bluuebunny/crossref_metadata_2025 huggingface dataset:
Low bone mineral density is a potential risk factor for symptom onset and related with hypocitraturia in urolithiasis patients: A single-center retrospective cohort study
Authors: Taguchi Kazumi , Hamamoto Shuzo , Okada Atsushi , Tanaka Yutaro , Sugino Teruaki , Unno Rei , Kato Taiki , Ando Ryosuke , Tozawa Keiichi , Yasui Takahiro
Published: September 2020

Background

Patients with urolithiasis have a lower bone mineral density (BMD) than those without stones, suggesting a potential correlation between calcium stone formation and bone resorption disorders, including osteopenia and osteoporosis.

Methods

To investigate the influence of BMD on clinical outcomes in urolithiasis, we performed a single-center retrospective cohort study to analyze patients with urolithiasis who underwent both BMD examination and 24-hour urine collection between 2006 and 2015. Data from the national cross-sectional surveillance of the Japanese Society on Urolithiasis Research in 2015 were utilized, and additional data related to urinary tract stones were obtained from medical records. The primary outcome was the development of stone-related symptoms and recurrences during follow-up. A total of 370 patients were included in this 10-year study period.

Results

Half of the patients had recurrent stones, and the two-thirds were symptomatic stone formers. While only 9% of patients had hypercalciuria, 27% and 55% had hyperoxaluria and hypocitraturia, respectively. There was a positive correlation between T-scores and urinary citrate excretion. Both univariate and multivariate analyses demonstrated that female sex was associated with recurrences (odds ratio=0.44, p=0.007), whereas a T-score <���������������������������������������������������������������������������������������������������������������������
Correcting inaccurate background mortality in excess hazard models through breakpoints
Authors: Mba Robert Darlin , Goungounga Juste Aristide , Grafféo Nathalie , Giorgi Roch , group CENSUR working survival
Published: September 2020

Background: Methods for estimating relative survival are widely used in population-based cancer survival studies. These methods are based on splitting the observed (the overall) mortality into excess mortality (due to cancer) and background mortality (due to other causes, as expected in the general population). The latter is derived from life tables usually stratified by age, sex, and calendar year but not by other covariates (such as the deprivation level or the socioeconomic status) which may lack though they would influence background mortality. The absence of these covariates leads to inaccurate background mortality, thus to biases in estimating the excess mortality. These biases may be avoided by adjusting the background mortality for these covariates whenever available.Methods: In this work, we propose a regression model of excess mortality that corrects for potentially inaccurate background mortality by introducing age-dependent multiplicative parameters through breakpoints, which gives some flexibility. The performance of this model was first assessed with a single and two breakpoints in an intensive simulation study, then the method was applied to French population-based data on colorectal cancer.Results: The proposed model proved to be interesting in the simulations and the applications to real data; it limited the bias in parameter estimates of the excess mortality in several scenarios and improved the results and the generalizability of Touraine’s proportional hazards model.Conclusion: Finally, the proposed model is a good approach to correct reliably inaccurate background mortality by introducing multiplicative parameters that depend on age and on an additional variable through breakpoints.
Neural Network Based 3D Tracking with a Graphene Transparent Focal Stack Imaging System
Authors: Zhang Dehui , Xu Zhen , Huang Zhengyu , Gutierrez Audrey Rose , Blocker Cameron , Liu Che-Hung , Lien Miao-Bin , Cheng Gong , Liu Zhe , Chun Il Yong , Fessler Jeffrey , Zhong Zhaohui , Norris Theodore
Published: September 2020

Recent years have seen the rapid growth of new approaches to optical imaging, with an emphasis on extracting three-dimensional (3D) information from what is normally a two-dimensional (2D) image capture. Perhaps most importantly, the rise of computational imaging, defined as the synergistic design of optical systems in conjunction with image reconstruction algorithms, enables both new physical layouts of optical components and new algorithms to be implemented. This paper concerns the convergence of two advances: the development of transparent photodetectors with high responsivity, and the rapid expansion of the capabilities of machine learning including the development of powerful neural networks. In particular, we demonstrate that the use of transparent photodetector arrays stacked vertically along the optical axis of an imaging system, called a focal stack, together with a feedforward neural network, provides a powerful new approach to real-time 3D optical imaging including object tracking. The focal stack imaging system is realized through the development of graphene transparent photodetector arrays. As a proof-of concept, 3D tracking of point-like objects was successfully demonstrated with multilayer feedforward neural networks, which was then extended for tracking of multi-point objects in position. Our computer model further demonstrates how this optical system can track extended objects in 3D, highlighting the promise of combining nanophotonic devices, new optical system designs, and machine learning for new frontiers in 3D imaging.
The clinical features of chronic intestinal schistosomiasis-related intestinal lesions
Authors: Qin Xian , Liu Cai-Yuan , Xiong Yi-Lin , Bai Tao , Zhang Lei , Hou Xiao-Hua , Song Jun
Published: September 2020

