bluuebunny/crossref_metadata_2025 huggingface dataset:
Long Term Outcomes of Colon Polyps with High Grade Dysplasia after Endoscopic Resection
Authors: Chang Jia-Jang , Chien Cheng-Hung , Chen Shuo-Wei , Chen Li-Wei , Liu Ching-Jung , Yen Cho-Li
Published: July 2020

Background
The clinical characteristics of patients with high-grade dysplasia (HGD) in colon polyps at baseline colonoscopy in relation to the risk of recurrent colonic adenomas have been unclear. We conducted this hospital- based cohort study recruiting patients who had undergone polypectomy at screening colonoscopy to assess the risk factors of recurrent colonic adenomas.
Methods
11,565 subjects had undergone screening colonoscopic examinations between September 1998 and August 2007. The patients who had HGD in colon polyps and had undergone surveillance colonoscopy were eligible.
Results
A total of 211 patients were recruited. The rates of metachronous adenomas and advanced adenomas at surveillance colonoscopy were 58% and 20%, respectively, during the mean follow-up period of 5.5 ± 1.8 (3–12) years. On univariate logistic regression analysis, the number of adenomas ≥ 3 at baseline colonoscopy was strongly associated with the rates of overall recurrence, multiple recurrence, advanced recurrence, proximal recurrence, and distal adenoma recurrence with odds ratios of 4.32 (2.06–9.04 95%CI), 3.47 (1.67–7.22 95%CI), 2.55 (1.11–5.89 95%CI), 2.46 (1.16–5.22 95%CI), 2.89 (1.44–5.78 95%CI), respectively. On multivariate analysis, male gender [P = 0.010; OR 3.09(1.32–7.25 95% CI)] and number of adenomas ≥ 3 [P = 0.002; OR 3.08(1.52–6.24 95%CI)] at index colonoscopy were significantly associated with recurrent advanced adenomas.
Conclusions
Recurrence of colonic adenomas at surveillance colonoscopy is common in patients who had undergone polypectomy for colon adenomas with HGD at baseline colonoscopy. The risk of developing future advanced adenomas is associated with the number of colon adenomas and male gender.
Effects of increasing dietary fat inclusion from different sources on growth performance, carcass and meat traits, and pork nutritional profile quality
Authors: Almeida Vivian Vezzoni , Silva Julia Pereira Martins da , Meira Ariana Nascimento , Moreira Gabriel Costa Monteiro , Gomes Julia Dezen , Poleti Mirele Daiana , Dargelio Mariana Damiames Baccarin , Patinho Iliani , Contreras-Castillo Carmen Josefina , Coutinho Luiz Lehmann , Mourão Gerson Barreto , Reecy James Mark , Koltes Dawn , Serão Nicola Vergara Lopes , Regitano Luciana Correia de Almeida , Fukumasu Heidge , Brustolini Ana Paula Liboreiro , Alencar Severino Matias de , Filho Albino Luchiari , Cesar Aline S.M.
Published: July 2020

Background

There has been an increased interest in nutritional strategies to manipulate the fatty acid profile of pigs. Dietary regimens involving the use of oils that are high in monosaturated fatty acid (MUFA), primarily oleic acid (OA), such as canola oil (CO), as well as in omega (n)-3 polyunsaturated fatty acid (PUFA), which are found in fish oil (FO), have been investigated aiming healthier fatty acid profile cuts, with a higher ratio of n-3 to n-6 fatty acids. Therefore, the effects of including 3% soybean oil (SO), CO, or FO in growing-finishing pig diets vs. feeding a standard commercial diet with 1.5% SO (control) on growth performance, carcass traits, meat quality, consumer acceptability, and intramuscular fatty acid composition of the longissimus lumborum (LL) muscle were evaluated.
Results

Dietary treatments had no effect on overall growth performance and pig carcasses. Although loins from pigs fed diets containing either 3% SO or CO showed a reduction (P = 0.05) in Warner-Bratzler shear force, only the addition of 3% SO to pig diets resulted in loin chops that were rated higher (P < 0.001) for consumer overall liking. Adding either 3% SO or CO increased (P < 0.01) the percentages of OA and total MUFA in the LL intramuscular fat compared to control- or FO-fed pigs. However, intramuscular fat from 3% SO- or CO-fed pigs had the lowest (P < 0.01) proportion of total n-3 PUFA than control- or FO-fed pigs. Including 3% fat, regardless of source, reduced (P < 0.01) total PUFA, total n-6 PUFA, and PUFA:saturated fatty acid (SFA) ratio than control-fed pigs. Dietary FO inclusion decreased (P < 0.01) n-6:n-3 PUFA ratio, but also increased total SFA (P < 0.01) and atherogenic index (P = 0.02) in the LL intramuscular fat.
Conclusions

Although adding 3% CO or FO to pig diets provided slight nutritional benefits to consumers in terms of MUFA and long chain n-3 PUFA contents, respectively, formulating growing-finishing diets with 1.5% SO was adequate enough in terms of LL intramuscular fatty acids composition for high quality meat destined to human consumption.
Association of 45-bp Ins/del Polymorphism of Uncoupling Protein 2 (UCP2) and Susceptibility to Nonalcoholic Fatty Liver and Type 2 Diabetes Mellitus in North-west of Iran
Authors: Rezapour Salehe , Khosroshahi Shiva Ahdi , Farajnia Hadi , Mohseni Fatemeh , Khoshbaten Manouchehr , Farajnia Safar
Published: July 2020

