bluuebunny/crossref_metadata_2025 huggingface dataset:
Attitudes of East Tennessee Residents Towards General and Pertussis Vaccination: A Qualitative Study
Authors: Tandy Corinne , Tree Jennifer M. Jabson
Published: August 2020

BackgroundDespite vaccination being one of the safest and most successful public health tools to control infectious diseases, some people still doubt the efficacy and safety of vaccines. In order to address vaccine hesitancy and anti-vaccination sentiment, it is necessary to understand vaccination attitude development and vaccination behaviors. The objective of this project was to qualitatively investigate general vaccination attitudes and behavior with an additional emphasis on pertussis vaccination. MethodsTo identify factors that influence attitudes toward vaccination and behaviors in East Tennessee, eleven one-on-one interviews were conducted with participants recruited through convenience and purposive sampling. Interview protocol and deductive codes were developed using the Triadic Theory of Influence as a theoretical framework. Interview transcripts were analyzed qualitatively and themes were identified through constant comparison of interviews, considering both deductively and inductively coded data. ResultsMost participants (8) held positive attitudes towards vaccination. Participants (8) comfortable with vaccinating themselves or their children said they followed recommendations of doctors. Vaccine hesitant participants’ (3) most frequently cited concern was safety and concern about side effects. These participants also reported that they referenced non-academic or professional sources and felt confident about their knowledge of vaccines and diseases. Vaccine hesitant participants had low perception of risk of vaccine-preventable diseases, particularly pertussis. Participants with children reported that friends and family were influential when deciding to vaccinate their children. ConclusionsThis study identified themes in the attitudes towards vaccination of participants recruited in East Tennessee. We found that risk perception and family and social group attitudes were the primary influences on vaccination decision making. We recommend that future research includes anti-vaccination participants in their research, if possible, and further explore the relationship between perception of one’s own knowledge and health behavior outcomes.
Validation and reproducibility of a semi-qualitative food frequency questionnaire for assessment of sodium intake in Iranian population
Authors: Mohammadifard Noushin , Grau Narges , Khosravi Alireza , Esmaillzadeh Ahmad , Feizi Awat , Abdollahi Zahra , Sarrafzadegan Nizal
Published: August 2020

Background Few semi-quantitative food frequency questionnaire (SFFQ) has yet been developed to assess sodium intake s in Middle East region. This study was performed to validate SFFQ for sodium consumption assessment and evaluation of food groups΄ contribution in sodium intake.Methods This was a validation study. This study was performed on 198 healthy participants aged ≥ 6 years in Isfahan city, central part of Iran in 2014–2015. They provided two SFFQ at the beginning and after one year to evaluate the reproducibility. The validity of SFFQ for assessment of sodium intake compared with 24-hour urine sodium and twelve 24-hour dietary recalls which were completed monthly during a year as two standard methods.Results Correlation coefficient between the contribution of food groups to sodium intake based on SFFQ and 24-hour dietary recalls varied from 0.04 for legumes (P = 0.667) to 0.47 for added salt (P < 0.001). There was a significant correlation between the estimated total sodium intake based on SFFQ and both standard methods (P < 0.01). Intraclass correlation coefficient (95% CI) between first and second SFFQ had a diverse range from 0.10 (0.05–0.17) for fats and oils to 0.49 (0.28–0.69) for bread. According to the Bland-Altman plots, we observed an acceptable level of agreement between the two methods for sodium intake.Conclusions The SFFQ was a relatively valid and reliable method for estimating sodium intake and food groups contribution in its intake. A combination of two or more methods will be useful in achieving more accurate results.
NUDT1-Knockdown Inhibits Proliferation, Invasion and Migration of CAL27
Authors: Shan Qiusheng
Published: August 2020

Background: The high level of reactive oxygen species (ROS) in cancer could oxidize guanine into 8-oxoG resulting in A: T changed into G: C or G: C into A: T. Nudix hydrolase 1 (NUDT1) overexpressed in many kind of cancers could hydrolyze the 8-oxo-dGTP into 8-oxo-dGMP or pyrophosphate to prevent the DNA damage or gene mutation. However, the role and function of NUDT1 in oral squamous cell carcinoma (OSCC) has not been investigated.Methods: Firstly, the bioinformatics methods were used to predict the biological process, cellular component and molecular function of NUDT1 and to confirm the mRNA and protein expression level of NUDT1 in OSCC. Furthermore, the MTT assay, Flow Cytometry, Transwell (Invasion), Scratch Test and Transwell (Migration) were used to test the effect of NUDT1 inhibitor on the proliferation, cell apoptosis, invasion and migration of CAL27. In addition, western blot was used to exam the expression level of NUDT1 and cleaved caspase-3 in different groups. Finally, the laser scanning microscope (LSM) was used to test the invadopodia formation level in different groups.Results: The bioinformatics analysis suggested that both mRNA and protein of NUDT1 overexpressed in head and neck squamous cell carcinoma (HNSCC) and OSCC. Furthermore, the biological process of NUDT1 mainly enriched in response to oxidative stress, aging, response to cadmium ion and male gonad development in OSCC. the cellular component of NUDT1 mainly enriched in extracellular exosome, cytoplasm, plasma membrane and nucleus in OSCC. The molecular function of NUDT1 mainly enriched in protein binding in OSCC. Finally, the biological experiments confirmed that NUDT1-knockdown could inhibit the proliferation, invasion, migration and promote cell apoptosis of CAL27.Conclusion: The overexpressed NUDT1 is positively associated with the progression of OSCC which has much potential to be new target in targeted therapy of OSCC.
Association of liver cirrhosis with the prognosis of patients with intrahepatic cholangiocarcinoma: a SEER-based cohort study
Authors: Li Wei , Wu Hong , Zhang Yange
Published: August 2020

