bluuebunny/crossref_metadata_2025 huggingface dataset:
Leukoplakia in HIV patients and risk of malignancy: A case report
Authors: Ossa Yuli Fatzia , Soegyanto Anandina Irmagita , Handjari Diah Rini , Wulandari Endah Ayu Tri
Published: September 2020

Background: Oral potentially malignant disorder (OPMD) was defined by the World Health Organization (WHO) as an oral lesion which shows abnormalities with potential to become malignant. Leukoplakia is one such OPMD that may present in patients with human immunodeficiency virus (HIV), with the condition of HIV presenting a heightened risk of malignancy. Purpose: This case report aims to describe the initial finding and case management of an oral lesion that was suspected as leukoplakia in an HIV-positive patient on antiretroviral therapy (ART). Case: A 34-year-old male patient was referred to the Oral Medicine Division from an HIV clinic at Dr. Cipto Mangunkusumo General Hospital, Jakarta, with a chief complaint of dental caries. The patient was HIV and hepatitis C positive and already undergoing ART. Case Management: During the intraoral examination, we found multiple caries, poor oral hygiene and a single thin white plaque lesion on the right buccal mucosa around the second and third mandibular molar region. The white plaque was painless, irregular, clearly demarcated, could not be rubbed off and did not disappear when stretched. History of trauma in this area was non-contributory and the lesion had gone unnoticed prior to oral examination. The patient had an existing smoking habit of 25 years. As clinical examination suggested leukoplakia, a biopsy was arranged. Conclusion: Leukoplakia is defined as a potentially malignant lesion. The risk of shifting into malignancy can be higher for patients who are HIV positive. Especially in HIV-positive patients, special measures are needed to prevent shifting into malignancy, such as early detection, elimination of risk factors, performing excisional biopsy and regular intraoral examination.
Tendências e desafios para a política de formação dos gestores: Uma análise interdisciplinar de educação intercultural no campo
Authors: Bernieri Celenita Gualberto Pereira , Machado Solange Aparecida
Published: September 2020

A pesquisa apresenta pensamentos sobre determinadas tendências na formação dos gestores educacionais e as necessidades de inovação para buscar suprir as lacunas relacionadas ao ensino básico. Estas quais têm exigido sob o panorama da realidade característica de educação do campo: a construção das demandas na política da educação fundamental e suas perspectivas de transformações da própria gestão. Com a menção teórica metodológica de uma pesquisa bibliográfica e documental, buscou-se fundamentos históricos e filosóficos para o entrosamento das categorias trabalhadas e o foco empírico estabelecido em escolas estaduais da Regional de Dianópolis, para delimitar o campo da mesma, que segundo a abordagem, as alternativas têm sido de buscar efetivar ações de auto formação, simultaneamente às organização das práticas nas instituições de ensino. O que tem possibilitado um exercício parcial do instrumento curricular, ao contemplar uma educação que pense com as diversidades culturais e as relações étnico-raciais, buscando através de experiências e diálogos, apreciar e adotar conhecimentos comunitários com a valorização da subjetividade nos modos de cada comunidade, evidenciando-os no cotidiano escolar. A contradição entre as legislações e a marginalização educacional, evidencia a insuficiência na aplicabilidade de educação do campo, contudo, consiste destacar – se como maior desafio a urgência na reformulação da política de formação continuada dos gestores, propõe-se a transdisciplinar.
Multinucleated Giant Cell Formation as a Portal to Chronic Bacterial Infections
Authors: Stockton Jacob L. , Torres Alfredo G.
Published: September 2020

This review provides a snapshot of chronic bacterial infections through the lens of Burkholderia pseudomallei; detailing its ability to establish multi-nucleated giant cells (MNGC) within the host, leading to the formation of pyogranulomatous lesions. We explore the role of MNGC in melioidosis disease progression and pathology by comparing the similarities and differences of melioidosis to tuberculosis, outlining the concerted events in pathogenesis that lead to MNGC formation, discussing the factors that influence MNGC formation and how they fit into clinical findings reported in chronic cases. Finally, we speculate about future models and techniques that can be used to delineate the mechanisms of MNGC formation and function.
Pest Animal's Detection and Habitat Identification in Low-resolution Airborne Thermal Imagery
Authors: Ulhaq Anwaar , Khan Asim
Published: September 2020

