bluuebunny/crossref_metadata_2025 huggingface dataset:
Metrics of perineal support (MOPS) study
Authors: Kalis Vladimir , Rušavŷ Rusavy , HAVELKOVA Linda , ZITKA Tomas , TOLAR David , Ismail Khaled M.K.
Published: June 2020

Background: Manual perineal protection (MPP) is an intrapartum intervention suggested to protect perineal integrity during childbirth. Proper execution of MPP is complex and evaluation of its true contribution is difficult in the clinical setting because of the large number of obstetric variables, some of which are hardly quantifiable. In this study we aimed to gather initial data on the forces executed by the accoucheur's thumb, index and middle fingers during MPP at the time of fetal head expulsion, quantify the duration of the intervention and investigate the timely interaction of the different components of MPP.Methods: Two bespoke right-handed measurement gloves (MG), with built in sensors, were designed and produced. The MG allowed the electronic real-time measurement of applied forces during MPP and transferred this data wirelessly to an integrated computer system. Sterile gloves were worn over the MG when used at the time of birth. The study was undertaken between January and December 2019. Singleton, term pregnant women having their first vaginal birth who provided a valid written consent were enrolled into this prospective pilot study. All deliveries were undertaken by one of two obstetricians experienced in MPP Results: Twenty women were enrolled. The mean duration of execution of MPP during the last contraction was 13.6s. In 20% it lasted <5s. The overall mean values of the average and maximum forces of the thumb, index and middle fingers were 26.7 N; 25.5 N; 20.2 N and 34.3 N; 32.6 N; and 27.6 N respectively. The onset of fingers and thumb activity was simultaneous in 13 cases (65%), while in seven (35%) deliveries the middle finger's force activity was initiated later. Conclusions: MPP during fetal head expulsion happens over a short period of time. In the majority of cases the thumb and fingers actions started simultaneously. There were differences in the duration of application and the forces executed by the fingers and thumb between the two practitioners, however this was only significant for thumb measurements. The results obtained will aid in improving further MPP modeling studies to optimize the technique.
Health Technology Assessment of Ultraviolate light based imaging technology to reduce burden of hospital acquired infections: A Study Protocol
Authors: Shah Komal , Kotwani Priya , Saha Somen
Published: June 2020

Background: HAIs impart a huge clinical and economic burden in India. Healthcare worker’s compliance to hand hygiene protocol can play an important role in preventing the transmission of cross-infection and thus reducing the HAIs. Over last few years, there has been a wide use of ultraviolate (UV) based fluorescent markers for assessing quality of hand hygiene. This Health Technology Assessment (HTA) study will be conducted with the aim to identify low cost, easy and feasible strategy having potential to get integrated in the current health system to deal with issue of HAI in ICU settings. Methods: The study will be conducted in three phases. The impact of innovation on hand hygiene compliance will be assessed quantitatively by undertaking meta-analysis of secondary literature on UV based imaging tool in improving hand hygiene compliance in ICUs. Following this, the feasibility of using this innovation in developing country like India will be assessed. Decision Analytic modelling will be conducted for cost-effectiveness analysis using health systems perspective. Cost per ICU stay (day) and QALY gained will be calculated and ICER will be reported to comment on the cost-effectiveness of the innovation. Discussion: The HTA study will provide a comprehensive overview of the effectiveness of UV light based imaging device in reduction of HAIs. The results of this HTA study will generate evidence for the decision makers for its incorporation in public healthcare system of India. Systematic review registration: The protocol has been registered in Prospero (Prospero Id: CRD42018108960)
Fast-track surgery after gynaecological oncological surgery: A Prospective Randomized Trial
Authors: Shi Xunwei , Cui Ling , Zhang Guonan , Shi Yu , Wang Dengfeng , Yang Zhirong
Published: June 2020

Background: Fast-track surgery (FTS)or enhanced recovery after surgery have been applied to many surgical procedures. The FTS interventions may lead to a major reduction in the undesirable sequelae of surgical injury with improved recovery and reduction in postoperative morbidity and overall costs. The aim of this study is whether FTS reduces the length of stay in hospital compared to traditional management. The secondary aim is whether FTS is associated with an increase in post-surgical complications compared to traditional management (for both open and laparoscopic surgery).Methods: A prospective randomized trial included 107 patients undergoing gynaecological oncological surgery. The patients were randomized to the FTS group (n=50) and the traditional group (n=57). LOS (Length of stay in hospital), and complications were assessed.Results: No signiﬁcant differences in LOS were observed between the groups. The total costs of hospitalization (RMB), and CRP (C-Reactive protein mg/l) are less in the FTS group (P < 0.05) and the overall complications were lower in the FTS Group, statistically significantly lower ((P < 0.05). Conclusions: Fast-track surgery after gynaecological oncological surgery is beneficial for patients. Trial registration number: NCT02687412. Approval Number: SCCHEC20160001.Date of registration: registered on 23 February 2016, https://clinicaltrials.gov/ct2/show/NCT02687412.
Bringing the Field into the Lab: a Novel Virtual Reality Outdoor March Simulator for Evaluating Cognitive and Physical Performance
Authors: Ketko Itay , Naor Shani Kimel , Yanovich Ran , Gottlieb Amihai , Bahat Yotam , Ben-Gal Oran , Heled Yuval , Plotnik Meir
Published: June 2020

