bluuebunny/crossref_metadata_2025 huggingface dataset:
Biased Technical Change in Hospital Care and the Demand for Physicians
Authors: Blank Jos L.T. , Niaounakis Thomas K. , Valdmanis Vivian G.
Published: June 2020

Background The development of labour productivity is relevant for accurately planning future staffing requirements, especially in sectors where technological developments may drive labour substitution. The present study investigates how labour productivity has developed across Dutch medical specialists (2007-2017) and discusses its implications for workforce planning, also in relation to the existing literature. Methods A regression model is developed in which the number of full-time equivalents is related to production (admissions), hospital characteristics and a trend parameter. The trend parameter captures the average annual change in the number of full-time equivalents per output and is a measure for labour productivity. The model is applied to a micro-data set of Dutch hospitals in the period 2007-2017 across 24 different specialties using regression methods. Results The results indicate that the number of full-time equivalents per admission has increased for most specialisms and that labour productivity has thus decreased. However, there is considerable heterogeneity and uncertainty across different specialisms. Conclusions The results amplify the issue of medical personnel shortages driven by the growing demand for health care. The research outcomes are linked to the existing literature regarding physicians’ productivity. Changes in accountability such as using relative value units, incentive payments, use of staff and mid-level providers, and technology have been discussed and some consensus has been reached.
Echocardiography Evaluation of the Effects of Midazolam on Passive Leg Raising Test in Critically ill Patients in the Intensive Care Unit, diagnosed with Sepsis, determined to be hypovolemic and responding to fluid treatment
Authors: Yektaş Abdulkadir
Published: June 2020

Background
This study used echocardiography parameters to investigate the effects of midazolam sedation on intravascular volume in intubated patients who are diagnosed with sepsis and treated with invasive mechanical ventilation in continuous positive airway pressure mode.
Methods
This study included 152 intensive care unit patients aged 30–50 years with spontaneous breathing; all were intubated, had their lungs ventilated with a positive end-expiratory pressure of 5 cmH2O in continuous positive airway pressure mode via invasive mechanical ventilation, had a Ramsey sedation scale score of 5–6 at 5 min after midazolam administration, and exhibited a fluid deficit (i.e., inferior vena cava collapsibility index > 42% and > 12% systolic arterial pressure increase in the passive leg raising test). Cardiac index, cardiac output, and velocity time integral measurements were taken after the passive leg raising test, before and after midazolam sedation, in patients with hypovolaemia who responded to fluid treatment. Changes in passive leg raising test results were compared before and after administration of midazolam.
Results
Cardiac output > 15%, cardiac index > 10%, and > 15% increase in velocity time integral during the passive leg raising test before midazolam administration indicated that patients exhibited hypovolaemia and responded to fluid therapy. Cardiac output < 15%, cardiac index < 10%, and < 15% increase in velocity time integral during the passive leg raising test after midazolam administration indicated that patients did not exhibit hypovolaemia.
Conclusions
We recommend that the passive leg raising test, which is used to determine intravascular volume status of critically ill intensive care unit patients who exhibit hypovolaemia and respond to fluid therapy, should be performed before midazolam sedation.
The Efficacy and Mechanism of Autologous Fat Stem Cells Combined with Microcarrier 6 Transplantation for Anal Fistula Treatment
Authors: Li Yansen , Fan Mingfeng , Le Hanxiang , Xu Xiangjun , Wang Shuai , Kong Lingyu , Bi Yanzhen , Tang Huixin , Cheng Shumin , Hong Feng , Chao Min
Published: June 2020

Background: Adipose-derived stem cells (ASCs) function in multi-directional differentiation, proliferation, and tissue regeneration. It is not clear whether microcarrier 6 can promote the migration, differentiation, and regeneration of fat stem cells, and improve therapeutic effects for the treatment of anal fistula.Methods: Japanese big ear rabbits were employed to establish an anal fistula model, and ASC-microcarrier 6 mixed transplantation was used as a treatment. HE staining, immunohistochemistry, and RNA sequencing were used to observe the effect of ASC-microcarrier 6 transplantation on anal fistula healing, in comparison with the ASC treatment group, rubber band operation group, and control group.Results: HE staining indicated scattered striated muscle cells and epithelial tissues in fistula tissues of the ASC-microcarrier 6 complex group and the ASC treatment group, while a small number of lymphocytes were clustered around the microcarrier 6, and fat cell aggregation was seen in the ASC treatment group. RNA sequence analysis showed that differential genes were mainly concentrated in striated muscle cells, vascular smooth muscle, and other tissues. PI3K/AKT signaling pathway molecules were significantly enriched, granulation tissue and lymphocyte infiltration were observed in the rubber band string operation group, and a large amount of necrotic tissue was seen in the control group.Conclusion: Microcarrier 6 is beneficial to the multi-directional differentiation of ASCs, which can provide a good environment for the survival of ASCs and promote fistula healing.
Roles of metabolic regulation in developing Quercus variabilis acorns at contrasting geologically-derived phosphorus sites in subtropical China
Authors: Yuan Jun , Sun Ningxiao , Du Hongmei , Yin Shan , Kang Hongzhang , Umair Muhammad , Liu Chunjiang
Published: June 2020

