bluuebunny/crossref_metadata_2025 huggingface dataset:
Genome Editing With CRISPR/Cas9 in Pinus Radiata (D. Don)
Authors: Poovaiah Charleson , Phillips Lorelle , Geddes Barbara , Reeves Cathie , Sorieul Mathias , Thorlby Glenn
Published: December 2020

BackgroundTo meet increasing demand for forest-based products and protect natural forests from further deforestation requires increased productivity from planted forests. Genetic improvement of conifers by traditional breeding is time consuming due to the long juvenile phase and genome complexity. Genetic modification (GM) offers the opportunity to make transformational changes in shorter time frames but is challenged by current genetically modified organism (GMO) regulations. Genome editing, which can be used to generate site-specific mutations, offers the opportunity to rapidly implement targeted improvements and is globally regulated in a less restrictive way than GM technologies.ResultsWe evaluated U6 snRNA promoters from three different species that were able to drive expression of guide RNA (gRNA) for CRISPR/Cas9 genome editing in P. radiata. Using a single-copy cell wall gene GUX1 as a target, we have demonstrated genome editing using CRISPR/Cas9 in somatic embryogenic tissue and plantlets derived from the edited tissue. We generated biallelic INDELs with an efficiency of 15% using a single gRNA. Twelve percent of the transgenic embryogenic tissue was edited when two gRNAs were used and deletions of up to 1.3 kb were identified. However, the regenerated plants did not contain large deletions but had single nucleotide insertions at one of the target sites. We also assessed the use of CRISPR/Cas9 ribonucleoproteins (RNPs) for their ability to accomplish DNA-free genome editing in P. radiata. We chose a hybrid approach, with RNPs co-delivered with a plasmid-based selectable marker. A two-gRNA strategy was used which produced an editing efficiency of 33%, and generated INDELs, including large deletions. Using the RNP approach, deletions found in embryogenic tissue were also present in the plantlets. But, all plants produced using the RNP strategy were monoallelic.Conclusion We have demonstrated the generation of biallelic and monoallelic INDELs in the coniferous tree P. radiata with the CRISPR/Cas9 system using DNA and RNPs respectively. This opens the opportunity to apply genome editing in conifers to rapidly modify key traits of interest.
Treatment of Compulsive Exercise in Eating Disorders and Muscle Dysmorphia: Protocol for a Systematic Review
Authors: Martenstyn Jordan Andre , Touyz Stephen , Maguire Sarah
Published: December 2020

Background: Compulsive exercise is a core feature of both eating disorders and muscle dysmorphia. Earlier models of treatment recommended complete abstinence from exercise in eating disorder populations, but recent guidelines advocate for the gradual inclusion of healthier forms of exercise into an overall treatment plan where appropriate. Given the association between problematic exercise behaviour and poorer prognosis, there has been a recent upsurge in the number of treatment interventions for compulsive exercise in eating disorders. However, no systematic review has been published summarising this existing treatment literature. The aim of this review is to determine the efficacy of existing treatments for compulsive exercise in eating disorders and muscle dysmorphia. Methods: A systematic review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five electronic databases (PsycInfo, MEDLINE, Embase, Web of Science, and Scopus) will be searched from database inception until November 2020. We will include studies that: (a) sampled adolescents and/or adults with either an eating disorder or muscle dysmorphia; (b) assessed changes in compulsive exercise from pre- to post-intervention; and (c) used a standardised instrument to measure compulsive exercise or related constructs. We chose to include studies with a comparison group (e.g., randomised controlled trials) and without a comparison group (e.g., pilot studies and case studies) to provide a comprehensive overview of the literature. One reviewer will screen all titles and abstracts against eligibility criteria, with 20% of excluded articles cross-referenced by another reviewer. Full texts will be obtained for articles deemed relevant or where inclusion was uncertain, and will be screened by both reviewers. We will also evaluate the quality of the included studies using a modified Downs and Black (1998) assessment checklist. Discussion: Results from this review will help to determine the most efficacious treatment components for compulsive exercise in eating disorders and muscle dysmorphia. We hope that our results will help inform clinical practice guidelines in recommending targeted interventions for the treatment of compulsive exercise.
Complex Samples Logistic Regression Analysis of Predictors of the Use of Modern Contraceptives Among Married or In-Union Women in Ethiopia.
Authors: Adegeh Senait Cherie , Zike Dereje Tesfaye
Published: December 2020

Background: Modern contraceptive use by currently married Ethiopian women has steadily increased over the last 15 years. The main objective of this study was to identify the magnitude and predictors of current use of modern contraceptives among married or in-union women aged (15-49) in Ethiopia using complex sampling. Methods: The study used data from the 2016 Ethiopia Demographic and Health Survey (EDHS, 2016) dataset. In the study a total number of 7,346 married or in-union women age 15-49 in Ethiopia were included. The current use of modern contraceptives among reproductive-age married or in-union women in Ethiopia, measured as ‘Yes’ (currently using a modern method) and ‘No’(using a folkloric method, traditional method, and no method) is considered as a dependent variable. Complex samples binary logistic regression was performed to examine the importance of each explanatory variables using SPSS version 23, and statistical significance was attached at p=0.05. Results: The study found that age 40–44 years (AOR = 2.064), wealth index Middle (AOR = 1.553); Rich (AOR =1.71), working status yes (AOR = 1.279), and sexual activity in the last 4 weeks active in the last 4 weeks (AOR=3.614) were highly significantly associated with current use of modern contraceptive. Conclusion: The variables age, religion, residence, region, wealth status, husband desire for children, women's working status, sexual activity in the last 4 weeks, and total number of children ever born were statistically significant predictors for the current use of modern contraceptives among married or in union women in Ethiopia.
Dihydromyricetin Ameliorates Inflammation-induced Insulin Resistance via Phospholipase C-CaMKK-AMPK Signal Pathway
Authors: Hou Lianjie , Jiang Fangyi , Huang Bo , Zheng Weijie , Jiang Yufei , Cai Gengyuan , Liu Dewu , Hu Ching Yuan , Wang Chong
Published: December 2020

