bluuebunny/crossref_metadata_2025 huggingface dataset:
The erosion of ambiguity tolerance and sustainment of perfectionism in undergraduate Medical training: A study of clerkship training effects.
Authors: Ndoja Silvio , Chahine Saad , Saklofske Donald H. , Lanting Brent
Published: May 2020

Background: Medicine is a field that is simultaneously factual and ambiguous. While studies have examined medical trainees’ tolerance of ambiguity (TOA), the extent to which TOA is affected by clinical experiences and its association with perfectionism is unknown. Methods: This was a multiple sampling, single cohort study of students in their first year of clinical clerkship which is comprised of 6 core rotations. Consenting students completed an online anonymous survey assessing their tolerance of ambiguity (TOA) and perfectionism in their first (pre) and last (post) 12 weeks of their clinical clerkship year. Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) and The Big Three perfectionism scale-short form (BTPS-SF) were used to assess TOA and perfectionism respectively. Pre-Post mean comparisons of TOA and perfectionism were assessed via t-tests. Results: From a total possible sample of 174 clinical clerkship students, 51 students responded to pre-survey, 62 responded to post-survey. Clerkship was associated with a significant decrease in TOA (p=0.00) with mean pre-TOA scores of 59.57 and post TOA of 43.8. Perfectionism scores were not significantly different over time (p>0.05). There was a moderate inverse correlation between TOA and perfectionism before clerkship (r=0.32) that increased slightly after clerkship (r=0.39). Those preferring primary care specialties had significantly lower rigid and total perfectionism scores in pre-clerkship than those choosing other specialties, but this difference was not found post-clerkship. Conclusion: We hypothesize that the decrease in TOA seen in this study may reflect an underlying anxiety cycle related to frequent rotation changes. Implications of the role of perfectionism and primary care is discussed. Overall these results require further investigation to better characterize the role of clinical exposure on TOA.
Pseudoscorpion Wolbachia symbionts: Diversity and Evidence for a New Supergroup S
Authors: Lefoulon Emilie , Clark Travis , Borveto Fanni , Perriat-Sanguinet Marco , Moulia Catherine , Slatko Barton , Gavotte Laurent
Published: May 2020

Background Wolbachia are the most widely spread endosymbiotic bacteria, present in a wide variety of insects and two families of nematodes, but as of now, relatively little genomic data has been available. The Wolbachia symbiont can be parasitic, as described for many arthropod systems, an obligate mutualist, as in filarial nematodes or a combination of both in some organisms. They are currently classified into 16 monophyletic lineage groups ("supergroups"). Although the nature of these symbioses remains largely unknown, expanded Wolbachia genomic data will contribute to understanding their diverse symbiotic mechanisms and evolution. Results This report focuses on Wolbachia infections in three pseudoscorpion species infected by two distinct groups of Wolbachia strains , based upon multi-locus phylogenies. Geogarypus minor harbours w Gmin and Chthonius ischnocheles harbours w Cisc, both closely related to supergroup H, while Atemnus politus harbours w Apol, a member of a novel supergroup S along with Wolbachia from the pseudoscorpion Cordylochernes scorpioides ( w Csco), most closely related to Wolbachia supergroups C and F. Using target enrichment by hybridization with Wolbachia -specific biotinylated probes to capture large fragments of Wolbachia DNA, we produced two draft genomes of w Apol. Annotation of w Apol highlights presence of a biotin operon, which is incomplete in many sequenced Wolbachia genomes. Conclusions The present study highlights at least two symbiont acquisition events among pseudoscorpion species. Phylogenomic analysis indicates that the Wolbachia from Atemnus politus ( w Apol), forms a separate supergroup ("S") with the Wolbachia from Cordylochernes scorpioides (w Csco). Interestingly, the biotin operon, present in w Apol, appears to have been horizontally transferred multiple times along Wolbachia evolutionary history.
Genome-wide association studies of ionomic and agronomic traits in USDA mini core collection of rice and comparative analyses of different mapping methods
Authors: Liu Shuai , Zhong Hua , Meng Xiaoxi , Sun Tong , Li Yangsheng , Pinson Shannon R. M. , Chang Sam , Peng Zhaohua
Published: May 2020

Background: Rice is an important human staple food vulnerable to heavy metal contamination due to its unique physiology and growth environment. High yield with low heavy metal contamination is a common but highly challenging goal for rice breeders worldwide due to lack of genetic knowledge. To identify candidate QTLs for rice yield and heavy metal content, sixteen ionomic traits and thirteen agronomic traits of the USDA Rice mini-core collection were analyzed using both univariate and multivariate GWAS methods in this study. The USDA Rice Mini-Core Collection contains about 1% of the whole Rice Collection of the National Small Grains Collection (NSGC), USA.Results: Using the p-value <1.53×10-8, this criterium p-value was determined by the Bonferroni correction for p-value of 0.05, 106, 47, and 97 QTLs were identified for ionomics in flooded environment, unflooded environment, and agronomic traits, respectively. A large number of QTLs coincide well with previous report results while many of the QTLs are new QTLs, suggesting the efficiency of GWAS methods and the reliability of this study. Our results further showed that each of the four GWAS methods can identify unique as well as common QTLs. When univariate methods failed to identify QTLs for a trait, the multivariate methods frequently detected QTLs. However, when many QTLs were detected by univariate methods, the number of QTLs detected by multivariate methods were reduced in many cases. These analyses suggest that using multiple GWAS methods can complement each other in QTL identification. In addition, several candidate genes involved in ionomic and agronomic traits control were identified by analyzing the sequences of the candidate QTL regions.Conclusions: Significant QTLs for heavy metal, mineral, and agronomic traits are presented in the rice genome and some of them have been fine mapped in the rice genome in this study. This research provides novel insights into the genetic basis of both ionomic and agronomic variations in rice, establishing an important foundation for further studies on reducing heavy-metal contamination and improving crop yields. In addition, the comparison analysis of the GAWS methods showed that each method has unique feature and different method can complement each other.
Development of a convenient detection method for Trichomonas vaginalis based on loop-mediated isothermal amplification targeting adhesion protein 65
Authors: Li Yuhua , Wang Shuai , Li Haoran , Song Xiaoxiao , Zhang Hao , Duan Yujuan , Luo Chengyang , Wang Bingli , Ji Sifan , Xie Qing , Zhang Zhenchao
Published: May 2020

