bluuebunny/crossref_metadata_2025 huggingface dataset:
Association Between Temperament Related Traits and SNPs in the Serotonin and Oxytocin Systems in Merino Sheep
Authors: Ding Luoyang , Maloney Shane K , Wang Mengzhi , Rodger Jennifer , Chen Lianmin , Blache Dominique
Published: June 2020

Background: Animal temperament is defined as the consistent behavioural and physiological differences that are seen between individuals in response to the same stressor. Neurotransmitter systems, like serotonin and oxytocin in the central nervous system, underlie the variation in temperament in humans. The variations like single nucleotide polymorphisms (SNPs) in the genes for tryptophan 5-hydroxylase (TPH2), the serotonin transporter (SLC6A4), the serotonin receptor (HTR2A), or the oxytocin receptor (OXTR) are associated with the behavior phenotypes in human. Thus, the objective of this study was to identify SNPs in TPH2, SLC6A4, HTR2A and OXTR and to test if those variations predict the temperament of Merino sheep. Results: Using ewes from the UWA temperament flock, that has been selected on emotional reactivity for more than 20 generations, eight SNPs (rs107856757, rs107856818, rs107856856 and rs107857156 in TPH2, rs20917091 in SLC6A4, rs17196799 and rs17193181 in HTR2A, and rs17664565 in OXTR) were found to be distributed differently between calm and nervous sheep. These eight SNPs were then genotyped in 260 sheep from a non-selected flock that has never been selected on emotion reactivity, followed by the estimation of the behavioural traits of those 260 sheep using an arena test and an isolation box test. We found that several SNPs in TPH2 (rs107856757, rs107856818, rs107856856 and rs107857156) were in strong linkage disequilibrium, and all were associated with behavioural phenotype in the non-selected sheep. Similarly, rs17196799 in HTR2A was also associated with the behavioural phenotype. Conclusions: We thus conclude that, rs107856856 and rs17196799 could be used as gene markers for the temperament of Merino sheep, with allele C of rs107856856 and allele A of rs17196799 being associated with calm temperament.
Flexibility and resilience of Great tit (Parus major) gut microbiomes to changing diets
Authors: Bodawatta Kasun H. , Freiberga Inga , Puzejova Katerina , Sam Katerina , Poulsen Michael , Jønsson Knud A.
Published: June 2020

Background: Gut microbial communities play important roles in nutrient management and can change in response to host diets. The extent of this flexibility and the concomitant resilience is largely unknown in wild animals. To begin untangling the dynamics of avian-gut microbiome symbiosis associated with diet changes, we exposed Parus major (Great tits) fed with a standard diet (seeds and mealworms) to either a mixed (seeds, mealworms and fruits), a seed, or a mealworm diet for four weeks, and examined the flexibility of gut microbiomes to these compositionally different diets. To assess microbiome resilience (recovery potential), all individuals were subsequently reversed to a standard diet for another four weeks. Cloacal microbiomes were collected weekly and characterised through sequencing the v4 region of the 16S rRNA gene using Illumina MiSeq. Results: Initial microbiomes changed significantly with the diet manipulation but the communities did not differ significantly between the three diet groups (mixed, seed and mealworm), despite multiple diet-specific changes of specific bacterial genera. Reverting birds to the standard diet led to only a partial recovery in gut community compositions. The majority of the bacterial taxa that increased significantly during diet manipulation decreased in relative abundances after reversion to the standard diet; however, bacterial taxa that decreased during the manipulation rarely increased after diet reversal.Conclusions: The gut microbial response and partial resilience to dietary changes support that gut bacterial communities of P. major play a role in accommodating dietary changes experienced by wild avian hosts. This may be a contributing factor to the relaxed association between microbiome composition and bird phylogeny. Our findings further imply that interpretations of wild bird gut microbiome analyses from single-time point sampling, especially for omnivorous species or species that have changing seasonal diets, should be done with caution. The partial community recovery implies that ecologically relevant diet changes (e.g., seasonality and migration) open up gut niches that may be filled by previously abundant microbes or replaced by different symbiont lineages, which has important implications for the integrity and specificity of long-term avian-symbiont associations.
High Anemia Prevalence in Korean Older Adults, an Urgent Healthcare Problem: 2007-2016 KNHANES
Authors: Chueh Hee won , Jung Hye Lim , Shim Ye Jee , Choi Hyoung Soo , Han Jin Yeong
Published: June 2020

