bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the Accuracy of Text Classification using Stemming Method, A Case of Non-formal Indonesian Conversation
Authors: Rianto Rianto , Mutiara Achmad Benny , Wibowo Eri Prasetyo , Santosa Paulus Insap
Published: November 2020

Stemming has long been used in data pre-processing in information retrieval, which aims to make affix words into root words. However, there are not many stemming methods for non-formal Indonesian text processing. The existing stemming method has high accuracy for formal Indonesian, but low for non-formal Indonesian. Thus, the stemming method which has high accuracy for non-formal Indonesian classifier model is still an open-ended challenge. This study introduces a new stemming method to solve problems in the non-formal Indonesian text data pre-processing. Furthermore, this study aims to provide comprehensive research on improving the accuracy of text classifier models by strengthening on stemming method. Using the Support Vector Machine algorithm, a text classifier model is developed, and its accuracy is checked. The experimental evaluation was done by testing 550 datasets in Indonesian using two different stemming methods. The results show that using the proposed stemming method, the text classifier model has higher accuracy than the existing methods with a score of 0.85 and 0.73, respectively. In the future, the proposed stemming method can be used to develop the Indonesian text classifier model which can be used for various purposes including text clustering, summarization, detecting hate speech, and other text processing applications.
Burnout And Depression Among Psychiatry Residents During Covid-19 Pandemic
Authors: Alkhamees Abdulmajeed A. , Assiri Hatem , Alharbi Hatim Yousef , Nasser Abdullah , Alkhamees Mohammad A.
Published: November 2020

Very few studies have been concerned with assessing the prevalence of burnout and depressive symptoms, especially during an infectious outbreak on non-frontline health care workers, such as a psychiatrist. In such instances, the role of psychiatrists and other mental health providers as a source of psychological support to the public and frontline workers is indispensable and valuable. This study aims to assess the prevalence of burnout and depressive symptoms, and their correlation, during the COVID-19 pandemic among psychiatry residents in Saudi Arabia. A total of 121 out of 150 psychiatry residents in Saudi Arabia completed the Maslach Burnout Inventory and Patient’s Health Questionnaire for the assessment of burnout and depressive symptoms. Around 27.3% reported having burnout and depressive symptoms, with a significant relationship between them. Participants in the first two years of training and having a history of receiving mental health treatment in the past two years were at higher risk. The need is urgent to increase investment in mental health services or risk a massive increase in mental health conditions in the coming months. Hence, the need to construct a plan to reduce this risk of burnout and depression among psychiatrists by developing preventative strategies to prevent burnout and promote wellness is more important than ever.
Efficacy of Silver Needle Therapy for The Treatment of Chronic Nonspecific Low Back Pain: A Prospective, Single-Center, Randomized, Parallel-Controlled Clinical Trial
Authors: Hu Xuesong , Dong Shaoxing , Zhang Bing , Wang Xuan , Yin Yanwei , Liu Chuansheng , Yu Junmin , Wu Xing , Xu Fenghe , Meng Chao
Published: November 2020

Background: Chronic nonspecific low back pain (CNSLBP) troubles approximately 30% of people worldwide. Silver needle therapy (SNT) is a treatment method to relieve soft tissue pain through heating. Therefore, this study aimed to observe the effects of SNT on CNSLBP.Methods: In this study, 100 patients were randomly divided into 2 groups: silver needle (SN) group and control group (n = 50). In the SN group, patients received SNT and physiotherapy, while patients received physiotherapy alone in the control group. At the 6-month follow-up, the numerical rating scale (NRS), Oswestry Disability Index (ODI), Short-Form 12 of quality of life (SF-12), the natural logarithms of low frequency measurement (InLF) and the natural logarithms of high frequency measurement (InHF) of heart rate variability (HRV) were recorded.Results: In both groups, NRS, ODI, SF-12 scores, and HRV at 2 weeks after treatment were improved and maintained for 6 months. Compared with the control group, more significant improvements were observed in the NRS and SF-12 scores at 1, 2, 3, and 6 months and in the ODI scores at 1 and 2 months in the SN group (P < 0.05). However, there was no significant difference between the groups in the ODI scores at 3 and 6 months. InLF and InHF in the SN group were higher than those in the control group at 3 and 6 months (P < 0.05).Conclusions: SNT relieved pain and improved quality of life and autonomic nerve activity, especially parasympathetic nerve, in patients with CNSLBP, without serious complications.Trial registration: This work has registered in the Chinese Clinical Trial Registry (No. ChiCTR-OOC-17013237; Date: 2017.11.09).
Molecular characterization of G6PD mutations reveals the high frequency of G6PD Aures in the Lao Theung population 
Authors: Sanephonasa Amkha , Cheepsunthorn Chalisa Louicharoen , Khaminsou Naly , Savongsy Onekham , Nuchprayoon Issarang , Leecharoenkiat Kamonlak
Published: November 2020

