bluuebunny/crossref_metadata_2025 huggingface dataset:
Immune-related lncRNAs as predictors of survival in breast cancer: a prognostic signature
Authors: ma wei , zhao fangkun , yu xinmiao , guan shu , suo huandan , tao zuo , qiu yue , wu yunfei , cao yu , jin feng
Published: August 2020

Background: Breast cancer is a highly heterogeneous disease, this poses challenges for classification and management. Long non-coding RNAs play acrucial role in the breast cancersdevelopment and progression, especially in tumor-related immune processes which have become the most rapidly investigated area. Therefore, we aimed at developing an immune-related lncRNA signature to improve the prognosis prediction of breast cancer.Methods: We obtained breast cancer patient samples and corresponding clinical data from The Cancer Genome Atlas (TCGA) database. Immune-related lncRNAs were screened by co-expression analysis of immune-related genes which were downloaded from the Immunology Database and Analysis Portal (ImmPort). Clinical patient samples were randomly separated into training and testing sets. In the training set, univariate Cox regression analysis and LASSO regression were utilized to build a prognostic immune-related lncRNA signature. The signature was validated in the training set, testing set, and whole cohorts by the Kaplan–Meier log-rank test, time-dependent ROC curve analysis, principal component analysis, univariate andmultivariate Cox regression analyses.Results:A total of 937 immune- related lncRNAs were identified, 15 candidate immune-related lncRNAs were significantly associated with overall survival (OS). Eight of these lncRNAs (OTUD6B-AS1, AL122010.1, AC136475.2, AL161646.1, AC245297.3, LINC00578, LINC01871, AP000442.2) were selected for establishment of the risk prediction model. The OS of patients in the low-risk group was higher than that of patients in the high-risk group(p=1.215e−06 in the training set; p=0.0069 in the validation set; p=1.233e−07 in whole cohort). The time-dependent ROC curve analysis revealed that the AUCs for OS in the first, eighth, and tenth year were 0.812, 0.81, and 0.857, respectively, in the training set,0.615, 0.68, 0.655 in the validation set, and 0.725, 0.742, 0.741 in the total cohort. Multivariate Cox regression analysis indicated the model was a reliable and independent indicator for the prognosis of breast cancer in the training set (HR= 1.432; 95% CI 1.204−1.702, p<0.001), validation set (HR= 1.162; 95% CI 1.004−1.345, p = 0.044), and whole set (HR=1.240; 95% CI 1.128−1.362, p<0.001). GSEA analysis revealed a strong connection between the signature and immune-related biological processes and pathways.Conclusions:We constructed and verified a robust signature of 8 immune-related lncRNAs for the prediction of breast cancer patient survival.
Transgenic and knockout analyses of Masculinizer and doublesex illuminated the unique functions of doublesex in germ cell sexual development of the silkworm, Bombyx mori
Authors: Yuzawa Tomohisa , Matsuoka Misato , Sumitani Megumi , Aoki Fugaku , Sezutsu Hideki , Suzuki Masataka
Published: August 2020

Background: Masculinizer (Masc) plays a pivotal role in male sex determination in the silkworm, Bombyx mori. Masc is required for male-specific splicing of B. mori doublesex (Bmdsx) transcripts. The male isoform of Bmdsx (BmdsxM) induces male differentiation in somatic cells, while females express the female isoform of Bmdsx (BmdsxF), which promotes female differentiation in somatic cells. Our previous findings suggest that Masc could direct the differentiation of genetically female (ZW) germ cells into sperms. However, it remains unclear whether Masc directly induces spermatogenesis or if it promotes male differentiation in germ cells indirectly by inducing the expression of BmdsxM. Results: In this study, we performed genetic analyses using the transgenic line that expressed Masc, as well as various Bmdsx knockout lines. We found that Masc-expressing females with a homozygous mutation in BmdsxM showed normal development in ovaries. The formation of testis-like tissues was abolished in these females. On the other hand, Masc-expressing females carrying a homozygous mutation in BmdsxF exhibited almost complete male-specific development in gonads and germ cells. These results suggest that BmdsxM has an ability to induce male development in germ cells as well as internal genital organs, while BmdsxF inhibits BmdsxM activity and represses male differentiation. To investigate whether MASC directly controls male-specific splicing of Bmdsx and identify RNAs that form complexes with MASC in testes, we performed RNA immunoprecipitation (RIP) using an anti-MASC antibody. We found that MASC formed a complex with AS1 lncRNA, which is a testis-specific factor involved in the male-specific splicing of Bmdsx pre-mRNA. Conclusions: Taken together, our findings suggest that Masc induces male differentiation in germ cells by enhancing the production of BmdsxM. Physical interaction between MASC and AS1 lncRNA may be important for the BmdsxM expression in the testis. Unlike in the Drosophila dsx, BmdsxM was able to induce spermatogenesis in genetically female (ZW) germ cells. To the best of our knowledge, this is the first report that the role of dsx in germ cell sexual development is different between insect species.
One-step purification of two novel thermotolerant β-1,4-glucosidases from a newly isolated strain of Fusarium chlamydosporum HML278 and their characterization
Authors: Qin Yongling , Li Qiqian , Luo Fengfeng , Fu Yue , He Haiyan
Published: August 2020