BackgroundPhosphorus (P) -rich soils develop in phosphorite residing areas while P-deficient soils are ubiquitous in subtropical regions. Little has been reported that how metabolites participate in the seed development and the processes involved in their coping with contrasting-nutrient environments.ResultsHere we quantified the metabolites of Quercus variabilis acorns in early (July), middle (August), and late (September) development stages at geologically-derived contrasting-P sites in subtropical China using Gas chromatography-mass spectrometry (GC-MS). The primary metabolic pathways included sugar metabolism, the TCA cycle, and amino acid metabolism. Most metabolites (especially C- and N-containing metabolites) increased and then decreased from July to September. Acorns between the two sites were significantly discriminated at the three stages, respectively, by metabolites (predominantly sugars and organic acids). Concentrations of P, orthophosphoric acid and most sugars were higher; erythrose was lower in late-stage acorns at P-rich sites than those at P-deficient sites. No significant differences existed in the size and dry mass of individual acorns between oak populations at the two sites. ConclusionsOak acorns at the two sites formed distinct metabolic phenotypes related to their distinct geologically-derived soil conditions, and the late-stage acorns tended to increase P-use-efficiency in the material synthesis process at P-deficient sites, relative to those at P-rich sites.
Melatonin activates adventitious root formation by promoting the function of MdWOX11 in apple
Authors: Mao Jiangping , Niu Chundong , Li Ke , Tahir Muhammad Mobeen , Han Mingyu , Zhang Dong
Published: June 2020

Background
Melatonin (MT) plays a key role in the plant growth and development, however, whether MT involved in apple adventitious root (AR) development is not entirely understood. In present study, we set up four MT-treated groups at different times according to the stages of AR development and one control group in Malus domestica (MP), endogenous hormones levels of MT, auxin (IAA), zeatin-riboside (ZR), gibberellins (GA1 + 3), abscisic acid (ABA) were analyzed in five groups, then the expression of MT signal, IAA synthesis, transport, and signal transduction, cell cycle, and root development related genes were measured by RT-qPCR, the function of MdWOX11 was analyzes by technology of apple transgenic.
Results
Advance of AR development by MT is depended on its promotion of stage of AR induction at 0–2 d in the apple rootstocks. MT-treated increased IAA levels, there were crosstalk between MT and IAA during inducing AR formation. Expression analysis exposed that the expression of MdWOX11 induced by MT-treatment, and positively regulated AR formation in apple. Furthermore, MdWOX11 over-expressed lines produced more ARs than ‘GL3’, phenotypic analysis indicated that MdWOX11 over-expressed lines were more sensitive to exogenous MT-treatment than ‘GL3’, it was also indicated that MdWOX11 regulated AR formation in response to MT in apple rootstock.
Conclusions
MT promotes AR formation mainly during AR induction stage by inducing IAA levels as well as by up-regulation of MdWOX11.
Nutritional support with energy and nutrient-dense formula for children with congenital heart defects: A clinical trial
Authors: Moghadam Ehsan Aghaei , Mirzaaghayan Mohammad Reza , Goedhart Annemiek C. , Hogenhuis Jochem , Zeinaloo Aliakbar , Azamakhlaghi Atoosa , Zanjani Keyhan Sayadpour , Rad Elaheh Malekan , Rabbani Ali , Ashrafi Mahmoudreza , Alavi Amir Hossein , Sadegh Saba Salamzadeh , Amini Sima , Etesamnia Nastaran , Mohebbi Ali , Ghamari Azin
Published: June 2020

Background: A large proportion of infants with congenital heart defects (CHD) suffer from malnutrition. The aim of this study was to assess the impact of using energy- and nutrient-dense formula on weight gain in malnourished infants with CHD before surgery. Methods: This was a one arm, open label intervention study, conducted in the pediatric cardiology department of children’s medical center, Teheran, Iran. 49 infants with moderate/high risk cardiac defects who were undernourished (WFA z-score ≤ - 2) and were candidates for surgical repair were enrolled in this study. Infants on regular infant formula were switched completely to energy- and nutrient-dense formula. The infants were evaluated for growth parameters (weight and length) at enrolment and every 3 weeks thereafter at the center for a period of 12 weeks. Results: The average head circumference was 37.1+2.8 cm at baseline and 39.0+3.46 cm at the final assessment (p=0.079). The mean MUAC increased from 11.25+1.39 cm at baseline to 14.75+2.06 cm at the final assessment (p=0.001). The average intake of energy- and nutrient-dense formula was 148.24+214.737 Kcal/day (36.23+ 52.49 Kcal/kg/day) at study start and 455.4+177.21 Kcal/day (98.61 ± 38.27 Kcal/kg/day) at the end of the study. The WFA z-score improved significantly on each visit during the follow-up interval (p<0.0001). Conclusion: The results of the current study highlight the efficacy of preoperative feeding with energy- and nutrient dense formula in improving weight gain of malnourished infants with CHD.reference number: IR.TUMS.VCR.REC.1396.3543
Griseococcin(1) from Bovistella radicata (Mont.) Pat and antimicrobial activity
Authors: qingmei zeng , ye yong , Zeng Qinghua
Published: June 2020

Background: To evaluate the antifungal activity of B. radicata fermentation broth, the broth was purified by DEAE-cellulose and sephadex LC-20 column. The compounds were submitted to spectral analysises(HPLC, FT-IR, 1D and 2D NMR etc.). Results: The purified compounds were identified as the Griseococcin(s) which were naphthoquinone derivatives, only Griseococcin(1) has antifungal activity among the Griseococcin(s). Minimum inhibitory concentration(MIC) and zone of inhibition(ZOI) of Griseococcin(1) were 31.2, 31.2 μg/ml and 18.06±0.85 mm, 15.01±1.02 mm respectively against main pathogenic fungus Trichophyton rubrum and Trichophyton mentagrophytes, the Chemical formula and MW of Griseococcin(1) was determined as C37O10H43N and 661Da.Conclusions: In this paper, the secondary metabolite compound Griseococcin(1) from B. radicata was purified. The purified compound can restrain main pathogens(T. rubrum and T. mentagrophytes) leading to tinea pedis. The antifungal activity of Griseococcin(1) was similar to that of the positive control.
Relationship Between the Levels of Inflammatory Cytokines in the Aqueous Humor and Cataract in Fuchs Uveitis Syndrome-A Case Control Study
Authors: Wang Hui , Tao Yong
Published: June 2020