Background: The prevalence and genotypes of G6PD deficiency vary worldwide, with higher prevalence in malaria endemic areas. The first time assessment of G6PD deficiency prevalence and molecular characterization of G6PD mutations in the Lao Theung population were performed in this study. Methods: A total of 252 unrelated Lao Theung participants residing in the Lao People's Democratic Republic (PDR) were recruited. All participant samples were tested for G6PD enzyme activity and G6PD gene mutations. The amplification refractory mutation system (ARMS)-PCR for detecting G6PD Aures was developed.Results: The G6PD mutations were detected in 11.51% (29/252) of the participants. Eight G6PD mutations were detected. The G6PD Aures was the most common mutation identified in this cohort, which represented 58.62 % (17/29) of all mutation. The mutation pattern was homogenous, predominantly involving the G6PD Aures mutation (6.75%), followed by 1.19% G6PD Union and 0.79% each G6PD Jammu, G6PD Mahidol and G6PD Kaiping. One subject (0.4%) each carried G6PD Viangchan and G6PD Canton. Interestingly, one case of coinheritance of G6PD Aures and Quing Yan was detected in this cohort. Based on levels of G6PD enzyme activity, the prevalence of G6PD deficiency in the Lao Theung population was 9.13 % (23/252). The prevalence of G6PD deficient males and females (activity < 30 %) in the Lao Theung population was 6.41 % (5/78) and 1.72 % (3/174), respectively, and the prevalence of G6PD intermediate (activity 30-70 %) was 5.95 % (15/252).Conclusion: The G6PD Aures mutation is highly prevalent in the Lao Theung ethnic group. The common G6PD variants in continental Southeast Asian populations, G6PD Viangchan, Canton, Kaiping, Union and Mahidol, were not prevalent in this ethnic group. The technical simplicity of the developed ARMS-PCR will facilitate the final diagnosis of the G6PD Aures.
Vagal afferent fibers contribute to the anti-inflammatory reactions by vagus nerve stimulation in concanavalin A model of hepatitis in rats
Authors: Jo Byung Gon , Kim Seung-Hyung , Namgung Uk
Published: November 2020

Background: Increasing number of studies provide evidence that the vagus nerve stimulation (VNS) dampens inflammation in peripheral visceral organs. However, the effects of afferent fibers of the vagus nerve (AFVN) on anti-inflammation have not been clearly defined. Here, we investigate whether AFVN are involved in VNS-mediated regulation of hepatic production of proinflammatory cytokines. Methods: An animal model of hepatitis was generated by intraperitoneal (i.p.) injection of concanavalin A (ConA) into rats, and electrical stimulation was given to the hepatic branch of the vagus nerve. AFVN activity was regulated by administration of capsaicin (CAP) or AP-5/CNQX and the vagotomy at the hepatic branch of the vagus nerve (hVNX). mRNA and protein expression in target tissues was analyzed by RT-PCR, real-time PCR, western blotting and immunofluorescence staining. Hepatic immune cells were analyzed by flow cytometry.Results: TNF-α, IL-1β, and IL-6 mRNAs and proteins that were induced by ConA in the liver macrophages were significantly reduced by the electrical stimulation of the hepatic branch of the vagus nerve (hVNS). Alanine transaminase (ALT) and aspartate transaminase (AST) levels in serum and the number of hepatic CD4+ and CD8+ T cells were increased by ConA injection and downregulated by hVNS. CAP treatment deteriorated transient receptor potential vanilloid 1 (TRPV1)-positive neurons and increased caspase-3 signals in nodose ganglion (NG) neurons. Concomitantly, CAP suppressed choline acetyltransferase (ChAT) expression that was induced by hVNS in DMV neurons of ConA-injected animals. Furthermore, hVNS-mediated downregulation of TNF-α, IL-1β, and IL-6 expression was hampered by CAP treatment and similarly regulated by hVNX and AP-5/CNQX inhibition of vagal feedback loop pathway in the brainstem. hVNS elevated the levels of a7 nicotinic acetylcholine receptors (a7 nAChR) and phospho-STAT3 (Tyr705; pY-STAT3) in the liver, and inhibition of AFVN activity by CAP, AP-5/CNQX and hVNX or the pharmacological blockade of hepatic a7 nAChR decreased STAT3 phosphorylation. Conclusions: Our data indicate that the activity of AFVN contributes to hepatic anti-inflammatory responses mediated by hVNS in ConA model of hepatitis in rats.
Factors affecting the technical efficiency of rural primary health care centers in Hamadan, Iran: data envelopment analysis and Tobit regression
Authors: Mohammadpour Saeed , Javan-Noughabi Javad , Najar Ali Vafaee , Zangeneh Moharram , Yousefi Shaghayegh , Nouhi Mojtaba , jahangiri reza
Published: November 2020

Background: Studying and monitoring the efficiency of primary health care centers has a special place in the health system. Although studies have been conducted in the field of efficiency in Iran, few have focused on rural primary health care centers. In addition, previous studies have not used the child mortality rate and Behvarzes as input and output. Objective: The present study was conducted aimed to estimate the technical efficiency of rural primary health care centers and determinant factors in Hamadan using data envelopment analysis and Tobit regression.Methods: This is a Longitudinal study of rural primary health care centers in Hamadan province (2002-2016). Data Envelopment Analysis was employed to estimate technical efficiency of sampled health facilities while Panel Tobit Analysis was applied to predict factors associated with efficiency levels. The outputs were child mortality rate under one year of age and child mortality rate one year to five years of age. The input was Behvarzes (rural health workers).Results: The results of efficiency analysis showed that the average efficiency scores of the centers had a fluctuating trend during the period of the study, but the average performance scores generally decreased in 2016, as compared with 2002. The highest and lowest average performance scores were observed in 2003 (0.78) and 2013 (0.56), respectively. Number of physicians and rural primary healthcare centers per population had a positive statistically significant and the number of midwives and the total fertility per population had a negative statistically significant effect on efficiency.Conclusions: The findings suggest some level of wastage of health resources in primary health centers. Findings indicate a level of waste of health resources in primary health centers. Behvarz functions in providing primary care services can be considered in the reallocation and optimal use of available resources at the level of rural health centers.
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: November 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.
Effects of aging on the skin and gill microbiota of farmed seabass and seabream
Authors: Rosado Daniela , Pérez-Losada Marcos , Pereira Ana , Severino Ricardo , Xavier Raquel
Published: November 2020

