bluuebunny/crossref_metadata_2025 huggingface dataset:
Contrasting Epidemiology and Genetic Variation of Plasmodium vivax Infecting Duffy Negatives across Africa
Authors: Lo Eugenia , Russo Gianluca , Pestana Kareen , Kepple Daniel , Abargero Beka Raya , Dongho Ghyslaine Bruna Djeunang , Gunalan Karthigayan , Miller Louis H , Hamid Muzamil Mahdi Abdel , Yewhalaw Delenasaw , Paganotti Giacomo Maria
Published: December 2020

Recent studies indicated that Plasmodium vivax can infect Duffy-negative individuals, but the varied diagnostic and methodological approaches have limited our ability to characterize P. vivax across Africa. Here, we utilized a standardized approach to compare epidemiological and genetic attributes of P. vivax from Botswana, Ethiopia, and Sudan, where Duffy-positive and Duffy-negative individuals coexist. Among 1,215 febrile patients, the proportions of Duffy negativity range from 20-36% in East Africa to 84% in Southern Africa. Considerable differences were observed in P. vivax prevalence among Duffy-negative populations ranging from averaged 9.2% in Sudan to 86% in Botswana. P. vivax parasite density in Duffy-negative infections is significantly lower than in Duffy-positive infections. Phylogenetic analyses of 229 PvDBP sequences indicated that Duffy-negative P. vivax were not monophyletic but occurred in multiple well-supported clades, suggesting independent origins. Duffy-negative Africans are clearly not resistant to P. vivax and the public health significance should no longer be neglected.
Los Glaciares Pirenaicos
Authors: Sánchez Miravalles Alberto , Cortada Ibáñez Unai , Vasiljević Ratko
Published: December 2020

Las condiciones climáticas actuales están modificando algunos de nuestros hábitats; los glaciares pirenaicos constituyen un enclave único en la península Ibérica, estos se ven afectados y evolucionan rápidamente por la subida de las temperaturas.
Las concepciones sobre el paisaje en la formación inicial del profesorado
Authors: Mateo Girona Maria Rosa
Published: December 2020

El presente trabajo aborda una investigación sobre educación en el paisaje, la cual se ha desarrollado ampliamente a partir del Convenio de Paisaje (2000). Se presenta un estudio de caso, cuyo objetivo ha sido analizar las concepciones sobre el paisaje del alumnado de los Grados de Educación Primaria e Infantil y del Máster Universitario de Formación del Profesorado. Para ello, se ha realizado una prueba inicial en la que el alumnado ha trabajado sobre sus espacios vitales. El análisis se basa en la categorización de los elementos bióticos, abióticos y antrópicos, de esos paisajes. Algunos de los resultados evidencian que los alumnos identifican los paisajes desde su experiencia, y utilizan un vocabulario no especializado del ámbito geográfico; no relacionan, por tanto, esa realidad vivida con los contenidos académicos aprendidos.
Walking tour como estrategia de aprendizaje en geografía aplicada a Sargadelos (Lugo)
Authors: Lee Keumbee , García de la Vega Alfonso
Published: December 2020

Este trabajo analiza la relación entre la industria de la cerámica y su localización geográfica, su influencia en el paisaje y sus valores educativos, destacando el valor de paisaje. Poniendo el foco en el papel de los museos como institución educativa, se examina el potencial de estos lugares para realizar actividades que puedan proporcionar los valores geográficos utilizando la estrategia de aprendizaje de walking tour. Por último, se propone una experiencia educativa para el Museo Histórico de Sargadelos relacionada con el currículo de Educación Secundaria Obligatoria y Bachillerato. Se espera que esta actividad pueda ofrecer una experiencia complementaria en comparación con la tradicional educación museística, en la que la aproximación geográfica ha sido habitualmente soslayada en favor de contenidos históricos o artísticos.
School projects in priority educational territories - geographical experiences in University of Oporto (Portugal)
Authors: Pacheco Elsa , Soares Laura , Ribeiro Salomé
Published: December 2020

Current education must prepare students for a global, uncertain and rapidly changing world, and this is not achieved with the excessive fragmentation of knowledge that occurs in school subjects. This is more evident when we talk about territories that, due to their characteristics of socioeconomic or cultural exclusion, make the education of young people an even greater and priority challenge. In this sense, a group of higher education teachers implemented Project Based Learning with students from elementary and secondary schools enrolled in the Educational Territories Program for Priority Intervention (TEIP), trying to test more engaging work methodologies for these students. These experiences are presented in this article, discussing the importance of project work for the promotion of school activities, the context of the TEIP program and the projects developed, to finally conclude on the significance of the contents covered in learning and training of young students.
La enseñanza de la geografía en tiempos de coronavirus: percepción de la comunidad educativa
Authors: Llorente-Adán José Ángel
Published: December 2020

El presente trabajo se enmarca en la situación actual generada en el sistema educativo por la crisis sanitaria causada por la pandemia del coronavirus a lo largo de los últimos meses del curso 2019-2020. El objetivo fundamental es analizar las primeras consecuencias que ha supuesto el cambio repentino e inesperado para la comunidad educativa, a nivel general, así como las repercusiones que se hayan podido generar en cuanto a la enseñanza y el aprendizaje de la geografía, a nivel particular. Para alcanzar este propósito se ha llevado a cabo un cuestionario que ha sido completado por 547 personas de toda España que forman parte de la comunidad educativa. Las conclusiones extraídas permiten conocer las transformaciones que se hayan podido dar tanto en el sistema de enseñanza-aprendizaje como en la docencia y adquisición de contenidos geográficos al pasar de un sistema presencial a una docencia a distancia.
La Fuente del Berro: una quinta y parque singular en el Madrid contemporáneo (paisaje, memoria y conocimiento del medio)
Authors: Diéguez Cequiel Uxío-Breogán
Published: December 2020