Background
Chronic intestinal schistosomiasis has been reported to be associated with colonic polyps, colorectal cancer and ulcerative colitis. We aim to investigate the clinical characteristics of intestinal-related lesions caused by chronic intestinal schistosomiasis japonicum.
Methods
Patients with and without chronic intestinal schistosomiasis were retrospectively enrolled from the endoscopy center of Wuhan Union Hospital from September 1, 2014, to June 30, 2019 with a ratio of 4:1. The characteristics of infected intestinal segments were analyzed in patients with chronic intestinal schistosomiasis. We also compared the characteristics of intestinal-related lesions, including colorectal. polyps, colorectal cancer (CRC), ulceration or erosion of the intestinal mucosa and hemorrhoids, between the two groups.
Results
A total of 248 patients with chronic intestinal schistosomiasis and 992 patients without chronic intestinal schistosomiasis were analyzed. The most common sites of chronic intestinal schistosomiasis were the sigmoid colon (79.0%) and rectum (84.7%). The frequency of intestinal polyps (64.5%vs42.8%, p < 0.001), especially rectal polyps (62.5%vs45.0%, p = 0.002), in the intestinal schistosomiasis group was significantly higher than that in the control group. Morphologically, type IIa polyps were more common in the schistosomiasis enteropathy group (68.5%vs60.7%, p = 0.001). Female patients with intestinal schistosomiasis had a higher detection rate of CRC than women in the control group (13.8%vs5.4%, p = 0.017). There was no significant difference in the incidence of ulcerative colitis between the two groups (0.8%vs0.6%, p = 0.664). In addition, the schistosomiasis enteropathy patients had a higher detection rate of internal hemorrhoids (58.9%vs51.0%, p = 0.027).
Conclusions
Chronic intestinal schistosomiasis mainly involved the rectum and sigmoid colon and was more likely to induce intestinal polyps, especially rectal polyps and internal hemorrhoids. Women with chronic schistosomiasis have a higher risk of colorectal cancer.
Effect of the COVID-19 Outbreak on Pediatric Patients’ Admissions to the Emergency Department in an Italian Orthopedic Trauma Hub
Authors: Verdoni Fabio , Ricci Martina , grigoli Cristina Di , Rossi Nicolò , Curci Domenico , Lombardo Michele Davide Maria , Viganò Marco , Accetta Riccardo , Mangiavini Laura , Peretti Giuseppe Maria
Published: September 2020

Background: The rapid diffusion of Coronavirus disease (Covid-19) in Northern Italy led Italian government to dictate national lockdown since March 12th 2020 to May 5th 2020. Aim of the study is to analyze the differences in the number of pediatric patients’ admission to the Emergency Room (ER) and in the type and causes of injury. Methods: The pediatric population was divided in a Pandemic group (PG) and Non-Pandemic group (NP). Sex, age, triage color-code at admission, declared cause of trauma and presence of symptoms related to COVID-19 infection, discharge diagnosis and discharge modes were investigated. Results: The Lockdown period led to a reduction of 87.0% in the ER admissions with a particular decrease in patients older than 12 years old from 41.8% in NG to 22.3% in PG. Moreover, a trend towards more severe codes was observed in the PG and the diagnosis of fracture was less frequent in NG (p<0,0001) and injuries at home were more frequent (34.8% compared to 6.8% in NG).Conclusions: A significant decrease in the ER attendances in our Trauma Hub center was reported after the outbreak of Covid-19 pandemic. Furthermore, a shift in the cause and type of injury undoubtedly was observed and only the most serious traumas sought the medical care with an higher percentage of severe triage codes and fractures.Level of evidence: III
Tailoring Topological Edge States with Photonic Crystal Nanobeam Cavities
Authors: Gong Yongkang , Guo Liang , Wong Stephan , Bennett Anthony , Oh Sang Soon
Published: September 2020

The realization of topological edge states (TESs) in photonic systems has provided unprecedented opportunities for manipulating light in novel manners. The Su-Schrieffer Heeger (SSH) model has recently gained significant attention and has been exploited in a wide range of photonic platforms to create TESs. We develop a photonic topological insulator strategy based on SSH photonic crystal nanobeam cavities. In contrast to the conventional photonic SSH schemes which are based on alternately tuned coupling rength in one dimensional lattice, our proposal provides higher flexibility and allows tailoring TESs by manipulating mode coupling in a two-dimensional manner. We reveal that the proposed hole array based nanobeams in a dielectric membrane can selectively tailor single or double TESs in the telecommunication region by controlling the coupling strength of the adjacent SSH nanobeams in both vertical and horizontal directions. Our finding provides an additional degree of freedom in exploiting the SSH model for integrated topological hotonic devices and functionalities based on the well-established photonic crystal nanobeam cavity platforms.
Electrospinning Nanofibres Of Pullulan Extracted From Phylloplane Fungus, Aureobasidium Pullulans
Authors: Saraf Komal , Vigneshwaran N
Published: September 2020

Aureobasidium pullulans isolated from the phylloplane of Peltophorum tree, produced pullulan, an extracellular polysaccharide. It was grown on three different carbon sources, sucrose, wheat bran and cotton stalk dust, for maximizing the pullulan yield. A. pullulans (67.4 gL-1) had the highest yield followed by A. pullulans MTCC 1991 (63.68 gL-1). Pullulan was characterized by X-ray diffractometer (XRD), Brunauer-Emmett-Teller (BET) surface area analyzer, DSC and NMR. Electrospinning of pullulan blended with poly (vinyl alcohol) (PVA) produced bead-less nanofibres. The optimized parameters for electrospinning were 25 kV applied voltage, 0.5 mL/h flow rate, 18% polymer concentration (pullulan + PVA) and 150 mm tip-to-collector distance. The pullulan nanofibre was characterized by SEM, AFM, BET, contact angle measurement, DSC and CIE color space analyzer. A maximum surface area of 183.4 m2/g while the minimum nanofibre diameter (79 ± 19 nm by SEM) was obtained for the electrospun mat of commercial pullulan + 40% PVA. This work signifies the importance of pullulan extracted from an isolate of Peltopohorum tree for conversion to high surface area nanofibres by electrospinning process.
Correlation between muscle strength, fatigue resistance, work ability and upper limb dysfunction in a sample of workers at a university hospital
Authors: Fonseca Marisa , Fifolato Thaís Marques , Nardim Heloísa Correa Bueno Bueno , Lopes Ester Rodrigues do Carmo , Suzuki Karen A Kawano , Silva Natalia Claro da , Serenza Felipe de Souza
Published: September 2020

