bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of Risk Factors for in-hospital Death of COVID - 19 Pneumonia
Authors: Wang Zhigang , Wang Zhiqiang
Published: July 2020

Objective: To examine the clinical characteristics and identify independent risk factors for in-hospital mortality of 2019 novel coronavirus (COVID-19) pneumonia.Methods: A total of 156 patients diagnosed with COVID-19 pneumonia at the central Hospital of Wuhan from January 29, 2020, to March 20, 2020 were enrolled in this single-centered retrospective study. Their epidemiological parameters, clinical presentations, underlying diseases, laboratory test results and disease outcomes were collected and analyzed. Results: The median age of enrolled patients was 66. Underlying diseases were identified in 101 patients, with hypertension being the most common one, followed by cardiovascular disease and diabetes. The most common symptoms identified upon admission were fever, cough, dyspnea and fatigue. Compared to survival cases, patients who dead during hospitalization had higher plasma levels of D-dimer, creatinine, creatine kinase, lactate dehydrogenase, lactate and lower percentage of lymphocytes (LYM [%]), platelet count and albumin levels. Most enrolled patients received anti-biotics and anti-viral treatment. In addition, 60 patients received corticosteroid and 51 received intravenous immunoglobulin infusion. 44 patients received noninvasive ventilation, 19 received invasive ventilation. Respiratory failure was the most frequently observed complication (106 [67.9%]), followed by sepsis (103 [66.0%]), acute respiratory distress syndrome (ARDS) (67 [42.9%]) and septic shock (50 [32.1%]). Multivariable regression suggested that advanced age (OR [odds ratio]= 1.059, 95% CI [confidence interval]: 1.011-1.110, P= 0.016) and elevated lactate level upon admission (OR= 2.411, 95% CI: 1.177-4.941, P= 0.016) were independent risk factors for in-hospital mortality for COVID-19 infection. Meanwhile, increased LYM (%) at admission (OR= 0.798, 95% CI: 0.728-0.876, P< 0.001) indicated a better prognosis. Conclusions: In this study, we discovered that age, LYM (%) and lactate level upon admission were independent factors that could influence in-hospital mortality rate.
A measurement of radiographers pandemic experiences & perceptions survey (PEPS) during the coronavirus pandemic in Kuwait.
Authors: AlMulla Muna
Published: July 2020

AimCOVID-19 has present the working environment with terms such as volatility, uncertainty, complexity, and ambiguity, which are factors that has the potential to significantly result in the possible breakdown of the workforce as they experience more and more collapse of community, absence of fairness, and conflicting values. This study aimed to measure radiographers' experience during COVID-19 using pandemic experiences & perceptions survey (PEPS) tool. The tool provides critical information on the extent of workflow disruption, the measure and availability of resources, risk perception, impact on working dynamics (workload, control, reward, community, fairness, and values) and management.Methods:An online survey was distributed from May 2020 to June 2020 to radiographers who work in Kuwait government, private hospitals, clinics, or newly authorized medical quarantine centers. The survey consists of 2 pages, 34 questions in total, with an additional added demographic page. In total, it takes 10 to 15 minutes to complete the survey. For reporting PEPS results, we used descriptive analysis for the demographic data, average scoring, and mean and standard deviation (SD) for the tool items.Results:The number of participants who attempted to answer the survey was 347; however, only 102 participants completed the survey. 48 (47.1%) males and 54 (52.9%) females, the questionnaire had a mean (± SD) age of (35.7 ± 8.2) years. 89% of participants have indicated that they have been in direct contact with COVID-19. 57.8% have expressed that they have had the training, support, and equipment to provide minimal control over the virus. Furthermore, more than half of the participants (68.7%) have expressed fear of the virus and that the virus presented a danger to them. With regards to the five PEPS tools, the mean ± SD (table 1) were: Disruption 2.487 (±1.094), resources 2.580 (±1.196), risk perception 2.963 (±1.713), impact on work-life areas 3.810 (±0.992), and Leadership 3.795 (±0.965).Conclusion:The majority of radiographers explained fear and risk of working with COVID-19; however, they had a positive attitude toward their leadership and management. Most radiographers explained that regardless of their faith in management, additional education interventions and campaigns were required to improve their sense of safety and confidence. Working with an insensitive working environment of COVID-19, any organization will experience some burnout, depending on both the quality of the management system and how leaders react in real-time. This PEPS tool can help to contain future burnouts and conflicts.
Nomogram to predict survival of patients with advanced and metastatic pancreatic cancer
Authors: Deng Guochao , Lv Yao , Yan Huan , Han Quan-li , Dai Guang-hai
Published: July 2020