El espacio urbano ha ido construyéndose a costa del espacio rural, realidad que el público más joven desconoce, reduciéndose su relación con el mismo al ocio puntual (y con ello la función esencial de lo rural a lo largo de la historia del ser humano). Incluso por parte de aquellos jóvenes que pudiesen tener abuelos que antaño hubiesen trabajado en el campo, lo rural es manifiestamente remoto y vinculado con duras faenas y desasosiegos. El tiempo en el que lo rural tenía una presencia muy notable no existe en la cosmovisión de los más jóvenes, incluso del profesorado en formación, aunque detrás de la realidad y epidermis urbana aflora la memoria del medio rural. El presente texto intenta, por un lado, poner el foco sobre la evolución de la Quinta de La Fuente del Berro y su entorno más próximo, poniendo en valor las huellas y memoria del medio rural de los barrios madrileños de Las Ventas y de La Fuente del Berro, señalando por otra parte el importante potencial didáctico de esta parte del ensanche Este de la capital española.
Trabajo de campo urbano: Una estrategia didáctica de la Geografía para la enseñanza proyectual del paisaje en el ámbito universitario
Authors: Campari Gabriela Eda
Published: December 2020

El objetivo del artículo es analizar el Trabajo de Campo Urbano (TCU) como estrategia didáctica de la asignatura Geografía de la Licenciatura en Planificación y Diseño del Paisaje, carrera de grado de la Universidad de Buenos Aires. En lo metodológico, se examinan el TCU dentro de la trayectoria del Trabajo Final Integrador del curso y testimonios de estudiantes colectados mediante encuestas. Como conclusión, la experiencia permite al alumnado potenciar el conocimiento del paisaje urbano y comprender la relevancia de articular las prácticas y percepciones comunitarias a su abordaje proyectual.
Classification of primary Glioblastoma cell lines into molecular subtypes
Authors: Cordenonsi Michelangelo , Bicciato Silvio , Piccolo Stefano
Published: December 2020

This protocol provides the details for the classification of the primary Glioblastoma cell lines HuTu10 and HuTu13 into the Glioblastoma molecular subtypes using microarray data.
Giving birth under hospital visitor restrictions: Heightened acute stress in childbirth in COVID-19 positive women
Authors: Mayopoulos Gus , Ein-Dor Tsachi , Li Kevin , Chan Sabrina , Dekel Sharon
Published: December 2020

As the novel coronavirus (COVID-19) has spread globally, a significant portion of women have undergone childbirth while possibly infected with the virus and also under social isolation due to hospital visitor restrictions. Emerging studies examined birth outcomes in COVID-19 positive women, but knowledge of the psychological experience of childbirth remains lacking. This study survey concerning childbirth and mental health launched during the first wave of the pandemic in the US. Women reporting confirmed/suspected COVID-19 during childbirth were matched on various background factors with women reporting COVID-19 negative. We found higher prevalence of clinically significant acute stress in birth in COVID-19 positive women. This group was 11 times as likely to have no visitors than matched controls and reported higher levels of pain in delivery, lower newborn weights, and more infant admission to neonatal intensive care units. Visitor restrictions were associated with these birth outcomes. COVID-19 positive women with no visitors were 6 times as likely to report clinical acute stress in birth than COVID-19 positive women with visitors. The findings underscore increased risk for childbirth-induced psychological morbidity in COVID-19-affected populations. As hospitals continue to revise policies concerning visitor restrictions, attention to the wellbeing of new mothers is warranted.
Effect of 17β-estradiol on a Human Vaginal Lactobacillus Crispatus Strain
Authors: Clabaut Maximilien , Suet Amandine , Racine Pierre-Jean , Tahrioui Ali , Verdon Julien , Barreau Magalie , Maillot Olivier , Tirant Agathe Le , Karsybayeva Madina , Kremser Coralie , Redziniak Gérard , Duclairoir-Poc Cécile , Pichon Chantal , Chevalier Sylvie , Feuilloley Marc
Published: December 2020

Lactobacillis and estrogens are essential in vaginal homeostasis. In the present study, we investigated the potential direct effect of 17β-estradiol on a vaginal strain of Lactobacillus cristapus, the major bacterial species of the vaginal microbiota. 17β-estradiol (10− 6 to 10− 10 M) has no effect on the growth of L. crispatus but markedly affects its membrane dynamic. This effect appears adaptative and coherent with a signal transduction process. The surface polarity and aggregation potential of the bacteria remains unchanged after exposure to 17β-estradiol but its mean size is significantly reduced. 17β-estradiol also promotes biosurfactant production by L. crispatus and adhesion to vaginal VK2/E6E7 cells. Conversely, the biofilm formation activity of the bacterium is marginally affected. A potential 17β-estradiol binding site was identified by bioinformatics in L. crispatus as the membrane lipid rafts associated SPFH domain containing protein. Taken together, this study reveals that 17β-estradiol can exert direct effects on L. crispatus. This process might be of importance in the vaginal environment physiology by promoting adhesion of Lactobacilli to the mucosa and providing protection against pathogens.
Risk Factors for Pregnancy Complications and Postpartum Glucose Intolerance in Women With Gestational Diabetes Mellitus
Authors: Masuko Naohisa , Tanimura Kenji , Kojima Nobue , Imafuku Hitomi , Deguchi Masashi , Fujioka Kazumichi , Okada Yuko , Hirota Yushi , Ogawa Wataru , Yamada Hideto
Published: December 2020

