bluuebunny/crossref_metadata_2025 huggingface dataset:
Hitting the Target but Missing the Point: Recent Progress Towards Adenovirus-Based Precision Virotherapies
Authors: Cunliffe Tabitha G. , Bates Emily A. , Parker Alan L.
Published: October 2020

More people are surviving longer with cancer. Whilst this can be partially attributed to advances in early detection of cancers, there is little doubt that the improvement in survival statistics is also due to the expansion in the spectrum of treatments available for efficacious treatment. Transformative amongst those are immunotherapies, which have proven effective agents for treating immunogenic forms of cancer, though immunologically “cold” tumour types remain refractive. Oncolytic viruses, such as those based on adenovirus have great potential as anti-cancer agents and have seen a resurgence of interest in recent years. Amongst their many advantages is their ability to induce immunogenic cell death (ICD) of infected tumour cells, thus providing the alluring potential to synergize with immunotherapies by turning immunologically “cold” tumours “hot”. Additionally, enhanced immune mediated cell killing can be promoted through the local overexpression of immunological transgenes, encoded from within the engineered viral genome. To achieve this full potential requires the development of refined, tumour selective “precision virotherapies” that are extensively engineered to prevent off-target up take via native routes of infection, and targeted to infect and replicate uniquely within malignantly transformed cells. Here, we review the latest advances towards this holy grail within the adenoviral field.
Variability in Anesthesia Models of Care In Cardiac Surgery
Authors: McCallister Dianne , Malone Bethany , Hanna Jennifer , Firstenberg Michael S
Published: October 2020

The operating room in a cardiothoracic surgical case is a complex environment, with multiple handoffs often required by staffing changes, and can be variable from program to program. This study was done to characterize what types of practitioners provide anesthesia during cardiac operations to determine the variability in this aspect of care. A survey was sent out via a list serve of members of the cardiac surgical team. Responses from 40 programs from a variety of countries showed variability across every dimension requested of the cardiac anesthesia team. Given that anesthesia is proven to have influence on the outcome of cardiac procedures, this study indicates the opportunity to further study how this variability influences outcomes, and to identify best practices.
Circular RNA, the Key for Translation
Authors: Prats Anne-Catherine , David Florian , Diallo Leila , Roussel Emilie , Tatin Florence , Garmy-Susini Barbara , Lacazette Eric
Published: October 2020

It was thought until the 1990s that the eukaryotic translation machinery was unable to translate a circular RNA. However internal ribosome entry sites (IRESs) and m6A-induced ribosome engagement sites (MIRESs) were discovered, promoting 5’end-independent translation initiation. Today a new family of non-coding RNAs, circular RNAs (circRNAs), has emerged, revealing the pivotal role of 5’end-independent translation. CircRNAs have a strong impact on translational control via their sponge function, and form a new mRNA family as they are translated into proteins with pathophysiological roles. While there is no more doubt about translation of covalently closed circRNA, the linearity of canonical mRNA is only theoretical: it has been shown for more than thirty years that polysomes exhibit a circular form and mRNA functional circularization has been demonstrated in the 1990s by the interaction of initiation factor eIF4G with poly(A) binding protein. More recently, additional mechanisms of 3’-5’ interaction have been reported, including m6A modification. Functional circularization enhances translation via ribosome recycling and acceleration of the translation initiation rate. This update of covalently and non-covalently circular mRNA translation landscape shows that RNA circular shape is the rule for translation with an important impact on disease development.
The Effects of the Invasive Seaweed Asparagopsis Armata on Native Rock Pool Communities: Evidences from Experimental Exclusion
Authors: Silva Carla , Lemos Marco , Gaspar Rui , Gonçalves Carlos , Neto João
Published: October 2020

Biological invasions represent a threat to ecosystems, through competition and habitat destruction, which may result in significant changes of the invaded community. Asparagopsis armata is a red macroalgae (Rodophyta) globally recognized as an invasive species. It is found from the intertidal to shallow subtidal areas, on rock or epiphytic, forming natural vegetation belts on exposed coasts. This study evaluated the variations on native intertidal seaweed and macroinvertebrate assemblages inhabiting rock pools with and without the presence of the invasive macroalgae A. armata. To achieve this, manipulation experiments on Atlantic (Portugal) rock pools were done. Three rock pools were maintained without A. armata by manual removal of macroalgae, and three others were not experimentally manipulated during the study period and A. armata was freely present. In this study the variations between different rock pools were assessed. Results showed different patterns in the macroalgae composition of assemblages but not for the macrobenthic communities. Ellisolandia elongata was the main algal species affected by the invasion of A. armata. Invaded pools tended to show less species richness, showing a more constant and conservative structure, with lower variation of its taxonomic composition than the pools not containing A. armata, where the variability between samples was always higher. Despite the importance of the achieved results, further data based on observation of long-term series are needed, in order to further understand more severe effects of the invader A. armata on native macroalgal assemblage.
Did the Baroque Composer Domenico Scarlatti Have Watch Glass Nails and Drumstick Fingers?
Authors: Otte Andreas
Published: October 2020