A newly identified cellulase-producing Fusarium chlamydosporum HML278 was cultivated under solid-state fermentation of sugarcane bagasse, and two new β-glucosides enzymes (BG FH1, BG FH2) were recovered from fermentation solution by modified non-denaturing active gel electrophoresis and gel filtration chromatography. SDS-PAGE analysis showed that the molecular weight of BG FH1 and BG FH2 was 93 kDa and 52 kDa, respectively, and the enzyme activity was 5.6 U/mg and 11.5 U/mg, respectively. The optimal reaction temperature of the enzymes was 60 ℃, and the enzymes were stable with a temperature lower than 70 ℃. The optimal pH of the purified enzymes was 6.0, and the enzymes were stable between pH 4-10. Km and Vmax values ​​were 2.76 mg/mL and 20.6 U/mg for pNPG, respectively. Thin-layer chromatography and high-performance liquid chromatography analysis showed that BG FH1and BG FH2 had hydrolysis activity toward cellobiose and could hydrolyze cellobiose into glucose. In addition, both enzymes exhibited transglycoside activity, which could use glucose to synthesize cellobiose and cellotriose, and preferentially synthesize alcohol. In conclusion, our study demonstrated that F. chlamydosporum HML278 produces heat-resistant β-glucosidases with both hydrolytic activity and transglycosidic activity, and these β-glucosidases have potential application in bioethanol and papermaking industries.
Feasibility study: Spot-scanning Proton Arc therapy (SPArc) for left-sided whole breast radiotherapy
Authors: Chang Sheng , Liu Gang , Zhao Lewei , Dilworth Joshua T , Zheng Weili , Jawad Saada , Yan Di , Chen Peter , Stevens Craig , Kabolizadeh Peyman , Li Xiaoqiang , Ding Xuanfeng
Published: August 2020

Background : This study investigated the feasibility and potential clinical benefit of utilizing a new proton treatment technique: Spot-scanning Proton Arc (SPArc) therapy for left-sided whole breast radiotherapy (WBRT) to further reduce radiation dose to healthy tissue and mitigate the probability of normal tissue complications compared to conventional Intensity Modulated Proton Therapy (IMPT).

Methods : Eight patients diagnosed with left-sided breast cancer and treated with breast-preserving surgery followed by whole breast irradiation without regional nodal irradiation were included in this retrospective planning. Two proton treatment plans were generated for each patient: vertical intensity-modulated proton therapy used for clinical treatment (vIMPT, gantry angle 10°-30°) and SPArc for comparison purpose. Both SPArc and vIMPT plans were optimized using the robust optimization of ±3.5% range and 5mm setup uncertainties. Root-mean-square deviation dose (RMSD) volume histogram s were used for plan robustness evaluation. All dosimetric results were evaluated based on dose-volume histograms (DVH), and the interplay effect was evaluated based on the accumulation of single-fraction 4D dynamic dose on CT50. The treatment beam delivery time was simulated based on a gantry rotation with energy-layer-switching-time (ELST) from 0.2 to 5s.

Results: The average D1 to the heart and LAD were reduced to 53.63cGy and 82.25cGy compared with vIMPT 110.38cGy (p = 0.001) and 170.38cGy (p = 0.001), respectively. The average V5Gy and V20Gy of ipsilateral lung was reduced to 16.77% and 3.07% compared to vIMPT 25.56% (p = 0.001) and 4.68% (p = 0.003). Skin3mm mean and maximum dose were reduced to 3999.38cGy and 4395.63cGy compared to vIMPT 4104.25cGy (p=0.039) and 4411.63cGy (p=0.043), respectively. A significant relative risk reduction (RNTCP = NTCP SPArc / NTCP vIMPT ) for organs at risk (OARs) was obtained with SPArc ranging from 0.61 to 0.86 depending on the clinical endpoint. The RMSD Volume Histogram (RVH) analysis shows SPArc provided better plan robustness in OARs sparing, including the heart, LAD, ipsilateral lung, and skin. The average estimated treatment beam delivery times were comparable to vIMPT plans when the ELST is about 0.5s.

Conclusion: SPArc technique can further reduce dose delivered to OARs and the probability of normal tissue complications in patient treated for left-sided WBRT.
Changes of Intestinal Oxidative Stress, Inflammation, and Gene Expression in Neonatal Goats Suffering from a Cold
Authors: cheng yan , Yang Chao , Tan ZhiLiang , He ZhiXiong
Published: August 2020

The authors have withdrawn this preprint due to author disagreement.
Safely reducing haemodialysis frequency during the COVID-19 pandemic
Authors: Lodge Michelle da Silva , Abeygunaratne Thilini , Alderson Helen , Ali Ibrahim , Brown Nina , Chrysochou Constantina , Donne Rosie , Erekosima Ibi , Evans Philip , Flanagan Emma , Gray Simon , Green Darren , Hegarty Janet , Hyde Audrey , Kalra Philip A , Lamerton Elizabeth , Lewis David , Middleton Rachel , New David , Nipah Robert , O’Donoghue Donal , O’Riordan Edmond , Poulikakos Dimitrios , Rainone Francesco , Raman Maharajan , Ritchie James , Sinha Smeeta , Wood Grahame , Tollitt James
Published: August 2020

