bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Inhaled Corticosteroids on Hospitalized Chronic Obstructive Pulmonary Disease Exacerbations: A Retrospective, Multicenter, Propensity Score-Matched Study in China
Authors: Li Kang , Tao Ningning , Pan Mingming , Liu Jingjing , Pan Ting , Fan Guoqing , Cao Yang , Zhu Jie , Liu Ye , Guo Yanfei , Wang Dandan , Sun Tieying
Published: November 2020

Background: Exacerbations are important events when managing chronic obstructive pulmonary disease (COPD) because they negatively impact disease progression. Inhaled corticosteroid (ICS) usage in patients with COPD is controversial. Therefore, we reviewed the benefits and risks of regular ICS treatment in patients with COPD regarding hospitalized acute exacerbation.Methods: This retrospective multicenter study—conducted in 18 medical centers across China—included 1,862 participants from 34 hospitals in northern China. Baseline characteristics, comorbidities, and administered medicines in the last year were matched using 1:1 propensity score-matching. We reviewed electronic patient medical records to ascertain symptoms, tests, in-hospital treatment, and prognosis. Subsequently, we reviewed computed tomography imaging results and pathogen identification tests.Results: Patients who used ICS in the past year presented more severe respiratory symptoms during acute exacerbations of COPD but less frequent right heart failure or consciousness disturbance. More antibiotics were used during hospitalization, resulting in higher costs; however, their prognosis was not different from patients who did not use ICS. Additionally, although ICS usage could increase gram-negative bacilli in sputum smears, it did not increase the probability of pulmonary infection.Conclusions: ICS use could protect patients from right heart failure, without detrimentally affecting prognosis during hospitalized exacerbations. Therefore, the risk of cardiovascular disease should be taken into consideration when making decisions regarding the potential administration of ICS in patients with COPD.
SNRPD1 confers diagnostic and therapeutic values on breast cancers through cell cycle regulation
Authors: Dai Xiaofeng , Yu Lihui , Chen Xiao , Zhang Jianying
Published: November 2020

Background
SNRPD1 is a spliceosome-associated protein and has previously been implicated with important roles in cancer development.
Methods
Through analyzing the differential expression patterns and clinical association of splicing associated genes among tumor and tumor adjacent samples across different tumors and among different breast cancer subtypes, we identify the tumor promotive role of SNRPD1 using multiple publicly available datasets. Through pathway, gene ontology enrichment analysis and network construction, we linked the onco-therapeutic role of SNRPD1 with cell cycle. Via a series of experimental studies including knockdown assay, qPCR, western blotting, cell cycle, drug response assay, we confirmed the higher expression of SNPRD1 at both gene and protein expression levels in triple negative breast cancer cells, as well as its roles in promoting cell cycle and chemotherapy response.
Results
Our study revealed that SNRPD1 over-expression was significantly associated with genes involved in cell cycle, cell mitosis and chromatin replication, and silencing SNRPD1 in breast cancer cells could lead to halted tumor cell growth and cell cycle arrest at the G0/G1 stage. We also found that triple negative breast cancer cells with reduced SNRPD1 expression gained reduced sensitivity to doxorubicin whereas luminal cancer cells did not.
Conclusions
Our results suggested the prognostic value of SNRPD1 on breast cancer survival, its potential as the therapeutic target halting cell cycle progression for breast cancer control, and warranted special attention on the combined use of doxorubicin and drugs targeting SNRPD1.
Video As An Effective Knowledge Transfer Tool to Increase Awareness Among Health Workers and Better Manage Dengue Fever Cases.
Authors: Dagenais Christian , Hébert Catherine , Ridde Valéry
Published: November 2020

Background context. For a patient with dengue fever, a wrong diagnosis can be fatal. Very few Burkinabé health workers are properly trained to diagnose and treat cases of dengue fever. Recent outbreaks of dengue fever in Burkina Faso, which is also carrying a significant malaria burden, have made updating health workers’ knowledge an urgent matter.Method. Following a trial to determine the most appropriate format, a video was specially developed as a knowledge translation tool to update health workers’ knowledge. We posted a training video online for front-line medical staff. In four months, it was viewed by 2,993 people. We conducted a qualitative evaluation using the theory of planned behaviour. Twenty interviews were conducted with health professionals who had viewed the video. A content analysis was performed.Results. The use of the knowledge contained in the video was mainly influenced by the fact that its format was adapted to the target audience, that it presented specific and concise information, that it conveyed a relevant message in everyday language, and that the context was one of urgency.Conclusion. The development of video as a knowledge translation tool is an effective and efficient way to update health workers’ knowledge and influence their practices. Users received the video enthusiastically because of the epidemic context.
Should the Diastatic Syndesmosis be Stabilized in Advanced Pronation-External Rotation Ankle Injuries? A Retrospective Cohort Comparison
Authors: Wu Chi-Chuan , Yeh Wen-Ling , Lee Po-Cheng , Chou Ying-Chao , Hsu Yung-Heng , Yu Yi-Hsun
Published: November 2020

