bluuebunny/crossref_metadata_2025 huggingface dataset:
Outpatient vs. Inpatient Hip Arthroplasty: A Matched Case-Control Study on 90-Day Complication Rate and 2-Year Patient Reported Outcomes
Authors: Rosinsky Philip J. , Chen Sarah L. , Yelton Mitchell J. , Lall Ajay C. , Maldonado David R. , Shapira Jacob , Meghpara Mitchell B , Domb Benjamin G
Published: July 2020

Background: The transition to outpatient-based surgery is a major development occurring in recent years in the field of total hip arthroplasty (THA). The effect of this transition on patient reported outcomes (PROs) is still not well established. The purpose of the current study was to compare patients undergoing inpatient THA (iTHA) to patients undergoing outpatient THA (oTHA) regarding (1) perioperative variables including: surgical time, blood loss, and length of stay (2) 90-day complication rates and unplanned emergency room or office visits (3) 2-year PROs including: modified Harris hip score (mHHS), Harris hip score (HHS), forgotten joint score (FJS), pain, and satisfaction, as well as quality of live measures. Methods: The XXX registry was analyzed for patients undergoing THA between July 2014 and April 2016. The first 100 patients undergoing oTHA were selected and matched to 100 patients undergoing iTHA via propensity matching based on the following variables: age, sex, body mass index (BMI), Charlson comorbidity index (CCI), and smoking status. The primary outcomes were PROs at two years post-operatively. The secondary outcomes were perioperative surgical variables, 90-day complication rates, and unplanned emergency and clinic visits. Results: After exclusions, 91 patients remained in each group and were compared. The oTHA group showed improved 2-year PROs with regard to mHHS (91.5 vs. 86.2; P=0.02), HHS (92.3 vs. 87.4; P=0.02), and pain (1.0 vs. 1.5; P=0.04). The oTHA group had an average length of stay of 6.8 hours compared to 43.2 hours for the iTHA group (P<0.001). There were no significant differences between the groups regarding readmissions, emergency room visits, and unplanned clinic visits. Complications and revision rates were similar in both groups. Conclusion: In appropriately selected, younger patients, oTHA can achieve improved postoperative 2-year PROs compared to iTHA. We found no differences regarding postoperative short-term complications or two-year revision rates, and no differences in unplanned office visits or readmissions.
Increasing Fat Deposition via Upregulates the Transcription of Peroxisome Proliferator-Activated Receptor Gamma (PPARγ) in Native Crossbred Chicken
Authors: Tunim Supanon , Phasuk Yupin , Aggrey Samuel E. , Duangjinda Monchai
Published: July 2020

Background: Crossbreeding using exotic breeds is usually employed to improve the growth characteristics of indigenous chickens. This mating not only provides growth but affect adversely to fat deposition as well. We studied the growth, abdominal, subcutaneous and intramuscular fat and mRNA expression of peroxisome proliferator-activated receptor (PPAR) α and PPARγ in adipose and muscle tissues of four chicken breeds [Chee breed (CH) (100% Thai native chicken), Kaimook e-san1 (KM1; 50% CH background), Kaimook e-san2 (KM2; 25% CH background), and broiler (BR)]. This study was aim to study role of PPARs on fat deposition in native crossbred chicken.Results: The BR chickens had higher abdominal fat than other breeds (P<0.05) and the KM2 had an abdominal fat percentage higher than KM1 and CH respectively (P<0.05). The intramuscular fat (IMF) of BR was greater than KM1 and CH (P<0.05). In adipose tissue, PPARα transcription expression was different among the chicken breeds. However, there were breed differences in PPARγ gene expression. Study of abdominal fat PPARγ gene expression showed the BR breed, KM1, and KM2 breed significantly greater (P<0.05) than CH. In 8 to 12 weeks of age, the result shows that the PPARγ expression of the CH breed is less than (P<0.05) KM2. The result of PPARs expression in muscle tissue was similar result in adipose tissue.Conclusion: Crossbreeding improved the growth of the Thai native breed, there was also a corresponding increase in carcass fatness. However, there appears to be a relationship between PPARγ expression and fat deposition traits. therefore, PPARγ activity plays a key role in lipid accumulation by up-regulation.
Cytokine Profile During Occult Hepatitis B Virus Infection In Chronic Hepatitis C Patients
Authors: Ribeiro Camilla Rodrigues de Almeida , de Almeida Nathalia Alves Araújo , Martinelli Katrini Guidolini , Pires Marcia Amendola , Mello Carlos Eduardo Brandao , De Paula Vanessa Salete , Barros José J.
Published: July 2020

Background: The hepatitis B virus (HBV) is one of the leading causes of acute, chronic and occult hepatitis (OBI) representing a serious public health threat. Cytokines are known to be important chemical mediators that regulate the differentiation, proliferation and function of immune cells. Accumulating evidence indicate that the inadequate immune responses are responsible for HBV persistency. The aim of this study were to investigate the cytokines IFN-γ, TNF, IL-2, IL-4, IL-6, IL-10 and IL-17A in patients with OBI and verify if there is an association between the levels of these cytokines with the determination of clinical courses during HBV occult infection. Methods: 114 patients with chronic hepatitis C were investigated through serological and molecular tests, the OBI coinfected patients were subjected to the test for cytokines using the commercial human CBA kit and the results were compared with healthy controls with no history of liver diseases. Results: Among 114 HCV patients investigated, 11 individuals had occult hepatitis B. The levels of cytokines were heterogeneous between the groups, most of the cytokines showed higher levels of production detection among OBI individuals when compared to the control group. We found a high level of IL-17A in the control group and high levels of TNF, IL-10, IL-6, IL-4 and IL-2 in OBI patients. Conclusion: These cytokines could be involved in the persistence of HBV DNA in hepatocytes triggers a constant immune response, inducing continuous liver inflammation, which can accelerate liver damage and favor the development of liver cirrhosis in other chronic liver diseases.
Comparison of mixed model based approaches for correcting for population substructure with application to extreme phenotype sampling.
Authors: Onifade Maryam Yetunde , Roy-Gagnon Marie-Hélène , Parent Marie-Élise , Burkett Kelly M
Published: July 2020