Background: Patients undergoing haemodialysis (HD) are at higher risk of developing worse outcomes if they contract COVID-19. In our renal service we reduced HD frequency from thrice to twice-weekly in selected patients with the primary aim of reducing COVID 19 exposure and transmission between HD patients.Methods: Dialysis unit nephrologists identified 166 suitable patients (38.4% of our HD population) to temporarily convert to twice-weekly haemodialysis immediately prior to the peak of the COVID-19 pandemic in our area. Changes in pre-dialysis weight, systolic blood pressure (SBP) and biochemistry were recorded weekly throughout the 4-week project. Hyperkalaemic patients (serum potassium > 6.0mmol/L) were treated with a potassium binder, sodium bicarbonate and received responsive dietary advice.Results: There were 12 deaths (5 due to COVID-19) in the HD population, 6 of which were in the twice weekly HD group; no deaths were associated with change of dialysis protocol. A further 19 patients were either hospitalised and/or developed COVID-19 and thus transferred back to thrice weekly dialysis as per protocol. Of 141 eligible patients 113 (80.1%) were still receiving twice-weekly HD by the end of the 4-week project. Indications for transfer back to thrice weekly were; fluid overload (19), persistent hyperkalaemia (4), patient request (4) and compliance (1). There were statistically significant increases in SBP and pre-dialysis potassium during the project. Conclusions: Short term conversion of a large but selected HD population to twice-weekly dialysis sessions was possible and safe. This approach could help mitigate COVID-19 transmission amongst dialysis patients in centres with similar organisational pressures.
Sphinx Modified Position For Scaphocephalic And Complex Craniofacial Patients. Technical Note
Authors: Mayorga-Buiza Maria Jose , Rivero-Garvia Monica , Vargas Maria Luisa Tosca , Gonzalez Emilio Gomez , Rivas Javier Marquez
Published: August 2020

Background

The development of less invasive surgical techniques means that surgical remodelling techniques can be performed at younger ages in more complex situations and at lower cost.
Methods
Descriptive study
Results

We describe the technique of positioning and reviews our experience with the partially-modified sphinx position (MSP) in a serie of 234 patients, 96 of these endoscopic procedures (EP). Patient position on the operating table with regard to the treatment area, as well as the position of the treatment area in regard to the floor plane, is paramount for their anaesthetic and surgical management.
Conclusions

We consider that MSP is safe, facilitates access to the operative field, shortens surgery time, reduces bleeding and offers maximum airway and cranio cervical safety in patients undergoing surgery to correct cranial vault pathologies.
Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease
Authors: Chakravarthy Krishnan V. , Chaturvedi Rahul , Agari Takashi , Iwamuro Hirokazu , Reddy Rajiv , Matsui Ayano
Published: August 2020

Background: In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson’s Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS).Methods: 15 patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst stimulation (40Hz, 500Hz, 1000μs), or cycle mode (on time of 10-15 sec, off time of 15-30 sec) with Burst (40Hz, 500Hz, 1000μs). Patients completed the Visual Analogue Scale (VAS), Unified Parkinson’s Disease Rating Scale, Self-Rating Depression Scale, Hamilton Depression Rating Scale, Profile of Mood State, 10-meter walking test, and the Timed Up and Go (TUG).Results: All patients experienced significant improvement in VAS scores with a mean reduction of 59% across all patients. Patients who chose the cycling burst stimulation parameter had an average 67% reduction in VAS scores, as compared to the continuous burst parameter group, which had an average 48% reduction in VAS scores. 73% of patients experienced improvement in the 10-meter walk, with an average improvement of 12%. 64% of patients experienced clinically relevant improvements in the TUG, with an average improvement of 21%. Conclusions: This study points to the potential utility of SCS to address both pain and certain aspects of motor symptoms in PD patients who have and have not received DBS therapy.
Young Key Populations Left Behind: The Necessity for a Targeted Response in Mozambique    
Authors: Boothe Makini , Baltazar Cynthia Semá , Sathane Isabel , Raymond Henry F. , Fazito Erika , Temmermen Marleen , Luchters Stanley
Published: August 2020