Background: Athletes, soldiers, and rescue personnel must often perform intense, prolonged, and physically demanding activities while maintaining cognitive focus. As cognitive and physical functions are believed to share central nervous system resources, their simultaneous activation can cause reciprocal disruptions in the performance of both. Methods: In the current study, we aimed to develop and validate a virtual reality-based experimental protocol enabling rigorous exploration of the effects of prolonged high-load physical and cognitive efforts, by comparing novel cognitive tasks presented in the context of a simulated loaded march to a battery of established neurocognitive tests. We then used this protocol in a pre-post pilot study exploring the effects of high-load physical and cognitive activity on physical and cognitive performance. Twelve participants underwent a simulated 10-km loaded march on a treadmill in our virtual reality environment, with or without integrated cognitive tasks (VR-COG). At each of three experimental visits, participants underwent pre-activity and post-activity evaluations, including the Color Trail Test, the Synthetic Work Environment (SYNWIN) battery for multitasking evaluation, and physical tests (i.e., ‘time to exhaustion’). Results: In general, strong or moderate correlations (r≥0.58 p≤0.048) were found between VR-COG scores and scores on the validated cognitive tests. Together, VR-COG and CTT measures were able to successfully predict the effects of the combined physical and cognitive load on multitasking performance, as assessed by SYNWIN score. Conclusions: As virtual environments are ideal for studying high performance professional activity in realistic but controlled settings, the novel protocol is optimal for measuring the effects of prolonged, high-load physical and cognitive activity, and can therefore contribute to our knowledge on physical-cognitive interactions.
The genome of the "Sea Vomit" Didemnum vexillum
Authors: Parra-Rincón Ernesto , Velandia-Huerto Cristian A , Fallmann Jörg , Gittenberger Adriaan , Brown Federico D , Stadler Peter F , Bermúdez-Santana Clara I
Published: June 2020

Background: Tunicates are the sister group of vertebrates and thus occupy a key position for investigations into vertebrate innovations as well as into the consequences of the vertebrate-specific genome duplications. Nevertheless, tunicate genomes have not been studied extensively in the past and comparative studies of tunicate genomes have remained scarce. The carpet sea squirt Didemnum vexillum is a colonial tunicate considered an invasive species with substantial ecological and economical risk.Results: We report a newly re-assembled genome of Didemnum vexillum. We used a hybrid approach that combines two genome sequencing technologies and also its first transcriptome. Started from 28.5 Gb Illumina and 12.35 Gb of PacBio data a new hybrid scaffolded assembly was obtained comprised of a total size of 517.55 Mb that increases contig length about 8-fold compared to previous, Illumina-only assembly. While still highly fragmented (L50=25284, N50=6539), the assembly is suffcient for comprehensive annotations of both protein-coding genes and non-coding RNAs.Conclusions: The draft assembly of the "sea vomit" genome provides a valuable resource for comparative tunicate genomics and for the study of the specific properties of colonial ascidians.Availability: Genome and annotation data as well as a link to a UCSC Genome Browser hub are available at http://tunicatadvexillum.bioinf.uni-leipzig.de/.
Sex differences in Alzheimer’s-related Tau biomarkers and a mediating effect of testosterone
Authors: Sundermann Erin , Panizzon Matthew S. , Chen Xu , Andrews Murray , Galasko Douglas , Banks Sarah J.
Published: June 2020

Women show greater pathological Tau biomarkers than men along the Alzheimer’s disease (AD) continuum, particularly among apolipoprotein ε-E4 (APOE4) carriers; however, the reason for this sex difference in unknown. Sex differences often indicate an underlying role of sex hormones. We examined whether testosterone levels might influence this sex difference and the modifying role of APOE4 status. Analyses included 172 participants (25 cognitively normal, 97 mild cognitive impairment, 50 AD participants) from the Alzheimer’s Disease Neuroimaging Initiative (34% female, 54% APOE4+, aged 55-90). We examined the separate and interactive effects of plasma testosterone levels and APOE4 on cerebrospinal fluid phosphorylated-tau181 (p-Tau) levels in the overall sample, and the sex difference in p-Tau levels before and after adjusting for testosterone. A significant APOE4-by-testosterone interaction revealed that lower testosterone levels related to higher p-Tau levels among APOE4 carriers regardless of sex. As expected, women had higher p-Tau levels than men among APOE4 carriers only, yet this difference was eliminated upon adjustment for testosterone. Results suggest that testosterone is protective against p-Tau particularly among APOE4 carriers. The lower testosterone levels that typically characterize women may predispose them to pathological Tau, particularly among female APOE4 carriers.
Chronic Obstructive Pulmonary Disease (COPD) management in the community: how could primary care team contribute?
Authors: CHEN Catherine Xiao Rui , Leung Siu Hong , Li Yim Chu
Published: June 2020

