bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of different feedback modalities for the training of procedural skills in Oral and Maxillofacial surgery: a blinded, randomized and controlled study
Authors: Seifert Lukas Benedikt , Herrera-Vizcaino Carlos , Herguth Philipp , Sterz Jasmina , Sader Robert
Published: June 2020

Background: The feedback given to students plays an important role concerning their efficiency related to learning practical skills. In the present literature, diverse feedback modalities have been investigated. Our hypothesis is that individualized and unsupervised video feedback can produce a similar learning experience as performing practical skills in the setting of oral and maxillofacial surgery as conventional direct expert feedback (control group). Methods: This prospective, randomized, controlled and blinded study compared direct expert feedback (DEF), individualized video feedback (IVF) and unsupervised video feedback (UVF). The participants were fourth-year dental students from University Goethe in Frankfurt. The students were assigned to one of the three feedback methods (n = 20) using simple randomization. All of the participants received an instruction video for an interdental (‘Ernst’) ligature and periphery venous catheterization. Subsequently, the students were video recorded performing the tasks by themselves (pre-test). Following this, every student received feedback using one of the above-mentioned modalities of feedback. The participants then performed the same task again while being video recorded (post-test) to measure the acquired competence. Six weeks later, the students participated in an objective structured clinical examination (OSCE) where their long-term knowledge retention was evaluated. All of the examiners were blinded regarding the students’ instructional approach and their affiliation in terms of learning group. Results: For the interdental ligature, significant performance improvements for each feedback modality between the pre-test and post-test were found (p <0.001). The comparison between each group in the post-test showed no significant differences between the three groups (p = 0.33). All groups showed a satisfying level of knowledge retention from the post-test through to the long-term knowledge retention test. Conclusion: This study showed that IVF and UVF can be considered an alternative or adjunct to conventional methods (i.e. DEF) when learning procedural skills in oral and maxillofacial surgery as no quantitative difference was found between them in the short- and long-term.
Multiple Imputation with Missing Indicators as Proxies for Unmeasured Variables: Simulation Study
Authors: Sperrin Matthew , Martin Glen P.
Published: June 2020

Background : Within routinely collected health data, missing data for an individual might provide useful information in itself. This occurs, for example, in the case of electronic health records, where the presence or absence of data is informative. While the naive use of missing indicators to try to exploit such information can introduce bias, its use in conjunction with multiple imputation may unlock the potential value of missingness to reduce bias in causal effect estimation, particularly in missing not at random scenarios and where missingness might be associated with unmeasured confounders. Methods: We conducted a simulation study to determine when the use of a missing indicator, combined with multiple imputation, would reduce bias for causal effect estimation, under a range of scenarios including unmeasured variables, missing not at random, and missing at random mechanisms. We use directed acyclic graphs and structural models to elucidate a variety of causal structures of interest. We handled missing data using complete case analysis, and multiple imputation with and without missing indicator terms. Results: We find that multiple imputation combined with a missing indicator gives minimal bias for causal effect estimation in most scenarios. In particular the approach: 1) does not introduce bias in missing (completely) at random scenarios; 2)reduces bias in missing not at random scenarios where the missing mechanism depends on the missing variable itself; and 3) may reduce or increase bias when unmeasured confounding is present. Conclusion : In the presence of missing data, careful use of missing indicators, combined with multiple imputation, can improve causal effect estimation when missingness is informative, and is not detrimental when missingness is at random.
Associations between high triglycerides and arterial stiffness in a population-based sample: Results from the Kardiovize 2030 study
Authors: Pavlovska Iuliia , Kunzova Sarka , Jakubik Juraj , Hruskova Jana , Skladana Maria , Rivas-Serna Irma Magaly , Medina-Inojosa Jose R. , Lopez-Jimenez Francisco , Vysoky Robert , Geda Yonas E. , Stokin Gorazd B. , González-Rivas Juan P.
Published: June 2020

Background : The term arterial stiffness (ArSt) describes structural changes in arterial wall related to the loss of elasticity and is known as an independent predictor of cardiovascular diseases (CVD). The evidence relating to ArSt and triglycerides (TG) shows contradictory results. This paper means to survey the association between high TG and ArSt, utilizing the cardio-ankle vascular index (CAVI). Methods : Subjects aged between 25 and 64 years from a random population-based sample were evaluated between 2013-2016. Data from questionnaires, blood pressure, anthropometric measures, and blood samples were collected and analyzed. CAVI was measured using VaSera VS-1500N devise. Subjects with a history of CVD or chronic renal disease were excluded. Results : 1934 participants, 44.7 % of males, were included. The median age was 48 (Interquartile Range [IQR] 19) years, TG levels were 1.05 (0.793) mmol/L, and CAVI 7.24 (1.43) points. Prevalence of high CAVI was 10.0 % (14.5 % in males and 6.4 % in females; P < 0.001) and prevalence of hypertriglyceridemia was 20.2 % (29.2 % in males and 13 % in females; P <0.001). Correlation between TG and CAVI was 0.136 ( P <0.001). High CAVI values were more prevalent among participants with metabolic syndrome (MetS), high blood pressure, dysglycemia, abdominal obesity, high LDL-cholesterol, and high total cholesterol. Using binary regression analysis, high TG were associated with high CAVI, even after adjustment for other MetS components, age, gender, smoking status, LDL-c, and statin treatment (β=0.474, OR= 1.607, 95 % CI = 1.063-2.429, P =0.024). Conclusion : TG levels were correlated with ArSt, measured as CAVI. High TG was associated with high CAVI independent of multiple cardiometabolic risk factors. Awareness of the risks and targeted treatment of hypertriglyceridemia could further benefit in reducing the prevalence of CVD and events.
Metadichol ® a novel nano lipid that inhibits In Vitro, SARS-COV-2 and a multitude of pathological viruses
Authors: Raghavan Palayakotai R
Published: June 2020