Invasive species are significant threats to global agriculture and food security being the major causes of crop loss. An operative biosecurity policy requires full automation of detection and habitat identification of the potential pests and pathogens. Unmanned Aerial Vehicles (UAVs) mounted thermal imaging cameras can observe and detect pest animals and their habitats, and estimate their population size around the clock. However, their effectiveness becomes limited due to manual detection of cryptic species in hours of captured flight videos, failure in habitat disclosure and the requirement of expensive high-resolution cameras. Therefore, the cost and efficiency trade-off often restricts the use of these systems. In this paper, we present an invasive animal species detection system that uses cost-effectiveness of consumer-level cameras while harnessing the power of transfer learning and an optimised small object detection algorithm. Our proposed optimised object detection algorithm named Optimised YOLO (OYOLO) enhances YOLO (You Only Look Once) by improving its training and structure for remote detection of elusive targets. Our system, trained on the massive data collected from New South Wales and Western Australia, can detect invasive species (rabbits, Kangaroos and pigs) in real-time with a higher probability of detection (85–100 %), compared to the manual detection. This work will enhance the visual analysis of pest species while performing well on low, medium and high-resolution thermal imagery, and equally accessible to all stakeholders and end-users in Australia via a public cloud.
Mechanistic Research for the Student or Educator (Part I of II)
Authors: Leak Rehana
Published: September 2020

Many discoveries in the biological sciences have emerged from observational studies, but student researchers also need to learn how to design experiments that distinguish correlation from causation. For example, identifying the physiological mechanism of action of drugs with therapeutic potential requires the establishment of causal links. Only by specifically interfering with the purported mechanisms of action of a drug can the researcher determine how the drug “causes” its physiological effects. Typically, pharmacological or genetic approaches are employed to modify the expression and/or activity of the biological drug target or downstream pathways, to test if the salutary properties of the drug are thereby abolished. However, experimental techniques have caveats that tend to be underappreciated, particularly for the newer methods. In this two-part series, the caveats and strengths of mechanistic preclinical research are described, using the intuitive example of pharmaceutical drug testing in experimental models of human diseases. This series is not intended to tackle the perpetual clash between the frequentist approach to statistics and other schools of thought. Rather, Part I focuses on technical practicalities and common pitfalls of cellular and animal models designed for drug testing, and Part II describes in simple terms how to leverage a full-factorial three-way ANOVA, to test for causality in the link between drug-induced activation (or inhibition) of a biological target and therapeutic outcomes. Upon completion of this series, the student is expected to appreciate the strengths as well as limitations of mechanistic research and to avoid some of its pitfalls.
Short-Term Firm-Level Energy Consumption Forecasting for Energy-Intensive Manufacturing: A Comparison of Machine Learning and Deep Learning Models
Authors: Ribeiro Andrea MariaN.C. , Carmo Pedro RafaelX.do , Rodrigues Iago , Sadok Djamel , Lynn Theo , Endo Patricia Takako
Published: September 2020

To minimise environmental impact, avoid regulatory penalties, and improve competitiveness, energy-intensive manufacturing firms require accurate forecasts of their energy consumption so that precautionary and mitigation measures can be taken. Deep learning is widely touted as a superior analytical technique to traditional artificial neural networks, machine learning, and other classical time series models due to its high dimensionality and problem solving capabilities. Despite this, research on its application in demand-side energy forecasting is limited. We compare two benchmarks (Autoregressive Integrated Moving Average (ARIMA), and an existing manual technique used at the case site) against three deep learning models (simple Recurrent Neural Networks (RNN), Long Short-Term Memory (LSTM), and Gated Recurrent Unit (GRU)) and three machine learning models (Support Vector Regression (SVM), Random Forest, and K-Nearest Neighbors (KNN)) for short term load forecasting (STLF) using data from a Brazilian thermoplastic resin manufacturing plant. We use the grid search method to identify the best configurations for each model, and then use Diebold-Mariano testing to confirm the results. Results suggests that the legacy approach used at the case site is the worst performing, and that the GRU model outperformed all other models tested.
Bilateral Atypical Femur Fractures Complicated by Carbon Fiber Cephalomedullary Nail Fracture
Authors: Goodloe J. Brett , Toner Sarah , Althoff Alyssa , Herzog Leah , Rothwell Stacey , Reid Kristoff
Published: September 2020

Case:

A 69-year-old woman with a history of breast cancer, on long-term antiresorptive medications, was treated with carbon fiber cephalomedullary nails for bilateral atypical femur fractures. Her thigh pain was presumed to be from metastatic lesions and was treated with radiation without standard imaging. The index procedure was complicated by a left nail fracture. The patient underwent exchange cephalomedullary nail fixation with plate augmentation. At 1 year, the patient was asymptomatic with radiographs demonstrating healing.

Conclusion:

This case highlights the importance of appropriate imaging in all patients with thigh pain on antiresorptive therapy and features an uncommon complication of carbon fiber cephalomedullary nail fixation.
Analysis of Risk Factor for Anastomotic Leakage after Lower Rectal Cancer Resection, Including Drain Type: A Retrospective Single-Center Study
Authors: Kinugasa Tetsushi , Nagasu Sachiko , Murotani Kenta , Mizobe Tomoaki , Ochi Takafumi , Isobe Taro , Fujita Fumihiko , Akagi Yoshito
Published: September 2020

