bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing veterans' risk for suicidal behaviors: A qualitative study to inform development of the RECLAIM health promotion program
Authors: Shue Sarah , Brosmer Jayme , Matthias Marianne
Published: July 2020

Background: In an effort to reduce the high rate of suicide among post-9/11 veterans, a collaborative team within the Department of Veterans Affairs (VA) has developed a holistic community-based health promotion program designed to facilitate social and self-connectedness. The purpose of this study was to elicit veteran and stakeholder feedback to prepare the program for piloting and implementation.Methods: Focus groups and interviews were conducted with post-9/11 veterans and veteran stakeholders (e.g., VA clinicians) to elicit feedback regarding the health promotion program. Focus groups and interviews were audio-recorded and transcribed. Qualitative thematic analysis identified key themes emerging from the focus groups and interviews.Results: Seven focus groups (3 Veteran groups, 4 stakeholder groups) and 3 interviews (2 Veterans, 1 stakeholder) were conducted with 41 participants (14 veterans, 27 stakeholders). Overall, participants had a positive perception of the program. Thematic analysis revealed shared perspectives that provided insight into 1) enhancing program recruitment and retention, 2) the perceived ability of a health promotion program to provide more holistic, veteran-centered care, and 3) using health promotion programs to help veterans establish structure in their daily lives.Conclusions: Findings indicated an overall acceptance of the program, and participants’ perspectives on how to reduce barriers and enhance facilitators can inform the development of a larger-scale health promotion program that can be tested through future research. While discussion questions were specifically focused on the program in this study, findings can be considered more broadly for the design and implementation of related programs to effectively improve the health and wellness of post-9/11 veterans.
Evaluation of duplicated reference genes for quantitative real-time PCR analysis in genome unknown hexaploid oat (Avena sativa L.)
Authors: Yang Zheng , Wang Kai , Aziz Usman , Zhao Cuizhu , Zhang Meng
Published: July 2020

Background: Oat (Avena sativa L.), a hexaploid crop with unknown genome, has valuable nutritional, medicinal and pharmaceutical uses. However, no suitable RGs (reference genes) for qPCR (quantitative real-time PCR) has been documented for oat yet. Single-copy gene is often selected as RG, which is challengeable or impactable in unexplored polyploids.Results: In this study, eleven candidate RGs, including four duplicated genes, were selected from oat transcriptome. The stability and the optimal combination of these candidate RGs were assessed in 18 oat samples by using four statistical algorithms including the ΔCt method, geNorm, NormFinder and BestKeeper. The most stable RGs for “all samples”, “shoots and roots of seedlings”, “developing seeds” and “developing endosperms” were EIF4A (Eukaryotic initiation factor 4A-3), UBC21 (Ubiquitin-Conjugating Enzyme 21), EP (Expressed protein) and EIF4A respectively. Among these RGs, UBC21 was a four-copy duplicated gene. The reliability was validated by the expression patterns of four various genes normalized to the most and the least stable RGs in different sample sets.Conclusions: Results provide a proof of concept that the duplicated RG is feasible for qPCR in polyploids. To our knowledge, this study is the first systematic research on the optimal RGs for accurate qPCR normalization of gene expression in different organs and tissues of oat.
Perspectives and practices of health workers around diagnosis of paediatric tuberculosis in hospitals in a resource-poor setting – modern diagnostics meet age-old challenges
Authors: Oliwa Jacquie Narotso , Odero Sabina Adhiambo , Nzinga Jacinta , Hensbroek Michaël Boele van , Jones Caroline , English Mike , Hoog Anja van't
Published: July 2020

Background Detection of tuberculosis (TB) in children in Kenya is sub-optimal. Xpert MTB/RIF® assay (Xpert®) has the potential to improve speed of TB diagnosis due to its sensitivity and fast turnaround for results. Significant effort and resources have been put into making the machines widely available in Kenya, but use remains low, especially in children. We set out to explore the reasons for the under-detection of TB and underuse of Xpert® in children, identifying challenges that may be relevant to other newer diagnostics in similar settings.Methods This was an exploratory qualitative study with an embedded case study approach. Data collection involved semi-structured interviews; small-group discussions; key informant interviews; observations of TB trainings, sensitisation meetings, policy meetings, hospital practices; desk review of guidelines, job aides and policy documents. The Capability, Opportunity and Motivation (COM-B) framework was used to interpret emerging themes. Results At individual level, knowledge, skill, competence and experience, as well as beliefs and fears impacted on capability (physical & psychological) as well as motivation (reflective) to diagnose TB in children and use diagnostic tests. Hospital level influencers included hospital norms, processes, patient flows and resources which affected how individual health workers attempted to diagnose TB in children by impacting on their capability (physical & psychological), motivation (reflective & automatic) and opportunity (physical & social). At the wider system level, community practices and beliefs, and implementation of TB programme directives impacted some of the decisions that health workers made through capability (psychological), motivation (reflective & automatic) and opportunity (physical). Conclusion We used comprehensive approaches to identify influencers of TB case detection and use of TB diagnostic tests in children in Kenya. These results are being used to design a contextually-appropriate intervention to improve TB diagnosis, which may be relevant to similar low-resource, high TB burden countries and can be feasibly implemented by the National TB programme.
Antibiotics prescription for febrile outpatients: a health facility-based secondary data analysis for the Greater Accra region of Ghana
Authors: Opoku Michael Mireku , Bonful Harriet Affran , Koram Kwadwo A.
Published: July 2020