Objective

Uncoupling protein 2 (UCP2) is a regulator of insulin secretion, free fatty acid (FFA) concentrations and lipid metabolism that plays crucial roles in energy homeostasis. Last decade reports have described close association between UCP2 polymorphisms and nonalcoholic fatty liver disease (NAFLD) and diabetes mellitus type 2 (T2DM).
Results

A higher prevalence of insertion/insertion genotype has been observed in T2DM patients compared with the control group (p value˂ 0.05). But, there was no difference in genotype distribution between NAFLD patients and control groups (p value > 0.05). NAFLD patients with D/D, D/I genotype had higher triglyceride, ALT and AST levels, and lower HDL level than healthy controls. Patients with T2DM together with D/D or D/I genotype also had significantly higher fasting serum glucose (FSG) level. While we found association between the 45 bp I/D polymorphism in 3ʹUTR of UCP2 and T2DM, existence of correlation between this polymorphism and NAFLD was not identified.
Evolution of the COVID-19 pandemic over six weeks in four French-speaking countries in West Africa
Authors: Millimouno Tamba Mina , Ahmed Mohamed Ali Ag , Ly Birama Apho , Boukary Sana , Faye Christophe Laba , Grovogui Fassou Mathias , Delamou Alexandre , Damme Wim Van
Published: July 2020

Background
The COVID-19 pandemic is an unprecedented international health crisis with different approaches to the response at country levels. The objective of this study was to analyze the evolution of this pandemic in Guinea, Mali, Senegal, and Burkina Faso over the first six weeks. We hypothesize that there exist significant differences in the incidence of COVID-19 between countries.
Methods
A cross-sectional study was conducted as part of a collaborative project. Data collection focused on the epidemiological surveillance indicators available in the countries’ COVID-19 daily situation reports. Data were entered into a standardized Microsoft Excel spreadsheet which was exported to the STATA 15 software for analysis.
Results
COVID-19 had a different dynamic in the four countries over the first six weeks. Its incidence in Burkina Faso and Senegal was dropping, while it was increasing slowly in Mali; only in Guinea, it increased rapidly. The analysis of variance revealed that the differences observed in the weekly COVID-19 incidence in the four countries were statistically significant (p ˂ 0.01). Different screening approaches have been used by the four countries. Guinea (n = 4,539) performed more tests compared to Senegal (n = 2,961), Burkina Faso (n = 2,455) and Mali (n = 2,397). The positivity rates were significantly higher in Mali (25.5%) and Burkina Faso (23.7%) than in Guinea (19.0%) and Senegal (9.5%) (p ˂ 0.0001). Hospitalization rates by country ranged from 32.0–79.6%, with Guinea’s hospitalization rate (79.6%) being significantly higher as compared to that of the three other countries (p ˂ 0.0001). The cure rates were significantly higher in Burkina Faso (61.4%) and Senegal (61.1%) than in Mali (37.3%) and Guinea (19.7%) (p ˂ 0.0001). The case fatality rate was significantly higher in Burkina Faso (6.5%) than in Mali (5.2%) (p ˂ 0.001), Guinea (0.7%), and Senegal (0.7%) (p ˂ 0.0001).
Conclusion
This study highlighted insights from COVID-19 surveillance data, as a basis for improving response strategies in the four countries. Large-scale screening seems relevant to not only facilitate controlling the disease spread but also reducing case fatality rates by early case detection, prior to the occurrence of complications.
Long Working Hours, Poor Sleep Quality, and Non-Officer Task: Determinant Factors of Fatigue Among Indonesian Tugboat Crews
Authors: Mansyur Muchtaruddin , Sagitasari Risna , Wangge Grace , Sulistomo Astrid , Kekalih Aria
Published: July 2020

Background

Tugboat crews are susceptible to fatigue their 24-hour stay in the working environment even in their rest time. The fatigue experienced by the seafarers contributes to marine accidents and metabolic and cardiovascular diseases which are long-term effects. This study aimed to analyze the association between working hours and fatigue, along with other possible related factors in tugboat crews.
Method:

This comparative cross-sectional study included 127 tugboat crew members from a randomly chosen tugboat in Samarinda Harbor, Indonesia. Their fatigue levels at work were subjectively measured using the reaction timer and standardized instrument questionnaire. Data on the crews' personal and occupational factors included age, marital status, rating (job position), duration on board, length of seafaring experience, watch system, smoking habit, coffee and alcohol consumption, and working hours. Moreover, sleep quality and levels of stress-related to the family conflict were measured and analyzed using the Pittsburgh Sleep Quality Index (PSQI) and Work-Family Conflict Scale (WCFS), respectively.
Results

It was found that 40.2% of the subjects experienced fatigue due to long working hours (≥ 72 hours/week), poor sleep quality, and being non-officer crews, with adj. OR and 95%CI values of (12.76; 3.91–41.70), (5.84; 1.67–20.47), and (4.38; 1.28–14.92), respectively. However, the variables of crews' characteristics and occupational factors included age, marital status, duration on board, length of seafaring experience, smoking habit, coffee and alcohol consumption were not statistically associated with the crews' fatigue.
Conclusion

The incidence of fatigue among Indonesian tugboat crews is considerably high. Working hours, sleep quality, and job rating were strongly associated with fatigue in tugboat crews. Working hours monitoring of tugboats crews needs to be improved.
Role of suppression and mitigation interventions in controlling the COVID-19 epidemics
Authors: Han YueXing , Wang Bing , Guo YiKe
Published: July 2020