Background: Ankle injuries with the advanced pronation-external rotation (PE) type are relatively uncommon and the debate about whether the diastatic syndesmosis should be stabilized concomitantly has yet achieved a consensus. Comparison of using (Group 1) or non-using (Group 2) screw stabilization for the diastatic syndesmosis was performed retrospectively. Methods: With the 10-year period, 81 consecutive adult patients with advanced PE ankle injuries (stage 3 or 4 PE type) were treated. After malleolar fractures were internally stabilized with screws and plates, the syndesmotic stability was re-checked by external rotation and hook tests. The necessity of insertion of cortical screws to stabilize diastatic syndesmosis was decided by the individual orthopedic surgeon. The outcomes of both approaches were compared. Results: Seventy-one patients were followed for at least one year (87.7%; average, 2 years; range, 1-11 years). Group 1 had 22 patients and Group 2, 49 patients. The union rate in Group 1 was 100% (22 / 22) and in Group 2, 91.8% (45 / 49; p= 0.30). Syndesmosis re-diastasis occurred in 13.6% (3 / 22) of Group 1 and 30.6% (15 / 49) of Group 2 (p= 0.13). Satisfactory ankle function was noted in 86.4% (19 / 22) of Group 1 and 65.3% (32 / 49) of Group 2 (p= 0.07). Conclusion: Although clinical comparison cannot demonstrate statistical difference, screw stabilization of the diastatic syndesmosis may guarantee safer results. The statistical insignificance may be due to insufficient sample sizes. Clinically and theoretically, insertion of syndesmotic screws to promote ligament healing may be reasonable.
Gibberellins Regulate Lateral Root Development that is Associated with Auxin and Cell Wall Metabolisms in Cucumber
Authors: Cai Bingbing , Wang Ting , Sun Hong , Liu Cuimei , Chu Jinfang , Ren Zhonghai , LI QIANG
Published: November 2020

Background: Cucumber is an economically important crop cultivated worldwide. However, it is susceptible to various stresses due to weak and shallow root systems, limiting its productivity. Lateral roots (LRs) are critical for plant stress tolerance and productivity. Increasing evidence showed that gibberellins (GAs) play important roles, positively or negatively, in LR development in many plants. Therefore, it is of great importance for cucumber production to study the role of GAs in LR development. Results: The application of various concentrations of GA3 and uniconazole, a GA biosynthesis inhibitor, on germinated cucumber seeds for 5 days showed that GAs regulated cucumber LR development in a concentration-dependent manner. 1 µM, 10 µM, 50 µM and 100 µM GA3 significantly increased secondary root length, tertiary root number and length. It is worthy note that 50 µM GA3 treatment showed strong effects in increasing root dry weight and the root/shoot dry weight ratio. Pairwise comparisons between GA3-treated roots and Control at 2, 3 and 5 days after germination (DAG) identified 417 down-regulated genes enriched for GA metabolism-related processes and 447 up-regulated genes enriched for cell wall metabolism-related processes in GA3-treated roots. Linear factorial modeling was also performed to systematically identify DEGs and a total of 3523 non-redundant DEGs were identified in our RNA-seq data. Of these, most of the genes involved in auxin and cell wall metabolisms were up-regulated in GA3-treated roots. Conclusions: GAs positively regulate LR development in cucumber putatively associated with enhanced IAA and cell wall metabolisms. Our findings not only shed light on LR regulation mediated by GA but also offer an important resource for functional studies of candidate genes putatively involved in the regulation of LR development in cucumber and other crops.
Prevalence of Scabies and Impetigo in School-Age Children in Timor-Leste
Authors: Matthews Alexander , Le Brandon , Amaral Salvador , Arkell Paul , Monteiro Merita , Clarke Naomi , Barros Terlinda , Mendonça Joaquim de Jesus , Gusmão Sonia Maria Exposto , Seixas Leonia Maria dos Reis , Piedade João Henrique Araújo da , Engelman Daniel , Steer Andrew C. , Fancourt Nicholas S. S. , Yan Jennifer , Kaldor John , Francis Joshua R. , Nery Susana Vaz
Published: November 2020

Background Scabies and impetigo are endemic in many tropical, low- and middle-income countries. With control strategies emerging based on mass drug administration (MDA) with ivermectin, there is a need for comprehensive data on the occurrence and risk factors of these conditions to guide interventions and enable their impact to be assessed. In 2019, Timor-Leste Ministry of Health planned to implement MDA including ivermectin for the control of lymphatic filariasis, so we undertook a baseline assessment of scabies and impetigo. Methods A cross-sectional school survey was conducted in April-May 2019 at six primary schools in a semi-urban (Dili) and two rural (Ermera and Manufahi) settings. Children under 19 years of age present at school on survey days were eligible to participate, of whom we enrolled 1183. Trained health workers interviewed and examined 1043 participants to clinically diagnose scabies using the 2020 International Alliance for the Control of Scabies (IACS) diagnostic criteria, as well as impetigo. Prevalence was adjusted for age and sex. Mixed-effects logistic regression models were used to analyse odds of scabies and impetigo infection accounting for clustering at school level. Population attributable risk of scabies as a cause of impetigo was also estimated. Results The overall weighted prevalence of scabies was 30.6%. Children in rural Manufahi were more likely to have scabies than those in semi-urban Dili (53.6% vs 28.2%, adjusted odds ratio (AOR) 3.5). Most cases of scabies were mild (3 to 10 lesions), and distributed on more than one body region. Scabies prevalence was lower among 10 to 14 year olds compared to 5 to 9 year olds. Overall weighted prevalence of impetigo was 11.3%. Relative to Dili, children in rural Ermera and Manufahi were twice as likely to have impetigo. Impetigo was twice as common in children with scabies than in those without, corresponding to an attributable risk of scabies as a cause of impetigo of 22.7%. Conclusions Scabies and impetigo prevalence in Timor-Leste are among the highest reported globally, particularly in rural areas. Scabies infestation was strongly associated with impetigo. Comprehensive control strategies are urgently needed in Timor-Leste.
Infected Open Depressed Skull Fracture Complicated with Tetanus Grade I in an Unimmunized Child: A Rare Case Report with Literature Review
Authors: Lukmanul Dzulfikar , Faried Ahmad , Nurhadiya Adila , Laymena Ericko H. , Arifin Muhammad Z. , Imron Akhmad , Rachman Iwan A.
Published: November 2020