Background: The first exposure to high-risk sexual and drug use behaviors often occurs during the period of youth (15-24 years old). These behaviors increase the risk of HIV infection, especially among young key populations (KP) – men how have sex with men (MSM), female sex workers (FSW), and people who inject drugs (PWID). We describe the characteristics of young KP participants in the first round of Biobehavioral Surveillance (BBS) surveys conducted in Mozambique and examine their risk behaviors compared to adult KP.Methods: Respondent-driven sampling (RDS) methodology was used to recruit KP in three major urban areas in Mozambique. RDS-weighted pooled estimates were calculated to estimate the proportion of young KP residing in each survey city. Unweighted pooled estimates of risk behaviors were calculated for each key population group and chi-square analysis assessed differences in proportions between youth (aged less than 24 years old) and older adult KP for each population group. Results: The majority of MSM and FSW participants were young 80.7% (95% CI: 71.5-89.9%) and 71.9% (95%CI: 71.9-79.5%), respectively, although not among PWID (18.2%, 95% CI: 13.2-23.2%). Young KP were single or never married, had a secondary education level or higher, and had lower employment rates. They reported lower perception of HIV risk (MSM: 72.3% vs 56.7%, p<0.001, FSW: 45.3% vs 24.4%, p<0.001), lower HIV testing uptake (MSM: 67.5 vs 72.3, p<0.001; FSW: 63.2 vs 80.6; p<0.001, PWID: 53.3 vs 31.2; p=0.001), greater underage sexual debut (MSM: 9.6 vs 4.8, p<0.001; FSW: 35.2 vs 22.9, p<0.001), and greater underage initiation of injection drug use (PWID: 31.9 vs 7.0, p<0.001). Young KP also had lower HIV prevalence compared to older KP: MSM: 3.3% vs 27.0%, p<0.001; FSW: 17.2% vs 53.7%, p<0.001; and PWID: 6.0% vs 55.0%, p<0.001. There was no significant difference in condom use across the populations. Conclusion: There is an immediate need for a targeted HIV response for young KP in Mozambique so that they are not left behind. Youth must be engaged in the design and implementation of interventions to ensure that low risk behaviors are sustained as they get older to prevent HIV infection.
Gastric Metastasis From Ovarian Carcinoma Revealed by Digestive Hemorrhage: Case Report
Authors: Erraichi¹ Hayat , RANDRIAMANOVONTSOA¹ Niaina Ezra , LITIQUE¹ valère , OUALLA² Karima , BENBRAHIM² Zineb , MELLAS² Nawfel , LIMACHER¹ Jean marc
Published: August 2020

Background: Gastric metastases due to ovarian carcinoma are extremely rare and the patients' prognosis is poor. We report a case of gastric ovarian cancer metastases revealed by gastrosplenic perforation. The secondary gastric tumor appeared seven years after the diagnosis of primary cancer.Case presentation:The patient is a 71-year-old woman with a serous ovarian cancer hospitalized for asthenia with digestive hemorrhage. At esophagogastroduodenoscopy, a protruding mass was noted at the level of the gastric antrum. She underwent a hemostasis of an endoscopic hemostasis by argon plasma; with effective hemostasis. The final pathology revealed gastric metastases of serous ovarian adenocarcinoma. Weekly gemcitabine chemotherapy was adopted, but the disease progressed rapidly. The patient died 4 months later.Conclusion:We have reported a case of gastric metastasis of ovarian tumor origin revealed by digestive hemorrhage. This work reiterates that this secondary localization of this cancer is possible although extremely rare. Studies are still needed to elucidate much of this unclear situation.
Water, Sanitation, and Hygiene (WASH) and the Incidence and Prevalence of Children in Five Public Primary Schools in N'Zerekore, Guinea
Authors: Bah Alseny , Diallo Alhassanel , Bah Alhassane , Li Feihu
Published: August 2020

Background: In Guinea, the incidence and prevalence of children in public primary schools to common disease, e.g., diarrhoeal, malaria, fever, etc. remained pretty high mainly because of the poor water, sanitation, and hygiene (WASH) conditions and practices. We aimed to evaluate the impacts of WASH conditions in and out of school, health education programs, and the behavioral determinants of pupils on the incidence and prevalence of children. Methods: A questionnaire was designed to collect necessary information on current hygiene conditions of all the studied primary schools, the WASH practices in and out of schools, and the incidence and prevalence of these pupils. The data were collected via a survey of the pupils (n = 1048) from five public primary schools in the center of the city of N’Zerekore, Guinea between December 2018 and May 2019. Using a social survey (questionnaire survey), face-to-face interviews with the headmasters and the teachers of several selected schools, data collection was based on students' knowledge of hygiene practices associated with WASH, hand washing situations in and out of school.Results: It reveals that the WASH conditions in all five schools are inadequate. The water access and quality in four schools over all the five schools are greatly limited by the boreholes or unprotected dug wells. The scarcity of essential hygiene kits, especially in the latrines, disinclined the pupils to use the toilets in schools. The WASH and health educations are also invalid in all schools, and therefore the pupils were ineffectively influenced to change their unhealthy WASH behaviors. Our data indicated that 100% (n = 1048) of pupils don’t wash their hands with soap after defecation in school, and over 87.9% (n = 922) of students don’t wash hands before eating. All the above determinants result in a high incidence and prevalence of children among these pupils, including malaria, typhoid, diarrhea, etc.Conclusion: To improve the WASH conditions and to change the pupils’ unhealthy behaviors in the long term, some effective interventions including the provision of clean water and sanitation and hygiene infrastructure, as well as widespread and effective health education should be implemented.
Evaluating Scenarios for School Reopening Under COVID19
Authors: Baxter Arden , Oruc Buse Eylul , Keskinocak Pinar , Asplund John , Serban Nicoleta
Published: August 2020