Background
The nomogram is increasingly being used in tumor prognosis. Few nomograms estimate the survival of patients with advanced and metastatic pancreatic cancer. We aim to establish a comprehensive nomogram to predict the survival probability of advanced and metastatic pancreatic cancer.
Methods
A total of 323 patients with advanced and metastatic pancreatic cancer who underwent first-line chemotherapy from January 2010 to December 2018 were identified from the Chinese People’s Liberation Army (PLA) General Hospital. The baseline nomogram was established with baseline variables of 323 patients. And 233 patients who had initial tumor responses to first-line chemotherapy were enrolled in chemotherapy response-based model. The 6-month survival probability was evaluated by multivariate logistic regression models. Discrimination and calibration of the nomogram were tested by the concordance index (C-index), calibration plots and Kaplan-Meier curves. The predictive accuracy and net benefit of the nomogram were performed via receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA), respectively.
Results
In the baseline model, the 4 variables (KPS, gender, baseline CA 19 − 9 and baseline LDH) were enrolled in the final model. In the chemotherapy response-based model, the 5 variables (KPS, gender, baseline CA 19 − 9, the initial response to chemotherapy and second-line chemotherapy) were included in nomogram. The C-index of the two nomograms was 0.704 (95%CI, 0.65–0.76) and 0.846 (95%CI, 0.79–0.89), respectively. The Hosmer-Lemeshow test x2 statistics were 4.182 (p = 0.840) and 9.427(P = 0.323), respectively. Both two nomograms with good performance were demonstrated by the calibration plots.
Conclusion
The nomograms had been established to predict the survival probability of advanced and metastatic pancreatic cancer who underwent first-line chemotherapy. And the chemotherapy response-based model was better than the baseline model.
Overexpression of C1QTNF6 Predicts a Poor Prognosis in Bladder Cancer
Authors: Zhu Xin , Tong Hang , Gao Shun , Yin Hubin , Zhu Gongmin , Li Xinyuan , He Weiyang , Gou Xin
Published: July 2020

Background: Bladder cancer is one of the most common urinary cancer. This study aimed to provide promising molecular biomarkers for bladder cancer by investigating the correlations between C1QTNF6 expressions and clinical characteristics as well as prognosis in patients with bladder cancer.Methods: C1QTNF6 RNA sequencing profiles of bladder cancer patients were collected to evaluate different expressions between normal bladder mucosa and bladder cancer from TCGA database and GEO database. The associations between C1QTNF6 expression and clinical characteristics as well as prognosis were evaluated by two independent cohorts. The cell expression of C1QTNF6 expression between normal bladder cell and bladder cancer cells were tested in western blot and PCR, and the underlying molecular mechanism was investigated.Results: RNA levels of C1QTNF6 were found to be differentially expressed in two independent public cohorts including TCGA database and GSE13507 from GEO database. The protein and RNA expressions C1QTNF6 in bladder cell lines were both significantly elevated than normal bladder cell line. High C1QTNF6 expressions were found in advanced T status, M status, pathological grade, AJCC stage compared with low C1QTNF6 expression group. The underlying mechanism may be explained by cell migration and invasion assays that bladder cancer cells 5637 and T24 were significantly reduced migration and invasion ability with the knock-down C1QTNF6 expressions. The low RNA expression group of C1QTNF6 demonstrated OS advantage over high-expression group in both TCGA and GSE13507 cohorts. Besides, protein expressions in tissues were further validated in HPA database and TMA. Survival analysis also indicated that the high expression of C1QTNF6 indicated unfavorable OS compared with low expressions group.Conclusions: High expression of C1QTNF6 predicted poor prognosis for bladder cancer patients, and the underlying mechanism is associated with cancer cell migration and invasion ability.
Predictors of adherence to prescribed exercise programs for older adults with non-musculoskeletal indications for exercise: a systematic review
Authors: Shaw Julia F , Pilon Sophie , Vierula Matthieu , McIsaac Daniel I
Published: July 2020

BACKGROUND AND OBJECTIVES:

Prescribed exercise to treat medical conditions and to prepare for surgery is a promising intervention to prevent adverse health outcomes for older adults; however, adherence to exercise programs may be low. Our objective was to identify and grade the quality of predictors of adherence to prescribed exercise in older adults.
METHODS

After registration (CRD42018108242), prospective experimental studies were identified using a peer-reviewed search strategy applied to MEDLINE, EMBASE, Cochrane and CINAHL from inception until April 23, 2019. Following independent and duplicate review of titles, abstracts and full texts, we included prospective studies with an average population age ≥ 65 years, where exercise was formally prescribed for a medical or surgical condition. We excluded studies where exercise was prescribed for a chronic musculoskeletal condition. Risk of bias was assessed using the Quality in Prognostic studies tool or Cochrane risk of bias tool, as appropriate. Predictors of adherence were identified, pooled, and graded for quality using an adaptation of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework for predictor studies.
RESULTS

We included 19 observational studies and 4 randomized controlled trials (n = 5785) Indications for exercise included cardiac (n = 6), pulmonary rehabilitation (n = 7), or other (n = 10; surgical, medical, and neurologic). Overall adherence rate was reported in 20 studies (range 21%-93%; mean 68%, standard deviation 23%). Moderate-quality evidence suggested that positive predictors of adherence were self-efficacy and good self-rated mental health; negative predictors were depression (high quality) and distance from the exercise facility. Moderate-quality evidence suggested that comorbidity and age were not predictive of adherence.
CONCLUSIONS

These findings can inform design of future exercise programs as well as identification of individuals who may require extra support to benefit from prescribed exercise.
Patient Perspectives on the Implementation of Routinised Syphilis Screening With HIV Viral load Testing: Qualitative Process Evaluation of the Enhanced Syphilis Screening Among HIV-positive Men Trial
Authors: MacKinnon Kinnon R , Grewal Ramandip , Tan Darrell HS , Rousseau Rodney , Maxwell John , Walmsley Sharon , MacPherson Paul A , Rachlis Anita , Andany Nisha , Mishra Sharmistha , Allen Vanessa G , Burchell Ann Natalie
Published: July 2020