Background: We investigated the correlations between surgery-related factors and the incidence of anastomotic leakage after low anterior resection (LAR) for lower rectal cancer.Methods: A total of 630 patients underwent colorectal surgery between 2011 and 2014 in our department. Of these, 97 patients (15%) underwent LAR and were enrolled in this retrospective study. Temporary ileostomy was performed in each patient.Results: Anastomotic leakage occurred in 21 patients (21.7%). Univariate analysis showed a significant association between operative duration (p=0.005), transanal hand-sewn anastomosis (p=0.014), and operation procedure (p=0.019) and the occurrence of leakage. Multivariate regression reanalysis showed that underlying disease (p=0.044), transanal hand-sewn anastomosis (p=0.019) and drain type (p=0.025) were significantly associated with the occurrence of leakage. The propensity-score analysis showed that closed drainage were 6.3 times more likely to have anastomotic leakage than open drainage in relation to the amount of postoperative drainage (ml), according to the inverse probability of treatment-weighted analysis.Conclusions: Our results indicate that underlying disease, transanal hand-sewn anastomosis, and closed drain may be a risk and predictive factors for anastomotic leakage after LAR for lower rectal cancer. The notable finding was that closed drainage was related to the occurrence of anastomotic leakage and closed drainage was correlated with less volume of postoperative drain discharge than open drain.
Evaluation of the contribution of tropical cyclone seeds to changes in tropical cyclone frequency due to global warming in high-resolution multi-model ensemble simulations
Authors: Yamada Yohei , Kodama Chihiro , Satoh Masaki , Sugi Masato , Roberts Malcolm J , Mizuta Ryo , Noda Akira T , Nasuno Tomoe , Nakano Masuo , Vidale Pier Luigi
Published: September 2020

Previous projections of the frequency of tropical cyclone genesis due to global warming, even in terms of sign of the change, depends on the chosen model simulation. Here, we systematically examine projected changes in tropical cyclones using six global atmospheric models with medium-to-high horizontal resolutions included in the sixth phase of the Coupled Model Intercomparison Project/High-Resolution Model Intercomparison Project. Changes in the frequency of tropical cyclone genesis could be broken down into the contributions from (i) the tropical cyclone seed, a depression having a closed contour of sea level pressure with a warm core and (ii) the survival rate, the ratio of the frequency of tropical cyclone genesis to that of tropical cyclone seeds. The multi-model ensemble mean indicates that tropical cyclone genesis frequencies are significantly decreased during the period 1990–2049, which is attributable to changes in tropical cyclone seeds. Analysis of the individual models shows that although most models project a more or less decreasing trend in tropical cyclone genesis frequencies and seeds, the survival rate also contributes to the result in some models. The present study indicates the usefulness of decomposition into the frequency of the tropical cyclone seeds and the survival rate to understand the cause of uncertainty in projected frequencies of tropical cyclone genesis.
Gene expression kinetics of Exaiptasia pallida innate immune response to Vibrio parahaemolyticus infection
Authors: Seneca Francois , Davtian David , Boyer Laurent , Czerucka Dorota
Published: September 2020

Background: Recent sequencing projects on early-diverging metazoans such as cnidarians, have unveiled a rich innate immunity gene repertoire; however, little is known about immunity gene regulation in the host’s early response against marine bacterial pathogens over time. Here, we used RNA-seq on the sea anemone Exaiptasia pallida (Ep) strain CC7 as a model to depict the innate immune response during the onset of infection with the marine pathogenic bacteria Vibrio parahaemolyticus (Vp) clinical strain O3:K6, and lipopolysaccharides (LPS) exposure. Pairwise and time series analyses identified the genes responsive to infection as well as the kinetics of innate immune genes over time. Comparisons between the responses to live Vp and purified LPS was then performed.Results: Gene expression and functional analyses detected hundreds to thousands of genes responsive to the Vp infection after 1, 3, 6 and 12 hours, including a few shared with the response to LPS. Our results bring to light the first indications that non-canonical cytoplasmic pattern recognition receptors (PRRs) such as NOD-like and RIG-I-like receptor homologs take part in the immune response of Ep. Over-expression of several members of the lectin-complement pathways in parallel with novel transmembrane and Ig containing ficolins (CniFLs) suggest an active defense against the pathogen. Although lacking typical Toll-like receptors (TLRs), Ep activates a TLR-like pathway including the up-regulation of MyD88, TRAF6, NF-κB and AP-1 genes, which are not induced under LPS treatment and therefore suggest an alternative ligand-to-PRR trigger. Two cytokine-dependent pathways involving Tumor necrosis factor receptors (TNFRs) and several other potential downstream signaling genes likely lead to inflammation and/or apoptosis. Finally, both the extrinsic and intrinsic apoptotic pathways were strongly supported by over-expression of effector and executioner genes.Conclusions: To our knowledge, this pioneering study is first to follow the kinetics of the innate immune response in a cnidarian during the onset of infection with a bacterial pathogen. Overall, our findings reveal the involvement of both novel immune gene candidates such as NLRs, RLRs and CniFLs, and previously identified TLR-like and apoptotic pathways in anthozoan innate immunity with a large amount of transcript-level evidence.
Brain SPECT perfusion and PET metabolism as discordant biomarkers in major depressive disorder
Authors: Tastevin Maud , Boyer Laurent , Korchia Theo , Fond Guillaume , Lançon Christophe , Richieri Raphaëlle , Guedj Eric
Published: September 2020