Background: Metabolic syndrome is associated with obesity, inflammation, and insulin resistance. Patients with metabolic syndrome have a higher risk of turning into type II diabetes and cardiovascular disease. The metabolic syndrome has become an urgent public health problem. Insulin resistance in obesity is the common pathophysiological basis of metabolic syndrome. The insulin resistance is induced by the increasing levels of inflammatory factors during obesity. Therefore, developing a therapeutic strategy for preventing inflammation-induced insulin resistance has great significance for the treatment of metabolic syndrome. Dihydromyricetin, as a bioactive polyphenol, has been used for anti-inflammatory, anti-tumor, and improving insulin sensitivity. However, the target of DHM and the molecular mechanism of DHM in preventing inflammation-induced insulin resistance are still unclear.Methods: In this study, we first confirmed the role of dihydromyricetin in inflammation-induced insulin resistance through ELISA, oral glucose tolerance test and glucose uptake test. Then, we demonstrated the pathway of dihydromyricetin ameliorated inflammation-induced insulin resistance by using signal pathway blockers, Ca2+ probes, and immunofluorescence. Finally, we clarified the target protein of dihydromyricetin by using drug affinity responsive target stability (DARTS) assay, qPCR, and western blotting.Results: In this study, we first confirmed that dihydromyricetin ameliorated inflammation-induced insulin resistance in vivo and in vitro. Then, we demonstrated that dihydromyricetin ameliorated inflammation-induced insulin resistance by activating Ca2+-CaMKK-AMPK signal pathway. Finally, we clarified that dihydromyricetin activated Ca2+-CaMKK-AMPK signaling pathway by interacting with phospholipase C (PLC), its target protein.Conclusions: Our results not only demonstrated that dihydromyricetin ameliorated inflammation-induced insulin resistance via the PLC-CaMKK-AMPK signal pathway but also discovered that the target protein of dihydromyricetin is PLC. Our results provided experimental data for the development of dihydromyricetin as a functional food additive and a new therapeutic strategy for treating or preventing insulin resistance and metabolic syndrome.
The Evolution of IBD Perceived Engagement and Care Needs Across the Life-Cycle: A Scoping Review
Authors: Volpato Eleonora , Bosio Caterina , Previtali Enrica , Leone Salvatore , Armuzzi Alessandro , Pagnini F. , Graffigna Guendalina
Published: December 2020

Background: The chronic and progressive evolution of Inflammatory Bowel Diseases (IBD), with its prototypical fluctuating trend, creates a condition of psycho-social discomfort, impacting the quality of life in terms of personal, working and interpersonal.Aims: In this article, we want to identify the nature and extent of the research evidence on the life experiences, the perceived engagement and the psychosocial and medical needs of people affected by IBD across the lifecycle. Methods: Following the approach set out by Arksey and O’Malley and the PRISMA extension for scoping reviews, we conducted a scoping review in March 2019 and closed the review with an update in October 2019. It was performed using electronic databases covering Health and Life Sciences, Social Sciences and Medical Sciences, such as PubMed, Medline, Embase, Scopus, Cochrane, Web of Science, PsycInfo.Results: We identified 95 peer-reviewed articles published from 2009 to 2019, that allowed to detect the main needs in children (psychological, need to be accepted, physical activity, feeding, parent style and support, social needs), adolescents (to understand, physical and psychological needs, protection, relational, gratitude, respect and engagement) and adults (information, medical, psychological, social, work-related, practical, future-related, engagement). ﻿Although the literature confirms that the majority of the IBD units have planned provision for the different types of transitions, the quality and appropriateness of these services have not been assessed or audited for all the kind of challenges across the life cycle. Conclusions: The literature shows the relevance of organising a flexible, personalised health care process across all the critical phases of the life cycle, providing adequate benchmarks for comparison in a multidisciplinary perspective and ensuring continuity between hospital and territory.
Anaphylaxis Induced by Exercise or Cold Stimulation with Hyperleukotrieneuria During a Challenge Testing Not Containing Food Ingestion
Authors: Motomura Chikako , Ide Koji , Shimoda Terufumi , Odajima Hiroshi
Published: December 2020