BACKGROUND: Anemia is associated with high morbidity and mortality in older people. However, anemia in older individuals is not fully understood, and national data on the prevalence and characteristics of anemia in Korean older people are lacking. This study aimed to evaluate the prevalence and characteristics of anemia in older adults using data from the Korea National Health and Nutrition Examination Survey (KNHANES) , which is the nation-wide cross-sectional epidemiological study conducted by Korean Ministry of Health and Welfare.Methods: Data from the total of 62,825 participants of the 2007-2016 KNHANES were merged and analyzed to investigate differences in participant characteristics and potential risk factors for anemia.RESULTS: The prevalence of anemia was higher in the population aged ≥65 years (older adults) than in the younger population. Anemia was also more prevalent among females than among males, but the difference was not statistically significant in people aged >85 years. Being underweight, receiving a social allowance, living alone, and having comorbidities such as hypertension, arthritis, diabetes mellitus (DM), cardiovascular disease (CVD), stroke, cancer, and chronic renal failure (CRF) were more prevalent in older adults with anemia than in the group without anemia. In the univariate and multivariate analyses, older age, female sex, underweight, and comorbidities including arthritis, DM, CVD, stroke, cancer, and CRF were associated with an increased risk of anemia. Furthermore, the prevalence data were significantly higher in this study than in previous studies.CONCLUSIONS: This study revealed that age, female sex, underweight, and the presence of comorbidities such as arthritis, DM, CVD, stroke, cancer, and CRF were associated with an increased risk of anemia in Korean older adults. Our findings may be useful in developing interventions and programs aimed at healthy aging. Further study on causal relationships between anemia and other variables in the older population is necessary.Trial registration: KNHANES was approved by the KCDC Research Ethics Review Committee annually since 2007(2007-02CON-04-P, 2008-05EXP-01-C, 2009-01CON-03-2C, 2010-02CON-21-C, 2011-02CON-06-C, 2012-01EXP-01-2C, 2013-07CON-03-4C, 2013-12EXP-03-5C, 2015-01-02-6C). Ethical approval of this study was obtained through the Institutional Review Board of Dong-A University Hospital (DAUHIRB-EXP-20-035).
Jumping into a Healthier Future: Trampolining for Increasing Physical Activity in Children
Authors: Schöffl Isabelle , Ehrlich Benedikt , Kathrin Rottermann , Annika Weigelt , Sven Dittrich , Volker Schöffl
Published: June 2020

Objectives: Physical activity in children and adolescents has positive effects on cardiopulmonary functions in this age-group as well as later in life. As poor cardiopulmonary function is associated with higher mortality and morbidity in later life, increasing physical activity especially in children needs to become a priority. Trampoline jumping is widely appreciated in children, the objective was to investigate its use as a possible training modality.Methods: 15 healthy children (10 boys and 5 girls) aged 8.8 years undertook an incremental running step test outdoors using a mobile cardiopulmonary exercise testing unit. After a rest period of at least two weeks a trampoline test using the mobile unit was realized by all participants including a 5-minute endurance interval with moderate jumping and two high-intensity intervals with vigorous jumping for 2 minutes, interspersed with 1 minute rests.Results: During the endurance interval the children achieved B-values slightly higher than VT1 and during the high-intensity interval comparable to VT2 of the running test. They were able to maintain these values for the duration of the respective intervals. The maximum values recorded during the trampoline test were significantly higher than during the incremental running test.Conclusion: Trampoline jumping is an adequate tool for implementing high-intensity interval training as well as moderate-intensity continuous training in children. As it is a readily available training device and is greatly enjoyed in this age-group this could represent a means for increasing physical activity in children.
A model based on CT radiomic features for predicting RT-PCR becoming negative in coronavirus disease 2019 (COVID-19) patients
Authors: Cai Quan , Du Siyao , Gao Si , Huang Guoliang , Zhang Zheng , Li Shu , Wang Xin , Li Peiling , Lv Peng , Hou Gang , Zhang Lina
Published: June 2020

Background
Coronavirus disease 2019 (COVID-19) has emerged as a global pandemic. According to the diagnosis and treatment guidelines of China, negative reverse transcription-polymerase chain reaction (RT-PCR) is the key criterion for discharging COVID-19 patients. However, repeated RT-PCR assays lead to medical waste and prolonged hospital stays for COVID-19 patients during the recovery period. Our purpose is to assess a model based on CT radiomic features and clinical characteristics to predict RT-PCR negativity during clinical treatment.
Methods
From February 10 to March 10, 2020, 203 mild COVID-19 patients in Fangcang Shelter Hospital were retrospectively included (training: n = 141; testing: n = 62), and clinical characteristics were collected. Lung lobes and lesions on lung CT images were segmented with a deep learning algorithm. CT quantitative features and radiomic features were automatically extracted. Clinical characteristics and CT quantitative features were compared between RT-PCR-negative and RT-PCR-positive groups. Univariate logistic regression and Spearman correlation analyses identified the strongest features associated with RT-PCR negativity, and a multivariate logistic regression model was established. The diagnostic performance was evaluated for both cohorts.
Results
The RT-PCR-negative group had a longer time interval from symptom onset to CT exams than the RT-PCR-positive group (median 23 vs. 16 days, p < 0.001). There was no significant difference in the other clinical characteristics or CT quantitative features. In addition to the time interval from symptom onset to CT exams, nine CT radiomic features were selected for the model. ROC curve analysis revealed AUCs of 0.811 and 0.812 for differentiating the RT-PCR-negative group, with sensitivity/specificity of 0.765/0.625 and 0.784/0.600 in the training and testing datasets, respectively.
Conclusions
The model combining CT radiomic features and clinical data helped predict RT-PCR negativity during clinical treatment, indicating the proper time for RT-PCR retesting.
Umbilical Cord-derived Wharton’s Jelly for Regenerative Medicine Applications in Orthopedic Surgery: A Systematic Review Protocol
Authors: Main Benjamin J. , Valk Josiah A. , Maffulli Nicola , Rodriguez Hugo C. , Gupta Manu , Stone Ian W. , III Saadiq F. El-Amin , Gupta Ashim
Published: June 2020