Background: Brain SPECT perfusion and PET metabolism have been, most often interchangeably, proposed to study the underlying pathological process in major depressive disorder (MDD). The objective of this study was to specify similarities and inconsistencies between these two biomarkers according to global characteristics of the disease. We conducted a retrospective study in 16 patients suffering from treatment-resistant MDD who underwent, during the same current episode, a cerebral perfusion SPECT with 99mTc-HMPAO and a metabolic PET with 18F-FDG. Whole-brain voxel-based SPM(T) maps were generated in correlation with the number of depressive episodes and in correlation with the depression duration, separately for the two exams (p-voxel<0.001 uncorrected, k>20). Results: No significant correlations were found between brain metabolism and either the number of depressive episodes or the duration of the disease, even at an uncorrected p-voxel<0.005. On the other hand, the increased number of depressive episodes was correlated with decreased perfusion of the right middle frontal cortex, the right anterior cingulum cortex, the right insula, the right medial temporal cortex and the left precuneus. The increased depression duration was correlated with decreased perfusion of the right anterior cingulum cortex. Conclusions: This preliminary study demonstrates more significant results with brain perfusion compared with glucose metabolism in treatment-resistant MDD, highlighting the value of brain SPECT despite less favourable instrumentation detection compared to PET.
Long-term results of additional pulmonary blood flow with bidirectional cavopulmonary shunt
Authors: Kowatari Ryosuke , Suzuki Yasuyuki , Daitoku Kazuyuki , Fukuda Ikuo
Published: September 2020

Objective: We evaluated additional pulmonary blood flow at the time of bidirectional cavopulmonary shunt and its effects on the Fontan procedure and long-term outcome of Fontan circulation and liver function.Methods: We included 22 patients (16 boys, 6 girls) having undergone bidirectional cavopulmonary shunt with additional pulmonary blood flow between April 2002 and January 2016. Mean age and body weight were 20 ± 13 months and 7.5 ± 6.5 kg, respectively. We retrospectively evaluated the patients' clinical data, including cardiac catheterization data, liver function, and liver fibrosis markers.Results: All patients were alive with a New York Heart Association status of I at the long-term follow-up. Changes between pre-bidirectional cavopulmonary shunt and 101 months after the Fontan procedure included the following: the cardiothoracic ratio of chest X-ray decreased from 52.2 ± 3.9% to 41.8 ± 5.9% (p < 0.001); systemic ventricle end-diastolic pressure decreased from 11.4 ± 3.2 mmHg to 6.9 ± 3.6 mmHg (p < 0.001); and the pulmonary artery index decreased from 485.1 ± 272.3 to 269.5 ± 100.5 (p = 0.02). Type IV collagen, hyaluronic acid, and procollagen levels increased over the normal range 116 months after the Fontan procedure.Conclusions: The additional pulmonary blood flow at the time of bidirectional cavopulmonary shunt may contribute to pulmonary arterial growth at the Fontan procedure with low pulmonary arterial resistance and without ventricle volume overload. The Fontan circulation was well-maintained at the long-term follow-up, while liver fibrosis markers were above their normal values.
Potential Biomarkers of Acute Myocardial Infarction Based on Co-Expression Network Analysis
Authors: Ding Zhiwen , Hu Zhaohui , Ding Xiangjun , Ji Yuyao , li Guiyuan , Wang Yiping , Xie Shengquan , Liu Xiaohong
Published: September 2020