Background: Trichomoniasis resulting from Trichomonas vaginalis (T. vaginalis) has been considered as a commonly seen disease with the transmission way of sex. At present, the detection methods of T. vaginalis mainly include wet mount microscopy, culture, PCR, immunofluorescence and ELISA. However, all of these detection methods exist shortcomings. Methods: In this study, a loop-mediated isothermal amplification (LAMP) assay that targeted the species-specific sequence of adhesion protein 65 (AP65) gene had been conducted to detect T. vaginalis. The optimum reaction system and conditions were optimized in this rapid detection method. Results: The results of sensitivity analysis showed that the LAMP assay targeting the AP65 gene was 1000 times more sensitive than the nested PCR targeting the actin gene commonly used for detection of T. vaginalis, and the detecting limitation of the former was 10 trichomonad. Moreover, the amplification of the target gene AP65 by LAMP assay exhibited high specificity and the product was exclusively from T. vaginalis. The detection technique of LAMP did not exhibit cross-reactivity with the common pathogens of Trichinella spiralis, Toxoplasma gondii, Escherichia coli, Candida albicans, Staphylococcus aureus, Haemophilus. Conclusions: According to the present study, the LAMP assay with the target of AP65 gene, was suitable for the early diagnosis of T. vaginalis infections. Consequently, the LAMP assay was proposed by the current study as a point-of-care examination and an alternative molecular tool which exhibited the potential value in the treatment, control and prevention of trichomoniasis transmission and relevant complication.
A Novel RP-HPLC-DAD Method Development for Anti-Malarial and COVID-19 Hydroxy Chloroquine Sulfate Tablets and Profiling of In-Vitro Dissolution in Multimedia.
Authors: DONGALA THIRUPATHI , Ettaboina Santhosh Kumar , Katari Naresh Kumar
Published: May 2020

Hydroxychloroquine sulfate is one of a large series of 4-aminoquinolines with antimalarial activity. Moreover, it is used for the treatment of rheumatoid arthritis. Sometimes Hydroxychloroquine sulfate is very effective for the treatment of autoimmune diseases. Based on the recent clinical experiments it is exploiting for the treatment of COVID-19, corona virus across the globe. A Reverse phase RP-HPLC method have been developed and validated as per the current ICH guidelines for estimation of Hydroxychloroquine sulfate tablets. As part of method validation specificity, linearity, precision and recovery parameters were verified. The concentration and area relationships were linear (R2 > 0.999), over the concentration range of 25 to 300 µg mL-1 for HCQ. The relative standard deviations for precision and intermediate precision were less than 1.5%. The proposed RP-HPLC generic method was applied successfully for evaluation of invitro dissolution profile with different pH conditions like 0.1N HCl, pH 4.5 Acetate buffer and pH 6.8 Phosphate buffers of US marketed reference product.
Clinical significance of circulating tumor cells and metabolic signatures in lung cancer after surgical removal
Authors: Yang Dawei , Yang Xiaofang , Li Yang , Zhao Peige , Fu Rao , Ren Tianying , Hu Ping , Wu Yaping , Yang Hongjun , Guo Na
Published: May 2020

Background: Lung cancer (LC) remains the deadliest form of cancer globally. While surgery remains the optimal treatment strategy for individuals with early-stage LC, what the metabolic consequences are of such surgical intervention remains uncertain. Methods: Negative enrichment-fluorescence in situ hybridization (NE-FISH) was used in an effort to detect circulating tumor cells (CTCs) in pre- and post-surgery peripheral blood samples from 51 LC patients. In addition, targeted metabolomics analyses, multivariate statistical analyses, and pathway analyses were used to explore surgery-associated metabolic changes. Results: LC patients had significantly higher CTC counts relative to healthy controls with 66.67% of LC patients having at least 1 detected CTC before surgery. CTC counts were associated with clinical outcomes following surgery. In a targeted metabolomics analysis, we detected 34 amino acids, 147 lipids, and 24 fatty acids. When comparing LC patients before and after surgery to control patients, metabolic shifts were detected via PLS-DA and pathway analysis. Further surgery-associated metabolic changes were identified when comparing LA (LC patients after surgery) and LB (LC patients before surgery) groups. We identified SM 42:4, Ser, Sar, Gln, and LPC 18:0 for inclusion in a biomarker panel for early-stage LC detection based upon an AUC of 0.965 (95% CI = 0.900–1.000). This analysis revealed that SM 42:2, SM 35:1, PC (16:0/14:0), PC (14:0/16:1), Cer (d18:1/24:1), and SM 38:3 may offer diagnostic and prognostic benefits in LC. Conclusions: These findings suggest that CTC detection and plasma metabolite profiling may be an effective means of diagnosing early-stage LC and identifying patients at risk for disease recurrence.
Modified Algorithm for Managing Postoperative Osteomyelitis Following Fracture Fixation with Cierny-Mader Type
Authors: Tan Yanbin , Li Hang , Pan Zhijun , Zheng Qiang
Published: May 2020