(1) Background: Little is known about the baroque composer Domenico Scarlatti (1685-1757), whose life was centred behind closed doors at the royal court in Spain. There are no reports about his illnesses. From his compositions, mainly for harpsichord, an outstanding virtuosity can be read. (2) Case Presentation: In this case report, the only known oil painting of Domenico Scarlatti is presented, on which he is about 50 years old. In it one recognizes conspicuous hands with hints of watch glass nails and drumstick fingers. (3) Discussion: Whether Scarlatti had chronic hypoxia of peripheral body regions as a sign of, e.g., bronchial cancer or a severe heart disease, is not known. (4) Conclusions: The above-mentioned signs recorded in the oil painting, even if they were not interpretable at that time, are clearly represented and recorded for us and are open to diagnostic discussion from today's point of view.
Prediction of Wind Speed Using Hybrid Techniques. Three locations: Colombia, Ecuador and Spain
Authors: Lopez Luis , Oliveros Ingrid , Torres Luis , Ripoll Lacides , Soto Jose , Salazar Giovanny , Cantillo Santiago
Published: October 2020

This paper presents a methodology to calculate day-ahead wind speed predictions based on historical measurements done by weather stations. The methodology was tested for three locations: Colombia, Ecuador, and Spain. The data is input into the process in two ways: 1) as a single time series containing all measurements, and 2) as twenty-four separate parallel sequences, corresponding to the values of wind speed at each of the 24 hours in the day over several months. The methodology relies on the use of three non-parametric techniques: Least-Squares Support Vector Machines, Empirical Mode Decomposition, and the Wavelet Transform. Also, the traditional and simple Auto-Regressive model is applied. The combination of the aforementioned techniques results in nine methods for performing wind prediction. Experiments using a MATLAB implementation showed that the Least-squares Support Vector Machine using data as a single time series outperformed the other combinations, obtaining the least mean square error.
Corn Silage, Meta-Analysis of The Quality and Yield of Different Regions in the World
Authors: García-Chávez Isidro , Meraz-Romero Edgar , Castelán-Ortega Octavio , Zaragoza Esparza Joob , Osorio Avalos Jorge , Robles Jimenez Lizbeth Esmeralda , González-Ronquillo Manuel
Published: October 2020

Corn silage (Zea mays L.) is the most widely used energy resource in the diets of dairy cattle around the world; it stands out for its higher biomass yields, good palatability, homogeneous quality at harvest and ease of silage due to its higher soluble sugar content. It was carried out a search of studies related to dry matter yield (ton ha-1), population density (plant density ha-1), dry matter (DM), crude protein (CP), neutral detergent fiber (NDF), non-fibrous carbohydrates (NFC), organic matter (OM), DM digestibility (DMD) and neutral detergent fiber digestibility (NDFD) and milk production per hectare (kg of milk ha-1) that was determined using MILK2006®. It was carried out a cluster analysis (CL, PROC CLUSTER) obtaining six groups of corn silage: CL1: "Starch", which included DMD, DFDN, TDN1xDM, Mega calories per kg of DM and kg of milk/ton/DM; CL2: "Fats" which included TDN1xMS, Mcal/kg/DM and kg of milk/ton/DM; CL3: "Dry Matter", conformed only by DFDN; CL4: "Plant Density" including Yield of DM ha-1 and Milk Production ha-1; CL5: "Neutral Detergent Fiber" and CL6: "Raw Protein". It is concluded that CL1 was characterized by a higher DMD, DFND, CNF and starch that allow a higher TNDx1DM and an energy concentration (Mcal/kg/DM) that shows a higher milk production (kg of milk/ton/DM ha-1). The characteristics of CL2 with higher EE, allow a higher TNDx1DM and an energy concentration (Mcal/kg/DM) with a higher milk production (kg of milk/ton/DM ha-1).
Timing of Spheno-Occipital Synchondrosis Ossification in Children and Adolescents with Cleft Lip and Palate
Authors: Vale Francisco , Francisco Inês , Lucas António , Roseiro Ana , Caramelo Francisco , Sobral Adriana
Published: October 2020

Background: Cleft lip and palate can affect the development of the maxilla, which may create a midfacial deficiency as well as an interference of the facial growth pattern and dentofacial esthetics. Objective: Estimate the chronological age of complete fusion of the spheno-occipital synchondrosis in cleft lip and/or palate patient´s and a control group, using cone beam computed tomography images. Methods: In this retrospective study, 125 patients were enrolled (cleft lip and/or palate group (n=91); control group (n=34)). Age comparison was made with Chi-square test and a Kaplan-Meyer analysis determined the median time to reach complete fusion of the spheno-occipital synchondrosis (p<0.05). Results: The experimental group showed statistically significant differences in the median time for complete ossification between males and females (p=0.019). No statistically significant differences were found in the control group between males and females (p=0.104). The median time for complete ossification of the spheno-occipital synchondrosis was, for males, 15.0 years in both groups; for females, it was 14.0 years in the experimental group and 13.0 years in the control group. Conclusions: The present study showed no differences in the ossification of the spheno-occipital synchondrosis between individuals with and without cleft lip and/or palate.
PENGELOLAAN ARSIP DI DINAS PERPUSTAKAAN DAN KEARSIPAN DAERAH KABUPATEN SAMBAS PROVINSI KALIMANTAN BARAT
Authors: Yusma Sari Riazmi , Zulaikha Siti Rohyanti
Published: October 2020

Archive is a document that is stored by individuals, companies and agencies both in print and electronic. In order for the existence of an archive, proper care and management must be done.