Background: Acute myocardial infarction (AMI) is a common cause of death in many countries. Analyzing the potential biomarkers of AMI is crucial to understanding the molecular mechanism of disease. However, specific diagnostic biomarkers have not been fully elucidated, and candidate regulatory targets for AMI have not been determined.Methods: In this study, AMI gene chip data GSE48060, blood samples from normal cardiac function controls (n = 21) and AMI patients (n = 26) were downloaded from Gene Expression Omnibus. The differentially expressed genes (DEGs) of AMI and control group were identified with Online tool GEO2R. the genes co-expressed with were found. The co-expression network of DEGs was analyzed by calculating the Pearson correlation coefficient of all gene pairs, MR screening and cutoff threshold screening. Then, GO database was used to analyze the function and pathway enrichment of genes in the most important modules. KEGG DISEASE and BioCyc were used to analyze the hub gene in the module to determine important sub-pathways. In addition, the expression of hub genes were certified by RT-qPCR in AMI and control specimens.Results: This study identified 52 DEGs, including 26 up-regulated genes and 26 down-regulated genes. Co-expression network analysis of 52 DEGs revealed that there are mainly three up-regulated genes (AKR1C3, RPS24 and P2RY12) and three down-regulated genes (ACSL1, B3GNT5 and MGAM) as key hub genes in the co-expression network. Furthermore, GO enrichment analysis was performed on all AMI co-expression network genes and found to be functionally enriched mainly in RAGE receptor binding and negative regulation of T cell cytokine production. In addition, through KEGG DISEASE and BioCyc analysis, the functions of genes RPS24 and P2RY12 were enriched in cardiovascular diseases, AKR1C3 was enriched in cardenolide biosynthesis, MGAM was enriched in glycogenolysis, B3GNT5 was enriched in glycosphingolipids biosynthesis, and ACSL1 enriched in icosapentaenoate biosynthesis II. Conclusion: The hub genes AKR1C3, RPS24, P2RY12, ACSL1, B3GNT5 and MGAM are potential targets of AMI and have potential application value in the diagnosis of AMI.
Effects of Autonomic Nervous System Activation on Endothelial Function in Response to Acute Exercise in Hypertensive Individuals: Study Protocol for A Randomized Double-Blind Study
Authors: Waclawovsky Gustavo , Boll Liliana FC , Neto Salvador Gomes , Irigoyen Maria Cláudia , Lehnen Alexandre Machado
Published: September 2020

Background: Arterial hypertension has a direct association with endothelial dysfunction and major cardiovascular events. There is evidence showing the benefits of aerobic exercise on flow-mediated dilation (FMD) in hypertensive individuals but little is known about the effect of autonomic nervous system (ANS) activation on FMD of the brachial artery in response to different types of exercise in this specific population. This study aims to examine the effects of ANS activation on FMD of the brachial artery in response to exercise in hypertensive individuals following a session of different types of exercise including aerobic exercise (AE), resistance exercise (RE) or combined exercise (CE). Methods: Thirty-nine hypertensive volunteers aged 35 to 55 years will be randomly assigned to two exercise sessions: AE (40 minutes on a cycle ergometer at 60% of HR reserve); RE (4 lower limb sets with 12 repetitions at 60% 1-RM for 40 minutes) or CE (RE for 20 minutes + AE for 20 minutes). Each exercise group will be randomized to receive either an α1-adrenergic blocker (doxazosin 0.05 mg/kg-1) or placebo. Ultrasound measurement of FMD is performed 10 minutes before and 10, 40 and 70 minutes after exercise. ANS activation is monitored using a Finometer and measurements are taken during 10 minutes before each FMD assessment. Arterial stiffness is assessed by pulse wave velocity (PWV) analysis using a Complior device. Discussion: We expect to demonstrate the effect of ANS activation on FMD of the brachial artery in hypertensive individuals in response to different types of exercise. This study may give some insight on how to improve exercise prescription for hypertension management. Trial registration: www.clinicaltrials.gov (ID: NCT04371757).
Label-free quantitative proteomic analysis of alfalfa in response to microRNA156 under high temperature
Authors: Arshad Muhammad , Puri Alpa , Simkovich Aaron J , Renaud Justin , Gruber Margaret Y , Marsolais Frédéric , Hannoufa Abdelali
Published: September 2020

Background: Abiotic stress, including heat, is one of the major factors that affect alfalfa growth and forage yield. The small RNA, microRNA156 (miR156), regulates multiple traits in alfalfa during abiotic stress. The aim of this study was to explore the role of miR156 in regulating heat response in alfalfa at the protein level. Results: In this study, we compared an empty vector control and miR156 overexpressing (miR156OE) alfalfa plants after exposing them to heat stress (40 ° C) for 24 hours. We measured physiological parameters of control and miR156OE plants under heat stress, and collected leaf samples for protein analysis. A higher proline and antioxidant contents were detected in miR156OE plants than in controls under heat stress. Protein samples were analyzed by label-free quantification proteomics. Across all samples, a total of 1878 protein groups were detected. Under heat stress, 45 protein groups in the empty vector plants were significantly altered (P < 0.05; |log 2 FC| > 2). Conversely, 105 protein groups were significantly altered when miR156OE alfalfa was subjected to heat stress, of which 91 were unique to miR156OE plants. The identified protein groups unique to miR156OE plants were related to diverse functions including metabolism, photosynthesis, stress-response and plant defenses. Furthermore, we identified transcription factors in miR156OE plants, which belonged to squamosa promoter binding-like protein, MYB, ethylene responsive factors, AP2 domain, ABA response element binding factor and bZIP families of transcription factors. Conclusions: These results suggest a positive role for miR156 in heat stress response in alfalfa. They reveal a miR156-regulated network of mechanisms at the protein level to modulate heat responses in alfalfa.
Knowledge, attitudes, and practices of tertiary education students in regard to air pollution in Windhoek, Namibia: a cross sectional study
Authors: KEMBA HAUSHIKU , Tshifhiwa Nkwenika , Vusumuzi Nkosi
Published: September 2020