Background: Tetanus is a rare disease caused by Clostridium tetani, which produces tetanolysin and tetanospasmin. In 2018, there were only approximately ten tetanus cases reported in Indonesia. Despite widespread vaccination, especially in low-middle income countries, tetanus still occurs (mostly in adult) due to the lack of immunization related to religious tenets, cultural belief or inaccesibility to medical care. In addition, tetanus in pediatric population shows features which are quite distinct from the adult group. Case Description: We reported a 7 year old girl that presented to our institution with a history of falling 10 days prior the admission, with only skin laceration of her forehead. Since one day prior to admission, the patient looked drowsy and difficult to be awakened, accompanied with stiffness of her jaw; we diagnosed as unimmunized child with open depressed skull fracture of her frontal bone and wound infection complicated with “lockjaw”. Perioperative management of that rare case is reported and discussed. Conclusion: This case is so exceptional, since the infected open depressed skull fracture complicated with trismus in an unimmunized child occurrence in our center is extremely rare; the pediatric intensive care of such patients requires halting further toxin production, neutralisation of circulating toxin and control of the clinical manifestation induced by the toxin that has already gained access to the central nervous system. The basic tents of anaesthetic care in such case had to well managed and planned prior the surgery.
Submarine Terraces Reveal Late Quaternary Tectonic Deformation in the Intermediate Zone Between the Island Shelf and Rift Zone of the Middle Part of the Nanseishoto Islands
Authors: Goto Hideaki
Published: November 2020

Late Quaternary tectonic deformation of coastal areas is usually examined based on the height distribution of paleo-shorelines observed on marine terraces. However, it is difficult to examine deformation along the subduction zone, in which small, isolated islands are distributed. In this paper, we focus on the widespread shallow submarine terraces surrounding the Iheya-Izena islands in the middle part of the Nanseishoto islands, where crustal deformation is not known. The islands are located in the intermediate zone between island shelf uplifted during the Late Quaternary and the rift zone occurred to the northwest, along the Okinawa trough.Detailed topographic anaglyph images and maps of the islands were produced using a digital elevation model (DEM) of the seafloor, which is stored by the Japan Coast Gard (JCG) and the Advanced Institute of Science and Technology (AIST). Topographic anaglyph images enabled us to identify the widespread distribution and deformation of the shallow seafloor above −200 m using red-cyan glasses.Four terrace-like features divided by small steps were found on the shallow seafloor, which are named T1, T2, T3, and T4, in descending order. Topographic expressions of paleo-shoreline depths are preserved on submarine terraces formed during the last glacial period. The paleo-shoreline depths of terraces T2 and T3 are −60 m and −70 m on the west side and −70 m and −80 m, respectively, on the east side of Iheyajima island; this indicates southeastward tilting. The tilting ratio of T2 and T3 was calculated to approximately 1‰. The tilting rate is approximately 1×10^4/kyr, assuming that the T2 was formed in 10–11 kyr. This is much more rapid than that of the last inter-glacial marine terraces in the Muroto peninsula, with a tilting rate of 4×10^5/kyr, which formed by steep northward tilting against the Nankai subduction zone. We suggest that this phenomenon is not related to mega-thrusting along the subduction zone, but rather to local deformation, probably caused by the reverse faulting of nearby active submarine faults along the west side of the islands.
Development of Multivalent Nanobodies Blocking SARS CoV 2 Infection by Targeting RBD of Spike Protein
Authors: Lu Qizhong , Zhang Zongliang , Li Hexian , Zhong Kunhong , Zhao Qin , Wang Zeng , Wu Zhiguo , Yang Donghui , Sun Shuang , Yang Nian , Zheng Meijun , Zhao Shasha , Long Cheng , Guo Wenhao , Yang Hui , Nie Chunlai , Tong Aiping
Published: November 2020