This prospective cohort study aimed to evaluate the risk factors for pregnancy complications and postpartum glucose intolerance (GI) in women with gestational diabetes mellitus (GDM). A total of 140 women with GDM were enrolled. Of these, 115 underwent a 75-g oral glucose tolerance test (OGTT) at 12 weeks after delivery. Clinical factors and parameters in the antepartum 75-g OGTT associated with pregnancy complications and postpartum GI were evaluated. Women with GDM experienced pregnancy complications, including hypertensive disorders of pregnancy (HDP, n=19), preterm delivery (PD, n=17), heavy-for-date (HFD, n=19), and light-for-date (LFD, n=12), and 22 of the 115 women with GDM developed postpartum GI. The univariate and multivariable logistic regression analyses revealed the following risk factors: histories of hypertension (odds ratio [OR], 23.8; 95% confidence interval [CI], 4.2–134.7; p<0.01) for HDP; histories of hypertension (OR, 9.8; 95% CI, 2.5–38.9; p<0.01) for PD; HbA1c levels (OR, 7.6; 95% CI, 1.5–37.9; p<0.05) for HFD; and oral deposition index (DI) (OR, 0.1; 95% CI, 0.02–0.7; p<0.01) for postpartum GI. Higher HbA1c levels and lower oral DI on the antepartum 75-g OGTT may be useful markers for identifying GDM women who are at high risk for HFD and postpartum GI, respectively.
Endonuclease Increases Efficiency of Osteoblast Isolation from Murine Calvariae.
Authors: Asano Yosuke , Matsumoto Yoshinori , Rose Jose , He Fang , Katsuyama Takayuki , Ziyi Wang , Tsuji Shigetomo , Kamioka Hiroshi , Rottapel Robert , Wada Jun
Published: December 2020

Bone is a highly dynamic organ that undergoes remodeling equally regulated by osteoblast-mediated bone formation and osteoclast-mediated bone resorption. To clarify the regulation of osteoblastogenesis, primary murine osteoblasts are required for an in vitro study. Primary osteoblasts are isolated from neonatal calvariae through digestion with collagenase. However, the number of isolated cells from one pup is not enough for further in vitro experiments, leading to an increase in the use of euthanized pups. In the present study, we hypothesized that the viscosity of digested calvariae and digestion solution supplemented with collagenase would result in cell clumping and reduction of isolated cells from bones. We simply added Benzonase, a genetically engineered endonuclease that shears all forms of DNAs/RNAs, in order to reduce nucleic acid-mediated viscosity. We found that addition of Benzonase increased the number of isolated osteoblasts by three fold compared to that without Benzonase through reduction of viscosity. Additionally, Benzonase has no effect on cellular identity and function. The new osteoblast isolation protocol with Benzonase minimizes the number of neonatal pups required for an in vitro study and expands the concept that isolation of other populations including osteocytes that are hard to be purified could be modified by Benzonase.
Hand-held Dual-particle Imager Implemented with a Multiplexed Low Sampling-rate Readout of a SiPM-based Pixelated Stilbene Array
Authors: Boo Jihwan , Hammig Mark , Jeong Manhee
Published: December 2020

Dual particle imaging, in which both neutrons and gamma-rays in the environment can be individually characterized, is particularly attractive for monitoring mixed radiation emitters such as special nuclear materials (SNM). Typical dual particle imagers (DPIs) are not readily deployable and easily portable for hand-held applications because they are implemented using bulky single-crystal scintillators and photomultiplier tubes (PMTs) implemented with a 1:1 channel readout. Effective SNM localization and detection also benefits from high instrument sensitivity so that real-time imaging or imaging with a limited number of acquired events is enabled. We have developed a hand-held type DPI equipped with a pixelated stilbene-silicon photomultiplier (SiPM) array module and low sampling-rate analog-to-digital converters (ADCs) processed via a multiplexed readout. The stilbene-SiPM array (12 × 12 pixels) is capable of effectively performing pulse shape discrimination (PSD) between gamma-ray and neutron events and neutron/gamma-ray source localization on the imaging plane, as demonstrated with 252Cf neutron/gamma and 137Cs gamma-ray sources. The low sampling rate ADCs connected to the stilbene-SiPM array module result in a compact instrument with high sensitivity that provides a gamma-ray image of a 137Cs source, producing 6.4 μR/h at 1 m, in less than 69 seconds. A neutron image for a 3.5 × 105 n/s 252Cf source can also be obtained in less than 6 minutes at 1 m from the center of the system. The instrument images successfully with field of view of 50° and provides angular resolution of 6.8°.
Welfare Technology – You Need to do it Right! A Qualitative Study of the Work of Care Workers to Provide Patient Safety at Home through Technology.
Authors: Stokke Randi , Obstfelder Aud , Andreassen Hege Kristin , Melby Line , Isaksen Jørn
Published: December 2020