Background: Misguided prescription of antibiotics is an important contributor towards the emergence and spread of antibiotic resistance. The absence of effective interventions to control antibiotic use leads to increased consumption beyond the needed requirements. Antibiotic stewardship interventions must be appropriately targeted and assessed to enhance the controlled use of antibiotics. The objective of this study was to determine the factors associated with antibiotic prescription to febrile outpatients who seek care in health facilities within the Greater Accra region of Ghana.Methods: Secondary data obtained from the medical records of 2,519 febrile outpatients, consecutively sampled at the outpatient department of 6 health facilities in 3 municipalities during the baseline survey of a quasi-experiment in 2016 was used. The primary outcome was prescription of any antibiotic. Independent variables included patients’ demographics, symptoms, laboratory investigations (blood film microscopy, malaria rapid diagnostic test, full blood count, urine and stool routine examinations), diagnoses, and prescribers’ demographics. Crude and adjusted logistic regression analyses were used to determine the factors associated with antibiotic prescription. Results: The prevalence of antibiotic prescription was 70.1% (95% CI: 67.7-72.4). Prescribers with more years of practice (>5years) were more likely to prescribe antibiotics compared to those with less than 3 years of practice (p < 0.001). Integrated Management of Neonatal and Childhood Illnesses (IMNCI) training was associated with a 2.3 (95% CI: 1.54, 3.53, p < 0.001) folds odds of antibiotic prescribing. Patients aged 5 years or more were 60% less likely to receive antibiotics compared with those under 5 years (AOR=0.40, 95% CI: 0.32, 0.51; p<0.001). Patients referred for laboratory investigations were 29% less likely to be prescribed for antibiotics than those not referred. The presence of cough as a presenting symptom was associated with a 3.5 (95% CI: 2.54, 4.92) fold odds of antibiotic prescription. Conclusion: Prescription of antibiotics to febrile outpatients was high. Promoting laboratory testing can potentially reduce irrational antibiotics prescribing. Prescribing antibiotics for children under five and the prescribing practices of prescribers with longer years of practice should be targeted with interventions to reduce high use of antibiotics.
An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi
Authors: Kayuni Sekeleghe , O’Ferrall Angus M. , Baxter Hamish , Hesketh Josie , Mainga Bright , Lally David , Al-Harbi Mohammad H. , LaCourse E. James , Juziwelo Lazarus , Musaya Janelisa , Makaula Peter , Stothard John Russell
Published: July 2020

Background: Intestinal schistosomiasis was not considered endemic in Lake Malawi until November 2017 when populations of Biomphalaria pfeifferi were first reported; in May 2018, emergence of intestinal schistosomiasis was confirmed. This emergence was in spite of ongoing control of urogenital schistosomiasis by preventive chemotherapy. Our current study sought to ascertain whether intestinal schistosomiasis is transitioning from emergence to outbreak, to judge if stepped-up control interventions are needed.Methods: During late-May 2019, three cross-sectional surveys of primary school children for schistosomiasis were conducted using a combination of rapid diagnostic tests, parasitological examinations and applied morbidity-markers; 1) schistosomiasis dynamics were assessed at Samama (n = 80) and Mchoka (n = 80) schools, where Schistosoma mansoni was first reported, 2) occurrence of S. mansoni was investigated at two non-sampled schools, Mangochi Orphan Education and Training (MOET) (n = 60) and Koche (n = 60) schools, where B. pfeifferi was nearby, and 3) rapid mapping of schistosomiasis, and B. pfeifferi, conducted across a further 8 shoreline schools (n = 240). After data collection, univariate analyses and Chi-square testing were performed, followed by binary logistic regression using generalized linear models, to investigate epidemiological associations.Results: In total, 520 children from 12 lakeshore primary schools were examined, mean prevalence of S. mansoni by ‘positive’ urine circulating cathodic antigen (CCA)-dipsticks was 31.5% (95% Confidence Interval (CI): 27.5–35.5). Upon comparisons of infection prevalence in May 2018, significant increases at Samama (Relative Risk (RR) = 1.7, 95% CI: 1.4–2.2) and Mchoka (RR = 2.7, 95% CI: 1.7–4.3) schools were observed. Intestinal schistosomiasis was confirmed at MOET (18.3%) and Koche (35.0%) schools, and in all rapid mapping schools, ranging from 10.0% to 56.7%. Several populations of B. pfeifferi were confirmed, with two new eastern shoreline locations noted. Mean prevalence of urogenital schistosomiasis was 24.0% (95% CI: 20.3–27.7). Conclusions: We notify that intestinal schistosomiasis, once considered non-endemic in Lake Malawi, is now transitioning from emergence to outbreak. Once control interventions can resume after coronavirus disease 2019 (COVID-19) suspensions, we recommend stepped-up preventive chemotherapy, with increased community-access to treatments, alongside renewed efforts in appropriate environmental control.
Concurrent ipsilateral Tillaux fracture and medial malleolar fracture in adolescents: management and outcome
Authors: yuan quanwen , Guo Zhixiong , Wang Xiaodong , Dai Jin , Zhang Fuyong , Fang Jianfeng , Yin Chunhua , Yu Wentao , Zhen Yunfang
Published: July 2020