Background: Musculoskeletal injuries and conditions affect millions of individuals. These ailments are typicallymanaged by immobilization, physiotherapy or activity modification. Regenerative medicine has experiencedtremendous growth in the past decades, especially in musculoskeletal medicine. Umbilical cord-derived Wharton’s Jelly is an exciting new option for such therapies. Wharton’s jelly is a connective tissue located within the umbilical cord largely composed of mesenchymal stem cells and extracellular matrix components, including collagen, chondroitin sulfate, hyaluronic acid and sulfated proteoglycans. Wharton’s Jelly is a promising and applicable biologic source for orthopedic regenerative application.Methods: A systematic search will be conducted in PubMed, ScienceDirect and Google Scholar databases of English, Italian, French, Spanish and Portuguese language articles published to date. References will be screened and assessed for eligibility by two independent reviewers as per PRISMA guidelines. Articles will be considered without exclusion to sex, activity or age. Studies will be included if they used culture-expanded, mesenchymal stem/stromal cells of mesenchymal stem cells and/or connective tissue obtained from Wharton’s Jelly. Studies will be excluded if Wharton’s Jelly is not the sole experimental examined cell type. Placebos, conventional non-operative therapies including steroids injections, exercise and NSAIDs will be compared. The study selection process will be performed independently by two reviewers using a reference software. Data synthesis and meta-analysis will be performed separately for clinical and pre-clinical studies.Discussion:The results will be published in relevant peer-reviewed scientific journals. Investigators will present results at national or international conferences.Trial registration: The Protocol will be registered on PROSPERO international prospective register of systematic reviews prior to commencement.
Impact of HPV-16/18 AS04-adjuvanted vaccine on preventing subsequent infection and disease after excision treatment: Post-hoc analysis from a randomized controlled trial
Authors: Zhao Shuang , Hu Shangying , Xu Xiaoqian , Zhang Xun , Pan Qinjing , Chen Feng , Zhao Fang-Hui
Published: June 2020

Background
It is widely acknowledged that HPV prophylactic vaccine could prevent new infections and their associated lesions among women who were predominantly HPV-naïve at vaccination. Yet there still remains uncertainty about whether HPV vaccination benefits to individuals who had undergone surgery for cervical disease.
Methods
This post-hoc analysis intends to focus on intent-to-treat participants who underwent excision treatment at baseline and the follow-up period in a phase II/III, double-blind, randomized trial (ClinicalTrials.gov, number NCT00779766) conducted in Jiangsu province, China. We evaluate the impact of HPV vaccination on preventing subsequent infection and cervical lesions (LSIL + and CIN2+) after excision treatment.
Results
168 (vaccine, n = 87; control, n = 81) performed excisional treatment in this clinical trial. We observed a significant effect of vaccination on rates of 14 types oncogenic HPV infection after treatment (vaccine efficacy: 27.0%; 95% CI 4.9%, 44.0%). Vaccine efficacy estimates against new infections after treatment for 14 types oncogenic HPV infection were 32.0% (95%CI 1.8%, 52.8%), for HPV16/18 infection were 41.2% (95%CI -162.7%, 86.8%).The accumulative clearance rate of the vaccine group and placebo group were respectively 88.9%, 81.6% for HPV16/18 infection (P = 0.345), 63.4%, 48.7% for 14 types oncogenic HPV infection (P = 0.062). There was no significant difference for the persistent rate of HPV16/18, 14 types oncogenic HPV infection and occurrence rate of LSIL + between the two groups.
Conclusions
There is no evidence that HPV-16/18 AS04-adjuvanted vaccine could lead to viral faster clearance or had effect on the persistent infection rate of the women after excision treatment. The women after treatment may get beneficial from the “primary prophylactic” effect of vaccine, while prophylactic HPV vaccine’ use as therapeutic agents deserves further researched.
Implications of COVID-19 in high burden HIV/TB countries: A systematic review of evidence
Authors: Tamuzi Jacques L , Birhanu Ayele T , Shumba Constance S , Adetokunboh Olatunji , Uwimana-Nico Jeannine , Haile Zelalem T , Inugu Joseph , Nyasulu Peter Suwirakwenda
Published: June 2020