New pathogenic virus outbreaks with increasing regularity are leading us to explore novel approaches, which will reduce the reliance on a time-consuming vaccine mode to halt the strike. The requirement is to find a universal approach to disarm any new and as yet unknown viruses as they appear. A promising approach could be by targeting the lipids membranes, common to all viruses and bacteria. The ongoing pandemic of the SARS-coronavirus 2 (SARS-CoV-2) has restated the importance of interactions between components of the host cell plasma membrane and the virus envelope as a critical mechanism of infection. Metadichol ®, a nano lipid emulsion, has been examined and shown to be a strong candidate to help stop the proliferation of the SARS-COV-2.Naturally derived substances, such long chain saturated lipid alcohols reduce the infectivity of various types of viruses, including the coronavirus like SARS-COV-2, by modifying the lipid-dependent attachment to human host cells. SARS-COV-2 uses the receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming. Metadichol®, a nano lipid formulation of long-chain alcohols, has been shown to inhibit TMPRSS2 (EC50 of 96 ng/ml). Compared to the inhibitor Camostat Mesylate (26000 ng/ml), it is 270 times more potent. Also, Metadichol ® is a moderate inhibitor of ACE2 @ 31 µg/ml. In the SARS-COV2 antiviral assay using CACO2 cells, it has an EC90 of 0.16 µg/ml.
Systematic Scoping Review of Factors and Measures of Rurality: Toward the Development of a Rurality Index for Health Care Research in Japan
Authors: Kaneko Makoto , Ohta Ryuichi , Vingilis Evelyn , Mathews Maria , Freeman Thomas Robert
Published: June 2020

BackgroundRural-urban health care disparities are an important topic. Hence, assessing rurality and evaluation of health outcomes based on rurality are indispensable. However, there is no universal measure of ruralityand Japan has no index to evaluate rurality for health care research. This study aimed to conduct a systematic scoping review to identify the important factors and methods of measuring rurality to inform the future development of a rurality index in Japan.MethodsFor our review, we searched six bibliographic databases (MEDLINE, PubMed, CINAHIL, ERIC, Web of Science and the Grey Literature Report) and official websitesof national governmentssuch asGovernment and Legislative Libraries Online Publications Portal (GALLOP),from 1 January 1989 to 31 December 2018. We extracted relevant variables used in the development of rurality indices, the formulas and reliability/validity measures.ResultsWe identified 17 rurality indices in 7 countries. These indices mainly aimed to assess access to health care or to decide incentives for health care providers. Frequently used variables for the indices were population size/density, travel distance/time to emergency care or referral centre. Many indices did not examine reliability and validity.ConclusionsWhile the concept of rurality and concerns about barriers to access to care for rural residents is shared by many countries, the operationalization of rurality is highly context-specific, with few universal measures or approaches to constructing a rurality index.The results will be helpful to develop a rurality index in Japan and other countries/areas.
Pelvic organ prolapse and uterine preservation: A case control study (POP-UP study)
Authors: Gagyor Daniel , Kalis Vladimir , Smazinka Martin , Rusavy Zdenek , Pilka Radovan , Ismail Khaled
Published: June 2020

Background: Abdominal and laparoscopic sacro-colpopexy (LSC) is the preferred surgical option for the management of a symptomatic apical pelvic organ prolapse (POP). Women who have their uterus, and for whom an LSC is indicated, can have a laparoscopic sacro-hysteropexy (LSH), a laparoscopic supra-cervical hysterectomy and laparoscopic sacro-cervicopexy (LSCH+LSC) or a total laparoscopic hysterectomy and laparoscopic sacro-colpopexy (TLH+LSC). The main aim of this study was to compare clinical and patient reported outcomes of uterine sparing versus concomitant hysterectomy LSC procedures. Methods: A retrospective analysis of clinical, imaging and patient reported outcomes at baseline, 3 and 12 months after LSH (cases) versus either LSCH+LSC or TLH+LSC between January 2015 and January 2019 in a tertiary referral urogynecology center in Pilsen, the Czech Republic. Results. In total, 294 women were included in this analysis (LSH n = 43, LSCH+LSC n = 208 and TLH+LSC n = 43). There were no differences in the rates of perioperative injuries and complications. Operating time and blood loss were higher in the concomitant hysterectomy compared to the uterine sparing group but this was only significant when comparing LSH to TLH+LSC (p = 0.048). There were no statistically significant differences in any of the clinical or patient reported outcomes except for a significantly lower anterior compartment failure rate (p= 0.017) and higher optimal mesh placement rate at 12 months in women who had concomitant hysterectomy procedures (p = 0.006).Conclusion. LSH is associated with shorter operative time and intraoperative blood loss; nevertheless, higher rates of anterior compartment failures and suboptimal mesh placement.
Energy infrastructure improvements have prompted inclusive growth in rural China
Authors: Zhu Bangzhu , Huang Liqing , Wei Yi-Ming , Zhang Lin
Published: June 2020