Background
This study aims to compare the levels of intraocular cytokines between FUS eyes and the senile cataract eyes. The association between inflammatory cytokine levels and cataract severity in FUS is evaluated to find the possible mechanism of cataract in FUS eyes.
Methods
A retrospective study of 28 eyes with FUS was performed. Auxiliary examinations were performed, including ophthalmic examinations, laser flare-cell photometry, and levels of inflammatory cytokines in the aqueous humor were measured. The control group included 25 eyes with senile cataract. Data on the aqueous humor inflammatory cytokines were compared between the two groups. The association between the aqueous humor cytokine levels and severity of cataract was assessed.
Results
There were 28 eyes with FUS in 27 patients. Unilateral involvement was noted in 26 patients (96.30%). Stellate keratic precipitates (KPs) were noted in 16 eyes (57.14%). Heterochromia was observed in 21.43% of affected eyes. Posterior capsular opacification cataract was observed in 16 of the 28 eyes. Eyes with FUS had significantly higher aqueous humor cytokine levels (VEGF, IL-6, IL-8 and IL-10) compared with the control eyes (P < 0.001). There was a statistically significant positive correlation between the severity of cataract and IL-6 and IL-8 levels in the aqueous humor (τ = 0.675 and 0.793, respectively; P = 0.001, P < 0.001, respectively).
Conclusions
Expression of VEGF, IL-6, IL-8 and IL-10 in the aqueous humor of FUS patients was significantly higher than in senile cataract eyes, and the aqueous levels of IL-6 and IL-8 were significantly positively associated with the severity of posterior capsular opacification of cataract. Our results imply that an inflammation mechanism may be involved in the early development of cataract in FUS.
What’s Different about Teratoma-Associated LGI1 Encephalitis? A Long-Term Clinical and Neuroimaging Case Series
Authors: Li Cun , Cai Hong-bin , Zhao Xu , Xi Xin-cong , Zhou Qing , Luo Hui-ya , Tang Zhou-ping , Kang Huicong , Kirsch Heidi E.
Published: June 2020

Background Leucine-rich glioma-inactivated 1 (LGI1) encephalitis is clinically heterogeneous, especially at presentation, and though it is sometimes found in association with tumor, this is by no means the rule. The aim of this study is to report a case of teratoma-associated LGI1 encephalitis, to summarize a retrospective series of LGI1 encephalitis and compare them. Methods Clinical data for 10 people with LGI1 encephalitis were collected. Patients were divided into those with and without associated teratoma, and compared for clinical characteristics. Microscopic pathological examination and immunohistochemical (IHC) assay of the LGI1 antibody were performed on teratoma tissue obtained by laparoscopic oophorocystectomy. Results The LGl1 patient with teratoma was similar to the non-teratoma (NT) group in many ways: age at onset (average 47.3 in NT group); percent presenting with rapidly progressive dementia (RPD) (67% of NT group) and psychiatric symptoms (33%); hyponatremia (78%); normal cerebrospinal fluid results except for positive LGI1 antibody (78%); bilateral hippocampal hyperintensity on magnetic resonance imaging (MRI) (44%); diffuse slow waves on electroencephalography (EEG) (33%); good response to immunotherapy (67%); and mild residual cognitive deficit (22%). Her chronic anxiety and presentation with status epilepticus were the biggest differences compared with the NT group. Teratoma pathology was characterized by mostly thyroid tissue and IHC assay confirmed positive LGI1 expression. Conclusion In our series, LGI1 encephalitis included common clinical features: RPD, faciobrachial dystonic seizures, behavioral disorders, hyponatremia, T2-MRI hyperintensity of hippocampus and residual cognitive deficit. We observed some differences in our case with teratoma, but a larger accumulation of cases is needed to improve our knowledge base.
Dipeptidyl Peptidase-4 Involved in Regulating Mitochondria Function in Cardiomyocytes through Nrf2 and PGC-1α Signaling
Authors: Lee Shih-Yi , Wu Shao-Tung , Su Ming-Jai , Liang Yao-Jen , Ku Hui-Chun
Published: June 2020

Background: Oxidative stress is an imbalance between the production of reactive oxygen species (ROS) and the detoxification ability of reactive intermediates. It will lead to mitochondrial damage and dysfunction, resulting in the dysfunction of bioenergetic control and loss of ATP production, which is contributed to the pathogenesis of cardiac diseases. Dipeptidyl peptidase-4 (DPP4) is a transmembrane glycoprotein ubiquitously expressed and has multifunctional properties. DPP4 inhibitors are a class of oral diabetes drugs that inhibit the enzyme activity. In addition to its enzymatic property, considerably less is known regarding the nonenzymatic function of DPP4.Methods: We knocked down DPP4 gene expression in cultured cardiomyocytes to exclude any external and enzymatic substrate effects and compared the response between DPP4 knockdown and wild-type cardiomyocytes in response to oxidative stress.Results: H2O2-induced oxidative stress-stimulated intracellular and mitochondrial ROS concentration led to the loss of mitochondrial function, ATP production, and increased Bax and cleaved PARP expression, resulting in the loss of cell viability in cardiomyocytes. Oxidative stress induced DPP4 expression. Knocking down DPP4 ameliorated H2O2-induced loss of cell viability by preserving mitochondrial bioenergy, reducing intracellular ROS production, alleviating apoptosis-associated protein expression. Knocking down DPP4 increased its capability against oxidative stress by enhancing Nrf2 and PGC-1α signaling, which is associated with preserving mitochondrial function.Conclusions: DPP4 is a mediator of oxidative stress. Knocking down DPP4 without any external substrate mediators increased the capability of cardiomyocytes against oxidative stress, which indicated that DPP4 mediated more than the enzymatic-dependent pathway.
Experimental Investigation on the Viscoelastic Properties of Constituents in Mudstone
Authors: Sun Changlun , Li Guichen , Elgharib Gomah Mohamed , Xu Jiahui , Rong Haoyu
Published: June 2020