Background: No standardized protocol has been suggested in the treatment of postoperative osteomyelitis following fracture fixation. Our team evaluates the clinical efficacy of the modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny-Mader type. Methods: 95wounds were reviewed from March 2009 to February 2016 in our hospital. 61 wounds were treated by the modified algorithm as following： Stable hardware + bone not healed Cierny–Mader 1 type = remove hardware, temporary stabilize; Stable hardware + bone not healed Cierny–Mader 2 type = retain hardware ; Stable hardware + bone not healed Cierny–Mader for type 3 and type 4 = remove hardware, temporary stabilize/ Ilizarov technique; Unstable hardware + bone not healed = remove hardware, temporary stabilize/ Ilizarov technique; Stable hardware + bone healed = remove hardware. 34 wounds were treated by the conventional algorithm. Autodermoplasty, flap transfer, myocutaneous flap and other methods including antibiotic irrigation and drug delivery system were used in wound repair.Results: The patients treated with modified algorithm had a significantly reduced recurrence (P＜0.01) , and increased results of negative bacterial cultures (P＜0.01), but however observed a decrease in the number of retained hardware cases (P＜0.05) . For those treated with tissue reconstruction, there was no significantly (P＞0.05) comparing with the conventional group. Conclusions: The modified algorithm for the postoperative osteomyelitis following fracture fixation according to the stability of the hardware and Cierny-Mader type represent a good clinical efficacy in the management of postoperative osteomyelitis. This procedure is simple and shows promising results, more clinical evidence is needed to confirm the existing findings and optimize the treatment of postoperative osteomyelitis following fracture fixation.
The prevalence and risk factors of work-related musculoskeletal disorders among adults in Ethiopia: a systematic review protocol
Authors: Gebreyesus Tsiwaye , Nigussie Kalkidan , Getnet Moges Gashaw , Janakiraman Balamurugan
Published: May 2020

Background: Work-related musculoskeletal disorders imposes a significant and most often underappreciated burden to the individual, nation, healthcare system, and society as a whole. A preliminary literature search suggests that there are at present no reliable estimates on the total prevalence of work-related musculoskeletal disorders in Ethiopia. Further, in Ethiopia, the cloud of infectious and other non-communicable diseases has led to a lack of attention towards work-related musculoskeletal disorders, empirical under-representation, and possible human capital loss. The objective of this protocol is to present a transparent process for how to review the existing literature on the prevalence rates and determinant factors of work-related musculoskeletal disorders in Ethiopia.Method: The proposed methodology is based on Preferred Reporting Systematic Reviews and Protocols (PRISMA-P) statements on the conduct of systematic review and meta-analysis and the MOOSE guidelines for Meta-analysis and Systematic Reviews of Observational Studies. The electronic databases MEDLINE, PubMed, CINAHL, Science Direct index, SCOPUS, PEDro, PsyINFO, Embase, Ebsco, and Google Scholar will be systematically searched. Besides, the grey literature resources such as databases or websites of dissertations and theses will be searched. The reference list of screened articles will also be hand searched. All observational studies reporting on the prevalence of work-related musculoskeletal pain of any bodily region among adult Ethiopians will be included. Random and quality effects models will be used to calculate pooled prevalence with a 95 % confidence interval. Subgroup and sensitivity analyses will be performed. Publication bias and heterogeneity between the included studies will also be assessed and reported.Discussion: The proposed systematic review and meta-analysis will provide valid insight into the pooled prevalence of multi-regional work-related musculoskeletal pain and factors associated. The consensus of data from this review will surely help the policymakers in occupational health and health care sectors in identifying priority areas for interventions in work-related musculoskeletal disorders and will also serve as a baseline for the decision-making processes of musculoskeletal health promotion, work exposure implementations, and prevention programs in workplaces.
Three-dimensional printing technology for localised thoracoscopic segmental resection for lung cancer
Authors: Chen Yangming , Zhang Jiguang , Chen Qianshun , Li Tian , Chen Kai , Yu Qinghua , Lin Xing
Published: May 2020