Background: The concurrent ipsilateral Tillaux fracture with medial malleolar fracture in adolescents commonly suffer from high-energy injury, making treatment more difficult. The aim of this study was to discuss the mechanism on injury, diagnosis and treatment of this complex fracture pattern. Methods: The charts and radiographs of six patients were reviewed. The function was assessed by the American Orthopedic Foot and Ankle Society ankle-hindfoot scores. Results: The mean age at operation was 12.8 years. The mean interval from injury to operation was 7.7 days. Five Tillaux fractures and all medial malleolar fractures were shown on AP plain radiographs. One Tillaux fracture and two cases with avulsion of posterolateral tibial aspect were confirmed in axial computerized tomography. Talar subluxation laterally with medial space widening in three, and syndesmotic disruption in one. There were five patients sustaining ipsilateral distal fibular fractures. All fractures, except nonunion in two medial malleolar fractures and in one Tillaux fracture, healed within 6-8 weeks. There was one case of osteoarthritis of ankle joint. The average AOFAS score was 88.7. Conclusions: Computerized tomography is helpful in identifying the fracture pattern. Anatomic reduction and internal fixation of Tillaux and medial malleolar fracture was recommended to restore the articular surface congruity and ankle stability.
Deficiency in Aim2 affects viability and calcification of vascular smooth muscle cells from murine aortas and Angiotensin-II induced aortic aneurysms
Authors: Wortmann Markus , Arshad Muhammad , Hakimi Maani , Böckler Dittmar , Dihlmann Susanne
Published: July 2020

Background: Phenotypic transformation of vascular smooth muscle cells is a key element in vascular remodeling and aortic aneurysm growth. Previously, deletion of several inflammasome components decreased formation of aortic aneurysm (AA) in the Angiotensin II (AngII) -induced mouse model. We hypothesized that the inflammasome sensor Absent in melanoma 2 (Aim2) might affect the phenotype of vascular smooth muscle cells (VSMC), thereby reducing AA formation.

Methods : Aim2-/- mice and wild-type (WT) C57Bl/6J mice were used as an animal model. VSMC were isolated from 6 months old mice and grown in vitro . Young (passage 3-5) and senescent (passage 7-12) cells were analyzed in vitro for calcification in mineralization medium by Alizarin Red S staining. Expression of calcification and inflammatory markers were studied by real-time RT-PCR and Western blotting, release of cytokines was determined by ELISA. To induce AA, osmotic mini-pumps loaded with AngII (1500 ng/kg bodyweight/min) were implanted for 28 days in male mice at 6 months of age.

Results : Compared with VSMC from WT mice, VSMC isolated from Aim2-/- mice were larger, less viable, and underwent stronger calcification in mineralization medium, along with induction of Bmp4 and repression of Tnfsf11/Rankl gene expression. In addition, Aim2 deficiency was associated with reduced inflammasome gene expression and release of Interleukin-6. Using the mouse model of AngII induced AA, Aim2 deficiency reduced AA incidence to 48.4% (15/31) in Aim2-/- mice versus 76.5% (13/17) in WT mice. In contrast to Aim2-/- mice, AA from WT mice expressed significantly increased levels of alpha-smooth muscle actin/ Acta2 , indicating tissue remodeling. Reduced cell proliferation in Aim2-/- mice was indicated by significantly increased p16ink4a/ Cdkn2a expression in untreated and AngII-infused aortas, and by significantly lower amounts of proliferating (Ki67 positive) VSMC in AngII-infused Aim2-/- mice.

Conclusions: Our results suggest a role for Aim2 in regulating VSMC proliferation and transition to an osteoblast-like or osteoclast-like phenotype, thereby modulating the response of VSMC in aortic remodeling and AA Formation.
Fermented Astragalus in diet improved laying performance, egg quality, antioxidant and immunological status and intestinal microbiota in laying hens
Authors: Shi Hongtao , Wang Baiyu , Bian Chuanzhou , Han Yingqian , Qiao Hongxing
Published: July 2020

In the era of increased antibiotic resistance and ever-stricter control on antibiotic use, it is urgent to develop green, safe, and non-residue alternatives to antibiotics applied to the poultry industry. To this end, we supplied the potential Lactobacillus Plantarum (L. Plantarum) fermented Astragalus in the diet of laying hens, with a final addition of 3‰. Its effects have been assessed on laying performance, egg quality, antioxidant and immunological status, and intestinal microbiota, and are compared to the control group, to the Astragalus group containing 3‰ unfermented Astragalus, and to the L. Plantarum group containing 2% L. Plantarum (5×108 colony-forming unit (CFU) per milliliter (mL)). During the second half of the experimental period (15 to 28 days), the egg production rate was considerably higher in the fermented Astragalus group than that in the other groups, with the fermented Astragalus group having the lowest feed conversion ratio. No significant difference (P>0.05) was noted among treatments on egg quality. Fermented Astragalus-treated hens exhibited significantly increased catalase (CAT), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) in serum, and reduced malondialdehyde (MDA) in serum. Furthermore, fermented Astragalus supplementation resulted in a significant increase in ileal microbiota abundance relative to control. In conclusion, feeding laying hens with L. Plantarum fermented Astragalus has beneficial effects on production, antioxidant potential, immunity, and ileal microbiota. L. Plantarum fermented Astragalus is expected to be a novel feed additive used in poultry production.
Operative invasiveness does not affect the prognosis of patients with non-small cell lung cancer
Authors: Motono Nozomu , Iwai Shun , Iijima Yoshihito , Usuda katsuo , Uramoto Hidetaka
Published: July 2020