Background: Important changes in microbioal composition related to sexual maturation have been already reported in the gut of several vertebrates including mammals, amphibians and fish. Such changes in fish are linked to reproduction and growth during developmental stages, diet transitions and critical life events. We used amplicon (16S rRNA) high-throughput sequencing to characterize the skin and gill bacterial microbiota of farmed seabass and seabream belonging to three different developmental age groups: early and late juveniles and mature adults. We also assessed the impact of the surrounding estuarine water microbiota in shaping the fish skin and gill microbiota. Results: Microbial diversity, composition and potential metabolic functions varied across fish maturity stages. Alpha-diversity in the seabass microbiota varied significantly between age groups and was higher in older fish. Conversely, in the seabream, no significant differences were found in alpha diversity between age groups. Microbial structure varied significantly across age groups; moreover, high structural variation was also observed within groups. Different bacterial metabolic pathways were predicted to be enriched in the microbiota of both species. Finally, we found that the water microbiota is significantly distinct from all the fish microbiota across the studied age groups, although a high percentage of ASVs is shared with the skin and gill microbiota. Conclusions: We report important microbial differences in composition and potential functionality across the different ages of farmed seabass and seabream. These differences may be related to somatic growth and the onset of sexual maturation. Importantly, some of the inferred metabolic pathways could enhance the host coping mechanisms during stressful conditions. Our results provide new evidence suggesting that growth and sexual maturation have an important role in shaping the external mucosa microbiota of fish and highlight the importance of considering different life stages in microbiota studies.
Ex vivo porcine model study on the treatment outcomes of scissor-type knife versus needle-type knife in endoscopic submucosal dissection performed by trainees
Authors: Ichijima Ryoji , Esaki Mitsuru , Yamakawa Shun , Minoda Yosuke , Suzuki Sho , Kusano Chika , Ikehara Hisatomo , Gotoda Takuji
Published: November 2020

BackgroundEndoscopic submucosal dissection (ESD) for gastrointestinal neoplasms can be technically difficult for trainee endoscopists. Presently, there is no consensus for trainees to select the endo-knife type in ESD. Therefore, we conducted a comparison study of treatment outcomes between scissors-type and needle-type knives in ESD performed by trainees in an ex vivo porcine model.MethodsThis study was conducted on trainee endoscopists who participated in ESD hands-on seminars held in August 2018 and September 2019. A total of 22 trainees from 13 institutions were divided into two groups according to their endoscopic experience. Under expert supervision, each trainee performed two ESDs in porcine models, namely, scissor-type knife (ESD-S) and needle-type knife (ESD-N). The efficacy and safety, including the procedure time and rates of self-completion, en bloc resection, and complications, were compared between ESD-S and ESD-N. In subgroup analysis, we also investigated the predictors associated with the difficulty of ESD for trainees using multivariate logistic regression analysis.ResultsEight trainees had an experience of over 1,000 endoscopies (senior trainee: S-Trainee), whereas the others had an experience of less than 1,000 endoscopies (junior trainee: J-Trainee). Among the S-Trainees, no significant differences were observed in any treatment outcome between ESD-S and ESD-N. Among the J-Trainees, the total procedure and mucosal incision times were significantly shorter in ESD-S than in ESD-N [total procedure time: 16.5 min (range: 10.0–31.0) vs. 22.3 min (range: 10.0–38.0), P = 0.018; circumferential incision time: 10.0 min (range: 6-16) vs. 17.0 min (range: 5.0–31.5); P = 0.019]. Regarding complications, muscular injury occurred in two patients during ESD-N performed by J-Trainees; however, no muscular injury occurred during ESD-S. In subgroup analysis, ESD-N was an independent predictive factor of difficult ESD (odds ratio 5.28, 95% confidence interval 1.25–22.30; p = 0.024).ConclusionsThis study revealed that trainees, particularly those who have experienced less than 1,000 endoscopies, should opt for the scissor-type knife to perform ESD.
Detection of SARS-CoV-2 from Patient Fecal Samples by Whole Genome Sequencing
Authors: Papoutsis Andreas , Borody Thomas , Dolai Siba , Daniels Jordan , Steinberg Skylar , Barrows Brad , Hazan Sabine
Published: November 2020

Background

SARS-CoV-2 has been detected not only in respiratory secretions, but also in stool collections. Here were sought to identify SARS-CoV-2 by enrichment NGS from fecal samples, and to utilize whole genome analysis to characterize SARS-CoV-2 mutational variations in COVID-19 patients.