Background: Chronic obstructive pulmonary disease (COPD) is a progressive lung disease commonly encountered in the primary care. This study aimed to audit COPD care at 13 public primary care clinics of Hong Kong and to work out improvement strategies. Method: All COPD patients who were aged 40 or above and had been followed up at 13 public primary care clinics of Kowloon Central Cluster (KCC), Hong Kong were included in this clinic audit. Evidence-based audit criteria and performance standards were established after thorough literature review. Phase 1 was from 01/04/2016 to 31/032017, with deficiencies identified, followed by one-year implementation phase with improvement strategies being executed. Phase 2 was from 01/04/2018 to 31/03/2019 with outcome of enhancement reviewed. Chi-square test and student’s t test were used to compare the significance of relevant changes noted. Results: 2,358 COPD cases were identified in phase 1. Among the 658 smokers, 332 (50.5%) had been referred to Smoking Counselling and Cessation and Service (SCCS) and 289 (43.9%) actually attended it. 991 cases (42%) received Seasonal Influenza Vaccine (SIV) and 938 (39.8%) received Pneumococcal Vaccine (PCV). 698 (29.6%) patients had spirometry done before and 423 cases (17.9%) had been admitted to hospital due to acute exacerbation of COPD (AECOPD). With the concerted effort taken during the implementation phase, phase 2 data showed significance improvement in almost all criteria. There was a marked improvement in SIV and PCV coverage, spirometry performance rate and most important of all, a reduction in the AECOPD (n=294, 13.5%, P=0.000043). However, the SCCS referral rate and attendance rate among smokers remained stagnant (both P>0.05). Conclusion: COPD care at primary care clinics of KCC has been tremendously improved in most of the audit criteria via a systematic team approach, therefore reducing the burden to specialist and hospital.
Oral Health Survey among Adolescents Undergoing Obesity Treatment
Authors: Ferreira Gabriela , Pereira Sângela Maria da Silva , Ferreira Inês , Antunes Henedina , Vaz Irene Pina
Published: June 2020

Background: Besides the bad nutritional habits, it has been studied that systemic changes induced by obesity may have repercussions on oral environment. This study evaluated the oral health status of obese adolescents undergoing follow-up at a tertiary hospital in Portugal. Methods: Ninety subjects were classified as obese or severe obese according to the World Health Organization references. Caries experience and periodontal condition were determined by the DMFT index (decayed, missing and filled teeth) and Community Periodontal Index (CPI), respectively. The data for the ages 12 and 15 were compared using Wilcoxon test for one sample to the National Prevalence Study of Oral Diseases (NPSOD), performed in Portugal and published in 2008 and 2015. Results: A mean BMI of 29.4 (± 4.1) was observed, and 64.4% (n = 58) of the subjects were diagnosed with severe obesity. The DMFT of obese adolescents was similar to that of the Portuguese population. At 12 years of age, obese individuals were found to have fewer missing teeth (p = 0.001) and more sealed teeth than those of the same age in Portugal in 2008 (p = 0.012) and 2015 (p = 0.001). At age 15, obese adolescents had fewer decayed teeth (p = 0.017) than individuals of the same age in Portugal (NPSOD, 2008). Conclusions: Obese children and adolescents presented an oral health status similar to that of the Portuguese population at the same age according to the majority of the criteria. These findings can be explained by the health care provided with repeated recommendations for oral hygiene.
Sleep quality, ability to concentrate, and fruit consumption suffice to predict young adult well-being: Findings from Bayesian predictive projection
Authors: Bartonicek Adam , Wickham Shay Ruby , Pat Narun , Conner Tamlin S.
Published: June 2020

Background
The search for reliable lifestyle predictors of psychological well-being is a key research pursuit in psychology and public health. Researchers often gather data on many candidate predictors and then are faced with the difficult task of variable selection – selecting only few “relevant” predictors from the large set of candidates. Many statistical methods that are currently being used for variable selection suffer from known shortfalls. Fortunately, there are newer methods available. The aim of the study is to illustrate the use of predictive projection – a novel Bayesian method for variable selection with many attractive properties – and identify the predictors of psychological well-being in a sample of young adults.
Methods
The sample consisted of 791 young adults (ages 18 to 25, 27.4% men) from New Zealand who had taken part in the Dunedin Daily Life Study in 2013–2014. For 13 days, participants completed an online daily diary assessment of their well-being and a range of modifiable lifestyle variables. Demographic characteristics were also measured. Participants’ diary data was averaged across days and analyzed cross-sectionally to identify predictors of average differences in flourishing. Predictive projection was used to select as few predictors as necessary to approximate the predictive accuracy of a large reference model with 28 predictors. Lastly, predictive projection was compared with other standard methods of variable selection.
Results
Three predictors were sufficient to make average daily flourishing to approximate the predictions of the reference model: higher sleep quality, less trouble concentrating, and more servings of fruit. Demographic factors were not selected into the model. The projected submodel performed adequately on the test data. Compared to other variable selection methods, projection had either slightly worse or matching predictive performance, but led to much more parsimonious inference.
Conclusion
Predictive projection was used to quickly arrive at a parsimonious submodel that approximated the predictive accuracy of the reference model. The variables selected into the submodel – felt refreshed after waking up, had less trouble concentrating, and ate more servings of fruit – were all theoretically meaningful. Our findings have broad implications for well-being research and public policy.
Hole Diameter ratio (HDR) for prediction of anatomical outcomes in stage III and IV idiopathic macular holes
Authors: Qi Yue , Yu Yanping , Wang Zengyi , Wang Jing , Liu Wu
Published: June 2020