Stable energy supply with high quality infrastructure is vital for sustainable energy consumption and inclusive growth. In this paper, we develop empirical methods to evaluate the extent to what energy infrastructure improvement towards inclusive growth, which help guide policy development to achieve Sustainable Development Goals. By investigating the national-scale energy infrastructure improvement project in rural China, we identify the general and inclusive effect of income growth attributed to improved quality of energy infrastructure. The results show that energy infrastructure improvement contributes to rural income increase up to 69 Chinese renminbi (RMB) a year and narrows the income gap by 10 RMB for residents originally with an income difference of 100 RMB. The inclusive growth effect is pronounced in the eastern region, for the poor, for the educated, and becomes remarkable over time. Energy infrastructure improvement leads to income inclusive growth through abundant working time in the eastern and western regions, and general income growth in the middle region through individual health condition. Continuous efforts to energy infrastructure improvement and investments in education and work trainings, especially in the middle and western regions, are critical to achieve inclusive growth.
Serum Profile of Lactate Dehydrogenase (LDH) and Alkaline Phosphatase (ALP) in Alcoholic Liver Diseases
Authors: Grytczuk Agnieszka , Gruszewska Ewa , Panasiuk Anatol , Cylwik Bogdan , Chrostek Lech
Published: June 2020

Background: Alcohol‐related liver diseases affect the capability of the liver for the synthesis of proteins including enzymes. Among enzymes two expose the liver specific isoenzymes. There are lactate dehydrogenase and alkaline phosphatase. The purpose of this study was to explore the profile of lactate dehydrogenase and alkaline phosphatase isoenzymes in alcoholic liver diseases.Methods: The serum profile of lactate dehydrogenase and alkaline phosphatase isoenzymes was studied in alcoholic cirrhosis and alcoholic hepatitis by electrophoresis method on agarose gel.Results: The relative concentration of LDH 1 isoenzyme is decreased in alcoholic hepatitis, but LDH 4 and LDH 5 isoenzymes are increased. In addition, the relative level of LDH 5 isoenzyme is increased in alcoholic cirrhosis. The concentrations of intermediate isoenzymes (LDH 2 and LDH 3) are reduced in alcoholic cirrhosis. There were also an increase of liver ALP isoenzyme and parallel decrease in its bone isoenzyme in alcoholic hepatitis and cirrhosis. The severity of liver cirrhosis, expressed as a Child-Pugh score, didn’t affect total activity of both enzymes but effects the relative concentration of LDH 2, LDH 3 and LDH 4 isoenzymes.Conclusions: The serum profile of lactate dehydrogenase and alkaline phosphatase isoenzymes alters in alcoholic liver diseases and differs between them. The differences can be explained by the tissue prevalence and metabolic preferences of isoenzymes.
Patients with isolated vertigo attack preceding stroke have different clinic characteristics: a retrospective study
Authors: Qiu Dongxu , Zhang Lei , Deng Jun , Xia Zhiwei , Deng Jingfeng
Published: June 2020

Background

Isolated vertigo attack history preceding the acute stroke were frequently accompanying with other focal neurological symptoms. To clarify the different clinical characteristics between isolated vertigo attack and vertigo symptom accompanying hemiplegia preceding stroke, we performed this 4-year retrospective study.
Methods

Medical records of 1283 patients hospitalized with vertigo symptom had been screened. Patients were divided into two groups: isolated vertigo attack history preceding the stroke defined as IVA group, vertigo symptom accompanying hemiplegia attack defined as VAH group. Clinic characteristics including ABCD2 score, infarction volume and location, relative risk factors and the following medical intervention were compared between the group.
Results

Patients featured with VAH had higher extracranial stenosis (21.2% vs. 9.0%, P < 0.01) and ABCD2 score (3.7 ± 1.9 vs. 2.3 ± 1.5, P = 0.03), patient with IVA showed a higher diabetic prevalence (40.9% vs. 29.7%, P = 0.02). The frequency of vertigo events tended to be more commonly in patient with VAH (median 3.1 vs. 5.5, p < 0.03). The total cerebral infarction volume in IVA group tended to be larger than VAH with a median of 4.56 cm3 versus 2.32 cm3 (p = 0.02). Additionally, less patients with IVA sought medical intervention when vertigo symptom occurred.
Conclusions

Clinical characteristics including ABCD2 score, total cerebral infarction volume and the location were different between AVH and IVH group. In addition, less patients in IVH cohort sought medical intervention when vertigo symptom occurred.
Composite Surface Roughness and Color Change Following Airflow Usage
Authors: Valian Azam , Ansari Zahra Jaber , Rezaie Mohammad Moien , Askian Roja
Published: June 2020