Background
Three-dimensional (3D) CT reconstruction technology has gained increasing attention owing to its potential in locating ground glass nodules in the lung. The 3D printing technology additionally allows visualising the surrounding anatomical structure and variations. However, the clinical utility of these techniques is not known. We aimed to establish a lung tumour and an anatomical lung model using three-dimensional (3D) printing and 3D chest computed tomography (CT) reconstruction and to evaluate the clinical potential of 3D printing technology in uniportal video-assisted thoracoscopic segmentectomy.
Methods
Eighty-nine patients with ground glass nodules who underwent uniportal video-assisted thoracoscopic segmentectomy were divided into the following groups: Group A, lung models for pre-positioning and simulated surgery that were made with 3D chest CT reconstruction and 3D printing; Group B, patients who underwent chest CT scans with image enhancement for 3D reconstruction. The differences in the surgery approach transfer rate, surgical method conversion rate, operative time, intraoperative blood loss, and postoperative complication rate were compared between the groups.
Results
The surgery approach transfer rate was 0% and 10.5% for Groups A and B, respectively, showing a significant difference (p = 0.030). The operative time was 2.07 ± 0.24 hours and 2.55 ± 0.41 hours, respectively, showing a significant difference (p<༜0.001). Intraoperative blood loss volume was 43.25 ± 13.63 and 96.68 ± 32.82 ml, respectively, showing a significant difference (p<༜0.001). The postoperative complication rate was 3.9% and 13.2%, respectively, showing a non-significant difference (P = 0.132). The rate of surgical method conversion to lobectomy in Group A was 0%, which was significantly lower than that of 10.5% in group B (p < 0.030).
Conclusions
3D printing technology helps surgeons to locate the nodules more accurately, as it is based on 2D and 3D imaging findings, thereby improving the accuracy and safety of surgery. This technique is worth for application in clinical practice.
Trial registration:
Retrospectively registered.
Genetic architecture and genomic selection of female reproduction traits in rainbow trout
Authors: D’Ambrosio Jonathan , Morvezen Romain , Brard-Fudulea Sophie , Bestin Anastasia , Poncet Charles , Haffray Pierrick , Dupont-Nivet Mathilde , Phocas Florence
Published: May 2020

Background
Rainbow trout is a significant fish farming industry under temperate climates. Female reproduction traits play an important role in the economy of breeding companies with the sale of fertilized eggs. The objectives of this study are threefold: to estimate the genetic parameters of female reproduction traits, to determine the genetic architecture of these traits by the identification of quantitative trait loci (QTL), and to assess the expected efficiency of a pedigree-based selection (BLUP) or genomic selection for these traits.
Results
A pedigreed population of 1,343 trout were genotyped for 57,000 SNP markers and phenotyped for seven traits at 2 years of age: spawning date, female body weight before and after spawning, the spawn weight and the egg number of the spawn, the egg average weight and average diameter. Genetic parameters were estimated in multi-trait linear animal models. Heritability estimates were moderate, varying from 0.27 to 0.44. The female body weight was not genetically correlated to any of the reproduction traits. Spawn weight showed strong and favourable genetic correlation with the number of eggs in the spawn and individual egg size traits, but the egg number was uncorrelated to the egg size traits. The genome-wide association studies showed that all traits were very polygenic since less than 10% of the genetic variance was explained by the cumulative effects of the QTLs: for any trait, only 2 to 4 QTLs were detected that explained in-between 1 and 3% of the genetic variance. Genomic selection based on a reference population of only one thousand individuals related to candidates would improve the efficiency of BLUP selection from 16 to 37% depending on traits.
Conclusions
Our genetic parameter estimates made unlikely the hypothesis that selection for growth could induce any indirect improvement for female reproduction traits. It is thus important to consider direct selection for spawn weight for improving egg production traits in rainbow trout breeding programs. Due to the low proportion of genetic variance explained by the few QTLs detected for each reproduction traits, marker assisted selection cannot be effective. However genomic selection would allow significant gains of accuracy compared to pedigree-based selection.
Efficacy of mistletoe extract as a complement to standard treatment in advanced pancreatic cancer: study protocol for a multi-centre, parallel group, double-blind, randomised controlled clinical trial (MISTRAL)
Authors: Wode Kathrin , Nordberg Johanna Hök , Kienle Gunver Sophia , Elander Nils , Bernhardson Britt-Marie , Sunde Berit , Sharp Lena , Henriksson Roger , Fransson Per
Published: May 2020

Background Most pancreatic cancer patients present with advanced stage at diagnosis with extremely short expected survival and few treatment options. A multimodal palliative approach is necessary for symptom relief and optimisation of health-related quality of life. In a recent open-label trial of mistletoe extract for advanced pancreatic cancer patients not eligible for chemotherapy, promising results on improved overall survival and better health-related quality of life were reported. The objective of the present study is to assess the value of mistletoe extract as a complement to standard 18 treatment (palliative chemotherapy or best supportive care) in advanced pancreatic cancer patients with 19 regard to overall survival and health-related quality of life. Methods The trial is prospective, randomised, double-blind, multicentre, parallel group and placebo-controlled. In total 290 participants are randomly assigned to placebo or mistletoe extract given subcutaneously in increasing dosage from 0.01mg to 20mg three times per week for nine months. Stratification is performed for site and palliative chemotherapy. Main inclusion criteria are advanced pancreatic cancer and Eastern Cooperative Oncology Group performance status zero to two; main exclusion criteria are life expectancy less than four weeks and neuroendocrine tumour of the pancreas. Two ancillary studies on sub-sets of participants are nested in the trial: a biomarker study collecting blood samples and a cross-sectional qualitative study with semi-structured face-to-face interviews. Discussion To our knowledge, this is the first placebo-controlled randomised trial assessing the impact of mistletoe extract as a complement to standard treatment on overall survival and health-related quality of life in patients with advanced pancreatic cancer. The presented trial with its two nested ancillary studies exploring biomarkers and patient experiences is expected to give new insights into the treatment of advanced pancreatic cancer. Trial registration EU Clinical Trial Register, EudraCT Number 2014-004552-64. Registered 19 January 2016, https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-004552-64/SE
Risk Factors and clinical features of deterioration of COVID-19 Patients in Zhejiang, China: a single-centered, retrospective study
Authors: Yi Ping , Yang Xiang , Ding Cheng , Chen Yanfei , Xu Kaijin , Ni Qing , Zhao Hong , Li Yongtao , Zhang Xuan , Liu Jun , Sheng Jifang , Li Lanjuan
Published: May 2020