Summary: In this study, we reviewed 101 eyes with stage III or IV IMHs treated by PPV combined with ILM peeling and room air tamponade, took the ratio of minimum diameter to maximum diameter (hole diameter ratio, HDR) as the predictive factor and found HDR<0.6(“A” type IMH) can be a predictive factor for a good anatomical outcome.Purpose: To identify hole diameter ratio (HDR) as the predictive factor for unclosed stage III and IV idiopathic macular holes (IMHs) by the use of preoperative optical coherence tomography (OCT).Methods: 101 eyes with stage III or IV IMH were included in this retrospective case series study. All cases were treated with vitrectomy combined with ILM peeling and room air tamponade. The MH minimum and maximum diameter, the ratio of the minimum to the maximum diameter (which defined as HDR) were performed. Results: 81 eyes (80.2%) got a Type I closure after surgery (group A). Postoperative unclosed MHs were found in 20 eyes (19.8%) (group B). The minimal diameter of IMHs (703.6±116.1um VS 597.6±120.1um, P<0.01) and HDR (0.6±0.1 VS 0.5±0.1, P=0.01) were both significantly different between two groups. The cutoff value of the receiver operating characteristic curve was 0.6. The IMH with the HDR that less than 0.6 were defined as “A” type IMH and the others were defined as “H” type IMH. The closure rate of two type IMHs were 90.2% and 65.0% respectively. It had significant differences. (P=0.002) Conclusions: HDR<0.6(“A” type IMH) can be a predictive factor for a good anatomical outcome in stage III and IV IMHs after vitrectomy combined with LM peeling and room air tamponade.
Repetitive Transcranial Magnetic Stimulation (RTMS) on Chronic Tinnitus: a Systematic Review and Meta-Analysis
Authors: Liang Zhengrong , Cheng Gui , Huang Lingfei , Zhang Tao , Yang Haidi , Jia Haiying
Published: June 2020

Background:Although the clinical efficacy and safety of repeated transcranial magnetic stimulation(rTMS)on the treatment of chronic tinnitushave been frequently reported, the results remain controversial.Therefore, its relatedclinical efficacy and safety were systematically evaluated and meta-classified in this study.Methods:Literature on repeated transcranial magnetic stimulation(rTMS)on chronic tinnitus was retrieved in PubMed, Embase and Cochrane Library due April 2020.Review Manager 5.3 software was appliedto data synthesis, and Stata 13.0 software was adopted for analyses of publication bias and sensitivity.Results:A total of 29randomized studies with 1,228 patients were included. Compared with sham rTMS, rTMSshowed statistical significance in tinnitus handicap inventory(THI) scores 1 week after intervention (MD-7.92, 95% condidence interval [CI] -14.18,-1.66), THI scores 1month after intervention (MD-8.52, 95% CI -12.49,-4.55),THI scores 6months after intervention (MD-6.53, 95% CI -11.406,-1.66), TQ scores 1 week after intervention (MD-8.54, 95% CI -15.56,-1.52),mean change in THI scores 1month after intervention(MD-14.86, 95% CI -21.42,-8.29) and mean change in THI scores 6months after intervention(MD-16.37, 95% CI -20.64,-12.11) .There was no statistical difference between rTMS and sham rTMS in THI scores 2 week after intervention (MD-1.51, 95% CI -13.42,-10.40),tinnitus questionnaire(TQ) scores 1 month after intervention (MD-8.97, 95% CI -20.41,2.48),TQ scores 6 months after intervention (MD-7.02, 95% CI -18.18,4.13) , mean change in TQ scores 1months after intervention(MD-3.67, 95% CI -8.56,1.22) and adverse events (OR 1.11, 95% CI 0.51,2.42).Egger's and Begg's testsindicatedno publication bias(P= 0.925).Conclusion:It was demonstrated that rTMS on chronic tinnitus has certain clinical curative effect and high safety,however, due to the lack of included studies and the small sample size, more large-sample, multi-center, randomized double-blind trials are needed for further verification.
Clinical Application of ICP Monitoring Based on FVEP in Treatment of Patients with Hypertensive Intracerebral Hemorrhage
Authors: Yu Fangping , Ying-chun Zhao , Yu Zhang , Xing-hua Luan , Ying Wu
Published: June 2020

ObjectiveTo investigate the application value of flash visual evoked potential (FVEP) in the monitoring of the noninvasive intracranial pressure (nICP) in patients with hypertensive intracerebral hemorrhage (HICH).MethodsOne hundred and two patients with HICH were randomly divided into FVEP nICP monitoring group (experimental group) and the non-monitoring group (control group). The experimental group were examined lumbar puncture immediately after intracranial pressure was monitored by FVEP. Mannitol was used to dehydration treatment of intracranial hypertension patients. The serum concentrations of creatinine and urea nitrogen were recorded to assess the renal function. Using the mannitol usage to evaluate the value of FVEP nICP monitoring techniques in guiding the adjustment of dehydrating agent. The Glasgow prognosis scores (GOS) were evaluated for patients' prognosis between two groups. ResultsThere was no statistical significance between FVEP nICP measurement and lumbar puncture intracranial pressure measurement (195.76 ±13.24 mmH2O vs 197.04 ±11.98 mmH2O, P>0.05). The use of mannitol in the experimental group was significantly lower than that in the control group (P< 0.05), and the serum creatinine and urea nitrogen concentrations in the two groups were not statistically significant (P> 0.05). The cure rate of the experimental group was higher than that of the control group (χ2=3.889, P=0.048). ConclusionFVEP nICP monitoring technology could replace invasive intracranial pressure monitoring technology in monitoring intracranial pressure for HICH patients. The application of FVEP nICP technique can reduce the dosage of dehydrating mannitol and improve the prognosis of patients with HICH.
Six-Year Trends on Prevalence of Myopia among School Children in Liuyang, Central South China: Screening Data from 2013 to 2018
Authors: Chen MengShi , Xu Xin , Abesig Julius , Long HuaJun , Wang Huan , Chen YanCong , Xiong YuTing , Zhang Hong , Li Tiao , Wu Irene XY
Published: June 2020