IntroductionThe upper extremity is related to the functional ability to perform activities of daily living, self-care and work. Complaints in the upper limbs negatively affect these skills, therefore, it is necessary to obtain information about work demands.ObjectiveTo correlate upper limb muscle strength with fatigue resistance, work ability and dysfunction in a sample of workers from a university hospital.MethodsShoulder and elbow strength were assessed by Biodex System 4™, hand grip by JAMAR™, fatigue resistance by Functional Impairment test Hand/Neck/Shoulder/Arm (FIT-HaNSA), the ability to work by the Work Ability Index and upper limb dysfunction by QUICK-DASH-Br. The Brazilian version of the Pain Catastrophising Scale (B-PCS) was applied in order to analyse the catastrophic profile of the sample. The correlations were analysed by Spearman's Correlation Coefficient (rho)(p < 0.05).Results27 workers presented with chronic pain of low intensity, were classified as active and underwent predominantly dynamic work. Muscle strength of abduction (0.49), adduction (0.40), internal rotation (0.44), elbow flexion (0.38) and hand grip (0.68) had a direct correlation with FIT-HaNSA. Only hand grip (-0.52) showed an inverse correlation with upper limb dysfunction. Muscle strength was not correlated with work ability or pain catastrophising.ConclusionThe results suggested that increasing muscle strength may improve fatigue resistance. Also, improving hand grip strength could decrease upper limb dysfunction. In contrast to previous findings, muscle strength was not related to the ability to work or to pain catastrophising, because these factors are not only influenced by physical function, but also by psychosocial functioning.
HPF1 remodels PARP1 active site for ADP-ribosylation of histones on serine
Authors: Yun Cai-Hong , Sun Fa-Hui , Zhao Peng , Zhang Nan , Kong Lu-Lu , Wong Catherine
Published: September 2020

Upon binding to DNA breaks, poly(ADP-ribose) polymerase 1 (PARP1) ADP-ribosylates itself and other factors to initiate DNA repair. Serine is the major residue for ADP-ribosylation upon DNA damage, which strictly depends on HPF1. Here we report the crystal structures of human HPF1/PARP1-CAT ΔHD complex at 1.98 Å resolution and mouse and human HPF1 at 1.71 Å and 1.57 Å resolution, respectively. These structures and mutagenesis data confirm that the structural insights obtained in the HPF1/PARP2 study apply to PARP1. Moreover, we quantitatively characterize the key residues for HPF1/PARP1 binding. This information clarifies the confusion regarding HPF1/PARP1 assembly and can direct following functional studies. Our data show that through salt-bridging to Glu284/Asp286, Arg239 positions Glu284 for catalyzing serine ADP-ribosylation, maintains the local conformation of HPF1 to limit PARP1 automodification and facilitates HPF1/PARP1 binding through neutralizing the negative charge of Glu284. These findings and the high-resolution structural data may facilitate drug discovery targeting PARP1.
Periarticular Analgesic Injection Containing A Corticosteroid Reduces D-Dimer Levels After Total Hip Arthroplasty: Retrospective Comparative Cohort Study
Authors: Hashimoto Akira , Sonohata Motoki , Hirata Hirohito , Kawano Shunsuke , Eto Shuichi , Mawatari Masaaki
Published: September 2020

Background: Of late, periarticular analgesic injection (PAI) has become a common alternative treatment for pain following total hip arthroplasty (THA). However, the systemic effects of PAI containing corticosteroids in patients subjected to THA have not been investigated. This study evaluated the analgesic efficacy and systemic effects of PAI containing a corticosteroid in patients subjected to THA. Methods: This single-center, retrospective cohort study enrolled patients undergoing unilateral, primary THA. A total of 197 patients (200 hips) were included in the final analyses, with 87 hips in the PAI group and 113 hips in the control group. Numeric Rating Scale (NRS) and laboratory data were assessed preoperatively and on postoperative days (POD) 1 and 7. Pearson’s correlation coefficients were obtained to assess the correlations between the D-dimer level on POD 7 and each outcome measure on POD 1. Results: The postoperative white blood cell count (WBC) was significantly higher in the PAI group than in the control group. Postoperative NRS, creatine phosphokinase (CK), and C-reactive protein (CRP) levels were significantly lower in the PAI group. D-dimer levels were significantly lower in the PAI group on POD 7. Postoperative aspartate transaminase (AST), alanine aminotransferase, blood urea nitrogen, and creatinine levels were within reference ranges. D-dimer levels on POD 7 showed a significant negative correlation with WBC on POD 1 (r=-0.4652) and a significant positive correlation with the NRS score and AST, CK, CRP, and D-dimer levels on POD 1 (r=0.1558, 0.2353, 0.2718, 0.3545, and 0.3359, respectively).Conclusions: PAI containing a corticosteroid may be an effective treatment for pain and inflammation after THA, and it does not seem to cause drug-induced liver or kidney injury. Moreover, corticosteroid PAI can reduce D-dimer levels, which are associated with deep venous thrombosis. Early ambulation may prevent the elevation of postoperative D-dimer levels, and PAI containing a corticosteroid may accelerate early ambulation and reduce the risk of deep venous thrombosis.
Cellular Analysis of Bronchoalveolar Lavage Fluid to Narrow Differential Diagnosis of Checkpoint Inhibitor-related Pneumonitis in Metastatic Melanoma
Authors: strippoli Sabino , Fucci Livia , Negri Antonio , Putignano Danila , Cisternino Marco Luigi , Napoli Gaetano , Filannino Ruggero , De Risi Ivana , Sciacovelli Angela Monica , Guida Michele
Published: September 2020