BackgroundA severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection swept through Wuhan and spread across China and overseas from December 2019. To identify predictors associated with disease progression, we evaluate clinical risk factors of exacerbation of SARS-CoV2 infection. Methoda retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019) diagnosed hospitalized cases between January 19, 2019 and February 19, 2020 in Zhejiang, China. We systematically analyzed the clinical characteristics of the patients and predictors of clinical deterioration.Result100 patients with COVID-19 were included, with median age of 54 years. Among them, 49 cases (49%) were severe and critical cases. Age (P=0.0001), gender (P=0.0031), BMI (P=0.0339), hypertension (P<0.0001), IL6 (P=0.0001), IL10 (P<0.0001), T lymphocyte count (P=0.0001), B lymphocyte count (P=0.0001), White blood cell count (P=0.0002), d2 dimer (P=0.005), PCT (P=0.0039), CRP (P<0.0001), AST (P=0.0484) and artificial liver therapy (P=0.0148), glucocorticoid therapy (P<0.0001) were associated with the severity of the disease. Age and overweigh were independent risk factors for disease severity. ConclusionDeterioration among covid-19 infected patients occurred rapidly after hospital admission, it is necessary to pay attention to these patients. In our cohort, we found that several factors resulted in increased severity. Among these factors, Early detection and reversal of these indicators may reduce the progression of the disease. In addition, early treatment with low doses of glucocorticoids and necessary liver therapy may help reduce mortality in critically ill patients.
Consolidating Strategic Information to Monitor Progress Against the UNAIDS 90-90-90 Targets: Evaluating the Operational Feasibility of an Electronic HIV Testing Register in Cape Town, South Africa
Authors: Jacob Nisha , Rice Brian , Kalk Emma , Heekes Alexa , Morgan Jennie , Brinkmann Samantha , Hargreaves James , Orgill Marsha , Boulle Andrew
Published: May 2020

Background: HIV diagnosis in South Africa is based on a point-of-care testing (PoCT) algorithm with paper-based record-keeping. Aggregated testing data are reported routinely. To facilitate improved HIV case-based surveillance, the Western Cape Province implemented a unique pilot intervention to digitise PoCT results, at an individual level, and generate an electronic register using the newly developed Provincial Health Data Centre (PHDC). We describe the intervention (phased) and present an evaluation of the operational feasibility of the intervention. We also offer implementation insights into establishing electronic capture of individual level testing data. Cross-sectional analyses were conducted on records of all patients attending a local Community Health Centre who had an HIV-PoCT during the study period. Data from the intervention were linked to the PHDC using a unique identifier and compared with aggregate data from the paper-based register. Correlation coefficients were calculated to quantify the correlation between the two monthly datasets. To support an understanding of the findings, the Department of Health project management team generated reflections on the implementation process, which were then grouped thematically into implementation lessons.Results: In total, 11 337 PoCT records were digitised (70% (7954) during Phase I; and 30% (3383) during Phase II). Linkage of forms to the PHDC was 96% in Phase I and 98% in Phase II. Comparison with aggregate data showed high correlation during Phase I, but notable divergence during Phase II. Divergence in Phase II was due to stringent data quality requirements and high clinical staff turnover. Factors supporting implementation success in Phase I included direct oversight of data capturing by a manager with clinical and operational insight. Implementation challenges included operational, health system, and high cost-related issues.Conclusions: We demonstrate that rapid digitisation of HIV PoCT data, without compromising currently collected aggregate data, is operationally feasible, and can contribute to person-level longitudinal HIV case-based surveillance. To take to scale, we will need to improve PoCT platforms and clerical and administrative systems. Although we highlight challenges, we demonstrate that electronic HIV testing registers can successfully replace manual registers and improve efforts to monitor and evaluate HIV testing strategies.
Straighter Low Lumbar Curvature in Isthmic Spondylolisthesis at L4
Authors: Zheng Shaoli , Zhong Zhaoming , Zhu Qingan , Li Zongze , Zhu Siyuan , Yao Xinqiang , Zheng Shuai , Liao Congrui , Zhu Yongjian , Chen Jianting
Published: May 2020

BackgroundThis study was conducted to compare differences in imaging features and clinical symptoms between patients with single-level isthmic spondylolisthesis (IS) at L4 and at L5 and to investigate the correlation between imaging and clinical parameters.MethodsThis cross-sectional study evaluated patients with single-level IS who were enrolled between June 2011 and June 2018. A total of 139 patients, 44 in the L4 IS group and 95 in the L5 IS group, met the study criteria and were included. Imaging and clinical parameters obtained from the two groups were compared and analyzed.ResultsPatients in the L4 IS group had smaller lower lumbar lordosis (LLL) (27.1 ± 8.2 vs. 30.9 ± 9.3, P = 0.021) and were of older age (58.5 ± 8.7 vs. 52.8 ± 10.1, P < 0.01) than those in the L5 IS group. As per the Roussouly classification system, most patients with L4 IS were classified as Type 2 (43.2%), whereas most patients with L5 IS fell under Type 3 (44.2%). In the L5 IS group, pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), and L5 incidence (L5I) were positively associated with slippage rate (SR), but the lumbosacral angle (LSA) was negatively associated with SR (P < 0.01). In the L4 IS group, only L5I showed a positive association with SR (P < 0.01). More significant associations were found among sagittal lumbo-pelvic parameters in the L5 IS group, but none were found between SR and Oswestry Disability Index (ODI) in either group.ConclusionsWhen compared with patients with L5 IS, patients with L4 IS were of older age and had straighter low lumbar curvature when they were obviously symptomatic. L5 I can be considered an important predictive factor for spondylolisthesis progression in patients with IS at L4.
Opioid Use Disorder in Pregnancy: Leveraging Provider Perceptions to Inform Medication-Assisted Treatment
Authors: Titus-Glover Doris , Shaya Fadia T , Welsh Christopher , Qato Danya M , Shah Savyasachi , Gressler Laura E , Vivrette Rebecca
Published: May 2020