Background: Thousands of school systems have been struggling with the decisions about how to safely and effectively deliver education during the fall semester of 2020, amid the COVID19 pandemic. This study evaluates the public health impact of various school reopening scenarios (when, and how to return in-person instruction) on the spread of COVID19.Methods: An agent-based simulation model was adapted and used to project the number of infections and deaths under multiple school reopening dates and scenarios, including different cohorts receiving in-person instruction on alternating days, only younger children returning to in-person instruction, regular schedule (all students receiving in-person instruction), and school closure (all students receiving online instruction). The study period was February 18th-November 24th, 2020 and the state of Georgia was used as a case study.Results: Across all scenarios, the number of COVID19-related deaths ranged from approximately 17 to 22 thousand during the study period, and on the peak day, the number of new infections ranged from 43 to 68 thousand. An alternating school day schedule performed: (i) almost as well as keeping schools closed, with the infection attack rate ranging from 38.5% to 39.8% compared to that of 37.7% under school closure; (ii) slightly better than only allowing children 10 years or younger to return to in-person instruction. Delaying the reopening of schools had a minimal impact on reducing infections and deaths under most scenarios.Conclusions: Reopening schools following a regular schedule, i.e., all children returning to school without strict public health measures, would have serious negative public health consequences. The alternating school day schedule, especially if offered as an option to families and teachers who prefer to opt in, provides a good balance in reducing the infection spread compared to the regular schedule, while ensuring access to in-person education.
Establishment of Functional Epithelial Organoid From Human Lacrimal Glands
Authors: Jeong Sang Yun , Choi Woo Hee , Lee Sookon , Park Jong-Moon , Park Mira , Lee Hoogeun , Lew Helen , Yoo Jongman
Published: August 2020

Background: Tear deficiency due to dysfunction of the lacrimal gland is one of the major causes of dry eye disease (DED). Artificial tears as conventional medicine often alleviate symptoms, however, they insufficient to prevent the progression of severe DED. Lacrimal gland stem cell-based therapies have been extensively reported to regenerate injured lacrimal tissue, but the number of stem cells in the lacrimal gland is pretty low, and 2D long-term cultivation results in the reduction of the differentiation capacity of stem cells. Therefore, 3D lacrimal gland organoids could be an alternative for a DED therapeutic method, which is capable of prolonged growth while maintaining the characteristics of the lacrimal gland tissue.Method: Digested cells from human lacrimal gland tissue were mixed with Matrigel and cultured in five different media modified from human prostate/salivary organoid culture media. After organoid formation, the growth, expression of specific markers and histological characters were analyzed to prove the lacrimal gland organoids. And then, the secretory function of lacrimal gland organoids was confirmed by calcium influx or proteomics after pilocarpine treatment.Result: Human lacrimal gland organoids were formed and cultured under a modified salivary organoid culture medium, and their histological features and gene expression pattern were similar to normal lacrimal gland tissue. After pilocarpine treatment, their secretory function was confirmed and the secretomes were analyzed by proteomics. More than 70% of the identified proteins were proven to exosome through GO analysis. Additionally, to explore the curability of developed organoids, mouse-derived lacrimal gland organoids were fabricated and transplanted into mouse lacrimal tissue with DED, and we confirmed that organoids were well engrafted in the lacrimal tissue.Conclusion: These results demonstrate that our established lacrimal gland organoids resemble characteristics of normal lacrimal gland tissue and could be used as cell therapy for patients with dry eye syndrome.
Executive Dysfunctions Mediate Between Altered Sensory Processing and Daily Activity Performance in Older Adults
Authors: Yeger Batya Engel , Rosenblum Sara
Published: August 2020

Background: Sensory processing is essential for the interaction with the environment and for adequate daily function. Sensory processing may be deteriorated in the elderly and restrict daily activity performance. Another factor impacted by aging which significantly affects daily activities is Executive functions (EF). Yet, most studies refer separately to the impacts of sensory processing or EF on daily activities and use clinical evaluations that do not necessarily reflect functional restrictions in real life. This study aims to describe the prevalence of altered sensory processing in the elderly as expressed in daily life scenarios and explore whether EF mediate between altered sensory processing and daily activity performance in older adults. Methods: This cross-sectional study included 167 healthy and independently functioning people living in the community and aged 65 years and older. Participants who had sufficient cognitive status and no symptoms of depression completed a demographic and health-status questionnaire, the Adolescent/Adult Sensory Profile, the Behavior Rating Inventory of Executive Function–Adult Version and the Daily Living Questionnaire. Results: Altered sensory processing, and mainly by the reduced ability to register and modulate sensory input from daily environment, are prevalent in older adults. Their impacts on daily activity performance are mediated by executive dysfunctions. Conclusions: Executive dysfunctions may worsen the negative effects of altered sensory processing on daily activity performance in older adults. The interaction between executive functions and sensory processing should receive growing attention in intervention and prevention programs for older adults, with the emphasis on their expressions in peoples’ real life context.
Midwives’ Integration of Post-Abortion Manual Vacuum Aspiration in the Democratic Republic of Congo: A Mixed Methods Case Study & Positive Deviance Assessment
Authors: Bourret Kirsty Marie , Larocque Sylvie , Hien Amélie , Hogue Carol , Muray Kalum , Lukusa Aurélie Thethe , Ngabo Abel Minani
Published: August 2020