Background: The diagnosis of check-point inhibitor-related pneumonitis (CIP) relies on radiological and clinical patterns which are not specific and can mimic other conditions (cancer progression, infectious diseases or interstitial pneumonitis). Cell pattern analysis of bronchoalveolar lavage (BAL) is well-known to support the diagnosis of interstitial lung disease; nevertheless, this analysis is somewhat performed and not required by immune-toxicity management guidelines for CIP. Methods: We performed BAL analysis in 5 metastatic melanoma (MM) patients who developed CIP among 112 patients treated with checkpoint inhibitors. We also correlated the BAL features with the computed tomography (CT) scan patterns and with various peripheral blood parameters to better define the profile of this patient population. Results: BAL flow cytometer and cytopathology analyses showed typical and homogeneous features with increased lymphoid population, prevalent CD8+ T cells and inversion of the CD4/CD8 ratio . Moreover, the extent of activated CD3+HLA-DR+ T cells was related to the grading of adverse events. Blood leucocytosis, hypoxemia, normal values for procalcitonin and lactate dehydrogenase were also found together with a cryptogenic organizing pneumonia-like radiologic pattern. In all our patients, CIP was associated with partial or complete response. Conclusions: Identification of a specific BAL cellular pattern allows clinicians to place this investigation in the appropriate position of CIP diagnosis and management to avoid misdiagnosis or considering this condition as progressive disease and delaying proper treatment.
Barriers on PV trade will impede global carbon mitigation and local pollutant emissions reduction
Authors: Wang Mudan , Mao Xianqiang , Xing Youkai , Lu Jianhong , Song Peng , Liu Zhengyan , Zusman Eric
Published: September 2020

The global trade of solar photovoltaic (PV) products substantially contributes to the increases in solar power generation and carbon emission reduction. This paper depicts the global PV product trade patterns and explores the emissions reduction potential, evaluates the impeding effect of tariff barriers on global PV product trade and the emissions reduction. In 2014 and 2017, the application of traded solar cells and modules resulted in emissions reductions of up to 840.71 and 1,734.59 Mt CO2e as well as substantial reductions in local pollutants. From 2017 to 2050, traded solar cells and modules will result in an approximately 55.76-86.45 Gt CO2e reduction. Extra-tariff imposition in its worst situation will result in global PV applications decreasing by 7.06% and carbon emissions mitigation potential decreasing by 5.09-7.89 Gt CO2e by 2050. Well-coordinated policy and institutional reforms are recommended to facilitate PV product trade and deliver related global and local environmental benefits.
North American boreal forests are a large carbon source due to wildfires from 1986 to 2016
Authors: Zhao Bailu , Zhuang Qianlai , Shurpali Narasinha , Köster Kajar , Berninger Frank , Pumpanen Jukka
Published: September 2020

Wildfires are a major disturbance to forest carbon (C) balance through both immediate combustion emissions and post-fire ecosystem dynamics. Here we use a process-based biogeochemistry model, the Terrestrial Ecosystem Model (TEM), to simulate C budget in Alaska and Canada during 1986-2016, as impacted by fire disturbances. We extracted the data of difference Normalized Burn Ratio (dNBR) for fires from Landsat TM/ETM imagery and estimated the proportion of vegetation and soil C combustion. We observed that the region is a C source of 2.74 Pg C during the 31-year period. The observed C loss, 57.1 Tg C yr-1, was attributed to fire emissions, overwhelming the net ecosystem production (1.9 Tg C yr-1) in the region. Our simulated during-fire emissions for Alaska and Canada are within the range of field measurements and other model estimates. As burn severity increases, combustion emission tended to switch from vegetation origin towards soil origin. Burn severity regulates post-fire C dynamics. Low severity fires increase soil temperature and decrease soil moisture and thus, enhance soil respiration. However, the opposite trend was found under moderate or high burn severity. The proportion of post-fire soil emission in total emissions increased with burn severity. Net nitrogen mineralization gradually recovered after fire, enhancing net primary production. Net ecosystem production recovered fast under higher burn severities. The impact of fire disturbance on the C balance of northern ecosystems and the associated uncertainties can be better characterized with long-term, prior, during- and post-disturbance data across the geospatial spectrum. Our findings suggest that the regional source of carbon to the atmosphere will persist if the observed forest wildfire occurrence and severity continues into the future.
IFN-λ4 Genetic Variants Influence Clinical Malaria Episodes in A Cohort of Kenyan Children
Authors: Reyes Gabriela Samayoa , Jackson Conner , Ogolla Sidney , Sabourin Katherine , Obajemu Adeola , Dent Arlene E. , Prokunina-Olsson Ludmilla , Rochford Rosemary
Published: September 2020

