corresponding primary healthcare information. Analyses included multivariable logistic regression and adjustment for potential confounders. Results: Our study included 126 cases and 1,260 matched controls. The current use of metformin and administration at high doses (>2g) were associated with lactic acidosis (adjusted OR: 1.92, 95% CI: 1.21-3.03; OR: 3.13, 95% CI: 1.63-6.01, respectively). The estimated case fatality rate was 46.8% (95% CI: 38.3-55.5%). An increased risk of lactic acidosis was observed In patients with mild to moderate renal impairment (OR: 3.41, 95% CI: 1.48-7.85). As an unexpected finding, diuretic drugs use was also associated with lactic acidosis (OR: 2.73, 95% CI: 1.67 - 4.46).Conclusions: Metformin was associated with an increased risk of lactic acidosis in patients with type 2 diabetes mellitus and chronic kidney disease. New data is needed to confirm the association between diuretic drugs and lactic acidosis in this group of patients.
ZNF674-AS1 suppresses non-small cell lung cancer growth through the miR-423-3p/p21 axis
Authors: Liu Yu , Huang Risheng , Xie Deyao , Lin Xiaoming , Zheng Liangcheng
Published: October 2020

Background: ZNF674-AS1, a recently characterized long noncoding RNA, shows prognostic significance in hepatocellualar carcinoma and glioma. However, the expression and function of ZNF674-AS1 in non-small cell lung cancer (NSCLC) is unclear. Methods: In this work, we investigated the expression of ZNF674-AS1 in 83 pairs of NSCLC specimens and adjacent noncancerous lung tissues. The clinical significance of ZNF674-AS1 in NSCLC was analyzed. The role of ZNF674-AS1 in NSCLC growth and cell cycle progression was explored. Results: Our data show that ZNF674-AS1 expression is decreased in NSCLC compared to normal tissues. ZNF674-AS1 downregulation is significantly correlated with advanced TNM stage and decreased overall survival of NSCLC patients. Overexpression of ZNF674-AS1 inhibits NSCLC cell proliferation, colony formation, and tumorigenesis, which is accompanied by a G0/G1 cell cycle arrest. Conversely, knockdown of ZNF674-AS1 enhances the proliferation and colony formation of NSCLC cells. Biochemically, ZNF674-AS1 overexpression increases the expression of p21 through downregulation of miR-423-3p. Knockdown of p21 or overexpression of miR-423-3p blocks ZNF674-AS1-mediated growth suppression and G0/G1 cell cycle arrest. In addition, ZNF674-AS1 expression is negatively correlated with miR-423-3p in NSCLC specimens. Conclusions: ZNF674-AS1 suppresses NSCLC growth by downregulating miR-423-3p and inducing p21. This work suggests the therapeutic potential of ZNF674-AS1 in the treatment of NSCLC.
Monophasic Synovial Sarcoma Presenting as Infantile Hemangioma: A Case Report
Authors: Kandari Abdulrahman Fahad Al , Alkandari Abdulwahab Fahad , Alhendi Sarah Faisal , Almousawi Hussain Saleh , Burezq Hisham Adel
Published: October 2020