In deep underground engineering, the creep behaviors of soft rocks have been widely investigated to help understand the mechanism of the time-dependent large deformation and failure of underground engineering structures. However, rocks were used to be regarded as homogeneous materials and there are limited studying results about the time-dependent properties of constituents in them to reveal their creep mechanism. In this context, the targeting nanoindentation technique (TNIT) was adopted to investigate the viscoelastic characteristics of kaolinite and quartz in a two-constituent mudstone sample. The TNIT consists of identifications of mineralogical constituents in mudstone and nanoindentation experiments on identified constituents. After conducting experiments, the unloading stages of the typical indentation curves were analyzed to calculate the hardness and elastic modulus of constituents in mudstone. And the 180 s load-holding stages with the maximum load of 50 mN were transformed to the typical creep strain-time curves for fitting analysis by using the Kelvin model, the standard viscoelastic model and the extended viscoelastic model. Fitting results show that the standard viscoelastic model can perfectly express the nanoindentation creep behaviors of both kaolinite and quartz and fitting constants are suitable to be used to calculate their creep parameters. The creep parameters of kaolinite are much smaller than that of quartz, which drives the time-dependent large deformation of the soft mudstone. At last, the standard viscoelastic model was verified on a sandstone sample.
Antibacterial Activity of cLFchimera and its Synergistic Potential with Antibiotics against Some Foodborne Pathogens Bacteria
Authors: Roshanak Sahar , Pirkhezranian Zana , Shahidi Fakhri , Sekhavati Mohammad hadi
Published: June 2020

Background: Frequent and unlimited use of antibiotics caused the development of antibiotic resistance by microorganisms. Therefore, there is an argent need to discover novel antibacterial agents or a combination of agents as a safe treatment strategy for various infections. The aim of the present study was to evaluate the synergistic effects of cLFchimera, an antimicrobial peptides (AMPs), and antibiotics on several foodborne bacterial strains. Methods: A checkerboard method was used to determine the synergistic effects of cLFchimera and several antibiotics (Gentamicin, Cefazolin and Ceftazidime) on bacterial strains (Escherichia coli, Pseudomonas aeruginosa and Salmonella typhi). Results: The combination of cLFchimera and antibiotics generated a total and partial synergistic interaction for all foodborne bacterial strain used in the present study (FIC= 0.25 to 0.77). In most cases, the effect of peptide and antibiotic synergist on release of cellular content was not different compared to antibiotics when they used alone, but the count of viable cells significantly decreased in combination peptide and antibiotics treatments. Generally, antibacterial dynamics of the combination of peptide and antibiotics showed an increase and stable trend after reaching the peak point for E. coli, P. aeruginosa and S. typhi, respectively. Scanning electron microscopy analysis showed that bacterial cells treated with the combination Gentamycin and cLFchimera were markedly damaged, and most of the outermost layer of the bacterial cells disappeared. Conclusion: Overall, our results may suggest that cLFchimera mediated its synergistic activity independent to antibiotics mode of action by disrupting the cell membrane and intramolecular mechanisms.
A new reference to evaluate the collapse of the posterior facet in displaced intra-articular calcaneal fractures
Authors: Wei Xiaohua , Zhao Jifu , Cui Wenbo , Chen Wenfeng , Lan Xiaosu
Published: June 2020

BackgroundWe proposed a new method to evaluate the height of the posterior articular surface in displaced intra-articular calcaneal fractures (DIACFs) by drawing two lines on the lateral radiograph of hindfoot: one line was drawn from the apex of the posterior facet to the apex of the posterior tuberosity (the apex line), and the other line was drawn from the apex of the anterior process to the posterior process (the anterior posterior process line). The aim of this study was to analyze the relationship between these two lines in normal calcanei and their changes in DIACFs.MethodsLateral radiographs of normal calcanei and DIACFs between January 2018 and February 2020 were collected. We draw two lines on the lateral radiograph, one line was the apex line and the other line was the anterior posterior process line. The value of the angle formed by these two lines was recorded, if these two lines were parallel to each other, the angle was recorded as 0°. if these two lines formed an angle anteriorly this was recorded as positive, and if these two lines formed an angle behind the calcaneum this was recorded as negative.ResultsIn 135 normal calcanei lateral radiographs, the minimum angle was − 8°, and the maximum angle was 6°, with an average angle of -1 ± 3°. In 145 DIACFs, the minimum angle was 6°; the maximum angle was 37°, and the average angle was 17°±6°. The difference between normal calcanei and DIACFs was statistically significant (P༜.001).ConclusionThe relationship between the apex line and the anterior posterior process line on lateral radiograph can evaluate the height of the calcaneal posterior facet simply and accurately. The two lines are approximately parallel or angulated backward in the normal calcanei, in DIACFs, these two lines angulated forward.Level of Evidence: Level III-retrospective comparative study.
Quantifying Macro Logistics Cost of India
Authors: Pratap Devender , Gupta Devendra B , Pohit Sanjib
Published: June 2020