Background

Myopia is the most common and leading cause of eye problems affecting people of all ages and yet a preventable cause of blindness. The prevalence of myopia in China varied a lot, and related study is lacking from Central South China. So the purpose of this study was to investigate the trends in the prevalence of myopia among under-college school children from 2013 to 2018 in Liuyang district, Central South of China.
Methods

This was a population-based retrospective study. Uncorrected visual acuity test with the Standard Logarithmic Visual Acuity E chart was used to detect myopia. The yearly age-specific prevalence was calculated and compared.
Results

A total of 854907 children from Grade 1 to 12 were included. The prevalence of myopia increased from 24.3% (2013) to 35.9% (2018), with a significant trend of increase (p < 0.001). Persistence higher prevalence was seen in girls than boys, urban dwellers than rural dwellers, and senior high school than that of junior high or primary school children. Significant increase trends in the prevalence of severe myopia were seen across time (from year 2013 to 2018) in each age group among students from 11 to 18 years old (p < 0.001).
Conclusions

There was a remarkable yearly increase in myopia prevalence among school children of all ages and across all grades in China from 2013 to 2018, especially in female, urban and high school students. It is urgently needed for an effective public health intervention for the control of myopia among all Chinese school children.
Validation of the Italian Version of the Revised Prenatal Coping Inventory (NuPCI) and its Correlations with Pregnancy-Specific Stress.
Authors: Penengo Chiara , Colli Chiara , Garzitto Marco , Driul Lorenza , Cesco Maddalena , Balestrieri Matteo
Published: June 2020

Background This cross-sectional study aimed to assess the psychometric properties of the Revised Prenatal Coping Inventory (NuPCI) in an Italian sample and to investigate how coping strategies were associated to pregnancy-specific stress.Methods Low-risk pregnant women (N = 211) were assessed with NuPCI, NuPDQ (Revised-Prenatal Distress Questionnaire), Brief-COPE (Coping Orientation to the Problems Experienced), and STAI (State-Trait Anxiety Inventory). The reliability of NuPCI was evaluated by assessing its internal consistency and factor structure. The concurrent validity between NuPCI and Brief-COPE and NuPDQ and STAI was investigated. Lastly, the relationship between NuPCI and NuPDQ was analyzed, as well as the ability of these scales to predict Apgar score at birth.Results Internal consistency of NuPCI scales was good for Planning-Preparation (ɑC=0.84) and Spiritual-Positive Coping (ɑC=0.81), acceptable for Avoidance (ɑC=0.76). The original three-factor structure was confirmed, using a promax solution. NuPCI and NuPDQ showed good concurrent validity. The NuPCI scales predicted NuPDQ score (Avoidance and Planning-Preparation positively, Spiritual-Positive Coping negatively). Also, Avoidance and Spiritual-Positive Coping scales were associated respectively to increasing and to decreasing Apgar score, with the moderation of NuPDQ.Conclusions Italian NuPCI has sound psychometric properties and it is a useful coping measure. NuPDQ showed also a good validity.
Analyzing Trend of Tropical Cyclone Activity Along Odisha Coast, India
Authors: Mishra Manoranjan , Pattnaik Namita , Dash Manoj Kumar , Kattel Dambaru Ballab , Mishra Shailendra Kumar
Published: June 2020

A general perception among scientific community and policy makers of developing countries exists that intensity and frequency of tropical cyclones are increasing over time due to climate change and global warming. In the present study, we have tried to investigate the trend and variability of tropical cyclone landfall along the Odisha coast, India. The data pertaining to landfall of the tropical cyclones were collected from Indian Metrological Department and were further filtered using Gaussian filter. The results were plotted in graphical form. Correlation and linear regressions analyses were carried out. The results highlight that the frequency and intensity of tropical cyclone exhibit a decreasing trend. It can be thus be inferred that growing economic loss and loss of lives are due to growing exposure of unplanned population settlements and business investments to extreme events. Therefore socio-economic landscapes need to be adjusted to the landfall of cyclone than blaming natural forces for the loss of lives and properties. Findings of the present study may help policy makers devising future policies in coastal zones.
Orofacial Manifestations of Chronic Renal Failure at Ahmed Gasim Hospital and Dr. Salma Center for Kidney Diseases. Khartoum
Authors: Abouna Arwa Mohamed
Published: June 2020