Background: Syphilis infections have been on the rise, affecting men living with HIV in urban centres disproportionately. Since individuals in HIV care undergo routine blood testing, HIV clinics provide practical opportunities to conduct regular and frequent syphilis testing. Following the implementation of a routine syphilis testing intervention in HIV outpatient clinics, we conducted a qualitative process evaluation of patient experiences to measure patient acceptability, barriers to implementation, and facilitators of successful uptake. Methods: Upon completion of the trial, which took place at four HIV outpatient clinics in Toronto and Ottawa, Canada, we recruited male patients attending these clinics from November 2017 to April 2018. Interviews were conducted on-site and were audio-recorded and transcribed verbatim. All participants provided written informed consent. Interview data were analyzed using grounded theory, assessing qualitative modulators of effective uptake of routinised syphilis testing. Results: A total of 21 male patients were interviewed. Overall, interviewees found the clinical intervention acceptable, endorsing the practice of routinising syphilis testing alongside regular viral load bloodwork. Some men preferred, based on their self-assessment of syphilis risk, to opt out of testing; we considered this as a potential barrier to uptake of population-wide routinised syphilis testing. Interviewees also identified multiple facilitators of successful uptake, including the de-stigmatising of STI testing as a consequence of the universal nature of routinised testing. Participants recommended a routinised syphilis screening intervention to give patients peace of mind surrounding their sexual health. Participants identified HIV care clinics as comfortable and efficient locations to offer testing. Conclusions: Overall, most men were in support of implementing routinised syphilis testing as part of standard HIV care. From the patient perspective, HIV care clinics are convenient places to be tested for syphilis, and the routine approach was viewed to have a de-stigmatisng effect on syphilis testing. Trial registration: ClinicalTrials.gov NCT02019043; registered December 23, 2013.Trial registration: ClinicalTrials.gov NCT02019043; registered December 23, 2013.
Modeling of antiproliferative effects of Salvia officinalis L. essential oil optimized using Box–Behnken design
Authors: Kallel Imen , Bayoudh Ahmed , Gargouri Bochra , Khannous Lamia , Elaguel Asma , Tharhouni Nidhal , Lassoued Saloua , Messaoud Ezeddine Ben , Hadrich Bilel
Published: July 2020

Background

Salvia officinalis L. essential oil (SoEO) was mostly traditionally used to medicate various diseases as cancer. Then, the present work aims were: (1) to model the cytotoxicity effects of Salvia officinalis L. essential oil (SoEO) related to the human cancer cell lines kind (MCF-7 and HeLa) ; (2) to optimize the hydro-distillation extraction conditions of SoEO; and, (3) to determine the in vitro scavenging capacity of the free radicals DPPH•, NO•, ABTS+, and the ability to reduce Fe3+.
Methods

The cytotoxicity and anti-proliferative abilities were evaluated by measuring cell viability and then modeled. Two human cell lines: MCF-7 and HeLa were used. The optimization of SoEO extraction by hydro-distillation was carried out with Response Surface Methodology (RSM) using the Box–Behnken design
Results

The cytotoxicity activity against both tumor cell lines MCF-7 and HeLa was considerably important with IC50 = 3.125 and 8.920 µg/mL, respectively. All treated cell lines showed a significant reducing in cell viability in response to the increasing oil concentration. The relative behaviors of both cell lines under SoEO treatment were modeled. The obtained optimal extraction yield was Y = 1.85 g/100 g d.b. The main identified fractions were camphene (23.7%), α-thujone (19.62%), 1,8-cineole (10.6%), viridiflorol (5.9%), borneol (5.72%); β-thujone (5.4%); caryophyllene (3,83%). Also, SoEO was mostly able to scavenge DPPH• free radical, ABTS+ radical and hydrogen peroxide in an amount dependent manner (IC50 = 0.97, 0.279 and 0.05 mg/mL, respectively).
Conclusion

The present work provides a preliminary platform for further investigation of the possible mechanism of S. officinalis essential oils and their individual compounds in cytotoxic and antitumor activity.
PVRL2 rs6859 Modifies the Effect of Triglyceride on Progression of Mild Cognitive Impairment: The Shanghai Aging Study
Authors: Wang Ruru , Ding Ding , Atibaike Abuduaili , Xi Jianxiong , Zhao Qianhua , Liang Xiaoniu , Zheng Li , Guo Qihao , Hong Zhen , Fu Hua , Xiao Qianyi
Published: July 2020

Background Mild cognitive impairment (MCI) is an intermediate stage between normal cognition and Alzheimer’s disease (AD). Genome-wide association studies (GWAS) have identified many AD-risk variants and indicated the important role of lipid metabolism pathway in AD progression. This study aimed to investigate the effects of triglyceride (TG) and genetic risk factors on progression from MCI to AD (MCI-AD progression).Methods The current study sample comprised of 305 MCI subjects aged 50 and over who were prospectively followed up for average 4.5 years in a sub-cohort of the Shanghai Aging Study. A consensus diagnosis of incident AD was conducted according to Diagnostic and Statistical Manual of Mental Disorders-IV and the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association criteria. Fasting blood samples were obtained at baseline for analyzing serum TG. Single nucleotide polymorphisms (SNPs) genotyping was performed using a MassARRAY system. The effect of TG, genetic variants and their interaction on MCI-AD progression were analyzed using Cox proportional hazards regression model.Results During a mean (±SD) follow-up period of 4.5±1.3 y, 58 subjects developed incident AD. The SNP, rs6859 in the Poliovirus Receptor–Related 2 (PVRL2) gene, was significantly associated with incident AD (false discovery rate (FDR)-adjusted P = 0.018). In multivariate cox model, the PVRL2 rs6859 AG, AA and AG+AA genotypes were associated with significantly increased incident AD, compared with the GG genotype (hazard ratio [HR] = 2.29, P = 0.029, and HR = 2.92, P = 0.013, and HR = 2.47, P =0.012, respectively). In PVRL2 rs6859 AG/AA carriers, higher ln TG was significantly associated with increased risk of incident AD (adjusted HR =2.64, P = 0.034). Ln TG and PVRL2 rs6859 had interactive effect on the MCI-AD progression (P Ln TG × rs6859 = 0.001). Conclusion The present study indicated that PVRL2 rs6859 modified the effect of TG on MCI-AD progression. Precision prevention in MCI population based on genetic information should be considered to avoid progression to AD.
Complex phase evolution of Brushite-based calcium phosphate CaHPO4·2H2O using in situ high temperature X-ray diffraction and thermal analysis
Authors: Hazzat Mouatamid El , Hamidi Adnane El , Halim Mohammed , ARSALANE said
Published: July 2020