Background: Knowing the residents' knowledge, attitude, and practices to air pollution is necessary for developing interventions specific to that population. Air pollution remains a neglected environmental concern in Windhoek, Namibia and people’s perceptions about air pollution and health have not been documented. This study investigated the knowledge, attitudes and practices of tertiary students to air pollution in Windhoek. Methods: Students from five tertiary institutions in Windhoek were included in cross sectional study. A previously validated questionnaire was used to collect data from the study participants. Frequency and a corresponding percentage were reported for categorical data, whereas the association between knowledge of air pollution and perceptions was evaluated using the Chi-square test. Kruskal Wallis rank test was used to assess the statistical difference in knowledge, attitudes and practices. Data analysis was performed using STATA 15 and evaluated at a 5% level of significance Results: More than half (59.4%) of the respondents thought that air pollution was a major problem, while over 90% knew that air pollution could negatively impact health. The media was found to be the main source of information for respondents (91.1%). Despite having the knowledge, less than a third (27%) of the respondents regularly took action out of concern of air pollution. There was a statistically significant association between knowledge, attitudes, and practices to air pollution (all P < 0.05). Conclusions: Air pollution interventions targeting tertiary students should be aimed at informing them on ways in which they could contribute individually and collectively to reducing air pollution and its negative effects.
Vibrionaceae core, shell and cloud genes are non-randomly distributed on Chr 1: An hypothesis that links the genomic location of genes with their intracellular placement
Authors: Sonnenberg Cecilie Bækkedal , Kahlke Tim , Haugen Peik
Published: September 2020

Background: The genome of Vibrionaceae bacteria, which consists of two circular chromosomes, is replicated in a highly ordered fashion. In fast-growing bacteria, multifork replication results in higher gene copy numbers and increased expression of genes located close to the origin of replication of Chr 1 (ori1). This is believed to be a growth optimization strategy to satisfy the high demand of essential growth factors during fast growth. The relationship between ori1-proximate growth-related genes and gene expression during fast growth has been investigated by many researchers. However, it remains unclear which other gene categories that are present close to ori1 and if expression of all ori1-proximate genes is increased during fast growth, or if expression is selectively elevated for certain gene categories.Results: We calculated the pangenome of all complete genomes from the Vibrionaceae family and mapped the four pangene categories, core, softcore, shell and cloud, to their chromosomal positions. This revealed that core and softcore genes were found heavily biased towards ori1, while shell genes were overrepresented at the opposite part of Chr 1 (i.e., close to ter1). RNA-seq of Aliivibrio salmonicida and Vibrio natriegens showed global gene expression patterns that consistently correlated with chromosomal distance to ori1. Despite a biased gene distribution pattern, all pangene categories contributed to a skewed expression pattern at fast-growing conditions, whereas at slow-growing conditions, softcore, shell and cloud genes were responsible for elevated expression.Conclusion: The pangene categories were non-randomly organized on Chr 1, with an overrepresentation of core and softcore genes around ori1, and overrepresentation of shell and cloud genes around ter1. Furthermore, we mapped our gene distribution data on to the intracellular positioning of chromatin described for V. cholerae, and found that core/softcore and shell/cloud genes appear enriched at two spatially separated intracellular regions. Based on these observations, we hypothesize that there is a link between the genomic location of genes and their cellular placement.
Contralateral spontaneous rupture of the esophagus following severe emesis after non-intubated pulmonary wedge resection
Authors: Liu Lei , Wu Wenbin , Gong Longbo , Zhang Miao
Published: September 2020

Background: Non-intubated thoracoscopic lung surgery has been reported to be technically feasible and safe. Spontaneous rupture of the esophagus, also known as Boerhaave's syndrome (BS), is rare after chest surgery.Case Presentation: A 60-year-old female non-smoker underwent non-intubated uniportal thoracoscopic wedge resection for a pulmonary nodule. Ultrasound-guided serratus anterior plane block was utilized for postoperative analgesia. However, the patient suffered from severe emesis, chest pain and dyspnea 6h after the surgery. Emergency chest x-ray revealed right-sided hydropneumothorax. BS was diagnosed by chest tube drainage and computed tomography. Besides antibiotics and tube feeding, a naso-leakage drainage tube was inserted into the right thorax for pleural evacuation. Finally, the esophagus was healed 40d after the conservative treatment.Conclusions: Perioperative antiemetic therapy is an indispensable item of fast-track surgery. Moreover, BS should be kept in mind when the patients complain of chest distress following emesis after thoracic surgery.
Sequential ruptures of penetrating atherosclerotic ulcers of ascending aorta, aortic arch and descending thoracic aorta
Authors: Kaul Pankaj , Paniagua Rodolfo , Petsa Afroditi , Singh Raj
Published: September 2020