Background: The global spread of the COVID-19 pandemic has become the most fundamental threat to human lives. In the absence of vaccines and effective therapeutical solutions, non-pharmaceutic interventions have been a major way to control the epidemics. Relaxed mitigation interventions can slow down the epidemics but cannot control it well, while strict suppression interventions can efficiently halt the spread of epidemics, bringing negative effects on economics and people’s daily lives. Hence, suppression strategy and mitigation strategy play different roles in manupulating the epidemic curves.Methods: Here, we propose a mathematical model to understand the rols of suppression and mitigation in changing the epidemic dynamics. By connecting the infection level with the consideration of the medical resources and a tolerence parameter, a combined intervention strategy of suppression and mitigation is proposed. Results: The combined intervention strategy is able to adaptively change with the infection level, resulting in a periodic wave of controlled infections. Depending on the tolerance level, the mitigation strategy can be adaptively switched on or off. The combined intervention can efficiently reduce the numbers of deaths and confirmed cases, and keep the infection within a low level, while such a wave of infection may exist for a long time before the availability of vaccines.Conclusion: In order to control the epidemics, policy-makers have to consider the issues of human lives and economics. To solve such a dilemma, we propose a combined intervention stategy of suppression and mitigation, which can adaptively alternate with the epidemic dynamics. The combined strategy of suppression and mitigation is able to effectively control the epidemics within a low level, it can also reduce the negative effect on economics and human’s normal lives.
Investigating the Effects of Cerebellar Transcranial Direct Current Stimulation on Post-Stroke Overground Gait Performance: a partial least-squares regression approach
Authors: Solanki Dhaval , Rezaee Zeynab , Dutta Anirban , Lahiri Uttama
Published: July 2020

Background
Stroke often results in impaired gait, which can limit community ambulation and the quality of life. Recent works have shown the feasibility of transcranial Direct Current Stimulation (tDCS) as an adjuvant treatment to facilitate gait rehabilitation. Since the cerebellum plays an essential role in balance and movement coordination, which is crucial for independent overground ambulation, so, we investigated the effects of cerebellar tDCS (ctDCS) on the post-stroke overground gait performance in chronic stroke survivors.
Methods
Fourteen chronic post-stroke male subjects were recruited based on convenience sampling at the collaborating hospitals where ten subjects finally participated in the ctDCS gait study. We evaluated the effects of two ctDCS montages with 2 mA direct current, a) optimized configuration for dentate stimulation with 3.14 cm2 disc anode at PO10h (10/5 EEG system) and 3.14 cm2 disc cathode at PO9h (10/5 EEG system), and b) optimized configuration for leg lobules VII-IX stimulation with 3.14 cm2 disc anode at Exx8 (electrodes defined by ROAST) and 3.14 cm2 disc cathode at Exx7. Two-sided Wilcoxon rank-sum test was performed at the 5% significance level on the percent normalized change measures in the overground gait performance.
Results
We found ctDCS to be acceptable by all the exposed subjects. The ctDCS intervention had an effect on the 'Normalised Step length Affected side' (p = 0.1) and 'Gait Stability Ratio' (p = 0.0569), which was found using Wilcoxon signed-rank test at 10% significance level. Also, ctDCS montage specific effect was found using a two-sided Wilcoxon rank-sum test at a 5% significance level for 'Step Time Affected Leg' (p = 0.0257) and '%Stance Time Unaffected Leg' (p = 0.0376). Moreover, the changes in the quantitative gait parameters across both the montages were found to be correlated to the mean electric field strength in the lobules based on partial least squares regression analysis (R2 statistic = 0.6574) where the mean electric field strength at the cerebellar lobules, Vermis VIIIb, Ipsilesional IX, Vermis IX, Ipsilesional X, had the most loading.
Conclusion
Our feasibility study indicated the potential of a single session of ctDCS to contribute to the immediate improvement in the balance and gait performance in terms of gait-related indices and clinical gait measures.
Epidemic and Molecular Characterization of Fluoroquinolone-Resistant Shigella Dysenteriae 1 Isolates From Calves with Diarrhea
Authors: Zhu Zhen , Cao Mingze , Wang Weiwei , Zhang Liwei , Liu Guanhui , Zhou Xuzheng , Li Bing , Shi Yuxiang , Zhang Jiyu
Published: July 2020