Results

Study participants underwent testing for SARS-CoV-2 from fecal samples by whole genome enrichment NGS (n = 14), and RT-PCR nasopharyngeal swab analysis (n = 12). The concordance of SARS-CoV-2 detection by enrichment NGS from stools with RT-PCR nasopharyngeal analysis was 100%. Unique variants were identified in four patients, with a total of 33 different mutations among those in which SARS-CoV-2 was detected by whole genome enrichment NGS.

Conclusion

These results highlight the potential viability of SARS-CoV-2 in feces, its ongoing mutational accumulation, and its possible role in fecal-oral transmission. This study also elucidates the advantages of SARS-CoV-2 enrichment NGS, which may be a key methodology to document complete viral eradication.
Suspected Heparin-Induced Thrombocytopenia in a COVID-19 Patient on Extracorporeal Membrane Oxygenation Support: A Case Report.
Authors: Phan Xuan T. , Nguyen Tuan Huu , Tran Tung T. , Huynh Thu-Hien T. , Hoang Thuy-Ha T. , Nguyen Vinh-Chau V. , Pham Thao N. T.
Published: November 2020

Background: Extracorporeal membrane oxygenation (ECMO) support can be life-saving in critically ill COVID-19 patients. However, there are many complications associated with this procedure, including Heparin-induced thrombocytopenia (HIT.) Despite its rarity in ECMO cases, HIT can lead to devastating consequences and is difficult to manage. Case presentation: In this report, we present a case of a COVID-19 patient on ECMO support who was diagnosed with HIT and required intensive treatment. Initially, HIT was only suspected due to newly-developed thrombocytopenia and oxygenator dysfunction, with thrombi observed later. Regarding his treatment, since there was no recommended replacement to heparin available to us at the time of diagnosis, we decided to use rivaroxaban temporarily. No adverse events were recorded during that period. The patient was able to make a full recovery.Conclusion: HIT may jeopardize patient’s care during ECMO. As COVID-19 may bring about a surge in the number of patients requiring ECMO support, we need consented guidance to optimize treatment in this specific situation.
Differential ketogenic diet-induced shift in CSF lipid/carbohydrate metabolome of pediatric epilepsy patients with optimal vs. no anticonvulsant response: a pilot study 
Authors: Masino Susan , Ruskin David , Freedgood Nathalie , Lindefeldt Marie , Dahlin Maria
Published: November 2020

Background: The low carbohydrate, high fat ketogenic diet can be an effective anticonvulsant treatment in some pediatric patients with pharmacoresistant epilepsy. Its mechanism(s) of action, however, remain uncertain. Direct sampling of cerebrospinal fluid before and during metabolic therapy may reveal key changes associated with differential clinical outcomes. We characterized the relationship between seizure responsiveness and changes in lipid and carbohydrate metabolites. Methods: We performed metabolomic analysis of cerebrospinal fluid samples taken before and during ketogenic diet treatment in patients with optimal response (100% seizure remission) and patients with no response (no seizure improvement) to search for differential diet effects in hallmark metabolic compounds in these two groups. Optimal responders and non-responders were similar in age range and included males and females. Seizure types and the etiologies or syndromes of epilepsy varied but did not appear to differ systematically between responders and non-responders. Results: Analysis showed a strong effect of ketogenic diet treatment on the cerebrospinal fluid metabolome. Longitudinal and between-subjects analyses revealed that many lipids and carbohydrates were changed significantly by ketogenic diet, with changes typically being of larger magnitude in responders. Notably, responders had more robust changes in glucose and the ketone bodies b-hydroxybutyrate and acetoacetate than non-responders; conversely, non-responders had significant increases in fructose and sorbose, which did not occur in responders. Conclusions: The data suggest that a differential and stronger metabolic response to the ketogenic diet may predict a better anticonvulsant response, and such variability is likely due to inherent biological factors of individual patients. Strategies to boost the metabolic response may be beneficial.
Penicillium janthinellum NCIM1366 shows improved biomass hydrolysis and a larger number of CAZymes with higher induction levels over Trichoderma reesei RUT-C30
Authors: Sreeja-R AthiraRaj , Christopher Meera , Kooloth-Valappil Prajeesh , Kuni-Parambil Rajasree , Gokhale Digambar Vittal , Sankar Meena , Abraham Amith , Pandey Ashok , Sukumaran Rajeev Kumar
Published: November 2020