Background
The association of liver cirrhosis with the prognosis of intrahepatic cholangiocarcinoma (ICC) remains controversial. We aimed to evaluate the relationship between liver cirrhosis (fibrosis score) and the long-term prognosis of patients with ICC.
Methods
SEER 18 registry from 2004 to 2015 was queried for this study. Propensity score matching (PSM) was performed to eliminate possible bias. In addition, multivariable analysis was utilized to adjust for potential confounders. The interaction test was performed to explore the impact of each stratified factor on the relationship between FS and patient survival. Overall survival (OS) and disease-specific survival (DSS) were the major endpoints.
Results
During the study period, 359 patients (66.5%) with lower fibrosis score (LFS; F0-4) and 181 patients (33.5%) with higher fibrosis score (HFS; F5-6) were enrolled. In the multivariable adjusted cohort (OS: n = 540; DSS: n = 417), patients with HFS had worse OS (HR, 1.43; 95% CI, 1.10 to 1.85; P = 0.007) and DSS (HR, 1.46; 95% CI, 1.08 to 1.97; P = 0.013) compared to patients with LFS. In the propensity-matched cohort, patients with HFS still had worse OS (HR, 1.50; 95% CI, 1.08 to 2.09; P = 0.016) and DSS (HR, 1.54; 95% CI, 1.05 to 2.26; P = 0.026) compared to patients with LFS. In multivariable analyses stratified by clinicopathologic features, patients with HFS were found to have significantly worse OS and DSS compared to those with LFS across all the subgroups.
Conclusion
Our outcomes indicated that fibrosis score is an independent risk factor for both overall and tumor-specific survival of ICC patients.
Deep Learning Substitutes Gadolinium in Detecting Functional and Structural Brain Lesions with MRI
Authors: Liu Chen , Zhu Nanyan , Sikka Dipika , Feng Xinyang , Sun Haoran , Liu Xueqing , Gjerswold-Selleck Sabrina , Wei Hong-Jian , Upadhyayula Pavan , Mela Angeliki , Canoll Peter , Wu Cheng-Chia , Laine Andrew , Lieberman Jeffrey , Provenzano Frank , Small Scott , Guo Jia
Published: August 2020

While MRI contrast agents such as those based on Gadolinium are needed to enhance the detection of structural and functional brain lesions, there are rising concerns over their safety. Here, we hypothesize that a deep learning model, trained using quantitative steady-state contrast-enhanced MRI datasets in mice and humans, could generate contrast-equivalent information from a single non-contrast MRI scan. The model was first trained, optimized, and validated in mice. It was then transferred and adapted to human data, and we find that it can substitute Gadolinium-based contrast agents for detecting functional lesions caused by aging, Schizophrenia, or Alzheimer’s disease, and, for enhancing structural lesions caused by brain or breast tumors. Since derived from a commonly-acquired MRI, this framework has the potential for broad clinical utility and can be applied retrospectively to research scans across a host of diseases.
Will the Strength of the Clavicle Plate be Increased by Inserting Small Screws into the Empty Holes above the Fracture Site?
Authors: Kim Dae-Geun , Kim Soo Min
Published: August 2020

Background: Open reduction and plate fixation is the standard surgery for displaced midshaft clavicle fractures because of biomechanical stability. Implant failure like plate breakage or deformation is the most serious complication of plate fixation. Several plate designs for midshaft clavicle fractures have been introduced, but traditional superior plate has been mostly used.Methods: We generated the clavicle 3D image using the computed tomography (CT) of the left normal clavicle of a 54-year-old female, and then made the comminuted midshaft clavicle fracture model with 10-mm fracture site gap. The fracture model was fixed with 7-hole superior locking compression plate. Finite element analysis (FEA) was performed between the presence (model B) and absence (model A) of screws above the fracture site.Results: The average peak stress from the cantilever bending force was much greater than the peak stress from the axial compression and axial torsion force. This means that the cantilever loading force is the main force which could cause plate breakage or deformation. The maximal stress of the model B was lower than the one of the model A. Therefore, model B showed superior biomechanical property than model A under all loading conditions, especially cantilever bending force.Conclusions: The peak stress of the superior clavicle plate could be decreased just by inserting a small screw into the screw hole above the fracture site.
Two Updates on Oesophagogastric Junction Adenocarcinoma from the Fifth WHO Classification of Tumors of the Digestive System: Alteration of Definition and Emphasis on HER2 Test.
Authors: Li Yunzhu , Li Jiayu , Li Manji
Published: August 2020