Background: The outbreak and pandemic of coronavirus SARS CoV 2 caused significant threaten to global public health and economic consequences. It is extremely urgent that global people must take actions to develop safe and effective preventions and therapeutics. Nanobodies, which are derived from single‑chain camelid antibodies, had shown antiviral properties in various challenge viruses. In this study, multivalent nanobodies with high affinity blocking SARS CoV 2 spike interaction with ACE2 protein were developed.Results: Totally, four specific nanobodies against spike protein and its RBD domain were screened from a naïve VHH library. Among them, Nb91 hFc and Nb3 hFc demonstrated antiviral activity by neutralizing spike pseudotyped viruses in vitro. Subsequently, multivalent nanobodies were constructed to improve the neutralizing capacity. As a result, heterodimer nanobody Nb91 Nb3 hFc exhibited the strongest RBD binding affinity and neutralizing ability against SARS CoV 2 pseudoviruses with an IC50 value at approximately 1.54 nM. Conclusions: The present study indicated that naïve VHH library could be used as a potential resource for rapid acquisition and exploitation of antiviral nanobodies. Heterodimer nanobody Nb91 Nb3 hFc may serve as a potential therapeutic agent for the treatment of COVID 19.
Dual energy spectral CT imaging of pulmonary embolism with Mycoplasma pneumoniae pneumonia in children
Authors: Yang Lixin , Sun Jihang , Li Jiangying , Yu Tong , Wang Bei , Peng Yun
Published: November 2020

Background: Pulmonary embolism (PE) associated with Mycoplasma pneumoniae pneumonia (MPP) in children has already attracted more attention. We aimed to evaluate the application of dual-energy spectral CT in diagnosing PE in children with MPP.Methods: Eight-three children with MPP and highly suspected PE, underwent CT pulmonary angiography (CTPA) with spectral imaging mode. Noise, clot-to-artery contrast-to-noise ratio, image quality and diagnosis confidence were calculated and assessed on nine monochromatic image sets (40 to 80keV). CTPA images were observed for the presence, localization, and embolic degrees of PE. Emboli were divided between intra and extra-consolidation. For extra-consolidation clots, iodine concentration (IC) of perfusion defects and normal lung, perfusion defects of 4 children before and after the treatment were measured and compared. For intra-consolidation clots, IC of consolidation areas with clots and consolidation areas without clot were measured and compared.Results: The optimal energy level for detecting PE in children was 55 keV. 116 clots (29 extra consolidations) were found in 25 children, IC of defect regions associated with PE was 0.69±0.28mg/mL (extra-consolidations) and 0.90±0.23mg/mL (intra-consolidations), both significantly lower than the 2.76±0.45mg/mL in normal lungs and 10.25±1.76mg/mL in consolidations without clots (P<0.001). Significant difference was found in the presence or absence of perfusion defects between occlusive clots and nonocclusive clots(P<0.001). IC of the perfusion defects significantly increased after treatment (P<0.001).Conclusions: In spectral CTPA 55 keV images optimize PE detection for children. and MD images quantify pulmonary blood flow of PE, and may help to detect small clots and quantify embolic degrees.
Methods of Health Education Delivery to the Parents and Caregivers on Preventing Childhood Injuries: A Systematic Review
Authors: Halim Siti Hafsah Abdul , MZ Nor Afiah , Ahmad Norliza , HS Minhat
Published: November 2020

Background: Unintentional injuries to children have significant impact on child mortality and mortality. Health education is one of the important strategies in the childhood injury prevention which involve various methods and techniques. The aim of the review is to provide narrative findings of systematic review of different methods of delivery for health education intervention to reduce unintentional childhood injuries among parents and caregivers in primary care setting. Methods: The systematic review was guided by PRISMA guidelines. The searched databases included Medline, CINAHL, PubMed, ProQuest and Ovid. All report titles and abstracts were screened using pre-defined criteria. Peer-reviewed journal and grey literature published from 1 January 2010 to 31 May 2020 were included. Two independent reviewers select studies, extracted data, checked accuracy, assessed risk of bias and assessed the quality of each article selected. Articles were included if they were peer-reviewed and published in English language. Data was extracted and analysed using narrative synthesis approach. Results: 325 articles were identified during initial search strategy. Duplicates were removed and article were screened by title and abstract. Final eight articles were selected and reviewed. Risk of bias for each study were assessed using Cochrane Risk of Bias tool. The systematic review synthesized the characteristics of the selected studies and features of delivery methods of health education intervention. All the reviewed paper concluded their intervention was effective in achieving their objectives which is improving the knowledge, attitude, and safety practice for injury prevention. Majority of the intervention supplemented their education intervention with printed materials such as pamphlets and booklets. Half of the intervention were delivered by healthcare professionals. This review provides fresh narrative evidence on the latest delivery methods for health education in injury prevention to the parents and caregivers. Conclusion: Majority of the studies reported using a combination of various methods of delivery in their intervention and proven to be effective. However, there is a gap in term of use of technology and economic evaluation of each methods that can be addressed in future research and practice. Study registration: The study was registered with PROSPERO International Prospective Register of Systematic Review (CRD:42020202753).
Evaluating Groundwater Quality for Sustainable Drinking and Irrigation Purposes and Assessing Nitrate Risks on Human Health in Rural Areas
Authors: Ahmed Salwa Hadi , Abed Mahmood F.
Published: November 2020

