bluuebunny/crossref_metadata_2025 huggingface dataset:
Time Trends in the Regional Distribution of Physicians, Nurses and Midwives in Europe
Authors: Winkelmann Juliane , Muench Ulrike , Maier Claudia B.
Published: July 2020

Background. Country-level data suggest large differences in the supply of health professionals among European countries. However, little is know about the regional supply of health professionals taking a cross-country comparative perspective. The aim of the study was to analyse the regional distribution of physicians, nurses and midwives in the highest and lowest density regions and examine time trends.Methods. We used Eurostat data and descriptive statistics to assess the density of physicians, nurses and midwives at national and regional levels (Nomenclature of Territorial Units for Statistics (NUTS) 2 regions) for 2017 and time trends (2005-2017). To ensure cross-country comparability we applied a set of criteria (working status, availability over time, geographic availability, source). This resulted in 15 European countries being available for the physician analysis and eight countries for the nurses and midwives analysis. Density rates per population were analysed at national and NUTS 2 level, of which regions with the highest and lowest density of physicians, nurses and midwives were identified. We examined changes over time in regional distributions, using percentage change and Compound Annual Growth Rate (CAGR).Results. There was a 2.4-fold difference in the physician density between the highest and lowest density countries (Austria: 513, Poland 241.6 per 100,000) and a 3.5-fold difference among nurses (Denmark: 1702.5, Bulgaria: 483.0). Differences by regions across Europe were higher than cross-country variation and varied up to 4.5-fold both for physicians and nurses/midwives and did not improve over time. Capitals and/or major cities in all countries showed a markedly higher supply of physicians than more sparsely populated regions while the density of nurses and midwives tends to be higher in more sparsely populated areas. Conclusions. The large variation in workforce supply at regional levels highlights the importance for countries to routinely collect data at sub-national geographic areas in order for workforce planners, employers, educators and others to develop policies and initiatives that may impact supply of health professionals at regional levels.
General public’s knowledge and practices on face mask use during the COVID-19 pandemic: a cross-sectional exploratory survey from Dharan, Nepal
Authors: Alam Kadir , Palaian Subish , Shankar Pathiyil Ravi , Jha Nisha
Published: July 2020

Background: Measures to prevent and control coronavirus disease-19 (COVID-19) include regular handwashing, physical distancing and covering mouth and nose using a face mask, thereby reducing spread of droplets. Use of facemask is considered as a cheap, effective and safe method with minimum disruption in day-to-day life. This study assessed the knowledge and practice of Nepalese general public on face mask use during lockdown period of COVID-19 pandemic. Method: A cross-sectional study using a self-developed, validated questionnaire (Cronbach alpha 0.556) was conducted in Dharan, eastern Nepal during May, 2020. Pharmacists from ten pharmacies, spread throughout Dharan city, after relevant training by the principal investigator, administered and recorded the responses from a selected sample stratified across age, gender, education and place of residence. Completed questionnaires were checked for consistency, coded and entered in IBM SPSS Version 26 and data was tested for normality using one-sample K-S test. Descriptive analyses were performed for demographic parameters and inferential statistics performed for outcome variables calculating median scores among different subgroups which were further compared using appropriate non-parametric tests at alpha=0.05. Results: Altogether 381 individuals, males [211 (55.4%)] and females [170 (44.6%)] participated. Ninety-three (24.5%) respondents were between 20-30 years of age and least number 3(0.8%) were above 70 years; 127 (33.3%) participants were housewives. Maximum 200 (52.5%) participants were educated between classes VIII to XII; seven (1.8%) were having postgraduate education; 129 (33.9%) participants were hill tribes. Knowledge scores were good (median score 16; maximum score 18). Around 20% of participant had never used face mask before the pandemic; majority of population (80%) were aware about the ongoing pandemic. Majority were aware about washing hands (92.6%) before using mask, covering mouth and nose (78.7%), and avoiding touching the mask while wearing (42.3%). Knowledge scores were significantly higher among men (p=0.038), among younger age groups (p=0.010), and among persons with greater education (p=0.048). Conclusion: The knowledge scores were good and public were aware about proper use of face masks. Educational interventions could be targeted to those with lesser knowledge, and steps to promote sustained face mask use can be beneficial.
Quality of life during the epidemic of COVID-19 and its associated factors among enterprise workers in East China
Authors: Chen Xiaoxiao , Xu Qian , Lin Haijiang , Zhu Jianfu , Chen Yue , Zhao QI , Fu Chaowei , Wang Na
Published: July 2020

Background: The impact of COVID-19 related quarantine on quality of life was expected and unclear for enterprise workers. We investigated the quality of life during the epidemic in enterprise workers just returned to work and assessed its potential influencing factors to get a better understanding of the impact of COVID-19 epidemic. Methods: This was a cross-sectional study among enterprise workers in Deqing and Taizhou, Zhejiang Province, China. Chinese version of EQ5D to assess life quality, and information about general characteristics and COVID-19 related information was collected by a structured questionnaire online distributed through the social application “Wechat”. Results: A total of 2435 participants were enrolled, 59.5% of which worked in Deqing. About 50% reported worries about the COVID-2019 epidemic and 40.1% of participants performed centralized or home quarantine during the epidemic. The mean EQ-5D score and VAS were 0.990 and 93.5. Multiple logistic regression suggested that physical activities (ORad=0.46) and keeping home ventilation (ORad=0.04) was related with life quality in Deqing, while for participants in Taizhou, wearing a mask when going out (ORad=0.35), keeping home ventilation (ORad=0.16), unmarried status (ORad=2.38) and experienced centralized or home quarantine (ORad=1.64) was related with quality of life.Conclusions: Enterprise workers in two areas with different risk of COVID-19 experienced different life quality during the epidemic of COVID-19. Physical activity, marital status, worry about epidemic of COVID-19, keeping home ventilation, wearing a mask and quarantine were related with quality of life.
Converting Habits of Antibiotic Use for Respiratory Tract Infections in German Primary Care (Change-3) - Process Evaluation of a Complex Intervention
Authors: Poß-Doering Regina , Kuehn Lukas , Kamradt Martina , Glassen Katharina , Thomas Fleischhauer , Kaufmann-Kolle Petra , Koeppen Martina , Wollny Anja , Altiner Attila , Wensing Michel
Published: July 2020