BackgroundPenetrating ulcers of aorta, aortic dissections and intramural hematomas all come under acute aortic syndromes and have important similarities and differences. Case ReportWe report a 67 year old man with rupture of a large penetrating ulcer of the distal ascending aorta with hemopericardium and left hemothorax. He underwent interposition graft replacement of ascending aorta and hemi-arch with a 30 mm Gelweave Vascutek graft but represented 6 months later with development of a penetrating ulcer which ruptured into a huge 14 cm pseudoaneurysm. This was repaired with a 28 mm Vascutek Gelseal graft replacement of arch and interposition graft reconstruction of innominate and left common carotid arteries. 6 weeks later, however, he ruptured his proximal descending aorta and underwent TEVAR satisfactorily. Unfortunately, 2 days later, he developed a pathological fracture of left proximal tibia with metastasis from a primary renal cell carcinoma. He died 3 weeks later from respiratory failure.We shall briefly outline the similarities and differences in presentation and management of penetrating aortic ulcers, aortic dissections and intramural haematomas. We shall discuss, in greater detail, penetrating ulcers of thoracic aorta, their natural history, location, complications and management.ConclusionThis case report is unique on account of initial successful surgical redressal following rupture of penetrating ulcer of distal ascending aorta into left pleural and pericardial cavities, normally associated with instant death. The haemodynamic effects of the rupture were staggered due to initial contained rupture into a smaller pseudoaneurysm, followed by a further rupture into a false aneurysmal sac followed eventually by generalised rupture into the pleural and pericardial cavities - a unique way of aortic rupture. Further development of another penetrating ulcer and a small pseudoaneurysm in the distal arch 6 months later which further ruptured into a larger 14 cm false aneurysmal sac, which again did not result in exsanguination, is again extraordinarily rare. Thereafter he underwent emergency thoracic endovascular aortic repair (TEVAR) for a further rupture of descending thoracic aorta. All three ruptures were managed successfully and would usually be associated with near-certain death, only for the patient to succumb eventually to the complications of metastatic renal cell carcinoma.
“I Don’t Want to go for an HIV Test Out of Fear that I Might be Positive”: Barriers and Facilitators to the Uptake of HIV testing Services Among Adolescents and Young Adults in Machinga District, Malawi.
Authors: Sakala Joseph Jasper , Stones William
Published: September 2020

Background: While studies generally indicate low utilization of HIV testing services (HTS) by young people in Sub-Saharan Africa, other reports also indicate a worrying HIV burden among the same group, evidenced by a recent trends in new infections. The low uptake of HTS among young people means that for many, new infections remain undiagnosed, hindering public health efforts for disease controlWe aimed to explore the factors that hinder – as well as those that encourage – HIV testing among adolescents and young adults in at individual, interpersonal, community and health system levels in a Malawi district.Methods: 24 In-depth interviews (IDIs) and 4 key-informant interviews (KIIs) were used to collect data, and purposive sampling was used to identify the respondents. IDIs targeted adolescents and young adults aged 15-24 years, whereas KIIs targeted HTS and youth-friendly health service (YFHS) providers. Coding and analysis were done using a modified Social-Ecological Framework.Results: Fear of a positive result, poor communication in relationships and families, cultural norms as well as lack of youth-friendly HIV testing services were key barriers to HIV testing. Perceived susceptibility to infection, presence of partner support, availability of community-level youth clubs or support groups, and the provision of HTS through outreach clinics were key facilitators for HIV testing. Conclusions: There is a pressing need for widespread mobile HIV testing at the community level to encourage uptake among young people who fail to visit health facilities for various reasons. Access to HIV self-testing through the distribution of kits at government health facilities is a promising strategy for young people who distrust service providers when it comes to maintaining the confidentiality of their results.
The Formulation of Minimal Clinically Important Differences in the Quality of Life Instrument for Patients with Chronic Renal Failure (QLICD-CRF) Based on Combinations of Anchor-Based and Distribution-Based Methods
Authors: Huang Xinping , Yang Zheng , Weng Min , Fan Xuejin , Xu Qingan , Wan Chonghua
Published: September 2020

Background Chronic renal failure is global problem and represents a major cause of morbidity and mortality. Studies of quality of life in patients with chronic renal failure can be helpful to improve patient survival rates. The minimal clinical important difference (MCID) is a score that reflects the effect of patient treatment or nursing care. Doctors or researchers use this factor to assess the validity of results, and this information reflects the combined importance of the patient's opinion and the doctor's explanation.Methods Patients diagnosed with chronic renal failure and able to read and understand the questionnaires at the First Affiliated Hospital of Kunming Medical University were included in this study and completed the questionnaires independently. Using the anchor-based method and the distribution-based method, the MCIDs of the QLICD-CRF were calculated based on the data from 164 valid questionnaires at the time of admission and 111 valid questionnaires at discharge. The medians of patients' quality of life scores calculated using the anchor-based method were referred to as MCIDs based on the anchor-based method, whereas the results calculated based on effect size (ES), standard error of measurement (SEM) and reliable change index (RCI) were referred to as MCIDs based on the distribution-based method. Then, the final results were calculated according to the weight of the calculation obtained using several methods. Results MCIDs of the physical domain (PHD), psychological domain (PSD), social domain (SOD), core/general domain (CGD), specific domain (SPD) and the total score (TOT) of the QLICD-CRF were 10, 9, 8, 7, 8 and 7, respectively. Conclusion Calculations of MCIDs of QLICD-CRF scores could compensate for insufficient P-values; thus, the interpretation of the outcomes in quality of life studies could be more objective and specific.
Cross-border Mobility in European Countries: Associations between Cross-border Worker Status and Health Outcomes
Authors: Nonnenmacher Lucas , Baumann Michele , Bihan Etienne le , Askenazy Philippe , Chauvel Louis
Published: September 2020