Background: Esthetic dental restorations have gained increasing popularity. The restoration surface should be smooth enough to prevent adhesion of microorganisms and food particles, and achieve maximum esthetics. This study aimed to assess the surface roughness and color change of composite specimens following the use of an airflow device. Methods: In this in vitro, experimental study, 30 Tokuyama composite discs were fabricated and randomly divided into three groups (n=10) for the use of airflow with calcium carbonate powder, airflow with sodium bicarbonate powder, and conventional polishing with FlexiDisc. The surface roughness of specimens was measured by profilometry while the color change was evaluated by measuring the L*, a* and b* color parameters by spectrophotometry before polishing (T1). The composite specimens were then polished for stain removal and their surface roughness and color parameters were measured again after polishing (T2). Paired t-test and Tukey’s test were applied for within-group and between-group comparisons.Results: Significant differences were noted in surface roughness (Ra) between airflow with calcium carbonate (0.251 ± 0.014 µm) and airflow with sodium bicarbonate (0.421 ± 0.208 µm), and also between airflow with sodium bicarbonate and FlexiDisc (0.207 ± 0.076 µm) groups after polishing (P<0.05). Regarding the correlation of change in surface roughness and color parameters at T1 and T2, an inverse correlation was noted between the change in surface roughness and all color parameters except for L*. In other words, increasing the surface roughness difference (surface smoothing), decreased the a* and b* color parameters. Conclusions: Within the limitations of this study, the results showed that the airflow device used in this study had no significant difference with the conventional polishing in terms of reduction in surface roughness and staining. Considering the cost and maintenance of the airflow device, it is not suggested as a suitable alternative to the conventional polishing procedures. Trial Registration Number: This is not a human subject research.
Improved Effect of a Mitochondria-Targeted Antioxidant on Hydrogen Peroxide-Induced Oxidative Stress in Human Retinal Pigment Epithelium Cells
Authors: KIM MYUNG HEE , Kim Dae Hyun , Yang Su Geun , Kim Dae Yu
Published: June 2020

Background: Oxidative damage in retinal pigmented epithelium (RPE) cells contributes to the development of age-related macular degeneration, which is among the leading causes of visual loss in elderly people. In the present study, we evaluated the protective role of TPP-Niacin against the hydrogen peroxide (H2O2)-induced oxidative stress to RPE cells. Methods: The cellular viability, lactate dehydrogenase, reactive oxygen species (ROS), and mitochondrial function were determined in the retinal ARPE-19 cells under the treatment with H2O2 or pre-treatment with TPP-Niacin. The expression level of mitochondrial related genes and some transcription factors were assessed using real-time polymerase chain reaction (RT-PCR). Results: TPP-Niacin significantly improved cell viability reduction, reduced ROS generation and increased the antioxidant enzymes in H2O2-treated ARPE-19 cells. Mitochondrial dysfunction from H2O2-induced oxidative stress was also significantly diminished by the TPP-Niacin treatment, reduced generation of ROS, an ameliorated reduction of mitochondrial membrane potential (MMP) and an upregulated mitochondrial associated gene. In addition, TPP-Niacin markedly enhanced the expression of transcription factors (PGC-1α and NRF2) and antioxidant associated genes (especially, HO-1 and NQO-1). Conclusion: We proved the protective effect of TPP-Niacin against H2O2-induced oxidative stress in RPE cells. TPP-Niacin is believed to have played a protective role against mitochondrial dysfunction by up-regulating antioxidant-related genes such as PGC-1α, NRF2, HO-1 and NQO-1 in RPE cells.
Disrupting COVID-19 by Improving Environmental Performance
Authors: Migliardo Carlo
Published: June 2020

This paper provides evidence that increasing environmental quality can mitigate the spread of COVID-19 by producing natural antibodies. Using recent data from the 2020 Environmental Performance Index for more than 70 countries, our findings validate the effectiveness of lockdown policies in preventing outbreaks. The results are robust across econometric techniques as well as across the environmental proxy variables adopted. We also suggest implementing specific reforms to strengthen ecological performance.
WITHDRAWN: Fabrication of Nimo Nanostructured Catalyst via Ultrasonic-Assisted Combustion Method Used in High Efficiency Thiophene Hydrodesulfurization: Influence of Organic Compound Type
Authors: Hamidi Roya , Khoshbin Reza , Karimzadeh Ramin
Published: June 2020

Alumina supported NiMo nanocatalysts were synthesized through ultrasonic-assisted combustion method with various organic additives, including citric acid, ethylene glycol, glycine and urea using in hydrodesulfurization of thiophene at atmospheric pressure. The samples were characterized by XRD, TGA, FESEM, EDX, BET-BJH and TPR analyses. The results indicated that the type of organic compound has a noticeable effect on phase structure, surface morphology and reducibility potential as a consequence of different amount of heat and gaseous products released during combustion reaction. Our method showed that a relatively homogeneous distribution of the active material over the support can be achieved. Using citric acid as an organic additive, led to synthesis of nanocatalyst in which more than 90% of particles are less than 70 nm. The sample synthesized by citric acid exhibited the highest activity in hydrodesulfurization reaction due to its significant properties such as high surface area, considerable surface hole and weakened metal-support interaction compared with other organic additives. In addition, activity assessment of the prepared catalyst by ethylene glycol and glycine demonstrated that 100% abatement of thiophene can be achieved at 105 °C and 30 min.
Black-white Racial Disparities in Household Food Insecurity from 2005-2014, Canada
Authors: Dhunna Simran , Tarasuk Valerie
Published: June 2020