Background: The widespread distribution of antimicrobial-resistant Shigella has become a recurrent challenge in many parts of the developing world. Previous studies indicate that the host of Shigella has expanded from humans to animals. This study aimed to investigate the prevalence of fluoroquinolone resistance and associated molecular characterization of S. dysenteriae 1 isolated from calves. Results: All 38 unduplicated S. dysenteriae 1 isolates were collected from calves in Gansu Province from October 2014 to December 2016. According to MLST and PFGE analysis, these isolates were separated into 4 and 28 genotypes, respectively. The most common STs identified were ST228 (34.21%, 13/38) and ST229 (39.47%, 15/38), which were first found in the present study. All isolates harbored virulence genes, and the incidence of the five virulence genes were ipaH (100%), ipaBCD (92.11%), stx (73.68%), ial (57.89%), and sen (28.95%). According to the results of antimicrobial susceptibilities, 76.32% (29/38) of S. dysenteriae isolates were resistant to fluoroquinolone and showed multidrug resistance. In a study on the polymorphism of QRDR of gyrA/B and parC/E genes, we identified two mutations in gyrA (Ser83→Leu and Asp87→Asn) and parC (Ser80→Ile and Ser83→Leu), respectively. Among them, 55.17% (16/29) of resistant strains had the gyrA point mutations (Ser83→Leu) and parC point mutation (Ser83→Leu). Moreover, 41.38% (12/29) of isolates had all five point mutations of gyrA and parC. In addition, the prevalence of the PMQR determinant genes was also investigated. All 29 fluoroquinolone-resistant isolates were positive for the aac(6’)-Ib-cr gene but negative for qepA, except SD001. In addition, only 6 (20.69%, 6/29) isolates harbored the qnr gene, including two with qnrB (6.90%, 2/29) and four with qnrS (13.79%, 4/29). Conclusion: Given the increased common emergence of multidrug resistant isolates, uninterrupted surveillance will be necessary to understand the actual epidemic burden and control this infection.
Analysis of the Role of the Human Papillomavirus 16/18 E7protein Assay in Screening for Cervical Intraepithelial Neoplasia: A Case Control Study
Authors: Kong Linghua , Xiao Xiaoping , Lou Huiping , Liu Pengfei , Song Shuhui , Liu Moudu , Xu Tao , Zhang Ying , Li Caijuan , Guan Ruoli , Li Yan , Yu Xin , Liu Haiyuan , Fan Qingbo , Shi Honghui , Zhu Lan
Published: July 2020

Background: Cervical cancer is the second-most common gynecological cancer, early screening plays a key role in the diagnosis and treatment of cervical intraepithelial neoplasia (CIN). Sustained E7 protein expression is the pathological basis for CIN and cervical cancer. Methods: We collected the cervical cell samples of 205 women who visited the gynecological clinic of Peking Union Medical College Hospital between September 2018 and September 2019 and submitted them to the high-risk human papillomavirus (Hr-HPV) test. We performed a magnetic particle–based chemiluminescence enzyme immunoassay to analyze the Hr-HPV16/18 E7 protein level in CIN of different severities and compared the results with those of cervical pathology (gold standard) and the Hr-HPV test. Results: The positive rate of Hr-HPV16/18 E7 protein increased with the severity of CIN: 26.55% in normal tissue, 58.33% in CIN1, and 70.59% in CIN2/CIN3. For CIN2 and above, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the E7 protein were 70.59%, 67.88%, 52.17%, and 82.30%, respectively. These values of the Hr-HPV test were 86.76%, 44.53%, 43.70%, and 87.14%, respectively. With the combination of the E7 protein assay and Hr-HPV test, the specificity for diagnosing CIN2 and above was 78.10%, which was significantly higher than that of the Hr-HPV test alone. Conclusions: Hr-HPV16/18 E7 protein level is correlated with the severity of CIN and has a high concordance rate with the pathological result. For cervical cancer screening, the combination of HPV16/18 E7 protein assay and Hr-HPV test improves the CIN diagnostic specificity, detection rate, and detection accuracy.
COVID-19 Transmission Risk in Dentistry: A Review and Protective Protocols
Authors: Banakar Morteza , Lankarani Kamran Bagheri , Jafarpour Dana , Moayedi Sedigheh , Banakar Mohammad Hasan , MohammadSadeghi Ashkan
Published: July 2020

Among several potential sources of transmission for the spreading of the COVID-19, dental services have received a high volume of attention. Several reports, papers, guidelines, and suggestions have been released on how this infection could be transmitted through dental services, and what should be done. This study has systematically reviewed the published literature on dentistry and COVID-19 in order to develop a practically feasible protocol for re-opening and reorientation of dental services. The recommendations identified were tested with a convenience sample of experienced practitioners, and a practical step-by-step protocol is presented in this paper.
Gradient local anesthesia for percutaneous endoscopic interlaminar discectomy at the L5/S1 level: a feasibility study
Authors: Feng Wan-Li , Yang Jun-Song , Wei Dongmei , Gong Han-Lin , Xi Yong , Lv Hui-Qiang , Wang Xin-Gang , Xia Bin , Wei Jian-Min
Published: July 2020

Background During the process of shearing the ligamentum ﬂavum, rotating the working channel, and manipulating the annulus fibrosis, the sinuvertebral nerve and the spinal nerve root can be irritated, inducing intolerable back and leg pain. Thus, GA is recommended and well accepted by most surgeons when performing PELD via the interlaminar approach. The aim of our study was to explore the efficacy and safety of percutaneous endoscopy interlaminar lumbar discectomy with gradient LA in patients with L5/S1 disc herniation. Methods This retrospective study was conducted between December 2017 and June 2018. The study included 50 consecutive patients who met the study criteria, had single-level L5/S1 disc herniation, and underwent PELD via the interlaminar approach under gradient LA. Different concentrations of LAC were injected into different tissues inside and outside the ligamentum flavum to complete gradient LA. The evaluation criteria included the intraoperative satisfaction score, VAS score, ODI, complications and adverse reactions. Results The intraoperative satisfaction score was consistently over 7, with an average score of 9.3±0.7, indicating that LAC can achieve satisfactory pain control throughout the PELD operation without additional anesthesia. The postoperative VAS score and ODI were dramatically improved at each follow-up interval (P < 0.001, respectively). There was no serious complication such as dural rupture caused by puncture, dural laceration caused by manipulation under endoscopy, total spinal anesthesia, iatrogenic nerve root injury, epidural hematoma, infections or local anesthetic-related adverse reactions. Three patients experienced transient postoperative dysesthesia of the lower limbs that gradually recovered within 24 hours. Conclusions Gradient local anesthesia can satisfactorily and safely control intraoperative pain during the PELD via the interlaminar approach. It can not only improve intraoperative satisfaction, but also reduce local anesthesia-related adverse reactions and surgery-related complications.
We have the program, what now? Development of an implementation strategy to bridge the research-practice gap prevalent in exercise oncology
Authors: Kennedy Mary Ann , Bayes Sara , Newton Robert U. , Zissiadis Yvonne , Spry Nigel A. , Taaffe Dennis R. , Hart Nicolas H. , Davis Michael , Eiszele Aileen , Galvão Daniel A.
Published: July 2020