Background: Chronic renal failure is defined as kidney damage, or a reduction in the glomerular filtration rate, for three or more months. Few studies were performed regarding the oral health status of chronic renal failure patients in Sudan.Objective: Study aims to investigate the pattern of orofacial manifestations in patients with chronic renal failure in Sudan and how the disease affecting their oral health. Methods: The present study is a hospital based study conducted at Dr. Salma Center for Treatment of Kidney diseases, University of Khartoum, Sudan and Department of Nephrology at Ahmed Gasim Hospital for Heart Surgery and Kidney Diseases –khartoum Bahri, Sudan, between January to June 2019. Two hundred and twenty six patients participated in the study. The frequency and pattern of orofacial manifestations among those patient in addition to presence of additional systemic diseases ,duration of dialysis and mean levels of urea ,creatinine and hemoglobin were all investigated. Results: Oral lesions were present in 103 out of 226 (45.6%) patients with chronic renal failure .Xerostomia was the most manifestation encountered [145 (64.2%)], followed by orofacial abcess , ulcers and candidiasis . Hypertention was the commonest systemic disease encountered .No significant difference was found regarding the orofacial manifestations with duration of dialysis ,urea ,hemoglobin and creatinine mean levels.Conclusions: Prevalence of orofacial manifestations was significantly high among CRF patients .Xerostomia was the main complaint recognized. The findings of the present study emphasize the importance of dental practitioners in monitoring the oral health of patients with chronic renal faliure, and the need for regular clinical examinations to ensure early diagnosis and management of patients.
Craniofacial Morphology/Phenotypes Influence on Mandibular Range of Movement in the Design of a Mandibular Advancement Device
Authors: Sanz Pedro Mayoral , Reyes Mariano Garcia , Torras Alex Bataller , Castillo JA Cabrera , Lagravere Manuel
Published: June 2020

Background. The mandibular opening path movements have different directions according to the craniofacial morphology of the patient but always downward and backward, therefore increasing the collapse of the upper airway. The aim of this work is to determine if there is a relationship between the craniofacial morphology and the mandibular movement to help understand the impact on the mandibular position. Methods. 52 students with full permanent dentition aged 19 to 23 years (mean 21.3 SD 1.7; 29 females and 23 males), participated in the study. Each subject had a lateral cephalometric radiograph taken. The opening angle was determined for two levels of vertical openings at 5 and 10 mm.Results. The opening angle showed a greater variability between subjects ranging from 63,15 to 77,08 for 5 mm angle and from for 61,65 to 75,72 for the 10 mm angle. Differences of facial phenotypes was evident when comparing the individual dissoccluding angle of the low angle horizontal pattern and high angle vertical pattern.Conclusions. The opening angle is related to craniofacial morphology with higher vertical anterior and shorter anteroposterior faces having a more horizontal path of mandibular movement than shorter vertical anterior and longer anteroposterior subjects who have a more vertical path.
Diversity and Composition of Gut Microbiome of Cervical Cancer Patients by 16S rRNA and Whole-Metagenome Sequencing
Authors: Biegert Greyson , Karpinets Tatiana , Wu Xiaogang , Alam Molly B. El , Sims Travis T. , Yoshida-Court Kyoko , Lynn Erica J. , Yue Jingyan , Medrano Andrea Delgado , Petrosino Joseph , Mezzari Melissa P. , Ajami Nadim J. , Solley Travis , Ahmed-Kaddar Mustapha , Colbert Lauren E , Klopp Ann H.
Published: June 2020

Background Next generation sequencing has progressed rapidly, characterizing microbial communities beyond culture-based or biochemical techniques. 16S ribosomal RNA gene sequencing (16S) produces reliable taxonomic classifications and relative abundances, while shotgun metagenome sequencing (WMS) allows higher taxonomic and functional resolution at greater cost. The purpose of this study was to determine if 16S and WMS provide congruent information for our patient population from paired fecal microbiome samples. Results Comparative indices were highly congruent between 16S and WMS. The most abundant genera for 16S and WMS data did not overlap. Overlap was observed at the Phylum level, as expected. However, relative abundances correlated poorly between the two methodologies (all p>0.05). Hierarchical clustering of both sequencing analyses identified overlapping enterotypes. Both approaches were in agreement with regard to demographic variables.Conclusion Diversity, evenness and richness are comparable when using 16S and WMS techniques, however relative abundances of individual genera are not. Clinical associations with diversity and evenness metrics were similarly identified with WMS or 16S.
Clinical Design for Phase II/III Clinical Trials for Testing Therapeutic Interventions in COVID-19 Patients
Authors: Rai Shesh , Qian Chen , Pan Jianmin , Seth Anand , Srivast Deo Kumar , Bhatnagar Aruni
Published: June 2020

Background
Researchers around the world are urgently conducting clinical trials to develop new treatments for reducing mortality and morbidity related to COVID-19. However, due to unknown features of the disease and complexity of the patient population, traditional trial designs may not be optimal in such patients. We propose two independent clinical trials designs based on careful grouping of the expected characteristics of patient population. This could serve as a useful guide for researchers designing COVID-19 related Phase II/III trials.
Methods
Using the commonly utilized World Health Organization ordinal scale on patient status, we classify patients into three risk groups. In this approach, patients in Stages 3, 4 and 5 are categorized as the intermediate-risk group while patients in Stages 6 and 7 are categorized as the high-risk group. To ensure that an intervention, if deemed efficacious, is promptly made available to vulnerable patients, we propose a group sequential design with two interim analyses along with a final analysis and a toxicity monitoring rule for the intermediate-risk group. For the high-risk group, we propose a group sequential design with two interim analyses without toxicity monitoring.
Results
Based on different response rates, effect sizes, and power, required sample size and toxicity boundaries are calculated for each scenario. Sample size requirements for the designs with interim analyses are only marginally greater than the ones without. In addition, for both the intermediate-risk group and the high-risk group, conducting two interim analyses have identical required sample size compared with just one interim analysis. Additional issues that could potentially impact the trial are discussed.
Conclusions
We recommend using composite endpoints, with binary outcome for those in Stages 3, 4 and 5 with a power of 90% to detect an improvement of 20% in response rate, and 30 days mortality rate outcome for those in Stages 6 and 7 with a power of 90% to detect 15% (effect size) reduced mortality rate, in the COVID-19 trial design. For the intermediate-risk group, two interim analyses for efficacy evaluation along with toxicity monitoring are encouraged. For the high-risk group, two interim analyses without toxicity monitoring is advised.
Chronic Loss of Stag2 Leads to Altered Chromatin Structure Contributing to De-Regulated Transcription in Aml.
Authors: Smith James , Craig Stephanie G , Liberante Fabio G , Lappin Katrina M , Crean Clare M , McDade Simon , Thompson Alexander , Mills Kenneth , Savage Kienan
Published: June 2020