Background: The relationship between operative invasiveness and the prognosis in non-small cell lung cancer (NSCLC) patients who have undergone surgery has been controversial.Methods: Clinical data were analyzed for 463 NSCLC patients. Operative invasiveness was defined by wound length, operation time, and the postoperative C-reactive protein (postCRP) level. The operative approach was divided into video-assisted thoracic surgery (VATS) and thoracotomy.Results: The wound length and operation time were significantly correlated with the postCRP level (correlation coefficient (CC) = 0.39, p<0.01; CC = 0.54, p<0.01, respectively). The postCRP level in the VATS group was significantly lower than that in the thoracotomy group (12.2 mg/dl vs 20.58 mg/dl, p<0.01). The relapse-free survival differed significantly based on wound length (p<0.01), operation time (p=0.01), CRP level (p<0.01), and operative approach (p<0.01). The carcinoembryonic antigen level (hazard ratio [HR], 1.58; p = 0.02), pathological stage (pStage) (HR, 2.57; p < 0.01), vascular invasion (HR, 1.95; p = 0.01), and preoperative CRP level (preCRP) (HR, 1.91; p < 0.01) were identified as significant prognostic factors for relapse-free survival in a multivariate analysis. Furthermore, the multivariate analysis showed that smoking history (HR, 2.36; p = 0.03), pStage (HR, 3.26; p < 0.01), and preCRP level were significant prognostic factors for overall survival.Conclusion: Preoperative CRP level was associated with poor prognosis. Although the VATS approach might be less invasive procedure for NSCLC patients, operative invasiveness does not affect the prognosis. Trial registrationThe Institutional Review Boards of Kanazawa Medical University approved the protocol (approval number: I392), and written informed consent was obtained from all of the patients.
Pelvic injury prognosis is more closely related to vascular injury severity than anatomical fracture complexity: The WSES classification for pelvic trauma makes sense
Authors: Wu Yu-Tung , Cheng Chi-Tung , Tee Yu-San , Fu Chih-Yuan , Liao Chien-Hung , Hsieh Chi-Hsun
Published: July 2020

Background: The most common cause of death in cases of pelvic trauma is exsanguination caused by associated injuries, not the pelvic injury itself. For patients with relatively isolated pelvic trauma, the impact of vascular injury severity on outcome remains unclear. We hypothesized that the severity of the pelvic vascular injury plays a more decisive role in outcome than fracture pattern complexity. Methods: Medical records of patients with pelvic fracture at a single center between Jan 2016 and Dec 2017 were retrospectively reviewed. Those with an abbreviated injury scale (AIS) score ≥3 in areas other than the pelvis were excluded. Lateral compression (LC) type 1 fractures and anteroposterior compression (APC) type 1 fractures according to the Young-Burgess classification and ischial fractures were defined as simple pelvic fractures, while other fracture types were considered complicated pelvic fractures. Based on CT, vascular injury severity was defined as minor (fracture with or without hematoma) or severe (hematoma with contrast pooling/extravasation). Patient demographics, clinical parameters, and outcome measures were compared between the groups.Results: Severe vascular injuries occurred in 26 of the 155 patients and were associated with poorer hemodynamics, a higher injury severity score (ISS), more blood transfusions, and a longer ICU stay (3.81 vs. 0.86 days, p=0.000) and total hospital stay (20.7 vs. 10.1 days, p=0.002) compared with minor vascular injuries. By contrast, those with complicated pelvic fractures (LC II/III, APC II/III, vertical shear and combined type fracture) required a similar number of transfusions and had a similar length of ICU stay as those with simple pelvic fractures (LC I, APC I and ischium fracture) but had a longer total hospital stay (13.6 vs. 10.3 days, p=0.034). These findings were similar even if only patients with ISS >=16 were considered.Conclusions: Our results indicate that even in patients with relatively isolated pelvic injuries, vascular injury severity is more closely correlated to outcome than the type of anatomical fracture. Therefore, a more balanced classification of pelvic injury that takes both the fracture pattern and hemodynamic status into consideration, such as the WSES classification, seems to have better utility for clinical practice.Trial registration: This is a retrospective review study, not a clinical trial.
Bioinformatic Analysis Revealing Mitotic Spindle Assembly regulated NDC80 and MAD2L1 as Prognostic Biomarkers in Non-Small Cell Lung Cancer Development
Authors: Wei Rong , Wang Ziyue , Zhang Yaping , Wang Bin , Shen Ningning , E Li , Li Xin , Shang Lifang , Shang Yangwei , Yan Wenpeng , Zhang Xiaoqin , Ma Wenxia , Wang Chen
Published: July 2020