Objective: This report describes a case of a monophasic synovial sarcoma that was initially misdiagnosed as an infantile hemangioma in a 3-month-old female infant. We also discuss the basic elements of evaluating a soft-tissue mass and important radiological and clinical features that should raise the index of suspicion for a synovial sarcoma. Summary Background Data: Synovial sarcoma is a rare pathology that is often challenging to diagnose due to its similarities with more common vascular lesions that occur in infancy. Infantile hemangioma, in particular, is common, has distinctive clinical and radiological findings, and is frequently diagnosed without histological confirmation. This increases the risk of misdiagnosis of rare tumors in infancy. Case Report: A 3-month-old female infant presented with a soft-tissue mass on the left forearm. Physical examination showed a well-defined, subcutaneous mass on the left forearm, measuring approximately 3 cm × 5 cm, firm in consistency, with no cutaneous involvement and normal skin coverage. Imaging suggested an infantile hemangioma but, due to the atypical presentation, a trial of beta-blocker therapy was conducted to confirm the diagnosis. The patient showed no clinical response to beta-blocker therapy, and therefore an incisional biopsy was performed. Using histopathology, the tumor was diagnosed as a monophasic synovial sarcoma.Conclusions: We highlight a rare presentation of a synovial sarcoma in a neonate and caution against making a diagnosis without histopathologic analysis. Clinicians should include sarcoma in the differential diagnosis when assessing a mass in neonates, as early diagnosis and intervention can reduce morbidity and mortality.MINI ABSTRACT A 3-month-old infant presented with a left forearm soft-tissue mass, initially diagnosed as infantile hemangioma. Biopsy revealed a monophasic synovial sarcoma. We discuss the basic elements of evaluating a soft-tissue mass and important radiological and clinical features that should raise the index of suspicion for a synovial sarcoma.
Risk Factors for Critical-Ill Events of Patients With COVID-19 in Wuhan, China: A Retrospective Cohort Study
Authors: Yang Sen , Ma Le , Wang Yu-Lan , Wang Qian , Tong Qiang , Chen Miao , Zhang Hua , Yu De-Hua , Dai Sheng-Ming , Cui Ran
Published: October 2020

Background To explore the risk factors for critical-ill events (intensive care, invasive ventilation, or death) in patients with COVID-19.Methods Patients with laboratory-confirmed COVID-19 admitted to the Wuhan Leishenshan Hospital from February 13 to March 14 was retrospectively analyzed. Demographic data, symptoms, laboratory values at baseline, comorbidities, treatments and clinical outcomes were extracted from electronic medical records and compared between patients with and without critical-ill events. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression models were developed to explore the risk factors for critical-ill events. A risk nomogram was established to predict the probability for the critical-ill events. Survival analysis of patients with critical-ill events was performed by the Kaplan-Meier method.Results 463 COVID-19 patients were included in this study, of whom 397 were non-critically ill and 66 were critically ill (all from the intensive care unit). The LASSO regression identified four variables (hypersensitive cardiac troponin I, blood urea nitrogen , haemoglobin, and interleukin-6) contributing to the critical-ill events. Multivariable regression showed increasing odds of in-hospital critical-ill events associated with hypersensitive cTnI greater than 0.04 ng/mL (OR 20.98,95% CI 3.51-125.31), blood urea nitrogen greater than 7.6 mmol/L (OR 5.22, 95% CI 1.52-17.81, decreased haemoglobin (OR 1.06, 95% CI 1.04-1.10), and higher interleukin-6 (OR 1.05, 95% CI 1.02-1.08) on admission. Conclusions Hypersensitive cTnI greater than 0.04 ng/mL, blood urea nitrogen greater than 7.6 mmol/L, decreased haemoglobin, and high IL-6 were risk factors of critical-ill events in patients with COVID-19.
Clinical and Deep-Learning Based Quantitative Serial Chest CT Features of The COVID-19 Disease: Association with Clinical Subtypes and A Follow-Up Study
Authors: Su Xiaoyun , Jia Yuxi , Zhu Qing , Liu Bo , Zhang Huiting , Wang Jing , Zheng Chuansheng
Published: October 2020