Background: Antimicrobial resistance remains a global challenge. In Germany, the national health agenda supports measures that enhance the rational use of antibiotics. The study “Converting Habits of Antibiotic Use for Respiratory Tract Infections in German Primary Care (CHANGE-3)” aimed at a sustainable reduction of antimicrobial resistance through the conversion of habits of antibiotics use and an increase in health literacy in primary care patients, practice teams, and in the general public. Embedded in a cluster-randomized trial of a multifaceted implementation program, a process evaluation focused on the uptake of program components to assess the fidelity of the implementation program in the CHANGE-3 study and to understand utilization of its educational components. Methods: A mix of qualitative and quantitative methods was used. Semi-structured telephone interviews were conducted with General Practitioners, Medical Assistants, patients treated for respiratory tract infection and outreach visitors who had carried out individual outreach visits. A two-wave written survey (T1: 5 months after start, T2: 16 months after start) was conducted in general practitioners and medical assistants. Qualitative data were analyzed using thematic framework analysis. Descriptive statistics were used to analyze survey data. Results: Uptake of intervention components was heterogenous. Across all components, the uptake reported by General Practitioners varied from 20% to 88% at T1 and 31% to 63% at T2. Medical Assistants reported uptake from 22% to 70% at T1 and 6% to 69% at T2. Analog paper-based components could by and large be integrated in daily practice (64% to 90% in T1; 41% to 93% in T2), but uptake of digital components was low. A one-time outreach visit provided thematic information and feedback regarding actual prescribing, but due to time constraints were received with reluctance by practice teams. Patients were largely unaware of program components, but assumed that information and education could promote health literacy regarding antibiotics use. Conclusions: The uptake of program components was heterogeneous, with lowest uptake of the digital components. Potential effects of the implementation program (i.e. reduced antibiotics prescribing), will warrant careful analysis of contributing program components. Trial registration: ISRCTN, ISRCTN15061174. Registered 13 July 2018 – Retrospectively registered, http://www.isrctn.com/ISRCTN15061174
Role of interleukin 6 as a predictive factor for a severe course of Covid-19: retrospective data analysis of patients from a Long-term Care Facility during Covid-19 Outbreak
Authors: Sabaka Peter , Koščálová Alena , Straka Igor , Hodosy Julius , Lipták Robert , Kmotorková Barbora , Kachlíková Mária , Kušnírová Alica
Published: July 2020

Background: Covid-19 is a disease with high morbidity and mortality among elderly residents of long-term care facilities (LTCF). During an outbreak of SARS-CoV-2 infection in the LTCF an effective screening tool is essential to identify the patients at risk for severe illness and death. We explored the role of interleukin 6 (IL-6) as a predictive factor for severe disease during the outbreak of Covid-19 in one LTCF in Slovakia.Methods: We conducted a retrospective data analysis of all laboratory-confirmed cases of COVID-19, diagnosed during the outbreak in one LTCF in Slovakia between April 11, 2020, and May 5, 2020. Within 24 hours after the diagnosis of Covid-19, clinical and laboratory screening was performed in the LTCF by trained clinicians to identify patients in need of hospitalization. Patients with oxygen saturation below 90% were immediately referred to the hospital. Patients staying in the LFTC were monitored daily and those that developed hypoxemia were transferred to the hospital. We analyzed the association between the level of IL-6 at the initial assessment and development of hypoxemia during the course of the disease and determined the cut-off of the IL-6 able to predict the development of hypoxemia requiring oxygen therapy or ventilatory support.Results: Fifty-three patients (11 men, 42 women) with diagnosed Covid-19 were included in the analysis. 19 (53%) patients developed hypoxemia during the course of the disease. Patients with hypoxemia had significantly higher concentrations of IL-6 at initial screening. The concentration of IL-6 > 24 pg/mL predicted the development of hypoxemia with the sensitivity of 100% and specificity of 88.9%. The positive and negative predictive values were 76.9%, and 100% respectively.Conclusions: The concentration of IL-6 > 24 pg/mL at initial assessment predicted the development of hypoxemia requiring hospitalization with excellent sensitivity and good specificity. IL-6 appears as a potential negative predictive factor for the development of the severe form of Covid-19 and might serve for early identification of patients in need of hospitalization. Further studies are needed to evaluate the robustness of the use of IL-6 as an effective screening tool for the severe course of Covid-19.
Factors Influencing the Result of Superior Oblique Weakening Procedures in Patients with Superior Oblique Overaction in Horizontal Strabismus
Authors: Chun Junwoo , Kim Seong-Joon
Published: July 2020