Background: Exercise-induced anaphylaxis (EIA) is rare and a potentially life-threatening disorder that can develop independently without food ingestion. Cold drinks can also trigger symptoms in some patients with cold-induced anaphylaxis. We present the case of a patient with exercise and cold-induced anaphylaxis that was diagnosed based on hyperleukotrieneuria in exercise loading and cold-drink challenge testing.Case presentation: A 12-year-old girl presented with acute flushing, cyanosis, swollen eyelids, and dyspnea after an endurance run in winter or swimming in a cold-water pool. She also developed dyspnea after having a cold drink. She had no history of food allergies or atopy. No association was noted between anaphylaxis and food intake in her history. On the 1st day, she ingested 200 mL cold water at a temperature of 5°C in 30 s, which did not trigger any symptomatic responses, but urinary LTE4 level increased (pre-challenge test 295 pg/mg.cr, post-challenge test 400 pg/mg.cr). On the 2nd day, she underwent the exercise loading test according to the Bruce protocol by increasing the power of exercise every 2 min using an ergometer. She had been fasting for >15 h and did not have breakfast. Just after the exercise loading test, the plasma adrenaline and noradrenaline increased. At 15min. after the exercise loading test, the plasma adrenaline and histamine (pre-challenge test 0.7 ng/mL, 15min.post-challenge test 81 ng/mL) rised sharply with anaphylaxis symptom accompaneid by increasing of urinary LTE4 (pre-challenge test 579 pg/mg.cr, post-challenge test 846 pg/mg.cr). After she was discharged, she was restricted from strenuous exercise especially in cold environments and prescribed an adrenaline autoinjector.Conclusion: To our knowledge, cold stimulation becomes a co-effector for EIA. Measurements of urinary LTE4 levels during challenge testing are useful to diagnose anaphylaxis induced by exercise or cold stimulation.
Plasma Glial Fibrillary Acidic Protein Detects Alzheimer Pathology and Predicts Future Conversion to Alzheimer Dementia in Patients With Mild Cognitive Impairment
Authors: Cicognola Claudia , Janelidze Shorena , Hertze Joakim , Zetterberg Henrik , Blennow Kaj , Mattsson-Carlgren Niklas , Hansson Oskar
Published: December 2020

IntroductionPlasma glial fibrillary acidic protein (GFAP) is a marker of astroglial activation and astrocytosis. We assessed the ability of plasma GFAP to detect Alzheimer’s disease (AD) pathology in the form of AD-related amyloid-b (Aβ) pathology and conversion to AD dementia in a mild cognitive impairment (MCI) cohort.Method160 MCI patients were followed for 4.7 years (average). AD pathology was defined using cerebrospinal fluid (CSF) Aβ42/40 and Aβ42/total tau. Plasma GFAP was measured at baseline and follow-up using Simoa technology.ResultsBaseline plasma GFAP could detect abnormal CSF Aβ42/40 and CSF Aβ42/total tau (T-tau) with an AUC of 0.79 (95% CI 0.72-0.86) and 0.80 (95% CI 0.72-0.86), respectively. Combination with APOE ε4 status improved the diagnostic accuracy for abnormal CSF Aβ42/40 status (AUC=0.86, p=0.02). Plasma GFAP predicted subsequent conversion to AD dementia with an AUC of 0.84 (95% CI 0.77-0.91), which was not significantly improved when combined with APOE ε4 or age. Longitudinal GFAP slopes for Aβ-positive and MCI who progressed to AD dementia were significantly steeper than for Aβ-negative (p=0.007) and stable MCI (p<0.0001).ConclusionPlasma GFAP can detect AD pathology in patients with MCI and predict conversion to AD dementia.
Effects of an Online Mindful Living With Challenge (MLWC) Intervention on Mental Health and Quality of Life Among COVID-19 Patients in China: A Protocol of a Randomized Controlled Trial
Authors: Si Mingyu , Xiao Weijun , Pan Chen , Wang Hao , Huang Yiman , Lian Jun , Mak Winnie WS , Leng Zhiwei , Tang Qiuping , Su Xiaoyou , Jiang Yu , Feng Luzhao , Yang Weizhong , Wang Chen
Published: December 2020

Background COVID-19 can lead to increased psychological symptoms such as post-traumatic stress disorder (PTSD), depression, and anxiety, especially for patients with COVID-19. Studies suggest that mindfulness-based intervention is an effective, easily delivered and non-aggressive online therapy for patients with mental disorders. This study aims to explore the efficacy and possible mechanism of a Mindful Living With Challenge (MLWC) intervention designed for Chinese COVID-19 survivors in alleviating their psychological problems caused by both the disease and the pandemic.Methods This study is a protocol for a randomized controlled trial. More than 1600 eligible participants will be assigned 1:1 to an online MLWC intervention group or a waitlist control group. All participants will be asked to complete online questionnaires at baseline , post-program, and 3-month follow-up. The primary outcome is mental health status which includes PTSD and other psychological symptoms (i.e. depression, anxiety). The secondary outcomes are related physical symptoms including fatigue and sleeplessness assessed by verified scales such as the Fatigue Scale-14, Pittsburgh Sleep Quality Index. In addition, Five Facets Mindfulness Questionnaire, the Nonattachment Scale, the Stillness Scale, the Resilience Style Questionnaire and the Social Support Scale will be used to assess the mindfulness, stillness, nonattachment level, resilience and perceived social support before and after the intervention, which may be the possible mediators and moderators of the link between the MLWC intervention and target outcomes. Data will be analyzed based on an intention-to-treat approach, and SPSS software will be used to perform statistical analysis.Discussion This study will provide scientific evidence on the efficacy and possible mechanism of the MLWC intervention in improving the quality of life and psychological status among COVID-19 survivors in China. Findings from this study will contribute to a growing research field that assesses the effectiveness of mobile-based and theoretically guided interventions for improving the psychological status of the COVID-19 survivors. Moreover, findings from this study will also contribute to the prevention and management of the psychological complications patients face during such public health emergencies.Trial registration Chinese Clinical Trial Registry (ChiCTR), ChiCTR2000037524; Registered on August 29, 2020, http://www.chictr.org.cn/showproj.aspx?proj=60034.
Stercoral Colitis in a Patient with Pediatric Onset Systemic Lupus Erythematosus: Case Analysis and Review of Literature
Authors: Gau Chunchun , Lin Li-lun , Wu Chao-Yi , Huang Jing-Long
Published: December 2020