Background Exercise has emerged as a promising therapy for people with cancer. Novel programs have been developed to translate this research into practice; however, implementation barriers have limited their success. The aim of this study was to employ the implementation mapping protocol to develop an implementation strategy to effectively support programming of a co-located exercise clinic and cancer treatment center. Methods The Implementation Mapping protocol, which consists of five specific, iterative tasks, was employed for this study. Data from interviews, surveys, clinic records, and implementation science literature was used to develop a comprehensive implementation strategy for the co-located exercise clinic. A stakeholder advisory group advised throughout the process. Results The organization’s general manager was identified as the program adopter; oncologists, center leaders, and various administrative staff as program implementers; and the operations manager as the program maintainer. Twenty performance objectives were identified and used to inform the development of a comprehensive theory-based implementation plan consisting of seven implementation strategies across the individual and organizational levels, including use of program champions and an implementation advisor, and revision of professional roles. Finally, an evaluation plan was developed to measure the success of the implementation strategy. Conclusion Successful translation of exercise oncology research into practice requires context-specific implementation plans. The Implementation Mapping protocol provided a roadmap to guide development of a robust implementation strategy that considered all ecological domains, was informed by theory, and demonstrated an extensive understanding of the implementation context. Strong research-practitioner partnerships and effective stakeholder engagement were critical to successful execution of the protocol.
Nomogram for Prediction of fatal outcome in Patients with Severe COVID-19 Pneumonia: A Multicenter Study
Authors: Yang Yun , Zhu Xiaofei , Huang Jian , Chen Cui , Zheng Yang , He Wei , Zhao Linghao , Gao Qian , Huang Xuanxuan , Fu Lijuan , Zhang Yu , Chang Yanqin , Zhang Huojun , Lu Zhijie
Published: July 2020

Background & Aims: To develop an
effective model of predicting fatal
Outcome in the severe coronavirus disease 2019
(COVID-19) patients.
Methods: Between February 20, 2020
and April 4, 2020, consecutive COVID-19 patients from three
designated hospitals were enrolled in this study. Independent high-
risk factors associated with death were analyzed using Cox
proportional hazard model. A prognostic nomogram was constructed to
predict the survival of severe COVID-19 patients.
Results: There were 124 severe
patients in the training cohort, and there were 71 and 76 severe
patients in the two independent validation cohorts, respectively.
Multivariate Cox analysis indicated that age ≥ 70 years (HR 1.184,
95% CI 1.061-1.321), Panting(breathing rate ≥ 30/min) (HR 3.300,
95% CI 2.509-6.286), lymphocyte count < 1.0 × 109/L
(HR 2.283, 95% CI 1.779-3.267), and IL-6 >10pg/mL (HR 3.029, 95%
CI 1.567-7.116) were independent high-risk factors associated with
fatal outcome. We developed the nomogram for identifying survival
of severe COVID-19 patients in the training cohort (AUC 0.900, [95%
CI 0.841-0.960], sensitivity 95.5%, specificity 77.5%); in
validation cohort 1 (AUC 0.862, [95% CI 0.763-0.961], sensitivity
92.9%, specificity 64.5%); in validation cohort 2 (AUC 0.811, [95%
CI 0.698-0.924], sensitivity 77.3%, specificity 73.5%). The
calibration curve for probability of death indicated a good
consistence between prediction by the nomogram and the actual
observation.
Conclusions: This nomogram could
help clinicians to identify severe patients who have high risk of
death, and to develop more appropriate treatment strategies to
reduce the mortality of severe patients.
Keywords: Severe COVID-19;
Nomogram; Prediction; Survival;
Colossal Permittivity and Multiple Effects in (Zn + Ta) co-doped TiO2 Ceramics
Authors: Fan Jiangtao , Yang TianTian , Cao Zhenzhu
Published: July 2020

The search for giant dielectric constant materials is imperative because of their potential for important applications for the areas of device miniaturization and energy storage. In this work, we report a (Zn + Ta) co-doped TiO2 (ZTTO) ceramics that manifests high dielectric permittivity (>104) and low dielectric loss. This dielectric property shows a high stability in wide temperature range (25-200℃) and frequency range(20-106Hz). The crystalline structure, microstructure and dielectric properties of ZTTO ceramics were systematically investigated. XPS, Impedance spectroscopy and frequency dependent dielectric constant under DC bias results reveal that the colossal dielectric properties of (Zn2+1/3Ta5+2/3)xTi1-xO2 ceramics were mainly caused by electron-pinned defect-dipoles (EPDD) model, internal barrier layer capacitance (IBLC) effect and electrode effect. This work would provide a guidance to further researching the colossal permittivity CP materials.
Application of Nano-Carbon and Titanium Clip Combined Labeling in Robot-Assisted Laparoscopic Transverse Colon Cancer Surgery
Authors: Lin Nan , Qiu Jiandong , Song Junchuan , Yu Changwei , Fang Yongchao , Wu Weihang , Yang Weijin , Wang Yu
Published: July 2020