Background: Few studies have evaluated the surgical outcome of superior oblique weakening procedures in patients with superior oblique overaction associated with exotropia or esotropia. This study aimed to evaluate the outcome of superior oblique muscle weakening and the influencing factors in patients with superior oblique overaction.Methods: The medical charts of 37 patients (55 eyes) with superior oblique overaction associated with esotropia or exotropia who were treated with a superior oblique weakening procedure at the Seoul National University Hospital from January 2010 to June 2017 were retrospectively reviewed. Superior oblique overaction was graded using, a 6-point scale ranging from +0.5 to +3, and pre- and postoperative grades were recorded for all patients. Results: The mean age of the patients was 91.81 ± 59.37 months. Superior oblique muscle suture spacer and superior oblique posterior tenectomy were performed for 17 (23 eyes) and 20 (32 eyes) patients, respectively. Surgical success was achieved in 15 (65.2%) eyes in the suture spacer group and 23 (71.9%) eyes in the posterior tenectomy group. Surgical success was achieved for 69.1% (38/55 eyes) of patients. Dissociated vertical deviation exhibited a significant negative association with the surgical success rate (p<0.001).Conclusions: There was no significant difference in surgical success rate between the superior oblique posterior tenectomy and superior oblique suture spacer groups in superior oblique overaction associated with horizontal strabismus. Associated dissociated vertical deviation can affect the surgical success of the superior oblique weakening procedure.
Evolution of DNA methylome from precancer to invasive lung adenocarcinoma
Authors: Hu Xin , Estecio Marcos , Chen Runzhe , Reuben Alexandre , Wang Linghua , Fujimoto Junya , Carrot-Zhang Jian , Ying Lisha , Fukuoka Junya , Chow Chi-Wan , McGranahan Nicholas , Pham Hoa , Godoy Myrna , Carter Brett , Behrens Carmen , Zhang Jianhua , Antonoff Mara , Sepesi Boris , Vaporciyan Ara , Heymach John , Wistuba Ignacio , Pass Harvey , Lu Yue , Kadara Humam , Scheet Paul , Lee J. Jack , Futreal Andrew , Su Dan , Issa Jean-Pierre , Zhang Jianjun
Published: July 2020

The evolution of DNA methylation at genome level and methylation intra-tumor heterogeneity (ITH) during early lung carcinogenesis has not been systematically studied. We performed multiregional reduced representation bisulfite sequencing (RRBS) of 62 resected lung nodules from 39 patients including atypical adenomatous hyperplasia (AAH, n=14), adenocarcinoma in situ (AIS, n=15), minimally invasive adenocarcinoma (MIA, n=22), and invasive adenocarcinoma (ADC, n=11). We observed significantly higher level of methylation ITH in later-stage lesions and gradual increase in both hyper- and hypomethylation compared to matched normal lung tissues over the course of neoplastic progression. The phyloepigenetic patterns inferred from methylation aberrations resembled those based on somatic mutations suggesting parallel methylation and genetic evolution during the early lung carcinogenesis. De-convolution of transcriptomic profiles from a previously published cohort and RBBS data from the current cohort demonstrated higher ratios of T regulatory cells (Tregs) versus CD8+ T cells in later-stage diseases implying progressive immunosuppression with neoplastic progression. Furthermore, increased global hypomethylation was associated with higher mutation burden, higher copy number aberration burden, higher allelic imbalance burden as well as higher Treg/CD8 ratio highlighting the potential impact of methylation states on chromosomal instability, mutagenesis and the tumor immune microenvironment.
Donor-acceptor Stenhouse Adducts with Three Orthogonally Controlled Intrisic Stationary States
Authors: Duan Yongli , Zhao Haiquan , Xue GuoDong , Wang Ze , Xiong Chaoyue , Mao Lijun , He Chao , Wang Dongsheng , Zheng Yonghao
Published: July 2020

Photoresponsive molecules with more than two intrinsic stationary states are very Interesting. Here, we demonstrate a series of crown ether (CE) substituted donor-acceptor Stenhouse adducts (DASAs) that can be switched between three stationary states under orthogonal control of light and metal ions. DASA-CE molecules are self-assembled into 1:1 head-to-tail supramolecular structures to form di-linear states due to strong van der Waals interactions between electron-donating and -withdrawing moieties. Furthermore, treatment with metal ions (Na+ or K+) switches the di-linear back to the linear state, which is reversible after adding free crown ether. On the other hand, green light irradiation induces linear-to-cyclic isomerization of DASA-CE, while the photoisomerization from di-linear to cyclic state is inhibited. The reverse cyclic-to-linear isomerization can occur under heating in the dark. All in all, the orthogonal switching of DASA-CE between di-linear, linear and cyclic states enables the development of smart materials in environments with complex stimuli.
Oxytocin administration for induction and augmentation of labour in Polish maternity units– an observational study
Authors: Baranowska Barbara , Kajdy Anna , Kiersnowska Iwona , Sys Dorota , Tataj-Puzyna Urszula , Daly Déirdre , Rabijewski Michał , Bączek Grażyna , Węgrzynowska Maria
Published: July 2020

BackgroundThere is not enough data regarding practices and protocols that healthcare personnel follow and the amount of oxytocin that women receive during labour. Empirical evidence indicates that compliance with the guidelines improves the quality of healthcare and reduces adverse effects. The aim of the study was to evaluate oxytocin supply practices of oxytocin for labour induction and augmentation in Polish maternity units.MethodsThe article presents a prospective observational study. Data collection took place in two selected maternity units between January 15 and July 31, 2019 (n=545). Inclusion criteria were women in term pregnancies, undergoing oxytocin induction or augmentation of labour. Exclusion criteria were women who were in preterm labour, aged less than 18 years, and women whose baby was known to have a malformation. ResultsThe average total amount of oxytocin administrated to women before birth was 7,329µg following labour induction and 3.952µg following labour augmentation. The actual administration of oxytocin deviated both from the unit and national guidelines in 93,6% of all observed labours. We found no statistically significant correlation between the amount of oxytocin administered and mode of delivery, immediate postpartum blood loss or Apgar scores. There was no observed effect of total oxytocin on short-term perinatal outcomes. Hospitals with similar protocols did not differ significantly in terms of total oxytocin amount, induction to stimulation ratio—the only observed difference was the mode of delivery. ConclusionsThere is a need for a thorough analysis to find out the reasons for the observed discrepancies between protocols and practice.
Disruption of Adaptive Immunity Enhances Disease in SARS-CoV-2 Infected Syrian Hamsters
Authors: Brocato Rebecca , Principe Lucia , Kimi Robert , Zeng Xiankun , Williams Janice , Liu Yanan , Li Rong , Smith Jeffrey , Golden Joseph , Gangemi Dave , Youssef Sawsan , Wang Zhongde , Glanville Jacob , Hooper Jay W
Published: July 2020