This study focused on a detailed examination of the thermal behavior of Brushite-based calcium phosphate (CaHPO 4 .2H 2 O, DCPD) to identify and characterize the intermediate phases which have been the subject of previous several controversies. For that, in situ high-temperature X-ray diffraction supported by infrared spectroscopy, thermal analysis, and scanning electron microscopy analysis were used and the results showed that the progressive thermal stress of DCPD in air resulted in a heterogeneous formulation consisting of dibasic calcium phosphate anhydrous (CaHPO 4 , DCPA) and an amorphous phase, which appears at low temperatures (~160 °C) and persists up to 375 °C. The deep examination of the amorphous phase by infrared spectroscopy revealed that its chemical composition is similar to that of disordered calcium pyrophosphate (Ca 2 P 2 O 7 , CPP) with the appearance of a characteristic band δ(P-O-P), located at 740 cm -1 . This IR band is shifted to low frequencies (725 cm -1 ) as the temperature is increased, indicating the crystallization of the amorphous phase into γ-CPP. The high temperature treatment (≥ 375 °C) leads to b-CPP polymorph. According to the present characterization results, obtaining pure DCPA from the thermal dehydration of DCPD is not effective and leads to biphasic materials including an amorphous phase.
Investigation of the room temperature ferromagnetism in transition metal doped ZnO thin films
Authors: Kumar Arun , Dhiman Pooja , Aggarwal Sanjeev , Singh Mahavir
Published: July 2020

In the present work, we have studied the ferromagnetic nature of the (Fe, Ni) co-doped Zn1-x-y NiyFexO (y = 0.01 and x = 0.01, 0.03, 0.05) thin films fabricated through the RF magnetron sputtering on Silicon (400) substrate. Structural information of the deposited transition metal-doped ZnO thin films was studied through X-ray Diffraction (XRD) techniques. The surface roughness and average grain size of the thin films examine through Atomic Force Microscopy (AFM). The optical band gaps of the thin films have been analyzed through the UV-Vis spectroscopy and it was appropriate for the optoelectronic devices. Tau’c Plots were used for the calculation of the band gap by extrapolating the (αhν) = 0, the straight-line portion of the plot to zero absorption coefficient. The magnetic study of these thin films confirmed the ferromagnetic (FM) behavior. RT-FM in all the deposited thin films was discuses on the base of polaron percolation theory.
Risks Of Ventilator-Associated Pneumonia And Invasive Pulmonary Aspergillosis In Patients With Viral Acute Respiratory Distress Syndrome Related or Not To Coronavirus 19 Disease
Authors: Razazi Keyvan , ARRESTIER Romain , Haudebourg Anne-Fleur , Benelli Brice , Carteaux Guillaume , Decousser Jean-Winoc , Fourati Slim , Woerther Paul-Louis , Schlemmer Frederic , Charles-Nelson Anais , Botterel Françoise , Prost Nicolas De , Mekontso-Dessap Armand
Published: July 2020

Background The goal of this study was to assess risk factors of ventilator-associated pneumonia (VAP) and invasive pulmonary aspergillosis in patients with SARS-CoV-2 infection.Methods. We conducted a monocenter retrospective study comparing the prevalence of VAP and invasive aspergillosis between patients with COVID-19 related acute respiratory distress syndrome (C-ARDS) and those with non-SARS-CoV-2 viral ARDS (NC-ARDS).Results. We assessed 90 C-ARDS and 82 NC-ARDS patients, who were mechanically ventilated for more than 48 hours. At ICU admission, there were significantly fewer bacterial coinfections documented in C-ARDS than in NC-ARDS: 14 (16%) vs 38 (48%), p<0.01. Conversely, significantly more patients developed at least one VAP episode in C-ARDS as compared with NC-ARDS : 58 (64%) vs. 36 (44%), p=0.007. The probability of VAP was significantly higher in C-ARDS after adjusting on death and ventilator weaning [sub-hazard ratio = 1.72 (1.14-2.52), p<0.01].The prevalence of multi-drug resistant bacteria (MDR) related VAP was significantly higher in C-ARDS than in NC-ARDS: 21 (23%) vs. 9 (11%), p=0.03. Carbapenem was more used in C-ARDS than in NC-ARDS: 48 (53%), vs 21 (26%), p<0.01. According to AspICU algorithm, there were fewer cases of putative aspergillosis in C-ARDS than in NC-ARDS [2 (2%) vs. 12 (15%), p=0.003], but there was no difference in Aspergillus colonization.Conclusions. In this retrospective case-control study, we evidenced a higher prevalence of VAP and MDR-VAP in C-ARDS than in NC-ARDS, and a lower risk for invasive aspergillosis in the former group.
High Frequency of 45,X/46,XY mosaicism carring a structurally abnormal Y chromosome in patients with Y chromosome microdeletions: a 8-year period retrospective study
Authors: Li Hong-Ge
Published: July 2020