Background: Systemic lupus erythematosus (SLE) is an autoantibody-related disease that affects multiple organs. Stercoral colitis (SC) is a rare type of inflammatory colitis with a high mortality rate in the elderly. We aimed to report the first case of pediatric-onset lupus in a patient complicated by stercoral colitis and to conduct a literature review of patients with SC under 30 years old to persuade a helpful clues for a rapid diagnosis in young ages.Case presentation: A 28-year-old female presented with a history of lupus, was admitted for severe abdominal pain with unremarkable laboratory data and image and was found to have stercoral colitis during the surgery. Two years later, the patient underwent Hartman’s operation due to ischemia colon. In addition, 10 patients younger than 30 years old (ranged 2 year old to 28 year old) including 7 females and 3 males with a diagnosis of SC were analyzed with clinical presentation, physical examination, laboratory exam, image and treatment. All 10 cases had a favorable outcome without mortality.Conclusions: Stercoral colitis is a rare but lethal complication and should highlight the importance of a multidisciplinary approach. The differential diagnosis should include stercoral colitis in patients with SLE developing unexplained sharp abdominal pain.
Deletion of an enhancer in FGF5 is associated with ectopic expression in goat hair follicles and the cashmere growth phenotype
Authors: Li Yefang , Song Shen , Liu Xuexue , Zhang Yanli , Wang Dandan , He Xiaohong , Zhao Qianjun , Pu Yabin , Guan Weijun , E Guangxin , Ma Yuehui , Jiang Lin
Published: December 2020

Background

Research on cashmere growth has a significant effect on the production of cashmere and a profound influence on cashmere goat breeding. Whole-genome sequencing is a powerful platform to rapidly gain novel insights into the identification of genetic mechanisms underlying cashmere fiber growth.
Results

In this study, we generated whole-genome sequences of 115 domestic goats from China, Nepal and Pakistan, including 51 cashmere goats and 64 non-cashmere goats. We found genetically distinct clusters according to their geographic locations but genetic admixture or introgression may have occurred between the Chinese and Nepalese goats. We identified that the fibroblast growth factor 5 gene (FGF5) shows a strong signature for positive selection in the cashmere goat. The 505-bp indel variant at the FGF5 gene locus appeared to be strongly associated with cashmere growth. Functional validation showed that the insertion variant may serve as an enhancer for transcription factor binding, resulting in increased transcription of the upstream FGF5 gene in non-cashmere goats.
Conclusions

Our study provides useful information for the sustainable utilization and improved conservation of goat genetic resources and demonstrates that the indel mutation in the FGF5 gene could potentially serve as a molecular marker of cashmere growth in cashmere goat breeding.
Mass SARS-CoV-2 serological screening for the Principality of Andorra
Authors: Royo-Cebrecos Cristina , Vilanova David , López Joel , Arroyo Vanessa , Francisco Guillem , Pons Marc , Carrasco Mireia G. , Piqué Josep M. , Sanz Sergi , Dobaño Carlota , García-Basteiro Alberto
Published: December 2020

Andorra is a small country located in the Pyrenees attracting millions of visitors, mainly for ski tourism. We estimated SARS-CoV-2 seroprevalence in the entire country by universal serological testing. From 4–28 May, 2020 two cross sectional serological surveys were conducted using a rapid serological test (nCOV IgG/IgM). 72,964 inhabitants (96.1% of the population) participated. Overall seroprevalence was 11.0%. The odds of being seropositive was higher among seasonal workers (OR 1.87; 95% CI 1.57–2.23), students (OR 1.64; 95% CI 1.48–1.82) or in the population living in La Massana region (OR 2.65; 95% CI 2.43–2.89). A higher seroprevalence was observed in those familiar nuclei with greater numbers of cohabitants: 18% in families with 6 household members or more; 13% in medium size families (3/4/5 people) and 12% in small size (1 to 2 people) nuclei (p < 0.001). Seasonal workers, students and inhabitants based in ski-related areas presented a higher seroprevalence. Mass antibody screening allows to identify infection hotspots and should contribute to the design of tailored interventions to prevent SARS-CoV-2 transmission.
WITHDRAWN: Plant growth promoting Bipolaris sp. CSL-1 mitigate salinity stress in soybean via altering endogenous phytohormonal level, antioxidants and genes expression
Authors: Lubna Lubna , Khan Muhammad Aaqil , Asaf Sajjad , Jan Rehmatullah , Waqas Muhammad , Kim Kyung-Min , Lee In-Jung
Published: December 2020