Background
The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the 21st century and in the future. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV/TB/COVID-19 as a newly related field and play an important role in the present and future management of the co-infections. However, several gaps are remaining in the knowledge of the burden of COVID-19 on patients with TB and HIV, the diagnosis, and management of these patients. The study was conducted to review different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection or only TB and to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected or TB patients, screening algorithm and clinical management.
Methods
We conducted electronic search of potential eligible studies published in English in the Cochrane Controlled Register of Trials, PubMed, Medrxiv, Google scholar and Clinical Trials Registry databases. We included case studies, case series and observational studies published between January, 2002 and March, 2020 in which SARS-CoV, MERS-CoV and COVID-19 co-infected to HIV/TB or TB were managed in adult patients. We screened titles, abstracts and full articles for eligibility. As we anticipated heterogeneity in the literature, results were reported narratively.
Results
After removing 69 duplicates, 24 out of 246 articles were assessed for eligibility, of which 9 studies were included for qualitative analysis. Among them, we included two case reports, four case series, one case-control and two retrospective observational studies. The studies have shown that TB may occur during or after SARS-CoV. In terms of severity, the proportion of severe/critical SARS, MERS and COVID cases with TB co-infection was higher than in patients with mild/moderate stages (P = 0.0008).
Conclusion
SARS/MERS-CoV/COVID-19 associated to HIV/TB or TB subjects had a higher risk of developing severe/critical than mild/moderate SARS/MERS-CoV/COVID-19. Diagnostic algorithms and clinical management were suggested for efficiently improving COVID-19/HIV/TB co-infections outcomes.
Selected ions and major- and trace elements as contaminants in coal-waste dump water from the Lower- and Upper Silesian Coal Basins (Poland)
Authors: Lewińska-Preis Lucyna , Szram Ewa , Fabiańska Monika , Nádudvari Ádám , Misz-Kennan Magdalena , Abramowicz Anna , Kruszewski Łukasz , Kita Andrzej
Published: June 2020

Many temporary- and permanent reservoirs of water occur on or in the immediate vicinity of coal-waste dumps in the Lower- and Upper Silesian Coal Basins (Poland). Little or nothing is known of the degree to which their water chemistry might reflect (a) reservoir type, i.e., whether permanent or temporary, (b) level of coal-waste thermal activity, i.e., whether inactive or self-heating or burnt-out or (c) region, i.e., whether the dumps lay in the Upper- or Lower Silesian basins. To provide some answers, concentrations of selected ions (NH4+, HCO3−, F−, Cl−, Br−, NO2−, NO3−, PO43−,SO42−) were determined by ion chromatography and of nineteen elements (Al, B, Ba, Ca, Cd, Cr, Cu, Fe, K, Li, Mg, Mn, Na, P, Pb, S, Si, Sr, Zn) by inductively coupled plasma mass spectrometry (ICP-MS). The data allow a number of observations. In temporary reservoirs, concentrations of ions and of major- and trace elements are relatively much lower and any correlations between components less significant; reservoirs exist for too short a time to allow any balance between coal waste- and water components to be established. A clear relationship does exist between concentrations of ions and of major- and trace elements and dump thermal activity. The highest concentrations occur where thermal activity is high and inorganic components are mobilized. Finally, a regional pattern of elemental- and ion concentrations in the dump waters reflects important regional differences in thermal activity.
Construction of a patient decision aid for the treatment of uncomplicated urinary tract infection in primary care
Authors: VINCENT Yves-Marie , FRACHON Adèle , BUFFETEAU Clotilde , CONORT Guillaume
Published: June 2020

Background
Uncomplicated urinary tract infection (uUTI) is a frequent reason for consulting a general practitioner. The risk of pyelonephritis is low. Antibiotics are prescribed empirically for symptomatic purposes. It can induce undesirable effects and resistance. Patients sometimes wish to avoid taking antibiotics. Some European countries recommend discussing a delayed prescription with the patient and developing a shared decision. The aim of our study is to develop a patient decision aid (PtDA) that can be used in primary care to make a shared decision about whether to treat uncomplicated urinary tract infection with antibiotics or not.
Methods
We followed the steps recommended by the International Patient Decision Aids Standards, which include a design phase (focus groups, bibliography) and an alpha-testing phase. A steering group developed a draft and then final version of a prototype PtDA.
Results
The information included in the PtDA is the definition of uUTI, information on the options, their benefits, risks and consequences. The patient's values and preferences to be considered in the decision are related to the discomfort felt, the impact on daily life, the representations of the antibiotic, the position relative to the risk of adverse effect.
Conclusions
Our results confirm a need for decision making and the equilibrium in this situation. We lacked advice from outside physicians in the study. This PtDA needs to be validated in a beta-testing phase. It must then be tested in a clinical study comparing its use with the systematic prescription approach.
Business models for primary health care delivery in low and middle income countries: a scoping study of nine social entrepreneurs
Authors: Lokman Lutfi , Chahine Teresa
Published: June 2020