BackgoundMixed models are used to correct for confounding due to population stratification and hidden relatedness in genome-wide association studies. This class of models includes linear mixed models and generalized linear mixed models. Existing mixed model approaches to correct for population substructure have been previously investigated with both continuous and case/control response variables. However, they have not been investigated in the context of extreme phenotype sampling (EPS), where genetic covariates are only collected on samples having extreme response variable values.MethodsIn this work, we compare the performance of existing binary trait mixed model approaches (GMMAT, LEAP and CARAT) on EPS data. Since linear mixed models are commonly used even with binary traits, we also evaluate the performance of a popular linear mixed model implementation (GEMMA). We use simulation to estimate the type 1 error of all approaches under confounding due to population stratification. We also apply all methods to a real dataset from a Québec, Canada, case-control study that is known to have population substructure.ResultsOur simulation results show that for a common candidate variant, both LEAP and GMMAT control the type 1 error rate. We observe similar type 1 error control with the analysis on the Québec dataset. However, for rare variants the false positive rate remains inflated even after correction with mixed model approaches.ConclusionsThe methods compared in this study do not perform equally well. Therefore, when data are from an EPS study, care should be taken to ensure that the models underlying the methodology are suitable to the sampling strategy and to the minor allele frequency of the candidate SNPs.
Regeneration of a Full-thickness Defect of Rotator Cuff Tendon with Freshly Thawed Umbilical Cord-Derived Mesenchymal Stem Cells in a Rat Model
Authors: Yea Ji-Hye , Park Jin-Kyung , Kim InJa , Sym Gayoung , Bae Tae Soo , Jo Chris Hyunchul
Published: July 2020

The authors have withdrawn this preprint due to erroneous posting.
Mitigative efficacy of the clinical dosage administration of granulocyte colony-stimulating factor and romiplostim in mice with severe acute radiation syndrome
Authors: Yamaguchi Masaru , Suzuki Marino , Funaba Moeri , Chiba Akane , Kashiwakura Ikuo
Published: July 2020

Background: It has been reported that the high-dosage administration of domestically approved pharmaceutical drugs, especially granulocyte colony-stimulating factor (G-CSF) and romiplostim (RP), is a rapid and appropriate medical treatment for preventing severe acute radiation syndrome (ARS) of victims exposed to lethal total-body irradiation (TBI). However, it remains unclear whether or not the clinical dosage administration of these drugs can ameliorate TBI-induced ARS and related high mortality in order to find various drug treatment options and less toxic optimum protocol depending on the situation surrounding the radiological accidents.Methods: We assessed the clinical dosage administration in combination with G-CSF and RP as intraperitoneal injection in C57BL/6J mice exposed to more than 7-Gy lethal dose of X-ray TBI for the survival study evaluated by the log-rank test. Bone marrow and splenic cells were collected on the 21st day, when 1 week have passed from last administration, to detect the level of cell apoptosis, intracellular reactive oxygen species (ROS), and nuclear factor erythroid 2-related factor 2 (Nrf2)-related anti-oxidative gene expressions, and enzyme-linked immune sorbent assay using sera was performed for cell senescence and inflammation status analyzed with one-way ANOVA and Tukey-Kramer or Bonferroni/Dunn multiple comparison tests.Results: The combined once-daily administration of 10 μg/kg G-CSF for 4 times and 10 μg/kg RP once a week for 3 times improve the 30-day survival rate of lethal TBI mice compared with untreated TBI mice, accompanied by a gradual increase in the body weight and hematopoietic cell numbers. The radio-mitigative effect is probably attributed to the scavenging of ROS and the reduction in cell apoptosis. These changes were associated with the upregulation of Nrf2 and its downstream anti-oxidative targets in TBI mice. Furthermore, this combination modulated TBI-induced cell senescence and inflammation markers. Conclusions: This study suggested that the clinical dosage administration in combination with G-CSF and RP may also have radio-mitigative effects on mice exposed to lethal TBI and may be a potent therapeutic agent for mitigating radiation-induced severe ARS.
Students’ Perspectives of Factors Related to Delayed Completion of Online RN-BSN Programs
Authors: Iheduru-Anderson Kechinyere
Published: July 2020

Background

There are multiple educational programs for individuals to become registered nurses (RNs), and the transition from an associate degree or diploma to a Bachelor of Science (BSN) degree is vital to healthcare. This study examined the factors contributing to delayed completion or withdrawal from online nursing programs from students’ perspectives.

Method

Thematic content analyses were conducted on qualitative data obtained from semi-structured interviews ( N = 26).