Groundwater quality has specific importance for domestic, agricultural, and drinking water supply. Therefore, the objective of the current paper is to investigate groundwater quality for drinking and irrigation purposes, as well as studying health hazard effects of nitrate-containing groundwater on age groups living in rural areas. Two water quality indices were used for checking groundwater suitability for drinking and irrigation purposes. For drinking water quality index (DWQI), 88% of groundwater wells were poor water, whereas 12% were good water for drinking. The values of irrigation water quality index (IWQI) showed that the suitability of groundwater for irrigation uses was ranged from high to medium. In addition, this paper also included a risk assessment of nitrate-containing groundwater on rural resident's health. calculating oral hazard quotient (HQoral) for nitrates showed that 94% of the groundwater wells of the study area were less than 1, indicating no adverse health hazards on infants and children, whereas 6% of total wells were above 1, suggesting there are health risks. Regarding health effects on adults, all HQoral values were less than 1, indicating no adverse health hazards. The Hazard Quotient via dermal contact (HQdermal) for nitrates was much less than the safety factor 1, indicating no health hazards on age groups via bathing.
In Situ Measurement of Airborne Particle Concentration in a Real Dental Office: Implications for Disease Transmission
Authors: Razavi Maryam , Butt Zahid , Chen Helen , Tan Zhongchao
Published: November 2020

Aerosols generated during dental procedures are one of the most significant routes for infection transmission and are particularly relevant now in the context of the current COVID-19 pandemic. This study aimed to assess the mechanisms of dental aerosol dispersion in dental offices and provide recommendations to minimize infection transmission in dental offices. The spread and removal of aerosol particles generated from a specific dental operation in a dental office are quantified for a single dental activity in the area near to the generation and corner of the office. The effects of the air purifier, door condition, and particle sizes on the spread and removal of particles were investigated. The results will help to develop technologies for the proper control of aerosols and splatters generated during the dental procedures. The results show that in the worst-case scenario it takes 95 min for 0.5 𝜇m particles to settle and that it takes a shorter time for the larger particles. The air purifier expedited the removal time at least 6.3 times faster than the case with no air purifier in the generation zone. Our results also indicate that particles may be transported from the source to the rest of the room, even when the particle concentrations in the generation zone dropped back to the background. Our findings have important implications for infection transmission in indoor spaces such as healthcare settings.
Glenoid Bone Grafting Procedures in the Treatment of Anterior Shoulder Instability With Bone Defect: When to Indicate? Protocol for a Systematic Review
Authors: Lara Paulo Henrique Schmidt , Ribeiro Leandro Masini , Pochini Alberto de Castro , Andreoli Carlos Vicente , Belangero Paulo Santoro , Ejnisman Benno
Published: November 2020

Background: Chronic traumatic anterior instability of the shoulder is a frequent event, especially in young athletes. Several management techniques have been proposed for this condition. The objectives of these procedures are to re-establish a stable and functional shoulder and to prevent the development of osteoarthritis. It is well known in the literature that a bone loss greater than 20% to 25% leads to a higher rate of recurrence and worse prognosis regarding the evolution of anterior shoulder instability, often requiring glenoid bone grafting procedures. Previous studies evaluated the recurrence and complications associated with these procedures; however, there are various clinical and radiological indications, and no study systematically evaluated these indications, which are associated with better clinical outcomes and lower rates of complications. This paper outlines the protocol for a systematic review intended to summarise the best available clinical evidence and will indicate what further research requires.Methods: An electronic search will be conducted on MEDLINE, EMBASE, Web of Science, CINAHL, Cochrane, and EBSCO databases. Clinical studies of glenoid bone grafting procedures have been indicated for the treatment of anterior shoulder instability, evaluating which indications are related to a better functional result for the patient. Risk of bias will be assessed using the Downs and Black checklist for observational studies and the Cochrane Collaboration tool for randomised controlled trials.Discussion: This systematic review will summarise the clinical and radiological indications for glenoid bone grafting procedures, revealing those related to better outcomes. The findings from this review will establish the quality of currently available evidence, thereby determining the need for further studies to establish the best indications for these procedures.Systematic review registration: PROSPERO CRD42020210462
Nursing in Intensive Care Unit: Exploring Factors Related to Ventilator-Associated Pneumonia
Authors: Yin Yanling , Sun Meirong , Li Zhe , Bu Jingjing , Chen Yuhong , Zhang Kun , Hu Zhenjie
Published: November 2020

Background:Most patients hospitalized intensive care units require mechanical ventilation.Ventilator-associated pneumonia is the most common and severe complication of mechanical ventilation.Nursing factors are closely related to the incidence of this type of pneumonia.Objectives:To explore nursing risk factors associated with ventilator-associated pneumonia(VAP ).Committing to provide the basis for future nursing training and quality control for technical offices.Methods:Through the quality control platform of Hebei province, questionnaires were sent to the intensive care nurses in 37 tertiary hospitals(5 hospitals were excluded due to incomplete information) in Hebei province,China, to collect the incidence of VAP and the nursing status of them from January to December 2019. All date was analyzed using an independent t-test, ANOVA, and Pearson correlation.Resluts:Two central themes were derived from the data analysis:Nurse human resources and standard of nursing practice.The incidence of VAP was higher when the proportion of nurses working less than five years and the number of nurses working night shifts increased(P = 0.000). The incidence of VAP was lower when the sputum suction tube radius was smaller and the selected oral care solution had disinfection effect(P = 0.000).Conclusions:The incidence of VAP is closely related to nursing factors.Choose different thickness of sputum suction tube and oral nursing liquid will lead to different outcomes.In addition, different nursing staff structure and scheduling mode will directly affect the incidence of VAP.Therefore, we should continue to standardize and unify nursing operation, and optimize nursing staff structure and scheduling mode.
Anti-Ro/SAA Autoantibodies Might Represent the Antineuronal Antibodies Responsible for Cerebellar Degeneration in Sjögren's Syndrome 
Authors: Tetsuka Syuichi , Suzuki Tomohiro , Ogawa Tomoko , Hashimoto Ritsuo , Kato Hiroyuki
Published: November 2020