Background: Household food insecurity is a public health concern in many high-income countries. Despite two decades of research charting the socio-demographic and geographic correlates of food insecurity in Canada, the relationship between race and vulnerability to food insecurity has not been interrogated. Our objectives were to examine the association of Black-White racial identity and prevalence and severity of household food insecurity in Canada, and understand how racialized vulnerability manifests differently for key sociodemographic predictors. Methods: Data for households with Black and White respondents with complete data on household food insecurity were drawn from the Canadian Community Health Survey cycles from 2005-2014 (N=491,400). Household food insecurity status was assessed using the Household Food Security Survey Module. Bivariate and multivariate logistic and multinomial regression models were run, including respondent’s race and immigration status, as well as six well-established household-level predictors of food insecurity in the general population: household composition, income, housing tenure, highest level of education in the household, main household income source, and province/territory. To test whether the relationship between food insecurity and these predictors differed by race, additional multivariable logistic regression models were run, with race interacted with each predictor individually and predicted probabilities estimated.Results: The weighted prevalence of household food insecurity was 10.0% for white respondents and 28.4% for Black respondents. The odds of Black households being food-insecure compared to white households fell from 3.56 (95% CI: 3.30-3.85), to 1.88 (95% CI: 1.70-2.08) with adjustment for household sociodemographic characteristics. In contrast to white households, there was relative homogeneity of risk of food insecurity among Black sub-groups defined by immigration status, household composition, education, and province of residence. Homeownership was associated with lower probabilities of food insecurity for Black and white households, but the probability among Black owners was similar to that for white renters (14.7% vs. 14.3%). Black households had significantly higher predicted probabilities of food insecurity than their white counterparts across all main sources of household income except child benefits and social assistance.Conclusions: Being racialized as Black appears to be an overriding factor predicting vulnerability to food insecurity for the Black population in Canada.
Rosaceae, Brassicaceae and Pollen Beetles: exploring relationships and evolution in an anthophilous beetle lineage (Nitidulidae, Meligethes-complex of genera) using an integrative approach
Authors: LIU MEIKE , HUANG MIN , CLINE ANDREW RICHARD , MANCINI EMILIANO , SCARAMUZZI ANDREA , PARADISI SIMONE , AUDISIO PAOLO , BADANO DAVIDE , Sabatelli Simone
Published: June 2020

Background: Meligethes are pollen-beetles associated with flowers of Rosaceae as larvae. This genus, in its present-day concept, consists of 63 known species in two subgenera, Meligethes and Odonthogethes, predominantly occurring in the eastern Palaearctic. We analyzed 61 morphological and ecological characters (128 states) of all species, as well as of 7 outgroup species from 7 Meligethinae genera (including the believed sister-genus Brassicogethes), to investigate their phylogeny. A parallel molecular analysis was carried out on 9 Meligethes, 9 Odonthogethes, 3 Brassicogethes and 2 Meligethinus species, based on DNA sequence data from mitochondrial (COI, 16S) and nuclear (CAD) genes, to obtain additional phylogenetic information on the group. Results: Morphological phylogenetic reconstructions supported the monophyly of the genus, and clades corresponding to purported subgenera Meligethes and Odonthogethes. Main species-groups were mostly recovered intact, however some unresolved polytomies remained. Molecular data suggested a different scenario, placing members of Brassicogethes (including 42 mostly W Palearctic species associated with Brassicaceae) as sister to Odonthogethes, with this clade being sister to Meligethes s.str. This alternative phylogenetic assessment suggests that the monophyletic clades Meligethes s.str., Odonthogethes and Brassicogethes should be regarded alternatively as three subgenera of a monophyletic Meligethes, or three genera in a monophyletic genus-complex, with mutually monophyletic Brassicogethes and Odonthogethes. Molecular analyses estimated the origin of this lineage at ca. 14-15 Mya from a common stem including Meligethinus. Conclusions: We hypothesize in the Middle Miocene (likely in Langhian Age), the first Meligethes specialized on Rosaceae, on which they subsequently radiated during Late Miocene and Plio-Pleistocene. This radiation was enforced by geographic isolation in E Asiatic mountain systems, and by larval host-plant specialization. Combined evidence from morphology, ancestral state parsimony reconstruction of host-plant associations, and molecular evidence, suggested that for Meligethes s.str., Rosoideae (Rosa spp.) represented the ancestral hosts, followed by an independent shift of ancestral Odonthogethes (ca. 9-15 Mya) on Rubus (Rosoideae) and members of Rosaceae Spiraeoideae. Other ancestral Odonthogethes probably shifted again on the unrelated plant family Brassicaceae (maybe 8-14 Mya in S China), allowing a rapid westward radiation of the Brassicogethes clade.
Development of a Novel Prognostic Score Combining Clinicopathologic Variables, Gene Expression and Mutationprofiles for Lung Adenocarcinoma
Authors: Li Guofeng , Wang Guangsuo , Guo Yanhua , Li Shixuan , Zhang Youlong , Li Jialu , Peng Bin
Published: June 2020

Background: Integrating phenotypic and genotypicinformation to improve prognostic prediction is under active investigation for lung adenocarcinoma (LUAD). In this study, we developed a new prognostic model for event-free survival (EFS)and recurrence-free survival (RFS) based on the combination of clinicopathologic variables, gene expression and mutation data. Methods: We enrolled a total of 408 patients from the Cancer Genome Atlas Lung Adenocarcinoma (TCGA-LUAD) project for the study. We pre-selected gene expression or mutation features, and constructed 14 different input feature sets for predictivemodel development.We assessed model performance with multiple evaluation metrics including the distribution of C-index on testing dataset, risk score significance and time-dependent AUC under competing risks scenario.We stratified patients into higher and lower-risk subgroups by the final risk score, and further investigated underlying immune phenotyping variations associated with the differential risk.Results: The model integrating all three types of data achieved the bestprediction performance. The resultant risk score provided a higher-resolution risk stratification than other models within pathologically-definedsubgroups. The score could account for extra EFS-related variationsthat were not captured by clinicopathologic scores. Being validated forRFS prediction under a competing risks modeling framework, the score achieved a significantly higher time-dependent AUC as compared to that of the conventional clinicopathologic variables-based model (0.772 vs. 0.646, p-value< 0.001). The higher-risk patients were characterized with transcriptionalaberrations of multiple immune-related genes, and a significant depletion of mast cells and natural killer cells. Conclusions: We developed a novel prognostic risk score with improved prediction accuracy,using clinicopathologic variables, gene expression and mutation profiles as input, for LUAD. Such score was an significant predictor of both EFS and RFS.Trail registration: This study was based on public open data from TCGA and hence the study objects were retrospectively registered.
Study Protocol for Draup: De-implementation Ofroutine Chest Radiographs After Adoption of Ultrasound Guided Insertion and Confirmation of Central Venous Catheter Protocol, A Hybrid Implementation/effectiveness Study
Authors: Ablordeppey Enyo A. , Powell Byron J. , McKay Virginia R. , Keating Shannon M. , James Aimee S. , Carpenter Christopher R. , Kollef Marin H. , Griffey Richard T.
Published: June 2020