Background In health care, the work of keeping the patient safe and reducing the risk of harm is defined as safety work. In our digitised and technology-rich era, safety work usually involves a relationship between people and technologies. Welfare technology is one of the fastest-growing technology-domains in western health care systems. In the marketing of welfare technology, the expectation is that safety is provided simply by being present in patients’ homes. Whilst both research and health authorities are concerned with developing cost-benefit analysis and measuring effects, there is a lack of attention to the daily work needed to ensure that technologies deliver patient safety. This paper aims to describe how patient safety in home care is performed through and with welfare technology. We base our exploration on the social alarm, an established technology that care workers are expected to handle as an integrated part of their ordinary work. MethodsWe draw on empirical data from three case studies, involving five Norwegian municipalities that use social alarm systems in home care services. Building on a qualitative explorative design, we analyse observations of practice and interviews with the actors involved, in accordance with King's outline of template analysis.ResultsOur analysis illuminated three co-existing work processes where patient safety is secured: “Aligning people and technologies”; “Being alert and staying calm”; and “Coordinating activities depending on people and technology”. Attention to these work processes exposes the detailed practices of safety, and how it is produced in relational practices involving multiple people and technologies.ConclusionsWe conclude that the three work processes identified are essential if the safety alarm is to function for the end-user’s safety. Home-dwelling patients' safety is reliant on the people involved with technologies, and technologies do not create this on their own. The efforts of care workers are a central feature of creating safety in a patient's home, and in doing so, they utilise a repertoire of skills and knowledge.
Impact of donor age on liver transplant outcomes in patients with hepatocellular carcinoma: Analysis of the SRTR dataset
Authors: Zhou Jie , Huang Zhichao , Chen Zheng , Xu Fangshen , Tong Rongliang , Zheng Shusen
Published: December 2020

Background: Donor age is an important predictor for liver transplant recipients. Studies have not fully explored its impact on transplant outcomes in hepatocellular carcinoma (HCC) patients, and its involvement in tumor recurrence has not yet been fully explored.Methods: HCC recipients who received liver transplants from 2010–2017 from the Scientific Registry of Transplant Recipients database were included. The recipients were divided into four groups on the basis of donor age: I (18–34 years), II (35–49 years), III (50–64 years), and IV (≥65 years). Transplant outcomes, including the overall survival (OS), tumor recurrence, and risks, were evaluated.Results: A total of 13,276 HCC recipients were included in this study. The OS was significantly different among four groups. The best 5-year survival was 76.0% in group I, followed by 73.5% in group II, 72.8% in group III, and 69.2% in group IV (P < 0.001). Donor age, recipient age, recipient race, recipient serum creatinine, sum of tumor diameter, and α-fetoprotein (AFP) were found to be independent predictors of OS. In subgroup analysis, OS was significantly different in hepatitis C virus (HCV) recipients, but there was no significant difference between recipients with hepatitis B virus (HBV), alcoholic diseases and nonalcoholic steatohepatitis (NASH). The cumulative tumor recurrence rates and the mean time to recurrence post-transplantation did not differ among the four groups.Conclusions: Older donor age was associated with decreased OS in HCC recipients, but it was not correlated with post-transplant tumor recurrence. Older donor age also had different effects in patients with different underlying liver diseases
Outcome of Scleral Buckling With or Without Gas Tamponade for Recurrent Retinal Detachment in Post-vitrectomy Eyes
Authors: Bai Jun-Xing , Zhang Xiao-Jian , Duan An-Li , Peng Xiao-Yan
Published: December 2020

Background: Treatment of recurrent retinal detachment (re-RD) following vitrectomy (post-gas/air tamponade and post-silicone oil removal) is challenging. Previously reported treatment is commonly revision pars plana vitrectomy (PPV) combined with tamponade, which is invasive and a burden both economically and emotionally when compared with scleral buckling (SB). The purpose of this study is to report anatomical and functional outcomes of SB with or without gas tamponade in eyes with recurrent retinal detachment (re-RD) that previously underwent PPV at least once.Methods: We retrospectively reviewed the medical records of 14 patients (14 eyes) who underwent PPV at least once and were treated with SB after re-RD. Preoperative characteristics, intraoperative complications, and postoperative data were assessed. The final anatomical and functional outcomes were analyzed.Results: The first PPV was performed for primary rhegmatogenous retinal detachment in 11 eyes, macular hole retinal detachment in 2 eyes, and myopic foveoschisis in 1 eye. Previously, 3 eyes underwent one PPV with gas tamponade, and the remaining 11 (79%) eyes underwent 2–5 operations. The re-RD involved the fovea in 7 (50%) eyes. There was no break detected in 2 eyes, suspected break in 5 eyes, 1 break in 4 eyes, 2 breaks in 2 eyes, and 3 breaks in 1 eye. Seven eyes underwent the procedure with gas injection. At the last follow-up, 13 eyes achieved total retinal attachment and 1 eye had re-RD. The postoperative intraocular pressure was within the normal range, except in 1 eye (6 mmHg). The finest postoperative best-corrected visual acuity (BCVA) was 20/25. There was a significant improvement in BCVA from 20/160±20/63 at baseline to 20/80±20/50 at the last visit in the 13 successfully treated eyes (P=0.025).Conclusions: SB can be effective for re-RD after PPV in specific cases.
Photoinduced regioselective olefination of arenes at proximal and distal sites
Authors: Maiti Debabrata , Saha Argha , Guin Srimanta , Ali Wajid , Bhattacharya Trisha , Sasmal Sheuli , Goswami Nupur , Prakash Gaurav , Sinha Soumya , Chandrashekar Hediyala , Anjana S. S.
Published: December 2020

