bluuebunny/crossref_metadata_2025 huggingface dataset:
Disturbed Flow Induces Endothelial Dysfunction by Regulating Thioredoxin-Interacting Protein-Mediated Mitochondrial Energy Homoeostasis
Authors: Wang Yongshun , Liu Jingjin , Sun Xin , Yuan Jie , Liu Huadong , Chen Ruimian , Liao Bihong , Gong Haixia , Xia Zhengyuan , Dong Shaohong
Published: January 2021

Endothelial cells are highly sensitive to hemodynamic shear stresses, which act in the blood flow’s direction on the blood vessel’s luminal surface. Endothelial cells on that surface, thusly, are exposed to various physiological and pathological stimuli, such as disturbed flow-induced shear stress, which may exert effects on adaptive vascular diameter or structural wall remodeling. Here we showed that human endothelial cells exposed to disturbed flow exhibited increased levels of thioredoxin-interactive protein (TXNIP) in vitro. On the other hand, deletion of human endothelial TXNIP increased capillary formation, NO production and mitochondrial function, as well as lessened oxidative stress response and endothelial cell inflammation. Additional beneficial impacts from TXNIP deletion were also seen in a glucose utilization study, as reflected by augmented glucose uptake, lactate secretion and extracellular acidification rate. Taken together, our results suggested that TXNIP is a key component involved in mediating shear stress-induced inflammation, energy homeostasis, and glucose utilization, ultimately establishing it as a potentially novel endothelial dysfunction regulator.
Microbiota–Muscle/–Immune Interactions in Rhesus Macaque under Simulated Weightlessness Revealed by Integrated Multi-Omics Analysis
Authors: Zhang Peng , Shao Libin , Zhang Jie , Wang Lu , Yuan Huimei , Pang Xiangsheng , Fan Guangyi , Peng Ling , Kan Guanghan , Li Wenjiong , Liang Xinming , Liu Xin , Chen Xiaoping
Published: January 2021

BackgroundLong-term exposure to microgravity during spaceflight has adverse effects on human health including muscle atrophy, impaired immune function, and alterations in gut microbiome profile. Gut microorganisms influence a wide range of host biological processes, but their interactions with skeletal muscle and the immune system under microgravity are not known. MethodsRhesus macaques (Macaca mulatta) were subjected to -6° head-down tilted bed rest (HDBR) for 6 weeks. Fecal samples, skeletal muscle tissue, and peripheral blood mononuclear cells (PBMCs) were collected for metagenomic, metabolomic, and transcriptomic analyses respectively and further integrated for a multi-omics analysis.ResultsHDBR resulted in significantly altered taxon abundance in 1 class, 5 orders, 11 families, 55 genera, and 122 species of microbes. We also identified the significantly changed metabolites in atrophied muscles, including some crucial metabolites (such as L-alanine and L-carnitine) and hub metabolites (such as pyridoxamine and epinephrine) involved in energy metabolism. Transcriptomic analysis of PBMCs revealed genes related to leukocyte activation, differentiation, and interleukin-2 production that were differentially expressed as a result of HDBR exposure. By integrating multi-omics analysis, we identified 3 bacterial genera (Klebsiella, Kluyvera, and Bifidobacterium) that were closely associated with immune dysfunction and 5 (including Oligella, Sporosarcina, Citrobacter, Weissella, and Myroide) that were associated with abnormal metabolism of amino acids in atrophied muscles induced by HDBR. Of note, the reduced abundance of butyrate-producing colon bacteria Eubacterium, Roseburia and their cross-feeding bacteria Bifidobacteria may contribute to both the impaired immune function and muscle atrophy caused by HDBR.ConclusionsWe first reported the HDBR-associated changes in gut microbiota composition, metabolomics of skeletal muscle and transcripts of PBMCs in non-human primate. Particularly, we revealed the underlying microbiota-muscle and microbiota-immune interactions during simulated microgravity, implicating that modulation of gut microbiota may represent a new strategy in enhancing crewmembers’ health and safety during long-term space expeditions.
The Intestinal Microbiome Primes Host Innate Immunity Against Enteric Virus Systemic Infection Through Type I Interferon
Authors: Yang Xiao-Lian , Wang Gan , Xie Jin-Yan , Li Han , Liu Wei , Zhu Shu Jeffrey
Published: January 2021

BackgroundIntestinal microbiomes are of vital importance in antagonizing systemic viral infection. However, very little literature has shown whether commensal bacteria play a crucial role in protecting enteric virus systemic infection from the aspect of modulating host innate immunity. Also, only a few specific commensal bacteria species have been revealed to be capable in regulating antiviral innate immune responses mediated by type I interferon (IFN). The underlying mechanisms have not yet been elucidated.ResultsWe utilized an enteric virus, encephalomyocarditis virus (EMCV) to inoculate PBS-treated or antibiotic cocktail-administrated mice (Abx) orally or intraperitoneally to examine the impact of microbiota depletion on virulence and viral replication in vivo. Microbiota depletion exacerbated the mortality, neuropathogenesis, viremia and viral burden in brain following EMCV infection. Furthermore, Abx-treated mice exhibited severely diminished macrophage activation and impaired type I IFN production and ISG expression in PBMC, spleen or brain. With the help of fecal bacterial 16S rRNA sequencing of PBS and Abx mice, we identified a single commensal bacterium Blautia coccoides (B. coccoides) that can restore macrophage- and IFNAR-dependent type I IFN responses to restrict systemic enteric virus infection.ConclusionOur present study demonstrates that intestinal microbiome is fundamental for protecting from enteric virus systemic infection through activating macrophages and type I IFN responses. Reconstitution with B. coccoides can inhibit enteric virus infection and mitigate its neuropathogenesis by activating IFN-I and ISG responses in macrophages via IFNAR- and STAT1-mediated signaling pathway.
Co-occurence of Secretory Immunoglobulin A-Coated Bacteria in Maternal Gut, Breast Milk, and Infant Gut in Humans
Authors: Qi Ce , Ding Mengfan , Xiao Hang , Li Duo , Chen Daozhen , Zhou Qin , Yu Renqiang , Sun Jin
Published: January 2021