Background Lung cancer has been the leading cause of tumor related death, and 80%~85% of it is non-small cell lung cancer (NSCLC). Even with the rising molecular targeted therapies, for example EGFR, ROS1 and ALK, the treatment is still challenging. The study is to identify credible responsible genes during the development of NSCLC using bioinformatic analysis, developing new prognostic biomarkers and potential gene targets to the disease. Methods Firstly, three genes expression profiles GSE44077, GSE18842 and GSE33532 were picked from Gene Expression Omnibus (GEO) to analyze the genes with different expression level (GDEs) between NSCLC and normal lung samples, and the cellular location, molecular function and the biology pathways the GDEs enriched in were analyzed. Then, gene function modules of GDEs were explored based on the protein-protein interaction network (PPI), and the top module which contains most genes was identified, followed by containing genes annotation and survival analysis. Moreover, multivariate cox regression analysis was performed in addition to the Kaplan meier survival to narrow down the key genes scale. Further, the clinical pathological features of the picked key genes were explored using TCGA data. Results Three GEO profiles shared a total of 664 GDEs, including 232 up-regulated and 432 down-regulated genes. Based on the GDEs PPI network, the top function module containing a total of 69 genes was identified, and 31 of 69 genes were mitotic cell cycle regulation related. And survival analysis of the 31 genes revealed that 17/31 genes statistical significantly related to NSCLC overall survival, including 4 spindle assembly checkpoints, namely NDC80, BUB1B, MAD2L1 and AURKA. Further, multivariate cox regression analysis identified NDC80 and MAD2L1 as independent prognostic indicators in lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC) respectively. Interestingly, pearson correlation analysis indicated strong connection between the four genes NDC80, BUB1B, MAD2L1 and AURKA, and their clinical pathological features were addressed. Conclusions Using bioinformatic analysis of GEO combined with TCGA data, we revealed two independent prognostic indicators in LUAD and LUSC respectively and analyzed their clinical features. However, more detailed experiments and clinical trials are needed to verify their drug targets role in clinical medical use.
Economic Impact of Improving Patient Safety Using Sugammadex for Routine Reversal of Neuromuscular Blockade in Spain
Authors: Martinez-Ubieto Javier , Aragón-Benedí Cristian , de Pedro José María , Cea Luis , Baladron Alberto Morell , Jiang Yiling , Cedillo Sergio , Ramírez-Boix Paula , Pascual-Bellosta Ana
Published: July 2020

Background
Neuromuscular blocking (NMB) agents are often administered to facilitate tracheal intubation and prevent patient movement during surgical procedures requiring the use of general anesthetics. Incomplete reversal of NMB, can lead to residual NMB, which can increase the risk of post-operative pulmonary complications. Sugammadex is indicated to reverse neuromuscular blockade induced by rocuronium or vecuronium in adults. The aim of this study is to estimate the clinical and economic impact of introducing sugammadex to routine reversal of neuromuscular blockade (NMB) with rocuronium in Spain.
Methods
A decision analytic model was constructed reflecting a set of procedures using rocuronium that resulted in moderate or deep NMB at the end of the procedure. Two scenarios were considered for 537,931 procedures using NMB agents in Spain in 2015: a scenario without sugammadex versus a scenario with sugammadex. Comparators included neostigmine (plus glycopyrrolate) and no reversal agent. The total costs for the healthcare system were estimated from the net of costs of reversal agents and overall cost offsets via reduction in postoperative pneumonias and atelectasis for which incidence rates were based on a Spanish real-world evidence (RWE) study. The model time horizon was assumed to be one year. Costs were expressed in 2019 euros (€) and estimated from the perspective of a healthcare system. One-way sensitivity analysis was carried out by varying each parameter included in the model within a range of +/-50%.
Results
The estimated budget impact of the introduction of sugammadex to the routine reversal of neuromuscular blockade in Spanish hospitals was a net saving of €57.1 million annually. An increase in drug acquisition costs was offset by savings in post-operative pulmonary events, including 4,806 post-operative pneumonias and 13,996 cases of atelectasis. The total cost of complications avoided was €70.4 million. All parameters included in the model were tested in sensitivity analysis and were favorable to the scenario with sugammadex.
Conclusions
This economic analysis shows that sugammadex can potentially lead to cost savings for the reversal of rocuronium-induced moderate or profound NMB compared to no reversal or reversal with neostigmine in the Spanish health care setting.
Regulating interfacial chemistry in lithium-ion batteries by a weakly-solvating electrolyte
Authors: Yao Yu-Xing , Chen Xiang , Yan Chong , Zhang Xue-Qiang , Cai Wen-Long , Huang Jia-Qi , Zhang Qiang
Published: July 2020

The performance of lithium-ion battery is highly dependent on its interfacial chemistry, which is regulated by electrolytes. Conventional electrolyte typically contains polar solvents to dissociate Li salts. Here, we report a novel weakly-solvating electrolyte (WSE) that consists of a pure non-polar solvent, which leads to a peculiar solvation structure where ion pairs and aggregates prevail under a low salt concentration of 1.0 M. Importantly, WSE forms unique anion-derived interphases on graphite electrodes that exhibit fast-charging and long-term cycling characteristics. First-principles calculations unravel a general principle that the competitive coordination between anions and solvents to Li ion is the origin of different interfacial chemistries. By bridging the gap between solution thermodynamics and interfacial chemistry in batteries, this work opens a brand-new way towards precise electrolyte engineering for energy storage devices with desired properties.
Flexible and efficient perovskite quantum dot solar cells via hybrid interfacial architecture
Authors: Hu Long , Zhao Qian , Huang Shujuan , Zheng Jianghui , Guan Xinwei , Patterson Robert , Kim Jijun , Shi Lei , Qi Lei , Lin Chun-Ho , Chu Dewei , Wan Tao , Cheong Soshan , Tilley Richard , Ho-Baillie Anita , Luther Joseph , Yuan Jianyu , Wu Tom
Published: July 2020