Background: Interferon (IFN)- λ4, a type III IFN, production is controlled by a dinucleotide frameshift variant (rs368234815-dG/TT) within the first exon of the IFNL4 gene. Carriers of the IFNL4-dG allele but not the IFNL4-TT allele are able to produce the IFN-λ4 protein. Patients with hepatitis C virus that do not produce the IFN-λ4 protein have higher rates of viral clearance suggesting a potential inhibitory role of IFN-λ4 in liver-tropic infections.Methods: In this study, we investigated whether children infected with Plasmodium falciparum, which has a well-characterized liver stage infection, would be more susceptible to clinical malaria relative to their IFNL4- rs368234815 allele. We analyzed a cohort of 122 children from a malaria holoendemic region of Kenya. Episodes of clinical malaria and upper respiratory tract infections (URTIs) were determined using information collected from birth to two years of age. The dinucleotide frameshift variant IFNL4-rs368234815-dG/TT was genotyped using a TaqMan assay.Results: In this cohort, we found that 33% had the dG/dG genotype, 45 % had the dG/TT genotype, and 22% had TT/TT genotype. We evaluated the number and time to first episode of clinical malaria and URTIs with respect to the IFNL4-rs368234815 allele. We found that children that carried the IFNL4-rs368234815-dG allele had an increased number of clinical malaria episodes. In addition, there was a significant association between earlier age of first malaria infection with carriers of the IFNL4-dG allele (p-value: 0.021).Conclusion: Our results suggest that the ability to produce IFN-λ4 negatively affects host immune protection against P. falciparum malaria in Kenyan children.Classification: Immunology, Microbiology, Genetics
Survival of Eight LLIN Brands 6, 12, 24 and 36 Months After a Mass Distribution Campaign in Rural and Urban Settings in Senegal
Authors: DIOUF Mbaye , FAYE Babacar Thiendella , DIOUF El hadji , DIA Abdoulaye Kane , KONATE Abdoulaye , FALL Fatou Ba , SENE Doudou , RAMIREZ Katherine Sturm , DIOUF Mame Birame , GADIAGA Libasse , KONATE Lassana , FAYE Ousmane
Published: September 2020

Background: Long lasting insecticidal nets (LLIN) are one of the core components of global malaria prevention and control. The lifespan of LLIN varies widely depending on the population or environment, and randomized studies are required to compare LLIN in households under different field condition. This study investigated survival of different LLIN brands in Senegal.Methods: 12,608 LLINs were distributed in 5 regions each stratified by rural and urban setting. As part of the longitudinal follow-up, 2222 nets were randomly sampled and monitored from 6 to 36 months. Using random effects for households, Bayesian model were allowed to estimate independent survival by net type and by area (rural/urban). The complement of survival, attrition and median survival time of each LLIN brand, was determined as those nets that were missing because they were reported given away, destroyed and thrown, or repurposed.Results: Three net types had a proportion of survival above 80% after 24 months: Interceptor®87.8% (95% CI 80-93.4); conical PermaNet® 2.0 86.9% (95% CI 79.3-92.4) and Life Net® 85.6% (95% CI 75-93). At 36 months, conical PermaNet® 2.0 maintained a good survival rate, 79.5% (95% CI 65.9-88.8). The attrition due to redistributed nets showed that the two conical net types (PermaNet® 2.0 and Interceptor®) were more often retained by households and their median retention time was well above three years (median survival time =3.5 years for PermaNet® 2.0 and median survival time =4 years for Interceptor®). Despite this good retention, Interceptor® had a weak physical integrity and its median survival due to wear and tear was below three years (median survival time = 2.4 years). The odds ratio of survival was 2.5 times higher in rural settings than in urban settings (OR 2.5; 95% CI 1.7-3.7). Conclusions: Differences in survival among LLIN may be driven by brand, shape or environmental setting. It appears that in Senegal, conical nets may be retained longer. This study suggests that a distribution of preferred LLIN brand, accompanied by good communication on care and repair, could lead to increased effective lifespan, and allow for longer intervals between universal coverage campaigns.
Multidrug-resistant and Extensively Drug-resistant Enterobacteriaceae: Prevalence, Treatments, and Outcomes: A Retrospective Cohort Study
Authors: Alkofide Hadeel , Alhammad Abdullah , Alruwaili Alya , Aldemerdash Ahmed , Almangour Thamer , Alsuwayegh Aseel , Almoqbel Daad , Albati Aljohara , Alsaud Aljohara , Enani Mushira
Published: September 2020

Background. Highly resistant gram-negative bacteria (GNB) is a global public health threat, especially in intensive care units (ICU). The purpose of this study is to explore the prevalence of drug resistant Enterobacteriaceae infections at an Intensive Care Unit (ICU) in Saudi Arabia. It also aims to assess the appropriateness of therapies used and whether these therapies improved clinical outcomes. Methods. A retrospective study was conducted from 2015 to 2018 in a tertiary hospital ICUs in Saudi Arabia. Positive cultures for multidrug-resistant (MDR), extensive drug resistant (XDR), and pan drug-resistant (PDR) Enterobacteriaceae: Klebsiella pneumoniae (K. pneumonia), Escherichia coli (E. coli), and Enterobacter species were included. Primary outcome was microbiological cure and 30 days in hospital mortality rates; while secondary outcome was length of hospital stay (LOS). Regression models were used to assess the relationship between appropriateness of therapy and outcomes. Results. This study included 227 Enterobacteriaceae cultures in which 60% were either MDR (n=130) or XDR (n=8) infections; no PDR Enterobacteriaceae cultures were identified. The average subjects’ age was 60.1±17.7 years and 54% were females. Half of the MDR/XDR cultures were E. coli, followed by 33% K. pneumoniae, and 16% Enterobacter infection. The most common antibiotics used were piperacillin/tazobactam (53%), followed by carbapenems (47%) and cephalosporins (21.3%). Antibiotic therapy was considered appropriate in 85 out of 138 (61.59%) subjects only. In-hospital death was 84%, microbiological cure rate was achieved in 40% of cases, and the average LOS was 27 days. Appropriateness of antibiotic therapy prescribed was not a predictor of any of the study clinical outcomes. Conclusion. In this study, there was a high prevalence of resistant Enterobacteriaceae infections, which were associated with a high mortality rate. This warrants the need to assess the effectiveness of antimicrobial stewardship program and infection prevention and control practices particularly in critically ill patients.
The Prognostic Value of the CA19-9/TBIL Ratio in Patients With Biliary Tract Cancers (BTCs): A Retrospective Study
Authors: Xiao Jianchun , Wang Li , Hong Tao , Li Binglu , Liu Wei , Qu Qiang , Zheng Chaoji , He Xiaodong
Published: September 2020