The Fujiwara-Moritani reaction has had a profound contribution in the emergence of contemporary C-H activation protocols. Despite the applicability of the traditional approach in different fields, the associated reactivity and regioselectivity issues had rendered it redundant. The revival of this exemplary reaction requires the development of a mechanistic paradigm that would have simultaneous control on both the reactivity and regioselectivity. Often high thermal energy required to promote olefination leads to multiple site functionalization. To this aim we established a photoredoxcatalytic system constituting a merger of palladium/organo-photocatalyst that forges oxidative olefination in an explicit regioselective fashion of diverse arenes and heteroarenes. Visible light plays a significant role in executing ‘regio-resolved’ Fuijiwara-Moritani reaction without the requirement of silver salts and thermal energy. The catalytic system is also amenable towards proximal and distal olefination aided by respective directing groups (DGs), which entails the versatility of the protocol in engaging the entire spectrum of C(sp2)-H olefination. Furthermore, streamlining the synthesis of natural products, chiral molecules, drugs and diversification through late-stage functionalizations underscore the importance of this sustainable protocol. The photoinduced attainment of this regioselective transformation is mechanistically established through control reactions, kinetic studies and theoretical calculations.
Promotion of Early and Exclusive Breastfeeding in Neonatal Care Units in Rural Rwanda: a Quasi-experimental Study
Authors: Gato Saidath , Biziyaremye Francois , Kirk Catherine M. , Sousa Chiquita Palha De , Mukuralinda Alain , Habineza Hamissy , Asir Maya , Silva Himali de , Manirakiza Marie Louise , Karangwa Egide , Nshimyiryo Alphonse , Tugume Alex , Beck Kathryn
Published: December 2020

Background: Early initiation of breastfeeding after birth and ongoing exclusive breastfeeding for the first 6 months improves child survival, nutrition and health outcomes. However, only 42% of newborns worldwide are breastfed within the first hour of life. Small and sick newborns are at greater risk of not receiving breastmilk and often require additional support for feeding. This study compares breastfeeding practices in Rwandan neonatal care units (NCUs) before and after the implementation of a package of interventions aimed to improve breastfeeding, aligned with the Baby Friendly Hospital Initiative for small and sick newborns.Methods: A pre-post quasi experimental study was conducted at two District hospital NCUs in rural Rwanda from October 2017–December 2017 (pre-intervention) and September 2018–March 2019 (post-intervention). Only newborns admitted before their second day of life (DOL) were included. Data was extracted from patient charts for clinical and demographic characteristics, feeding throughout admission, and patient outcomes. Bivariate analyses were conducted using Fisher’s exact and Wilcoxon rank sum tests. Logistic regression was used to evaluate factors associated with exclusive breastfeeding at discharge following a backwards stepwise procedure.Results: Pre-intervention, 255 newborns were admitted in the NCUs and 793 were admitted in the post-intervention period. The percentage of infants who were exclusively breastfed on their day of birth, or day-of-life zero (DOL0) increased from 5.4% to 35.9% (p<0.001). For newborns discharged alive, the proportion exclusively breastfeeding increased from 69.6% to 87.0% (p<0.001). The mortality rate for all admitted newborns decreased from 16.1% to 10.5% (p<0.019). Factors associated with greater odds of exclusive breastfeeding at discharge included post-intervention time point (Odds Ratio (OR): 4.91, 95% Confidence Interval (CI) 1.99-12.11, p<0.001), and admission for infection (OR 2.99, 95%CI 1.13-7.93, p=0.027). Home deliveries (OR 0.15, 95%CI 0.05-0.47, p=0.001), preterm delivery (OR 0.36, 95%CI 0.15-0.87, p=0.0260 and delayed first breastmilk feed (OR=0.04 for DOL3 vs. DOL0, 95%CI 0.01, 0.35, p=0.004) reduced odds of exclusive breastfeeding at discharge. Conclusion: Expansion and adoption of evidenced-based guidelines, using innovative approaches, aimed at the unique needs of small and sick newborns should be expanded and adapted in similar settings to improve outcomes for these infants.
Impact of Sarcopenia on the Hip Fracture Treatment Outcomes: A Single-institution Case-control Study
Authors: Iida Hiroki , Seki Taisuke , Sakai Yoshihito , Watanabe Tsuyoshi , Wakao Norimitsu , Matsui Hiroki , Imagama Shiro
Published: December 2020

Background: Although sarcopenia has been known as a risk factor for hip fractures, only a few reports have described the impact of sarcopenia on hip fracture treatment outcomes. The current study therefore sought to investigate the effect of sarcopenia on treatment outcomes of patients with hip fractures.Methods: This case–control study involved 337 patients (67 males and 270 females) with hip fractures aged ≥ years (mean age: 84.1 ± 7.1 years) who underwent surgery from January 2013 to June 2019. The mean follow-up period was 17.1 (1–60) months. All patients were assessed for sarcopenia using dual-energy X-ray absorptiometry upon hospitalization. Treatment outcomes and one-year mortality rates were compared between patients with and without sarcopenia. Furthermore, we determined whether sarcopenia was a risk factor for one-year mortality in hip fracture patients using a Cox proportional hazards model.Results: The prevalence of sarcopenia in patients with hip fracture was 231(68.5%). Those with sarcopenia had a lower Barthel index (P < 0.0001) and hospital discharge rate (P = 0.035). Cox proportional hazards regression analysis adjusted for age and sex found that sarcopenia was a risk factor for one-year mortality (hazard ratio, 3.173, 95% confidence interval, 1.095–9.199, P = 0.033).Conclusions: Patients with hip fracture who had sarcopenia had a lower Barthel index, lower hospital discharge rate, and higher one-year mortality. Moreover, sarcopenia was identified as a risk factor for one-year mortality among those with hip fractures. The aforementioned findings may help clinicians better manage those with hip fracture.
“The Effect of Obstructive Sleep Apnea on Peripheral Blood Amino Acid and Biogenic Amine Metabolome at Multiple Time Points Overnight“
Authors: Kiens Ott , Taalberg Egon , Ivanova Viktoria , Veeväli Ketlin , Laurits Triin , Tamm Ragne , Ottas Aigar , Kilk Kalle , Soomets Ursel , Altraja Alan
Published: December 2020