Globalisation has opened up economic opportunities for developing countries in the form of outflow of value-added services, low-cost raw materials , human resource skills, improved market access for their exports, efficiency gains in their economies through technology transfer and spill-over, and resource re-allocations. Consequently, various developing countries, including India, have increasingly begun to position themselves for greater participation in regional and global markets. It goes without saying that India needs to build its capacity for establishing linkages with global and regional markets for deriving the optimal benefits of engaging with the globalised world. This, in turn, depends on the creation of an efficient logistics system. For this purpose, most of the developed and emerging countries estimate logistics costs on a regular basis, and use performance indicators to measure the efficiency levels of logistics activities. Till now, no attempt has been made to estimate logistics cost of India by the official statistical organisation. Two estimate of logistics cost computed by private bodies are usually quoted when one refers to Indian estimate. However, the methodology of the two needs serious introspection. In this context, this paper makes an attempt to estimate logistics cost of India.
Parecoxib alleviates the inflammatory effect of leukocyte-rich platelet-rich plasma in normal rabbit tendons
Authors: Zhou Ming , Wang Ning , Wang Gang , Jia Zishan , Qi Xiaolei
Published: June 2020

Background: Platelet-rich plasma (PRP) is widely used to treat tendon injuries. Its therapeutic effect varies depending on the different cell components, and white blood cells (WBCs) may play an important role in this phenomenon. The purpose of this study was to evaluate how PRP with different concentrations of WBCs affect normal rabbit tendon and assess whether non-steroidal anti-inflammatory drugs (NSAIDs) can suppress the catabolic effects of WBCs.Methods: Sixteen adult New Zealand White rabbits were used. Blood samples were collected from each rabbit, and PRP was extracted following two different protocols to obtain leukocyte-poor PRP (LP-PRP) and leukocyte-rich PRP (LR-PRP). LP-PRP or LR-PRP was injected into the patellar tendon of each rabbit, while normal saline (NS) was injected as control. In LR-PRP + NSAID group, Parecoxib was administered after LR-PRP injection. For each group, 2 rabbits were euthanatized at day 5 and 14. The patellar tendons were collected and stained with hematoxylin and eosin. A semi-quantitative approach was used to assess the inflammatory response and tendon destruction based on the evaluation of the WBCs, vascularization, fiber structure, and fibrosis.Results: The LR-PRP group exhibited a higher total tendon score than the LP-PRP group at day 5 after PRP injection, but there was no significant difference between the two groups at day 14. For the NSAID group, the tendon score was lower than that of the LR-PRP group both at day 5 and 14.Conclusion: LR-PRP can promote a higher inflammatory response than LP-PRP in the normal rabbit patellar tendon, and this effect can be suppressed by NSAIDs.
Associations between maternal exposure to particulate matter (≤10 microns) and congenital anomalies in Liaoning Province, China: A case-control study (2010–2015)
Authors: Huang Shanshan , Chen Yanling , Huang Yanhong , Li Jing , Liu Shu , Chen Zongjiao , Jiang Chengzhi , Li Lili , Zhou Chen
Published: June 2020

Background: A growing number of reports suggest that maternal exposure to ambient air pollution is a potential risk factor for congenital anomalies (CAs). However, most studies have focused on specific CAs, especially congenital heart defects, while relatively few have investigated the effects of exposure to particulate matter of ≤10 microns (PM10) on CAs overall, but with inconsistent results. This study aims to investigate the associations between maternal exposure to PM10 and the risks of CAs in offspring in Liaoning Province.Methods: Cases of CAs (n = 31,407) and controls (n = 7,958) were selected from the Maternal and Child Health Certificate Registry of Liaoning Province from 2010 to 2015. PM10 concentrations were obtained from the Environment Protection Bureau in the same region. A multivariable logistic regression model combined with variables was used to analyze the association between maternal PM10 exposure and the risks of CAs.Results: Exposure to higher levels of PM10 significantly increased the risks of CAs. In adjusted model I, the odds ratio (OR) of moderate and severe exposure at 3 months before pregnancy was 1.25 (95% confidence interval [CI] = 1.11–1.40) and 1.40 (95% CI = 1.25–1.57), respectively. In the first trimester, the OR of moderate and severe exposure was 1.27 (95% CI = 1.12–1.44) and 1.71 (95% CI = 1.16–1.93), respectively.Conclusions: Maternal exposure to PM10 was significantly associated with increased risks of CAs in Liaoning Province from 2010 to 2015. Pre-pregnancy (3 months) and the first trimester were identified as potential windows of susceptibility.
The Relationship between Low Ocular Perfusion Pressure with Acute Non-Arterial Anterior Ischemic Optic Neuropathy
Authors: Wang Xiaotang , Wang Runsheng , Wang Ying , Wang Xu
Published: June 2020