BackgroundMajor cost of bioethanol is attributed to enzymes employed in biomass hydrolysis. Biomass hydrolyzing enzymes are predominantly produced from the hyper cellulolytic mutant filamentous fungus Trichoderma reesei RUT-C30. Several decades of research have failed to provide an industrial grade organism other than T. reesei, capable of producing higher titers of an effective synergistic biomass hydrolyzing enzyme cocktail. Penicillium janthinellum NCIM1366 was reported as a cellulase hyper producer and a potential alternative to T. reesei, but a comparison of their hydrolytic performance was seldom attempted. ResultsHydrolysis of acid or alkali pretreated rice straw using cellulase enzyme preparations from P. janthinellum and T. reesei indicated 37 and 43 % higher glucose release respectively with P. janthinellum enzymes. A comparison of these fungi with respect to their secreted enzymes indicated that the crude enzyme preparation from P. janthinellum showed 28 % higher overall cellulase activity. It also had an exceptional 10-fold higher beta-glucosidase activity compared to that of T. reesei, leading to a lower cellobiose accumulation and thus alleviating the feedback inhibition. P. janthinellum secreted more number of proteins to the extracellular medium whose total concentration was 1.8 fold higher than T. reesei. Secretome analyses of the two fungi revealed higher number of CAZymes and a higher relative abundance of cellulases upon cellulose induction in the fungus.ConclusionsThe results revealed the ability of P. janthinellum for efficient biomass degradation through hyper cellulase production, and it outperformed the established industrial cellulase producer T. reesei in the hydrolysis experiments. A higher level of induction, larger number of secreted CAZymes and a high relative proportion of BGL to cellulases indicate the possible reasons for its performance advantage in biomass hydrolysis.
Demography and determinants of dog and cat ownership in three towns of West Shoa Zone, Oromia Region, Ethiopia
Authors: Gebremedhin Endrias Zewdu , Sarba Edilu Jorga , Getaneh Abraham Mekebib , Tola Getachew Kebebew , Endale Solomon Shiferaw , Marami Lencho Megersa
Published: November 2020

BackgroundThe dog and cat population data is generally scarce in developing countries due to absence of surveys. The demography of owned dogs and cats, and the associated ownership characteristics, are essential for the control of pet population and zoonosis. This study was conducted in three towns of West Shoa Zone of Ethiopia with the objectives of assessing demographic characteristics of owned dogs and cats and determinants of ownership. MethodsA cross-sectional questionnaire-based survey was designed and administered to households to collect data on the demography and determinants of dog/cat ownership. Six hundred and ten households, consisting of 305 in Ambo, 182 in Bako, and 123 in Gojo towns were interviewed. Logistic regression analysis was used to identify predictors of dog/cat ownership. ResultsAbout 65.1% (95% CI: 62.1 – 69.8%) of the householders own dogs, 39.2% (95% CI: 35.8 – 43.8%) own cats, and 30.6% (95% CI: 27.4 – 35.0%) own both. The majority of the dog-owning households own a single dog (74.8%) and cat (74.9%). There were significantly higher proportion of dog and cat-owning households in Bako than Ambo and Gojo towns. The human to owned-dog ratio was 6:1, and that of cat ratio was 10:1. There were more male dogs (72.1%) and more female cats (59.7%). The male to female sex ratio was estimated at 3:1 for the dog while nearly 1:1 for cats. About 37.5% of the owned dogs were indoor, and 62.5% have free access to outside. Dogs and cats were acquired as a gift from families, neighbors, and friends. The identified reason for not owning dogs/cats were fear of zoonosis, dislike, no time to devote, benefit not realized, and shortage of finance. Logistic regression analysis identified study town, community type, gender of head of household, ownership of other animals as determinants for dog/cat ownership. Besides, possessing dogs was significantly associated with cat ownership. ConclusionData on dog/cat ownership status is important for the provision of veterinary services, pet population control, and for quantifying risks associated with dog/cat to the community and control of dog/cat borne zoonosis.
Prognostic value of bedside lung ultrasound score in patients with COVID-19
Authors: Ji Li , Cao Chunyan , Gao Ying , Zhang Wen , Xie Yuji , Duan Yilian , Kong Shuangshuang , You Manjie , Ma Rong , Jiang Lili , Liu Jie , Sun Zhenxing , Zhang Ziming , Wang Jing , Yang Yali , Lv Qing , Zhang Li , Li Yuman , Zhang Jinxiang , Xie Mingxing
Published: November 2020

Background: Bedside lung ultrasound (LUS) has emerged as a useful and noninvasive tool to detect lung involvement and monitor changes in patients with coronavirus disease 2019 (COVID-19). However, the clinical significance of the LUS score in patients with COVID-19 remains unknown. We aimed to investigate the prognostic value of the LUS score in patients with COVID-19.Methods: The LUS protocol consisted of 12 scanning zones and was performed in 280 consecutive patients with COVID-19. The LUS score based on B-lines, lung consolidation and pleural line abnormalities was evaluated.Results: The median time from admission to LUS examinations was 7 days (interquartile range [IQR] 3-10). Patients in the highest LUS score group were more likely to have a lower lymphocyte percentage (LYM%); higher levels of D-dimer, C-reactive protein, hypersensitive troponin I and creatine kinase muscle-brain; more invasive mechanical ventilation therapy; higher incidence of ARDS; and higher mortality than patients in the lowest LUS score group. After a median follow-up of 14 days [IQR, 10-20 days], 37 patients developed ARDS, and 13 died. Patients with adverse outcomes presented a higher rate of bilateral involvement; more involved zones and B-lines, pleural line abnormalities and consolidation; and a higher LUS score than event-free survivors. The Cox models adding the LUS score as a continuous variable (hazard ratio [HR]: 1.05, 95% confidence intervals [CI]: 1.02～1.08; P < 0.001; Akaike Information Criterion [AIC] =272; C-index = 0.903) or as a categorical variable (HR: 10.76, 95% CI: 2.75～42.05; P = 0.001; AIC =272; C-index = 0.902) were found to predict poor outcomes more accurately than the basic model (AIC =286; C-index = 0.866). An LUS score cut-off >12 predicted adverse outcomes with a specificity and sensitivity of 90.5% and 91.9%, respectively.Conclusions: The LUS score devised by our group performs well at predicting adverse outcomes in patients with COVID-19 and is important for risk stratification in COVID-19 patients.
Anti-Platelet Aggregation of Panax Notoginseng Triol Saponins by Regulating GP1BA for Ischemic Stroke Therapy
Authors: Xu Zhiyi , Xu Yang , Xie Xiaofang , Tian Yin , Sui Junhui , Sun Yong , Lin Dasheng , Gao Xing , Peng Cheng , Fan Yujiang
Published: November 2020