This research uses a qualitative research method with a descriptive approach. Data collection techniques used in this study were through observation and interviews. The researchers observed by surveying the mass media owned by the Sambas District Library and Archives Service related to information needs, namely the archives. Research interviews conducted through whatsapp communication media with Darmadi, who is a staff in the field of archival administration under the head of the archiving and supervision section. Research also use books supporting information needs in this study.

Based on this research, it was concluded that the Library and Archives Office of the Sambas Regency had carried out well according to the classification of dynamic and static archives. However, because the archiving facilities and infrastructure in the Sambas Regency Regional Library and Archives Service are minimal, archival storage is still using conventional media such as cabinet filing and filing shelves. This is far from the current development that uses digital as a storage medium. Maintenance of the archive is carried out periodically for 3 months with makeshift maintenance such as giving camphor in each archive storage media. For the destruction of archives, the Sambas Regency Library and Archives Service has never destroyed archives due to the limited and structural funds that deal with this frequently changing so that the knowledge about the destruction of archives is inadequate but the regulations regarding the archive retention schedule (JRA) have been completed in the formulation and made the regent regulation number 14 of 2014.
Removing a Retained Antibiotic Cement Nail from a Tibia
Authors: Mallon Zachary , Provus Jason , Lee Gavin
Published: October 2020

Case:

We present a case of osteomyelitis after a grade 3A open tibial shaft fracture complicated by incomplete removal of an antibiotic intramedullary rod. The authors are unaware of any reports with this specific complication and provide a novel technique for cement mantle removal involving a distal tibial corticotomy and antegrade cement impaction.

Conclusion:

Antibiotic nails can successfully treat intramedullary osteomyelitis, but surgeons may encounter unexpected issues due to custom, intraoperative fabrication. This case describes one example of how to solve the intraoperative problem of a retained cement mantle during antibiotic rod extraction.
The Cohort Effect Approach to a Friction in Students-Life Beyond Religious and Mental Health for Anxiety Disorder at IAIN Langsa
Authors: Iqbal Iqbal , Afna Mauloeddin , Sari Rita
Published: October 2020

The article scrutinized a friction stem in students, a false or a real of hope, struggle, and retentive in life when anxiety attacking the consciousness and bridging religious tradition and mental health status. Beyond reality to fantasy, within the inner perceptive, students construct artificial facts in the brain to stimulate action as a course of reactions. The artificial are related to a hope, an expectation, inviting a positive outcome to be believed as an alternative fact to subdue anxiety of fears, which come to overshadow students’ mental status. For inner students’ mental status, there is friction which pressing one to another for their artificial feeling either became the greatest power or worst nightmare affected to daily life and exposure both internally and externally reactions. A cohort effect approaches were applied to observe a longitudinal study for students’ behaviors in contemplating anxiety disorder affect that relied on religious and mental health for an individual sample. Student’s behaviors respect a particular characteristic as the aging process. The approaches aimed at physical features; body shape, decision making, level of aggressiveness, fears, and matting patterns. Thus, students’ frictions are traceable to foresee students’ mental health disorders as an umbrella from a diverse field in clinical psychology.
Insights into Polyphase Phanerozoic Tectonic Events in SE China: Integrated Isotopic Microanalysis of Detrital Zircon and Monazite
Authors: Wu Li-Guang , Li Xian-Hua , Yao Weihua , Ling Xiao-Xiao , Lu Kai
Published: October 2020

Widespread Paleozoic and Mesozoic granites are characteristics of SE China, but the geodynamic mechanisms responsible for their emplacement are an issue of ongoing debate. To shed new light on this issue, we present an integrated geochronological and isotopic study of detrital zircon and monazite from Cambrian metasandstones and modern beach sands in the Yangjiang region, SE China. For the Cambrian metasandstone sample, detrital zircon displays a wide age range between 490 and 3000 Ma, while monazite grains record a single age peak of 235 Ma. The results suggest that a significant Triassic (235 Ma) metamorphic event is recorded by monazite but not zircon. For the beach sand sample, detrital zircon ages show six peaks at ca. 440, 240, 155, 135, 115, and 100 Ma, whereas detrital monazite yields a dominant age peak at 237 Ma and a very minor age peak at 435 Ma. Beach sand zircon displays features that are typical of a magmatic origin. Their Hf–O isotopes reveal two crustal reworking events during the early Paleozoic and Triassic, in addition to one juvenile crustal growth event during the Jurassic–Cretaceous. The beach sand monazite records intense Triassic igneous and metamorphic events with significant crustal reworking. Such early Paleozoic and Triassic geochemical signatures of detrital zircon and monazite suggest they were derived from granitoids and metamorphic rocks which formed in intraplate orogenies, i.e., the early Paleozoic Wuyi–Yunkai Orogeny and Triassic Indosinian Orogeny. The Jurassic–Cretaceous signature of detrital zircon may reflect multistage magmatism that was related to subduction of the Paleo-Pacific Plate beneath SE China.
Prediction of Slug/Churn Transition for Viscous Upward Two-Phase Flows in Vertical Pipes
Authors: Abdul-Majeed Ghassan H. , Firouzi Mahshid
Published: October 2020