Background: Structural abnormalities of Y chromosome are commonly described in associated with the occurrence of a 45,X/46,XY chromosomal mosaicism. In recent years, evidences of an association between Y chromosome microdeletions and 45,X/46,XY mosaicism had been investigated, and 45,X/46,XY mosaicism was found to be particularly common in patients with Y chromosome microdeletions. The aim of our study was to investigate the presence of 45,X/46,XY mosaicism carrying a structurally abnormal Y chromosome in patients with Y chromosome microdeletions.Results: A 8-year retrospective study was conducted on 6545 infertile men with nonobstructive azoospermia or oligozoospermia. A total of 19 patients with 45,X/46,XY mosaicism or its variants were found, of which 78.95% (15/19) had a structural Y chromosome abnormalities in 46,XY cell line. Thirteen of 19 (68.42%, 13/19) patients with 45,X/46,XY mosaicism had Y chromosome microdeletions, and 12/13 (92.31%) of them exhibited a structurally abnormal Y chromosome.Conclusions: Our results were consistent with previous studies that a high frequency of 45,X/46,XY mosaicism or its variants were detected in patients with Y chromosome microdeletions. Different from previous studies, we found that 45,X/46,XY mosaicism in patients with Y chromosome microdeletions almost all exhibited a structurally abnormal Y chromosome.
The deadly “bulging balloon” within the mediastinum: a case of a giant aortic root aneurysm in a young patient with Marfan syndrome
Authors: SHEN JIAYU , Gan Changping , Rajaguru R.D.T. , Yuan Dou , XIAO ZHENGHUA
Published: July 2020

Introduction:
Marfan syndrome (MFS) is a common heritable connective tissue disease involving multiple organs. Even though the clinical manifestations of MFS can be various, aortic root aneurysm is estimated as one of the most serious complications. We herein describe an individualized treatment decision-making process for a 23-year-old male with MFS, suffering from a giant but stable aortic root aneurysm which is extremely rare at his age.
Case:
The patient, a 23-year-old male with a family history of MFS, presented to our cardiovascular department because of progressive exertional chest distress, fatigue and occasional precordial pain. Physical examinations revealed six-foot-three inches of height, high myopia, and a diastolic murmur at the aortic valve area. Laboratory examinations for systemic vasculitis and infectious diseases were negative. The transthoracic echocardiography (TTE) and enhanced thoracic computed tomography (CT) scan revealed the existence of a giant aortic root aneurysm (125.1 mm in short-axis), severe aortic valve regurgitation, cardiac dilatation (LV; 99 mm in diastolic diameter) and a poor ejection fraction (EF; 18%). Considering the risk of rupture or dissection of the dilated aortic root, we successfully performed the Bentall procedure based on the intraoperative exploration results. Postoperative thoracic CT scan revealed a normal sized reconstructed aortic root, and the patient was discharged uneventfully 7 days later.
Conclusion
It is extremely rare to report such a giant aortic root aneurysm in a young patient. In the treatment decision-making process, the patient’s specific situation should be taken into consideration. The composite replacement of the aortic valve and ascending aorta should be performed if the patient is not suitable for valve-sparing operation.
Chemical Diversity of Essential Oils from Pinus Nigra Arn. Subspecies Growing in Tunisia
Authors: Fkiri Sondes , Mezni Faten , Khouja Mohamed Larbi , Nasr Zouheir , Khaldi Abdelhamid
Published: July 2020

Background: The aim of this study was the determination of chemical diversity of Pinus nigra Arn essential oils. The work was conducted on needles collected from eighteen provenances of Black pine grown in common garden located in West-Northern Tunisia and belonging to four different subspecies (P. nigra subsp. nigra, P. nigra subsp. salzmannii, P. nigra subsp. pallasiana and P. nigra subsp. laricio). The GC analysis was carried out with a Gas Chromatograph coupled to a mass spectrometry. Results: Oil yields ranged from 0.19% to 0.68%. Twenty-three constituents accounting about 98% of total oil composition were identified. The essential oil compositions appeared to be very different in the different provenances. There appear to be five basic essential oil chemotypes in P. nigra plants investigated: caryophllene oxide, camphene, β caryophyllene, α amorphene and Germacrene D. Oils from nigra subsp. were the richest in α-pinene.Conclusions: this study showed that the analyzed oils belonged to five different chemotypes. Caryophyllene oxide was the main component of almost studied oils.
Participatory Forestry Improves Mangrove Forest Management in Kenya
Authors: Kairu Anne , Kotut Kiplagat , Mbeche Robert , Kairo James Gitundu
Published: July 2020