BackgroundGut microbiota promote and maintain infant health. Vertical transmission of bacteria from the maternal gut through breast milk to an infant is an important source of microbial colonisation in human offspring. However, the causative active/culturable bacteria and mechanisms responsible for their mother-neonate vertical transfer via breastfeeding remain unclear. Secretory immunoglobulin A (sIgA) may mediate this vertical transmission; however, evidence supporting this hypothesis is required. In this study, we aimed to investigate whether sIgA-coated bacteria in the maternal intestine may migrate to breast milk and colonise the infant gut.ResultsMaternal faeces, breast milk, and neonatal faeces were collected from 19 mother-infant dyads during lactation stages specific to colostrum, transitional, and mature milk. sIgA-coated bacteria were enriched using magnetic-activated cell sorting, and live bacteria were cultured in lactic acid bacteria- and gut bacteria-specific medium. 16S ribosomal RNA gene amplicon sequencing showed that microbiota diversity in maternal faeces, breast milk, and infant faeces decreased sequentially from colostrum to transitional milk to mature milk. Significant beta diversity existed between sample types (p < 0.05). However, high similarity was found between sIgA-coated microbiota of the three types of samples at the mature milk stage. Source track analysis showed that sIgA-coated microbiota in breast milk and maternal gut are major contributors of sIgA-coated microbiota in infant gut. Genera with co-occurrence in sample types included Bifidobacterium, Enterococcus, Streptococcus, Lactobacillus, Klebsiella, Escherichia-Shigella, and an unclassified genus of Enterobacteriaceae. Shotgun sequencing of three dyads identified co-occurring species Lactobacillus and Bifidobacterium, including Lactobacillus salivarius, Lactobacillus reuteri, Lactobacillus gasseri, Lactobacillus jonsonii, Lactobacillus oris, Bifidobacterium longum, and Bifidobacterium breve. Conclusions﻿Breastmilk and infant faeces samples showed unique microbial composition and diversity in the three lactation stages. The fractions of sIgA-coated microbiota in maternal faeces, breast milk, and infant gut showed similar bacterial abundance patterns. This study will facilitate development of strategies to adjust aberrant microbial establishment and reduce the risk of disease by providing essential information for effective probiotic administration to the neonate and/or breastfeeding mother.
Improvement in Growth and Yield Attributes of Cluster Bean Through Optimization of Sowing Time and Plant Spacing Under Climate Change Scenario
Authors: Hussain Ibrar , Ali Muqarrab , Modaihsh Abdullah , Shahzad Khurram , Farooq Omer , Iqbal Shahid , Nawaz Fahim , Ahmad Shakeel , Akthar Lal Hussain , Iqbal Muhammad Mazhar , Fahad Shah , Ghoneim Adel , Danish Subhan , TABAN Süleyman , Datta Rahul
Published: January 2021

Cluster bean (Cyamopsis tetragonoloba L.) yield have plateaued due to reduction in rainfall and rise in temperature. Therefore, its production cycle could not get appropriate water and temperature. It becomes important to standardize sowing time and plant spacing of cluster bean in changing climate scenario to get higher productivity. Therefore, a field study was conducted to evaluate the effect of four sowing times (15th May, 1st June, 15th June, and 1st July) and three plant spacings (10, 12 and 15 cm) on crop growth, yield, and physiological functions of cluster bean genotype BR-2017. The sowing times (15th May, 1st June, 15th June, and 1st July) were placed in the main plot while plant spacing (10, 12 and 15 cm) were maintained in subplots. Results showed that 1st June sowing performed better over 15th May, 15th June, and 1st July while plant spacing 15 cm about in all sowing times showed higher results on growth and yield parameters of cluster bean over plant spacing 10, 12, and 15 cm. The 1st June sowing time at 15 cm plant spacing showed 8.0, 22.7, and 28.5% higher grains pod-1 as compared to 15th May, 15th June, and 1st July sowing respectively. The chord diagram clearly indicates that the crop has received optimum environmental conditions when sown 1st June over other sowing times. In conclusion, 1st June sowing with 15 cm plant spacing could be a good option to achieve maximum productivity of cluster bean under changing climate scenario.
The Impact of Gender on Researchers’ Assessment: A Randomized Controlled Trial
Authors: FRANCO Marina , Helal Lucas , Cenci Maximiliano , Moher David
Published: January 2021