Results

Complex factors contributed to delayed completion of online RN to BSN programs, including student-, institutional-, and faculty-related factors.

Conclusion

This study validated and extends previous studies without delineating students in fully online programs from hybrid and face-to-face programs. Students, faculties, and institutions all have a role to play in facilitating on-time program completion. Recognizing and mitigating the barriers that delay on-time program completion is required to foster nurses to obtain a BSN degree.
gCAnno: A Graph-based Single Cell Type Annotation Method
Authors: Yang Xiaofei , Gao Shenghan , Wang Tingjie , Yang Boyu , Dang Ningxin , Ye Kai
Published: July 2020

Background
Current single cell analysis methods annotate cell types at cluster-level rather than ideally at single cell level. Multiple exchangeable clustering methods and many tunable parameters have a substantial impact on the clustering outcome, often leading to incorrect cluster-level annotation or multiple runs of subsequent clustering steps. To address these limitations, methods based on well-annotated reference atlas has been proposed. However, these methods are currently not robust enough to handle datasets with different noise levels or from different platforms.
Results
Here, we present gCAnno, a graph-based Cell type Annotation method. First, gCAnno constructs cell type-gene bipartite graph and adopts graph embedding to obtain cell type specific genes. Then, a naïve Bayes classifier is built for annotation. We compared the performance of gCAnno to other state-of-art methods on multiple single cell datasets, either with various noise levels or from different platforms. The results showed that gCAnno outperforms other state-of-art methods with higher accuracy and robustness.
Conclusions
gCAnno is a robust and accurate cell type annotation tool for single cell RNA analysis. The source code of gCAnno is publicly available at https://github.com/xjtu-omics/gCAnno.
Nutritional Status of Children 24–60 Months Attending Early Child Development Centres in a Semi-Rural Community in South Africa
Authors: Makanjana Onwaba , Naicker Ashika
Published: July 2020

Background: Despite the numerous efforts to improve the nutritional status of children, a high prevalence of malnutrition still exists in South Africa. This study aimed to determine the nutritional status of children attending Early Child Development centres in South Africa.Methods: In this baseline study, we randomly selected two Early Child Development centres comprising of 116 children aged 24–60 months, separated into two cohorts, 24–47 and 48–60 months from the Valley of a Thousand Hills area in the Ethekweni municipality. Dietary intake was measured through the 24hDR and analysed using Food Finder software. The food frequency questionnaire was used to calculate the food variety and food group diversity scores. Anthropometric measurements; weight and height were taken and the WHO Anthro software was used to convert it to nutritional data indices. Vitamin A and haemoglobin levels were collected through dry blood spot cards and assessed using WHO indicators.Results: The findings showed that participants had a low mean energy intake (24–47 months; 4906.2kJ and 4997.9kJ, 48–60 months; 5936.4kJ and 5621.2kJ (p = 0.038), low fruit and vegetable consumption (24–47 months; 63.8g and 69.5g (p = 0.037), 48–60 months; 68.3g and 74.4g (p = 0.038) and the top five foods consumed were carbohydrate rich foods for girls and boys respectively. Stunting was noted in 7% and 20% (48–60 months) (p = 0.012) and overweight in 8% and 17% (24–47 months) and 17% and 13 % (48–60 months) (p = 0.041) in girls and boys respectively. Low serum retinol levels (<0.070µmol/L) were found in 9.1% of boys (24–47 months), 8% and 7.4% of girls and boys (48–60 months). Low haemoglobin levels (<11.0 g/dL) were found in 50.0% and 30.4% (24–47 months) and 8.6% and 39.3% (48–60 months) of girls and boys respectively. Conclusion and recommendation: Malnutrition, despite many national and provincial initiatives, still exists at Early Childhood Development centres in South Africa calling for the application of contextualized nutrition interventions to suite resource-poor settings.
The impact of body mass index on short-term and long-term surgical outcomes of laparoscopic hepatectomy in liver carcinoma patients, a retrospective study
Authors: Zhao Lei , Wang JianGang , Kong JingXia , Zheng Xing , Yu Xin
Published: July 2020

Background

To investigate the influence of body mass index (BMI) on the short-term and long-term outcomes including disease free survival (DFS) and overall survival (OS) rate in patients with liver carcinoma who underwent laparoscopic hepatectomy (LH) as primary treatment.
Methods

Data were collected from 137 patients with liver carcinoma who underwent attempted LH between August 2003 and April 2014. Patients were classified into three groups depending on their BMI according to the WHO’s definition of obesity for Asia-Pacific region: underweight (BMI < 18.5 kg/ m2, Group1), normal (18.5 ≤ BMI < 23 kg/m2, Group2), overweight (BMI ≥ 23 kg/m2, Group3) respectively. Short-term and long-term outcomes including overall survival (OS) and disease free survival (DFS) were compared across the BMI categories.
Results

Of the 137 patients, 14 were underweight, 65 were normal weight, and 58 were overweight. The overall conversion rate of 137 patients was 20.44%. Conversion rate in the three groups was 14.29%, 21.54% and 20.69% (P = 0.8284). The median follow-up duration was 26 months, 30 months, and 28 months, respectively. The mean postoperative hospital stay in the three groups were comparable (10.85 ± 4.04, 11.57 ± 5.56, and 10.88 ± 5.70, P = 0.76). The complications rate was much higher in Group 1 (42.85%) than that in Group 2 and Group 3 (20.08% and 17.2%, P = 0.048). Underweight patients were more likely to develop grade III or higher postoperative complications (Clavien-Dindo classification) as compared to normal and overweight patients (P = 0.042). Overweight patients had a longer 3- and 5-years DFS (41.4%, 36.2%) than those for underweight (21.4%, 14.3%) and normal weight (28.1%, 21.9%) patients (P = 0.048, and 0.025). Overweight patients had a longer 5-years OS (44.8%) than those for underweight (28.6%) and normal weight (28.0%) patients (P = 0.043).
Conclusions