Background: Panax notoginseng triol saponins (PTS) has been used clinically for ischemic stroke therapy (IST) in China for more than sixteen years due to its anti-platelet aggregation and neuro-protective effects, but its mechanism of action is still unclear. In this study, anti-platelet aggregation-related protein analysis and computer simulations of drug-protein binding interactions were performed to explore the mechanism of the effects of PTS against ischemic stroke in an ischemia reperfusion model. Methods: Three oral doses of PTS were administered in a model of middle cerebral artery occlusion (MCAO) in rats. Panax notoginseng total saponins (PNS) and a combination of PTS and aspirin were chosen for comparison. To evaluate therapeutic effects and explore possible mechanisms of anti-platelet aggregation, we measured cerebral infarct size and water content in brain tissue, histomorphological changes, expression of related factors (such as arachidonic acid metabolites) and platelet receptors in serum, as well as the binding affinity of PTS for platelet adhesion receptors. Results: Compared with PNS, PTS showed a stronger and more extensive anti-platelet aggregation effect in MCAO model rats. The combination of PTS and aspirin could reduce adverse gastrointestinal effects by regulating the TXA2/PGI2 ratio. PTS was found to regulate Glycoprotein Ib-α (GP1BA) in a model animal for the first time, and they had a relatively stable binding ability, especially ginsenoside Rg1 and GP1BA, which could form a stable structure. However, PTS could reduce von Willebrand factor (VWF)-mediated platelet adhesion to damaged vascular endothelium, and thus enhance the probability of anti-platelet aggregation and anti-thrombosis under pathological conditions.Conclusions: Our results showed that GP1BA was closely related to the anti-platelet aggregation action of PTS, which provided new scientific evidence for its clinical application.
Comparative transcriptomic analysis of antimony resistant and susceptible Leishmania infantum lines
Authors: Andrade Juvana Moreira , Gonçalves Leilane Oliveira , Liarte Daniel Barbosa , Lima Davi Alvarenga , Guimarães Frederico Gonçalves , Resende Daniela , Santi Ana Maria Murta , de Oliveira Luciana Marcia , Velloso João Paulo Linhares , Delfino Renato Guimarães , Pescher Pascale , Späth Gerald F. , Ruiz Jeronimo Conceição , Murta Silvane Maria Fonseca
Published: November 2020

Background: One of the major challenges for leishmaniasis treatment is the emergence of parasites resistant to antimony. In order to study differentially expressed genes associated with drug resistance we performed a comparative transcriptomic analysis between wild-type and potassium antimonyl tartrate (SbIII)-resistant Leishmania infantum lines using high-throughput RNA sequencing.Methods: All the cDNA libraries were constructed from promastigote forms of each line, sequenced and analyzed using STAR for mapping the reads against the reference genome (L. infantum JPCM5) and DESeq2 for differential expression statistical analyses. All the genes were functionally annotated using sequence similarity search.Results: The analytical pipeline considering an adjusted p-value lower than 0.05 and fold change greater than 2.0 identified 933 transcripts differentially expressed (DE) between wild-type and SbIII-resistant L. infantum lines. Out of 933 DE transcripts, 504 presented functional annotation and 429 were assigned as hypothetical proteins. A total of 837 transcripts were upregulated and 96 were downregulated in the SbIII-resistant L. infantum line. Using this DE dataset, the proteins were further grouped in functional classes according to the Gene Ontology database. The functional enrichment analysis for biological processes showed that the upregulated transcripts in the SbIII-resistant line are associated with protein phosphorylation, microtubule-based movement, ubiquitination, host-parasite interaction, cellular process and other categories. The downregulated transcripts in the SbIII-resistant line are assigned in the GO categories: ribonucleoprotein complex, ribosome biogenesis, rRNA processing, nucleosome assembly and translation.Conclusions: The transcriptomic profile of L. infantum showed a robust set of genes from different metabolic pathways associated with antimony resistance phenotype in this parasite. Our results address the complex and multifactorial antimony resistance mechanisms in Leishmania, identifying several candidate genes that may be further evaluated as molecular targets for chemotherapy of leishmaniasis.
Whole microbial community viability is not quantitatively reflected by propidium monoazide sequencing approach
Authors: Wang Ya , Yan Yan , Thompson Kelsey N. , Bae Sena , Accorsi Emma K. , Zhang Yancong , Shen Jiaxian , Vlamakis Hera , Hartmann Erica M. , Huttenhower Curtis
Published: November 2020