Women remain underrepresented in Dentistry in academia, and this gap is widened whenever each career step is progressed. It is of utmost importance to investigate underlying associated factors to predict researchers’ assessment of their gender in Dentistry and the overall STEM (Science, technology, engineering, and mathematics) fields. Thus, we developed a randomized controlled trial to test whether women or men would be preferred with identical curriculum vitae (CV); and the impact of the career stage in the evaluators’ choice. To this, a simulated post-doctoral process was carried forward to be assessed for judgment. Level 1 and 2 Brazilian fellow researchers in the field of Dentistry were invited to act as external reviewers in a post-doctoral process and were randomly assigned to receive a female or male CV. They were required to rate the CV from 0 to 10 in scientific contribution, leadership potential, ability to work in groups, and international experience. For all categories of CVs evaluated, men received higher scores compared to the CVs from women. Robust variance Poisson regressions demonstrated that men were more likely to receive higher scores in all categories, despite applicants’ career stage. For example, CVs from men had nearly three quarters more likely to be seen as having leadership potential than equivalent CVs from women. Gender bias is powerfully prevalent in academia in the dentistry field, despite researchers' career stage. Actions like implicit bias training must be urgently implemented to avoid (or at least decrease) that more women are harmed.
Persistence and baseline determinants of seropositivity in health care workers up to nine months after COVID-19
Authors: Dobaño Carlota , Ramirez Anna , Alonso Selena , Vidal-Alaball Josep , Ruiz-Olalla Gemma , Vidal Marta , Rubio Rocio , Cascant Emma , Parras Daniel , Melero Natalia Rodrigo , Serra Pau , Carolis Carlo , Santamaria Pere , Forcada Anna , Mendioroz Jacobo , Aguilar Ruth , Moncunill Gemma , Ruiz-Comellas Anna
Published: January 2021

We determined the duration and baseline determinants of antibody responses to SARS-CoV-2 up to nine months after COVID-19 symptoms onset in 173 primary health care worker patients from Spain. Seropositivity to SARS-CoV-2 spike and RBD antigens was 92.49% (60.69% IgM, 76.3% IgA, 90.17% IgG), with four suspected reinfection cases. Antibody levels significantly correlated with fever, hospitalization, anosmia/hypogeusia, allergies, smoking and occupation, and persisted 149-270 days in this cohort of patients
Modelling the viral load dependence of residence times of virus laden droplets from COVID-19 infected subjects in indoor environments
Authors: Anand Srinivasan , Krishan Jayant , Bathula Sreekanth , Mayya Yelia S
Published: January 2021

In the ongoing COVID-19 pandemic situation, exposure assessment and control strategies for aerosol transmission path are feebly understood. A recent study pointed out that Poissonian fluctuations in viral loading of airborne droplets significantly modifies the size spectrum of the virus laden droplets (termed as “virusol”). Herein we develop theory of residence time of the virusols, as contrasted with clean droplets in indoor air using a comprehensive “Falling-to-Mixing-plateout” model that considers all the important processes. This model fills the existing gap between Wells falling drop model and the stirred chamber models. The effect of various parameters on mean residence time are examined in detail. Significantly, the mean residence time of virusols is found to increase nonlinearly with the viral load in the ejecta, ranging from ~125 s at low viral loads (<104/mL) to about 1150 s at high viral loads (>1011/mL). The implications are further discussed.
A Bayesian spatio-temporal analysis of malaria in the Greater Accra Region of Ghana from 2015 to 2019.
Authors: Donkor Elorm , Kelly Matthew , Eliason Cecilia , Amotoh Charles , Gray Prof. Darren J , Clements Prof. Archie CA , Wangdi Kinley
Published: January 2021

Background: Efforts towards malaria control in Ghana have had positive impacts. However, these efforts need to be locally tailored to further accelerate progress. The aim of this study was to examine the climatic drivers of malaria transmission in the Greater Accra Region and identify inter-district variation of malaria burden.Methodology: Monthly malaria cases for the Greater Accra Region were obtained from the Ghanaian District Health Information and Management System from 2015 to 2019. Malaria cases were decomposed using the seasonal-trend decomposition, based on locally weighted regression to analyze the seasonality. A Poisson regression model with a conditional autoregressive prior structure was used to quantify associations between climatic variables and malaria risk, and spatial dependence. Posterior parameters were estimated using Bayesian Markov chain Monte Carlo simulation with Gibbs sampling.Results: A total of 1,105,370 malaria cases was recorded in the region from 2015–2019. The overall malaria incidence rate for the region was approximately 1 per 1,000,000 population. Malaria transmission was highly seasonal with an irregular inter-annual pattern during the study period. Malaria incidence was found to increase by 0.1% (95% credible interval [CrI]: 0.02–0.16%) for a 1°C rise in monthly mean maximum temperature lagged at 6 months and 0.2% (95% CrI: 0.5–0.3%) for 1°C rise in monthly mean minimum temperature without lag. No spatial dependency was observed after accounting for climatic variables. Only five districts located in the south-central part of the region had a malaria incidence rate that was lower than the regional average at > 95% probability level.Conclusion: The distribution of malaria cases was heterogeneous, seasonal and significantly associated with climatic variables. Targeted malaria control and prevention in high-risk districts at the appropriate time points could result in a significant reduction in malaria transmission in the Greater Accra Region.
Temporal and spatial changes in phyllosphere microbiome of acacia trees growing in arid environments
Authors: Al-Ashhab Ashraf , Meshner Shiri , Alexander-Shani Rivka , Dimerets Hana , Brandwein Michael , Bar-Lavan Yael , Winters Gidon
Published: January 2021