BACKGROUNDAvoiding low value medical practices is an important focus in current healthcare utilization. Despite advantages of point of care ultrasound (POCUS) over chest x-ray (CXR), including improved workflow and timeliness of results, POCUS-guided central venous catheter (CVC) position confirmation and exclusion of pneumothorax (PCEP) has had slow rate of adoption. This demonstrates a gap that is ripe for the development and application of de-implementation strategies that support substitution of POCUS for CXR after CVC insertion.METHODSDe-implementation of routine chest radiographs after adoption of ultrasound guided insertion and confirmation of central venous catheter protocol (DRAUP) will be created to de-implement an unnecessary imaging modality in the critical care environment. Guided by the Consolidated Framework for Implementation Research constructs, we will explore barriers and facilitators of POCUS for CVC PCEP in a single center, large tertiary, academic hospital via focus groups. The focus groups will inform the development and testing of strategies that address identified determinants of implementation and de-implementation.Operational use of the de-implementation strategies will be conceptualized using Morgan’s framework for understanding and reducing medical overuse. We will locally implement these strategies and assess them using Proctor’s outcomes (adoption, de-adoption, fidelity and penetration) in an observational study to demonstrate proof of concept, gaining valuable insights on our selected implementation and de-implementation strategies. Secondary outcomes will include POCUS-guided CVC PCEP efficacy measured by time and effectiveness measured by sensitivity and specificity of POCUS detection.DISCUSSIONWith limited data available to inform interventions that use concurrent implementation and de-implementation strategies to substitute CXR for POCUS using DRAUP, we propose that this primary implementation and secondary effectiveness pilot study will provide novel data that would expand the knowledge of replacing low value or unnecessary care in critically ill patients. Trial Registration: ClinicalTrials.gov Identifier, NCT04324762, Registered on 27 March 2020
Experimental evaluation of the shear behavior of large landslide slip zone using Multistage - Multiphase shearing method.
Authors: Getahun Ephrem , Qi Shengwen , Guo Songfeng , Shi Zhenming
Published: June 2020

Abstract
The study of shear behaviors comprises of the analysis of shear deformation characteristics and strength parameter determinations. Understanding the constitutive behaviour of shear zone soil samples is essential for evaluation of the critical shear behaviors of reactivated landslides, through considerate experimental tests. The experiment was carried out based on the multistage - multiphase shear technique via ring shear apparatus. The main advantage of this new method is to examine the same soil specimen for progressive loading and the continuous phases of shearing. The result shows that two major shear characteristics under the multiphase shear mode; the first is a post-peak shear weakening behavior of the soils on the last phase shear process, it indicated a decrease in friction resistance on fast rate effects, which enables to narrate with fastly moved coseismic landslide behaviors. The other one is a practical increase in friction coefficient values (hardening behavior) on the entire shear process as the rate increases. This shear resistance scenario can also be related with the stabilization mechanism of landslide slip surface soils against sliding.
Quantum dots as targeted doxorubicin drug delivery nanosystems in human lung cancer cells
Authors: Ruzycka Monika , Kowalik Patrycja , Kowalczyk Agata , Bujak Piotr , Nowicka Anna M. , Wojewódzka Maria , Kruszewski Marcin , Grudzinski Ireneusz P.
Published: June 2020

Background

Lung cancer is one of the most frequently diagnosed cancer all over the world and a leading cancer-related mortality. The therapy of lung cancer includes surgery, chemotherapy and radiatherapy and mailny depends on the type and stage of lung cancer characterized based on WHO guidelines. Althought the conventional chemotherapy is the main treatment option for small cell lung cancer (SCLC) and a common treatment for non-SCLC it is characterized with lack of specificity resulting to severe toxicities of normal cells and harmful side effects. Therefore, targeted drug delivery (TDD) systems have been used to reduce the systemic toxicity of some conventional chemotherapies in lung cancer. Quantum dots (QDs) are fascinating nanoscale crystals that can serve as nanocarriers in TDD due to their unique physicochemical properties. Therefore, in this paper, the as-desiged QDs, Ag-In-Zn-S-based nanoconjugates for selective doxorubicin (DOX) targeting to lung cancer cells were developed. The QD nanocrystals were modified with 11-mercaptoundecanoic acid (MUA), L-cysteine (Cys) and lipoic acid (LA) used as drug carriers for targeted delivery of DOX to A549 cells through conjugated folic acid (FA) a self-navigation molecule that docks to the folate receptors on cancer cells. The comprechensive physicochemical, cytotoxicity and genotoxicity studies were performed to characterise the novel QD-based nanocaries and their anticancer cargos.