Introduction: Robot-assisted laparoscopic transverse colon tumor surgery requires precise tumor localization. The purpose of this study was to evaluate the safety and efficacy of nano-carbon and titanium clip combination labeling methods in robot-assisted transverse colon tumor surgery.Methods: From January 2018 to January 2019, the clinical data of 16 patients who underwent preoperative nano-carbon and titanium clip combined with robot-assisted laparoscopic transverse colon cancer surgery were retrospectively analyzed.Results: Of the 16 patients, no signs of abdominal pain, fever, or diarrhea were observed after colonoscopy. Two titanium clips were seen on all of the 16 patients' abdominal plain films. Nano-carbon staining sites were observed during the operation, and no staining disappeared or abdominal cavity contamination. All patients underwent R0 resection. The average number of lymph nodes harvsted was 18.23±5.04 (range, 9-32). The average time to locate the lesion under the laparoscopic was 3.03±1.26 min(range, 1-6min), and the average operation time was 321.43±49.23 min (range, 240-400min). All were consistent with the surgical plan, and there was no intraoperative change of surgical procedure or conversion to open surgery.Conclusion: Preoperative colonoscopy combined with nano-carbon and titanium clip is safe and effective in robot-assisted transverse colon cancer surgery. A At the same time, the labeling method shows potential in shortening the operation time, ensuring sufficient safety margin and reducing complications.
Exploring the usability of the COM-B model and Transtheoretical Domains Framework (TDF) to define the underlying helpers and hindrances of evidence-based change in midwifery
Authors: De Leo Annemarie , BAYES Sara , BLOXSOME Dianne , BUTT Janice
Published: July 2020

Background
Despite the ongoing production of new scientific evidence in the field of maternity care, midwives continue to face challenges when translating latest evidence into evidence-informed care, and report reticence towards implementing evidence-based change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to implement evidence-based practice, and test the usability of the Capability, Opportunity, Motivation and Behaviour model and Transtheoretical Domains Framework to analyse the barriers and facilitators to evidence-based change.
Methods
This qualitative study formed part of a larger Participatory Action Research (PAR) project designed to improve the processes by which midwives implement evidence-based practice change in clinical areas. Data were obtained from a focus group workshop and individual face-to-face interviews between July – September 2019. Thematic analysis was used to interpret the transcribed data, which were then coded and categorised into meaningful themes.
Results
One overarching core finding emerged from four major categories: Fear can stop change and midwives are reticent towards evidence-based change; however, inter-disciplinary collaboration and midwives in leadership roles is a huge advantage.
Conclusion
This study confirms what is known about the helpers and hinderances of evidence-based change, and provides valuable insight into the usability of behavioural theories and context assessment tools to both diagnose and develop implementation strategies applicable to midwives in clinical areas.
Factors associated with the practice of exclusive breastfeeding for six months among mothers on antiretroviral therapy in the Eastern Cape, South Africa
Authors: GOON PROF DANIEL TER , Ajayi Anthony Idowu , ADENIYI OLADELE VINCENT
Published: July 2020

Background
Despite the beneficial health effects of exclusive breastfeeding (EBF) for infants, the practice of EBF remains low in South Africa, a country burdened with HIV. Given that the factors limiting EBF are multi-factorial and context-specific, we sought to examine the factors influencing EBF practice among mothers on antiretroviral therapy (ART) in the Eastern Cape, South Africa.
Methods
This was a prospective cross-sectional study of 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. A structured questionnaire was used to collect relevant socio-demographic, lifestyle and maternal information. Bivariate and multivariate logistic regression analyses were performed to assess associations between socio-demographic, lifestyle factors and EBF.
Results
EBF for six months was practised by a few women (32.0%). The prevalence of EBF was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%), and those who never drank alcohol (37.0%). Unemployed women (AOR = 1.66, 95% CI: 1.08–2.56) and those with grade 12 or less level of education (AOR = 2.76, 95% CI: 1.02–7.49) had a higher likelihood of practising EBF for six months compared to employed women and women who attained tertiary level of education. While mothers who take alcohol (AOR = 0.54, 95% CI: 0.34–0.85) were less likely to practice EBF for six months compared to those who never drank alcohol.
Conclusions
Factors contributing to the low prevalence of EBF among mothers in this setting are employment, tertiary education and alcohol consumption. Strategies should target these socioeconomic indicators and lifestyle behaviour in the region.
The Awareness of Women on Prostate Cancer: A Mixed-Methods Systematic Review Protocol
Authors: Wiafe Ebenezer , Mensah Kofi Boamah , Mensah Adwoa Bemah Boamah , Bangalee Varsha , Oosthuizen Frasia
Published: July 2020