Background: Medication-assisted treatment is recommended for pregnant women with opioid use disorder (OUD), yet only 50% receive the treatment. Knowledge deficit, limited access to prescribing providers, and complex delivery models are known barriers to treatment. Strategies for improvement of medication-assisted treatment during pregnancy require multi-disciplinary provider input. The objective of this study is to explore provider perceptions and factors critical to medication-assisted treatment delivery for pregnant women with OUD. Methods: A qualitative research approach was used to gather data from individual provider and group semi-structured interviews. Providers ( n =12) responded to questions in several domains related to perceptions of medication-assisted treatment, treatment delivery, access to resources, and challenges/barriers. Data were collected, transcribed, coded (by consensus) and emerging themes were analyzed using grounded theory methodology. Results: Emerging themes in this pilot study, revealed persistent provider knowledge/training gaps, inadequate service coordination, inconsistent treatment guidelines, stigmatization, and lack of resources such as housing and transportation. Providers found medication-assisted treatment offered pregnant women with OUD, a “lifeline.” Conclusions: In this pilot study, we conclude that, MAT variances can be improved by leveraging healthcare provider perceptions, direct experiences and recommendations towards a team-based, patient-centered integrated approach.
Lipoprotein (a) Predicts Recurrent Worse Outcomes in Type 2 Diabetes Mellitus Patients with Prior Cardiovascular Events: A Prospective, Observational Cohort Study
Authors: Zhang Yan , Jin Jing-Lu , Cao Ye-Xuan , Zhang Hui-Wen , Guo Yuan-Lin , Wu Na-Qiong , Zhu Cheng-Gang , Gao Ying , Hua Qi , Li Yan-Fang , Xu Rui-Xia , Li Jian-Jun
Published: May 2020

Background
Merging studies have reported the association of lipoprotein(a) [Lp(a)] with poor outcomes of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). However, the prognostic importance of Lp(a) for recurrent cardiovascular events (CVEs) is currently undetermined in patients with T2DM and prior CVEs.
Methods
From April 2011 to March 2017, we consecutively recruited 2,284 T2DM patients with prior CVEs. Patients were categorized into low, medium, and high groups by Lp(a) levels and followed up for hard, recurrent CVEs, including nonfatal acute myocardial infarction, stroke, and cardiovascular mortality. Caplan-Meier, Cox regression and C-statistic analyses were performed.
Results
During 7,613 patient-years’ follow-up, 153 recurrent CVEs occurred. Lp(a) levels were significantly higher in patients with recurrent CVEs than counterparts (20.44 vs. 14.71 mg/dL, p = 0.002). Kaplan–Meier analysis revealed that the event-free survival rate was dramatically lower in high and medium Lp(a) groups than that in low group irrespective of HBA1c status (< 7.0%; ≥7.0%, both p < 0.05). Furthermore, multivariate Cox regression models indicated that Lp(a) was independently associated with high risk of recurrent CVEs [HR(95% CI): 1.996(1.266–3.148)], such data remains in different HBA1c status (HR(95% CI): <7.0%, 1.914(1.007–3.640); ≥7.0%, 2.174(1.132–4.174)). Moreover, the results of C-statistic were significantly improved by 0.029 when added Lp(a) to the Cox model.
Conclusions
Our data, for the first time, confirmed that Lp(a) was an independent predictor for recurrent CVEs in T2DM patients with prior CVEs, suggesting that Lp(a) measurement may help to further risk stratification for T2DM patients after they suffered a first CVE.
Oral care and oral assessment guide in breast cancer patients receiving everolimus and exemestane: Subanalysis of a randomized controlled trial (Oral Care-BC)
Authors: Umeda Masahiro , Ota Yoshihide , Kashiwabara Kosuke , Hayashi Naoki , Naito Mariko , Yamashita Toshinari , Mukai Hirofumi , Nakatsukasa Katsuhiko , Amemiya Takeshi , Watanabe Ken-ichi , Hata Hironobu , Kikawa Yuichiro , Taniike Naoki , Yamanaka Takashi , Mitsunaga Sachiyo , Nakagami Kazuhiko , Adachi Moriyasu , Kondo Naoto , Shibuya Yasuyuki , Niikura Naoki
Published: May 2020