Objective: To investigate the relationship between low ocular perfusion pressure (OPP) with acute non-arterial anterior ischemic optic neuropathy (ANAION).Methods: Forty- six patients (46 eyes) with ANAION from July 2010 to December 2016 were retrospectively analyzed. The 24-h intraocualr pressure (IOP) in sitting position was measured by non-contact tonometer. The brachial artery systolic blood pressure (SBP) and diastolic blood pressure (DBP) were simultaneously measured by electrocardiogram monitor. The 24-h OPP was calculated according to the measured blood pressure and intraocular pressure: OPP= 45% DBP-IOP. OPP< 10mmHg was defined as low OPP. Sudden visual acuity declining or visual field defect was recorded as the attack of ANAION. 24h was divided into four periods: period A (1-6 A.M), period B (6-12 A.M), period C (12-18 P.M) and period D (18-24 P.M). The correlation between low OPP and ANAION was analyzed. Statistical method was used by Person correlation analysis.Results: There was a statistical difference in the low OPP in the four periods (P< 0.05). The most common period of low OPP was period A (1-6 A.M), with the incidence of low OPP as high as 58.3%. There was a statistical difference in the incidence of ANAION in the four periods (P< 0.05). Most common time period of ANAION was also period A (1-6 A.M), with the incidence rate as high as 46.3%. Person correlation analysis showed that the period of low OPP was associated with the period of ANAION onset (r=0.934, P < 0.05).Conclusion: There was a significant clinical correlation between low OPP and ANAION. Period A (1-6 A.M) was the high-risk period for low OPP and ANAION. The occurrence of ANAION can be reduced by elevating the OPP to improve the blood perfusion of the anterior optic nerve.
Impact of Covid-19 Pandemic on Quality of Sleep Among Nepalese Residents
Authors: Chandra Avinash , Karki Pramila , Prakash Pooja , Chandra Ayush , Khadka Sweta
Published: June 2020

Background

A periodic state of rest accompanied by varying degree of unconsciousness and relative inactivity, the sleep is vital to human health, insufficiency of which can lead to serious problem with physical and mental health consequences. Because of COVID-19 Pandemic, Nepal is under a total lockdown, with total restrictions on the movement of individual in the entire nation, forcing people to home confinement. People are extremely worried about their and families’ health as well as lost or verge of losing jobs. The daily news of increasing COVID-19 cases inside nation and all around the globe is adding to the fear that leads to anger, anxiety, frustration, and stress that directly affects the quality of sleep.
Objectives

The study aimed to assess the quality of sleep before and after COVID-19 pandemic among Nepalese residents.
Method:

A cross-sectional study was conducted that recruited 206 Nepalese residents. The participants completed an anonymous, self-administered questionnaires (SAQ). Insomnia Severity Index (ISI) questionnaire was used to measure the sleep quality before and after the COVID-19 pandemic. Analysis of gathered data was done by descriptive statistics and inferential statistics using SPSS-20 version statistical software.
Result

There was significant variation on sleep quality among Nepalese residents before and after COVID-19 pandemic (t = 3.227) at p < 0.001. Clinical moderate insomnia increased tremendously high in Nepalese. Before the onset of pandemic only 2.9% of participants had moderate and 1% had severe level of clinical insomnia that increased up to 16.5% and 1% after the pandemic, respectively. The mean ISI score was 6.35 ± 4.65 and 8.02 ± 6.01 before and after COVID-19 pandemic, respectively.
Conclusion

This is only one study being carried in Nepal so far that looks for the sleep quality during COVID-19 pandemic. These results show that the people are suffering tremendously with their sleep quality and calls for further research and active measures to help people have good sleep quality during the COVID-19 pandemic. Public awareness regarding the importance of good sleep quality to maintain their mental and physical health during the COVID-19 pandemic.
Pathway-based analysis enables deeper mining of GWAS data on H/L in chickens
Authors: Wang Jie , Zhu Bo , Wen Jie , Li Qinghe , Zhao Guiping
Published: June 2020

Background Heterophils are refers to white blood cells with phagocytosis and killing functions in the avian immune system, These cells identify and kill pathogenic microorganisms through precise regulatory mechanisms. As a simple index, the heterophil/lymphocyte ratio (H/L) in the blood reflects the immune system status of chickens. H/L is a complex trait affected by multiple genetic loci, but single nucleotide polymorphisms (SNPs) significantly associated with traits can usually explain only part of the phenotypic variation. Combining a genome-wide association study (GWAS) with pathway analysis can improve understanding of the biological pathways affecting traits. Our objective was to conduct a SNP- and pathway-based analysis to identify possible biological mechanisms involved in H/L traits. Methods GWAS for H/L was performed in 1,317 Cobb broilers to identify significant single nucleotide polymorphisms (SNPs) associated with H/L. Eight SNPs (P< 1/8,068) reached a significant level of association. The following results were obtained through a series of analyses, including pathway-based association analysis and analysis of the proportion of phenotypic variance explained by SNPs. Results On the basis of GWAS analysis results, one associated SNP (5% genome-wide significance (6.80E-6,0.05/8,068)) on GGA 1(chicken chromosome 1) and seven suggestively associated SNPs with a trend toward significance(1.24E-4, 1/8,068) on GGAs 1, 7, 13 and 19 were detected. The significant SNP on GGA 19 was in Complement C1q Binding Protein (C1QBP). The wild-type and mutant individuals showed significant differences in H/L at five loci (P< 0.05). According to the results of pathway-based analysis, nine associated pathways (P < 0.05) were identified, including small cell lung cancer, proteoglycans in cancer, sulfur relay system, pathways in cancer, gastric acid secretion and purine metabolism. By combining GWAS with pathway analysis, we found that all SNPs after QC explained 12.4% of the phenotypic variation in H/L and 53 SNPs associated with H/L explained as much as 9.7% of the phenotypic variation in H/L. Conclusions Our findings contribute to understanding of the genetic regulation of H/L and provide theoretical support.
Mechanical Performance of Long-fibre Reinforced Polymer Composites by 3D Printing
Authors: Dantas Francis , Gibbons Greg
Published: June 2020