All-inorganic CsPbI3 perovskite quantum dots (QDs) have received intense research interest for photovoltaic applications because of the recently demonstrated higher power conversion efficiency compared to solar cells using other QD materials. These QD devices also exhibit good mechanical stability amongst various thin-film photovoltaic technologies. In this work, through developing a hybrid interfacial architecture consisting of CsPbI3 QD/PCBM heterojunctions, we report the formation of an energy cascade for efficient charge transfer at both QD heterointerfaces and QD/electron transport layer interfaces. The champion CsPbI3 QD solar cell has a best power conversion efficiency of 15.1%, which is among the highest report to date. Building on this strategy, we demonstrate the very first perovskite QD flexible solar cell with a record efficiency of 12.3%. A detailed morphological characterization reveals that the perovskite QD film can better retain structure integrity than perovskite bulk thin-film under external mechanical stress. This work is the first to demonstrate higher mechanical endurance of QD film compared to bulk thin-film, and highlights the importance of further research on high‐performance and flexible optoelectronic devices using solution-processed QDs.
Runx2 deficiency in osteoblasts promotes myeloma resistance to bortezomib by increasing thrombospondin 1-mediated TGF-ß1 activation and suppression immunity in the bone marrow
Authors: Zhang Chao , Xu Xiaoxuan , Trotter Timothy N. , Gowda Pramod S. , Lu Yun , Suto Mark J. , Javed Amjad , Murphy-Ullrich Joanne E. , Li Juan , Yang Yang
Published: July 2020

The authors have withdrawn this preprint due to author disagreement.
High-dose versus low-dose ergocalciferol for correcting hypovitaminosis D after fragility hip fracture: A randomized controlled trial
Authors: Jarusriwanna Atthakorn , Phusunti Suchat , Chotiyarnwong Pojchong , Unnanuntana Aasis
Published: July 2020

Background: Hypovitaminosis D can be observed in most fragility hip fracture patients. However, measurement of 25-hydroxyvitamin D [25(OH)D] level is costly and may not be available in some centers. Without the baseline 25(OH)D level, the appropriate dose of vitamin D supplementation is not known. The aim of this study was to evaluate the effectiveness and safety of vitamin D supplementation in fragility hip fracture patients compared between high- and low-dose vitamin D supplementation. Methods: A total of 140 patients diagnosed with fragility hip fracture were randomly allocated to either the high-dose (60,000 IU/week) or low-dose (20,000 IU/week) vitamin D2 supplementation group for 12 weeks. The number of patients who achieved sufficient vitamin D level [25(OH)D level > 30 ng/mL], the proportion of patients who developed hypercalcemia, and the functional outcome were compared between groups. Results: Of the 140 patients who were enrolled, 21 patients were lost to follow-up during the study period. The remaining 119 patients (58 and 61 in the high- and low-dose group, respectively) were included in the final analysis. The high-dose group had a higher rate of serum 25(OH)D restoration to sufficient level than the low-dose group (82.8% vs 52.5%, respectively). Approximately 3.4% and 1.6% of patients in the high- and low-dose groups, respectively, had mild hypercalcemia, but none developed moderate, severe, or symptomatic hypercalcemia. There were no differences in functional outcome scores between groups.Conclusions: In treatment settings where baseline serum 25(OH)D level can’t be evaluated, we recommend high-dose vitamin D2 of approximately 60,000 IU/week for 12 weeks, with subsequent switch to a maintenance dose. This regimen effectively restored serum vitamin D to a sufficient level in 82.8% of patients without causing symptomatic hypercalcemia.Trial registration: The protocol of this study was retrospectively registered in the Thai Clinical Trials Registry database no. TCTR20180302007 on 20 February 2018.
Awareness of Coronavirus Disease From Conception to Delivery: Antenatal Mental Journey Breaking Anxiety During Outbreak
Authors: Palalioglu Rabia Merve Erbiyik , Karadeniz Ozan , Aytok Gokce Ipek , Palalioglu Batuhan , Koyan Gizem Nur , Erbiyik Halil Ibrahim , Muhcu Murat
Published: July 2020

Purpose
The objective of this study was to evaluate the psychological impact of the coronavirus disease on women sensitized by pregnancy after the first case was confirmed in Turkey, which has been declared a pandemic by the World Health Organization. This study also intends to help developing preventive measures for pregnants, reducing infection incidence, developing solutions to protect public health, and establishing whether pregnants have sufficient knowledge and awareness to manage this situation.
Methods
This prospective study was conducted at two centers. A total of 529 pregnant women from all three trimesters were given questionnaires that consisted of 51 original questions.
Results
The period when anxiety was highest was the 2nd trimester, whereas women in the 1st trimester had the lowest level of anxiety. High levels of awareness were observed in patients with heart disease, but patients with diabetes mellitus had a high level of anxiety. There was a statistically significant correlation between anxiety and awareness scores of the coronavirus disease.
Conclusion
The treatment and the long-term effects of the coronavirus disease remain unknown. It is important to maintain the mental and physical health of pregnants, who are in a more delicate condition in the society.
Neurological and Clinical Outcomes After In-Hospital Cardiac Arrest Following a New Legislation on Life-Sustaining Treatments
Authors: Jeon Sang-beom , Lee Hyunjo , Park Bobin , Choi Soh Hyun , Hong Yoon-Hee , Kim Won Young , Hong Sang-Bum , Kim Young-Hak
Published: July 2020