Animal models recapitulating human COVID-19 disease, especially with severe disease, are urgently needed to understand pathogenesis and evaluate candidate vaccines and therapeutics. Here, we develop novel severe disease animal models for COVID-19 involving disruption of adaptive immunity in Syrian hamsters. Cyclophosphamide (CyP) immunosuppressed or RAG2 knockout (KO) hamsters were exposed to SARS-CoV-2 by the respiratory route. Both the CyP-treated and RAG2 KO hamsters developed clinical signs of disease that were more severe than in immunocompetent hamsters, notably weight loss, viral loads, and fatality (RAG2 KO only). Disease was prolonged in transiently immunosuppressed hamsters and uniformly lethal in RAG2 KO hamsters. We evaluated the protective efficacy of a neutralizing monoclonal antibody and found that pretreatment, even in immunosuppressed animals, limited infection. Our results suggest that functional B and/or T cells are not only important for the clearance of SARS-CoV-2, but also play an early role in protection from acute disease.
Salivary Desulfovibrio Desulfuricans Level and Oral Hygiene Index for the Prediction of Colorectal Cancer in Chinese Patients
Authors: Wang Yao , Zhang Yao , Wang Zheng , Tang Jian , Cao Dongxing , Qian Yun , Xie Yuanhong , Chen Haiying , Chen Yingxuan , Chen Zhaofei , Fang Jingyuan
Published: July 2020

Background: Mounting evidence have shown that fecal microbiome can act as biomarkers for diagnosing colorectal cancer (CRC). Recent studies demonstrate that oral microbiome is concordant with gut microbiome. The role of oral microbiome in colorectal cancer has not been fully illustrated. Methods: We collected preoperational saliva with a final cohort of 237 patients who underwent surgical resections or colorectal endoscopy in XX Hospital from January 2018 to January 2020. Clinical demographics, comorbidities and oral conditions were obtained from medical records or questionnaires. Salivary microbial biomarkers were detected by quantitative polymerase chain reaction (PCR) after DNA extraction. Multivariate logistics regression analysis was employed to analyze the risk factors for colorectal cancer. A four-variable prediction model was constructed based on the logistics analysis.Results: Among the 237 patients enrolled, there were 95 endoscopy confirmed healthy control and 142 pathologically confirmed colorectal adenocarcinoma patients. Logistics regression analysis demonstrated that the risk factors associated with CRC included age at diagnosis (OR=1.111, 95%CI=1.072-1.151), male sex (OR=2.111, 95%CI=1.068-4.175), oral hygiene index (OR=1.769, 95%CI=1.116-2.804) and relative salivary Desulfovibrio desulfuricans (Dd) abundance (OR=1.156, 95%CI=1.05-1.272), based on which a four-variable model was developed. The four-variable model had good discriminative (Brier score=0.144, Concordance index=0.866) and calibration (0.834) abilities after bias correction. Conclusions: Elevated salivary Dd level is an independent risk factor for CRC. We have developed a four-variable model that could help identify at-risk patients for CRC.
An Investigation Into the Cause of Road Failure Along Sagamu-papalanto Highway Southwestern Nigeria
Authors: UBIDO OYEM EMMANUEL , Ogbonnaya Igwe , Ukah Bernadette Uche
Published: July 2020

Road Failure in Nigeria has been a monumental disaster that has resulted to loss of lives and damage of vehicles which has also in turn increased the travel time of motorist plying on the these roads. In order to unravel the cause of this disaster geotechnical, geochemical, mineralogical and geophysical tests were conducted to evaluate the cause of failure along Sagamu-Papalanto Highway southwestern Nigeria. The laboratory tests result conducted shows that the percentage amount of fines ranges from 12-61.3%,natural moisture content ranges from 6.8 to 19.7%, the liquid limit in the range of 25.1-52.2%, linear shrinkage between 3.96 to 12.71%, plastic limit ranges from 18.2-35%, the plasticity index ranges from 5.2 to 24.6%,free swell in the range from 5.17 – 43.9%,maximum dry density from1.51 -1.74g /cm 3 , the specific gravity ranges from 2.52-2.64 and the CBR between 3-12%. The Cone Penetrometer Test (CPT) has a resistance value in the range of 20-138 kgf/cm 2 .There is the predominance of kaolinite as the major clay minerals and the main oxides in the study area shows SiO 2 , Al 2 O 3 , Fe 2 O 3 , K 2 O,Na 2 O, MgO and CaO.2D Electrical Resistivity Wenner Array Method was employed in the investigation. Four profiles covering a distance of 250 meters for profiles 1, 2, and 3 and 500meters for profile 4 each were established parallel and perpendicular to the road pavement along the sections of the road. Data were gather along the four profiles using ABEM Terra meter SAS 1000. The recorded field data were filtered and inverted using 2-D modelling inversion algorithm with the aid RES2DINV Software . The results revealed a low resistivity values for profile 2 and 3 ranging from 100 Ωm – 300 Ωm, between distances of 20 m – 240 m along the profile to a depth of 7.60 m and a low resistivity value ranging from 50 Ωm – 111Ωm, between distances of 80 m –120 m along the profile to a depth of 15m from the surface of the profile the topsoil along the profile. The low resistivity values and low shear strength obtained from the profiles shows the study areas comprises of incompetent materials which has the propensity to retain water and eventually results to swelling and collapse under imposed load with subsequent failure as the resultant effect. Sections of the road with sandy and clayey materials should be scooped out from the subsurface to a depth of 3 m – 5 m from the top soil of the road and put back with competent fill materials.
High Number of RNA Copies in Asymptomatic Individuals Infected with SARS-CoV-2 in an Area of the Colombian Caribbean
Authors: Mattar Salim , Martinez-Bravo Caty , Rivero Ricardo , Contreras Hector , Faccini-Martinez Alvaro , Guzman Camilo , Galeana Ketty , Alvis Nelson , Contreras Veronica , Arrieta German , Gonzalez Marco , Miranda Jorge , Ospina Martha , Camargo-Assis Francisco , Mercado Marcela , Garay Evelyn , Garcia-Perez Alejandra , Lopez Yesica , Tique Vaneza
Published: July 2020