In this study, we investigate the effect of liquid viscosity (μL) on the slug/churn transition in gas/liquid flows in vertical pipes. A total of 80 experimental churn-flow data points from two different sources are compiled as a data set, covering liquid viscosities from 17.23 to 586 mPa·s. Air was used in these studies as a gas phase with two different liquids, aqueous glycerol and a commercial synthetic mineral oil, flowing in vertical pipes of 0.0192- and 0.0508-m inner diameter (ID). The data set is used to examine the existing slug/churn-flow-transition models and provide further insights into the effect of μL on the transition. The existing models are categorized into two groups according to their response of the slug/churn transition to the increase in liquid superficial velocity (Vsl) on the Vsg/Vsl flow map. The first category exhibits a decrease in superficial gas velocity (Vsg) with the increase in Vsl at slug/churn (the transition concave to the left). The other one predicts an increase in Vsg with increasing of Vsl (the transition concave to the right). Analysis of the data set reveals that on the Vsg/Vsl flow map, the slug/churn transition moves toward lower superficial gas velocities as liquid viscosity increases and occurs approximately at a constant Vsg for low to medium Vsl. The predictions of these models were tested against the data set and poor results were shown by most models. The best performance is given by the Abdul-Majeed (1997) model. A dimensional analysis is applied in the present study to develop a new slug/churn-transition model. This analysis indicates that the transition is related to three dimensionless numbers, namely gas- and liquid-phase Froude numbers, in addition to the inverse liquid-viscosity number. An improved revision to the Abdul-Majeed model is achieved using these three dimensionless numbers. The revision enables the model to predict the transition for low, medium, and high liquid viscosity. The revised model clearly outperforms all the existing models for the present data and viscous data from independent studies. Furthermore, the revised model exhibits the expected trend against changes in pipe diameter and gas density.
Experimental and Theoretical Studies on the Porous Media Zeta Potential in Mineral Particle Mixtures
Authors: Ghane Reza , Sadeqi-Moqadam Mohsen , Riahi Siavash
Published: October 2020

Numerous studies on electrical potential of particles have proven its wide range of applications in areas such as electrochemistry, geophysics, and hydrology. Because most researchers have only focused on single-type mineral particles, our knowledge about zeta potential is extremely limited, despite the fact that most natural rocks are mixtures of different pure minerals.

In this research, we investigated the zeta potential of mixed samples, made of two pure components with different surface potentials. The ultimate goal is to measure the zeta potential of mixed minerals, existing on different surfaces, and subsequently to evaluate the effect of permeability (capillary radius) on the measured zeta of single-type particles.

The analysis of the obtained results from the samples, made of two different minerals, suggests that there is a linear relationship between zeta potential and the overall area of single-type particles. Furthermore, it indicates that the absolute values of zeta potential, existing in samples of similar types and different sizes, change linearly by varying permeability. Eventually, a simple model is proposed to predict the overall zeta potential based on each component’s zeta. The predictability of the model is also evaluated by conducting a stream potential experiment on porous media of different sizes and types. The model is properly able to predict zeta potential of different mixtures based on the average of surface area and permeability changes.
The effect of initiating neuraxial analgesia service on the rate of cesarean delivery in Hubei, China: A 16-month retrospective study
Authors: ZHAO Yun , GAO Ying , SUN Guoqiang , YU Ling , LIN Ying
Published: October 2020

Background No Pain Labor ＆Delivery (NPLD) is a nongovernmental project to increase access to safe neuraxial analgesia through specialized training. This study explores the change in overall cesarean delivery (CD) rate and maternal request CD(MRCD) rate in our hospital after the initiation of neuraxial analgesia service (NA). Methods NA was initiated in May 1st 2015 by the help of NPLD. Since then, the application of NA became a routine operation in our hospital, and every parturient can choose to use NA or not. The monthly rates of NA, CD, MRCD, multiparous women, intrapartum CD, episiotomy, postpartum hemorrhage (PPH), operative vaginal delivery and neonatal asphyxia were analyzed from January 2015 to April 2016. Results The rate of NA in our hospital was getting increasingly higher from 26.1% in May 2015 to 44.6% in April 2016 (p<0.001); the rate of CD was 48.1% (3577/7360) and stable from January to May 2015 (p＞0.05), then decreased from 50.4% in May 2015 to 36.3% in April 2016 ( p<0.001); the rate of MRCD was 11.4% (406/3577) and also stable from January to May 2015 (p＞0.05), then decreased from 10.8% in May 2015 to 5.7% in April 2016 (p<0.001). At the same time, the rate of multiparous women remained unchanged during the 16 month of observation (p＞0.05). There was a negative correlation between the rate of NA and rate of overall CD, r=-0.782 (95%CI [-0.948, -0.534], p＜0.001), and between the utilization rate of NA and rate of MRCD, r=-0.914 (95%CI [-0.989, -0.766], p＜0.001). The rates of episiotomy, PPH, operative vaginal delivery and neonatal asphyxia in women who underwent vaginal delivery as well as the rates of intrapartum CD, neonatal asphyxia, and PPH in women who underwent CD remained unchanged, and there was no correlation between the rate of NA and anyone of those rates from January 1st 2015 to April 30th 2016 (p＞0.05). Conclusions: Our study shows that the rates of CD and MRCD in our department were significantly decreased from May 1st 2015 to April 30th 2016, which may be due to the increasing use of NA during vaginal delivery with the help of NPLD.
Prescribing antidepressants and anxiolytic medications to pregnant women: Comparing perception of risk of foetal teratogenicity between Australian Obstetricians and Gynaecologists, Speciality trainees and upskilled General Practitioners
Authors: Williams Summer , Bruxner George , Ballard Emma , Kothari Alka
Published: October 2020