BackgroundThis randomized, controlled, multicenter, open-label, phase III study was conducted to determine whether professional oral care (POC) reduces oral mucositis in estrogen receptor-positive metastatic breast cancer patients treated with everolimus and exemestane.MethodsOne hundred seventy-four patients were randomized into the POC group (n = 86) or the control group (n = 88). Four patients in the POC group and one patient in the control group were excluded from the study because they did not receive the protocol treatment. Thus, 169 patients (POC group: 82 patients; control group: 87 patients) were evaluated for efficacy and safety. The POC group received oral health instruction (OHI), professional mechanical tooth and tongue cleaning, gargling with a benzethonium chloride mouthwash, and dexamethasone ointment when grade 1 mucositis manifested. The control group received OHI and gargling. Eight weeks after everolimus and exemestane were administered, the patients were evaluated for oral status (based on the Oral Assessment Guide [OAG] criteria) and oral mucositis status (assessed with Common Terminology Criteria for Adverse Events [CTCAE] functional and clinical examinations).ResultsThe incidences of oral mucositis of any grade and severe mucositis of grade 2 were significantly lower in the POC group (p = 0.034 and p = 0.013, respectively), based on the CTCAE functional and CTCAE clinical examinations (p = 0.034 and p < 0.001, respectively). The longitudinal data of the total OAG score (p = 0.012), total OAG grade (p = 0.014), and the longitudinal data of the OAG score of teeth/dentures (p = 0.026) and mucous membranes (p = 0.011) were significantly different between the two groups. The grade of oral mucositis diagnosed with CTCAE functional/clinical examinations was significantly correlated with the OAG grade for swallow (p = 0.04/p < 0.01), lip (p = < 0.01/p < 0.01), teeth/dentures (p = 0.04/p = 0.01), mucous membrane (p < 0.01/p < 0.01), tongue (p < 0.01/p < 0.01), and saliva (p < 0.01/p < 0.01).ConclusionsProfessional oral care may prevent oral mucositis and improve the condition of teeth/dentures in patients receiving everolimus and exemestane treatment.Trial registration:The study protocol was registered on the website of the University Hospital Medical Information Network (Tokyo, Japan; protocol ID 000016109) on January 5, 2015, and was registered on the ClinicalTrials.gov website (ClinicalTrials.gov identifier: NCT02376985) on March 3, 2015.# These authors contributed equally to this work.
Laboratory investigation of earthquake lightning due to landslide
Authors: Enomoto Yuji , Yamabe Tsuneaki , Mizuhara Kazuyuki , Sugiura Shigeki , Kondo Hiroshi
Published: May 2020

Several laboratory experimental studies of photoemission characteristics of rocks as they fracture have been conducted to elucidate the mechanism of earthquake lightning (EQL). In most of these studies, granite, which exhibits remarkable photoemission, is widely used to explain the mechanism attributed to the piezoelectric effect or piezo-induced effect of quartz, a constituent mineral of granite. Photoemission induced by rock fracturing has been observed prominently during landslides caused by earthquakes. According to the literature on historical earthquakes, landslide-induced EQL was witnessed even at locations where quartz was not present. In this study, we therefore studied the physicochemical characteristics of photoemissions associated with impact shear fractures in various rocks, selected based on historical earthquake records of landslide EQL. As a result, we could highlight various physicochemical processes associated with the frictional heating generated during shear impacts between rocks.
Depression and Experience of Incarceration in North Central Nigeria: A Situation Analysis at Makurdi Medium Security Prison
Authors: NWEFOH EMEKA , aguocha chinyere MIRIAN , RYAN GRACE , ODE PHILIP , Ighagbon FESTUS , Akinjola OYEDELE , OMOI SAMUEL , ABDULMALIK JIBRIL , AGBIR TERKURA , OBEKPA OBEKPA , OGBOLE SAMUEL , EATON JULIAN
Published: May 2020

Background: Human rights watchdogs have described conditions in Nigerian correctional facilities and detention centers as damaging to the physical and mental health of inmates. While the prevalence of mental disorders is high, access to appropriate healthcare is grossly inadequate. Understanding the current state of prison inmates’ mental health and well-being is an essential first step to addressing this important issue. This study aims to document the mental health and experiences of incarceration of inmates of the largest medium security prison in Nigeria’s Benue State.Methods: A cross-sectional survey and descriptive analysis was carried out with a random sample of 381 prison inmates of Benue State Makurdi Medium Security Prison. Survey tools included: (1) a structured questionnaire on participants’ experiences in prison, and (2) the Patient Health Questionnaire (PHQ-9), a screening tool for depression. Results: Most participants were young men (95.5%, mean age 27.95) and had completed secondary school (63.5%). While prison authorities had identified only 27 participants as having a mental disorder, 144 (37.8%) screened positive for depression. Twenty six had received professional counseling while in prison. Of the six participants who were already taking a psychotropic medication at the time of imprisonment, four received medication after being imprisoned. Approximately half, (52%) of participants were dissatisfied with prison health care. Conclusions: Despite the high prevalence of depression among prison inmates, few cases are detected and treated. Prison staff may not recognize depression as a mental disorder, and the mental health care available is generally poor. Inadequate mental health and social care not only affects prison inmates’ well-being, but may also impact recidivism and health outcomes upon release. Prison inmates should be screened routinely for depression and other less-commonly recognized mental health conditions, and appropriate treatment made available.
Has the Level of Evidence in Orthopaedic Trauma and Nontrauma Publications Improved? A Publication Review of 3 Major Orthopaedic Journals
Authors: Luksameearunothai Kitchai , Chaudhry Yash Paul , Thamyongkit Sorawut , Jia Xiaofeng , Hasenboehler Erik A.
Published: May 2020

Background

In biomedical research, level of evidence (LOE) indicates the quality of a study. Recent studies evaluating orthopaedic trauma literature between 1998-2013 have indicated that LOE in this field has improved. The objective of this study was to determine the validity of one such study by 1) comparing our results and how they relate to more recent years of publications; and 2) assessing how our findings may be used to estimate future changes.