Background: Neurologic disorders are one of the most common extraglandular manifestations of Sjögren's syndrome (SjS). Central neurologic symptoms can appear in about 5% of patients with SjS. However, only a few reports of cerebellar degeneration have been reported, and the clinical features and pathologic mechanisms of cerebellar degeneration associated with SjS are unclear.Patients and methods: We recently treated cerebellar degeneration in a patient with SjS. We analyzed the serum and cerebrospinal fluid (CSF) to detect anti-Ro/anti-SjS-related antigen A (SSA) and anti-La/anti-SjS-related antigen B (SSB) antibodies. We also searched the literature for previous case reports on SjS to evaluate the characteristics of cerebellar degeneration in patients with SjS and examined whether the Ro/SSA (Ro52/tripartite motif protein [TRIM]21) protein was expressed in murine cerebellum using immunohistochemistry.Results: Although all patients were positive for anti-Ro/SSA antibodies, some patients were negative for anti-La/SSB antibodies. Anti-Ro/SSA antibodies were observed in both serum and CSF. Anti-Ro/SSA antibodies were negative in the CSF of SjS patients without central nervous system involvement. Cerebellar atrophy was observed, and sequelae remained in the majority of the patients. Autopsy findings indicated a selective loss of Purkinje cells. Ro52/TRIM21 expression was detected throughout murine brains, including the hippocampus, cerebral cortex, and cerebellum. High Ro52/TRIM21 expression was observed in Purkinje cells.Conclusions: We described the characteristics of cerebellar degeneration in patients with SjS and Ro52/TRIM21 expression in Purkinje cells of murine cerebellar tissue sections. Thus, these outcomes indicated that anti-Ro/SSA autoantibodies were likely responsible for cerebellar degeneration in SjS.
Promising Anticancer Activity of [Bis(1,8-quinolato)palladium (II)] Alone and in Combination
Authors: Alam Md. Nur , Moni Mohammad , Yu Jun , Beale Philip , Turner Peter , Proschogo Nick , Rahman Mohammad , Huq Fazlul
Published: November 2020

Due to similar coordination chemistry of palladium and platinum, a large number of palladium compounds too have been investigated for their anticancer activity. In the present study we describe synthesis, characterization and anticancer activity of palladium complex [Bis(1,8-quinolato)palladium (II)], coded as NH3 against seven different cancer cell lines. NH3 is found to have higher antitumour activity than cisplatin against both parent ovarian A2780 cell line and cisplatin-resistant cell lines. Also, NH3 has the lowest IC50 value against HT-29 colorectal cancer cell line. The higher antitumour activity of NH3 is due to the presence of bulky 8-hydroxy-quinoline ligand thus reducing its reactivity. Proteomic study has identified significantly expressed proteins which have been validated through bioinformatics. NH3 has been found to be less toxic than cisplatin at 2.5 mg/kg and 5 mg/kg dosages on mice models. Binary combinations of NH3 with curcumin and epigallocatechin gallate (EGCG) have demonstrated dose and sequence dependent synergism in ovarian and colorectal cancer models. All of the preclinical studies indicate promising therapeutic potentiality of NH3 [Bis(1,8-quinolato)palladium (II) ] as an anticancer drug.
First Record of Traumatic Myiasis Obtained From Forest Musk Deer (Moschus Berezovskii) Using DNA Barcoding
Authors: Gao Yunyun , Fu Yajun , Yan Liping , Hu Defu , Jiang Benmo , Zhang Dong
Published: November 2020

Background: Myiasis is a common disease occurring in humans and livestock all over the world. It is closely related to human society and of great significance to animal husbandry, forensic science, and medicine. Myiasis is known to occur in wild animals, while no information is reported in forest musk deer. On July 6, 2019, we found severe traumatic myiasis of an injured forest musk deer (Moschus berezovskii) (Flerov, 1929), infected by lots of maggots and clusters of eggs. However, the precise identification of the larvae that we collected was difficult with few specific morphology characteristics.Methods: DNA barcoding is an efficient technique for species diagnosis, therefore is employed to identify the samples collected from the infected forest musk deer. Firstly, we extracted genomic DNA from one larva and one egg respectively. The cytochrome oxidase I (COI) gene barcoding region was amplified by polymerase chain reaction (PCR) and bidirectionally sequenced by Sanger sequencing. The sequences were searched for similarity using BLAST and the best hits were Lucilia. To identify these blowflies accurately, these newly generated sequences were subsequently analyzed with COI sequences of Lucilia and Calliphora downloaded from GenBank, to calculate nucleotide divergence, and to construct a neighbor-joining tree.Results: Our results suggest that nucleotide divergence between the two samples is 0.0033cM, between two samples and Lucilia caesar (Diptera: Calliphoridae) (Linnaeus, 1758) is 0.0016–0.0050cM. Furthermore, the NJ tree construction indicates that the flies collected from the musk deer are Lucilia caesar.Conclusions: Our results indicate that DNA barcoding can successfully identify pathogenic species. As far as the authors know, this is the first time that myiasis is detected in forest musk deer caused by a traumatic infection in China. The affected individual was clinically treated immediately and apparently recovered.
Contact Analysis and Static Load Carrying Capacity of Planetary Roller Screw Mechanism
Authors: Kim Nam Su , Kim Kyongho , Jong Sinhyok
Published: November 2020