Background: The decision of whether to prescribe antidepressants (AD) and anxiolytics (AX) to pregnant women is complex, with serious potential ramifications. Clinicians’ perception of the risk of teratogenicity significantly influences their prescribing decisions and in turn impacts maternal decision making. Our cross-sectional study sought to discern differences in perceived risk between Obstetricians and Gynaecologists (O&Gs) and General Practitioners (GPs) when prescribing these medications in pregnancy. Furthermore, we investigated factors impacting perception, clinicians’ willingness to prescribe and their approach to provision of patient information. Methods: This cross-sectional study was conducted via a nation-wide online SurveyMonkey extended to Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) database-derived affiliates: GP diplomates, fellows and trainees (5409 survey invitations: 545 respondents). O&Gs and GPs were compared using Pearson Chi-squared test for categorical variables and the Student t-test for continuous variables. Results: GPs reported higher rates of being aware of up-to-date medication prescription recommendations (57.6%) compared with O&Gs (44.2%). GPs also reported higher rates of training adequacy in psychotropic prescription (56.1% versus 29.0%). There was evidence to suggest GPs level of confidence in knowledge base, initiation and prescription of AD and AX was higher than those of O&Gs. The mean perception of patient non-compliance was similar between clinician groups (approximately 35%), but GPs perceived the extent of patient anxiety as higher compared to O&Gs (mean 73.7% (SD 21.3) versus 63.1% (SD 24.1), p<0.001). Both groups showed a strong preference for improved training rather than patient-focused technology (above 70% for both groups). Conclusion: Further development of clinician training in perinatal psychotropic prescription is warranted. Keywords : psychotropics, teratogenicity, pregnant, prescribing, foetal, perception
Disinfectant Wipes Transfer Clostridioides difficile Spores from Contaminated Surfaces to Uncontaminated Surfaces during the Disinfection Process
Authors: Nkemngong Carine A. , Chaggar Gurpreet K. , Li Xiaobao , Teska Peter J. , Oliver Haley F
Published: October 2020

Background: Pre-wetted disinfectant wipes are increasingly being used in healthcare facilities to help address the risk of healthcare associated infections (HAI). However, HAIs are still a major problem in the US with Clostridioides difficile being the most common cause, leading to approximately 12,800 deaths annually in the US. An underexplored risk when using disinfectant wipes is that they may cross-contaminate uncontaminated surfaces during the wiping process. The objective of this study was to determine the cross-contamination risk that pre-wetted disinfectant towelettes may pose when challenged with C. difficile spores. We hypothesized that although the tested disinfectant wipes had no sporicidal claims, they will reduce spore loads. We also hypothesized that hydrogen peroxide disinfectant towelettes would present a lower cross-contamination risk than quaternary ammonium products. Methods: We evaluated the risk of cross-contamination when disinfectant wipes are challenged with C. difficile ATCC 43598 spores on Formica surfaces. A disinfectant wipe was used to wipe a Formica sheet inoculated with C. difficile. After the wiping process, we determined log10 CFU on previously uncontaminated pre-determined distances from the inoculation point and on the used wipes. Results: We found that the disinfectant wipes transferred C. difficile spores from inoculated surfaces to previously uncontaminated surfaces. We also found that wipes physically removed C. difficile spores and that hydrogen peroxide disinfectants were more sporicidal than the quaternary ammonium disinfectants. Conclusion: Regardless of the product type, all disinfectant wipes had some sporicidal effect but transferred C. difficile spores from contaminated to otherwise previously uncontaminated surfaces. Disinfectant wipes retain C. difficile spores during and after the wiping process.
Seroepidemiology of Respiratory Syncytial Virus infection in rural and semi-rural areas of the Littoral Region of Cameroon
Authors: Mandi Henshaw Eyambe , Yimer Solomon Abebe , Bekolo Cavin Epie , Eyoh Agnes , Jan Sindhiya , Clemens Ralf
Published: October 2020

Background: The respiratory syncytial virus (RSV) has been established as a leading cause of acute lower respiratory illness (ALRI) in infants and children. In 2015, the global disease burden (GBD) study estimated that the overall RSV-ALRI mortality could be as high as 118200, with most death occurring in low- and middle-incomes countries (LMICs). This study aimed to assess the burden of RSV infection among children less than two years with acute respiratory infections (ARI) in the littoral region of Cameroon.Methods: We carried out a cross-sectional study in seven health in the littoral region of Cameroon. Venous blood was collected using serum separation tubes from eligible children who visited these healthcare facilities with acute respiratory infections. ELISA testing was used to assess the seroprevalence of anti-IgM RSV for the total population and by selected demographic and health parameters and potential risk factors. Results: The overall RSV-associated ARI seroprevalence was 33% (95%CI:23.6-42.3; 33/100 children). The only demographic factor significantly associated with RSV acquisition was age of six months and below (odds ratio: 7.54 (2.62, 23.36); p=0.000). Children who were concomitantly infected with malaria had a lower risk of RSV infection (odds ratio: 0.38 (0.14, 0.95; P = 0.03). Conclusions: The RSV burden is high among children less than two years with ARI in the littoral region of Cameroon. There is a need for an effective public health RSV surveillance system with standard laboratory techniques and equipment to better understand the RSV disease age-specific incidence, seasonality, risk factors and RSV burden among patients in communities in Cameroon.
Biomechanical Control of Paretic Lower Limb During Imposed Weight Transfer in Individuals Post-Stroke
Authors: Hsiao Hao-Yuan , Gray Vicki L , Borrelli James , Rogers Mark W
Published: October 2020