Background: The precise neurological profiles after in-hospital cardiac arrest (IHCA) are yet to be elucidated. We aimed to evaluate the neurological profiles of patients with IHCA from early time to long-term follow-up and the changes in their neurological outcomes after implementing legislation on the cessation of life-sustaining treatments.Methods: A national legislation allowing the withdrawal of life-sustaining treatments was implemented in South Korea on February 4, 2018. For this prospective cohort study, we established a neurological rapid response team on March 21, 2017, and serially evaluated the neurological status of patients with IHCA from the initial resuscitation to 12 months after the onset of IHCA. The primary outcome was good neurological status defined as a Clinical Performance Category score (range from 1 to 5, with higher scores indicating greater disability) of 1−2 at 12 months after IHCA. The secondary outcomes were the awakening and neurological recovery during the first week and the survival at 12 months. The outcomes were also compared between before and after the implementation of the legislation.Results: Of 291 adult patients with IHCA, 144 were included in the Before Period, and 147 were included in the After Period. Physician Orders for Life-Sustaining Treatments were made in 63 (42.9%) patients in the After Period. On the first day and during the first week after IHCA, the awakening was achieved in 21.0% and 40.9%, respectively, and neurological recovery in 4.1% and 15.8%, respectively. The proportion of patients with good neurological status at 12 months was not significantly different between the Before Period (19.0%) and the After Period (15.1%; p = 0.37). Awakening (40.0% vs. 42.2%; p = 0.65) and neurological recovery (16.7% vs. 15.0%; p = 0 .69) during the first week as well as survival at 12 months (25.0% vs. 18.4%; p = 0.17) also did not show significant differences between the two periods. Conclusion: Awakening and neurological recovery were remarkable throughout the first week. In the current study, implementating the legislation allowing the cessation of life-sustaining treatments did not significantly affect the neurological and survival outcomes after IHCA. Trial registration: This study was registered in clinical-trial.gov (NCT03006484) in December 2016.
Bayesian Learning of Chemisorption for Bridging Complexities of Electronic Descriptors
Authors: Wang Siwen , Pillai Hemanth , Xin Hongliang
Published: July 2020

Building upon the d-band reactivity theory in surface chemistry and catalysis, we develop a Bayesian learning approach to probing chemisorption processes at atomically tailored metal sites. With representative species, e.g., *O and *OH, the Bayesian model trained with ab initio adsorption properties of transition metals predicts site reactivity at a diverse range of intermetallics and near-surface alloys while naturally providing uncertainty quantification from posterior sampling. More importantly, this conceptual framework sheds light on the orbitalwise nature of chemical bonding at adsorption sites with d-states characteristics ranging from bulk-like semi-elliptic bands to free-atom-like discrete energy levels, bridging complexities of electronic descriptors for the prediction of novel catalytic materials.
Force Generation of the Hallux is More Sensitive to the Ankle and Metatarsophalangeal Joint Angle Than the Lesser Toes
Authors: Saeki Junya , Iwanuma Soichiro , Torii Suguru
Published: July 2020

Background: Because the structure of the hallux is independent of that of the lesser toes and it uses different muscles to move, the force generation characteristics of the hallux could be independent of those of the lesser toes. The purpose of this study is to clarify the torque–angle relationships in the first and second–fifth metatarsophalangeal joints (MTPJs).Methods: Ten healthy young men served as volunteers in this study. The maximal voluntary contraction (MVC) of the plantar-ﬂexion torques of the first and second–fifth MTPJs were measured at 0°, 15°, 30°, and 45° dorsiflexed positions of the MTPJs and 20° plantar-flexed, neutral, and 20° dorsiflexed positions of the ankle. The Friedman test and the Wilcoxon signed-rank test with a Holm correction was used for the ankle and MTPJ angles.Results: When the first MTPJ was 0° to DF30°, the MVC torque of the first MTPJ at DF20° of the ankle was higher than at PF20°of the ankle. On the other hand, no significant difference existed between the MVC torques of the second–fifth MTPJs at any ankle position. When the ankle was in a neutral position, the MVC of the first MTPJ torque increased as the MTPJ was dorsiflexed. However, the MVC torques of the second through fifth MTPJs did not significantly differ for the 15°, 30°, and 45° dorsiflexed positions of the MTPJ.Conclusion: The MVC torque of the first MTPJ is more sensitive to the MTPJ and ankle positions than the second–fifth MTPJs.
Efficacy and safety of tocilizumab in COVID-19 patients: A Meta-Analysis
Authors: Liu Li-Peng , Zong Su-Yu , Li Jun , Zhang Ao-Li , Liu Chao , Guo Ye , Yang Wen-Yu , Chen Xiao-Juan , Zhang Ying-Chi , Zhu Xiao-Fan
Published: July 2020

The therapeutic effect of tocilizumab remains controversial. We aimed to evaluate whether tocilizumab might be beneficial in COVID-19 patients. We searched PubMed, Embase and Cochrane library from inception to June 23, 2020. Summary estimates of overall response rate (ORR) and all-cause death rate in all patients were analyzed. This study was registered with PROSPERO (CRD42020191313). We included data from 28 articles including 991 COVID-19 patients who underwent tocilizumab administration. The pooled ORR was 72% (95% CI, 66-79%) and pooled all-cause death rate was 16% (95% CI, 11-22%). The optimal timing of administration was the 7.15 day from the symptom onset and with the lowest death rate of 13.11%. 562 patients were defined as with severe infection, and the pooled ORR was 78% (95% CI, 70-85%). The pooled ORR of 56 organ transplantation recipients was 53% (95% CI, 26-78%), which was lower than non-transplant patients [75% (95% CI, 69-81%)]. Nearly all studies confirmed the safety of tocilizumab administration. Tocilizumab improves the clinical outcome of COVID-19 patients, especially in severe cases, and the optimal timing of administration may provide the guidance for management. However, tocilizumab may be used with caution in solid transplant recipients for the suboptimal efficacy.
Expanding Enhanced Recovery Protocols for Cardiac Surgery to Include the Patient Voice: a Scoping Review Protocol
Authors: Oravec Nebojša , Arora Rakesh C. , Bjorklund Brian , Gregora April , Monnin Caroline , Duhamel Todd A. , Kent David E. , Schultz Annette S.H. , Chudyk Anna Maria
Published: July 2020