Background. Mobility of workers living in one country and working in a different country has increased in the European Union. Exposed to commuting factors, cross-border workers (CBWs) constitute a potential high-risk population. But the relationships between health and commuting abroad are under-documented. Our aims were to: (1) measure the prevalence of the perceived health status and the physical health outcomes (activity limitation, chronic diseases, disability and no leisure activities), (2) analyse their associations with commuting status and countries of destination, and (3) confirm the positive association between wage and health index for both CBWs and non-cross border workers (NCBWs). Methods. Based on the ‘Enquête Emploi’, the French cross-sectional survey segment of the European Labour Force Survey (EU LFS), the population was composed of 2,546,802 workers. Inclusion criteria for the samples were aged between 20 and 60 years and living in the French cross-border departments of Germany, Belgium, Switzerland and Luxembourg. The Health Index is an additional measure obtained with five health variables. A logistic model was used to estimate the odds ratios of each group of CBWs, taking NCBWs as the reference group, controlling by demographic background and labour status variables.Results. A sample of 34,362 observations (3,453 CBWs vs. 30,909 NCBWs) was retained. The CBW status is positively associated with a better perceived health, activity limitation, chronic diseases and disability. A marginal improvement of the health index is correlated with a wage premium for both NCBWs and CBWs. Commuters to Switzerland have the higher health outcomes among all CBWs. Commuters to Germany report lower disability and more leisure activities.Conclusion. CBWs are healthier and have more income. This main finding suggests (1) a healthy cross-border phenomenon steming from a social selection and a positive association between income and the health index is confirmed; (2) the existence of major health disparities among CBWs; and (3) the rejection of the spillover phenomenon assumption for CBWs. The newly founded European Labour Authority (ELA) should take into account health policies as a promising way to support the cross-border mobility within the European Union.
RNA N6-methyladenosine reader IGF2BP3 regulates cell cycle and angiogenesis in colon cancer
Authors: Yang Zhou , Wang Tingfeng , Wu Dejun , Min Zhijun , Tan Jingyun , Yu Bo
Published: September 2020

Background: N6-Methyladenosine (m6A) modification has been implicated in multiple processes for colon cancer development. IGF2BP3 was a newly reported m6A reader, whereas its role in colon cancer remains unclear. Methods: The expression of m6A associated enzymes and total m6A level were measured by Western Blotting analysis and m6A RNA Methylation Quantification Kit respectively. Cell cycle was analyzed by flowcytometry. The interaction of IGF2BP3 and related targets was analyzed by RNA immunoprecipitation (RIP) and m6A RNA immunoprecipitation (MeRIP) assays.Results: We investigated all m6A regulated enzymes in colon cancer and found only the overexpression of IGF2BP3 was associated with cancer progression and survival based on The Cancer Genome Atlas (TCGA) databases. Additionally, we also demonstrated IGF2BP3 was associated with DNA replication in the cell cycle. Knockdown of IGF2BP3 significantly repressed percentage of S phase of cell cycle as well as cell proliferation. Further research demonstrated IGF2BP3 binds to the mRNA of Cyclin D1 (CCND1, checkpoint of G1/S phase of cell cycle) and reduced its mRNA stability via reading m6A modification in the CDS region. Overexpression of Cyclin D1 in IGF2BP3 down-regulated cells completely rescued the inhibited percentage of S phase in cell cycle as well as cell proliferation. Additionally, we also demonstrated a similar role of IGF2BP3 at VEGF. IGF2BP3 binds to the mRNA of VEGF and reads m6A modification, thus regulated both expression and stability of VEGF mRNA. Knockdown of IGF2BP3 repressed angiogenesis in colon cancer via regulating VEGF. Conclusion: Knockdown of IGF2BP3 repressed DNA replication in the S phase of cell cycle and angiogenesis via reading m6A modification of CCND1 and VEGF respectively. IGF2BP3 was a possible prognosis marker and potential therapeutic target of colon cancer.
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: September 2020

Background: Former 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 health professions education system in Mongolia, a transition economy country, and to identify changes in requirements. Methods: We used a multi-level perspective to explore the effects of the transition, including the input, process, and output levels of the health professions education system. 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. Results: We 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.Conclusion: Mongolia 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.