Being underweight was associated with an increased perioperative complication and being overweight has a better 3-, 5-years DFS and 5-years OS than those in under and normal weight patients with liver carcinoma who underwent LH.
Pineal gland transcriptomic profiling reveals the differential regulation of lncRNA and mRNA related to prolificacy in STH sheep with two FecB genotypes
Authors: Li Chunyan , He Xiaoyun , Zhang Zijun , Ren Chunhuan , Chu Mingxing
Published: July 2020

Backgroundlong non-coding RNA (lncRNA) has been identified as important regulator in hypothalamic-pituitary-ovarian axis associated with sheep prolificacy. However, there is little report about lncRNA in pineal gland of sheep. Herein, RNA-Seq was used to detect transcriptome expression pattern in pineal gland between follicular phase (FP) and luteal phase (LP) in FecB BB (MM) and FecB ++ (ww) STH sheep, respectively, and differentially expressed (DE) lncRNAs and mRNAs associated with reproduction were identified.ResultsOverall, 135 DE lncRNAs and 1,360 DE mRNAs in pineal gland between MM and ww sheep were screened. Wherein, 39 DE lncRNAs and 764 DE mRNAs were identified (FP vs LP) in MM sheep, 96 DE lncRNAs and 596 DE mRNAs were identified (FP vs LP) in ww sheep. Moreover, GO and KEGG enrichment analysis indicated that the targets of DE lncRNAs and DE mRNAs were annotated to multiple biological processes such as phototransduction, circadian rhythm, melanogenesis, GSH metabolism and steroid biosynthesis, which directly or indirectly participate in hormone activities to affect sheep reproductive performance. Additionally, co-expression of lncRNAs-mRNAs and the network construction were performed based on correlation analysis, DE lncRNAs can modulate target genes involved in related pathways to affect sheep fecundity. Specifically, like XLOC_466330 , XLOC_532771 , XLOC_028449 targeting RRM2B and GSTK1 , XLOC_391199 targeting STMN1 , XLOC_503926 targeting RAG2 , XLOC_187711 targeting DLG4 were included.ConclusionAll of these differential lncRNAs and mRNAs expression profiles in pineal gland provide a novel resource for elucidating regulatory mechanism underlying STH sheep prolificacy.
Defect-driven Selective Metal Oxidation at Atomic Scale
Authors: Zhu Qi , Pan Zhiliang , Zhao Zhiyu , Luo Langli , Ni Chaolun , Wei Hua , Zhang Ze , Sansoz Frederic , Wang Jiangwei
Published: July 2020

Nanoscale materials modified by crystal defects exhibit significantly different behaviours upon chemical reactions such as oxidation, catalysis, lithiation and epitaxial growth. However, unveiling the exact defect-controlled reaction dynamics (e.g. oxidation) at atomic scale remains a challenge for applications. Here, using in situ high-resolution transmission electron microscopy and first-principles calculations, we reveal the dynamics of a general site-selective oxidation behaviour in nanotwinned Ag and Pd driven by isolated stacking-faults and twin-boundaries. The coherent planar defects crossing the surface exhibit the highest oxygen binding energies, leading to preferential nucleation of oxides at these intersections. Fast diffusion of oxygen atoms along the planar-fault highways is shown to catalyse subsequent layer-by-layer inward oxide growth via atomic steps migrating on the oxide-metal interface. These findings provide an atomistic visualization of the complex reaction dynamics controlled by coherent planar defects in metallic nanostructures, which could enable the modification of physiochemical performance of nanomaterials through defect engineering.
Prevalence of Staphylococcus aurues carriage in patients with chronic kidney disease: A preliminary cross-sectional study of outpatients at the National Hospital of Sri Lanka
Authors: Silva Nipun de , Mufeena M.N.F. , Sam Gayathri , Dayarathna Shashika , Kumari Deepthi , Wijayaratne Dilushi , Patabendige Geethika , Jayasinghe Saroj
Published: July 2020

Objectives:

To compare carriage rates of Staphylococcus aureus in patients with and without chronic kidney disease (CKD) and identify associated factors.
Results:

We enrolled 64 CKD (A-1 = 13, A-2 = 17, A-3 = 34) and 56 non-CKD controls (B). Patients were categorized as: stage 5 CKD on haemodialysis (A-1), stage 5 CKD not on haemodialysis (A-2), renal transplant recipients with glomerular filtration rate > 60 ml/min (A-3) and those having chronic medical diseases with glomerular filtration rate > 60 ml/min/m2 (B). Median age = 57 years (range = 17–77). Nasal or axillary Staphylococcus aureus carriage was seen in 5 (38.5%), 2 (11.8%), 5 (14.7%) and 9 (16.1%) patients from A-1 to A-3 and B groups respectively. All isolated organisms were methicillin sensitive. Haemodialysis (p = 0.035) and antibiotic use in the preceding month (p = 0.02) were associated with carriage. Demographic factors and co-morbidities were not associated with carriage.
Expression of Cyr61 is associated with Clinical Course in Patients with Crohn’s Disease
Authors: Lee Su-Mi , Lee Kyung-Hwa , Park Seon-Young , Chung Jin Ook , Kim Dong Hyun , Ju Jae Kyun , Kim Hyun Soo
Published: July 2020