There are no clinical studies that have investigated the differences in blood serum metabolome between obstructive sleep apnea (OSA) patients and controls. In a single-center prospective observational study, we compared metabolomic profiles in the peripheral blood of OSA patients with apnea-hypopnea index (AHI) > 15/h and control individuals. Blood was obtained at 3 different time points overnight: 21:00 p.m.; 5:00 a.m. and 7:00 a.m. We used a targeted approach for detecting amino acids and biogenic amines and analyzed the data with ranked general linear model for repeated measures. We recruited 31 patients with moderate-to-severe OSA and 32 controls. Significant elevations in median concentrations of alanine, proline and kynurenine in OSA patients compared to controls were detected. Significant changes in the overnight dynamics of peripheral blood concentrations occurred in OSA: glutamine, serine, threonine, tryptophan, kynurenine and glycine levels increased, whereas a fall occurred in the same biomarker levels in controls. Phenylalanine and proline levels decreased slightly, compared to a steeper fall in controls. The study indicates that serum profiles of amino acid and biogenic amines are significantly altered in patients with OSA referring to vast pathophysiologic shifts reflected in the systemic metabolism.
Survey of Medical Student Empathy at a Canadian Medical School
Authors: Adatia Safina , Tellier Pierre-Paul
Published: December 2020

Purpose: Within a medical context, empathy is defined as "an appropriate understanding and communication of a patient's experience." While it has been established that empathy is an important quality to have as a future doctor, studies have shown that empathy in medical students declines during their clinical years. However, there are no studies to date that evaluate medical student empathy in Canada. Therefore, we aimed to evaluate medical student empathy at McGill University Medical School using the Jefferson Scale of Empathy (JSE). Methods: We used a cross-sectional study design and invited medical students across all 4 years, in October 2019, to complete the JSE. The JSE is a validated psychometric tool that measures empathy at one point in time. The survey was distributed via email and on social media. We offered the chance for participants to win a prize if they completed the survey. Results: A total of 133 students from all 4 years responded, proportionate across each year. Differences in mean questionnaire were not statistically significant for gender (p=0.364), age (p=0.2746) or specialty interest (p=0.436). The ANOVA for differences in year of medical school was significant (p=0.0104). Between groups analysis revealed a statistically significant decrease between Med-2 empathy scores (average score 117.6) and Med-3 (107.5), p<0.01. Conclusion: Our statistical analysis determined that medical students’ empathy declines between the second and third year of medical school in a Canadian context, consistent with global results. This information can help us target changes in the medical curriculum to preserve empathy in students, and prevent this decline, which could then be applied to other medical schools internationally.
WITHDRAWN: Inflammatory Metabolic Profile of South African Patients with Prostate Cancer
Authors: Cacciatore Stefano , Wium Martha , Licari Cristina , Ajayi-Smith Aderonke , Masieri Lorenzo , Anderson Chanelle , Salukazana Azola Samkele , Kaestner Lisa , Carini Marco , Carbone Giuseppina M , Catapano Carlo V. , Loda Massimo , Libermann Towia A. , Zerbini Luiz Fernando
Published: December 2020

Background: Men with African ancestry are more likely to develop aggressive prostate cancer (PCa) and to die from this disease. A distinct genomic landscape associated with specific ethnic groups may lead to different metabolic adaptations and inflammatory responses that permit tumor cells to proliferate and to grow. We hypothesize that a higher risk of lethal PCa in men with African ancestry may be associated with high level of systemic inflammation. Methods: In this study, plasma samples were profiled from a cohort of 41 South African men with PCa using Nuclear Magnetic Resonance (NMR) spectroscopy. A total of 41 features, including metabolites, lipid classes, total protein, and the inflammatory NMR markers, GlycA and GlycB were quantified from each NMR spectrum. The Bruker’s B.I.-LISA protocols were used to characterize 114 parameters related to the lipoproteins, such as HDL, LDL and VLDL, and their relative subclasses. The unsupervised KODAMA method was used to stratify the patients of our cohort based on their metabolic profile. Results: We found that the plasma of patients with very high risk, aggressive PCa and high level of C-reactive protein have a peculiar metabolic phenotype (metabotype) characterized by extremely high levels of GlycA and GlycB. The inflammatory processes linked to the higher level of GlycA and GlycB are characterized by a deep change of the plasma metabolome that leads the stratification of patients with PCa. We also identified a not previously relationship between high values of very-high density lipoprotein and low level of GlycB in a different metabotype of patients characterized by lower risk PCa. Conclusions: Systemic inflammation plays a role in the metabolic profile of cancer. This study advances our understanding of the relationship between metabolome and systemic inflammation in the context of PCa and opens the door to a totally innovative approach for biomarker discovery and to the development of new therapies aiming to reduce the systemic inflammation in these patients.
Effect of Surface Electrical Stimulation in a Seated Position on Pelvic Floor Muscle Functions, Urinary Leakage, and Quality of Life in Women With Stress Urinary Incontinence
Authors: Hwang Ui-jae , Lee Min-seok , Jung Sung-hoon , Kim Young-shin , Kwon Oh-yun
Published: December 2020