Background: The incidence of oesophagogastric junction adenocarcinoma has increased rapidly but remains controversial over the last decades. There are two crucial updates of the fifth World Health Organization(WHO) classification, including the alteration of its definition and the emphasize on human epidermal growth factor receptor 2 (HER2) test.Methods: A total of 566 clinicopathological samples from patients who were diagnosed with gastric adenocarcinoma were retrospectively analyzed. We comprehensively compared the clinicopathological features of oesophagogastric junction adenocarcinoma between fourth (V4.0) and fifth (V5.0) WHO version. The clinicalpathological features among oesophagogastric junction, proximal and distal gastric tumors with fourth and fifth edition were also compared, respectively. Besides, we discussed the correlation of the HER2-expression with clinicopathological features according to the V5.0. Results: The results showed that the difference was mainly between oesophagogastric junction and distal adenocarcinoma in V4.0, while some were found between proximal and distal adenocarcinoma in V5.0. Tumors invading oesophagus more than 3cm were still mainly oesophagogastric junction tumors. The expression of HER2 in oesophagogastric junction and proximal gastric adenocarcinoma was still higher than that in gastric body and distal site.Conclusions: The clinicopathological parameters of the oesophagogastric junction tumors changed to some extent in the updated WHO version. The proximal gastric tumors tended to be more invasive, rather than that located in oesophagogastric junction. But the latter with oesophageal invasion required additional management. The HER2-expression of oesophagogastric junction adenocarcinoma is the highest. The classification of the V5.0 is reasonable and worth a recommendation.
LPG for Free? A Difference-in-Differences approach to analyze effect on adoption of India’s PMUY LPG program
Authors: Gill-Wiehl Annelise , Brown Timothy , Smith Kirk R.
Published: August 2020

In 2016, India introduced the Pradhan Mantri Ujjwala Yojana (PMUY) policy, which offers below-the-poverty-line (BPL) households a free liquified petroleum gas (LPG) connection. Using a difference-in-differences approach with a non-equivalent comparison group, we provide causal evidence of the effect of the PMUY policy on the probability of obtaining an LPG connection, overall LPG consumption, and clean cooking access. Overall, the policy led to a 3.3-to-3.6 percentage point increase in the probability of obtaining an LPG connection for PMUY-eligible households. We also find that PMUY-households will consume 7.4 fewer kgs of LPG per year than the comparison group and no effect on the tier level of clean cooking access or opting for home delivery. Our work suggests the need to expand the policy to address consumption and the Clean Cooking Tier Group. Finally, this analysis advocates investigation into the size of the refill subsidy beyond simply improved targeting of BPL households.
What Alternative and Innovative Sources of Healthcare Finance Can be Explored for the Sustainability of the National Health Insurance Scheme of Ghana? Perspectives of Health Managers
Authors: Laar Alexander Suuk , Asare Michael , Dalinjong Philip Ayizem
Published: August 2020

BackgroundSustainable healthcare financing is one of the key components for the achievement of universal health coverage (UHC) globally. This study explored health managers views on alternative and sustainable healthcare financing sources for the National Health Insurance Scheme (NHIS) in Ghana. MethodsA qualitative study using in-depth interviews with 16 health facility managers were held. The participants were selected using purposive sampling. A written consent was obtained from participants prior to participation in the interview. Data was transcribed verbatim and analyzed using thematic framework approach. Results All the participants indicated reimbursement of claims to health facilities by the NHIS as the main challenge. They attributed reasons to inadequate provision of funds from Government and the National Health Insurance Authority. Concerns were raised about how the situation affected health managers’ delivery of services to insured clients. Participants suggested exploring of additional funding sources by levying of special taxes on incomes from local natural resources and telecommunication service companies in Ghana to raise additional funds. Conclusion The findings of this study are important to government of Ghana and similar settings in LMICs who are working towards sustainable financing of their UHC system.
Myricitrin Attenuates Hypoxic-ischemic Brain Injury in Neonatal Rats by Mitigating Oxidative Stress and Nrf2/HO-1/ARE Signaling Pathway
Authors: Yan Ting , Lu Man
Published: August 2020

The present study has been explored the neuroprotective efficacy of myricitrin and unveil the mechanism of action via the regulation of Nrf2/ HO-1/ARE-dependent signaling cascade in hypoxic-ischemic (HI) induced brain injury of neonatal rats. Upon HI operation neonatal rats received 20 and 40mg/kg bw of myricitrin as intraperitoneally up to one week twice in a day. Myricitrin administration augmented HI induced increase of infarct volume and oedema of the brain, as well as improve neurobehavioral impairments. Further, we measured the level the antioxidant enzymes and oxidative stress marker level of ROS, NO and product of lipid peroxidation. These data support the well-established radical scavenging and antioxidant potential of myricitrin corresponds to a significant decline in most vulnerable radical formation with an obvious increase in antioxidant enzyme content. Interestingly, myricitrin source a significant reduction in NF-κB p65 and inflammatory marker gene expression, while reducing levels of the nuclear fraction of Nrf2- antioxidant response element (ARE) and cytosolic fraction of HO-1 enzyme activation. The results substantiate the efficiency of myricitrin an activation of Nrf2/ARE-dependent HO-1 pathway via improve defense mechanism and mitigate oxidative stress associated neuroprotective effect
The Impact of Successful Chronic Total Occlusion Percutaneous Coronary Intervention on Long-Term Clinical Outcomes in Real World
Authors: Gong Xuhe , Zhou Li , Ding Xiaosong , Chen Hui , Li Hongwei
Published: August 2020