Background: The evolutionary relationships and interactions between plants and their microbiomes are of high importance to the survival of plants in extreme conditions. Changes in the plant’s microbiome can affect plant development, growth and health. Along the arid Arava, southern Israel, acacia trees (Acacia raddiana and Acacia tortilis) are considered keystone species. In this study, we investigated the ecological effects of plant species, microclimate (different areas within the tree canopy) and seasonality on the epiphytic and endophytic microbiomes associated with these two tree species. One hundred and thirty nine leaf samples were collected throughout the year and their microbial communities were assessed using 16S rDNA gene amplified with five different primers (targeting different gene regions) and sequenced (150 bp paired-end) on an Illumina MiSeq sequencing platform.Results: Epiphytic bacterial diversity estimates (Shannon-Wiener, Chao1, Simpson and observed number of OTUs), were found to be nearly double compared to endophyte counterparts, in addition epi- and endophyte communities were significantly different from each other. Interestingly, the epiphytic bacterial diversity was similar in the two acacia species but the canopy sides and sample months exhibited different diversity, while the endophytic bacterial communities were different in the two acacia species but similar throughout the year. Abiotic factors, such as air temperature and precipitation, were shown to significantly affect both epi- and endophytes communities. Bacterial community compositions showed that Firmicutes dominate Acacia raddiana and Proteobacteria dominate Acacia tortilis; these bacterial communities only consisted of a small number of bacterial families mainly Bacillaceae and Comamonadaceae in the endophyte for A. raddiana and A. tortilis, respectively, and Geodematophilaceae and Micrococcaceae for epiphyte bacterial communities. Interestingly, about 60% of the obtained bacterial classification were unclassified below family level. Conclusions: These results shed light on the unique desert phyllosphere microbiome highlighting the importance of multiple genotypic and abiotic factors in shaping the epiphytic and endophytic microbial communities. This study also shows that only a few bacterial families dominate both epi- and endophytes, highlighting the importance of climate change (precipitation, air temperature and humidity) in affecting arid land ecosystems where acacia trees are considered keystone species.
Adapting the Sudden Landslide Identification Product (SLIP) and Detecting Real-Time Increased Precipitation (DRIP) algorithms to map rainfall-triggered landslides in the West-Cameroons’ highlands (Central-Africa)
Authors: Mfondoum Alfred Homère Ngandam , Nguet Pauline Wokwenmendam , Mfondoum Jean Valery Mefire , Tchindjang Mesmin , Hakdaoui Sofia , Cooper Ryan , Gbetkom Paul Gérard , Penaye Joseph , Bekoa Ateba , Moudioh Cyriel
Published: January 2021

Background – NASA’s developers recently proposed the Sudden Landslide Identification Product (SLIP) and Detecting Real-Time Increased Precipitation (DRIP) algorithms. This method uses the Landsat 8 satellite images and daily rainfall recordings for a real-time mapping of this geohazard. This study adapts the processing to face the issues of data quality and unavailability/gaps for the mapping of the recent landslide events in west-Cameroon’s highlands. Methods – The SLIP algorithm is adapted, by integrating the inverse NDVI to assess the soil bareness, the Modified Normalized Multi-Band Drought Index (MNMDI) combined with the hydrothermal index to assess soil moisture, and the slope inclination to map the recent landslide. Further, the DRIP algorithm uses the mean daily rainfall to assess the thresholds corresponding to the recent landslide events. Their probability density function (PDF) curves are superimposed and their intersections are used to propose sets of dichotomous variables before (1948-2018) and after the 28 October 2019 landslide event. In addition, a survival analysis is performed to correlate the occurrence date of the landslide with the rainfall since the first known event in Cameroon, through the Cox model.Results – From the SLIP model, the Landslide Hazard Zonation (LHZ) map gives an overall accuracy of 96 % . Further, the DRIP model states that 6/9 ranges of probability are rainfall-triggered landslides at 99.99% , between June and October, while 3/9 ranges show only 4.88% of risk for the same interval. Finally, the survival probability for a known site is up to 0.68 for the best value and between 0.38 and 0.1 for the lowest value through time. Conclusions – The proposed approach is an alternative based on data (un)availability, completed by the site’s lifetime.
Effect of physical exercise in bariatric surgery patients: protocol of a randomized controlled clinical trial.
Authors: Herrera Andrea , Tabach Andrea , Andaur Karen , Zamunér Antonio
Published: January 2021