Results

The results from FTIR, DLS and fluorescence quenching evidenced the successful attachment of FA to the QDs nanocrystals and DOX to the QDs-FA nanocarriers. UV-vis analysis determined the amount of FA and DOX covalently anchored to the QDs nanocrystal surface. Biological screeining revealed that QDs-FA-DOX nanoconjugates showed higher cytotoxicity in comparison to other forms of the synthesized QD samples, suggesting the cytotoxic effect of liberated DOX from the QD constructs. QD-MUA-FA-DOX occurred to be the most cytotoxic against A549 cells among nanoconjugates. In vitro scratch assay also revealed significant inhibition of A549 migration only due to treatment with QD-MUA-FA-DOX. Studies evidenced that all the nanoconjugates at IC 50 induced significantly more DNA breaks than that observed in non-treated cells. All in all, significant and the greatest cytotoxicity, genotoxicity together with inhibition of migratory potential of A549 cells was observed for QD-MUA-FA-DOX.

Conclusion

The studies show the therapeutic efficacy of DOX-loaded QD-based cargos suggesting their promising role as novel drug delivery systems navigating to folate receptors in lung cancer cells.
Machine Learning Model Demonstrates Stunting at Birth and Systemic Inflammatory Biomarkers as Predictors of Subsequent Infant Growth – A Four-year Prospective Study.
Authors: Harrison Elizabeth , Syed Sana , Ehsan Lubaina , Iqbal Najeeha T. , Sadiq Kamran , Umrani Fayyaz , Ahmed Sheraz , Rahman Najeeb , Jakhro Sadaf , Jennie Z. , Hughes Molly , Ali S. Asad
Published: June 2020

Background: Stunting affects up to one-third of children in low-to-middle income countries (LMICs) and has been correlated with cognitive decline and vaccine immunogenicity. Infants with stunting often have growth refractory to nutritional interventions. Early identification of at-risk infants is critical for early intervention and prevention of subsequent morbidity. The aim of this study was to investigate patterns of growth in infants up through 48 months of age, as well as potential predictors of growth.Methods: Height-for-age z-scores (HAZ) of children from Matiari (rural site in Pakistan) at birth, 18 months, and 48 months were obtained. Results of serum-based biomarkers collected at 6 and 9 months were recorded. A descriptive analysis of the population was followed by biomarker prediction assessment via machine learning methods; random forest classification bins of z-scores and random forest regression for continuous z-scores. Results: Of 107 children who were followed up to 48 months, about half were stunted (HAZ < -2) at birth which increased to 54% by 48 months of age. HAZ at 18 months had a positive linear correlation with HAZ at 48 months, while HAZ at birth was less strongly correlated with HAZ at either 18 or 48 months. Stunting status for the majority of children at 48 months was found to be the same as at 18 months. Most children with large gains started off stunted or severely stunted, while all of those with notably large losses were not stunted at birth. Random forest models identified HAZ at birth as the most important feature in predicting HAZ at 18 months. Of the biomarkers, AGP (Alpha- 1-acid Glycoprotein), CRP (C-Reactive Protein), and IL1 (interleukin-1) were assigned the highest importance rankings across both the classification and regressor models.Conclusion: We demonstrated that HAZ at birth is a strong predictor of subsequent growth in infants up through 48 months of age. Biomarkers of systemic inflammation, AGP, CRP, IL1, were also strong predictors of growth outcomes. These findings provide support for continued focus on interventions at birth and early infancy in children at risk for stunting who live in resource-constrained regions of the world.
Negative Regulation of Ptch1 by miR-342-5p and FoxO3 Induced Autophagy Involved in Renal Fibrosis
Authors: Tang Simin , Wang Yi , Xie Guiling , Li Wenjun , Chen Yanna , Liang Jinshu , Liu Pei , Song Fuhu , Zhou Jun
Published: June 2020

Background: The pathogenesis of renal fibrosis (RF) is not well understood. Here, we performed an integrative database analysis of miRNAs and mRNAs to discover the major regulatory pathway in RF.Methods: Putative miRNAs and mRNAs involved in RF in unilateral ureteral obstruction (UUO) model mice were extracted and analyzed using the Gene Expression Omnibus (GEO) database. The bioinformatics analysis suggested that Ptch1 expression is negatively regulated by miR-342-5p and FoxO3. Then real-time PCR, Western blot, Fluorescence in situ hybridization were done to confirm the hypothesis.Results: Sixty-three differentially expressed miRNAs (DE-miRNAs) in GSE118340, 141 DE-miRNAs in GSE42716, and 183 DE-mRNAs in GSE69101 were identified. Various bioinformatic analyses revealed miR-342-5p as a strong candidate regulator in RF. We also predicted that miR-342-5p targets Ptch1 and that FoxO3 is the transcription factor of Ptch1. We also observed that TGF-β1 upregulated the expression of miR-342-5p and inhibited the expression of FoxO3 and Ptch1 in TCMK-1 cells. Furthermore, downregulation of miR-342-5p or FoxO3 reversed the inhibitory effect of TGF-β1 on the expression of Ptch1 in TCMK-1 cells. Additionally, downregulation of Ptch1 increased TGF-β1-induced autophagy, as evidenced by an increase in the number of GFP-LC3 puncta and the increased protein expression of SOSTM1/p62 and LC3II/LC3I.Conclusion: Our findings showed that downregulation of Ptch1 induced autophagy in TGF-β1-stimulated TCMK-1 cells, and Ptch1 expression is negatively regulated by miR-342-5p and FoxO3. These findings will further our understanding of the molecular mechanisms of RF and provide useful novel therapeutic targets for RF.
Biopsy Quality is Essential for Preoperative Prognostication in Oral Tongue Cancer
Authors: Bello Ibrahim O , Wennerstrand Pia M. , Suleymanova Ilida , Siponen Maria , Qannam Ahmed , Nieminen Pentti , Leivo Ilmo , Almangush Alhadi , Salo Tuula
Published: June 2020