Background
Salinity stress is one of the most devastating environmental stress that inhibits plants growth and development. Many strategies including plant growth promoting fungi have been reported to mitigate salt stress.
Results
In this study, we adopted environmental friendly technique and screened different plant growth promoting fungi for different PGP traits and salinity stress. Among these isolate CSL1 were selected based on the basis of plant growth promoting characteristics producing IAA, GAs, organic acid and tolerance to NaCl stress. Furthermore, inoculation of fungal isolate CSL1 significantly increased shoot length (16%), root length (37%), shoot fresh and dry weight (19% and 25%), root fresh and dry weight (47 and 51%) and chlorophyll content (24%) under NaCl stress (200 mM). Endogenous ABA level (0.77 folds) were significantly decreased while SA contents (16%) were increase in CSL1 inoculated plants under NaCl stress. Similarly, higher level of antioxidants such as MDA (2 folds), SOA (29%), POD (8 folds) and PPO (3 folds) was observed in NaCl treated non-inoculated plants. ICP analysis showed an increase in Na+ (11 folds) and decrease in K+ content (15%). Furthermore, CSL-1 inoculation improved soybean adaptability against NaCl stress and a significant decrease in GmFDL19 expression (5 folds) GmNARK (4 folds) and GmSIN1 (3 folds) was observed. However, higher expression of GmAKT2 (15%) were observed in CSL-1 treated plants.
Conclusion
Fungal isolate CSL-1 have capability to mitigate salinity stress in soybean, increase plant growth and could be used as valuable ecofriendly microorganism resource, low cost based biotechnological approach for sustainable agriculture in salt affected areas.
Comparing the Performance of the New Fully Automated Urine Particle Analyzer UF-5000 with UF-1000i and Gram Stain in Predicting Bacteria Growth Patterns in Women with Uncomplicated Urinary Tract Infections
Authors: Yang Stephen Shei-Dei , yang Chun-Chun , Chen Yi-Shen , chang Shangjen
Published: December 2020

BackgroudTo compare the performance of the new flow cytometer UF-5000 with UF-1000i (Sysmex, Kobe, Japan) and Gram stain in predicting the bacterial patterns in urine samples MethodsWomen with symptoms suggestive of urinary tract infection were enrolled. Mid-stream urine sample was collected for gram staining, urine analysis and urine culture. Bacterial patterns were classified though UF1000i (none, cocci bacteria or rods/mixed growth), UF-5000 (none, cocci, rods or mixed growth) and Gram stain. Results Among the 102 samples, there were 10 gram-positive cocci, 2 gram-positive bacilli, 66 gram-negative rods, and 24 mixed growth. The sensitivity/specificity of the UF-1000i was 81.8/91.1% for gram-negative rods and 23.5/96.9% for cocci/mixed. The sensitivity/specificity of the UF-5000 was 80.0/88.2% for gram negative rods and 70.0/86.5% for gram-positive cocci.ConclusionsThe UF-5000 demonstrated the good sensitivity and specificity for Gram-negative bacilli bacteria and demonstrated an improved sensitivity for detecting Gram-positive cocci.
Association of Pigmentation Related-Genes Polymorphisms and Geographic Environmental Variables in the Chinese population
Authors: Wang Yuxin
Published: December 2020

Background: Human skin color is highly heritable and one of the most variable phenotypic traits. However, the genetic causes and environmental selective pressures underlying this phenotypic variation have remained largely unknown. To investigate whether the pigmentation related-genes polymorphisms are associated with the geographic environmental variables. We selected randomly 795 healthy individuals from eight ethnic groups in nine provinces in China. Six single nucleotide polymorphisms (SNPs) of SLC45A2 and TYR were genotyped using Agena MassARRAY. The chi-square test and Spearman correlation analysis were used to compare the frequency distribution of genotypes among different ethnic groups and evaluate the relationship between SNP genetic diversity and environmental variables, respectively. Results: The results indicated that rs28777 and rs183671 (SLC45A2) and rs1042602 (TYR) genotype frequency distributions were significantly different between the Xinjiang-Uighur and other ethnic groups (P < 0.05). Spearman correlation analysis found that rs28777 (r = -0.090, P = 0.011), rs183671 (r = -0.105, P = 0.003), rs1042602 (r = -0.108, P = 0.002), rs1126809 (r = -0.151, P < 0.001) allele frequencies were negatively correlated with the longitude; rs183671 (r = 0.151), rs1042602 (r = 0.157) and rs1126809 (r = 0.138) allele frequencies were positively associated with the latitude (P < 0.001); rs183671 (r = 0.116, P = 0.001), rs1042602 (r = 0.105, P = 0.003) and rs1126809 (r = 0.070, P = 0.048) allele frequencies were positively correlated with the sunshine hours; rs183671 (r = -0.076, P = 0.033), rs1042602 (r =-0.079, P = 0.027) and rs1126809 (r = -0.076, P = 0.031) were negatively correlated with the annual average temperature. Conclusions: Our results confirm the idea that environmental factors have been an important selective pressure upon pigmentation related gene polymorphisms.
Silent monster inside the ear! Understanding the level of awareness about Cholesteatoma in hospital visitors of Puducherry.
Authors: Bhat Poornima S , Kaliavaradan Santhanakrishnan , Surendran Pravin , Muruganidhi Nisha
Published: December 2020