Backgrounds: Cysteine-rich angiogenic inducer 61 (Cyr61) is emerging as an important regulator of tissue homeostasis and wound repair. We aim to explore the colonic mucosal expression of Cyr61 and analyze the association between Cyr61 expression and clinical course in patients with Crohn’s disease (CD).Methods: Endoscopic samples were identified from 83 CD patients with and 372 controls without any pathologic findings by searching pathological reports. Among them, age- and sex- matched 43 of each group by a propensity score were selected to compare Cyr61 expression by immunohistochemistry (IHC). IHC scores for Cyr61 expression of CD patients were divided into tertiles to evaluate the association with clinical course. Results: The mean IHC scores for Cyr61 expression was higher in CD patients (86.5) than in controls (46.1, P<0.001). In CD patients, the mean IHC scores for Cyr61 expression (68.3) was lower in patients with clinical recurrence than in patients without recurrence (92.2, P=0.01). When CD patients were stratified into tertile groups according to IHC scores for Cyr61 expression, clinical recurrence rates tended to be lower in patients with high Cyr61 expression (P for trend=0.02). Compared with tertile 1 of Cyr61 expression, tertile 3 of Cyr 61 expression was associated with reduced risk of clinical recurrence (OR 0.43, 95%CI 0.20~0.92) after adjustment for age, sex and CD activity index at the time of colonoscopy in CD patients (P=0.03). Conclusions: Cyr61 mucosal expression in CD patients was inversely associated with clinical course. In the future, the possible therapeutic role of Cyr61 should be considered.
Impacts of Reopening Strategies for COVID-19 Epidemic: A Modeling Study in Piedmont Region
Authors: Pernice Simone , Castagno Paolo , Marcotulli Linda , Maule Milena Maria , Richiardi Lorenzo , Moirano Giovenale , Sereno Matteo , Cordero Francesca , Beccuti Marco
Published: July 2020

Background Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), the causative agent of the coronavirus disease 19 (COVID-19), is a highly transmittable virus. Since the first person-to-person transmission of SARS-CoV-2 was reported in Italy on February 21 st , 2020, the number of people infected with SARS-COV-2 increased rapidly, mainly in northern Italian regions, including Piedmont. A strict lockdown was imposed on March 21 st until May 4 th when a gradual relaxation of the restrictions started. In this context, computational models and computer simulations are one of the available research tools that epidemiologists can exploit to understand the spread of the diseases and to evaluate social measures to counteract, mitigate or delay the spread of the epidemic. Methods This study presents an extended version of the Susceptible-Exposed-Infected-Removed-Susceptible (SEIRS) model accounting for population age structure. The infectious population is divided into three sub-groups: (i) undetected infected individuals, (ii) quarantined infected individuals and (iii) hospitalized infected individuals. Moreover, the strength of the government restriction measures and the related population response to these are explicitly represented in the model. Results The proposed model allows us to investigate different scenarios of the COVID-19 spread in Piedmont and the implementation of different infection-control measures and testing approaches. The results show that the implemented control measures have proven effective in containing the epidemic, mitigating the potential dangerous impact of a large proportion of undetected cases. We also forecast the optimal combination of individual-level measures and community surveillance to contain the new wave of COVID-19 spread after the re-opening work and social activities. Conclusions Our model is an effective tool useful to investigate different scenarios and to inform policy makers about the potential impact of different control strategies. This will be crucial in the upcoming months, when very critical decisions about easing control measures will need to be taken.
The dual amylin and calcitonin receptor agonist KBP-089 and the GLP-1 receptor agonist liraglutide act complimentarily on body weight reduction and metabolic profile
Authors: Larsen Anna Thorsø , Gydesen Sofie , Sonne Nina , Karsdal Morten Asser , Henriksen Kim
Published: July 2020

Background
Weight loss therapy is becoming more and more important, and two classes of molecules, namely amylin receptor and GLP-1 receptor agonists, have shown promise in this regard. Interestingly, these molecules have several overlapping pharmacological effects, such as suppression of gastric emptying, reduction of glucagon secretion and weight loss in common; however, they also have distinct effects on prandial insulin secretion. Hence, a combination of these two mechanisms is of significant interest.
Methods
In this study, we investigated the add-on potential of the dual amylin and calcitonin receptor agonist (DACRA) KBP-089 in combination with the GLP-1 receptor agonist liraglutide as obesity treatment in high-fat diet (HFD) fed rats.
Results
Increasing doses of KBP-089 and liraglutide alone and in combination were studied with respect to their effects on body weight, food intake and glucose metabolism during a 9-week intervention study conducted in HFD rats. Further, the gastric emptying rate during an oral glucose tolerance was assessed. Treatment with KBP-089 and liraglutide dose-dependently lowered body weight 15% (at 2.5 µg/kg/day) and 7% (at 400 µg/kg/day) in HFD rats, respectively, while the combination resulted in a 21% body weight reduction, which was mirrored by reduction in fat depot sizes. Gastric emptying and glucose metabolism were improved, primarily by KBP-089, although liraglutide led to a reduction in fasting plasma glucagon.
Conclusion
DACRAs complement GLP-1 on food intake, body weight, and glucose tolerance indicating the potential for an add-on therapy.
Caries experience by socio-behavioral characteristics in HIV-1 infected and uninfected Ugandan mothers - a multilevel analysis
Authors: BIRUNGI NANCY , Fadnes Lars Thore , Engebretsen Ingunn Marie Stadskleiv , Tumwine James Kashugyera , Lie Stein Atle , Åstrøm Anne Nordrehaug
Published: July 2020