Introduction: Incidence of biliary tract cancers (BTCs) in China is high, and surgery is the only curative option. Preoperative CA19-9 has been identified as a predictor for survival in patients with resectable BTCs, but more potential predictors need to be studied. This retrospective study aimed to establish the prognostic significance of CA19-9/TBIL ratio (CTR) in patients with BTCs.Methods: A retrospective analysis was performed in patients who diagnosed with BTCs and received surgical resection between 2013 and 2018 at PUMCH. Demographic and clinical parameters were collected. Preoperative CA19-9 and CTR were classified as elevated (> 58.6 and > 0.83) according to the receiver operating characteristics (ROC) analysis. Demographic and clinical parameters were compared between the groups using Student’s t-test, chi-square, or Fisher’s exact test. Survival analysis was performed by the Kaplan-Meier methods and the relationship between variables and survival was assessed by the log-rank test. Cox regression analysis was conducted to identify potential risk factors for overall survival.Results: In total 109 participants were involved in the final analysis. The overall survival rate was 18.0% at 5 years, with a median survival duration of 1.58 years. The Kaplan-Meier analysis indicated that higher CTR was associated with shorter OS (15 vs. 50, p < 0.01). Univariate survival analysis identified TNM staging, CA19-9, and CTR as statistically significant prognostic factors. In a multiple COX analysis, only CTR was proved as a significantly independent prognostic factor.Conclusion: CTR acts as an independent prognostic predictor for patients with biliary tract cancer.
Equivalency Between the Shock Index and Subtracting the Systolic Blood Pressure From the Heart Rate: An Observational Cohort Study
Authors: Kamikawa Yohei , Hayashi Hiroyuki
Published: September 2020

Background: Although the shock index is known to predict mortality and other severe outcomes, deriving it requires complex calculations. Subtracting the systolic blood pressure from the heart rate may produce a simple shock index that would be a clinically useful substitute for the shock index. In this study, we investigated whether the simple shock index was equivalent to the shock index.Methods: This observational cohort study was conducted at 2 tertiary care hospitals. Patients who were transported by ambulance were recruited for this study and were excluded if they were aged <15 years, had experienced prehospital cardiopulmonary arrest, or had undergone inter-hospital transfer. Pearson’s product-moment correlation coefficient and regression equation were calculated, and two one-sided tests were performed to examine their equivalency. Results: Among 5,429 eligible patients, the correlation coefficient between the shock index and simple shock index was extremely high (0.917, 95% confidence interval 0.912 to 0.921, P <.001). The regression equation was estimated as sSI = 258.55 log SI. The two one-sided tests revealed a very strong equivalency between the shock index and the index estimated by the above equation using the simple shock index (mean difference was 0.004, 90% confidence interval 0.003 to 0.005). Conclusion: The simple shock index strongly correlated with the shock index.
RCO-3 and COL-26 form an External-to-Internal Module that Regulates the Dual-Affinity Glucose Transport System in Neurospora Crassa
Authors: Li Jinyang , Liu Qian , Li Jingen , Lin Liangcai , Li Xiaolin , Zhang Yongli , Tian Chaoguang
Published: September 2020

Background Low- and high-affinity glucose transport system is a conserved strategy of microorganism to cope with environmental glucose fluctuation for their growth and competitiveness. In Neurospora crassa, the dual-affinity glucose transport system consists of a low-affinity glucose transporter GLT-1 and two high-affinity glucose transporters HGT-1/HGT-2, which play diverse roles in glucose transport, carbon metabolism, and cellulase expression regulation. However, the regulation of this dual-transporter system in response to environmental glucose fluctuation is not yet clear.Results In this study, we report that a regulation module consisting of a downstream transcription factor COL-26 and an upstream non-transporting glucose sensor RCO-3 regulates the dual-affinity glucose transport system in N. crassa. COL-26 directly binds to the promoter regions of glt-1, hgt-1, and hgt-2, whereas RCO-3 is an upstream factor of the module whose deletion mutant resembles the Δcol-26 mutant phenotypically. Transcriptional profiling analysis revealed that Δcol-26 and Δrco-3 mutants had similar transcriptional profiles, and both mutants had impaired response to a glucose gradient. We also showed that the AMP-activated protein kinase (AMPK) complex is involved in regulation of the glucose transporters. AMPK is required for repression of glt-1 expression in starvation conditions by inhibiting the activity of RCO-3.Conclusions RCO-3 and COL-26 form an external-to-internal module that regulates the glucose dual-affinity transport system. Transcription factor COL-26 was identified as the key regulator. AMPK was also involved in the regulation of the dual transporter system. Our findings provide novel insight into the molecular basis of glucose uptake and signaling in filamentous fungi, which may aid in the rational design of fungal strains for industrial purposes.
Sleep Quality in the Withdrawal of Medical Members from Wuhan Using the Pittsburgh Sleep Quality Index
Authors: Li Chen , Liu Yang , Xu Wei , Zhang Changjing , Shen Yezhou , Lv Xingping , Zhang Yunhe , Wang Feifei , Ma Shaolin
Published: September 2020