Background
Cardiac surgery is becoming increasingly common in older, more vulnerable adults. A focus on timely and complete medical and functional recovery has led to the development of enhanced recovery protocols (ERPs) for a number of surgical procedures and subspecialties, including cardiac surgery (ERAS® Cardiac). An element that is often overlooked in the development and implementation of ERPs is the involvement of key stakeholder groups, including surgery patients and caregivers (e.g., family and/or friends). The aim of this study is to describe a protocol for a scoping review of cardiac patient and caregiver preferences and outcomes relevant to cardiac surgery ERPs.
Methods
Using Arskey and O’Malley’s six-stage framework for scoping review methodologies with adaptions from Levac et al., a scoping review of existing literature describing patient- and caregiver-identified preferences and outcomes as they relate to care received in the perioperative period of cardiac surgery will be undertaken. The search for relevant articles will be conducted using electronic databases (i.e., the Cochrane Library, Medline, PsycINFO, Scopus, and Embase), as well as through a search of the grey literature (e.g., CPG Infobase, Heart and Stroke Foundation, ProQuest Theses and Dissertations, Google Advanced and Prospero). Published and unpublished full-text articles written in English, published after the year 2000, and that relate to the research question will be included. Central to the design of this scoping review is our collaboration with two patient partners who possess lived experience as cardiac surgery patients.
Discussion
This review will identify strategies that can be integrated into ERPs for cardiac surgery which align with patient- and caregiver-defined values. Broadly, it is our goal to demonstrate the added value of patient engagement in research to aid in the success of system change processes.
Clinical characteristics of neonates with coronavirus disease 2019 (COVID-19): a systematic review﻿
Authors: Hu Yuan , Xiong Jing , Shi Yuan
Published: July 2020

This study aimed to summarize the existing literature on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in newborns to clarify the clinical features and outcomes of neonates with COVID-19. A systematic search was performed in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP databases from January 1, 2019 to April 30, 2020. The references of relevant studies were also searched. A descriptive summary was organized by aspects of clinical presentations (symptoms, laboratory examinations, and imaging) and outcomes. We identified 14 studies reporting 18 newborns with COVID-19. The most common clinical manifestations were fever (62.5%), shortness of breath (50.0%), diarrhea/vomiting/feeding intolerance(43.8%), cough (37.5%), dyspnea (25.0%), and nasal congestion/runny nose/sneeze(25.0%). Atypical symptoms included jaundice and convulsion. Lymphocyte numbers decreased in 5 cases, and radiographic findings were likely to show pneumonia. All newborns recovered and discharged from the hospital, and there was no death.Conclusion: Clinical symptoms of neonatal SARS-CoV-2 infection are atypical, most of them are mild. Up to now, the prognosis of newborns is good, and there is no death. Intrauterine vertical transmission is possible, but confirmed evidence is still lacking. The Long-term follow-up of potential influences of SARS-CoV-2 infection on neonates need further exploration.
A Comparative Analysis of Strategic Planning Based on a Systems Engineering Approach
Authors: Souza Andrade Herlandí , Loureiro Geilson
Published: July 2020

Strategic planning is an organizational process, the purpose of which is to conceive, formulate and manage the strategies implementation in the enterprise. The implementation of strategic planning involves the implementation of a set of actions aimed at taking the organization from a known position to a more desirable position, creating sustainable competitive advantages. This study deals with substantiating the role and importance of organizational strategic planning in the development of the organization using a systems approach. Systems engineering consists of a multidisciplinary and collaborative engineering approach, the purpose of which is to derive, develop and verify the effectiveness of decisions or the functioning of the system throughout its life cycle to satisfy the needs, expectations and desires of stakeholders. The purpose of this article is critically to analyze the Andrade method by comparing the processes and tools used in this method with those obtained as a result of traditional strategic planning. The methods were compared by developing a case study conducted in a science, technology and innovation institution operating in Brazil and annually conducting strategic planning cycles, using traditional methodologies for managing and analyzing the effectiveness of the organization and defining strategies for its development. The paper using the engineering system, carries out the comparison of the applied phases and tools with the offers in the model. The obtained results prove disadvantages of the traditional strategic planning process in comparison with the model proposed by Andrade. The application of the proposed model would allow to obtain indicators, different from the results of traditional strategic planning, in terms of forming another set of strategies and tools to manage the organization’s development. The paper concludes that the model proposed by Andrade is more complex than the traditional one. It indicates the expediency of organizations using other tools to analyze and formulate company development strategies in the context of strengthening their competitive advantages and achieving strategic goals. Keywords: Strategy, Strategic Planning, Strategic Planning Model, Strategic Management, Systems Engineering.