Background: Mangrove forests worldwide are highly valued for their social, ecological and environmental roles. Participatory forestry has been recognized as a tool for improvement of forest conditions. The current study assessed impacts of PFM implementation on structure and regeneration of mangroves at Gazi Bay, Kenya. Forest data was collected along belt transects perpendicular to waterline in both community and state managed blocks. Results: Basal area and standing density were significantly higher in the co-managed forests (16 m2 ha-1 and 4,341 tree ha-1) as compared to the state managed forests (eastern block 10.3 m2 ha-1 and 2,673 trees ha-1; western block 6.2 m2 ha-1 and 2,436 trees ha-1). There were significantly higher (p = 0.0068) densities of quality class poles in co-managed forest block as compared to state-managed eastern and western blocks. Natural regeneration values of 38,822 juveniles ha-1 in the co-managed central block and 23,556 and 35,061 juveniles ha-1 in the state managed eastern and western blocks respectively are considered adequate to support recovery of the forest. A higher complexity index (CI) recorded in the co-managed mangrove forest compared to the state managed eastern and western blocks is particularly due to improved stand density, tree height, and biomass resulting from increased surveillance and protection by the community. The results have wide implications in the management of mangroves for community and biodiversity benefits and climate change mitigation.Conclusion: The results support community participation for improved management of mangrove forests and are in conformity with sectoral policies on natural resources management in Kenya.
The Relationship Between Seasonality, Latitude and Tuberculosis Notifications in Pakistan
Authors: Butt Mohsin F. , Younis Sidra , Wu Zhenqiang , Hadi Syed H. , Latif Abdullah , Martineau Adrian R.
Published: July 2020

BackgroundPakistan is amongst the top 20 highest burden tuberculosis (TB) countries in the world. Approximately 369,548 cases of TB (all forms) were notified in 2018, with an estimated incidence of 265 per 100,000 people per year. In other settings, TB has been shown to demonstrate seasonal variation, with higher incidence in the spring/summer months and lower incidence in the autumn/winter; the amplitude of seasonal variation has also been reported to be higher with increasing distance from the equator.MethodsNotifications of newly-diagnosed pulmonary and extrapulmonary TB cases were obtained for 139 districts in Pakistan from 2011–2017. Data were provided by the Pakistan National TB Control Programme, Islamabad, Pakistan. Statistical analyses were performed to determine whether there was seasonal variation in TB notifications in Pakistan; whether the amplitude of seasonal variation in TB notifications varied according to latitude; whether the amplitude of seasonal variation of TB in Pakistan differed between extrapulmonary TB vs. pulmonary TB. To assess the quarterly seasonality of TB, we used the X-13-ARIMA-SEATS seasonal adjustment programme from the United States Census Bureau. The mean difference and corresponding 95% confidence intervals of seasonal amplitudes between different latitudes and type of TB were estimated using linear regression.ResultsTB notifications were highest in quarter 2, and lowest in quarter 4. The mean amplitude of seasonal variation was 25.5% (95% CI 25.0–25.9%). The mean seasonal amplitude of TB notifications from latitude 24.5ºN-<26.5ºN was 29.5% (95% CI 29.3–29.7%) whilst the mean seasonal amplitude of TB notifications from latitude 34.5ºN -<36.5ºN was 21.7% (95% CI 19.6–23.9%). The mean seasonal amplitude of TB notifications across Pakistan between latitudes 24.5ºN to 36.5ºN reached statistically significant difference (p < 0.001). The amplitude of seasonal variation was greater for extrapulmonary TB (mean seasonal amplitude: 21.6%, 95% CI 32.1–33.1%) vs. smear positive pulmonary TB (mean seasonal amplitude 32.6%, 95% CI 21.4–21.8%), p < 0.001.ConclusionTB notifications in Pakistan exhibit seasonal variation with a peak in quarter 2 (April-June) and trough in quarter 4 (October-December). The amplitude of seasonality decreases with increasing latitude, and is more pronounced for extrapulmonary TB than for pulmonary TB.
Comparison of the Reduction of LDL-C or nonHDL-C induced by Red Yeast Rice Extract, Xuezhikang, between Fasting and Postprandial States in Patients with Coronary Artery Disease
Authors: Zhu Li-Yuan , Wen Xing-Yu , Xiang Qun-Yan , Guo Li-Ling , Xu Jin , Zhao Shui-Ping , Liu Ling
Published: July 2020

Background: Xuezhikang, an extract of red yeast rice, effectively lowers fasting and postprandial triglyceride (TG) levels. It was unknown that whether Xuezhikang could contribute the lipid management goals, low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (nonHDL-C) at fasting and postprandial states in patients with coronary artery disease (CAD).Methods: Fifty CAD patients were divided into Xuezhikang (XZK, n=25) group and control (CON, n=25) group randomly to receive red yeast rice exact, 1200mg/d Xuezhikang capsules or not for 6 weeks (6w). Blood lipids were detected repeatedly before and after 6w at 0, 2, 4 and 6 hours (h) after a standard breakfast with 800kcal.Result: When taking all patients as a whole (n=50), serum LDL-C level decreased while TG and RC levels increased significantly at 2, 4 and 6 h after breakfast (P＜0.05). Serum nonHDL-C level mildly but significantly increased at 4h and 6h after breakfast (P＜0.05). Short-term Xuezhikang treatment decreased tAUCs of TC, TG, LDL-C, nonHDL-C and RC whereas increased that of HDL-C significantly (P＜0.05). Serum LDL-C level showed a drop of 27.8%, 28.1%, 26.2%, 25.3% at 0, 2, 4 and 6 h, respectively, after breakfast. Serum nonHDL-C level showed a drop of 27.6%, 28.7%, 29.0% and 28.0% at 0, 2, 4 and 6 h, respectively. There was no significant difference in the percentages of reduction in LDL-C or nonHDL-C level among four time-points.Conclusions: Xuezhikang significantly decreased LDL-C or nonHDL-C level with similar percentages of reduction between fasting and postprandial states in patients with CAD, indicating that postprandial blood lipids detected at the same time point after a daily meal could replace fasting blood lipids to evaluate the efficacy of cholesterol-lowering therapy in CAD patients, unwilling or unable to keep a fasting state.
Bone erosions detected by ultrasound are prognostic for clinical arthritis development in patients with ACPA and musculoskeletal pain
Authors: Ziegelasch Michael , Eloff Emma , Hammer Hilde Berner , Cedergren Jan , Martinsson Klara , Reckner Åsa , Skogh Thomas , Magnusson Mattias , Kastbom Alf
Published: July 2020