Background. Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) is an emerging pandemical virus that has caused millions of reported cases and hundreds of thousands of deaths in less than six months. South America has suffered the pandemic because it lacks the hospital and economic capacities needed to contain the pandemic's advance. Public health implications of transmission, while asymptomatic is a critical concern at the current pandemic.Objective: Describe the socio-demographic, clinical, and viral kinetics features of a cohort of SARS-CoV-2 infected individuals from the Colombian Caribbean. Methods: Six hundred eighty-six clinical samples from several hospital centers in the province were received between April 9th and May 16th, 2020. RNA was extracted using lysis buffers and spin columns. The samples were tested for SARS-CoV-2 by RT-qPCR (Reverse transcription real-time polymerase chain reaction) using commercially available multiplex real-time PCR assay for simultaneous detection of 3 target genes of SARS-CoV-2 (AllplexTM, 2019-nCoV assay, Korea). Viral copies quantification was done using a standard curve constructed from seriated dilutions of a SARS-CoV-2 positive control. Statics descriptive methods were used. Results: Thirty-five nasopharyngeal samples were positive for SARS-CoV-2 infection; the average age was 43 (range, 1-95 years). Seventeen of 35 (49%) of the patients showed symptoms. Most of them had cough, fever, and odynophagia, 3 of the patients reported having arthralgia. Only two patients required hospitalization. None of the patients had known co-morbidities. RT-qPCR results show that two of the symptomatic patients had significantly higher RNA copies than the rest of the patients. Eighteen of 35 (51%) individuals were asymptomatic, the average age was 30 (range, 6-61 years. Four individuals showed a higher copy than some symptomatic patients. Nonetheless, the average of RNA copies 8.26 x10+10 was lower than the symptomatic.Conclusions: the population studied was young with an average of 43 years in symptomatic and 30 years of asymptomatic; this is important because of the high impact in the economy, and probably it is the cause of the reduced lethality observed in the department. Because a large proportion of infections probably result from transmission from asymptomatic or pre-symptomatic persons, the usefulness of public health interventions in Colombian provinces should be based in the molecular screening in a vast conglomerate's population and to quantify the viral load.
Prevalence and Outcomes of Twin Pregnancies in Botswana: a National Birth Outcomes Surveillance Study
Authors: Isaacson Arielle , Diseko Modiegi , Mayondi Gloria , Mabuta Judith , Davey Sonya , Mmalane Mompati , Makhema Joseph , Jacobson Denise , Luckett Rebecca , Shapiro Roger , Zash Rebecca
Published: July 2020

Background: Twin deliveries have a high risk of adverse birth outcomes, but most data comes from high-resource settings. The prevalence and outcomes of twin pregnancies in Botswana have not previously been reported.

Methods: The Tsepamo Study conducted birth outcomes surveillance at 8 hospitals (~40% of all births in Botswana) from August 2014-June 2018 and up to 18 hospitals (~70% of all births in Botswana) from July 2018-March 2019. Maternal demographics, antenatal care visits, ultrasound reports, and infant delivery characteristics (including the number of infants delivered, gestational age (GA) at delivery, birthweight, and vital status at birth and discharge) were abstracted from maternity obstetric records. Log binomial regression models were fit to determine the relative risk (RR), adjusted risk (aRR), and 95% confidence intervals (95% CI) of adverse birth outcomes among twin compared with singleton pregnancies. Higher order multiples were excluded from analyses.

Results: Between August 2014 and March 2019, 119,477 deliveries were recorded, including 1859 (1.6%) sets of twins. Women with twin pregnancies had a similar median number of antenatal care visits (9 vs. 10), but were more likely to deliver in a tertiary center (54.8% vs. 45.1%, p<0.001) and more likely to have a C-section (54.6% vs. 22.0%, p<0.001) than women with singletons. Adverse birth outcomes were notably higher in twins than in singletons. Compared with singletons, twin pregnancies had a higher risk of preterm delivery (<37 weeks GA) (47.6% vs. 16.7%, aRR 2.8, 95% CI 2.7, 2.9) and very preterm delivery (<32 weeks) (11.8% vs. 4.0%, aRR 3.0 95% CI 2.6, 3.4). Twin pregnancies were more likely than singletons to have at least one low-birthweight (77.1% vs. 13.6%, aRR 4.5, 95% CI 4.3, 4.6) or very low-birthweight (16.8% vs. 3.2%, aRR 5.2, 95% CI 4.7, 5.8) infant. Among all twin pregnancies, 128 (6.9%) had at least one stillborn infant compared with 2845 (2.4%) stillbirths among singletons (aRR 2.8, 95% CI 2.3, 3.3).