Additive Manufacturing (AM), also known as 3D Printing, has been around for more than 2 decades and has recently gained importance for use in direct manufacturing. The quantified physical properties of materials are required by design engineers to inform and validate their designs, and this is no less true for AM that it is for traditional manufacturing methods. Recent innovation in AM has seen the emergence of long-fibre composite AM technologies, such as the Mark Two (Markforged Inc, USA) system, enabling the manufacture of thermoplastic polymer composites with long-fibre reinforcement. To date though, the mechanical response of the materials with respect to build parameter variation is little understood. In this project, selected mechanical properties (ultimate tensile strength – UTS and flexural modulus) of samples processed using the Mark Two printer were studied. The effect of the reinforcement type (Carbon, Kevlar®, and HSHT glass), amount of reinforcement, reinforcement lay-up orientation, and the base matrix material (Onyx and polyamide) on these properties were assessed using accepted standard test methods. For Onyx, the UTS and Flexural Modulus was improved by a maximum of 244 ± 10 MPa (1228 ± 19%) and 14.2 ± 0.3 GPa (1114 ± 6%) (Carbon), by 143 ± 1 MPa (721 ± 18%) and 7.1 ± 0.3 GPa (560 ± 6%) (Kevlar®) and 209 ± 4 MPa (1049 ± 19%) and 6.0 ± 0.1 GPa (469 ± 6%) (HSHT glass). For Nylon the UTS and Flexural Modulus was improved by 235 ± 4 MPa (1431 ± 56%) and 14.1 ± 0.2 GPa (1924 ± 5%) (Carbon), 143 ± 3 MPa (867 ± 56%) and 6.79 ± 0.08 GPa (927 ± 5%) (Kevlar®) and 204 ± 2 MPa (1250 ± 55%) and 5.73 ± 0.09 GPa (782 ± 5%) (HSHT glass). A regression and ANOVA analysis for UTS indicated that the number of layers of reinforcement had the largest impact on UTS (F = 11,483 P < 0.005), with the second most important parameter being the type of reinforcement (F = 855 P < 0.005). The parameter effects for all four parameters were significant (P ≤ 0.05). For the Flexural Modulus, the number of layers of reinforcement was again the most significant parameter (F = 2733 P < 0.005), with the second most important parameter again being the type of reinforcement (F = 1339 P < 0.005). Again, the parameter effects for all four parameters were significant (P ≤ 0.05), although the influence of base material had much less significant effect on determining the Flexural Modulus than it did in controlling UTS.
Global Trends of Antimicrobial Susceptibility of Ceftaroline and Ceftazidime-Avibactam: A Surveillance Study from the ATLAS Program (2012-2016)
Authors: Zhang Hui , Xu Yingchun , Jia Peiyao , Zhu Ying , Zhang Ge , Zhang Jingjia , Duan Simeng , Kang Wei , Wang Tong , Jing Ran , Cheng Jingwei , Liu Yali , Yang Qiwen
Published: June 2020

Background: Antibiotic resistance is a global health threat.This study reported the global trends of antimicrobial susceptibility ofceftaroline and ceftazidime-avibactam using data from the Antimicrobial Testing Leadership And Surveillance (ATLAS)programbetween2012and2016.Methods:Theminimum inhibitory concentrations (MICs) andin vitro susceptibilities of ceftarolineandceftazidime-avibactam were assessed using the Clinical andLaboratory Standards Institute (CLSI) guidelines.Results:Between 2012 and 2016, a total of 176,345 isolates were collected globally and included for analysis.Regarding Gram-negative bacteria, ceftazidime-avibactam demonstrated high susceptibility (>90%) against EnterobacteriaceaeandPseudomonas aeruginosa, with increasedantimicrobial activity observed from the addition of avibactam (4 mg/L) to ceftazidime.Regarding Gram-positive bacteria, ceftaroline showed >90% susceptibility againstStaphylococcus aureus, Streptococcus pneumoniae, α-and β-hemolytic Streptococcus.The antimicrobial susceptibility of ceftaroline and ceftazidime-avibactam were mostly stable from 2012 to 2016. Nevertheless, the susceptibility ofceftazidime-avibactam to carbapenem-resistant Klebsiella pneumoniae(CRKPN, 88.4% to 81.6%) and to CR-Pseudomonas aeruginosa(CRPAE, 89.6% to 72.7%) decreased. In terms of regional difference, susceptibilities of MRSA to ceftaroline in Asia and of CRKPN to ceftazidime-avibactam in Asia/Africa-Middle East were loweras compared with other regions whereas the susceptibility of CRPAE to ceftazidime-avibactam in North America was higher.Conclusion: The addition of avibactam improved the activity of ceftazidime against EnterobacteriaceaeandPseudomonas aeruginosa. The global antimicrobial susceptibilities of ceftaroline and ceftazidime-avibactam were in general stable from 2012 to 2016, but a marked reduction in the susceptibility of CRPAEtoceftazidime-avibactam was observed.
Feedback of ATP Measurement as a Tool for Reducing Environmental Contamination in Hospitals in the Dutch/Belgian Border Area.
Authors: Arkel Andreas van , Willemsen Ina , Kilsdonk-Bode Linda , Vlamings-Wagenaars Sindy , Oudheusden Anne van , De Waegemaeker Pascal , Leroux-Roels Isabel , Verelst Martine , Maas Evelien , Oosten Anita van , Willemse Patricia , Asselen Esther van , Klomp-Berens Ella , Franssen Karen , Cauwenberg Elise Van , Schweitzer Valentijn , Kluytmans Jan
Published: June 2020