Aims: With the COVID-19 pandemic resulting in most centres postponing the non-emergency services, there is a potential risk of under reporting of uncomplicated cholesteatoma cases, due to lack of symptoms and awareness. This study aims to assess the level of knowledge about CSOM, especially cholesteatoma and related harmful practices among general population. Methods: All consenting adult hospital visitors, irrespective of their purpose of visit were invited to participate in this questionnaire based, cross sectional study at the preregistration point of the tertiary care teaching hospital. Data was collected and analyzed using appropriate methods. Results: Among 350 respondents, majority exhibited poor level of knowledge about general perceptions about ear infections [295(84.3%)], perceptions about cholesteatoma[246(70.3%)]; knowledge about intratemporal complications[244(69.7%)]; knowledge about intracranial complications[247(70.6%)] and harmful practices in ear disease patients[279(79.7%)].Multivariate analysis of socio-demographic and ear disease history related characteristics with overall ear disease related knowledge has shown that unskilled workers and unemployed respondents have poor knowledge levels compared to their counterparts, but at the same time the study has found that respondents with higher level of education also exhibited poor levels of knowledge in contrary to the existing evidence. Conclusion: This study highlights the lack of awareness about CSOM, especially cholesteatoma and its complications, harmful practices mainly in rural population, even in well educated groups, and the need for health education measures to create awareness among the general population regarding various areas ofconcern, to prevent a potential increase in the incidence of complications, especially during and post COVID-19 pandemic.
Low Engagement in HIV Services and Progress through the Treatment Cascade among Key Populations Living with HIV in Mozambique: Alarming Gaps in Knowledge of Status
Authors: Boothe Makini , Sathane Isabel , Baltazar Cynthia Semá , Chicuecue Noela , Horth Roberta , Fazito Erika , Raymond Henry Fisher
Published: December 2020

Background. Mozambique has a generalized HIV epidemic of 13.5% among the general population. Early modeling exercises in Mozambique estimate that key populations (KP), defined as men who have sex with men (MSM), female sex workers (FSW), and people who inject drugs (PWID), along with their partners account for about one third of all new infections. There is limited data describing the engagement of KP living with HIV in testing, care and treatment services. Methods. We conducted a secondary data analysis of HIV-positive participants in the first Bio-behavioral Surveillance (BBS) surveys in Mozambique conducted 2011-2014 in order to assess service uptake and progress though the HIV treatment cascade among MSM, FSW, and PWID. Unweighted pooled estimates were calculated for each key population group.Results. Among HIV-positive MSM, 63.2% of participants had ever received an HIV test, 8.8% were aware of their status, 6.1% reported having been linked to care, while 3.5% initiated ART and were currently on treatment. Of the HIV-infected FSW participants, 76.5% reported a previous HIV test and 22.4% were previously aware of their status. Linkage to care was reported by 20.1%, while 12.7% reported having initiated ART and 11.8% reported being on treatment at the time of the survey. Among HIV-infected PWID participants, 79.9% had previously received an HIV test, 63.2% were aware of their HIV status, and 49.0% reported being linked to care for their HIV infection. ART initiation was reported by 42.7% of participants, while 29.4% were on ART at the time of the survey. Conclusion. Among the three high risk populations in Mozambique, losses occurred throughout critical areas of service uptake with the most alarming breakpoint occurring at knowledge of HIV status. Special attention should be given to increasing HIV testing and linkage to ART treatment. Future surveys will provide the opportunity to monitor improvements across the cascade in line with global targets and should include viral load testing to guarantee a more complete picture of the treatment cascade.
Predictors of long-term post-thrombotic syndrome following high proximal deep vein thrombosis: a cross-sectional study
Authors: Engeseth Marit , Enden Tone , Sandset Per Morten , Wik Hilde Skuterud
Published: December 2020

Background Post-thrombotic syndrome (PTS) is a frequent chronic complication of proximal deep vein thrombosis (DVT) of the lower limb, but predictors of PTS are not well established. We aimed to examine predictors of PTS in patients with long-term PTS following proximal DVT. Methods During 2006-09, 209 patients with a first time acute upper femoral or iliofemoral DVT were randomized to receive either additional catheter-directed thrombolysis or conventional therapy alone. In 2017, the 170 still-living participants were invited to participate in a cross-sectional follow-up study. In the absence of a gold standard diagnostic test, PTS was defined in line with clinical practice by four mandatory, predefined clinical criteria: 1. An objectively verified DVT; 2. Chronic complaints (>1 month) in the DVT leg; 3. Complaints appeared after the DVT; and 4. An alternative diagnosis was unlikely. Possible predictors of PTS were identified with multivariate logistic regression. Results 88 patients (52%) were included 8-10 years following the index DVT, and 44 patients (50%) were diagnosed with PTS by the predefined clinical criteria. Younger age and higher baseline Villalta score were found to be independent predictors of PTS, i.e., OR 0.96 (95% CI, 0.93-0.99), and 1.23 (95% CI, 1.02-1.49), respectively. Lack of iliofemoral patency at six months follow-up was significant in the bivariate analysis, but did not prove to be significant after the multivariate adjustments.Conclusions In long-term follow up after high proximal DVT, younger age and higher Villalta score at DVT diagnosis were independent predictors of PTS.
Readmission rate after epilepsy surgery: A systematic review and meta-analysis
Authors: Bameri Omid , Saravani Khadijeh , Salarzaei Morteza
Published: December 2020