Background
Social entrepreneurship can help increase access to primary health care in low resource settings. Research on social enterprises in health have focused either on developing countries, or on secondary and tertiary care in low and middle income countries, where common business models include differential pricing to cross-subsidize low income populations. This is the first study to examine social enterprises providing primary health care in low and middle income countries using primary data. The purpose is to determine whether social enterprise is a viable model in this setting and to identify common patterns and characteristics that could inform the work of social entrepreneurs, funders, and researchers in this area.
Methods
We identify social entrepreneurs working to deliver primary care in low- and middle-income countries who have been vetted by international organizations dedicated to supporting social entrepreneurs. Through in-depth interviews, we collect information on medical processes, business processes, social impact and organizational impact according to the Battacharyya et al framework. We then conducted qualitative analysis to identify common patterns and themes emerging within these four categories.
Results
Distinguishing characteristics in the business models of primary care social enterprises include flat rate rather than differential pricing; cross-subsidizing across services rather than patients. Subscription packages and in-house IT systems were utilized to generate revenue and increase reach through telemedicine, franchising, and mobile units. In some cases, alternate revenue streams are employed to help break even. About half of the social enterprises interviewed were for-profit, and about half non-profit. The majority faced challenges in engaging with the public sector. This is still a nascent field, with most organizations being under ten years old.
Conclusions
Social enterprise has been demonstrated as a feasible model for providing primary care in low resource settings, with key characteristics differing from the previously commonly studied social enterprises in tertiary care. There are opportunities to complement existing public health systems, but most organizations face challenges in doing so. More research and attention is needed by researchers, governments and funders to support social entrepreneurs and avoid parallel systems.
Development and Validation a Nomogram and Prognosis of Chemotherapy for Evaluation in Giant-cell Lung Carcinoma With Metastases: A Propensity Score Matching Analysis
Authors: Yang Zhihao , Chen Kun , Zhang Xinbo , Zhao Tianhao , Xie Deyao , Deng Xiaofang , Zhang Jiandong , Cheng Dezhi
Published: June 2020

Background and Objectives: Whether chemotherapy couldimprove prognosis for giant-celllung carcinoma with metastases remains controversial. The present study aimed to determine the significanceof chemotherapy in patients with metastases giant-cell Lung carcinoma, and to develop a nomogram to predict its outcomes.Methods:Data of 566 patients from the Surveillance, Epidemiology, and End Results(SEER) database were analyzed; 346 matched patients were divided into a chemotherapy group and non-chemotherapy group, respectively, using the propensity scorematching method. Univariate and multivariate analyses were performed to determine theprognostic factors of giant-celllung carcinoma, and subgroup analysis was performed according tothe site of metastases. While a visual nomogram wasestablished to judge the prognosis.Results: With the median follow-up of 20.5 months, The 3-yearsurvival rates were 20.2% in the chemotherapy set and 16.7% in the non-chemotherapy set (P=0.006).Chemotherapy did improve the Giant-cell Lung Carcinoma survival rates in patients with metastases(HR = 0.490, 95% CI = 0.358–0.669, P<0.001). In subgroup analysis, radiotherapy did not improved the Giant-cell Lung Carcinoma survival rates in patients with metastases(HR = 0.951, 95% CI = 0.690-1.311, P = 0.758, Table 2). Chemotherapy improved the CSS in patients with lung metastases (HR = 0.090, 95% CI = 0.017-0.470, P =0.004).In addition, chemotherapy improved the CSS in patients with brain metastases (HR = 0.117, 95% CI = 0.014-0.955, P =0.045). Compared with bone metastasis, liver metastasis and metastasis of more than 2 sites, the effect of chemotherapy is not obvious.Furthermore, our nomogram could predict the probability of surviving to the median survival time of the population with a c-index of 0.768.Conclusion:The benefit of chemotherapy in giant-celllung carcinoma with metastases patients was obviously different, andthe recommendation of chemotherapy for this population should be individualized. chemotherapy shouldbe considered for patients with only lungmetastasis or brain metastasis, but chemotherapy could be avoided in those with other site metastases or multiple metastases.We developed the first competing risk nomogram to predict the risk of GCLC patients, which performed well in the evaluation and might be helpful for individualized screening.
Perioperative Patient-specific Factors-based Nomograms Predict Short-term Periprosthetic Bone Loss After Total Hip Arthroplasty
Authors: Fu Guangtao , Li Mengyuan , Xue Yunlian , Li Qingtian , Deng Zhantao , Ma Yuanchen , Zheng Qiujian
Published: June 2020