Background: Few studies consider the oral health status of adults with HIV in comparison with negative controls. This study aims to assess caries experience in Ugandan mothers according to HIV status, socio-behavioral-characteristics and gingival bleeding status and to examine whether HIV status modifies the association of socio-behavioral characteristics with caries experience. Secondly, using multilevel analysis this study also assessed to what extent site specific caries experience vary between and within individuals.Methods: This study uses data from the Ugandan site of the ANRS 121741 PROMISE- PEP trial (ClinicalTrials.gov, number NCT00640263) conducted in 2009-2013 that recruited mothers with HIV-1. In 2017 a comparison group of 181 HIV-1 negative controls was recruited. Caries experience was recorded using the World Health Organization’s Decayed, Missed and Filled teeth/surfaces (DMFT/DMFS) indices. Mixed effects logistic regression with the melogit program within Stata was conducted with DMFT/DMFS as the outcome and HIV-1 infection status as well as socio-behavioral characteristics as exposures. Results: Caries experience differed statistically significantly between HIV infected and non-infected mothers with 81% and 71% having DMFT>0, respectively. The corresponding mean and standard deviation were 4.6 (5.3) and 2.8 (3.2) respectively. Mixed effect logistic regression revealed significant positive associations between site specific caries and women’s age (OR=1.8, 95% CI: 1.1‒2.8), and presence of gingival bleeding (OR =2.0, 95% CI: 2.0 1.2‒3.2). Compared to premolar teeth, caries experience was more likely to occur in maxillary molars and mandibular molars and less likely to occur in incisors. The intra class correlation (ICC) for the correlation of individuals was 0.54 (95% CI: 0.48‒0.59). No two-way interactions terms between HIV-1 status and socio-demographic, behavioral and clinical covariates were observed. Conclusion: The prevalence of dental caries is higher in Ugandan mothers with HIV-1 than in uninfected Ugandan mothers and varies with mothers’, age, education and clinically recoded gingival inflammation. Socio-demographic differences in dental caries did not vary by HIV-1 status. We found that a multilevel random intercept model is appropriate and efficient for analyses of site specific dental caries data in the context of HIV-1 infected and uninfected Ugandan mothers
The Acute Stress Scale in Healthcare Professionals Caring for Patients with COVID-19. Validation Study
Authors: Mira José Joaquín , Cobos Angel , García Olga Martínez , Domínguez Maria Jose Bueno , Astier-Peña María Pilar , Pérez Pastora Pérez , Carrillo Irene , Guilabert Mercedes , Jover Maria Virtudes Perez , Peris Cesar Fernandez , Ripoll Maria Asuncion Vicente , Martin Matilde Lahera , Busto Carmen Silvestre , Martínez Susana Lorenzo , Martinez Ascension Sanchez , Delgado Jimmy Martin , Mula Aurora , Marco-Gomez Bárbara , Abad-Bouzan Cristina , Aibar-Remon Carlos , Aranaz-Andres Jesús
Published: July 2020

Backgroud: This study designed and validated a scale to measure acute stress experienced during the care of patients with COVID-19 (EASE scale). Methods: The COSMIN recommendations were followed in the design and validation of the EASE scale. Internal consistency was calculated using Cronbach's Alpha and McDonald's Omega. Qualitative research was conducted to assess content validity. Exploratory and Confirmatory Factorial Analysis were used to assess construct validity. Mann-Whitney-Wilcoxon test and Lineal Regression were applied to assess criterion validity. Responsiveness and interpretability were also assessed.Results: A total of 228 health professionals from the Spanish public health system responded to the ten items, of the EASE scale. Internal consistency was 0.87 (McDonald’s Omega). Two factors explaining 55% of the variance were isolated. Goodness-of-fit indices confirmed this factor structure. The highest level of stress was found among professionals working in health services who accumulated a higher number of deaths from COVID-19 (P<.05). By means of translation-counter-translation, it was adapted to Latin American Spanish, Brazilian Portuguese, and English.Conclusions: EASE gathers adequate metric properties. Its systematic use would allow the identification of professionals with a higher risk of developing affective/anxiety disorders and Moral injury that could limited that patients received safety and integrated care.
Building Cohesion in Distributed Telemedicine Teams Findings from the Department of Veterans Affairs National Telestroke Program
Authors: Patel Himalaya , Damush Teresa M. , Miech Edward J. , Rattray Nicholas A. , Martin Holly A. , Savoy April , Plue Laurie , Anderson Jane , Martini Sharyl , Graham Glenn D. , Williams Linda S.
Published: July 2020