Background The cohesin complex plays a major role in folding the human genome into 3D structural domains. Mutations in members of the cohesin complex are known early drivers of myelodysplastic syndromes (MDS) and acute myeloid leukaemia (AML), with STAG2 the most frequently mutated complex member.Methods Here we use functional genomics (RNA-seq, ChIP-seq and HiChiIP) to investigate the impact of chronic STAG2 loss on three-dimensional genome structure and transcriptional programming in a clinically relevant model of chronic STAG2 loss.Results The chronic loss of STAG2 led to loss of smaller loop domains and the maintenance/formation of large domains that in turn led to altered genome compartmentalisation. These changes in genome structure lead to altered gene expression, including deregulation of the HOXA locus and the MAPK signalling pathway resulting in increased sensitivity to MEK inhibition.Conclusions The altered genomic architecture driven by the chronic loss of STAG2 results in altered gene expression that may contribute to leukaemogenesis which may be therapeutically targeted.
Factors associated with anemia among children 6-59 months in Ethiopia, using Ethiopia Demographic and Health Survey data, 2016
Authors: Woldegebreal Ataklity Gebretsadik , Gebrehiwot Gebremedhin Gebregziabiher , Desta Abraham Aregay , Ajemu Kiros Fenta , Berhe Asfawosen Aregay , Woldearegay Tewolde Wubayehu , Bezabih Nega Mamo
Published: June 2020

BackgroundAnemia is the most common nutritional problem and a wide spread micronutrient deficiency disorder even at global scale. In Ethiopia, child hood anemia is the most prevalent and a serious public health problem. The aim of this study is to assess determinants of anemia among children 6–59 months in Ethiopia, Ethiopia Demographic and Health Survey, 2016.MethodThis study was based on the 2016 Ethiopian Demographic Health Survey (EDHS).A community-based cross-sectional with a two-stage stratified cluster sampling technique was implemented at national level. Total of 7689 children were included in the analysis. Descriptive, bivariate and multivariable logistic regression analysis was employed.ResultThe prevalence of anemia among 6–59 months old children was 56.6% and highest among 6–11 months age groups. Child age 6–23 months, maternal age 20–29 and 30–39 years, poorest wealth index, mothers not currently living with husband, Birth order of the child eighth and, birth interval, one times, stunted children and underweight were significantly associated with anemiaConclusionsThe prevalence of anemia in this study was the highest from all EDHS reports. Itwas skyrocketed from the preceding report (EDHS 2011) and remains the main public health problem in Ethiopia. Comprehensive intervention strategies should be in place tailored to different government hierarchies (national, regional and district level) including household and individual level interventions for combating child hood anemia by giving an emphasis on the identified variables.
Expansion or Incubation? Which is Better to Manipulating Stem Cells for Improving the Effects of Umbilical Cord Blood Transplantation
Authors: Lei Yang-Yang , Wang Lu , Deng Lei , Yang Yang , Zhang Ang , Chang Shao-Hong , Hua Wen-Ming , Rong Bin , Guo Mei , Ai Hui-Sheng , Hu Kai-Xun
Published: June 2020

Background: Delayed hematopoietic recovery was one of the factors that limited the clinic application of umbilical cord blood (UCB) transplantation. Two different methods of overcoming the limitation were evaluated by this systematic review and meta-analysis. One strategy was to expand UCB unit ex vivo for increasing cell dose and another strategy was to incubate UCB unit with small molecules in vitro for enhancing bone marrow (BM) homing ability. Methods: Relevant literatures were collected from 2000 to 2020 by searching the databases of PubMed, Medline, and EMBASE. A total of 15 studies that met the inclusion criteria were included in the meta-analysis. Results: Similar clinical effects including neutrophil recovery (P=0.308), platelet recovery (P=0.4754), and 100-day survival (P=0.4216) between two methods were observed. Faster neutrophil recovery was associated with higher infused total nucleated cells (TNCs) (R2=0.4526 P<0.05) and higher infused CD34+ cells (R2=0.9777 P=0.095) in patients of expansion group and incubation group, respectively. Conclusion: Although the treatment outcomes by using expanded stem cells were getting better all these years with fast development of cell culture techniques according to our cumulative meta-analysis. It seems the application of incubation procedure was safer and more convenient than expansion regarding to their similar clinic effects. This study was registered at RROSPERO (Registration no. CRD42020149750).
CircRNA CDR1as Promotes Glioma Progression by Regulating miR-514a-3p/STAT3 Signaling Pathway
Authors: Cao Yiqun , Yang Wentao , Li Deheng , Li Liangdong , Chen Xin , Chen Lei , Hao Bin , IW Lao , Wang Qifeng
Published: June 2020