Background & objective: The objective of this study was to determine the effect from feedback of ATP measurements on environmental contamination within hospitals in the Dutch/Belgian border area. Setting: Standardized ATP measurements were conducted in 9 hospitals on pre-defined fomites. Four different fomite groups were defined: medical devices, patient bound materials, ward bound materials and sanitary items. ATP results were reported in relative light units (RLU), RLU >1000 was considered as “not clean.” Two rounds of ATP measurements were conducted. After the first round of ATP measurements, results were provided to the wards. There were no structured cleaning interventions implemented. The second round of ATP measurements was performed one year later. The amount of surface contamination before and after the feedback were compared. Results: In total 1923 ATP measurements were performed. Before feedback 960 ATP measurements were conducted and after feedback 963. The overall median reduction in RLU was 381 (p<0.001), from 568 before feedback to 187 afterwards. In each hospital there was a reduction of the median RLU after feedback. Conclusion/discussion: Substantial reductions in RLU values were found after feedback of ATP measurements. Feedback of ATP measurements was associated with a major reduction of surface contamination in hospitals.
Cation Exchange Strategy to Construct a Targeting Nanoprobe for Enhanced Positive MR Imaging Capability
Authors: Chen Siyu , Sun Haitao , Zheng Yingyan , Chen Qian , Luo Yu , Chen Hangrong , Zhou Quan
Published: June 2020

Background: Excellent imaging performance and good biocompatibility of contrast agents are considered as prerequisites for accurate tumor diagnosis and treatment. Results: Herein, a novel imaging nanoprobe with actively targeting performance based on ultrasmall paramagnetic iron oxide (USPIO) was constructed by a facile cation exchange strategy followed by conjugation with transferrin (Tf). The stable gadolinium (Gd3+) chelation endows the nanoparticles (NPs) with a low value of r2/r1 (1.28) and relatively high r1 value of 3.2 mM-1s-1, enabling their use in T1-weighted positive MR imaging.Conclusion: This constructed transferrin modified gadolinium-iron chelate nanoprobe, named as TUG, shows high biocompatibility within a given dose range. More importantly, compared with clinically used Gd-based small molecule contrast agents, the obtained TUG can be more engulfed by breast cancer cells, showing much enhanced T1-weighted positive MR imaging in either subcutaneous or in situ tumor models of breast cancer. This novel nanoprobe holds enormous promise to be utilized as a targeting contrast agent with high efficacy for T1-weighted positive MR imaging.
Nutritional status of school children living in Northern part of Sri Lanka
Authors: Sathiadas Gitanjali , Annieston A , Arunath V , Kasthuri T , Wickramasinghe V P
Published: June 2020

Background
Nutritional status is an important indicator for measuring quality of life in children. A region that is recovering from war will face many problems related to nutrition. Very few studies have addressed the nutritional problems in school-going children. This study was undertaken to identify the prevalence of various nutritional problems and to assess the correlation of it to certain socio-demographic factors.
Methods
Community based cross sectional study using multistage stratified proportionate cluster sampling technique, was done among healthy children attending schools in the Northern part of the country. Height and weight were measured and the Body Mass Index (BMI) was calculated [weight (kg)/Height (m) ²]. BMI-for-age z-score (BAZ) and Height for age Z (HAZ) scores were determined and WHO growth references were used to categorise the nutritional status of the children. Correlation between various nutritional problems with Maternal education and household income was assessed.
Results
A total of 1012 children were recruited, and the mean age was 11.12 ± 1.77yrs. Girls in the age ranges of 9–14 were heavier and taller when compared to the boys compatible to the pubertal growth spurt. Stunting based on the height for age was seen in 10.9% of boys and 11.8% of girls. Wasting based on BMI for age WHO standard (WHO 2007) was seen in 30.6% of boys and 29.1% of the girls. The prevalence of overweight was 11% and Obesity was 6.3% of the population. Obesity was predominantly seen in boys (4.2%) and it was significantly higher when compared to the girls (2.1%) (p < 0.001). Older boys (> 10 years) were significantly affected more than the younger ones (p < 0.01). The prevalence of wasting, stunting, overweight and obesity had significant variations in different educational zones comparable with the geographical areas. Maternal Education and Family income had a significant impact on the prevalence of stunting and obesity. (p < 0.001).
Conclusion
Findings suggest that stunting, wasting, overweight and obesity are prevalent among 6-16-year-old leading to concerns in public health. The nutritional problems significantly vary according to the geographical location maternal education and the household income.
Regulatory network underlying alterations of gene expression in early death of Huntington's disease
Authors: Zhou Zhike , Chen Fenqin , Zhong Shanshan , Zhou Yi , Zhang Rongwei , Kang Kexin , Zhang Xiaoqian , Zhao Mei , Xu Ying , Zhao Chuansheng
Published: June 2020

The aim of this study is to explore the genomic mechanism of early death in Huntington’s disease (HD). We identified 10160 and 1511 differentially expressed genes (DEGs) from comparisons of HD versus control and early versus late death, respectively. On the basis of 922 overlapped DEGs among them, six functional modules were established by weight gene correlation network analysis. The turquoise module most strongly related to overall survival of HD was significantly enriched in GABAergic synapse, retrograde endocannabinoid signaling and neuroactive ligand-receptor interaction. Low expression of five DEGs (CA10, WSB2, ACTR3B, PCDH19 and GABRB3) with highest degree of connectivity and non-zero regression coefficients were identified as hub genes, based on which the LASSO model exactly predicted the occurrence of early death in HD. Furthermore, the network analysis revealed indirect interaction of CA10 with the central hub gene GABRB3, which was involved in the pathway of GABAergic synapse. Compared with high expression of hub genes, their low expression appeared shorter overall survival of HD patients according to Kaplan-Meier survival analysis. Consequently, low expression of CA10, WSB2, ACTR3B, PCDH19 and GABRB3 were possibly associated with early death of HD. The likelihood of low expression of GABRB3 regulated by CA10 in GABAergic synapse contributed to the pathogenesis of early death in HD.