Background: To explore the clinical features and deep-learning (DL) based quantitative CT finding’s applications and evolution as well as the correlations in COVID-19.Methods: 273 chest CT scans (median interval, 6 days) from 75 COVID-19 RT-PCT positive patients (53 moderate and 22 severe) were included. Quantification parameters, such as CT value distribution, lesion (abnormal), GGO, consolidation rates, Hellinger distance and IOU, were automatically extracted from CT images by a combination of traditional image process algorithm and DL network. Clinical characteristics were also collected and analysed.Results: The hypertension and diabetes were more common in severity. The CRP, ESP, LDH and D-dimer were higher while LYM and LYM% lower in severity (P < 0.05). The DL network was detected the lesions to obtain quantitively CT indicators, with fast to process a chest CT images (average time, 2.2s) and high overlap with radiologist. The hellinger, abnormal, GGO, consolidation rates and HU values were higher and the IOU lower in severity than moderate patients (P < 0.05). The largest AUC was 0.943, using the cutoff value of 10.5% for abnormal rate. The CT score have postive correlations with CRP, D-dimer and ESR (P < 0.05). The increased levels of ESR and D-dimer were positively correlated with abnormal, consolidation and GGO rates (P < 0.05). Investigation for quantitative CT changes were performed in three periods: 1) 1-2 weeks, CT score and abnormal rate were increased. The GGO converted to consolidation in severity; 2) 2-5 weeks, CT scores stable trend, while abnormal and GGO rates had upward trend in severity; 3) > 5weeks, CT score and abnormal rate have decreased.Conclusions: There were three phases of two patterns’ evolutionary trends in quantitative CT findings with differences in two groups, and have correlations with laboratory markers, which helpful for evaluating severity and prognosis in COVID-19 patients.
Variants Translating Reduced Expression of the Beta Estrogen Receptor Gene Were Associated With Increased Carotid Intima Media Thickness. A Cross-Sectional Study in Late Postmenopausal Women.
Authors: Cano-Marquina Antonio-Jorge , García-Pérez Miguel-Ángel , Tarín Juan J , Maceira Alicia M , Cosín-Sales Juan , Cano Antonio
Published: October 2020

Background There is debate on the role of estrogens in modulating the risk for atherosclerosis in women. Our purpose was to investigate whether the size of the estrogenic impact was independently associated with variation of carotid intima-media thickness (IMT) in healthy late postmenopausal women. The levels of circulating estrogens have been used in previous studies but the influence of SNPs of the estrogen receptors (ER) α and β has not been investigated.Methods We performed a crossed-sectional study of 91 women in a university hospital. We used a double approach in which, in addition to the measurement of estradiol levels by ultrasensitive methods, genetic variants (SNPs) associated with differing expression of the ER α and β genes were assessed. Multivariable analysis was used to examine the association of candidate factors with the value of IMT and plaque detection at both the carotid wall and the sinus.Results The levels of glucose were directly associated with IMT at both the carotid wall (p<0.001) and the sinus (p=0.001), while age was positively associated with IMT at the sinus (p=0.003) and vitamin D with IMT at the carotid wall (P=0.035). A genotype combination translating reduced gene expression of the ERβ was directly associated with IMT at both the carotid wall (p=0.001) and the sinus (p=0.002).Conclusions Poorer estrogenic impact, as concordant with a SNP variant imposing reduced expression of the ERβ, was directly associated with IMT at both the carotid wall and the sinus. Glucose level, vitamin D only for the carotid wall, and age only for the sinus, also emerged as independent factors in the IMT variance.
Transfer of Rhodamine-123 into the Brain and Cerebrospinal Fluid of Fetal, Neonatal and Adult Rats
Authors: Koehn Liam , Dziegielewska Katarzyna M , Habgood Mark D , Huang Yifan , Saunders Norman R
Published: October 2020