Background: stroke is a leading cause of disability with associated hemiparesis resulting in difficulty bearing and transferring weight on to the paretic limb. Difficulties in weight bearing and weight transfer may result in impaired mobility and balance, increased fall risk, and decreased community engagement. Despite considerable efforts aimed at improving weight transfer after stroke, impairments in its neuromotor and biomechanical control remain poorly understood. In the present study, a novel experimental paradigm was used to characterize differences in weight transfer biomechanics in individuals with chronic stroke versus able-bodied controls. Methods: fifteen participants with stroke and fifteen age-matched able-bodied controls participated in the study. Participants stood with one foot on each of two custom built platforms. One of the platforms dropped 4.3 cm vertically to induce lateral weight transfer and weight bearing. Trials involving a drop of the platform beneath the paretic lower extremity (non-dominant limb for control) were included in the analyses. Paretic lower extremity joint kinematics, vertical ground reaction forces, and center of pressure velocity were measured. All participants completed the clinical Step Test and Four-Square Step Test. Results: reduced paretic ankle, knee, and hip joint angular displacement and velocity, delayed ankle and knee inter-joint timing, increased downward displacement of center of mass, and increased center of pressure (COP) velocity stabilization time were exhibited in the stroke group compared to the control group. In addition, paretic COP velocity stabilization time during induced weight transfer predicted Four-Square Step Test scores in individuals post-stroke. Conclusions: the induced weight transfer approach identified stroke-related abnormalities in the control of weight transfer towards the paretic limb side compared to controls. Decreased joint flexion of the paretic ankle and knee, altered inter-joint timing, and increased COP stabilization times may reflect difficulties in neuromuscular control during weight transfer following stroke. Future work will investigate the potential of improving functional weight transfer through induced weight transfer training exercise.
Biomechanical analysis of canine medial patellar luxation with femoral varus deformity using a computer model
Authors: Lee Jiyun , Sim Heedong , Jeong Jaemin , DVM Sun-Young Kim , Yang Seokjo , Jeong SeongMok , Lee Haebeom
Published: October 2020

Background Femoral varus deformities complicating the realignment of the quadriceps muscles are frequently associated with medial patellar luxation (MPL) in dogs. Therefore, distal femoral osteotomy (DFO) is recommended in dogs affected with severe MPL and a distal femoral varus deformity. The presence of an anatomic lateral distal femoral angle (aLDFA) of ≥ 102° has been anecdotally recommended as an indication for performing corrective DFO in large-breed dogs. However, the effect of a femoral varus deformity on MPL has not been scientifically evaluated. We aimed to evaluate the influence of a femoral varus deformity on MPL using a finite element method based computer model. Three-dimensionally reconstructed computed tomographic images of a normal femur from a Beagle dog were deformed using meshing software to create distal varus deformities. A total of thirteen aLDFAs, including 95°, 98° and 100°–110°, were simulated. The patellar positions and reaction force between the patella and trochlear grooves were calculated for all finite element models under constant rectus femoris muscle activation.Results: The patella was displaced medially from the trochlear groove at an aLDFA of ≥103°. With an aLDFA of 103° to 110°, the reaction force was equal to zero and then decreased to negative values during the simulation, while other models with aLDFAs of 95°, 98°, and 100°-102° had positive reaction force values. The patella began to luxate at 24.90 seconds (sec) with an aLDFA of 103°, 19.80 sec with an aLDFA of 104°, 21.40 sec with an aLDFA of 105°, 20.10 sec with an aLDFA of 106°, 18.60 sec with an aLDFA of 107°, 15.30 sec with an aLDFA of 108°, 16.60 sec with an aLDFA of 109°, and 11.90 sec with an aLDFA of 110°.Conclusion: Severe distal femoral varus with an aLDFA of ≥103° caused MPL when other anatomical factors were controlled. This simplified computer model provides complementary information to anecdotal cutoffs for DFO, hence it should be applied to clinical patients with caution.
Why do pregnant women prefer cesarean birth? : a qualitative study in a tertiary care center in Southern Thailand
Authors: Suwanrath Chitkasaem , Chunuan Sopen , Matemanosak Phawat , Pinjaroen Sutham
Published: October 2020