BackgroundTo assess the prognostic value of ultrasound for clinical arthritis development among anti-citrullinated peptide antibody (ACPA)-positive patients with musculoskeletal (MSK) pain.MethodsWe prospectively followed 82 ACPA-positive patients with MSK pain without clinical signs of arthritis at baseline. Ultrasound examination at baseline assessed synovial hypertrophy (SH), and inflammatory activity by power Doppler (PD) in 36 small joints and 6 tendons, and erosions in 18 joints. We applied Cox regression analyses to examine associations with clinical arthritis development during follow-up (median, 69 months; range, 24–90 months). We also compared the ultrasound findings among the patients to a control group of 100 blood donors without MSK pain.ResultsClinical arthritis developed in 39/82 patients (48%) after a median of 6 months (range, 1–71 months). One or more ultrasound erosions occurred in 13/82 patients (16%), with none in control subjects (p < 0.001). Clinical arthritis development was more common among patients with baseline ultrasound erosions than those without (77% vs 42%, p = 0.032), and remained significant in a multivariable Cox regression analysis that included previously described prognostic factors (HR 3.9, 95% CI 1.6–9.4, p = 0.003). Ultrasound-detected tenosynovitis was more frequent among the patients and associated with clinical arthritis development in a univariable analysis (HR 2.5, 95% CI 1.1–5.7, p = 0.031), but did not remain statistically significant in multivariable analysis. Neither SH nor PD was associated with arthritis development.ConclusionsBone erosions detected by ultrasound are independent predictors of clinical arthritis development in an ACPA-positive at-risk population.Trial registrationRegional Ethics Committee in Linköping, Sweden, Dnr M220-09. Registered 16 December 2009, https://etikprovningsmyndigheten.se/
Arthroscopic Reconstruction of Anterior Cruciate Ligaments With Allograft: Single-tunnel Double-bundle Versus Single-tunnel Single-bundle
Authors: Zhu Weimin , Zhou Yuanhui , Chen Kang , Zheng Yizi , Lu Wei , Wang Daping , Zeng Yanjun , Deng Zhenhan , Xiong Jianyi
Published: July 2020

Purpose

Arthroscopic reconstruction of anterior cruciate ligament (ACL) commonly adopted single-tunnel single-bundle (STSB) or double-tunnel double-bundle (DTDB) methods. Though single-tunnel double-bundle (STDB) has been used in clinical practice, the efficacy remains unclear. The objective of this study is to compare the clinical results of ACL reconstruction using the STDB and STSB techniques.
Methods

Between March 2010 to June 2013, 78 patients with ACL rupture underwent arthroscopic STDB reconstruction (42 cases) or STSB reconstruction (36 cases) using anterior tibialis tendon allografts in our department. IKDC, Lysholm and Tegner scores were used to evaluate the subjective function of the knee joint during the postoperative follow-up. In addition, the Lachman test and pivot shift test were used to objectively assess the stability of the knee.
Results

The average follow-up time is 24.2 ± 5.7 months in the STDB group, and 24.8 ± 6.6 months in the STSB group. Patients in both groups recovered to preoperative sports level with few complications. The postoperative Lysholm, IKDC, Tegner scores, and knee joint stability were significantly improved compared to preoperative status in both groups (P < 0.05). However, no statistically significant difference was observed between the two groups at the final follow-up (P > 0.05), except for the improvement of pivot shift test positive rate in the STDB group compared with STSB group (P < 0.05).
Conclusion

Both techniques can be used to restore the stability and function of the knee joint with satisfactory short-term efficacy, and STDB showed better rotational stability than STSB technique, indicating the STDB technique may also considered a reliable method for ACL reconstruction.
Innovative Strategies For Providing Menstruation-Supportive Water, Sanitation And Hygiene (Wash) Facilities: Learning From Refugee Camps In Cox’s Bazar, Bangladesh
Authors: Schmitt Margaret L , Wood Olivia R. , Clatworthy David , Rashid Sabina Faiz , Sommer Marni
Published: July 2020