Background High-throughput sequencing provides a powerful window into the structural and functional profiling of microbial communities, but it is unable to characterize only the viable portion of microbial communities at scale. There is as yet not one best solution to this problem. Previous studies have established viability assessments using propidium monoazide (PMA) treatment coupled with downstream molecular profiling (e.g. qPCR or sequencing). While these studies have met with moderate success, most of them focused on the resulting “viable” communities without systematic evaluations of the technique. Here, we present our work to rigorously benchmark “PMA-seq” (PMA treatment followed by 16S rRNA gene amplicon sequencing) for viability assessment in synthetic and realistic microbial communities. Results PMA-seq was able to successfully reconstruct simple synthetic communities comprising viable/heat-killed Escherichia coli and Streptococcus sanguinis. However, in realistically complex communities (computer screens, computer mice, soil and human saliva) with E. coli spike-in controls, PMA-seq did not accurately quantify viability (even relative to variability in amplicon sequencing), with its performance largely affected by community properties such as initial biomass, sample types and compositional diversity. We then applied this technique to environmental swabs from the Boston subway system. Several taxa differed significantly after PMA treatment, while not all microorganisms responded consistently. To elucidate the “PMA-responsive” microbes, we compared our results with previous PMA-based studies and found that PMA-responsiveness varied widely when microbes were sourced from different ecosystems but were reproducible within similar environments across studies. Conclusions This study provides a comprehensive evaluation of PMA-seq exploring its quantitative potential in synthetic and complex microbial communities, where the technique was effective for semi-quantitative purposes in simple synthetic communities, but provided only qualitative assessments in realistically complex community samples.
An Intersectional Analysis Providing More Precise Information on Inequities in Self-Rated Health
Authors: Wemrell Maria , Karlsson Nadja , Vicente Raquel Perez , Merlo Juan
Published: November 2020

Background: Intersectionality theory combined with an analysis of individual heterogeneity and discriminatory accuracy (AIHDA) can facilitate our understanding of health disparities. This enables the application of proportionate universalism for resource allocation in public health. Analyzing self-rated health (SRH) in Sweden, we show how an intersectional perspective allows for a detailed mapping of health inequalities while avoiding simplification and stigmatization based on indiscriminate interpretations of differences between group averages.Methods: We analyzed participants (n=133,244) in 14 consecutive National Public Health Surveys conducted in Sweden in 2004-2016 and 2018. Applying AIHDA, we investigated the risk of bad SRH across 12 intersectional strata defined by gender, income and migration status, adjusted by age and survey year. We calculated odds ratios (with 95% confidence intervals) to evaluate between-strata differences, using native-born men with high income as the comparison reference. We calculated the area under the receiver operating characteristic curve (AU-ROC) to evaluate the discriminatory accuracy of the intersectional strata for identifying individuals according to their SRH status.Results: The analysis of intersectional strata showed clear average differences in the risk of bad SRH. For instance, the risk was seven times higher for immigrated women with low income (OR 7.00 [95% CI 6.14-7.97]) than for native men with high income. However, the discriminatory accuracy of the intersectional strata was small (AU-ROC=0.67).Conclusions: The intersectional AIHDA approach provides more precise information on the existence (or the absence) of health inequalities, and can guide public health interventions according to the principle of proportionate universalism. The low discriminatory accuracy of the intersectional strata found in this study warrants universal interventions rather than interventions exclusively focused on strata with a higher average risk of bad SRH.
Reduced human-biting preferences of the African malaria vectors Anopheles arabiensis and Anopheles gambiae in an urban context: controlled, competitive host-preference experiments in Tanzania
Authors: Mlacha Yeromin P , Chaki Prosper P. , Muhili Athuman , Massue Dennis J. , Tanner Marcel , Majambere Silas , Killen Gerry F , Govella Nicodem J.
Published: November 2020

BackgroundHost preference is a critical determinant of human exposure to vector-borne infections and the impact of vector control interventions. Widespread use of long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS) across sub-Saharan Africa, which protect humans against mosquitoes, may select for altered host preference traits of malaria vectors over the long term. Here, the host preferences of Anopheles arabiensis and Anopheles gambiae sensu stricto (s.s.) were experimentally assessed in the field, using direct host-preference assays in two distinct ecological settings in Tanzania.MethodsEight Ifakara Tent Trap (ITT), four baited with humans and four with bovine calves, were simultaneously used to catch malaria vectors in open field sites in urban and rural Tanzania. The numbers of mosquitoes collected in human-baited traps versus calf-baited traps were used to estimate human feeding preference for each site's vector species. ResultsThe estimated proportion [95% confidence interval (CI)] of mosquitoes attacking humans rather than cattle was 0.60 [0.40, 0.77] for An. arabiensis in the rural setting and 0.61 [0.32, 0.85] for An. gambiae s.s. in the urban setting, indicating no preference for either host in both cases (P=0.32 and 0.46, respectively) and no difference in preference between the two (Odds Ratio (OR) [95%] = 0.95 [0.30, 3.01], P=0.924). However, only a quarter of An. arabiensis in the urban setting attacked humans (0.25 [0.09, 0.53]), indicating a preference for cattle that approached significance (P=0.08). Indeed, urban An. arabiensis were less likely to attack humans rather than cattle when compared to the same species in the rural setting (OR [95%] = 0.21 [0.05, 0.91], P =0.037). ConclusionUrban An. arabiensis had a stronger preference for cattle than the rural population and urban An. gambiae s.s. showed no clear preference for either humans or cattle. In the urban setting, both species exhibited stronger tendencies to attack cattle than previous studies of the same species in rural contexts. Cattle keeping may, therefore, particularly limit the impact of human-targeted vector control interventions in Dar es Salaam and perhaps in other African towns and cities.
Development and Validation of a Model for Individualized Prediction of Cervical Insufficiency Risks in Patients undergoing IVF/ICSI Treatment
Authors: Wu Yaoqiu , Liang Xiaoyan , Cai Meihong , Gao Linzhi , Lan Jie , Yang Xing
Published: November 2020