Background: Prostate cancer accounts for about 10% of cancers affecting and claiming the lives of men. Studies have reported that women are better than men in recognition of the early manifestations of various cancers. Besides, women have been recognized to show a profound interest in their partners' health and hence, make observations that men don't know. Several studies have reported on the knowledge gaps of prostate cancer among patients and the general population. It is vital to comprehensively review the available evidence and identify research gaps in our current understanding of knowledge of women on prostate cancer.Methods: A search of bibliographic databases, MEDLINE (EBSCOhost), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Web of Science, and EMBASE (Ovid) will be undertaken from January 1999 to December 2019. The search will be limited to studies published in the English language. Duplication of studies will be removed using the EndNote citation manager. After deduplication, citations will be screened independently by two authors according to prespecified criteria. Data extraction and quality assessment of the selected studies will be done independently by two authors. Meta-analytic methods will be used where appropriate. The convergent segregated method of synthesis will be adopted in this review. Ethics and dissemination: Primary data collection will not be involved in this study, hence formal ethical clearance will not be needed. The results of the study will be presented through a peer-reviewed journal and conference presentation.Patient and public involvement: Patients or the public will not be engaged in the conduct of this study.Trial registration number: Open Science Framework (OSF) registration DOI: https://doi.org/10.17605/OSF.IO/EYHF2
Structural stigma and its impact on healthcare for consumers diagnosed with Borderline Personality Disorder: protocol for a scoping review
Authors: Klein Pauline , Fairweather-Schmidt A. Kate , Lawn Sharon , Stallman Helen , Cammell Paul
Published: July 2020

BackgroundStructural stigma in health systems experienced by consumers diagnosed with Borderline Personality Disorder (BPD), is a widespread phenomenon that causes health inequities and harm for this population. Structural stigma in this context relates to organisational practices, cultural norms, and institutional policies that limits consumers’ access to health services, quality of care, and health and well-being. BPD is a mental illness with high morbidity and mortality, characterised by instability in interpersonal relationships, self-image, and emotional and behavioral deregulation, which stem from significant traumatic childhood/life events, and/or biological etiologies. This scoping review aims to explore the literature on structural stigma in health systems specific to BPD, and to provide an overview of the impact of stigma on healthcare services for BPD consumers, and their carers/families.MethodsThis scoping review will follow the Joanna Briggs Institute (JBI) guidelines. The search strategy was developed and tested using PsycINFO. A comprehensive search will be conducted across PsycINFO, MEDLINE, CINAHL, Scopus, ProQuest, Cochrane library and JBI Evidence-Based databases; as well as a grey literature search using Google search engine. Studies will be screened by title, abstract and full text articles, by separate reviewers against the eligibility criteria. Selected full text articles will be accessed against the inclusion criteria. Quantitative and qualitative data will be extracted from the selected full text articles. A narrative summary of findings will then be conducted and presented in accordance with the JBI guidelines for scoping reviews, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 checklist. Quality appraisal of the included articles will be assessed using the Mixed Methods Appraisal Tool (MMAT) 2018 version.DiscussionThis review is anticipated to enhance both identification and understanding of those structures in health systems (i.e., policies, cultural norms, and practices), that manifest and perpetuate stigma experienced by consumers with BPD, and their carers/families. The findings can be used to inform future research, policy and practice relating to stigma reduction strategies that can be adopted to improve the provision of BPD-responsive services and care for this population.Scoping review registrationThis scoping review was submitted for registration in Open for Science Framework on 11th June 2020.
Women’s experiences of planning a home birth with maternity care providers in middle to high-income countries: a systematic review protocol
Authors: Healy Maria , Bamidele Olufikayo , Gillen Patricia
Published: July 2020

Background: A woman’s choice of birth place does not only influence her birth experience, but also impacts on maternal and neonatal outcomes. For healthy women who have had a straightforward pregnancy, a planned home birth supported by midwives and other maternity care providers, is now a recognised choice within their individual country’s health care system. However, there is limited evidence on women’s actual experiences of engaging with maternity care providers to plan for a home birth, especially within the context of middle to high-income countries where there is integration of maternity care services. Therefore, this systematic review will synthesise findings from previous studies, which have reported on women’s experiences of planning a home birth in consultation with maternity care providers, in middle to high-income countries.Methods: Using a systematic approach, we will develop a search strategy to identify relevant research studies on women’s experiences of planning a home birth, with the support of their maternity care providers. Search terms will be iteratively developed using text words derived from the review aim, the PICO framework and database-indexed terms. In May 2020, the searches will be conducted on seven bibliographic databases: Ovid Medline, Embase, PsycInfo, and CINAHL plus, Scopus, ProQuest and Cochrane (Central and Library) from January 2015 to 26th May 2020. Supplementary searches will also be undertaken to identify additional articles. At least two reviewers will do the screening, quality appraisal, data extraction and analysis. Included studies will be appraised using a quality appraisal tool suited to the study design. Data will be analysed using either a narrative or thematic synthesis depending on the methodological design of the studies included. Discussion: Review findings will provide useful recommendations to improve care and support provided for women when planning a home birth. We will publish review findings in a peer-reviewed journal and present it at relevant conferences while also sharing summaries with maternity care providers and service users via social media fora. PROSPERO registration ID: CRD42018095042
U-Shaped Association Between Serum Bilirubin Levels and Peripheral Arterial Disease in Chinese Males with Hypertension
Authors: Shi Yumeng , Hu Lihua , Li Minghui , Huang Xiao , Ding Congcong , Zhou Wei , Wang Tao , Zhu Lin juan , Bao Huihui , Cheng Xiaoshu
Published: July 2020