Backgroud: Chronic total occlusions (CTOs) are an important and increasingly recognized subgroup of coronary lesions; the optimal treatment strategy for CTO has not been well established. We sought to examine the impact of CTO percutaneous coronary intervention (PCI) on long-term clinical outcome in the real world.Methods: A total of 592 consecutive patients with CTO in Beijing Friendship Hospital from June 2017 to December 2019 were enrolled. 29 patients were excluded due to Coronary artery bypass grafting (CABG), 301 patients were revascularized by PCI (CTO-R group) and 262 were not revascularized (CTO-NR group). The primary endpoint was cardiac death; Secondary endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, cardiac death, recurrent myocardial infarction, target lesion revascularization, re-hospitalization, heart failure, and stroke. Results: Percent of Diabetes mellitus (53.4% vs 39.5), Chronic kidney disease (8.8% vs 3.7%), CABG history (7.6% vs 1%), three vessel disease(96.2% vs 90%) and LM disease(25.2% vs 13.6%) was significantly higher in the CTO-NR group than in success PCI group (all P<0.05). Moreover, the CTO-NR group has lower EF (0.58±0.11 vs 0.61±0.1, p=0.002) and FS (0.32±0.07 vs 0.33±0.07, p=0.003). At a median follow-up of 12 months, CTO-R was superior to CTO-NR in terms of cardiac death (adjusted hazard ratio [HR]: 0.32, 95% conference interval [CI] 0.11-0.94). The superiority of CTO-R was consistent for MACCE (HR: 0.57, 95% CI 0.37-0.87). At multivariable Cox hazards regression analysis, CTO-R remains one of the independent predictors of lower risk of cardiac death and MACCE.Conclusions: Successful revascularization by PCI offered CTO patients more clinical benefits. The presence of LVEF＜0.5 and LM-disease was associated with an incidence of cardiac death; CTO revascularised was a protected predictor of cardiac death.
Outbreak of KPC-producing Klebsiella pneumoniae ST15 strains in a Chinese tertiary hospital: resistance and virulence analyses
Authors: Huang Jiansheng , Chen Xiuying , Zhao Yunan , Shi Yang , Ding Hui , Xv Jianfen , Zhao Xinmi , Wu Rongzhen , Zhao Zhigang
Published: August 2020

Background
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of clinical infection. However, KPC-producing K. pneumoniae ST15 strains are occasionally identified and have never been reported to cause hospital outbreaks in China.
Methods
In this study, pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS) were used to characterize 32 KPC-producing K. pneumoniae ST15 strains, which were collected at a Chinese tertiary hospital. Susceptibilities, resistance genes, virulence factors and clinical performances of the ST15 strains were comparatively analysed with corresponding ST11 strains.
Results
The ST15 strains were distributed in 7 wards, mainly in the intensive care unit (ICU, 24/32, 75%). PFGE results from 24 strains covering all the wards presented a similarity of more than 92%, indicating clonal spread. In 84% of the ST15 strains, the imipenem (IPM) and meropenem (MEM) minimum inhibitory concentrations (MICs) were ≤ 8 and ≤ 16 µg/mL, respectively, both of which were 4-fold lower than those of the ST11 strains. The infection rates of the ST15 and ST11 strains were 28.1% and 43.9%, respectively (P = 0.018). PCR evaluation and WGS indicated that all the CRKP strains shared a 100% identical blaKPC−2 genetic structure, though a synonymous mutation and a Gly115-Asp116 (GD) insertion in the OmpK36 were identified in the ST15 and ST11 strains, respectively. None of the ST15 strains were positive for hypervirulence factors; however, the positive rate was 92.7% (38/41) in the ST11 isolates.
Conclusion
To the best of our knowledge, this is the first description of nosocomial outbreaks caused by KPC-producing K. pneumoniae ST15 strains in China. The ST15 strains had low carbapenem resistance and virulence, emphasizing the importance of careful evaluation of phenotypic and genetic characteristics for anti-infection therapy.
Sexual Health and COVID-19: Protocol for a Living Scoping Review
Authors: Kumar Navin , Janmohamed Kamila , Nyhan Kate , Forastiere Laura , Zhang Wei-Hong , Kågesten Anna , Uhlich Maximiliane , de Velde Sarah M Van , Francis Joel M , Erasquin Jennifer Toller , Larrson Elin C , Callander Denton , Scott John , Minichiello Victor , Tucker Joseph D
Published: August 2020

Background: Global responses to the COVID-19 pandemic have exposed and exacerbated existing socioeconomic and health inequities that disproportionately affect the sexual health and well-being of many populations, including people of color, ethnic minority groups, women, and sexual and gender minority populations. Although there have been several reviews published on COVID-19 and health disparities across various populations, none have focused on sexual health. We plan to conduct a scoping review that seeks to fill several of the gaps in the current knowledge of sexual health in the COVID-19 era and facilitate multi-country comparisons.Methods: A scoping review focusing on sexual health and COVID-19 will be conducted. Multiple bibliographic databases will be searched. Study selection will conform to Joanna Briggs Institute Reviewers’ Manual 2015 Methodology for JBI Scoping Reviews. Data will be used to inform multi-country comparisons.Results: N/AConclusions: Original research is urgently needed to mitigate the risks of COVID-19 on sexual health. The planned scoping review will help to address this gap and contribute to multi-country comparisons as part of the I-SHARE network.Systematic Review registrations: N/A
Peer victimisation during adolescence and its impact on wellbeing in adulthood: A prospective cohort study.
Authors: Armitage Jessica M , Wang R. Adele H , Davis Oliver S. P. , Bowes Lucy , Haworth Claire M. A.
Published: August 2020