Conclusion:
Adverse birth outcomes are common among twins in Botswana, and are often severe. Interventions that allow for earlier identification of twin gestation and improved antenatal management of twin pregnancies may improve infant and child survival.
Genome-wide Identification and Characterization of Perirenal Adipose Tissue MiRNAs in Rabbits Fed With a High-fat Diet
Authors: Wang Jie , Shao Jiahao , Li Yanhong , Elzo Mauricio A. , Jia Xianbo , Lai Songjia
Published: July 2020

Background

MicroRNAs (miRNAs) are a class of endogenous single-stranded RNA molecules that play an important role in gene regulation in animals by pairing with target gene mRNAs. However, the functions of miRNAs in the adipogenesis of obese rabbits are poorly understood.
Methods

Six small RNA libraries from rabbits under a standard normal diet (SND; n = 3) and a high-fat diet (HFD; n = 3) were constructed and sequenced. Differentially expressed (DE) miRNAs were identified using the edgeR data analysis package from R. Software miRanda and RNAhybrid were used to predict the target genes of miRNAs. To further explore the functions of DE miRNAs, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed.
Results

A total of 69577441 clean reads were obtained from the six libraries, of which, 52 known DE miRNAs (24 up-regulated, 28 down-regulated) and 31 novel DE miRNAs (14 up-regulated, 17 down-regulated) were identified. GO enrichment analysis revealed that the DE miRNAs target genes were involved in intermediate filament cytoskeleton organization, intermediate filament-based process, and alpha-tubulin binding. DE miRNAs were involved in p53 signaling, linoleic acid metabolism, and other adipogenesis-related KEGG pathways.
Conclusions

Our study further elucidates the possible functions of DE miRNAs in rabbit adipogenesis, contributing to the understanding of rabbit obesity.
Metastasis to The Submandibular Gland In Patients Presenting With Oral Squamous Cell Carcinoma
Authors: Ahmed Shaheen , Salim Zohra , Shaikh Abdul hafeez , Iqbal Syeda Noureen , Ali Anwar
Published: July 2020

Background:Approximately one third of patients undergoing neck dissection procedure that includes gland resection experience xerostomia, particularly nocturnal xerostomia. Metastasis to level 1b lymph nodes in patients presenting with OSCC is considered frequent, however, submandibular gland invasion is rare and preservation of the gland offers multiple benefits. Objective:The objective is to study the prevalence of submandibular gland involvement in patients presenting with oral squamous cell carcinoma. Methods:It’s a cross sectional analytical study consisting of 90 patients presenting with biopsy proven OSCC. All patients presenting to centers of Dow university of health sciences are included in the study. Data entry and analysis was carried out on SPSS version 21. Results are expressed in frequencies and percentages. Chi squared test was applied to analyze the relationship between submandibular gland involvement and patient’s sociodemographic and tumor related variables. Results:A total of 90 participants were a part of the study. 71.1% were male whereas 28.9% were female. The median age is 48. The most common tumor site among our patients is buccal mucosa (63.3%). The depth of invasion ranged from 0.2cm to 5cm (median 0.95cm) with round 55.6% patients presenting with depth of invasion <1cm. Majority of the patients (48.9%) presented with stage IVa (AJCC). 71.1% had level 1b negative nodes, whereas 28.9% patients demonstrated positive level 1b nodes. 50% of the patients presented with stage IVa. Number of patients with submandibular gland involvement were 5. Conclusion:Based on the results of our study, due to rare involvement of submandibular gland, it should be persevered wherever possible and decision to preserve should be based on determinants, such as, primary tumor site, level 1b involvement and depth of invasion.
Asymptomatic COVID-19 Patient, Occurrence of Fatal Pulmonary Arterial Thrombosis.
Authors: Nonno Franca Del , Colombo Daniele , Nardacci Roberta , Falasca Laura
Published: July 2020

The induction of hypercoagulability is one of the pathophysiological mechanism in patients with a severe presentation of the SARS-CoV-2 infection that can contribute to death. A considerable number of SARS-Cov-2 infected individuals could be asymptomatic and they don’t need medical treatment. We reported autoptic evidences of COVID-19 trombotic fatal lesions in a asymptomatic COVID-19 patient after negative conversion.This study provides evidences that an appropriate diagnostic screening for thrombotic complications and the early treatment recommendations of antithrombotic drugs could represent an important topic even in asymptomatic individuals.
Stem-like cells from Cancer of Unknown Primary are endowed with distinctive hypermetastatic properties and unveil liability to MEK inhibition
Authors: Verginelli Federica , Pisacane Alberto , Gambardella Gennaro , D'Ambrosio Antonio , Ferrio Marco , Panero Mara , Casorzo Laura , Benvenuti Silvia , Senetta Rebecca , Geuna Elena , Ballabio Andrea , Montemurro Filippo , Sapino Anna , Comoglio Paolo , Boccaccio Carla
Published: July 2020