Methods

A total of 3,449 articles published from 2013 to 2018 in The Journal of Orthopaedic Trauma (JOT); Journal of Bone and Joint Surgery, American Volume (JBJS-Am); and Clinical Orthopaedics and Related Research (CORR) were evaluated for their LOE. Articles published in JBJS-Am or CORR were classified as trauma or nontrauma studies; articles published in JOT were considered trauma studies. Articles were assigned a LOE using guidance published by JBJS-Am in 2015.

Results

The percentage of total high-level (level I or II) trauma and nontrauma articles published in JOT, JBJS-Am, and CORR decreased from 2013 to 2018 (trauma 23.1% to 19.2%, p = 0.190; nontrauma 28.8% to 24.9%, p = 0.037). JBJS-Am published the highest percentage of level-I trauma studies, and CORR published the lowest percentage of level-IV studies. JBJS-Am and CORR published higher percentages of level-I trauma studies and lower percentages of level-IV nontrauma studies than all trauma studies.

Conclusions

Based on our results we cannot validate the findings of previous studies as we found the overall LOE of both trauma and nontrauma orthopaedic literature has decreased in recent years. JBJS-Am published a greater percentage of high-level studies than did JOT and CORR. Although the number and percentage of high-level studies published in JOT increased during the study period, it still lagged behind JBJS-Am and CORR.
Evaluating variability in coseismic slips of paleo-earthquakes using a flight of displaced terraces across the Kamishiro fault, Itoigawa-Shizuoka Tectonic Line, central Japan
Authors: Takahashi Naoya , Toda Shinji
Published: May 2020

Examining the regularity between events during an earthquake slip leads to an understanding of earthquake recurrence and provides the basis for probabilistic seismic hazard assessment. Generally, scientists use systematic analysis of three-dimensional paleoseismic trenches and numerous offset markers along fault zones to study slip history. Flights of displaced terraces have also been used, under the assumption that the number of earthquakes contributing to the observed cumulative slip is known. This study presents a Monte Carlo-based approach to estimating slip variability from a series of displaced terraces when such an assumption cannot be satisfied. First, we mapped fluvial terraces across the Kamishiro Fault, which is an intra-plate reverse fault in central Japan, and systematically measured the cumulative net slip in the mapped terraces. By combining these measurements with the age of the paleoearthquakes, we estimated the amount of net slip for the penultimate event (PE) and antepenultimate event (APE) to be 1.5 ± 0.2 and 2.7 ± 0.4 m, respectively. The APE slip was twice that of the PE slip and 2.5 times larger than the most recent event, the Nagano-ken-hokubu earthquake, and measured 1.2 ± 0.1 m. This suggests that the APE ruptured along the entire length of the 26 km-long Kamishiro Fault or that there were multiple faults involving adjacent segments. As we are unsure how many earthquakes had occurred since the oldest terrace was formed, we assumed three cases based on available paleoseismic records. In each case, we calculated the slip that could reproduce the cumulative slips within a reasonable range of observed terrace offsets and then estimated the coefficient of variation for coseismic slips (COVs) of paleoearthquakes. The resulting COVs typically fell into the range of 0.3 to 0.5, indicating that, over the last few thousand years, the Kamishiro Fault did not regularly behave as it had done before the 2014 event. Instead, there were large variations in the fault’s coseismic slip, as suggested by the global dataset. Although we acknowledge that our approach may be oversimplified, the Monte Carlo-based approach should help assess the regularity of earthquakes from displaced terraces where limited data are available.
Pcgf1 regulates early neural tube development through histone methylation in zebrafish
Authors: Li Xinyue , Ji Guangyu , Zhou Juan , Du Jingyi , Li Xian , Hu Yong , Zhou Wenjuan , hao aijun
Published: May 2020

Objective
Early neural tube development in the embryo includes neural induction and self-renewal of neural stem cells (NSCs). The abnormal of neural tube development could lead to neural tube defects. The research on the mechanism of neural induction is the key to reveal the pathogenesis of the abnormal of neural tube. Though studies have confirmed a genetic component, the responsible mechanisms for the abnormal of neural tube are still largely unknown. Polycomb repressive complex 1 (PRC1) plays an important role in regulating early embryonic development, and has been sub-classified into six major complexes based on the presence of a Pcgf subunit. Pcgf1, as one of six Pcgf paralogs, is an important requirement in early embryonic brain development. Here, we intended to investigate the role and mechanism of Pcgf1 in early neural tube development of zebrafish embryos.
Material and methods
Morpholino (MO) antisense oligonucleotides were used to construct a Pcgf1 loss-of function zebrafish model. We analyzed the phenotype of zebrafish embryos and the expression of related genes in the process of neural induction by in situ hybridization, immunolabelling and RNA-sEq. The regulation of histone modifications on gene was detected by western blot and chromatin immunoprecipitation.
Results
In this study, we found that zebrafish embryos exhibited small head and reduced or even absence of telencephalon after inhibiting the expression of Pcgf1. Moreover, the neural induction process of zebrafish embryos was abnormal, and the subsequent NSCs self-renewal was inhibited under the inhibition of Pcgf1. RNA-seq and gene ontology (GO) analysis identified that the differentially expressed genes were enriched in many functional categories which related to the development phenotype. Finally, our results showed that Pcgf1 regulated the trimethylation of histone H3K27 in the Ngn1 and Otx2 promoter regions, and the levels of H3K4me3 at the promoters of Pou5f3 and Nanog.
Conclusion
Together, our data for the first time demonstrate that Pcgf1 plays an essential role in early neural induction phase through histone methylation in neural tube development. Our findings reveal a critical context-specific function for Pcgf1 in directing PRC1 to control cell fate.