Background: This collaborative research with the Professional Association of Congolese midwives (SCOSAF) in the province of Kinshasa, Democratic Republic of Congo sought to understand how midwives have integrated manual vacuum aspiration (MVA) for post abortion care. Methods: A positive deviant approach to Creswell’s mixed method comparative case study design was used to identify midwives who have integrated MVA post training and to explore enabling factors. Case group comparisons of positive and non-positive deviant midwives provided further interpretations. Results: All 102 midwives invited to be surveyed were recruited. They included 34% who reported practicing MVA post training. No statistical significance was found between the two groups’ demographics and facility type. Overall, groups had positive attitudes regarding midwifery, MVA, and legalization of abortion. Positive deviant midwives demonstrated and described more confidence and competence to practice and teach MVA. They were more likely to identify as teachers and overcome interprofessional barriers by teaching MVA to physicians, medical students and other midwives and position themselves as experts during post abortion emergencies.Conclusion: Results provided important insight to midwives’ integration of post abortion care in Kinshasa. Strategies used by positive deviant midwives in emergencies allowed them to navigate challenging contexts in order to practice MVA, while simultaneously increasing the credibility of their profession and the dissemination of evidenced-based MVA practice. Programs designed to work with and promote positive deviant midwives as knowledge brokers could be tested for its overall impact on the diffusion of midwifery led MVA to improve access to safe respectful reproductive care.
Efficacy of Home-Based Fortified Diet in Rehabilitation of Malnourished Children in Resource Restrained Country: An Institution Based Retrospective Study
Authors: Shahid Saba , Mahesar Marvi , Rahim Anum , Sadiq Yumna
Published: August 2020

Background: Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3% and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections and currently WHO recommends community-based management of malnutrition with provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using home fortified diet in Pakistan. This study aims to evaluate effectiveness of using energy dense, home fortified diet in weight gain of malnourished children in Karachi, through a retrospective chart review.Methods: A retrospective chart review of pediatric patients (aged 6 month–5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about demographic characteristics, feeding, anthropometric, micronutrient, and nutritional details at enrollment and on follow-up.Results: A total of 361 patients were included in the final analysis. The median age (IQR) of children was 15 (14) months. Forty eight percent (n= 172) children had diarrhea and 54% (n= 195) children had respiratory tract infection. The median length of stay in the program was 28 days. The median (IQR) for average weight gain was 4.8 (0-10.3) g/Kg/day, 64.6% (n=226) children defaulted, 29% (n=102) were cured and 3% (n=10) died.Conclusion: This study revealed adequate weight gain and recovery in malnourished children by using home fortified diet in real life situations without using therapeutic food or monetary support. Home fortified diets may serve as effective strategy in community-based rehabilitation of malnourished children.
Effectiveness of Usual-Care Cognitive-Behavioral Therapy for Adolescents with Depressive Disorders Rated by Parents and Patients
Authors: Walter Daniel , Buschsieweke Jana , Dachs Lydia , Goletz Hildegard , Goertz-Dorten Anja , Kinnen Claudia , Perri Daniela , Rademacher Christiane , Schuermann Stephanie , Viefhaus Paula , Woitecki Katrin , Metternich-Kaizman Tanja Wolff , Wirth Elena von , Doepfner Manfred
Published: August 2020

BackgroundDepressive disorders are common in adolescence and are associated with a wide range of negative long-term outcomes. Highly controlled randomized controlled trials (RCT) provide considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) as a treatment for depression, but the effectiveness of CBT under routine care conditions remains unproven.MethodsIn the present observational study, the changes achieved through routine CBT in adolescents with depressive disorders treated in a university outpatient clinic were analyzed, and compared to a historical control group of adolescents with depressive disorders who had received treatment as usual. At the start and end of treatment (pre- and post-assessment), parent and self-ratings of the German versions of the Youth Self-Report (YSR), the Child Behavior Checklist (CBCL) and rating scales for depressive symptoms (FBB-DES, SBB-DES) were assessed. A total of 331 adolescents aged 11–18 years with complete data were assessed for the main analysis.ResultsThe analysis yielded small to large pre-post effect sizes (Cohen’s d) for the total sample (d = 0.33 to d = 0.82) and large effect sizes for adolescents who were rated in the clinical range on each (sub)scale at the start of treatment (d = 0.85 to d = 1.30). When comparing patients in the clinical range with historical controls, medium to large net effect sizes (d = 0.53 to d = 2.09) emerged for the total scores in self- and parent rating. However, a substantial proportion of the sample remained in the clinical range at the end of treatment.ConclusionsThese findings suggest that CBT is effective for adolescents with depressive disorders when administered under routine care conditions, but the results must be interpreted with caution due to the lack of a direct control condition.Trial registrationDRKS, DRKS00021518. Registered 27 April 2020 - Retrospectively registered, http://drks.de
Non-Timber Forest Products and Climate Change Adaptation / Forest Dependent Communities in Bamboko Forest Reserve, South West Region of Cameroon
Authors: Nghogekeh Tieminie Robinson , Loh Chia Eugene , Chupezi Tieguhong Julius , Mayiadieh Nghobuoche Frankline , Mandiefe Piabuo Serge , Tieguhong Mamboh Rolland
Published: August 2020