Objective Today, quality of care has become a central issue with regard to redesigning health care delivery. For improvement of quality of care, measurement and analysis of outcomes is essential. the aim of this study is to evaluate the 30 day readmission rate of epilepsy surgery.Material and Methods A systematic literature review was performed in April 2020. We reviewed MEDLINE/PubMed, Cochrane Library, and ClinicalTrials.gov for citation or ongoing trials from January 2010 to March 2020. The search criteria were limited to human studies published in English language. The Medical Subject Headings terms used for the search in PubMed were ‘epilepsy surgery’ ,’readmission’, ’reoperation ’ and ‘neurological surgery’. We used random-effects meta-analyses to estimate pooled risk ratios and 95% confidence intervals for early readmissionResults In the 7trials reporting readmission rates, the overall prevalence of readmission and re-operation within 30 days was 10% and 9%. The most common cause of re-admission was seizure(31.6%). The overall mean Elixhauser index among readmitted patients after epilepsy surgery was 8.05.Conclusion Minimizing factors that contribute to readmission in various patient populations and procedures becomes important for patient care, resource utilization, and physician reimbursement.understanding about a readmission rate of 10% can be useful to health systems designing quality improvement efforts.Awareness of the reasons for readmission is important for patient counseling and surgical decision making.In epilepsy surgery, although our study did not show a significant difference but ,readmissions might be reduced with optimization of pre-existing comorbidities
The clinical characteristics and outcome of cryptococcal meningitis with AIDS in a tertiary hospital in China: An observational cohort study
Authors: Wu Liang , Xiao Jiang , Song Yangzi , Gao Guiju , Zhao Hongxin
Published: December 2020

Background Despite the profound impact of antiretroviral therapy in the control of AIDS mortality, central nervous system opportunistic infections remains a significant burden in AIDS patients. This retrospective study aims to elucidate the clinical characteristics, outcome and risk factors of cryptococcal meningitis (CM) poor prognosis in AIDS patients from a tertiary hospital in China.Methods Clinical data from 128 patients admitted in Beijing Ditan Hospital, Capital Medical University from November 2008 to November 2017 was collected. The cohort was stratified based on treatment outcome (effective 79%, and ineffective 21%), and Multivariate Logistic regression analysis used to identify risk factors of poor disease prognosis.Results Age, incidence of cerebral infarction, the proportion of consciousness disorder, and fasting plasma glucose was higher in the ineffective treatment group than the effective treatment group. The duration of treatment in the induction period of the ineffective group was significantly shorter than that of the effective group. Multivariate Logistic regression analysis indicated that the occurrence of cerebral hernia and consciousness disorder were risk factors for the prognosis of AIDS patients with CM infection, while the duration of treatment in the induction period was a indicative of a better prognosis in AIDS with CM infection complications. Finally, shunt decompression therapy correlated with a better disease outcome. Conclusions This retrospective study exposes the main risk factors associated with worse disease prognosis in AIDS patients with CM infection complications.
Urine collection in cervical cancer screening – analytical comparison of two HPV DNA assays
Authors: Tranberg Mette , Jensen Jørgen Skov , Bech Bodil Hammer , Andersen Berit
Published: December 2020

Background: To reach non-participants, reluctant to undergo clinician-based cervical cancer screening and vaginal self-sampling, urine collection for high-risk human papillomavirus detection (hrHPV) may be valuable. Using two hrHPV DNA assays, we evaluated the concordance of hrHPV positivity in urine samples in comparison with vaginal self-samples and cervical cytology samples taken by the general practitioner (GP). We also studied women's acceptance of urine collection and preferences towards the different sampling procedures.Methods: One hundred fifty paired self-collected urine and vaginal samples and GP-collected cervical cytology samples were obtained from 30 to 59-year-old women diagnosed with ASC-US within the Danish cervical cancer screening program. After undergoing cervical cytology at the GP, the women collected first-void urine and vaginal samples at home and completed a questionnaire. Each sample was hrHPV DNA tested by the GENOMICA CLART® and COBAS® 4800 assays. Concordance in hrHPV detection between sample types was determined using Kappa (k) statistics. Sensitivity and specificity of hrHPV detection in urine was calculated using cervical sampling as reference.Results: With the COBAS assay, urine showed good concordance to the vaginal (k=0.66) self-samples and cervical samples (k =0.66) for hrHPV detection. The corresponding concordance was moderate (k=0.59 and k=0.47) using CLART. Compared to cervical sampling, urinary hrHPV detection had a sensitivity of 63.9% and a specificity of 96.5% using COBAS; compared with 51.6% and 92.4% for CLART. Invalid hrHPV test rates were 1.8% for COBAS and 26.9% for CLART. Urine collection was well-accepted and 42.3% of the women ranked it as the most preferred future screening procedure.Conclusions: Urine collection provides a well-accepted screening option. With COBAS, higher concordance between urine and vaginal self-sampling and cervical sampling for hrHPV detection was found compared to CLART. Urinary hrHPV detection with COBAS is feasible, but its accuracy may need to be improved before urine collection at home can be offered to non-participants reluctant to both cervical sampling and vaginal self-sampling.
Prognostic models for predicting overall survival and cancer-specific mortality in hepatocellular carcinoma: A competing risk analysis
Authors: Lin Kongying , Huang Qizhen , Ding Zongren , Zeng Yongyi , Liu Jingfeng
Published: December 2020