This paper aims to investigate the contact characteristics and static load carrying capacity of planetary roller screw mechanism (PRSM). Compared to the ball screw mechanism, the advantages of the PRSM are high stiffness, high load capacity, long travel life and compact structure, etc., since the PRSM possesses more contact points than ball screws in a comparable size. The actuated load is carried through the threaded surface contacts of the screw, the rollers and the nut and the contact characteristics of these components are very important for studying the wear, transmission accuracy and efficiency of a PRSM. Prior work has neglected to take a fundamental approach towards understanding the elastic-plastic contact characteristics of threaded surfaces under high loads and it is closely related to the static load carrying capacity of PRSM. Accordingly, in this paper, the contact characteristics of PRSM under the different working loads are modeled based on Hertz contact theory and the calculation formulas between normal force of thread turns and the elastic-plastic contact stress and deformation are derived. Then, it goes further to derive a calculation method of static load carrying capacity of PRSM based on simplified model of static load distribution. Finally, a verification model is developed by finite element method (FEM) to perform contact stress and strain analysis of PRSM. Besides, through the comparison of the results between the theory model and ANSYS Workbench finite element model verify the reliability of the theory.
Safety aid elimination as a brief, preventative intervention for social anxiety: A randomized controlled trial in university students
Authors: Arai Honami , Ishikawa Shin-ichi , Okawa Sho , Kishida Kohei , Korte Kristina Jo , Schmidt Norman Brad
Published: November 2020

BackgroundAlthough there are a variety of treatment options for social anxiety, effective prevention strategies for those with subclinical social anxiety are limited. This study evaluated a single session group formatted prevention program focused on the reduction of safety behaviors in both a proof-of-concept study and a randomized controlled trial (RCT). MethodsParticipants (N = 59) were nontreatment seeking Japanese students with high levels of social anxiety. Participants were randomized to either an active treatment focused on identification and elimination of safety behavior or a control group involving the discussion of healthy coping strategies. Both conditions met for 120 minutes in small groups (4 to 6 participants per group). The preliminary proof-of-concept study as well as the RCT demonstrated high levels of acceptability. ResultsFindings from the RCT indicated significant improvement in social anxiety symptoms compared to HEAL group among those in the active treatment condition at post-treatment, which was maintained at follow-up. In addition, participants in the treatment condition showed significant improvement in depression. The effect size difference in symptoms between conditions was in the large range. ConclusionsThe present study provides preliminary support for the efficacy of a newly developed treatment program targeting safety behaviors in students with subclinical social anxiety. The present results also illustrate the promise of a brief, indicated prevention strategy focused on safety behavior among those with subclinical social anxiety.
Evaluating the Long-Term Impact of a Capacity Building Program for Displaced Community Health Workers in Fragile Settings in Lebanon on Women’s Health
Authors: Naal Hady , Mendelsohn Rebecca , Brome Dayana , Noubani Aya , Nabulsi Dana , Muhieddine Dina , Saleh Shadi
Published: November 2020

Background: Displaced populations in fragile settings such as Syrian refugees and host community members in Lebanon, experience a multitude of health disparities that are seldom attended to. Task-shifting, which involves training non-specialized community health workers (CHW) to deliver basic education and health services is a favorable strategy to address this problem, however very little data exists on this topic in the Middle East region. We conducted a long-term evaluation of the Women’s Health Certificate delivered to two cohorts in informal tented settlements in Lebanon under the Mobile University for Health (MUH) program.Methods: We collected short-term data from the n=42 trained CHW (knowledge assessments and satisfaction measures) during the delivery of the intervention between March and August 2019, and long-term data (semi-structured interviews with n=8 CHW and focus group discussion with n=9 randomly selected community members) one year later between July and August 2020. The evaluation approach was informed by the Kirkpatrick evaluation model, and the qualitative data was analyzed using qualitative content analysis. Results: Data from the CHWs and community members were triangulated, and they showed that the training enhanced access to education due to its mobile nature and provided opportunities for CHWs to engage and interact with learning material that enhanced their knowledge and favorable behaviors regarding women’s health. In turn, CHWs were empowered to play an active role in their communities to transfer the knowledge they gained through educating community members and providing women’s health services and referrals. Community members benefited from the CHWs and called for the implementation of more similar training programs. Conclusion: This is one of few studies reporting a long-term community-level evaluation of a task-shifting program on women’s health among displaced populations in Lebanon. Our findings support the need to increase funding for similar programs, and to focus on delivering programs for a variety of health topics. It is also essential to enhance the reach and length of recruitment to wider communities, to design concise, interactive, and engaging sessions, and to provide tools to facilitate circulation of learning material, and resources for referrals to health services.
Crispr-cas 12a combination to alleviate the false-positive in loop-mediated isothermal amplification-based diagnosis of Neisseria meningitidis
Authors: Trung Ngo Tat , Son Le Huu Phuc , Hien Trinh Xuan , Quyen Dao Thanh , Bang Mai Hong , Song Le Huu
Published: November 2020