Background: Forests are tremendously endowed to combat climate change by protecting people and livelihoods, and creating a base for more sustainable economic and social development. But this natural mechanism is often hampered by anthropogenic activities. It is therefore imperative to take measures that are environmentally sustainable not only for mitigation but also for its adaptation. This study was carried out to assess the role of Non-timber forest products (NTFPs) was conducted among forest-dependent communities around the Bamkoko Forest Reserve in the South West Region of Cameroon as a strategy to cope with the impacts of climate change. Data were collected through household questionnaires, participatory rural appraisal techniques, transect walks, and direct field observations.Results: A total of 18 plant species were identified to be harvested by residents around Bamkoko Forest Reserve as Non-Timber Forest Products. The majority of the respondents (88%) perceived that there has been a change in climate patterns due to increased temperatures and unpredictable rainfalls. Eru was found to be the most affected livelihood activity (55%) by climate change around Bamboko Forest Reserve. Communities living around Bamboko Forest Reserve were found to use more than one strategy to cope with the adverse effects of climate change. Conclusions: The study concluded that non-timber forest products still play a safety net role to assist communities in an adverse situation such as crop failure under the current change in the climate. The need to emphasize sustainable harvesting, improve processing, and access to non-timber forest products markets is crucial.
Successful Live Birth in a Chinese Woman with P450 Oxidoreductase Deficiency through Frozen-thawed Embryo Transfer
Authors: Pan Ping , Zheng Lingyan , Chen Xiaoli , Huang Jia , Yang Dongzi , Li Yu
Published: August 2020

Background: Congenital adrenal hyperplasia (CAH) caused by P450 oxidoreductase deficiency (PORD) in 46,XX patients is characterized by genital ambiguity, primary amenorrhea, absent or incomplete sexual maturation, infertility, skeletal malformations and so on. But few pregnancies have been reported from these female patients with PORD. Case Description: A 29-year-old Chinese woman with PORD due to the compound heterozygous mutation (c.1370G>A/c.1196_1204del) in the P450 oxidoreductase(POR) gene had suffered from primary amenorrhea and infertility. She had one cancelled cycle of ovulation induction due to low serum estradiol(E2), high progesterone(P) levels and thin endometrium，then in vitro fertilization (IVF) was recommended. At the first IVF cycle, 4 oocytes were retrieved and 4 viable embryos were cryopreserved due to thin endometrium associated with low E2 and prematurely elevated P after ovarian stimulation, even though oral dexamethasone were used to control adrenal P overproduction at the same time. When basal P fell to <1.5ng/ml, artificial endometrial preparation and frozen embryo transfer were performed, resulting in a twin pregnancy. She delivered a healthy boy and a healthy girl by caesarean section at 37 weeks and 2 days of gestation. Conclusions: We report the pregnancy achieved in a CAH woman caused by a compound heterozygous POR mutation, with primary amenorrhea and disorders of steroidogenesis. It seemed that disorders of steroidogenesis caused by PORD didn’t impair the developmental potential of oocytes. IVF and frozen embryo transfer after adequate hormonal control and endometrial preparation should be an effective infertility treatment for PORD women.
White Oak (Quercus Fabri Hance) Regenerated Stump Sprouts Show Few Symptom of Senescence During 40 Years’growth in the Natural Forest
Authors: Sun Honggang , Wu Sisheng , Wu Liwen
Published: August 2020

Background: The linkage between parent tree’s physiological age and clonal offspring’s lifespan is unclear. White Oak (Quercus fabri Hance) have high sprouting ability after harvest, the regenerated sprouts are typical clonal individuals. Methods: To confirm whether regenerated sprouts will senesce faster, we evaluated the senescence level regenerated stump sprouts with the age of 5-, 10-, 20- and 40- years in the natural forest, compared antioxidative abilities and transcriptomes in leaves and shoots. Results: We found elder regenerated sprouts still had robust antioxidative system, peroxidation products were lower in elder sprouts, antioxidative enzymes activities were similar in 5- and 40-years sprouts. Elder leaves even had higher transcriptional activities in pathways related to cell growth and division. However, elder sprouts also had a few signals of unhealthy: base excision repair, proteasome, proteasome, and glycerophospholipid metabolism pathways upregulated in 40 years leaves, that meant DNA damage and tissue remodeling was more frequent in leaves; plant-pathogen interaction and MAPK signals pathways upregulated in elder shoots, that meant shoots suffered more biotic stress form pathogen. Conclusions: The results indicate 40 years sprouts still had the same vitality with 5 years sprouts, although some unhealthy signals occurred in 40 years sprouts. We conclude that regenerated stump sprouts do not begin to senesce in 40 years, parent tree’s physiological age do not significant shorten the lifespan of clonal offspring.
Psychophysiological responses to group cognitive-behavioral therapy in depressive patients
Authors: Varela Yves Martins , De Almeida Raíssa Nóbrega , Galvão Ana Cecília de Menezes , Junior Geovan Menezes Sousa , de Lima Ana Cecília Lopes , Silva Neuciane Gomes da , Leocádio-Miguel Mário André , Lobão-Soares Bruno , Hallak Jaime Eduardo Cecílio , Maia-de-Oliveira João Paulo , Galvão-Coelho Nicole Leite
Published: August 2020