Background: Mortality due to hepatocellular carcinoma (HCC), which is the most common liver cancer, is often overestimated because of deaths from other causes. This study was conducted to estimate the probability of cancer-specific mortality (CSM) of patients with HCC and establish a competing risk nomogram for predicting the CSM of among these patients HCC using a large population-based cohort. Methods: Patients diagnosed with HCC between 2004 and 2015 were identified from the Surveillance Epidemiology and End Results Program. CSM and overall survival (OS) were the endpoints of the study. A competing risk nomogram for predicting CSM was built using the Fine and Gray regression model, and the nomogram for predicting OS was constructed with the Cox proportional hazard regression model, and 10-fold cross-validation was performed for the entire set. Results: A total of 34,957 patients were included in the study and randomly divided into a training set and validation set at a ratio of 7:3. Multivariate analysis identified age, race, surgical therapy, chemotherapy, radiotherapy, tumour diameter, and tumour staging as the independent predictive factors of CSM. In addition to these factors, sex and marital status were also identified as independent predictive factors of OS. Using these factors, corresponding nomograms were constructed for CSM and OS. In the validation set, the 5 year concordance-indices of the two nomogram models were estimated as 0.746 and 0.74. Calibration curves revealed good consistency between model predictions and observed outcomes. Furthermore, based on the results of cumulative incidence function analysis and Kaplan-Meier analysis, patients were categorised into four distinct risk subgroups, supporting the predictive performance of the models. Conclusions: In this population-based analysis, we developed and validated nomograms for individualized prediction of CSM and OS in patients with HCC.
Association between breakfast skipping and metabolic outcomes by sex, age, and work status stratification
Authors: Heo Jun , Choi Won-Jun , Ham Seunghon , Kang Seong-Kyu , Lee Wanhyung
Published: December 2020

Background: The association between breakfast skipping and abnormal metabolic outcomes remains controversial. A comprehensive study with various stratified data is required.Objective: The aim of this study was to investigate the relationship between abnormal metabolic outcomes and breakfast skipping by sex, age, and work status stratification. Methods: We used data from the Korea National Health and Nutrition Examination Surveys from 2013-2018. A total of 21,193 (9,022 men and 12,171 women) participants were included in the final analysis. The risk of metabolic outcomes linked to breakfast skipping was estimated using the negative binomial regression analysis by sex, work status, and age stratification. Results: A total of 11,952 (56.4%) participants consumed breakfast regularly. The prevalence of abnormal metabolic outcomes was higher among those with irregular breakfast consumption habits. Among young male workers, negative binomial regression analysis showed that irregular breakfast eaters had a higher risk of abnormal metabolic outcomes, after adjusting for covariates (odds ratio, 1.15; 95% confidence interval, 1.03-1.27). Conclusions: The risk of abnormal metabolic outcomes was significant in young men in the working population. Further studies are required to understand the association of specific working conditions (working hours or shift work) with breakfast intake status and the risk of metabolic diseases.
Neural stemness contributes to cell tumorigenicity
Authors: Xu Liyang , Zhang Min , Shi Lihua , Yang Xiaoli , Chen Lu , Cao Ning , Lei Anhua , Cao Ying
Published: December 2020

Background: Previous studies demonstrated the dependence of cancer on nerve. Recently, a growing number of studies reveal that cancer cells share the property and regulatory network with neural stem/progenitor cells. However, relationship between the property of neural stemness and cell tumorigenicity is unknown.Results: We show that neural stem/progenitor cells, but not non-neural embryonic or somatic stem/progenitor cell types, exhibit tumorigenicity and the potential for differentiation into tissue types of all germ layers when they are placed in non-native environment by transplantation into immunodeficient nude mice. Likewise, cancer cells capable of tumor initiation have the property of neural stemness because of their abilities in neurosphere formation in neural stem cell-specific serum-free medium and in differentiation potential, in addition to their neuronal differentiation potential that was characterized previously. Moreover, loss of a pro-differentiation factor in myoblasts, which have no tumorigenicity, lead to the loss of myoblast identity, and gain of the property of neural stemness, tumorigenicity and potential for re-differentiation. By contrast, loss of neural stemness via differentiation results in the loss of tumorigenicity. These suggest that the property of neural stemness contributes to cell tumorigenicity, and tumor phenotypic heterogeneity might be an effect of differentiation potential of neural stemness. Bioinformatic analysis reveals that neural genes in general are correlated with embryonic development and cancer, in addition to their role in neural development; whereas non-neural genes are not. Most of neural specific genes emerged in typical species representing transition from unicellularity to multicellularity during evolution. Genes in Monosiga brevicollis, a unicellular species that is a closest known relative of metazoans, are biased toward neural cells.Conclusions: We suggest that the property of neural stemness is the source of cell tumorigenicity. This is due to that neural biased unicellular state is the ground state for multicellularity and hence cell type diversification or differentiation during evolution, and tumorigenesis is a process of restoration of neural ground state in somatic cells along a default route that is pre-determined by an evolutionary advantage of neural state.