Background: Peer victimisation is a common occurrence in schools and has well-established links with a range of psychiatric problems in adulthood. Significantly less is known however, about how victimisation influences positive aspects of mental health such as wellbeing. The purpose of this study was therefore to assess for the first time, whether peer victimisation in adolescence is associated with adult wellbeing. We aimed to understand whether individuals who avoid a diagnosis of depression after victimisation, maintain good wellbeing in later life, and therefore display resilience.Methods: Longitudinal data was taken from the Avon Longitudinal Study of Parents and Children, a prospective cohort study based in the UK. Peer victimisation was assessed at 13 years using a modified version of the bullying and friendship interview schedule, and wellbeing at age 23 using the Warwick-Edinburgh Mental Well-Being Scale. The presence or absence of depression was diagnosed using the Clinical Interview Schedule–Revised at 18 years. A series of logistic and linear regression analyses were used to explore relationships between peer victimisation, depression, and wellbeing, adjusting for potentially confounding individual and family factors. Results: Just over 15% of victims of frequent bullying had a diagnosis of depression at age 18. Victimisation also had a significant impact on wellbeing, with a one-point increase in frequent victimisation associated with a 2.71-point (SE=0.46, p<0.001) decrease in wellbeing scores aged 23. This finding was only partly attenuated when adjusting for depression, suggesting that the burden of victimisation extends beyond depression to impact wellbeing. Results therefore show that individuals who remain partially resilient by avoiding a diagnosis of depression after victimisation have significantly poorer wellbeing than their non-victimised counterparts.Conclusion: Overall, our study demonstrates for the first time that victimisation during adolescence is a significant risk factor for not only the onset of depression, but also poor wellbeing in adulthood. Such findings highlight the importance of investigating both dimensions of mental health to understand the true burden of victimisation and subsequent resilience. In addition to the need for interventions that reduce the likelihood of depression following adolescent victimisation, efforts should also be made to promote good wellbeing.
Predictors and Risk Factors of Severity of GBS, the Requirement for Mechanical Ventilation and Poor Short-Term Prognosis of Severe GBS
Authors: Wen Pu-Yuan , Zhang Min , Chu Wen-Zheng , Feng Qiao-Chan , Ji Han , Wu Hong-Liang
Published: August 2020

Background/Objective:It is still an extraordiarily exigent thing to early recognize the severity, therapeutic method and prognisis of Guillain-Barré syndrome (GBS). Our research’s goal is to investigate the clinical predictive factors indicating severity of GBS and the requirement for mechanical ventilation(MV) in severe patients with GBS, and to explore the identification of modifiable risk factors for predicting poor short-run outcome of severe GBS. Methods: A total of 155 patients were included in a cohort of GBS patients admitted to the Affiliated Yantai Yuhuangding Hospital of Qingdao University between 2014 and 2020. Demographic, clinical, therapeutical and evolutionary data were collected. Neurological testing which used standardized data collection were carried out by the same investigators on the whole study period. Comparion of the results were implemented by single and multiple regression analysis.Result: Of 155 patients, 66 patients were severe GBS, of which twenty-nine patients (18.7%) needed MV. Significant clinical predictors for severe GBS were recent history of surgery, time from onset to admission, Medical Research Council(MRC) sum score on admission, autonomic dysfunction, cranial nerve impairment(glossopharyngeal, facial, Oculomotor and/or abducent nerve deficits) and elevated liver enzyme levels were significantly bound up with severity scores(p<0.05). With regard to risk factors of MV in severe GBS, univariate logistic analysis indicated presence of cranial nerve involvement, autonomic dysfunction, MRC score at nadir, elevated liver enzymes and pneumonia were significantly different(p<0.05); Multivariate analysis determined that MRC score at nadir and autonomic dysfunction were also considered to be predictors for MV in severe GBS(p<0.05).As to prognostic of factors, recent history of surgery, MRC score at nadir, the requirement for MV, MRC score at admission and pneumonia during hospitalization were predictors of poor short-run outcome in severe patients with GBS by univariate logistic analysis, and that the nadir MRC score and the requirement for MV were identically proved as clinic parameters of unfavourable prognosis by multivariate logistic analysis (p<0.05) .Conclusions: Clinical risk factors of severity in GBS, the requirement of MV and unfavourable short-run prognosis in severe GBS were evident. Recent history of surgery is also a predictor for severity in GBS patients.
The negative impact of chronic tobacco smoking on adult neuropsychological function: a case control study
Authors: Nadar Mohammed Shaban , Hasan Abdullah M. , Alsaleh Mohammed
Published: August 2020

Background: The evidence on the effects of chronic tobacco smoking on neuropsychological functions is conflicting. The literature remains limited by inconsistent accounting for potentially confounding biomedical and psychiatric conditions. This study aimed to assess the neuropsychological functions of adult chronic tobacco smokers in comparison to healthy matched-subjects’ controls. Method: The study included 73 smokers and 84 matched-subject non-smoker controls. The data was collected during the year 2019. After an initial interview to collect demographics and smoking profile, the subjects undertook neuropsychological assessments that targeted a wide range of cognitive domains. Results: The performance of smokers was poorer on almost all neuropsychological domains, namely selective attention (p ≤ .001, p =.044), alternating attention (p = .002) working memory (p ≤ .001), Short-term memory (p = .006 and .003), Long-term memory (p ≤ .001), processing accuracy (p ≤ .001), and executive function (p = .011 and .026). Smokers were intact on processing speed. smoking accumulation and the age onset of regular smoking we negatively correlated with neuropsychological function. Conclusion: Our findings add to the growing body of evidence suggesting that chronic tobacco smoking impacts negatively on cognition.
Skeletal Muscle Depletion and Nutrition Support Affected Postoperative Complications in Patients Underwent Pancreatoduodenectomy
Authors: Duan Kaipeng , Gao Xin , Wei Luxin , Gong Mengting , Zhou Jin , Zhu Dongming
Published: August 2020