Background: As telemedicine adoption increases, so does the importance of building cohesion among physicians in telemedicine teams. For example, in acute telestroke services, stroke specialists provide rapid virtual stroke assessment and treatment to patients at hospitals without stroke specialty care. In the National Telestroke Program (NTSP) of the U.S. Department of Veterans Affairs, a virtual (distributed) hub of stroke specialists throughout the country provides 24/7 consultations nationwide. We examined how these specialists adapted to distributed teamwork, and we identified cohesion-related factors in program development and support. Methods: We conducted a case study of the stroke specialists employed by the NTSP. Semi-structured, confidential interviews with stroke specialists in the virtual hub were recorded and transcribed. We explored the extent to which these specialists had developed a sense of shared identity and team cohesion, and we identified factors in this development. Using a qualitative approach with constant comparison methods, two researchers coded each interview transcript independently using a shared codebook. We used matrix displays to identify themes, with special attention to team cohesion, communication, trust, and satisfaction. Results: Of 13 specialists with at least 8 months of NTSP practice, 12 completed interviews; 7 had previously practiced in telestroke programs in other healthcare systems. Interviewees reported high levels of trust and team cohesion, sometimes even more with their virtual colleagues than with local colleagues. Factors facilitating perceived team cohesion included a weekly case conference call, a sense of transparency in discussing challenges, engagement in NTSP development tasks, and support from the NTSP leadership. Although lack of in-person contact was associated with lower cohesion, annual in-person NTSP meetings helped mitigate this issue. Despite technical challenges in establishing a new telehealth system within existing national infrastructure, providers reported high levels of satisfaction with the NTSP. Conclusion: A virtual telestroke hub can provide a sense of team cohesion among stroke specialists at a level comparable with a standard co-located practice. Engaging in transparent discussion of challenging cases, reviewing new clinical evidence, and contributing to program improvements may promote cohesion in distributed telemedicine teams.
Tocilizumab and Thromboembolism in COVID-19: A Retrospective Hospital-based Cohort Analysis
Authors: Chan Kok Hoe , Patel Bhavik , Podel Bishnu , Szabela Maria E , Shaaban Hamid S , Guron Gunwant , Slim Jihad
Published: July 2020

Background:Tocilizumab, an IL-6 receptor antagonist has been used in patients with Coronavirus Disease 2019 (COVID-19) as an anti-cytokine agent. IL-6 also plays a complex role in hemostasis and thrombosis. We observed a transient elevation of D-dimer in our patients who received Tocilizumab, which triggered the current study.Methods:A retrospective hospital-based cohort analysis of patients with confirmed COVID-19 who received Tocilizumab during the study period of 03/15/2020 to 05/20/2020. We retrieved demographic, clinical and laboratory data, we excluded patients who were receiving therapeutic anticoagulation therapy prior to Tocilizumab administration. Descriptive analysis was performed, the cause of death and trends of D-dimer and inflammatory markers were studied. Results: Out of the 436 confirmed COVID 19 patients admitted during the study period, 24 met the inclusion criteria. Their median age was 47.5 years old. They were 18 males and 6 females; 15 patients survived, and 9 expired. Of the group that survived, 12 received therapeutic anticoagulation. Of the 7 patients who did not receive therapeutic anticoagulation, 4 expired, 1 from sepsis and 3 probably from thromboembolic complications, compared to 5 deaths in the 17 patients who received therapeutic anticoagulation with 4 dying from sepsis, and one possibly from thromboembolic complications.Conclusions:The interplay between IL-6, IL-6 receptor antagonist and venous thromboembolism are complex. We observed a transient elevation of D-dimer in COVID-19 patients who received Tocilizumab, and a trend toward increased death secondary to thromboembolism. This observation is novel and highlights the potential thrombophilic side effects of Tocilizumab.
US Consumer Confidence Responses to Shocks: COVID19 Scenarios and Recovery.Under review: REHO Special Issue
Authors: Elmassah Suzanna , A.Hassanein Eslam
Published: July 2020

Personal consumption expenditure has long been a key driver of the US economy, accounting for roughly two-thirds of GDP. Consumer confidence is a significant predictor of consumer expenditure especially in times of shocks. The US has experienced many shocks since 1978; the latest of which is the outbreak of coronavirus. COVID19 has spread from China to the whole world; the pandemic has had far-reaching consequences for global political, social, economic, and financial structures. Consumer confidence is one of the leading economic indicators that provides information on the current and future path of the economy, helps in stimulating economic activity, and predicts change in macroeconomic variables, especially during times of economic and political uncertainty. Our study investigates the relationship between consumption expenditure and consumer confidence in the USA. It analyzes the US consumer confidence response to 11 different shocks since 1978, focusing on COVID-19 shock. Our investigation uses Michigan's monthly Consumer Sentiment Index (CSI) and its five components from January 1978 to April 2020. The paper is unique in quantifying the potential variations in US consumer confidence due to COVID-19 under different scenarios; by providing a projection until August 2021. The goal is to estimate the time needed for recovery and provide guidance to policymakers on ways to restore consumer confidence to tame the impact of coronavirus on effective demand. Under the two more optimistic scenarios we predict that recovery will begin by January 2021. Under the third, less optimistic, scenario we predict that recovery will begin by April 2021.
Material characterisation of a painted beehive panel by hyperspectral imaging in combination with advanced spectroscopic and chromatographic techniques
Authors: Retko Klara , Kavčič Maša , Legan Lea , Ropret Polonca , Škafar Bojana Rogelj , Gao Yingwang , Gilchrist John , Strlič Matija , Cigić Irena Kralj
Published: July 2020