Background: Women who conceived with in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) are more likely to experience adverse pregnancy outcomes than women who conceived naturally. Cervical insufficiency (CI) is one of the important causes of miscarriage and premature birth, however there is no published data available focusing on the potential risk factors predicting CI occurrence in women who received IVF/ICSI treatment. This study aimed to identify the risk factors that could be integrated into a predictive model for CI, which could provide further personalized and clinically specific information related to the incidence of CI after IVF/ICSI treatment.Patients and methods: This retrospective study included 4710 patients who conceived after IVF/ICSI treatment from Jan 2011 to Dec 2018 at a public university hospital. The patients were randomly divided into development (n = 3108) and validation (n = 1602) samples for the building and testing of the nomogram, respectively. Multivariate logistic regression was developed on the basis of pre-pregnancy clinical covariates assessed for their association with CI occurrence.Results: A total of 109 patients (2.31%) experienced CI among all the enrolled patients. Body mass index (BMI), basal serum testosterone (T), gravidity and uterine length were associated with CI occurrence. The statistical nomogram was built based on BMI, serum T, gravidity and uterine length, with an area under the curve (AUC) of 0.84 (95% confidence interval: 0.76 - 0.90) for the developing cohort. The AUC for the validation cohort was 0.71 (95% confidence interval: 0.69 - 0.83), showing a satisfactory goodness-of-fit and discrimination ability in this nomogram.Conclusion: The user-friendly nomogram which graphically represents the risk factors and a pre-pregnancy predicted tool for the incidence of CI in patients undergoing IVF/ICSI treatment, provides a useful guide for medical staff on individualized decisions making, where preventive measures could be carried out during the IVF/ICSI procedure and subsequent pregnancy.
Seeking Research Questions from Implementers: Considerations for Leveraging Ground Actors Research Needs in the Fight against Malaria in West Africa.
Authors: Amouh Tete Sitou , Ekoye Saidou Malam , Ahanhanzo Césaire Damien , Guiguemdé Tinga Robert , Sombié Issiaka
Published: November 2020

In Sahel countries in West Africa malaria remains a public health scourge. To strengthen the fight against malaria, weaknesses, and solutions must be identified before programs implementation. This study reports experiences gained from collaborations between decision-makers and researchers. This project was undertaken in the framework of the regional World Bank funded project titled: Malaria and Neglected Tropical Diseases in the Sahel (SM/NTD). The objectives of this World Bank program are to identifying bottlenecks in program implementation as well as the related research questions they enticed. National malaria control program managers and prioritization workshops were used as working method to identify research questions. These identified priority research questions were implemented in selected countries. The results of this study showed that priority issues were related to prevention, governance, drugs, monitoring, and evaluation of programs. The first five priority questions were related to (1) factors of compliance with drug doses for the second and third days during the seasonal chemoprevention (SMC) campaigns, (2) the contribution of community-based distributors to the management of severe cases of malaria in under 5 years-old children, (3) the SMC efficacy, (4) artemisinin-based combination therapy (ACTs) tolerance and efficacy according to existing guidelines, and (5) the quality of malaria control at all levels of the health system. In conclusion, this work showed the effectiveness of collaboration between implementers, programs managers, and researchers in identifying research questions. Furthermore, the results of this study will contribute to improve the implementation of malaria control programs across African countries.
Sex and nest type influence avian blood parasite prevalence in a high elevation bird community
Authors: Rodriguez Marina D. , Doherty Paul F. , Piaggio Antoinette J. , Huyvaert Kathryn P.
Published: November 2020

Background - Prevalence of avian haemosporidian parasites and the factors influencing infection in the Colorado Rocky Mountains are largely unknown. With climate change expected to promote the expansion of vector and avian blood parasite distributions, baseline knowledge and continued monitoring of the prevalence and diversity of these parasites is needed. Methods - Using an occupancy modeling framework, we conducted a survey of haemosporidian parasite species infecting an avian community in the Colorado Rocky Mountains in order to estimate prevalence and diversity of blood parasites and to investigate species-level and individual-level characteristics that may influence infection. Results - We estimated prevalence and diversity of avian haemosporidia across 24 bird species, detecting 39 parasite haplotypes. We found that open cup nesters have higher Haemoproteus prevalence than cavity or ground nesters. Additionally, we found that male Ruby-crowned Kinglets, White-crowned Sparrows, and Wilson’s Warblers have higher Haemoproteus prevalence compared to other host species. Plasmodium prevalence was relatively low (5%), consistent with the idea that competent vectors may be rare at high altitudes. Conclusions - Our study presents baseline knowledge of haemosporidian parasite presence, prevalence, and diversity among avian species in the Colorado Rocky Mountains and adds to our knowledge of host-parasite relationships of blood parasites and their avian hosts.