Background Although medical intervention of periprosthetic bone loss in the immediate postoperative period was recommended, not all the patients experienced periprosthetic bone loss after total hip arthroplasty (THA). Prediction toolsthat enrolledallpotential risk factors to calculate an individualized prediction of postoperative periprosthetic bone loss were strongly needed for clinical decision-making.MethodsData of the patients underwent primary unilateral cementless THA between April 2015 and October 2017 in our center were retrospectively collected. Candidate variables included demographic data and bone mineral density (BMD) in spine, hip and periprosthetic regions that measured 1 week after THA. Outcomes of interest included the risk of postoperative periprosthetic bone loss in Gruen zone 1, 7 and total zones in the 1st postoperative year. Nomograms were presented based on multiple logistic regressions via R language.Bootstrap was used for internal validation. Results 427 patients (195 male and 232 female) were included in this study.The mean BMD of Gruen zone 1, 7,and total were decreased by 4.1%, 6.4%, and 1.7% at the 1st year after THA, respectively. 61.1% of the patients (261/427) experienced bone loss in Gruen zone 1 at the 1st postoperative year, while there were 58.1% (248/427) in Gruen zone 7 and 63.0% (269/427) in Gruen zone total. Bias-corrected c-index for risk of postoperative bone lossin Gruen zone 1, 7 and total zones in the 1st postoperative year were 0.700, 0.785, and 0.696, respectively. The most highly influential factor for the postoperative periprosthetic bone loss was the BMD in the corresponding Gruen zones at the baseline.ConclusionsThe present study presented the perioperative factors-based nomograms for predicting periprosthetic bone loss after THA with adequate predictive discrimination and calibration.Those tools would helpsurgeons to identify high-risk patients who may benefit from anti-bone-resorptive treatment on the early postoperative period effectively. Such prediction model could also provide patients with reasonable expectations following surgery, which may improve satisfaction and patient compliance.
Molecular detection of drug resistant polymorphisms in Plasmodium falciparum isolates from Southwest, Nigeria.
Authors: Tola Monday , Ajibola Olumide , Idowu Taiwo Emmanuel , Omidiji Olusesan , Awolola Samson Taiwo , Amambua-Ngwa Alfred
Published: June 2020

Objective Nigeria bears 25% of global malaria burden despite concerted efforts towards its control and elimination. The emergence of drug resistance to first line drugs, artemisinin combination therapies (ACTs), indicates an urgent need for continuous molecular surveillance of drug resistance especially in high burden countries where drug interventions are heavily relied on. This study describes mutations in Plasmodium falciparum genes associated with drug resistance in malaria; Pfk1 3, Pfmdr1 , PfATPase6 and Pfcrt in isolates obtained from 83 symptomatic malaria patients between 1-61 years old from Lagos, a Mega city in South-west Nigeria. Results Two Pfmdr 1, N86 and Y184 variants were present at a prevalence of 56% and 13.25% of isolates respectively. There was one synonymous (S679S) and two non-synonymous (M699V, S769M) mutations in the Pfatp6 gene, while Pfcrt genotype (CVIET), had a prevalence of 45%. The Pfk13 C580Y mutant allele was detected by allelic discrimination in two samples with mixed genotypes. Pfk13 C580Y in west Africa is rare and this result calls for robust and larger scale surveillance of artemisinin resistance associated polymorphisms and delayed clearance phenotype in Nigeria.
Implementation and Evaluation of Nonclinical Interventions for Appropriate Use of Cesarean Section in Low- and Middle-income Countries: Protocol for a Multisite Hybrid Effectiveness-implementation Type III Trial
Authors: Dumont Alexandre , Betrán Ana Pilar , Kabore Charles , De Loenzien Myriam , Lumbiganon Pisake , Bohren Meghan , Nhu Hung Mac Quoc , Ph.D. Newton , Carroli Guillermo , Annerstedt Kristi Sidney , Ridde Valery , Escuriet Ramon , Robson Michael , Hansen Claudia , group QUALI-DEC Research
Published: June 2020