Background: Adenosine triphosphate binding cassette transporters such as P-glycoprotein (PGP) play an important role in drug pharmacokinetics by actively effluxing their substrates at barrier interfaces, including the blood-brain, blood-cerebrospinal fluid (CSF) and placental barriers. For a molecule to access the brain during fetal stages it must bypass efflux transporters at both the placental barrier and brain barriers themselves. Following birth, placental protection is no longer present and brain barriers remain the major line of defense. Understanding developmental differences that exist in the transfer of PGP substrates into the brain is important for ensuring that medication regimes are safe and appropriate for all patients. Methods: In the present study PGP substrate rhodamine-123 (R123) was injected intraperitoneally into E19 dams, postnatal (P4, P14) and adult rats. Naturally fluorescent properties of R123 were utilized to measure its concentration in blood-plasma, CSF and brain by spectrofluorimetry (Clariostar). Statistical differences in R123 transfer (ratios between tissue and plasma concentrations) were determined using Kruskal-Wallis tests with Dunn’s corrections. Results: Following maternal injection the transfer of R123 across the E19 placenta from maternal blood to fetal blood was around 20%. Of the R123 that reached fetal circulation 41% transferred into brain and 38% into CSF. The transfer of R123 from blood to brain and CSF was lower in postnatal pups and decreased with age (brain: 43% at P4, 22% at P14 and 9% in adults; CSF: 8% at P4, 8% at P14 and 1% in adults). Transfer from maternal blood across placental and brain barriers into fetal brain was approximately 8%, similar to the transfer across adult blood-brain barriers (9%). Following birth when placental protection was no longer present, transfer of R123 from blood into the newborn brain was significantly higher than into adult brain (3 fold, p<0.05). Conclusions: Administration of a PGP substrate to infant rats resulted in a higher transfer into the brain than equivalent doses at later stages of life or equivalent maternal doses during gestation. Toxicological testing of PGP substrate drugs should consider the possibility of these patient specific differences in safety analysis. Trial Registration: N/A.
WITHDRAWN: Action Mechanism and Practical Experience of City Parks from the Perspective of Health Promotion —Take Hangzhou West Lake City Parks as an Example
Authors: Lu Jiancheng , Luo Xiaolong , Zhang Peigang
Published: October 2020

Background: The development of health theory has deepened the function of city parks. It is urgent to explore the action mechanism and practical experience of city parks from a health promotion perspective. Methods: This paper adopts the dynamic tracking method, which has been widely used in the study of city park health problems. Between 2009 and 2010, the author participated in the redesigning project of WLCP. From 2014 to 2018, the author participated in the health management project of WLCP. Additionally, in order to complete the study more accurately, the author conducted three interviews between April and May 2020. After transcribing, condensing, and categorizing talking content, we summarized the theme structure and results.Results: First, the transformation of the health benefits of city parks depends on the use of residents, and the supportive design is the intermediary mechanism for stimulating park use. Second, residents' demand for health is no longer limited to physical and psychological, but includes a higher level of spiritual satisfaction and a comfortable environment. Third, the supporting design of city parks should include a health management system, and a standardized and normalized management system can alleviate health damage. Conclusions: The theoretical framework, action mechanism and practical experience of city parks from the perspective of health promotion proposed may be applicable to other cities at home and abroad.
Cardiovascular Mechanisms In Covid-19: Methodology of A Prospective Observational Multimodality Imaging Study (COSMIC-19 study)
Authors: Alam Shirjel , Shah Anoop , Onyinkwa Kevin , Nganga Edward , Gitau Samuel , Makhdomi Khalid , Chung Michael , Vinayak Sudhir
Published: October 2020

Background: 8-28% of patients infected with COVID-19 have evidence of cardiac injury, and this is associated with an adverse prognosis. The cardiovascular mechanisms of injury are poorly understood and speculative. We aim to use multimodality cardiac imaging including cardiac magnetic resonance (CMR) imaging, computed tomography coronary angiography (CTCA) and positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG-PET/CT) to identify the cardiac pathophysiological mechanisms related to COVID-19 infections.Methods: This is a single-centre exploratory observational study aiming to recruit 50 patients with COVID-19 infection who will undergo cardiac biomarker sampling. Of these, 30 patients will undergo combined CTCA & 18F-FDG-PET/CT, followed by CMR. Prevalence of obstructive and non-obstructive atherosclerotic coronary disease will be assessed using CTCA. CMR will be used to identify and characterise myocardial disease including presence of cardiac dysfunction, myocardial fibrosis, myocardial oedema and myocardial infarction. 18F-FDG-PET/CT will identify vascular and cardiac inflammation. Primary endpoint will be the presence of cardiovascular pathology and the association with troponin levels.Discussion: The results of the study will identify the presence and modality of cardiac injury associated COVID-19 infection, and the utility of multi-modality imaging in diagnosing such injury. This will further inform clinical decision making during the pandemic.TRIAL REGISTRATION: This study has been retrospectively registered at the ISRCTN registry (ID ISRCTN12154994) on 14th August 2020. Accessible at www.isrctn.com/ISRCTN12154994
Impact of Novel Coronavirus Disease-19 (COVID-19) Pandemic in Italian Pediatric Emergency Departments: A National Survey
Authors: Talarico Valentina , Pinto Luciano , Marseglia Gian Luigi , Centonze Antonella , Cristofaro Concetta , Reina Rocco , Nocerino Agostino , Lubrano Riccardo , Zampogna Stefania
Published: October 2020