Background: Bariatric surgery is an effective approach to weight loss and long-term comorbidity resolution. Although recommended in several guidelines, supervised exercise has not been systematically prescribed after bariatric surgery. The aim of this study is to determine the effects of two types of exercise, moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT), on body composition, cardiopulmonary function and perceived quality of life in bariatric surgery patients.Methods: This randomized controlled exploratory pilot trial will include 75 adults of both sexes scheduled for bariatric surgery. They will be randomly assigned to one of three groups: 1) MICT, 2) HIIT, or 3) a control group. The intervention will occur 2 days a week for 4 months. Outcomes will be assessed at four points: 1) one week before surgery; 2) 21 days after surgery (baseline before the exercise program); 3) 8 weeks after beginning the exercise program; and 4) one week after the end of intervention. Primary outcomes will include body composition, heart rate variability, and six-minute walk test and quality of life scores. Secondary outcomes will be maximal respiratory pressure, flowmeter, hand dynamometry, and 30-second sit-to-stand test results.Discussion: Both exercise protocols in this study were developed according to evidence-based practice. It is expected that, after 16 weeks of intervention, body composition (measured by electrical bioimpedance), cardiopulmonary function (measured by heart rate variability, maximal inspiratory pressure, maximal expiratory pressure, peak expiratory flow, handgrip strength, and the six-minute walk test) and perceived quality of life (measured by the Moorehead-Ardelt quality of life questionnaire II and bariatric analysis and reporting outcome system scores) will improve, especially in the HIIT group.Trial registration: ClinicalTrials.gov, NCT04235842, registered 22 January 2020.
The Impact of Writing on Academic Performance for Medical Students
Authors: Kim Songeui , Yang Ji Won , Lim Jaeseo , Lee Seunghee , Ihm Jungjoon , Park Jooyong
Published: January 2021

Background: Writing is a useful learning activity that promotes higher-order thinking, but there are limited studies that prove its effectiveness. In previous research, researchers tested the effect of summary writing on students’ comprehension and found no significant difference from that of re-studying texts. The purpose of this study, therefore, is to expand previous findings and investigate the effect of two types of writing tasks on medical students’ academic performance, specifically in the transfer of knowledge.Methods: An experiment was conducted with 139 medical students from Seoul National University College of Medicine. They were randomly assigned to three study conditions: self-study (SS), expository writing (EW), and argumentative writing (AW) group. Each group studied the given material by the method they were assigned, and they were tested on their comprehension and transfer of knowledge using rote-memory type items and transfer type items respectively.Results: The results showed that the two writing groups displayed better performance than the SS group in transfer type items, while there was no difference in scores between the EW and AW group. However, the three groups showed no significant difference in their scores for rote-memory type items. Also, there was a positive correlation between the writing scores and transfer type item scores in the AW group.Conclusions: This study provides empirical evidence for writing to be adopted in medical education for greater educational benefits. Our findings indicate that writing can enhance learning and higher-order thinking, which are critical for medical students.
Intraoperative three-dimensional imaging in ankle syndesmotic reduction.
Authors: Beck Markus , Brunk Manuela , Wichelhaus Alice , Mittlmeier Thomas , Rotter Robert
Published: January 2021

Background: Injuries of the distal syndesmosis in ankle fractures are traditionally treated with a temporary adjusting screw fixation. Conventional fluoroscopic and X-ray examinations cannot reliably diagnose malpositions of the fixed tibiofibular syndesmosis. Postoperative computer tomography allows a reliable control of the transfixed region.The aim of the retrospective single-study was to clarify whether an intraoperative 3D image intensifier examination can detect malpositions of the syndesmosis already intraoperatively and whether the examination has an influence on the postoperative revision rate.Methods: In 200 patients with tibiofibular syndesmosis injuries, an intraoperative 3D scan was performed after reduction of the distal tibiofibular syndesmosis and placement of the adjusting screw. Postoperative computer tomography of both ankle joints was performed in all patients. Results: 15% of all intraoperative 3D scans (30 patients) showed a finding requiring correction in the area of the ankle joint. In 7% of the cases, a malposition of the fibula in the tibial incisura requiring correction was found. Further corrections were necessary due to the extent and position of the osteosynthesis material (7%) and for the removal of joint bodies (1%). Postoperative computer tomographies of the ankle joints showed no deformities requiring revision. Conclusion: An intraoperative 3D scan allows a reliable assessment of the injured ankle region and reduces the postoperative revision rate. This makes a postoperative routine CT examination of the ankle joint dispensable.
Chinese herbal extract granules combined with 5-aminosalicylic acid for patients with moderately active ulcerative colitis: study protocol for a multicenter randomized double-blind placebo-controlled trial
Authors: Shen Zhaofeng , Zheng Kai , Zou Jiandong , Gu Peiqing , Xing Jing , Zhang Lu , Zhu Lei , Shen Hong
Published: January 2021

Background: Ulcerative colitis (UC) is an intestinal inflammatory disease characterized by inflammation of the colonic mucosa. With unknown pathogenesis, it has become a chronic lifetime disorder worldwide. In patients with moderately active UC, several therapies (e.g. aminosalicylates, corticosteroids, immunosuppressants and biologics) are recommended for induction (or maintenance) of remission. Given the side effects and disease burden, it is difficult for most patients to achieve ideal treatment goals in clinical practice. Chinese herbal medicine (CHM), as a complementary therapy, has been widely used in the management of UC in China. Qing-Chang-Hua-Shi granule (QCHS) is a classical Chinese herbal formula. Our preliminary study suggested that the QCHS decoction has a significant effect on patients with moderately active UC. However, its effectiveness and safety has not been evaluated convincingly. Therefore, we designed this protocol to investigate the efficacy of QCHS granule for moderately active UC.Methods: This is a multicenter, randomized, double-blind, placebo-controlled, superiority trial. A total of 120 patients with moderately active UC will be recruited from 10 hospitals in China. Each eligible participant will be randomly assigned to receive QCHS granule or placebo for 12 weeks. Both groups will be given basic treatment with mesalazine (4g/d). The primary outcomes are the clinical response (remission) rate. The secondary outcomes are health-related quality of life, endoscopic response rate, mucosal healing rate and inflammatory markers (e.g. Fecal calprotectin and CRP). The whole study period will last 36 weeks, including 24 weeks follow-up time. According to the intention-to-treat principle, variables will be assessed at 2, 4, 6, 8, 10 and 12 weeks after study commencement. Discussion: This is the first randomized controlled clinical study protocol regarding Chinese herbal extract granules in the management of moderately active UC. We aim to investigate the superiority of QCHS granules over placebo in terms of induction of remission. If the trial shows significant benefits of QCHS granules, it will help clinical practitioners, UC patients and policymakers make more informed choices in the decision-making.Trial registration: Chinese Clinical Trial Registry, ChiCTR-IOR-14005554. Registered on 27 November 2014.
Combined subcostal and posterior transversus abdominis plane block for postoperative pain relief after abdominoplasty
Authors: Sayed Haytham El , Fadhul A Shaheed , Falalki Mohamed Al , Awad M Nasr
Published: January 2021