BackgroundPostoperative complications remain high in patients underwent pancreaticoduodenectomy (PD). Body composition has been shown closely related to the outcome in critical and surgical patients. The aim of the present study was to investigate whether preoperative skeletal muscle condition and postoperative nutrition would affect major complications in patients underwent PD.MethodsThis retrospective study included 265 patients underwent PD with a CT scan of the abdomen within 1 week before surgery. Body compartment data was extracted from the L3 level of the CT scan, which included skeletal muscle area and density, subcutaneous and visceral fat area. Univariable and multivariable regression analyses were performed to investigate correlations between the above variables and postoperative complications. Furthermore, a subgroup analysis was conducted to explore the relationship between postoperative nutrition strategy and the outcome.ResultsOf all the 265 patients, the mean age and BMI was 59.5±13.9 years and 23.1 ±3.6 kg/m2, respectively. Major complications occurred in 81 patients (30.6%). Cutoff values for skeletal muscle depletion were defined by ROC curve analysis from postoperative complications in skeletal muscle index (SMI) (male 47.32 cm2/m2 and female 40.65 cm2/m2). Univariable analysis showed postoperative complications were significantly associated with age, sex, systemic comorbidity, SMI, skeletal muscle density (SMD) and visceral adipose tissue index (VATI). Multivariable regression reveled only age (OR 1.49, 95% CI 1.22-1.83, p=0.026), SMI (OR 0.77, 95%CI 0.51-0.94, p=0.015) and SMD (OR 0.85, 95%CI 0.64-1.03, p=0.029) were independent predictors for major complications. Subgroup analysis showed the initial parenteral nutrition time (IPNT) (OR1.89, 95% CI 1.43-2.49, p=0.032) and average protein delivery (APD) (OR 0.76, 95% CI 0.53-0.89, p=0.021) were significantly associated with major complications in patients with lower SMI. However, in normal SMI patients, such association was not significant enough.ConclusionsPreoperative skeletal muscle index and density were independently associated with major complications in patients underwent PD. In patients with lower SMI, early parenteral nutrition and higher protein delivery were related to better outcome.
Targeting the RHOA pathway improves learning and memory in adult Kctd13 and 16p11.2 deletion mouse models
Authors: Lorenzo Sandra Martin , Nalesso Valérie , Chevalier Claire , Birling Marie-Christine , HERAULT Yann
Published: August 2020

Background

Gene copy number variants have an important role in the appearance of neurodevelopmental disorders. Particularly, the deletion of the 16p11.2 locus is associated with autism spectrum disorder, intellectual disability, and several other features. Earlier studies highlighted the implication of Kctd13 genetic imbalance in the 16p11.2 deletion through the regulation of the RHOA pathway.
Methods

Here, we generated a new mouse models with a small deletion of two key exons in Kctd13. Then we targeted the RHOA pathway to rescue the cognitive phenotypes of the Kctd13 and 16p11.2 deletion mouse models in a pure genetic background. We used a chronic administration of fasudil (HA1077), an inhibitor of the Rho-associated protein kinase (ROCK), for several days, in mouse models carrying a heterozygous inactivation of Kctd13, or the deletion of the entire 16p11.2 BP4-BP5 homologous region.
Results

We found that the small Kctd13 heterozygous deletion induced similar cognitive phenotype to the whole deletion of the 16p11.2 homologous region, in the Del/+ mice. Then we showed the chronic fasudil treatment can restore object recognition memory in adult heterozygous mutant mice for Kctd13 and for 16p11.2 deletion. In addition, the learning and memory improvement was parallel to change in the RHOA pathway.
Limitations:

The Kcdt13 mutant line does not recapitulate all the phenotypes found in the 16p11.2 Del/+ model. In particular the locomotor activity was not altered at 12 and 18 weeks of age and the object location memory was not defective in 18 weeks old mutants. Similarly, the increased in locomotor activity was not modified by the treatment in the 16p11.2 Del/+ mouse model suggesting other loci involved in such defects. Then, the rescue was only observed after four weeks of treatment but no long term experiment has been done so far. Finally we did not check the social behaviour that require to work in another hybrid genetic background.
Conclusion

These findings confirm KCTD13 as one target gene causing cognitive deficits in 16p11.2 deletion patients, and the relevance of the RHOA pathway as a therapeutic path for the 16p11.2 deletion. Nevertheless, they reinforce the contribution of other gene(s) involved in cognitive defects found in the 16p11.2 models in older mice.
Economic Analysis of the CLIP Trials in India, Pakistan and Mozambique
Authors: Bone Jeffrey N , Khowaja Asif , Vidler Marianne , Payne Beth A. , Bellad Mrutyunjaya B , Goudar Shivaprasad S , Mallapur Ashalata , munguambe Khátia , Qureshi Rahat , Sacoor Charfudin , Sevene Esperança , Frederix Geert , Bhutta Zulfiqar , Mitton Craig , Magee Laura , Dadelszen Peter von
Published: August 2020