BackgroundCognitive-Behavioral Therapy (CBT) has a significant adjunctive effect in the treatment of Major Depressive Disorder (MDD), however its uses as monotherapy is less explored, mainly the group-based approaches.MethodsWe assessed the responses of distinct psychophysiological domains after a intervention using group-based CBT (gCBT, 16 weeks) in drug-free patients with mild-moderate MDD (n = 20; women = 11) and to compare with a healthy control group (n = 25, women = 13).ResultsTreatment resulted in 65% of response and 55% of remission rates. Reductions in depressive and anxiety symptoms and increase in self-esteem and sleep quality were observed as responses of gCBT. After treatment patients regulated their previous deregulated salivary cortisol awakening response (CAR) and sleep quality to healthy parameters. These improvements were correlated among themselves and dependent of remission condition. Remitted patients showed large progresses than non-remitted patients, who significantly changed only serum cortisol and self-perceived depressive symptoms. Further, better baseline sleep quality was predictor of remission.ConclusionThese psychophysiological changes in response of gCBT support its use as tool with low cost and no side effects for treatment of mild-moderate major depression, as well as suggests a stronger exploration of these psychological domains in psychotherapies and stimulates furthers studies of neurobiology of MDD and alternatives treatments.Trial registrationU1111-1215-4472. Registered 21 August 2018, http://www.ensaiosclinicos.gov.br/rg/RBR-3npbf8/
Nextgen Vector Surveillance Tools: Sensitive, Specific, Cost-effective and Epidemiologically Relevant
Authors: Farlow Robert , Russell Tanya , Burkot Tom
Published: August 2020

Background Vector surveillance provides critical data for decision-making to ensure that malaria control programs remain effective and responsive to any threats to effectiveness. The quality and quantity of is dependent on the sampling tools and laboratory techniques used which may lack the sensitivity required to collect relevant data for decision-making. Here, 40 vector control experts were interviewed to assess the benefits and limitations of the current vector surveillance tools and techniques. In addition, experts shared ideas on “blue sky” indicators which encompassed ideas for novel methods to monitor presently used indicators, to measure novel vector behaviours not presently measured, algorithms for deploying surveillance tools and priorities for understanding vector behaviours critical for collecting and interpreting vector data. Results. The available tools for sampling and analysing vectors are often hampered by high labour and resource requirements (human and supplies) coupled with high outlay and operating costs and variable tool performance across species and geographic regions vector. The next generation of surveillance tools needs to address the limitations of our present tools by being more sensitive, specific and less costly to deploy to enable the collection and use of epidemiologically relevant vector data to facilitate more proactive vector control guidance. Ideas and attributes for Target Product Profiles (TPPs) generated from this analysis provide targets for research and funding to develop next generation tools.Conclusions. More efficient surveillance tools and a more complete understanding of vector behaviours and populations will provide a basis for more cost effective and successful malaria control by better enabling intervention to be selected that align with vulnerabilities in vector behaviours and thus enable more effective control. Through defining the strengths and weaknesses of the current vector surveillance methods, a foundation and initial framework was provided to define the TPPS for the next generation of vector surveillance methods. The TTPs presented here aim to ensure that the next generation tools and technologies are not encumbered by the limitations of our present surveillance methods, and can be readily deployed in low resource settings.
Continuous extracorporeal treatments in a dialysis patient with COVID-19
Authors: Nihei Yoshihito , Nagasawa Hajime , Fukao Yusuke , Kihara Masao , Ueda Seiji , Gohda Tomohito , Suzuki Yusuke
Published: August 2020

The coronavirus disease 2019 (COVID-19) pandemic is now a major global health threat. More than half a year have passed since the first discovery of severe acute respiratory syndrome coronavirus-2 (SARS-CoV2), no effective treatment has been established especially in intensive care unit. Inflammatory cytokine storm caused by SARS-CoV-2 infection has been reported to play a central role in COVID-19; therefore, treatments for suppressing cytokines, including extracorporeal treatments, are considered to be beneficial. However, until today the efficacy of removing cytokines by extracorporeal treatments in patients with COVID-19 is unclear. We herein report our experience with a 66-year-old male patient undergoing maintenance peritoneal dialysis who became critically ill with COVID-19 and underwent several extracorporeal treatment approaches including plasma exchange, direct hemoperfusion using a polymyxin B-immobilized fiber column and continuous hemodiafiltration. Though the patient developed acute respiratory distress syndrome (ARDS) repeatedly and subacute cerebral infarction and finally died for respiratory failure on day 30 after admission, these attempts appeared to somewhat dampen the cytokine storm based on the observed decline in serum IL-6 levels and were effective against ARDS and secondary haemophagocytic lymphohistiocytosis. This case suggests the significance of timely initiation of extracorporeal treatment approaches in critical ill patients with COVID-19.
Forest carbon prospecting for climate mitigation
Authors: Koh Lian Pin , Zeng Yiwen , Sarira Tasya Vadya , Siman Kelly
Published: August 2020

Carbon finance projects that protect tropical forests could support both nature conservation and climate mitigation goals. Global demand for nature-based carbon credits is outpacing their supply, due partly to gaps in knowledge needed to inform and prioritize investment decisions. Here, we show that at current carbon market prices the protection of tropical forests can generate investible carbon amounting to 2.4 (±1.1) GtCO2e yr-1 globally. We further show that financially viable carbon projects could generate return-on-investment amounting to $77.5b y-1 in net present value (Asia-Pacific: $38.4b y-1; Americas: $33.4b y-1; Africa: $5.7b y-1). However, we also find that ~75% (1.24 billion ha) of forest carbon sites would be financially unviable for failing to break even over the project lifetime. From a conservation perspective, unless carbon prices increase in the future, it is imperative to implement other conservation interventions, in addition to carbon finance, to safeguard carbon stocks and biodiversity in vulnerable forests.