Background: A role for incisional biopsy in preoperative prognostication is increasingly being advocated in oral tongue squamous cell carcinomas (OTSCC). Biopsies at two locations were compared and prognostic factors in biopsies and their corresponding resections were evaluated. Methods: A total of 138 OTSCC biopsy slides from Finland and Saudi-Arabia were compared for size (horizontal and vertical) and invasive front. The Finnish cases were assessed for tumor stroma ratio (TSR) and tumor-infiltrating lymphocytes (TILs) using light microscopy and digital image analysis assessment and compared. Furthermore, TSR, TILs, and previously analyzed budding and depth of invasion (BD) score in biopsies were compared with their evaluation in the corresponding resections. Results: Finnish biopsies were deeper than Saudi-Arabian biopsies (59% versus 42%) while Saudi-Arabian biopsies were wider (98% versus 76%). Invasion fronts were more readily assessable in Finnish biopsies (72% versus 40%). There was 86.8% agreement between TSR and 75% agreement between TIL evaluation using light microscopy and digital assessment. Significant agreement was obtained on comparing the TSR (P=0.04) and BD (P<0.001) values in biopsies and resections. Conclusions: Biopsies of ≥5 mm depth from representative OTSCC areas are essential for prognostic information. Clinical pathologists are advised to assess BD score and TSR for prognostic features in such biopsies.
Does Sequential Balloon Expulsion Test improve the screening of Defecation Disorders?
Authors: Caetano Ana Célia , Costa Dalila , Gonçalves Raquel , Correia-Pinto Jorge , Rolanda Carla
Published: June 2020

Purpose
A Defecation Disorder (DD) is a difficulty in evacuation documented by physiological exams. However, this physiological evaluation can be cumbersome, inaccessible and costly. Three “low-cost” tools to evaluate DD – a clinical DD score, the balloon expulsion test (BET) and a digital rectal examination (DRE) score were evaluated as separate or combined tests for DD screening.
Methods
This prospective study occurred between January 2015 and March 2019 in the Gastroenterology Department of a tertiary hospital. Besides the gold standard physiological tests, constipated patients answered the clinical DD score and were evaluated by DRE and BET (standard and variable volume (vv)).
Results
From 98 constipated patients, 35 (38.9%) were diagnosed with DD according to Rome IV criteria, mainly female (n = 30, 86%) with a median age of 60 years old. The clinical DD score revealed an AUC of 0.417 (SE = 0.07, p = 0.191). The DRE score displayed an AUC of 0.56 (SE = 0.063, p = 0.301). The standard BET displayed a sensitivity of 86%, specificity of 58%, positive predictive value (PPV) of 57% and negative predictive value (NPV) of 86%. The sequential vvBET followed by standard BET improved the BET performance regarding the evaluation of DD, with a sensitivity of 86%, specificity of 67%, PPV of 63% and NPV of 87%. The sequential BET had an OR 8.942, p > 0.001, CI 3.18–25.14, revealing to be the most significant predictor for DD screening.
Conclusion
The sequential BET is a low cost, well-performing DD screening tool, appropriate to the Primary Care Setting.
CCBlock based on deep learning for diagnosis COVID-19 in chest x-ray image
Authors: Al-Bawi Ali , Al-Kaabi Karrar Ali , Jeryo Mohammed , Al-Fatlawi Ahmad
Published: June 2020

Purpose: COVID-19 pandemic continues to hit countries one after the other and has dramatically affected the health and well-being of the world's population. With the daily increase in the number of people with this disease, the impressive speed of spread and the delay in the results of PCR analysis, it may cause the disease to spread more broadly. Therefore it is necessary to consider finding alternative methods of detection and diagnosis COVID-19 to prohibit the spread of the disease among people. Convolutional Neural Network (CNN) automated detection systems have shown auspicious results in detecting patients with COVID-19 through radiography; thus, we suggest them as an alternative option to diagnose COVID-19.Method: In this study, an early screening model based on the enhancement of classical Visual Geometry Group Network (VGG) with Convolutional Covid Block (CCBlock) was proposed to detect and distinguish COVID-19 from Pneumonia, and healthy people using chest X-ray radiographs. The data set used for model testing is the x-ray images available on public platforms, which consist of 1,828 x-ray images, including 310 images for confirmed COVID-19 patients, 864 images for pneumonia patients, and 654 images for healthy people.Results: The experiment result of the dataset showed that the added enhancements to the classical VGG network with X-ray imaging provide the highest detection performance and overall accuracy of 98.52% for two classes and 95.34% accuracy for three classes.Conclusions: Considering the achievement results obtained, it was found that utilizing the enhanced VGG deep neural network helps radiologists automatically diagnose COVID-19 in X-ray images.