BACKGROUND: Coronavirus Disease-19 (COVID-19) has rapidly become a pandemic emergency, distressing health systems in each affected country. Preparation strategies for managing this pandemic have been keys to face the COVID-19 surge all over the world and all levels of care. MATERIAL and METHODS: During the epidemic, the Italian society of pediatric emergency-urgency (SIMEUP) promoted a national survey aiming to evaluate preparedness and response of pediatric emergency departments (PED) critical in ensuring optimal management of COVID-19 cases. RESULTS: Our results suggest that Italian PED have promptly set a proactive approach to the present emergency. 96.6% of the hospitals have defined special pathways and assistive protocols concerning the management of pediatric COVID-19 cases. The highest percentage of application of the measures for preventive and protective for COVID-19 concerned the use of personal protective equipments. CONCLUSIONS: Results show that the following measures for pediatric patients, admitted in PED, have been promptly implemented throughout the whole country: eg. use of protective devices, pre-triage of patients accessing the hospital. Despite COVID-19 being a new threat, we have shown that by developing an easy-to-follow decision algorithm and clear plans for the interventional platform teams, we can ensure optimal health care workers and patients’ safety.
Validation of Nursing Documentation Regarding in-hospital Falls: A Cohort Study
Authors: Franzén-Dahlin Åsa , Krakau Karolina , Andersson Helene , Egberg Louise , Sterner Eila , Unbeck Maria
Published: October 2020

BackgroundIn-hospital fall incidents are common and sensitive to nursing care. It is therefore important to have easy access to valid patient data to evaluate and follow-up nursing care. The aim of the study was to validate the nursing documentation, using a specific term in the registered nurses´ (RNs´) discharge note, regarding inpatient falls according to the outcome of a digitalized data extraction tool and the discharge note itself.MethodsAt a teaching hospital, 31,571 episodes of care were eligible for inclusion in this cohort study. A stratified sampling including five groups was used, two with random sampling and three with total sampling. In total, 1,232 episodes of care were reviewed in the electronic patient record using a study-specific protocol. Descriptive statistics were used. ResultsIn total, 590 episodes of care in the study cohort included 712 falls. When adjusted for the stratified sampling the cumulative incidence for the study population was 1.9%.The positive predictive value in total for the data extraction tool regarding the presence of any fall, in comparison with the record review, was 87.4%. Discrepancies found were, for example, that the RNs, at discharge, stated that the patient had fallen but no documented evidence of that could be detected during admission. It could also be the opposite, that the RNs correctly had documented that no fall had occurred, but the data extraction tool made an incorrect selection. When the latter had been withdrawn, the positive predictive value was 91.5%.Information about minor injuries due to the fall was less accurate. In the group where RNs had stated that the patient had fallen without injury, minor injuries had actually occurred in 28.3% of the episodes of care. Conclusions The use of a specific term regarding fall in the RNs´ discharge note seems to be a valid and reliable data measurement and can be used continuously to evaluate and follow-up nursing care.
Improvement of Gender Balance Based on the Real-Time Visual Feedback System of the Pressure Center of Smart Wearable Devices: A Case Control Study
Authors: Wang I-Lin , Wang Li-I , Xue Shi-Jie , Hu Rui , Su Yu , Jian Rong-Jiun , HO Chun-Sheng
Published: October 2020