Background: Abdominoplasty is a common aesthetic surgery. Adequate pain management during the postoperative period is of great importance. This research aims to investigate the outcome of the abdominoplasty operation for the patients who have received transversus abdominis plan block in comparison with the non-blocked patients.Methods: 58 patients, undergoing elective abdominoplasty, patients were randomly assigned to two equal groups of 29 patients each. Combined subcostal and posterior transversus abdominis plane block group and non-blocked group. For both groups, the standard postoperative analgesic regimen consisted of IV Paracetamol 1 g every 6 hours. Values of visual analog scale (VAS) were recorded postoperatively, once the patient had a VAS ≥ 4, IV opioids administered. The primary outcome was opioids consumption in the first 72 hours postoperatively, the secondary outcome was the value of VAS at rest and movement (or with knee flexion) in the first 72 hours postoperatively, time to first ambulation and time to first incentive spirometer 900 ml/min were recorded.Results: Pethidine consumption in the first 72 hours was 208.62±85.64 in the non-blocked group and 20.69±25.06 in the blocked group (p < 0.05). VAS was lower in the blocked group during the first 72 hours either during rest or movement where (p < 0.05). Time to first ambulation was 12.41±5.04 hours in the non-blocked group and 4.62±1.08 hours in the blocked group (p < 0.05), time to first incentive spirometer 900 ml/min was 11.45±5.05 hours in the non-blocked group and 4.27±1.09 hours in the blocked group (p < 0.05).Conclusion: Combined subcostal and posterior transversus abdominis plane block is a promising regional anesthetic technique for postoperative pain relief in abdominoplasty surgery, it offers a longer postoperative analgesic effect duration and fewer analgesic requirements with less postoperative complications.Trial Registration Clinical Trial: TCTR20200602001 “Retrospectively registered” Date of registration on May 30, 2020
Rapid review of COVID-19 epidemic estimation studies for Iran
Authors: Pourmalek Farshad , Hemami Mohsen Rezaei , Janani Leila , Moradi-Lakeh Maziar
Published: January 2021

Background: To inform researchers about the methodology and results of epidemic estimation studies performed for COVID-19 epidemic in Iran, we aimed to perform a rapid review. Methods: We searched for and included published articles, preprint manuscripts and reports that estimated numbers of cumulative or daily deaths or cases of COVID-19 in Iran. We found 131 studies and included 29 of them. Results: The included studies provided outputs for a total of 84 study-model/scenario combinations. Sixteen studies used 3-4 compartmental disease models. At the end of month two of the epidemic (2020-04-19), the lowest (and highest) values of predictions were 1777 (388951) for cumulative deaths, 20588 (2310161) for cumulative cases, and at the end of month four (2020-06-20), were 3590 (1819392) for cumulative deaths, and 144305 (4266964) for cumulative cases. Highest estimates of cumulative deaths (and cases) for latest date available in 2020 were 418834 on 2020-12-19 (and 41475792 on 2020-12-31). Model estimates predict an ominous course of epidemic progress in Iran. Increase in percent population using masks from the current situation to 95% might prevent 26790 additional deaths (95% confidence interval 19925-35208) by the end of year 2020. Conclusions: Meticulousness and degree of details reported for disease modeling and statistical methods used in the included studies varied widely. Greater heterogeneity was observed regarding the results of predicted outcomes. Consideration of minimum and preferred reporting items in epidemic estimation studies might better inform future revisions of the available models and new models to be developed. Not accounting for under-reporting drives the models’ results misleading.
Two novel biallelic mutations in PSMC3IP in a Chinese patient affected by primary ovarian insufficiency: case report and review of the literature
Authors: Mei Libin , Huang Lingling , Huang Yanru , Wu Xiaoling , He Huang , He XueMei , Su Zhiying , Li Ping
Published: January 2021