Cancers of Unknown Primary (CUPs), featuring metastatic dissemination in the absence of a primary tumor, are a biological enigma and a fatal disease. We propose that CUPs are a distinct, yet unrecognized, pathological entity originating from stem-like cells endowed with unique properties. These cells can be isolated in vitro (agnospheres) and propagated in vivo by serial transplantation, displaying exceptionally high tumorigenicity. After subcutaneous engraftment, agnospheres recapitulated the CUP phenotype, by showing the ability to spontaneously and quickly disseminate, and form widespread established metastases. Regardless of different genetic backgrounds, agnospheres invariably displayed cell-autonomous proliferation and self-renewal, mostly relying on unrestrained activation of the MAP kinase/MYC axis, which confers sensitivity to MEK inhibitors in vitro and in vivo. Such sensitivity is associated with a transcriptomic signature predicting that 75% of CUP patients could be eligible to MEK inhibition. These data shed light on CUP biology and unveil an opportunity for therapeutic intervention.
Conversion From Chronic to Episodic Migraine in Patients Treated With Erenumab: Real-life Data From an Italian Region
Authors: Ornello Raffaele , Casalena Alfonsina , Frattale Ilaria , Caponnetto Valeria , Gabriele Amleto , Affaitati Giannapia , Giamberardino Maria Adele , Assetta Maurizio , Maddestra Maurizio , Marzoli Fabio , Viola Stefano , Cerone Davide , Marini Carmine , Pistoia Francesca , Sacco Simona
Published: July 2020

BackgroundMost patients treated with erenumab in clinical practice have chronic migraine (CM). We assessed the rate and possible predictors of conversion from CM to episodic migraine (EM) in a real-life study.Main bodyWe performed a subgroup analysis of patients treated with erenumab from January 2019 to February 2020 in the Abruzzo region, central Italy. Treatment was provided according to current clinical practice. For the purpose of the present study, we included patients fulfilling the definition of CM for the three months preceding erenumab treatment and with at least 6 months of follow-up after treatment. We assessed the rate of conversion to EM from baseline to Months 4–6 of treatment and during each month of treatment. To test the clinical validity of conversion to EM, we also assessed the decrease in monthly headache days (MHDs), acute medication days, and median headache intensity on a Numerical Rating Scale (NRS). We included in our study 91 patients with CM. At Months 4–6, 62 patients (68.1%) converted from CM to EM; the proportion of converters increased from Month 1 to Month 5. In the overall group of patients, median MHDs decreased from 26.5 (IQR 20–30) to 7.5 (IQR 5–16; P < 0.001) compared with baseline, while median acute medication days decreased from 21 (IQR 16–30) to 6 (IQR 3–10; P < 0.001) and median NRS scores decreased from 8 (IQR 7–9) to 6 (IQR 4–7; P < 0.001). Significant decreases were found both in converters and in non-converters. We found no significant predictors of conversion to EM among the patients’ baseline characteristics.ConclusionsIn our study, two thirds of patients with CM converted to EM during 6 months of treatment with erenumab. MHDs, acute medication use, and headache intensity decreased regardless of conversion from CM to EM.
Gemini Surfactant Abetted Synthesis Of Mesoporous Mn/Mg Bimetal Doped TiO2 Nanomaterial: Characterization And Photocatalytic Activity Studies Under Visible Light Irradiation
Authors: Miditana Sankara Rao , Tirukkovalluri Siva Rao , Raju Imandi Manga , Alim Shaik Abdul , Jaishree Genji , Chippada M.L.V. Prasanna
Published: July 2020

﻿The present work mainly aimed to synthesize different weight percentages (0.25 Wt% - 1.00 Wt%) of Manganese (Mn2+) and Magnesium (Mg2+) bimetal ions doped TiO2 nanomarerial assisted with different weight percentages (5 Wt% - 15 Wt%) of Gemini Surfactant (GS) using sol-gel method. The bimetal doped and undoped TiO2 photocatalysts were characterized by XRD, SEM, EDX, FT-IR, UV Vis-DRS, TEM, BET and PL. Characterization results evinced that Mn2+/Mg2+ bimetal ions doping and encapsulation of GS on TiO2 nanoparticles promote the formation of mesoporous multi-particle anatase TiO2 nanocatalysts with narrowed band gap, less particle size and high surface area. The surface elemental composition of the MMT5-GS2 (after calcination) revealed the presence of both the metal dopants Mn2+ and Mg2+ along with the Ti and O and their chemical interactions were further confirmed by FT-IR results. The photocatalytic activity of these catalysts was assessed by the degradation of Methyl Red (MR) using visible light irradiation. To understand the effect of different reaction parameters on the photocatalytic activity of the nanocatalysts such as the dopant concentration, GS concentration, catalyst dosage, solution pH and initial dye concentrations were investigated and optimized to achieve best performance. The photoluminescence results conclude that OH radicals are the crucial reactive species responsible for oxidative photocatalytic degradation of MR.
Osteopontin as a novel biomarker for the prognosis and clinical pathology of prostate cancer: a systematic review and meta-analysis
Authors: Yu Anze , Xie Kai , Xing Changsheng , Qin Qilin , Liu Longfei , Zu Xiongbing
Published: July 2020