Background: While cesarean sections (CSs) are a life-saving intervention, an increasing number are performed without medical reasons in low- and middle-income countries (LMICs). Unnecessary CS diverts scarce resources and thereby reduces access to healthcare for women in need. Argentina, Burkina Faso, Thailand and Vietnam are committed to reducing unnecessary CS, but many individual and organizational factors in healthcare facilities obstructthis aim. Nonclinical interventions can overcome these barriers by helping providers improve their practices and supporting women’s decision-making regarding childbirth. Existing evidence has shown only a modest effect of single interventions onreducing CS rates, arguably because of the failure to design multifaceted interventions effectively tailored to the context. The aim of this studyis to design, adapt and test a multifaceted intervention for the appropriate use of CS in Argentina, Burkina Faso, Thailand and Vietnam. Methods: We designed an intervention (QUALIty DECision-making - QUALI-DEC) with four components: (1) opinion leaders at heath care facilities to improve adherence to best practices among clinicians, (2) CS audits and feedback to help providers identify potentially avoidable CS, (3) a decisionanalysistool to helpwomen make an informed decision on the mode of birth, and (4) companionship to support women during labor.QUALI-DEC will be implemented and evaluated in 32 hospitals (8 sites per country) using a pragmatic hybrid effectiveness-implementation design to test our implementation strategy, and information regardingits impact on relevant maternal and perinatal outcomes will be gathered. The implementation strategy will involve the participation of women, healthcare professionals and organizations and account for the local environment, needs, resources and social factors in each country.Discussion:There is urgent need for interventions and implementation strategies to optimize the use of CS while improving health outcomes and satisfaction in LMICs. This can only be achieved by engaging all stakeholders involved in the decision-making process surroundingbirth and addressing their needs and concerns. The study will generate robust evidence about the effectiveness and the impact of this multifaceted intervention. It will also assess the acceptability and scalability of the intervention and the capacity for empowerment among women and providers alike. Trial registration: ISRCTN67214403
Asphericity of Tumor FDG Uptake in Non-Small Cell Lung Cancer: Reproducibility and Implications for Harmonization in Multicenter Studies
Authors: Rogasch Julian MM , Furth Christian , Bluemel Stephanie , Radojewski Piotr , Amthauer Holger , Hofheinz Frank
Published: June 2020

Background
Asphericity (ASP) of the primary tumor’s metabolic tumor volume (MTV) in FDG-PET/CT is independently predictive for survival in patients with non-small cell lung cancer (NSCLC). However, comparability between PET systems may be limited. Therefore, reproducibility of ASP was evaluated at varying image reconstruction and acquisition times to assess feasibility of ASP assessment in multicenter studies.
Methods
Retrospective study of 50 patients with NSCLC (female, 20; median age, 69 years) undergoing pretherapeutic FDG-PET/CT (median, 3.7 MBq/kg; 180 s/bed position). Reconstruction used OSEM with TOF4/16 (iterations, 4; subsets, 16; in-plane filter, 2.0, 6.4 or 9.5 mm), TOF4/8 (4 it; 8 ss; filter, 2.0/6.0/9.5 mm), PSF + TOF2/17 (2 it; 17 ss; filter, 2.0/7.0/10.0 mm) or Bayesian penalized likelihood (Q.Clear; beta, 600/1750/4000). Resulting reconstructed spatial resolution (FWHM) was determined from hot sphere inserts of a NEMA IEC phantom. Data with approx. 5 mm FWHM were retrospectively smoothed to achieve 7 mm FWHM. List mode data were rebinned for acquisition times of 120/90/60 s. Threshold-based delineation of primary tumor MTV was followed by evaluation of relative ASP/SUVmax/MTV differences between datasets and resulting proportions of discordantly classified cases.
Results
Reconstructed resolution for narrow/medium/wide in-plane filter (or low/medium/high beta) was approx. 5/7/9 mm FWHM. Comparing different pairs of reconstructed resolution between TOF4/8, PSF + TOF2/17, Q.Clear and the reference algorithm TOF4/16, ASP differences were lowest at FWHM of 7 vs. 7 mm. Proportions of discordant cases (ASP > 19.5% vs. ≤19.5%) were also lowest at 7 mm (TOF4/8, 2%; PSF + TOF2/17, 4%; Q.Clear, 10%). Smoothing of 5 mm data to 7 mm FWHM significantly reduced discordant cases (TOF4/8, 38% reduced to 2%; PSF + TOF2/17, 12–4%; Q.Clear, 10–6%) resulting in proportions comparable to original 7 mm data. Shorter acquisition time only increased proportions of discordant cases at < 90 s.
Conclusions
ASP differences were mainly determined by reconstructed spatial resolution, and multicenter studies should aim at comparable FWHM (e.g., 7 mm; determined by in-plane filter width). This reduces discordant cases (high vs. low ASP) to an acceptable proportion for TOF and PSF + TOF of < 5% (Q.Clear: 10%). Data with better resolution (i.e. lower FWHM) could be retrospectively smoothed to the desired FWHM resulting in a comparable number of discordant cases.
N-glycolyl chondroitin synthesis using metabolically engineered E. coli
Authors: Awofiranye Adeola E. , Baytas Sultan N. , Xia Ke , Badri Abinaya , He Wenqin , Varki Ajit , Koffas Mattheos , Linhardt Robert J
Published: June 2020