Background: Premature ovarian insufficiency (POI) is a heterogeneous condition occurring when a woman experiences a loss of ovarian activity before the age of 40. It is one of the most common reproductive endocrine diseases in women of childbearing age. Here, we investigated the clinical manifestations and genetic features of a Chinese patient affected by POI.Methods: We applied next-generation whole-exome capture sequencing with Sanger direct sequencing to the proband and her clinically unaffected family members. Results: Two novel compound heterozygous mutations were identified in the PSMC3IP gene. The first is a splicing mutation (c.597+1G>T) that was inherited from her father, while the second mutation (c.268G>C p.D90H) was also discovered in her mother and younger sister. The two mutations were co-segregated with the disease phenotype in the family. Conclusions: To our knowledge, this is the first report of PSMC3IP mutations causing POI in the Chinese population. Our findings further support the key role of the PSMC3IP gene in the etiology of POI. However, additional studies are required to explore the underlying molecular mechanisms involved.
Evaluation of Preventive, Supportive and Awareness Building Measures among International Students in China in Response to COVID-19: A Structural Equation Modeling Approach
Authors: Sarker Tanwne , Sarkar Apurbo , Rabbany Md. Ghulam , Barmon Milon , Roy Rana , Rahman Md. Ashfikur , Hossain Kh Zulfikar , Hoque Fazlul , Asaduzzaman Muhammad
Published: January 2021

Background:To prevent dissemination of COVID-19 among international students in China, educational institutions promptly took various preventive, supportive and awareness building measures like restricting outdoor activities, wearing mask, every day health reporting and so on. Success of such behavioral change campaigns largely depends on awareness building, satisfaction and trust on the authorities. The objective of this current study is to evaluate the preventive, supportive and awareness building measures taken for the international students in China during COVID-19 pandemic which will be helpful in designing such behavioral change campaign in other parts of the world in the future pandemic situation.Methods:In this study, we have evaluated how the level of awareness, satisfaction, and trust in authorities (i.e., government, local authorities, and institutions) shapes the behavior and close interconnection each other. Simple bivariate statistics was used to describe the background characteristics of the respondents along with adoption of the partial least squares-structural equation modeling (PLS-SEM) as the final model to show the association between the variables.Results:Our study findings showed the great impact of preventive and supportive measures in the development of students’ satisfaction (R2 = 0.507 indicating moderate relationship). The satisfied students possessed a strong influence which eventually helped in building sufficient trust on their institutions (R2 = 0.797 indicating above substantial relationship). The extents of the R2 values were found significant in our model. Moreover, present study provides insight views of the selected latent variables by counteracting the interaction among them.Conclusions:The worldwide student group is one of the most affected and vulnerable communities in this situation. So, there is a profound ground of research on how different states or authorities handle such situation. In this study we have depicted the types and magnitude of care taken by Chinese government and educational institutions towards international students to relieve the panic of pandemic situation. Further research and such initiatives should be taken in to consideration for future emerging conditions.
Multiple Sclerosis incidence rate in southern Iran: A Bayesian epidemiological study
Authors: Asmarian Naeimehossadat , Sharafi Zahra , Mousavi Amin , Jacques Reis , Tamayo Ibon , Bind Marie-Abèle , abutorabi-zarchi Marzie , Moradian Mohammad Javad , Izadi Sadegh
Published: January 2021

Background: Multiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanisms and clinical impacts on young people. The prevalence of this disease in Iran is reported to be 5.30 to 74.28 per 100,000-person. Because of high prevalence of this disease in Fars province, the purpose of this study was to assess the spatial pattern of MS incidence rate by modeling both the associations s of spatial dependence between neighboring regions and risk factors in a Bayesian Poisson model, which can lead to the improvement of health resource allocation decisions.Method: Data from 5,468 patients diagnosed with MS were collected, according to the McDonald’s criteria. New cases of MS were reported by the MS Society of Fars province from 1991 until 2016. The association between the percentage of people with low vitamin D intake, smoking, abnormal BMI and alcohol consumption in addition to spatial structure in a Bayesian spatio-temporal hierarchical model were used to determine the relative risk and trend of MS incidence rate in 29 counties of Fars province. Results: County-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000-person population. The highest relative risk was estimated at 1.80 in the county of Shiraz, the capital of Fars province, while the lowest relative risk was estimated at 0.11 in Zarindasht county in southern of Fars. The percentages of vitamin D supplementation intake and smoking were significantly associated with the incidence rate of MS. The results showed that 1% increase in vitamin D supplementation intake is associated with 2% decrease in the risk of MS and 1% increase in smoking is associated with 16% increase in the risk of MS.Conclusion: Bayesian spatio-temporal analysis of MS incidence rate revealed that the trend in the south and south east of Fars province is less steep than the mean trend of this disease. The lower incidence rate was associated with a higher percentage of vitamin D supplementation intake and a lower percentage of smoking. Previous studies have also shown that smoking and low vitamin D, among all covariates or risk factors, might be associated with high incidence of MS.
Double plating with autogenous bone grafting as a salvage procedure for recalcitrant humeral shaft nonunion
Authors: Feng Dongxu , Wang Xiaolong , Sun Liang , Cai Xiao , Zhang Kun , Wang Zhan , Zhu Yangjun
Published: January 2021