Background The pathogenesis of glioma is very complicated and the molecular mechanisms have not been clearly demonstrated so far. CircRNA CDR1as as non-coding RNA was highly expressed in multiple human cancers and promoted tumorigenesis and cancer progression. However, there were no reports to address the roles of CDR1as in glioma.Methods In this study, we used glioma cell lines to investigate the function of CDR1as. Cell viability, colony formation, migration, invasion, gene expression, luciferase activity, miRNA-circRNA interaction, protein-circRNA interaction, and tumor formation in vivo were assessed.Results We found that CDR1as is up-regulated in human glioma tissues and cell lines, and its expression is significantly associated with the prognosis of patients with glioma. Loss-of-function studies revealed that CDR1as increases glioma cell proliferation, migration, and invasion in vitro and tumor growth in vivo. We showed that CDR1as can bind miR-514a-3p and act as a sponge of miR-514a-3p. Furthermore, we identified that the expression of STAT3 is regulated by miR-514a-3p and CDR1as as the direct target of miR-514a-3p. Additionally, the decreased glioma cell malignancy by CDR1as knockdown can be reversed by miR-514a-3p inhibitor and overexpression of STAT3. CDR1as knockdown can result in the down-regulated expression of PCNA, Ki67, N-cadherin, and MMP9 and up-regulated expression of E-cadherin. Moreover, the aberrant expression of these genes by CDR1as knockdown also can be reversed by miR-514a-3p inhibitor and overexpression of STAT3.Conclusions Taken together, our findings uncover the molecular mechanisms of CDR1as-mediated the progression of glioma through the miR-514a-3p/STAT3 signaling pathway. These results will provide a theoretical basis for further understanding of the molecular mechanisms of glioma tumorigenesis and developing new therapeutic targets.
Association Between Micronutrient Dietary Intake and Semen Quality: A Cross-Sectional Study
Authors: Bazarganipour Fatemeh , Akbarzadeh Gouhar , Asemi Zatollah , Kutenaee Maryam Azizi , Sadeghi Hossein , Khashavi Zahra , Taghavi Seyed Abdolvahab
Published: June 2020

Background: To evaluate association between sperm parameters and micronutrient dietary intake in young Iranian men.Material and methods: This cross-sectional study includes 520 men referred to the Infertility Clinic. The quality of semen was measured by measuring the concentration, number, motility and morphology according to WHO guidelines. The micronutrient content of the diet was assessed using a valid food frequency questionnaire (FFQ).Results: After age and BMI adjustment, increased intake of saturated fatty acids, and decreased intake of linoleic acids and selenium were associated with count of sperm (P<0.05). Decreased dietary intake of selenium, zinc and vitamin E were also associated with sperm concentrations (P<0.05). In addition, zinc, vitamin E, selenium and vitamin D were associated with motility of sperm (P<0.05). Increased intake of saturated fatty acids, and decreased intake of linoleic acids and zinc were associated with morphology of sperm (P<0.05).Conclusions: In summary, we found a significant unfavorable association between sperm quality and increased dietary intake of saturated fatty acids, decreased intake of linoleic acids; selenium, zinc, vitamin E and vitamin D. Diets containing higher micronutrient antioxidants and lower saturated fats were associated with optimal sperm quality parameters.
Assessment of urinary biomarkers of mycotoxin exposure in adults from Cameroon
Authors: Abia Wilfred Angie , Tchana Angele N. , Djonabaye Doumani , Šarkanj Bojan , Mfopou Euloge Yiagnigni , Ezekiel Chibundu N. , Sulyok Micheal , Turner Paul C. , Elliott Christopher T. , Warth Benedikt , Krska Rudolf , Moundipa Paul F.
Published: June 2020

Background

In Cameroon dietary staples are contaminated with diverse toxic fungal metabolites, known as mycotoxins. Aflatoxins and fumonisins are of particular public health concern, particularly in relation to cancer and/or early life stunting. Mixtures of these toxins are predicted from food measures, and in this work, the levels and frequencies of urinary mycotoxin biomarkers are reported in Cameroonian adults.
Methods

A single first void urine sample was collected from 89 adults (aged range: 28–85, male 39, female 50) from the city of Yaoundé, Centre Region, Cameroon. Urines were tested for eight distinct mycotoxins using measures of both parent compounds and/or their metabolites by Liquid Chromatography tandem mass spectrometry (LC-MS/MS).
Results

Altogether seven distinct mycotoxins, aflatoxin, fumonisin, deoxynivalenol, zearalenone, nivalenol, ochratoxin A and citrinin, (or their metabolites) were observed in urine samples. At least one mycotoxin was detected in all of the urine samples, 87 (97.8%) of which were above the method’s quantification limit. Aflatoxin M1 was detected in 42% (n.d. − 0.21 µg L− 1) of samples of which about a quarter additionally contained fumonisin B1. Of the remaining toxins deoxynivalenol, zearalenone, ochratoxin A, nivalenol and citrinin were present in 78%, 99% 95%, 53%, and 87% of the samples respectively. Alternariol was not detected in any sample. Mixtures of mycotoxins in the samples were frequently observed with 64 samples (72%) containing more than five mycotoxins. Estimates of intake exceeded the TDIs for fumonisin (n = 4), deoxynivalenol (n = 1) and zearalenone (n = 2), no TDI is set for aflatoxin.
Conclusions

This study reveals frequent co-exposure of Cameroonian individuals to a complex mixture of toxic and carcinogenic mycotoxins, with mixtures of aflatoxin and fumonisin a particular priority from a public health standpoint.