Loop mediated Isothermal amplicafication (LAMP) was recently suggested as a diagnostic tool for the identification of Neisseria meningitides. Howevere, this isothermal amplification is challenged by the fact its amplification leads to risks of obtaining false-positive results. Whereas, with abilities to accurately recognize specific sequence, the CRISPR/Cas12a can forms complexes with cognate RNA sensors and cleave pathogen’s DNA targets complimerntary to its cognate RNA and acquires collateral activity to unbiasedly cut nearby off-target fragments. Therefore, if relevant fluorescent-quencher-nucleic probes are present in the reaction, the non-specific cleavage of probes releases fluorescences and establish diagnostic read-outs. In this study, we demonstrate a proof-of-concept that in relevant biochemical conditions, CRISPR/Cas12a and LAMP can work synchronously to identify genetics materials of Nesseria menitigistis at the level of 0.00004% in less than 2 h. Additionally, our clinical data also showed that the combinatory of CRISPR/Cas12a help to alleviate false positive result therefore enhance the specificity gained by the LAMP assays.
Isolated Calf Deep Venous Thrombosis: Prevalence, Clinical Characteristics and Implications for Ultrasound Evaluation
Authors: Heller Thomas , Becher Mattes , Kröger Jens-Christian , Beller Ebba , Heller Susanne , Höft Raimund , Weber Marc-André , Meinel Felix G.
Published: November 2020

Objectives It remains controversial whether to include calf veins in the initial ultrasound evaluation of suspected deep venous thrombosis (DVT). We sought to investigate the prevalence and clinical characteristics of isolated calf DVT.Materials and Methods We retrospectively analyzed a cohort of 596 patients (median age 69 years, 52.3% women) evaluated with complete duplex ultrasound of the leg veins for suspected acute DVT within one year. Radiology reports were analyzed for the presence and localization of DVT. Electronic chart review was performed to collect clinical information.Results DVT was found in 157 patients (26.3%), of which 74 patients (47.1%) had isolated calf DVT. Isolated calf DVTs were most commonly located in the posterior tibial veins (22 patients, 29.7%), fibular veins (41 patients, 55.4%) and muscle veins (19 patients, 25.7%). There were no differences in age or gender between patients with isolated calf DVT and patients with more proximal DVT. Isolated calf DVT was more commonly associated with leg pain (52.7% vs. 33.7%, p = 0.0234) and less commonly associated with subjective leg swelling (35.1% vs. 55.4%, p = 0.0158) and objectively measured difference in leg circumference (23% vs. 39.8%, p = 0.0268). D-Dimers were significantly lower in patients with isolated lower leg DVT (median 2.3 vs. 6.8 mg/L, p < 0.0001) compared to patients with more proximal DVT.Conclusions Isolated calf DVT is almost as common as more proximal DVT. Our data supports performing complete duplex ultrasound including the calf veins in suspected DVT.
Association of low alanine aminotransferase values with extubation failure in adult critically ill patients: A retrospective cohort study
Authors: Weber Yoav , Epstein Danny , Miller Asaf , Segal Gad , Berger Gidon
Published: November 2020

Background: Liberation from mechanical ventilation is a cardinal landmark during hospitalization of ventilated patients in intensive care units. Sufficient respiratory muscle strength and function are essential for successful extubation; therefore, decreased muscle mass and sarcopenia are associated with a high risk of failure. A low level of alanine aminotransferase (ALT) is a known biomarker of sarcopenia. This study was aimed to determine whether low levels of ALT are associated with increased risk of extubation failure among critically ill patients.Methods: This was a retrospective single-center cohort study of mechanically ventilated patients hospitalized in a medical intensive care unit and undergoing their first extubation. The primary outcome was extubation failure, which was defined as reintubation within seven days. Multivariable logistic regression was performed to determine whether ALT was an independent predictor of this outcome.Results: The study included 329 patients with a median age of 62.3 years (interquartile range [IQR] 48.13–71.16); 210 (63.83%) patients were at high risk for extubation failure and 83 (25.23%) failed the first extubation attempt. Low ALT values were more common among patients requiring reintubation (61.45% vs. 41.06%, P=0.002). Multivariable logistic regression analysis identified the age of 75 years or older and low ALT values as the only independent predictors of extubation failure, with adjusted odds ratio (OR) of 2.74 (95% confidence interval [CI] 1.23-6.11, p=0.01) and 2.14 (95% CI 1.16-3.96, p=0.02), respectively.Conclusions: Low ALT, an established biomarker of sarcopenia and frailty, is an independent risk factor for extubation failure among adult patients hospitalized in the medical intensive care unit. This simple laboratory parameter can be used as an effective adjunct predictor, along with other weaning parameters, and thereby facilitate the identification of high-risk patients.