Background: Although most cases of humeral shaft nonunion respond well to surgical intervention, surgeons still encounter patients with humeral shaft nonunion who have already undergone repeated surgeries for nonunion. This study retrospectively analyzed the efficacy of double locking compression plate (LCP) fixation in combination with autogenous iliac crest bone grafting for recalcitrant humeral shaft nonunion.Methods: A consecutive series of patients with aseptic recalcitrant humeral shaft nonunion underwent surgical treatment between May 2010 and August 2017 in our institution. Standardized treatment included thorough debridement, double LCP and screw fixation, and autogenous iliac bone grafting. The injury type and the duration of nonunion were recorded for all patients. The main outcome measurements were the Constant and Murley scale for shoulder function, Mayo elbow performance index (MEPI) for elbow function, and visual analog scale (VAS) for pain. In addition, all complications were documented.Results: The study cohort comprised six females and nine males with a mean age of 45.3±13.1 years. Each patient had already undergone at least one failed surgery for humeral shaft nonunion. The average duration of nonunion before the index intervention was 126.8±124.2 months. All patients achieved bone union without implant failure. At final follow-up, the mean Constant and Murley score and mean MEPI were significantly improved, and the mean VAS score was significantly decreased. Each patient was very satisfied with the treatment. Four patients had complications, including one with a superficial wound infection, one with radial nerve palsy, one with ulnar nerve palsy, and one with discomfort at the iliac crest.Conclusion: Double plate fixation combined with autogenous iliac crest bone grafting results in successful salvage of humeral shaft nonunion after prior failed surgical interventions.
Comprehensive analysis of NAC transcription factor family uncovers drought and salinity stress response in pearl millet ( Pennisetum glaucum)
Authors: Dudhate Ambika , Shinde Harshraj , Yu Pei , Tsugama Daisuke , Gupta Shashi Kumar , Liu Shenkui , Takano Tetsuo
Published: January 2021

Background: Pearl millet (Pennisetum glaucum) is a cereal crop that possesses the ability to withstand drought, salinity and high temperature stresses. The NAC [NAM (No Apical Meristem), ATAF1 (Arabidopsis thaliana Activation Factor 1), and CUC2 (Cup-shaped Cotyledon)] transcription factor family is one of the largest transcription factor families in plants. NAC family members are known to regulate plant growth and abiotic stress response. Currently, no reports are available on the functions of the NAC family in pearl millet. Results: Our genome-wide analysis found 151 NAC transcription factor genes (PgNACs) in the pearl millet genome. Thirty-eight and 76 PgNACs were found to be segmental and dispersed duplicated respectively. Phylogenetic analysis divided these NAC transcription factors into 11 groups (A-K). Three PgNACs (-073, -29, and -151) were found to be membrane-associated transcription factors. Seventeen other conserved motifs were found in PgNACs. Based on the similarity of PgNACs to NAC proteins in other species, the functions of PgNACs were predicted. In total, 88 microRNA target sites were predicted in 59 PgNACs. A previously performed transcriptome analysis suggests that the expression of 30 and 42 PgNACs are affected by salinity stress and drought stress, respectively. The expression of 36 randomly selected PgNACs were examined by quantitative reverse transcription-PCR. Many of these genes showed diverse salt- and drought-responsive expression patterns in roots and leaves. These results confirm that PgNACs are potentially involved in regulating abiotic stress tolerance in pearl millet.Conclusion: The pearl millet genome contains 151 NAC transcription factor genes that can be classified into 11 groups. Many of these genes are either upregulated or downregulated by either salinity or drought stress and may therefore contribute to establishing stress tolerance in pearl millet.
Prevalence, predictors, and mortality of bloodstream infections due to methicillin-resistant Staphylococcus aureus in patients with malignancy: systemic review and meta-analysis
Authors: Li Zhouqi , Zhuang Hemu , Wang Guannan , Wang Hui , Dong Ying
Published: January 2021

Background: Cancer patients are more likely to develop and die of bloodstream infection (BSI) than noncancer patients. Methicillin-resistant Staphylococcus aureus (MRSA), which is associated with immense mortality and economic burden worldwide, is not covered by the recommended initial antibiotic therapy for cancer patients with BSI. This systemic review was performed to estimate the global methicillin-resistant Staphylococcus aureus (MRSA) prevalence among bacteremia in patients with malignancy, and further study the predictors and mortality of cancer patients with MRSA bacteremia. Methods: The PubMed and EMBASE databases were searched for studies published from Jan. 2000 to Mar. 2020 that provided primary data on the prevalence, predictors, or mortality of MRSA bacteremia in cancer patients. A random-effects model meta-analysis was performed to estimate the pooled prevalence of MRSA with 95% confidence intervals (95% CIs).Results: The pooled prevalence of MRSA was 3% (95% CI 2–5%) among all bloodstream infections (BSIs) and 44% (95% CI 32–57%) among S. aureus bacteremia in cancer patients. Based on geographical stratification, the pooled prevalence was 5% in Africa (95% CI 1–14%), 1% in Americas (95% CI 1–2%), 2% in Europe (95% CI 1–4%), 4% in Western Pacific (95% CI 2–7%), 8% in South-east Asia (95% CI 4–14%) and 0% in Eastern Mediterranean (95% CI 0–3%). No significant temporal change in MRSA rates was detected in this analysis (R2 = 0.06; P=0.24). Predictors for MRSA BSIs among cancer patients were identified by comparison with their methicillin-susceptible counterparts, and they were mainly related to healthcare-associated infections and immunosuppression. Finally, the 60-day mortality in adult cancer patients with MRSA BSIs was reported to be 12%, and the 6-month overall mortality was 43.2%, with community-onset infection, secondary BSI, and vancomycin MIC≥2g/mL being the risk factors for mortality.Conclusions: Although the prevalence of MRSA BSIs among cancer patients is relatively low, it did not decline over time as MRSA BSIs in the general hospital population and the high mortality rate was related to MRSA BSIs in patients with malignancy.