BackgroundThe aim of this study was to demonstrate the effect of surface electrical stimulation in a seated position (SESSP), as pelvic floor muscle (PFM) training, on PFM functions (time to reach maximal pressure [TRMP], muscle strength, power and endurance), urinary leakage and quality of life in patients with stress urinary incontinence (SUI). MethodsWomen with SUI were randomized into an SESSP group (n = 18) or control group (n = 18). Quality of life were assessed by the Incontinence Quality of Life Questionnaire (I-QOL). Ultra-short pad test results and PFM functions were measured by perineometer. Changes in the outcomes were assessed before and 8 weeks after SESSP training. ResultsThirty-three participants were included in the analysis. There were significant differences in I-QOL (avoidance and limiting behaviors, psychosocial impacts, social embarrassment and total score) in between (SESSP vs. control group) and within (pre vs. post) group analyses. Significant increases in PFM strength, power, and endurance, and significant decreases in the TRMP and pad weight, were observed between (SESSP vs. control group) and within (pre vs. post) groups. ConclusionSESSP in a seated position can be recommended to improve QOL, urinary leakage, and PFM functions in SUI patients.Trial registrationCurrent Controlled Trials KCT0003357 (the date of registration: 2018.11.16) and retrospectively registered
The Effects of Placental Mesenchymal Stem Cells Labelled With Ultrasmall Superparamagnetic Iron Oxides on the Growth of Colorectal Cancer (CRC) Cells
Authors: Wang Fang , He Hua , Xiong Yao , HU Jie-ting , Guo Yu-lin
Published: December 2020

Objective: To investigate the effects of human placental mesenchymal stem cells (PMSCs) labelled with ultrasmall superparamagnetic iron oxides (USPIOs) on the growth of colorectal cancer (CRC) cells and the feasibility of 3.0T MR in vivo tracer. Methods: PMSCs were labelled with USPIOs, the labeling efficiency was determined by Prussian blue-stained, and their biological characteristics were identified. A subcutaneous CRC HT-29 xenograft model in immunodeficient mice was established, and we attempted to consider the group was injected with labelled MSCs as experimental group. The growth and MR signal changes of xenograft tumors of nude mice was assessed, then, plot growth curve and analyzed the MR image quality in different sequences, obtained the pathological results after scan.Results: 1. USPIOs-labelled PMSCs had no significant influence on biological characteristics, such as cell viability, proliferation ability, and apoptosis rate (P> 0.05). 2. The regions with low signal value could be observed in the experimental group on the first day on the MR. On the 7th day, the regions with low signal value were narrowed, and in some tumors showed poor clarity, whereas the signal values did not significantly change. The trend of growth of tumors in mice in the experimental group before injection of PMSCs was similar to that of the control group, while growth rate of tumor in the experimental group on day 5 after injection of PMSCs was slightly lower than that in the control group, and the volume of tumor on day 14 was noticeably smaller than that in the control group. There was no significant difference in the positive expression rates of CD31, CD34, and Ki67 between the two groups (P> 0.05). 3. The tracing ability of T2* mapping sequences for USPIOs-labelled cells was superior than T2WI and T2 mapping sequences. Conclusion: USPIOs-labelled PMSCs had high labeling efficiency, while cell viability, proliferation ability, and apoptotic rate were not markedly influenced. labelled cells injected into CRC transplanted tumors were studied for a long period of time, and only a certain inhibitory effect on growth of tumor volume was noted, while no meaningful influence on tumor proliferation and angiogenesis was found.
The Distribution and Accessibility of Assisted Reproductive Technology Clinics in Mainland China From 2006 to 2018: a Population-based Retrospective Study
Authors: Ma Yi , Bai Fu , Gao Lina , Fan Yanjun
Published: December 2020

Background: Infertility is a global health problem that carries a high social and economic burden. Assisted reproductive technology (ART) has been developed in mainland China for over 30 years. We aimed to evaluate the accessibility and equity of distribution of ART facilities in mainland China from 2006 to 2018, and quantify the population with reduced geographic access to ART services.Method: A retrospective study was conducted to describe the trend and analyze the equity of distribution of ART clinics in 2006, 2012, and 2018. Coverage rates were calculated by city and by population. Size of population living in areas with different regional choice of ART services was identified. The Gini coefficients were calculated to measure the equity of the distribution of ART clinics.Results: There were 85 ART clinics (not counting artificial insemination clinics) in mainland China in 2006, 356 in 2012, and 498 in 2018 . The coverage rate of ART clinics was increased significantly (P＜0.05). Eastern China had the most extensive coverage, followed by the central region, while the western region had the least coverage (P＜0.05). At the end of 2018, 171.4 million people in 47 cities had no access to in vitro fertilization (IVF) clinics, but had access to at least one artificial insemination clinic in their own cities. There were still 354.9 million people (25.4% of the population) living in 148 cities without any ART clinics, indicating that 179.5 million people of reproductive age had no access to ART services. The Gini coefficients for the distribution of IVF clinics in mainland China in 2006, 2012, and 2018 were 0.389, 0.275 and 0,267 respectively, and for the distribution of ART clinics in 2012, and 2018 were 0.222 and 0.213.Conclusion(s): The accessibility of ART clinics in mainland China increased significantly in the twelve years to 2018. The equity of distribution of ART clinics was quite balanced over the country. However, underserved areas still exist, especially in the western region, which has spurred more targeted policies and cost-effective measures to improve the accessibility and availability of ART services in such areas.
Inequalities in Antenatal Care Coverage and Quality: an Analysis From 63 Low and Middle-income Countries Using the ANCq Content-qualified Coverage Indicator
Authors: Arroyave Luisa , Saad Ghada E , Victora Cesar G , Barros Aluisio J D
Published: December 2020