Background: There is growing attention to addressing the menstrual hygiene management (MHM) needs of the over 21 million displaced adolescent girls and women globally. Current approaches to MHM-related humanitarian programming often prioritize the provision of menstrual materials and information. However, a critical component of an MHM response includes the construction and maintenance of water, sanitation and hygiene (WASH) facilities, including more female-friendly toilets. This enables spaces for menstruating girls and women to change, dispose, wash and dry menstrual materials; all of which are integral tasks required for MHM. A global assessment identified a number of innovations focused on designing and implementing menstruation-supportive WASH facilities in the refugee camps located in Cox’s Bazar (CXB), Bangladesh. These pilot efforts strove to include the use of more participatory methodologies in the process of developing the new MHM-supportive WASH approaches.Methods: A qualitative assessment was conducted in the Rohingya refugee camps in CXB in September of 2019 to capture new approaches and practical insights on innovating for menstrual disposal, waste management and laundering. This included Key Informant Interviews with 19 humanitarian response staff from the WASH and Protection sectors of a range of non-governmental organizations and UN agencies; Focus Group Discussions with 47 Rohingya adolescent girls and women; and direct observations of 8 WASH facilities (toilets, bathing, and laundering spaces).Results: Key findings included one, the identification of new female-driven consultation methods aimed at improving female beneficiary involvement and buy-in during the design and construction phases; two, the design of new multi-purpose WASH facilities to increase female beneficiary usage; three, new menstrual waste disposal innovations being piloted in communal and institutional settings, with female users indicating at least initial acceptability; and four, novel strategies for engaging male beneficiaries in the design of female WASH facilities, including promoting dialogue to generate buy-in regarding the importance of these facilities and debate about their placement.Conclusions: Although the identified innovative participatory methodologies and design approaches are promising, the long term viability of the facilities, including plans to expand them, may be dependent on the continued engagement of girls and women, and the availability of resources.
Intratumoral Hemorrhage in Jugular Foramen Schwannoma after Stereotactic Radiosurgery: A Case Report
Authors: Kawashima Mariko , Hasegawa Hirotaka , Shin Masahiro , Shinya Yuki , Saito Nobuhito
Published: July 2020

Background: Clinically significant intratumoral hemorrhage is an extremely rare complication of stereotactic radiosurgery (SRS) for benign tumors.Case Presentation:Here, we present the case of a 64-year-old man who underwent SRS for a relatively large dumbbell-shaped left jugular foramen schwannoma and thereafter developed intratumoral hemorrhage. On post-SRS day 3, he developed lower cranial nerve palsies with radiographically evident tumor expansion. His neurological conditions had gradually improved thereafter; however, he suddenly developed headache, dizziness, and mild hearing deterioration at seven months due to intratumoral hemorrhage. We managed the patient conservatively, and eventually his symptoms improved except for slight ataxia and hearing deterioration. Follow-up images at three years from SRS demonstrated significant tumor shrinkage. This is the first report describing intratumoral hemorrhage after SRS for jugular foramen schwannoma.Conclusions:Transient expansion of the tumor and subsequent venous stasis around the tumor may have played a role in the hemorrhage. Intratumoral hemorrhage should be considered as a rare but potential complication of SRS for jugular foramen schwannomas.
The Importance of Duration of Acute Kidney Injury after Severe Trauma: A Cohort Study
Authors: Hatton Gabrielle Elise , Harvin John A , Wade Charles E , Kao Lillian S
Published: July 2020

Introduction: Acute kidney injury (AKI) is common after severe trauma. AKI incidence and AKI stage have previously been shown to be associated with poor outcomes after trauma. However, AKI duration may also be important for outcomes after trauma, given that it has been shown to be associated with long-term morbidity and mortality in general intensive care unit (ICU) and hospitalized patients. We hypothesized that duration of AKI is independently associated with poor outcomes after trauma. Methods: A cohort study was conducted at a single, level 1 trauma center. Patients admitted to the ICU between 2009 and 2018 were included. Data were extracted from the trauma registry and electronic medical records. AKI within 7 days from presentation was defined according to the Kidney Disease Improving Global Outcomes guidelines. Multivariable analyses were performed to assess the association between AKI incidence, AKI stage, and AKI duration with outcomes including prolonged ICU and hospital length-of-stay, discharge to home, and mortality. Collinearity was assessed using the variance inflation factor. Results: Of 7049 patients included, 72% were male, the median age was 41 years (IQR 27-58), and 10% expired. The AKI incidence was 45%, with 69% of these patients presenting with AKI on arrival. The majority (73%) of patients who suffered AKI recovered within 2 days. After adjustment in separate models, AKI incidence, AKI stage and AKI duration were each associated with prolonged hospitalization, an unfavorable discharge disposition, and mortality. AKI stage and duration were collinear and therefore not used in the same model. Conclusions: Post-traumatic AKI was common on arrival and frequently short-lasting. Duration was correlated with highest AKI stage, and both were separately associated with prolonged hospitalization, discharge destination other than home, and mortality on adjusted analyses. Given the high incidence of AKI on arrival, stage or duration may be better targets for future interventions and quality improvement initiatives to improve outcomes after post-traumatic AKI.
Research on Image Recognition of Intangible Cultural Heritage Based on CNN and Wireless Network
Authors: Liu Enmao
Published: July 2020

The image of national costumes is the main way of presenting the digitalization of intangible cultural heritage and provides important resources for educational informatization. How to use modern information technology to efficiently retrieve images of national costumes has become a hot research topic. Due to the diverse styles and colorful colors of ethnic costumes, it is difficult to accurately describe and extract visual features. In view of the above problems, this paper proposes an image recognition model of intangible cultural heritage based on CNN and wireless network. First of all, the clothing images of ethnic settlements and ethnic museums are acquired through wireless network transmission, so as to construct an image material library of intangible cultural heritage. Secondly, the CNN algorithm is used to train and optimize the national costume image samples, extract the high-level semantic features of the national costume image, and finally realize the efficient retrieval of the national costume image educational resources. This model lays a good foundation for the informatization of national costumes and contributes to the inheritance and protection of intangible cultural heritage.