In this study, a painted beehive panel from the collection of Slovene Ethnographic Museum was examined with respect to its material composition with the aim to reveal the painting technique. Due to the state of degradation due to outdoor weathering (UV irradiation, rainfall, extreme temperature and humidity fluctuations), as well as past conservation interventions, the object represented a complex analytical challenge. We aimed for non-invasive techniques (FTIR in reflection mode, Raman spectroscopy and hyperspectral imaging in the range of 400 to 2500 nm), however in order to explore paint layers, cross-sections were also analysed using Raman spectroscopy. FTIR spectroscopy in transmission mode and gas chromatography coupled to mass spectrometry were also used on sample fragments. Various original materials were identified such as pigments and binders. The surface coating applied during restoration interventions was also characterised. Additionally, organic compounds (oxalate, carboxylate), representing transformation products, were found. The potential use of Prussian blue as a background paint layer is discussed.
The First Documented Detection in Taiwan of The Hepatitis E Virus in Rats
Authors: Chiang Pai-Shan , Huang Wei-Lun , Chung Han-Hsuan , Yang Jyh-Yuan , Teng Hwa-Jen
Published: July 2020

Background: Human infections by rat HEV (HEV-C1) have been serially reported, including a case who had visited Taiwan before having the illness in 2019. The objective of this study was to investigate whether HEV-C1 is circulating and causing human infections in Taiwan.Methods: Fifty acute-phase human sera samples from HEV suspected patients with the negative results were randomly chosen for retrospective review. Rat sera were collected from 3 Rattus rattus and 47 R. norvegicus, which were captured at international airports or harbors. Identifying HEV-C1 RNA was performed by hemi-nested RT-PCR in human and rat serum samples. Rat sera were also tested for anti-rat HEV antibodies. Results: HEV-C1 RNA was not detected in either human or R. rattus samples, but the viral RNA was identified in two R. norvegicus samples. The 2 rat HEV strains shared identical partial sequences in the RNA polymerases gene. In serology, anti-HEV antibodies were detected in 52% (26/50) of the trapped wild rats.Conclusions: This study documents the first detection of HEV-C1 in Taiwan. The high homology between HEV-C1 sequences from rats observed in this study might result from viral circulation and transmission within certain rodent populations. The risk of indigenous human infection in Taiwan should not be ignored because of the domestic detection of HEV-C1 RNA.
The effects of fluid therapy during the first 12 hours from septic shock onset in pediatric patients
Authors: Ha Eunju , Kim DaHyun , Park SeongJong , Jhang Won Kyoung
Published: July 2020

Background: Initial fluid therapy is the cornerstone of hemodynamic resuscitation in pediatric patients suffering from septic shock. This study aimed to evaluate the association between fluid therapy during the first 12 hours from septic shock onset and clinical outcomes in a pediatric cohort.Method: This was a retrospective, observational study of consecutive pediatric patients with septic shock admitted to our multidisciplinary pediatric intensive care unit (PICU) between January 2012 and December 2019. Total fluid administration within the first 12 hours from septic shock onset, patient characteristics, and outcome measurements were collected from validated electronic medical records. Results: A total of 144 cases were included with an overall 28-day mortality rate of 20.1%. Among the survivors, the proportion of fluid received within the first 3 hours (36.9 % vs 25.4%, p=.004) and within the last 3 hours (18.9 % vs 21.3 %, p=.031) of the total amount administered over a 12 hour period from septic shock onset showed a significant difference compared with the non-survivors. The mortality rate was lower in the group receiving the highest proportion of the total administered fluid within the first 3 hours (13.9 % vs 26.4 %, p=.048). Patients receiving the highest proportion of fluid in the last 3 hours had a significantly higher mortality rate (29.6 % vs 14.4 %, p=.025). By multivariable logistic regression analysis, we also found that a higher proportion of administered fluid within the first and last 3 hours was associated with decreased mortality (OR, 0.951; 95% CI, 0.918-0.986; p=.028) and increased mortality (OR, 2.761; 95% CI, 1.175-6.495; p=.020), respectively.Conclusions: An increased fluid intake within the first 3 hours of septic shock onset is associated with a decreased 28-day mortality. Moreover, a higher administration of fluids from 9 to 12 hours after this onset seems to be related to a poorer survival outcome. Treating pediatric septic shock cases with higher amounts of fluid within the first 3 hours of onset and then with more conservative levels thereafter may lead to better survival outcomes.
Probable Forecasting of Epidemic COVID-19 in Using COCUDE Model for the State of Tamilnadu, India
Authors: Theerthagiri Prasannavenkatesan
Published: July 2020

The world has been struck due to the dangerous human threat called Corona Virus Disease 2019. This research work proposes a methodology to encounter the future infection rate, curing rate, and decease rate. This uses the artificial intelligence algorithm to design and develop the proposed confirmed, cured, deceased (COCUDE) model. A machine learning model has been developed with several iterations to design the proposed COCUDE model. The Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), and Correlated Akaike Information criterion (AICc) metrics are analyzed to check the stationary and quality for the proposed COCUDE model. The prediction results are evaluated by the performance error metrics such as mean square error (MSE) and root mean square error (RMSE), in which the errors are lower for the proposed model. Thus, the prediction results indicate the proposed COCUDE model might accurately predict future COVID-19 infection rates. It might support the corresponding authorities to take the precautious action on the required necessities for the medical and clinical infrastructures and equipment.