Background: The Community-Level Interventions for Pre-eclampsia (CLIP) Trials (NCT01911494) in India, Pakistan, and Mozambique (February 2014-7) involved community engagement and task-sharing with community health workers for triage and initial treatment of pregnancy hypertension. Maternal and perinatal mortality was less frequent among women who received ≥8 CLIP contacts. The aim of this analysis was to assess the costs and cost-effectiveness of the CLIP intervention overall, and by POM visit frequency. Methods: Included were all women enrolled in the three CLIP trials who had delivered with known outcomes by trial end. According to the number of POM-guided home contacts received (0, 1-3, 4-7, ³8), costs were collected from annual budgets and spending receipts, with inclusion of family opportunity costs in Pakistan. A decision-tree model was built to determine the cost-effectiveness of the intervention (vs. usual care), based on the primary clinical endpoint of years-of-life-lost (YLL) for mothers and infants. A probabilistic sensitivity analysis was used to assess uncertainty in the cost and clinical outcomes.Results: The incremental per pregnancy cost of the intervention was USD$12.66 (India), USD$11.51 (Pakistan) and USD$13.26 (Mozambique). As implemented, the intervention was not cost-effective, due largely to minimal differences in years-of-life-lost between arms. However, among women who received ≥8 contacts (4 in Pakistan), the probability of health system and family (Pakistan) cost-effectiveness was ≥80% (all countries). Conclusion: The intervention was likely to be cost-effective for women receiving ≥8 contacts in Mozambique and India, and ≥4 in Pakistan, supporting World Health Organization guidance on antenatal contact frequency.Funding: The University of British Columbia, a grantee of the Bill & Melinda Gates Foundation (OPP1017337).Trial registration: clinicaltrials.gov. Registered 30 July 2013, https://clinicaltrials.gov/ct2/show/NCT01911494
Synergistic Effect of Combination Interventions for Methicillin-resistant Staphylococcus aureus Transmission Control in Nursing Homes: A Computation Modelling Evaluation with Heterogeneous Contact Mixing
Authors: Tang Arthur , Kwok Kin On , Wei Vivian Wan In , Chen Hong , Park Woo-Hyun , Wong Samuel Yeung Shan , Tam Wilson
Published: August 2020

Background

The endemic threat of Methicillin-Resistant Staphylococcus aureus (MRSA) in nursing homes pose a serious and escalating challenge to public health administration in infection control. Nursing homes are considered as major reservoirs for MRSA colonization, with considerable high levels of colonization prevalence.
Aim

Direct contact is the major transmission mode of MRSA colonization. This study employed a computation model to evaluate the effect of 3 intervention scenarios on MRSA colonization prevalence rate in nursing homes.
Methods

Simulations were conducted using a deterministic compartmental model featuring heterogeneous contact matrix between residents and health-care workers (HCWs). Contact parameters were derived from a nursing home survey. Three intervention scenarios were simulated: (1) hand-hygiene compliance by HCWs, (2) screening-and-isolation upon admission, and (3) implementing both interventions at the same time.
Results

For every 10% reduction in average contamination duration in HCWs, the estimated average reduction in prevalence rate is 1.29 percentage point compared with the prevalence rate before the intervention was implemented. Screening-and-isolation intervention results in an average reduction of 19.04 percentage point in prevalence rate (s.d. = 1.58; 95% CI = 18.90-19.18) compared with the prevalence rate before the intervention was implemented. In intervention scenario 3, synergistic effects were observed when implementing hand-hygiene compliance by HCWs and screening-and-isolation together.
Conclusion

Our results provide quantitative data for nursing home administrators in interventions planning, design, adjustment, effect estimation and comparison.
Research on the Move: Exploring WhatsApp as a Tool for Understanding the Intersections between Migration, Mobility, Health and Gender in South Africa
Authors: Gruchy Thea de , Vearey Jo , Opiti Calvin , Mlotshwa Langelihle , Manji Karima , Hanefeld Johanna
Published: August 2020

Background: Reflecting global norms, South Africa is associated with high levels of cross-border and internal population mobility, yet migration-aware health system responses are lacking. Existing literature highlights four methodological challenges limiting the development of evidence-informed responses to migration and health: (1) lack of engagement with the process of migration; (2) exclusion of internal migrants; (3) insufficient attention to the ways in which gender and other identity markers shape health systems access; and, (4) lack of methodologies that are able to capture ‘real-time’ data about health needs, healthcare seeking experiences, and interactions with healthcare systems over both time and place. In this paper, we reflect on a four-month pilot project which explored the use of WhatsApp Messenger - a popular mobile phone application used widely in sub-Saharan Africa – as a research tool to address these challenges. Results: A four-month pilot was undertaken with 11 participants between October 2019 and January 2020. Using Survey Node, an online platform that allows for the automatic administration of surveys through WhatsApp, monthly surveys were administered. The GPS coordinates of participants were also obtained. Recruited through civil society partners in Gauteng, participants were over the age of 18, comfortable engaging in English, and owned WhatsApp compatible cell phones. Enrolment involved an administered survey and training participants in the study protocol. Participants received reimbursement for their travel costs and cell phone data monthly. Out of a possible 88 survey and location responses, 61 were received. Findings emphasise the ethical and methodological challenges of using WhatsApp as a tool for data collection with migrant and mobile populations.Conclusions: The pilot demonstrates the potential of WhatsApp for addressing our concerns with the current state of research exploring migration and health. It suggests, through the ability to focus on the process of migration, including internal migration, and the opportunities it provides to elucidate the ways in which this process intersects with access to healthcare and gender, that WhatsApp has real potential as a research tool. The pilot informed finalisation of the main study, including ensuring that our approach and research met the ethical standards congruent with the method.
Development of quantitative direct prediction algorithm for the human target organ similarity of human pluripotent stem cell-derived organoids and cells
Authors: Lee Mi-Ok , Lee Sugi , Jung Cho-Rok , Ryu Jea-Woon , Son Ye Seul , Jung Kwang Bo , Ahn Jun-Ho , Oh Jung-Hwa , Kim Janghwan , Jang Insu , Choi Jinhyuk , Jung Jaeeun , Park Kunhyang , Lee Byungwook , Kim Dae-Soo , Son Mi-Young , Cho Hyun-Soo
Published: August 2020