Background: Previous studies indicated that serum total bilirubin might play an important role in peripheral artery disease (PAD). However, the effects of different levels of serum total bilirubin (TBiL) on PAD development remain an uncertainty and had limited data in male participants. We aimed to examine the prevalence of PAD and TBiL among Chinese male adults with hypertension.Methods: A total of 5129 hypertension male subjects aged 27-93 years was included in the current study. The outcome was a peripheral arterial disease (PAD), defined as present when ABI of either sides was ≤ 0.90.Results: Of 5,129 hypertension male participants, 194 (3.78%) had PAD, and the median serum concentrations of TBiL were 14.10 μmol/L (interquartile range 11.00 to18.60 μmol/L). Compared to participants in Q2-Q3 of LgTBiL, there was a significantly increased risk of PAD for participants in both Q1 (OR,1.49; 95%CI: 1.04-2.14) and Q4 (OR,1.70; 95%CI: 1.16-2.48). After adjusting for potential confounders, a nonlinear U-shaped relationship was detected between TBiL and PAD, and calculated the inflection point was 1.08 (LgTBiL = 1.08, TBiL = 12.02 μmol/L). The ORs (95% CIs) were 0.11 (0.02, 0.83) on the left side of an inflection point and 5.26 (1.59, 17.38) on the right side of the inflection point, respectively. Similar results were found in various subgroups.Conclusions: This cross-sectional study had shown that there was a U-shaped curve for the risk of PAD with TBiL concentration in Chinese males with hypertension, with a turning point at 12.02 μmol/L.
Different Effects of Monophasic Pulses and Biphasic Pulses Applied by a Bipolar Stimulation Electrode in the Rat Hippocampal CA1 Region
Authors: Yuan Yue , Zheng Lvpiao , Feng Zhouyan , Yang Gangsheng
Published: July 2020

Background: Deep brain stimulation (DBS) has been successfully used for treating certain brain diseases such as movement disorders. High-frequency stimulations (HFS) of charge-balanced biphasic pulses have been used in clinic DBS to minimize the risk of tissue damages caused by the electrical stimulations, while HFS sequences of monophasic pulses have been used in animal experiments to investigate DBS therapy. However, it is not clear whether HFS sequences of monophasic pulses could induce abnormal neuronal responses different from biphasic pulses. Thus, the present study investigates the differences of neuronal responses to HFS of monophasic pulses and biphasic pulses.Methods: Orthodromic-HFS (O-HFS) and antidromic-HFS (A-HFS) of the two types of pulses (with a 1-min duration) were delivered by bipolar electrodes to the Schaffer collaterals (i.e., afferent fibers) and the alveus fibers (i.e., efferent fibers) of the rat hippocampal CA1 region in-vivo, respectively. Responses of CA1 pyramidal neurons to the stimulations were recorded in the CA1 region. Single pulses of antidromic- and orthodromic-test stimuli were applied before and after HFS to evoke population spikes for evaluating the baseline and the recovery of neuronal activity. Results: Spreading depression (SD) appeared during sequences of 200 Hz monophasic O-HFS with a high incidence (4/5), but did not appear during corresponding 200 Hz biphasic O-HFS (0/6). The potential waveform of SD was accompanied by a preceding burst of population spikes, propagated slowly, silenced neuronal firing temporarily and resulted in a non-recovery of orthodromically-evoked population spikes (OPS) after the O-HFS. No SD events appeared during the O-HFS with a lower frequency of 100 Hz of monophasic and biphasic pulses (0/5 and 0/6, respectively) nor during the A-HFS of 200 Hz pulses (0/9). However, the antidromically-evoked population spikes (APS) only recovered partially after the 200 Hz A-HFS of monophasic pulses.Conclusions: The O-HFS with a high enough frequency of monophasic pulses may induce the abnormal neuron activity of SD instantaneously, which may be used as a biomarker to warn the damages caused by improper stimulations in brain tissues.
RGG1, involved in the cytokinin regulatory pathway, controls grain size in rice
Authors: Tao Yajun , Miao Jun , Wang Jun , Li Wenqi , Xu Yang , Wang Fangquan , Jiang Yanjie , Chen Zhihui , Fan Fangjun , Xu Mengbin , Zhou Yong , Liang Guohua , Yang Jie
Published: July 2020

Heterotrimeric GTP binding proteins (G proteins) and cytokinin play important roles in regulating plant growth and development. However, little is known about the mechanism by which they coordinate the regulation of grain size in rice. We functionally characterized one gene, RGG1, encoding a type-A Gγ subunit. Strong GUS staining were detected in young panicles and spikelets, suggesting the role of this gene in modulating panicle-related traits development. By regulating cell division, over-expression of RGG1 in Nipponbare (NIP) and Wuyunjing 30 (WYJ30) significantly decreased plant height, panicle length and grain length. However, rgg1 mutants generated by CRISPR/Cas9 system exhibited no obvious phenotypic differences, which may be due to its extremely low expression level in vivo. Transcriptomic analysis showed that differentially expressed genes (DEGs) were enriched in the cytokinin biosynthesis pathway. We confirmed this result by measuring the endogenous cytokinin levels and showed that the content of cytokinin was lower in OE lines. Additionally, the results of 6-benzylaminopurine (6-BA) treatment showed that increased expression of RGG1 decreased the sensitivity to 6-BA under low concentration. Our results reveal a novel G proteins—cytokinin module controlling grain size in rice, which will be beneficial for understanding the mechanisms of G proteins regulating grain size and plant development.