Objective: The main purpose of this paper is to investigate sleep quality in the withdrawal of medical members dispatched to control the Corona Virus Disease 2019(COVID-19) outbreak in Wuhan, Hubei province, China. Methods: Forty-seven medical members (including twenty medical members treating mild COVID-19, seventeen medical members treating severe COVID-19 and ten logistics team members) completed questionnaire using Pittsburgh Sleep Quality Index. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of the medical members. Results: A total of forty-seven medical members participated in the sleep quality survey. The PSQI total scores are 5.6±4.3, 11.0±5.0 and 3.4±2.0 in treating mild COVID-19, treating severe COVID-19 and logistics team members, respectively. Medical members treating patients with severe COVID-19 had significantly higher PSQI total scores than those who facing up to the patients with mild COVID-19 and logistics team members. (P<0.005). The components of PSQI such as sleep duration and sleep medications were significantly higher in medical members treating patients with severe COVID-19 than those who facing up to the patients with mild COVID-19 and logistics team members (P<0.005). The components of PSQI such as sleep quality and daytime dysfunction were worse in medical members treating patients with severe COVID-19 than logistics team members (P<0.005).Conclusions: Findings indicate that medical members treating patients with severe COVID-19 had worse sleep quality than who facing up to the patients with mild COVID-19 and logistics team members.
Evaluating Putative Repellent ‘Push’ and Attractive ‘Pull’ Components for Manipulating the Odour-orientation of Host-seeking Malaria Vectors in the Peri-domestic Space
Authors: Njoroge Margaret Mendi , Fillinger Ulrike , Saddler Adam , Moore Sarah , Takken Willem , Loon Joop van , Hiscox Alexandra
Published: September 2020

Background Novel malaria vector control approaches aim to combine tools to work in synergy for maximum protection. This study aimed to evaluate novel and re-evaluate existing, putative repellent ‘push’ and attractive ‘pull’ components for manipulating the odour-orientation of malaria vectors in the peri-domestic space. Methods Anopheles arabiensis outdoor human landing catches and trap comparisons were implemented in large semi-field systems to (1) test the efficacy of citriodiol or transfluthrin-treated fabric strips positioned in house eave gaps as push components for preventing bites; (2) understand the efficacy of an MB5-baited Suna-trap in attracting vectors in the presence of a human being; (3) assess 2-butanone as a CO2 replacement for trapping; and (4) determine the protection provided by a full push-pull set up. The air-concentrations of the chemical constituents of the push-pull mosquito control tool were quantified.Results Microencapsulated citriodiol eave strips did not provide any outdoor protection against host-seeking An. arabiensis. Transfluthrin-treated strips significantly reduced the odds of a mosquito landing on the human volunteer (OR 0.17; 95% CI 0.12-0.23). This impact was lower (OR 0.59; 95% CI 0.52-0.66) during the push-pull experiment which was associated with low night-time temperatures likely affecting the transfluthrin vaporisation. The MB5-baited Suna trap supplemented with CO2 attracted only a third of the released mosquitoes in the absence of a human being, however, with a human volunteer in the same system, the trap caught less than 1% of all released mosquitoes. The volunteer consistently attracted over two-thirds of all mosquitoes released. This was the case in the absence (‘pull’ only) and in the presence of a spatial repellent (‘push-pull’), indicating that in its current configuration the tested ‘pull’ does not provide a valuable addition to a spatial repellent. The chemical 2-butanone was ineffective in replacing CO2. Transfluthrin was detectable in the air space but with a strong linear reduction in concentrations over 5 metres from release. The MB5 constituent chemicals were only irregularly detected, potentially suggesting insufficient release and concentration in the air for attraction.Conclusion This step-by-step evaluation of the selected ‘push’ and ‘pull’ components led to a better understanding of their ability to affect host-seeking behaviours of the malaria vector Anopheles arabiensis in the peri-domestic space and helps to gauge the impact such tools would have when used in the field for monitoring or control.
Lentinan Administration Alleviates Diarrhea of Rotavirus-Infected Weaned Pigs via Regulating Intestinal Immunity
Authors: Fan Xiangqi , Hu Haiyan , Chen Daiwen , Yu Bing , He Jun , Yu Jie , Luo Junqiu , Eckhardt Erik , Luo Yuheng , Wang Jianping , Yan Hui , Mao Xiangbing
Published: September 2020

BackgroundThis study aimed to verify whether lentinan (LNT) administration could relieve diarrhea via improving gut immunity in rotavirus (RV)-challenged weaned pigs. MethodsTwenty-eight weaned pigs were randomly fed 2 diets containing 0 or 84 mg/kg LNT product for 19 d (n = 14). RV infection was executed on d 15.ResultsDietary LNT supplementation supported normal function of piglets even when infected with RV, as reflected by reduced growth performance loss and diarrhea prevalence, and maintained gut immunity (P < 0.05). The polysaccharide was isolated from LNT product, whose molecular weight was 5303 Da, and major monosaccharides included glucose, arabinose and galactose. In RV-infected IPEC-J2 cells, this polysaccharide significantly increased cell viability (P < 0.05), and significantly increased anti-virus immunity via regulating pattern recognition receptors and host defense peptides (P < 0.05). ConclusionThose results suggest that LNT administration increases the piglets’ resistance to RV-induced stress, likely by supporting intestinal immunity.
Outcome of Hydrocephalus in Tuberculous Meningitis. A Retrospective Study
Authors: Kanesen Davendran , Kandasamy Regunath , Hieng Albert Wong Sii , Tharakan John , Lim Chien Joo , Abdullah Jafri Malin
Published: September 2020