Background: Antenatal care (ANC) is an essential intervention associated with a reduction of maternal and new-born morbidity and mortality. However, evidence suggested substantial inequalities in maternal and child health, mainly in low- and middle-income countries (LMICs). We aimed to conduct a global analysis of socioeconomic inequalities in ANC using national surveys from LMICs.Methods: ANC was measured using the ANCq, a novel content-qualified ANC coverage indicator, created and validated using national surveys, based upon contact with the health services and content of care received. We performed stratified analysis to explore the socioeconomic inequalities in ANCq. We also estimated the slope index of inequality, which measures the difference in coverage along the wealth spectrum. Results: We analyzed 63 national surveys carried out from 2010 to 2017. There were large inequalities between and within countries. Higher ANCq scores were observed among women living in urban areas, with secondary or more level of education, belonging to wealthier families and with higher empowerment in nearly all countries. Countries with higher ANCq mean presented lower inequalities; while countries with average ANCq scores presented wide range of inequality, with some managing to achieve very low inequality.Conclusions: Despite all efforts in ANC programs, important inequalities in coverage and quality of ANC services persist. If maternal and child mortality Sustainable Development Goals are to be achieved, those gaps we documented must be bridged.
Diversity Enhancement Random Forest Model for the Risk Identification of Disease Deterioration
Authors: Peng Jun-Feng , Chen Xing-Ji , Li Xiao-Xin , Zhou Mi , Xu Jun , Zhu Xiong-Yong , Chen Jia-Yuan , Zou Kai-Qiang , Zhang Zhan , Chen Guo-Ming
Published: December 2020

BackgroundRandom forest (RF) is a powerful ensemble algorithm for medical decision-making supporting (MDS). However the requirement of higher accuracy and smaller ensemble size remain significant burdens for the current RF, particularly for the risk identification of disease deterioration. To achieve the goal of higher accuracy and smaller ensemble size for the risk identification of disease deterioration, a diversity enhancement random forest (DERF) model is proposed.MethodsWe explored the idea of integrating trees that are accurate and diverse to build the DERF model. First, we calculated the accuracy of the out of bag data to select the best K trees. Then, we assessed the diversity of these trees using logarithmic loss functions on the validation data set. Further, we utilized the greedy stepwise backward search to increase the diversity of the random forest. Finally, public bench mark data sets on disease deterioration from KEEL and real data sets from tertiary hospitals in the last three years were used to assess the performance of the proposed DERF model and compared it with the existing model. ResultsExperiments show that the proposed model can improve the prediction performance and reduce the ensemble size of random forest model. Compared with the existing model random forest, the extreme random tree and the ensemble of optimal tree, our proposed DERF model obtains a higher predictive accuracy and a smaller ensemble size. ConclusionIt reveals that the proposed DERF could reduce the size of the ensemble and achieve good classification results in the risk identification of disease deterioration
Statistical Joint Modeling on Longitudinal Body Weight and CD4 Cell Progression with Survival Time-to-Death Predictors on HIV/AIDS Patients in Mekelle General Hospital, Ethiopia
Authors: Gebrerufael Geberu , Asfaw Zeytu , Chekole Dessie
Published: December 2020

This study assessed the impact of repeated biomarker measurements of statistical joint modeling on survival time-to-death and determines potential predictors of HIV/AIDS patients on ART in Mekelle General Hospital Ethiopia. A retrospective cohort study was conducted among HIV/AIDS patients who were under ART follow-up during September 11, 2013 - September 5, 2016, at Mekelle General Hospital, Ethiopia. The relationship between the two biomarkers CD4 cell and body weight with risk for survival time-to-death were statistically insignificant. Thus, death is less probable to occur in HIV/AIDS patients with a higher value of CD4 cell count and body weight progression. In the event process the sub-model, Baseline CD4, Fair, and Good Adherence, HIV/TB, and Sex were significant factors of risk to short survival Time-to-Death on HIV/AIDS patients. In the 1st longitudinal process sub-model, Baseline CD4, Ambulatory functional status, HIV/TB (yes), Time*Ambulatory functional status, Time*Working functional status, and Time*Baseline CD4 were the significant factors of √CD4 Cell count progression. Moreover, In the 2nd longitudinal process sub-model, visit Time of follow-up, Age, Sex (male), Baseline weight, Time*Ambulatory and Time*Working functional status were the significant factors of log 10(bodyweight) progression. Both governmental and non-governmental stakeholders should pay special attention to HIV-positive adults, especially those who had developed HIV/TB, male, bedridden functional status, poor adherence, and lower Baseline CD4 cell count progression so that mortality due to HIV/AIDS optimally reduced.