Background: The body maintains stability by integrating inputs from the central nervous system of vision, hearing, proprioception, and multiple senses. With the development of smart wearable devices, smart wearable devices can provide real-time center of pressure (COP) position-assisted balance control, which is beneficial to maintain physical balance.Methods: Forty healthy college students (20 male-20 female) participated in this study, and the posture balance actions of left-leg stance non-visual feedback, left -leg stance visual feedback, right-leg stance non-visual feedback, and right-leg stance visual feedback are performed. Visual feedback provides smart insoles matching Podoon APP on a tablet computer with the COP position displayed by a dot as real-time visual feedback. A mixed-design two-way ANOVA was performed and included the study.Results: The experimental results show that the displacement, velocity, radius, and area of the COP decreased significantly in the left-leg stance visual feedback/right-leg stance visual feedback, the test compared with the parameters in the eft-leg stance non-visual feedback/right-leg stance non-visual feedback (P < 0.05). Providing visual feedback through intelligent insoles can reduce the movement of the center of mass (COM) and maintain physical stability for healthy young people of different genders. In the one leg visual/non-visual in standing, the COP maximum anteroposterior displacement, COP anteroposterior velocity, COP radius, and COP area of women are significantly decreased than men (P < 0.05). Women have better real-time balance control ability than men with smart insoles.Conclusion: The simple intelligent wearable assisted devices can immediately increase the control ability in static stance of men and women, and women have better real-time balance control ability than men.
The "diagonal" principle in the surgery of femoral intertrochanteric fractures
Authors: Li Guanghui , Liu Tuoen , Duan Jianhui
Published: October 2020

Objective: To explore the role of "diagonal principle" surgical technique in the treatment of elderly femoral intertrochanteric fractures. Methods: From October 2015 to February 2018, we treated 28 cases of femoral intertrochanteric fractures (8 cases of AO / OTA classification 31A1 type, 12 cases of 31A2 type, and 8 cases of 31A3 type), and they all received extended pith internal nail (length ≥340mm) internal fixation surgery. Results: Hip function scores were excellent in 18 cases, good in 7 cases, poor in 1 case, and dead in 2 cases. The excellent and good rate was 89.3%. No internal fixation fracture, failure, or re-fracture occurred. Conclusion: The use of "diagonal principle" for the treatment of elderly femoral intertrochanteric fractures has promising results.
Magnetic domains and domain wall pinning in two-dimensional ferromagnets revealed by nanoscale imaging
Authors: Sun Qi-Chao , Song Tiancheng , Anderson Eric , Shalomayeva Tetyana , Förster Johannes , Brunner Andreas , Taniguchi Takashi , Watanabe Kenji , Gräfe Joachim , Stöhr Rainer , Xu Xiaodong , Wrachtrup Jörg
Published: October 2020