Background: The increasing worldwide rate of cesarean sections is of global concern. In recent years, cesarean births upon maternal request have become both a hotly debated issue. Hence, this study aimed to explore maternal reasons for cesarean preference without medical indications.Methods: A descriptive qualitative study was conducted, using in-depth interviews with 27 pregnant women, attending antenatal care in Songklanagarind Hospital from September 2018 to June 2019, who preferred cesarean birth. Data were analyzed using content analysis.Results: Maternal reasons for cesarean preference were classified into six main categories including: fear of childbirth, safety concerns related to health risk perception, negative previous birth experience, positive attitude toward cesarean birth, access to biased information and superstitious belief in auspicious birth dates. Most women had more than one reason for opting cesarean birth. Conclusion: Several reasons for cesarean birth preference have been elucidated. One striking reason was a superstitious belief in auspicious birth dates, which is challengable for obstetricians to deal with. Obstetricians should explore the exact reasons why women request cesarean birth, so as to prevent or diminish unnecessary cesarean births.
Neuroprotective effect of Indobufen against pyroptosis following cerebral ischemia-reperfusion injury both in vivo and in vitro
Authors: Zhang Tian , Xu Dan , Li Fengyang , Liu Rui , Hou Kai , Gou Xue , Liu Jia , Fang Weirong , Li Yunman
Published: October 2020

Background: Indobufen is a new generation of antiplatelet agents and has been shown to have antithrombotic effects in animal models. However, the efficacy of Indobufen on cerebral ischemia/reperfusion (I/R) injury and its mechanisms remain to be investigated. Methods: In this study, the efficacy of Indobufen with both pre- (5days) and post- (15days) treatment on rats suffering middle cerebral artery occlusion/reperfusion (MCAO/R, 2h of ischemia and 24h/15days of reperfusion) was investigated. Furthermore, human umbilical vein endothelial cells (HUVECs) were cultured and underwent oxygen glucose deprivation/reoxygenation (OGD/R) injury for in vitro studies. Relationship between Indobufen and pyroptosis associated NF-κB/Caspase-1/GSDMD pathway was preliminarily discussed.Results: The pharmacodynamic tests revealed that Indobufen ameliorated I/R injury by decreasing the platelet aggregation, infarct size, brain edema and neurologic impairment in rats and rescuing cell apoptosis/pyroptosis in HUVECs. The underlying mechanisms were probably related to pyroptosis suppression by platelet inhibition induced regulation of the NF-κB/Caspase-1/GSDMD pathway. Conclusion: Overall, these studies indicates that Indobufen exerts protective and therapeutic effects against I/R injury by pyroptosis suppression via downregulating NF-κB/Caspase-1/GSDMD pathway.
Assessing the Effectiveness of Chagas Disease Education for Healthcare Providers in the United States
Authors: Granados Paula Stigler , Pacheco Gerardo J , Patlán Evangelina Núñez , Betancourt Jose , Fulton Lawrence
Published: October 2020

Background: Chagas disease is a zoonotic infection caused by the parasite Trypanosoma cruzi, which affects an estimated 8-11 million people globally. Chagas disease is almost always associated with poverty in rural areas and disproportionately impacts immigrants from Latin America living in the United States. Approximately 20-30% of people who are infected with Chagas disease will develop a chronic form of the infection that can be fatal if left untreated. Chagas disease is vastly underestimated in the United States, often goes undiagnosed and is not well understood by most U.S. healthcare providers. One of the most important ways at reducing barriers to improving diagnostics of Chagas disease in the U.S. is giving healthcare providers the most up-to-date information and access to leading experts. Methods: An online webinar was conducted for healthcare providers, veterinarians and public health professionals using Chagas disease expert panelists. Pre and post tests were administered to participants (n=57) to determine the efficacy in raising awareness and to determine key focus areas for improving knowledge. A Wilcoxon rank-sum was used for non-parametric variables equivalent and for questions that assessed knowledge the McNemar’s Chi-Square test was used.Results: There were statistically significant learning increases in multiple categories including transmission (p=<.001), clinical presentation (p= 0.016), diagnostics (p=<.001), and treatment (p=<.001). Conclusion: Providing easily accessible learning opportunities using validated testing and evaluations should be further developed for rural healthcare providers in the U.S. as well as healthcare providers serving under represented populations such as immigrants. There is a clear lack of knowledge and awareness surrounding Chagas disease in the United States and just by raising awareness and providing education on the topic, lives will be saved.
Prevalence and Clinical Phenotype of the Triplicated α-Globin Genes and its Ethnic and Geographical Distribution in Guizhou of China
Authors: Luo Xi , Chen Shi-ping , Zhang Xiang-mei , Wu Liu-song , Peng Zhi-yu , Chen Yan , Chen Jindong
Published: October 2020