PurposeTo study outcome of Hydrocephalus in Tuberculous Meningitis (TBMH) and factors associated with poor clinical outcome.MethodsClinical data of 143 adult patients diagnosed with TBM over a 6-year period in 2 tertiary hospitals in Malaysia were retrospectively reviewed. Relevant clinical and radiological data was studied. Patients with Hydrocephalus in TBM (TBMH) were further analysed based on their clinical grade and rendered treatment to identify prognostic factors and outcome of this subgroup of patients. The functional outcome of patients was assessed at 12 months from treatment.Results The mean age of patients was 35.6P12.4 year, with a male gender predominance of 67.1%. Forty four percent had TBMH, of which 42.9% had surgical intervention. In the good Modified Vellore Grade, 76.5% was managed medically with concurrent ATT, steroids and osmotic agents. Four patients had surgery early in the disease as they did not respond to medical therapy and reported a good outcome subsequently. Poor outcome (65.2%) was seen in the poor Modified Vellore Grade despite medical and surgical intervention. Multivariate model Multiple Cox Regression showed significant results for seizure (adjusted HR: 15.05, 95%CI: 3.73, 60.78), GCS (adjusted HR: 0.79, 95%CI: 0.70, 0.89) and CSF cell count (adjusted HR: 1.11, 95%CI: 1.05, 1.17).Conclusion Hydrocephalus was seen in 44% of patients in this study. GCS score, seizure and high CSF cell count were factors associated with a poor prognosis in TBM. Patients with TBMHM had better survival function compared to those with TBMHS (p value <0.001). This retrospective study emphasizes that TBMH is still a serious illness, as 47.6% of these patients had poor outcome despite adequate treatment.
The Osteogenic Differentiation of Mesenchymal Stem Cells Derived From Dental Pulp in Modular Alginate-gelatin/nano-hydroxyapatite Microcapsules
Authors: Alipour Mahdieh , Firouzi Nima , Aghazadeh Marziyeh , Samiei Mohammad , Montazersaheb Soheila , Khoshfetrat Ali Baradar , Aghazadeh Zahra
Published: September 2020

Background Microcapsule is considered as a promising 3D microenvironment for Bone Tissue Engineering (BTE) applications. Microencapsulation of cells in an appropriate scaffold not only protects cells against excess stress but also promotes cell proliferation and differentiation. ResultsThe SEM results revealed that Alg/Gel microcapsules containing nHA showed a rough and more compact surface morphology in comparison with the Alg/Gel microcapsules. Moreover, microencapsulation by Alg/Gel/nHA could improve cell proliferation and induce osteogenic differentiation. The cells cultured in the Alg/Gel and Alg/Gel/nHA microcapsules after 21 days showed 1.4-fold and 1.7-fold more activity of BMP-2 gene expression in comparison with the cells cultured on the polystyrene surface as a control group. These amounts for the BMP-2 gene were 2.5-fold and 4-fold more expression for the Alg/Gel and Alg/Gel/nHA microcapsules after 28 days. The nHA addition to hDPSCs-laden Alg/Gel microcapsule could also up-regulate the bone-related gene expressions of osteocalcin, osteonectin, and RUNX-2 during 21 and 28 days culture period. Calcium deposition and ALP activities of the cells were observed in accordance with the proliferation results as well as the gene expression analysis. ConclusionThe study demonstrated that microencapsulation of hDPSCs inside Alg/Gel/nHA hydrogel can be a potential approach for regenerative dentistry in the near future.
Can Mechanical Injury Really Trigger Relapsing Polychondritis? The First Report From A Large Case Series
Authors: Zhang Lei , Yun Shuang , Wu Tiange , He Yujie , Guo Jinyan , Han Lishuai , Lu Jiameng , Liu Xiaojun , Yang Rui , Zhang Shitao , Li Tianfang , Liu Shengyun
Published: September 2020

Objectives The triggers of relapsing polychondritis (RPC) are not fully characterized. This study was performed to explore the association between mechanical injuries and RPC.Methods The history of mechanical injuries of 127 RPC patients was reviewed and confirmed. The characteristics and survivals of patients with mechanical injuries were analyzed. Results Fifty-four patients (42.5%) had 63 mechanical injuries, among which 17 were cartilage-related. Thirty mechanical injuries in 28 patients occurred in the preceding one year before disease onset. Patients with mechanical injuries(n=54) had a higher proportion of female gender (59.3% vs 38.4%, P=0.002) and similar features compared to those without injuries(n=73), regarding clinical manifestations and mortality rate. Among 54 patients with mechanical injuries, patients with cartilage related injury(n=17) had a significantly higher rate of tracheobronchial chondritis (64.7% vs 27%, P= 0.008), a significantly lower rate of auricular chondritis (35.3% vs 67.6%, P=0.026) and a relatively higher mortality rate(29.4% vs 8.1%, P=0.041) compared with those with non-cartilage related injury(n=37).Conclusion Our findings suggest that both cartilage-related and non-cartilage related injury may be triggers of RPC and patients with cartilage related injury seem to be more severe than those without.