Magnetic-domain structure and dynamics play an important role in understanding and controlling the magnetic properties of two-dimensional magnets, which are of interest to both fundamental studies and applications. However, the probe methods based on the spin-dependent optical permeability and electrical conductivity can neither provide quantitative information of the magnetization nor achieve nanoscale spatial resolution. These capabilities are essential to image and understand the rich properties of magnetic domains. Here, we employ cryogenic scanning magnetometry using a single-electron spin of a nitrogen-vacancy center in a diamond probe to unambiguously prove the existence of magnetic domains and study their dynamics in atomically thin CrBr3. The high spatial resolution of this technique enables imaging of magnetic domains and allows to resolve domain walls pinned by defects. By controlling the magnetic domain evolution as a function of magnetic field, we find that the pinning effect is a dominant coercivity mechanism with a saturation magnetization of about 26μB/nm2 for bilayer CrBr3. The magnetic-domain structure and pinning-effect dominated domain reversal process are verified by micromagnetic simulation. Our work highlights scanning nitrogen-vacancy center magnetometry as a quantitative probe to explore two-dimensional magnetism at the nanoscale.
Population genomics provides insights in diversity, epidemiology, evolution and pathogenicity of the waterborne pathogen Mycobacterium kansasii
Authors: Luo Tao , Xu Peng , Zhang Yangyi , Porter Jessica L. , Ghanem Marwan , Liu Qingyun , Jiang Yuan , Li Jing , Miao Qing , Hu Bijie , Howden Benjamin P. , Fyfe Janet , Globan Maria , He Wencong , He Ping , Wang Yiting , Liu Houming , Takiff Howard , Zhao Yanlin , Chen Xinchun , Pan Qichao , Behr MA , Stinear Timothy , Gao Qian
Published: October 2020

Mycobacterium kansasii is a nontuberculous mycobacterium that can cause serious pulmonary disease. Genotyping suggested that the species is composed of at least six subtypes that vary in clinical significance, with subtype I being clinically dominant but less commonly isolated from environmental sources. Here we report a population genomics study of 358 M. kansasii isolates obtained from global water and clinical sources. Phylogenomic analyses revealed that the six subtypes are more accurately designated as closely related subspecies. These subspecies show ample evidence of recombination mediated by distributive conjugative transfer that has contributed to subspeciation and on-going diversification. Water was confirmed as a source of clinical infections by showing that genomes of clinical strains from an Australian outbreak were almost indistinguishable from strains contaminating the drinking water supply. Most clinical infections (nearly 80%) were due to a recently emerged group of strains designated the M. kansasii main complex (MKMC), which appears to have originated in Europe in 1900s and expanded globally over the past century. Comparative genomic analyses revealed that the MKMC has maintained the methylcitrate cycle and expanded ESX-I secretion-associated proteins, perhaps facilitating metabolic adaptation and pathogenicity for human hosts. Evidence of on-going positive selection in isolates of the MKMC was found in genes involved in carbon and secondary metabolism, metal ion homeostasis and cell surface remodeling that could represent adaptation to human hosts. These results further our understanding of the epidemiology and pathogenicity of M. kansasii and emphasize the importance of monitoring its potential transition to a more human-adapted pathogen.
Clinical and Radiological Results of Treating Lumbar Spondylosis With Cortical Bone Trajectory Screws
Authors: Bielecki Mateusz , Kunert Przemyslaw , Balasa Artur , Kujawski Sławomir , Marchel Andrzej
Published: October 2020

Background: The cortical bone trajectory (CBT) technique is a popular minimally invasive spine surgery. Few studies have reported long-term outcomes. Here, we evaluated the complication profile and long-term follow-up of patients with lumbar degenerative disease treated with the CBT technique. Methods: This retrospective analysis included the first 40 consecutive patients that underwent the CBT technique. The indication for surgery was critical stenosis of the intervertebral foramen, which required removal of the entire intervertebral joint, on at least one side, during decompression. Results: The CBT technique was performed on one spine level, in 29 cases, and on two levels, in 11 cases. The last follow-up showed minimal clinically important differences in the numerical rating scale (NRS) of leg pain, the NRS of back pain, and the Oswestry Disability Index (ODI), in 97%, 95%, and 95% of patients, respectively. Thirty-nine patients completed long-term radiological follow-ups. Computed tomography demonstrated solid bone unions on 47 (92%) operated levels, collapsed unions on 2 (4%) levels, non-union on 1 (2%) level, and 1 (2%) lost to follow-up. Seven patients experienced complications (4 hardware-related). Three patients required four revision surgeries.Conclusions: The CBT technique effectively achieved spinal fusion; over 90% of patients achieved clinical improvement at a mean follow-up of 4.4 years (minimum 3 years in all cases).