Human pluripotent stem cell (hPSC)-derived organoids and differentiated cells have similar characteristics, such as cell types, structure, and functions, to human organs and tissues. Thus, in vitro human organoids and tissue-specific cells serve as a superior alternative to conventional cell lines and animal models in drug development and regenerative medicine. However, since hPSC-derived organoids and differentiated cells show fetal-like features, further differentiation and maturation methods have been developed for the generation of high-quality in vitro models of the corresponding human organs and tissues. Therefore, for a simple and reproducible analysis of the quality of organoids and cells to compensate for the shortcomings of existing experimental validation studies, a quantitative evaluation method should be developed. In this study, using the GTEx database (a total of 8,555 samples in 53 tissues), we constructed a quantitative calculation system (organ-specific panels and calculation algorithm) to assess the similarity to the human lung, stomach, and heart and confirmed the algorithm using in-house RNA-seq data (total RNA from 20 tissues). To evaluate our system, we generated hPSC-derived lung organoids, gastric organoids, and cardiomyocytes and detected 33.4%, 51.7%, and 83.4% similarity, respectively, to the corresponding human target organs. To facilitate access and use of our system for researchers, we developed the web-based user interface (Web-based Similarity Analysis System, W-SAS; for liver, lung, stomach, and heart) presenting similarity to the appropriate organs as percentages and specific gene expression patterns. Thus, the W-SAS system could provide valuable information for the generation of high-quality and readily available organoids/cells differentiated from hPSCs and a strategy to guide proper lineage-oriented differentiation.
Liver Resection Combined with Radiotherapy versus Liver Resection Alone in the Treatment of Hepatocellular Carcinoma: A Population-based Study
Authors: Chen Lei , Guo Xiaopeng , Chen Shi , Ren Yanqiao , Sun Tao , Yang Fan , Zheng Chuansheng
Published: August 2020

BackgroundRadiotherapy has been used in the treatment of hepatocellular carcinoma (HCC) more widely. However, little research focus on comparing the efficacy of patients with liver resection combined with radiotherapy with that received liver resection alone. The study was conducted to evaluate whether the efficacy of liver resection combined with radiotherapy in the treatment of patients with HCC is better than liver resection alone.MethodsThe study utilized the data from the Surveillance, Epidemiology, and End Results 18 registry (SEER-18). Patients diagnosed with HCC between 2004 and 2015 who received liver resection or the combination of liver resection and radiotherapy were included in the analysis. The propensity score matching model (PSM) was used to reduce selection bias and potential confounding factors.ResultsBefore PSM, the median overall survival (mOS) and median cancer-specific survival (mCSS) of patients treated with liver resection alone were longer than in patients treated with the combination of liver resection and radiotherapy (P<0.001). However, there was no statistically significant difference in mOS and mCSS between the groups after PSM (P>0.05). The subgroup analysis after PSM documented that patients with American Joint Committee on Cancer (AJCC) stage I and II who were treated with liver resection and radiotherapy had no longer mOS and mCSS than patients subjected to the combination of liver resection alone (P=0.151 and P=0.185). Similar results were obtained in the subgroup group of patients with a single tumor smaller than 5 cm. Univariate analysis showed that patients undergoing liver resection combined with radiotherapy did not have an increased all-cause mortality risk (HR:1.214, 95%CI: 0.950-1.553; P=0.122) and cancer-specific mortality risk (HR:1.132, 95%CI: 0.848-1.510; P=0.401) when compared to patients treated with liver resection alone after PSM.ConclusionThe combination of liver resection and radiotherapy does not prolong the survival of HCC patients more than liver resection alone.
mSwap: A Large-Scale Image-Compositing Method with Optimal m-ary Tree
Authors: Hou Min , Bi Chongke , Wang Fang , Deng Liang , Zheng Gang , Meng Xiangfei
Published: August 2020

With the increasing of computing ability, large-scale science simulations have been generating massive amounts of data in aerodynamics. Sort-last parallel rendering is a proven approach for large-scale science visualization. However, in the stage of image compositing, the sort-last method may suffer from scalability problem on large-scale processors. Existing image compositing algorithms tend to perform well in certain situations. For instance, Direct Send is well on small and medium scale; Radix-k gets well performance only when the k -value is appropriate and so on. In this paper, we propose a novel method named mSwap for science visualization in aerodynamics, which uses the best scale of processors to make sure its performance at the best. mSwap groups the processors that we can use with a ( m, k ) table, which records the best combination of m (the number of processors in subgroup of each group) and k (the number of processors in each group). Then in each group, using a m-ary tree to composite the image for reducing the communication of processors. Finally, the image is composited between different groups to generate the final image. The performance and scalability of our mSwap method is demonstrated through experiments with thousands of processors.