Background: Thalassemia is relatively epidemic in Guizhou province of southwestern China. To predict the clinical manifestations of α-globin gene aberration for genetic counseling, we examined the prevalence of the α-globin triplication and the genotype-phenotype correlation in this subpopulationMethods: A cohort of 7644 subjects was collected from nine ethnicities covering four regions in Guizhou province of China. Peripheral blood was collected from each participant for routine blood testing and hemoglobin electrophoresis. PCR-DNA sequencing and Gap-PCR were used to identify the thalassemia gene mutations. Chi-square tests and one-way analysis of variance (ANOVA) were used to statistically analyze the data. ﻿Results: We found that the frequency of α-globin triplication in Guizhou province was 0.759% (58/7644). Genotypically, the αααanti4.2/αα accounted for 0.523% (40/7644), the αααanti3.7/αα for 0.235% (18/7644). The αααanti4.2/αα is more prevalent than the αααanti3.7/αα in Guizhou. In addition, the frequency of the αααanti4.2/-α3.7 (HK αα) was 0.235% (18/7644), and the αααanti3.7/--SEA was 0.013% (1/7644). Ethnically, the Tujia group presented the highest prevalence (2.47%) of α-globin triplication. Geographically, the highest frequency of the α-globin triplication was identified in Qiannan region (2.23%). Of the triplicated α-globin cases, 5 coinherited with heterozygote β-thalassemia and presented various clinical manifestations of anemia. Conclusions: These data will be used to update the triplicated α-globin thalassemia database and provide insights into the pathogenesis of thalassemia. These findings will be helpful for the diagnosis of thalassemia and future genetic counseling in those regions.
Effects of Tocilizumab in COVID-19 patients: a cohort study
Authors: Vu Christine , Deronde Kailynn J , Vega Ana D , Maxam Meshell , Holt Gregory , Natori Yoichiro , Zamora Jose Gonzales , Salazar Veronica , Boatwright Renata , Morris Stephen R , Corvino Daniela de Lima , Betances Anmary Fernandez , Colucci Leah , keegan James , Lopez Andy , Rezk Andrew Hany , Rodriguez Yvette , Doblecki Susanne , Zerda David De La , Abbo Lilian M
Published: October 2020

Background: Due to the lack of proven therapies, we evaluated the effects of early administration of tocilizumab for COVID-19. By inhibition of the IL-6 receptor, tocilizumab may help to mitigate the hyperinflammatory response associated with progressive respiratory failure caused by SARS-CoV-2. Methods: A retrospective, observational study was conducted on hospitalized adults who received intravenous tocilizumab for COVID-19 between March 23, 2020 and April 10, 2020. Results: Most patients were male (66.7%), Hispanic (63.3%) or Black (23.3%), with a median age of 54 years. Tocilizumab was administered at a median of 8 days (range 1-21) after initial symptoms and 2 days (range 0-12) after hospital admission. On the day of administration, the median PaO2/FiO2 was 166 (range 33-523) and 50 patients (83.3%) had ARDS. By day 30, 36 patients (60.0%) demonstrated clinical improvement, 9 (15.0%) died, 33 (55.0%) were discharged alive, and 18 (30.0%) remained hospitalized. Successful extubation occurred in 13 out of 29 patients (44.8%). Infectious complications occurred in 16 patients (26.7%) at a median of 10.5 days. There was an increase in PaO2/FiO2 and an initial reduction in CRP that was not sustained beyond day 10. Conclusions: Majority of patients demonstrated clinical improvement and were successfully discharged from the hospital alive after receiving tocilizumab. Similar to previous studies, infectious complications were not uncommon. We observed a rebound effect with CRP, which may suggest the need for higher or subsequent doses to adequately manage cytokine storm. Based on our findings, we believe that tocilizumab may have a role in the treatment of COVID-19, however randomized controlled studies are urgently needed.
Autologous peripheral blood-derived stem cells transplantation for treatment of no-option angiitis-induced critical limb ischemia: 10-year management experience
Authors: Fang Gang , Jiang Xiaolang , Fang Yuan , Pan Tianyue , Liu Hao , Wei Zheng , Gu Shiyang , Chen Bin , Jiang Junhao , Shi Yun , Guo Daqiao , Liu Peng , Dong Zhihui , Fu Weiguo
Published: October 2020

Background: Previous studies have demonstrated that no-option angiitis-induced critical limb ischemia (NO-AICLI) could be significantly improved by transplantation of peripheral blood-derived stem cells (PBDSCs). Additionally, a randomized controlled trial (RCT) recently conducted by us suggested that peripheral blood-derived purified CD34+ cells (PCCs) were not inferior to non-purified peripheral blood mononuclear cells (PBMNCs) at limb salvage in treatment of NO-AICLI. However, most of these clinical trials whether RCT or single-arm studies were characterized with a small sample size and absence of long-term outcomes. Methods: To analyze long-term clinical outcomes of PBDSCs transplantation for NO-AICLI, we reviewed clinical data of patients with NO-AICLI receiving PBDSCs transplantation at our center during the past decade. Meanwhile, we first compared the long-term safety and efficacy of intramuscular transplantation of PCCs versus PBMNCs in a sizable number of patients with NO-AICLI.Results: From May 2009 to December 2019, a total of 160 patients with NO-AICLI patients were treated by PBDSCs transplantation (82 with PCCs, 78 with PBMNCs) at our center. Baseline characteristics between two groups were similar. Up to June 2020, the mean follow-up period was 46.6±35.3 months. No critical adverse events were observed in either group. There was one death during the follow-up period. A total of eight major amputations occurred. The cumulative major amputation-free survival (MAFS) rate at 5 years after PBDSCs transplantation was 94.4%, without difference between two groups (P=.855). Wound healing, rest pain, pain-free walking time, ankle-brachial index, transcutaneous oxygen pressure, and quality of life (QoL) also significantly improved after PBDSCs transplantation. Conclusions: Autologous PBDSCs intramuscular transplantation could significantly decrease the major amputation rates and improve the QoL in patients with NO-AICLI. Long-term observation of a large sample of patients confirmed that the clinical benefits of PBDSCs transplantation were durable, without difference between the PCCs and PBMNCs groups.