Background Evaluation of the feasibility for osteopontin (OPN) to serve as a biomarker in the prognosis and clinical pathological features of prostate cancer patients.Methods The original publications related to osteopontin and prostate cancer were comprehensively searched in the online databases, including PubMed, Embase, Cochrane Library, Web of Science, Medline, Wanfang database and China National Knowledge Infrastructure up to August 2019. Results were analyzed by software Revman 5.3 and Stata 12.0.Results A total of 21 studies were included in the analysis and the result showed that the positive OPN expression group had a lower overall survival than the negative expression group (univariate: HR = 2.32, 95%CI [1.74, 3.10], multivariate: HR = 2.41, 95%CI [1.63, 3.57]) and a lower biochemical relapse-free survival than the negative group (univariate: HR = 1.42, 95%CI [0.92, 2.17], multivariate: HR = 1.61, 95%CI [1.39, 1.87]). In addition, there was a higher expression level of OPN in prostate cancer tissues than in normal prostate tissues (OR = 46.55, 95%CI [12.85, 168.59], p < 0.00001) and benign prostatic hyperplasia tissues (OR = 11.07, 95%CI [3.43, 35.75], p < 0.0001). Moreover, OPN positive expression was also related to high Gleason score (OR = 2.64, 95%CI [1.49, 4.70], p = 0.0009), high TNM stage (OR = 3.15, 95%CI [1.60, 6.20, p = 0.0009), high Whitmore-Jewett stage (OR = 2.53, 95%CI [1.06, 6.03], p = 0.04), high lymph node (OR = 3.69, 95%CI [1.88, 7.23], p = 0.0001), and distant metastasis (OR = 8.10, 95%CI [2.94, 22.35], p = 0.01). There was no difference observed in the differentiation of prostate cancer (OR = 1.79, 95%CI [0.39, 8.33], p = 0.46).Conclusion Osteopontin could be recognized as a promising novel diagnostic and prognostic biomarker for prostate cancer patients.
Modeling of tumor radiotherapy with damage and repair processes
Authors: Zhao Jiantao , Wei Xin , Tian Jianjun Paul
Published: July 2020

Background: Under irradiation, some cells are damaged permanently and die while some damaged cells can be self-repaired and become normal cells. The same situation happens in tumor radiotherapy. There has been several models to calculate the probability of cell survival after irradiation, and mathematical models for tumor growth to incorporate cell survival probability in radiotherapy. However, there is no detailed study about how both radiation damage process and cell repair process impact outcomes of tumor radiotherapy. This study will focus on impacts of these two processes on tumor radiotherapy.Methods: The study employs mathematical modeling. Based on established mathematical models for tumor growth and irradiation, a functional reaction diffusion system for tumor radiotherapy is proposed. The model has the tumor cell population and damaged tumor cell population, and tracks their movements in the tumor site. The model considers the repair time of damaged tumor cells as a delay parameter. Detailed analysis is conducted while numerical simulations are performed with glioma data.Results: We obtain the radiation threshold which combines the tumor growth rate, the damaged cell death rate, and damaged cell repair rate. The radiation threshold is a decreasing function of radiation dose while the radiation damage rate is a increasing function of radiation dose. The radiation damage rate and repair time determine the outcome of radiotherapy. When the radiation damage rate is greater than the radiation threshold, radiotherapy may destroy the tumor while radiotherapy may control tumor growth and the tumor load decreases as the radiation dose increases when the radiation damage rate is less than the radiation threshold. For both situations, we also observe oscillations of two cell populations occurring from Hopf bifurcations and Turing instability appearing from a large repair time of damaged tumor cells and different cell motilities.Conclusions: The damaged tumor cell repairing process increases the radiation threshold and complicates outcomes of radiotherapy. The medical implication of our results is that radiotherapy may control the tumor growth and the radiation dose can reduce the total tumor load when the damage rate is greater than the radiation threshold, and otherwise, radiotherapy may kill the tumor and the amount of the does not matter.
Flexible and High-Performance Electrochromic Devices Enabled by Self-Assembled 2D TiO2/MXene Heterostructures
Authors: Li Ran , Ma Xiaoyuan , Li Jianmin , Cao Jun , Gao Hongze , Li Tianshu , Zhang Xiaoyu , Wang Lichao , Zhang Qinghong , Wang Gang , Hou Chengyi , Li Yaogang , Palacios Tomas , Lin Yuxuan , Wang Hongzhi , Ling Xi
Published: July 2020

Transition metal oxides (TMO) are promising electrochromic (EC) materials for applications such as smart windows and displays, yet challenge still exists to achieve good flexibility, high coloration efficiency and fast response simultaneously. MXenes (e.g. Ti3C2Tx) and their derived TMOs (e.g. 2D TiO2) are good candidates for high-performance and flexible EC devices because of their 2D nature and the possibility of assembling them into loosely networked structures. Here we demonstrate flexible, fast, and high-coloration-efficiency EC devices based on self-assembled 2D TiO2/Ti3C2Tx heterostructures, with the Ti3C2Tx layer as the transparent electrode, and the 2D TiO2 layer as the EC layer. Benefiting from the well-balanced porosity and connectivity of these assembled nanometer-thick heterostructures, they present fast and efficient ion and electron transport, as well as superior mechanical and electrochemical stability. We further demonstrate large-area flexible devices which could potentially be integrated onto curved and flexible surfaces for future ubiquitous electronics.
Dithienylethene metallodendrimers with high photochromic efficiency
Authors: Wang Yu-Xuan , Zhou Qi-Feng , Xu Lin , He Xiaoxiao , Zhang Ying , Tan Hongwei , Xu Jianhua , Shi Xueliang , Wang Wei , Luo Xiping , Chen Jinquan , Yang Hai-Bo
Published: July 2020

It has been extremely challenging to achieve multi-photochromic systems with-out affecting the individual photoswitching properties of the constituent units. Herein, we present the design and synthesis of a new family of platinum-acetylide dendrimers containing up to twenty-one photochromic dithienylethene (DTE) units that exhibit both high photochromic efficiency and individual switch-ing properties. Upon irradiation with ultraviolet (UV) and visible (Vis) light, the resultant metallodendrimers display high conversion yield and excellent fatigue resistance. More interestingly, cyclization-cycloreversion kinetics revealed that the photochromic property of each DTE unit in these metallodendrimers is unaf-fected by its neighbor and the full ring-closure of up to twenty-one DTE units in one single dendrimer has been achieved.