N -glycolylneuraminic acid (Neu5Gc) is a sialic acid missing in humans but commonly found in mammals and is the proposed cause of “xenosialitis” in humans, a “xenoautoimmune” inflammatory reaction believed to result from humans consuming Neu5Gc from red meat that human cells incorporate into some cell types, but is also recognized as a foreign antigen. The production of antibodies against Neu5Gc-containing glycans causes inflammation that is hypothesized to be an aggravating factor to multiple diseases associated with red meat consumption, including cancers arising from epithelial cells lining hollow organs and atherosclerosis involving vascular endothelial cells. The small amounts of Neu5Gc involved is glycosidically-linked at the reducing end of glycans but is difficult to quantitate because of its location on endothelial and epithelial cells. A more stable recently discovered metabolite of Neu5Gc, N-glycolyl chondroitin (Gc-CN), is present in the serum of humans who eat red meat and is more easily isolated and analyzed. Here, we present the biosynthesis of Gc-CN by feeding chemically synthesized N-glycolylglucosamine to Escherichia coli. A metabolically engineered strain of E. coli K4, fed with glucose supplemented with GlcNGc, converted it to N-glycolylgalactosamine (GalNGc) that could then be utilized as a substrate in the chondroitin biosynthetic pathway. The final product, Gc-CN was converted to disaccharides using chondroitin lyase ABC and analyzed by liquid chromatography-tandem mass spectrometry with multiple reaction monitoring detection. This analysis showed the incorporation of GalNGc into the backbone of the chondroitin oligosaccharide.
Determinants of Immediate Postpartum Contraception among Parturient Women with HIV in the Eastern Cape, South Africa; A Prospective Cross-sectional Study
Authors: Adeniyi Oladele Vincent , Ajayi Anthony Idowu , Somefun Oluwaseyi Dolapo , Lambert John Shearer
Published: June 2020

Background: Universal access to contraception is an important strategy adopted by the South African government in order to reduce the rate of unintended pregnancies in women with HIV. In this article, we describe the choices of contraception and also, examine the influencing factors of the choices of contraception in the immediate postpartum period in parturient women with HIV in the Eastern Cape, South Africa.Methods: In this prospective cross-sectional study, 1617 parturient women with HIV completed a survey on the choice of contraception received in the immediate postpartum period (within 72 hours) across three large maternity services in the Eastern Cape between September 2015 to May 2016. Additional information was extracted from their medical records. Choices of contraception were categorised as; short-acting, long-acting reversible and permanent contraception. Adjusted and unadjusted multinomial regression models were employed to determine the influencing factors of the choices of contraception received by the cohort. Results: Participants were predominantly single (69.1%), unemployed (75.1%), had a grade 7-12 level of education (88.4%) and were HIV positive before their index pregnancy (81.3%).The uptake rate of immediate postpartum contraception was high (n=1507; 93.2%) with injectables being the preferred choice in the majority of the participants (n= 1218; 75.3%). Caesarean delivery was associated with higher odds of initiating long-acting reversible (AOR: 7.79; 95% CI:4.04-15.04) and permanent contraception (AOR: 6.52; 95% CI: 3.48-12.22).Conclusions: We found a high uptake of immediate postpartum contraception with a preference for injectables in the study setting. Long-term monitoring of this cohort will elucidate on the loss to follow-up and risk of unintended pregnancies in the region.
Comprehensive genetic testing combined with citizen science reveals a recently characterized ancient MC1R mutation is associated with partial recessive red phenotypes in dog
Authors: Anderson Heidi , Honkanen Leena , Ruotanen Päivi , Mathlin Julia , Donner Jonas
Published: June 2020

Background
The Melanocortin 1 Receptor (MC1R) plays a central role in regulation of coat color determination in dogs and is commonly referred to as the “E (extension) Locus”. Allelic variation of the MC1R gene is associated with coat color phenotypes EM (melanistic mask), EG (grizzle/domino) and e1–3 (recessive red) in dogs. In addition, a previous study of archeological dog specimens over 10,000 years of age identified a variant p.R301C in the MC1R gene that may have influenced coat color of early dogs.
Results
Commercial genotyping of 11,726 dog samples showed the R301C variant of the MC1R gene was present in 34 breeds or breed varieties, at an allele frequency of 1.48% in the tested population. We detected no linkage disequilibrium between R301C and other tested alleles of the E locus. Based on current convention we propose that R301C should be considered a novel allele of the E locus, which we have termed eA for “e ancient”. Phenotype analysis of owner-provided dog pictures reveals eA allele has an impact on coat color and is recessive to wild type E and dominant to the e alleles. In dominant black (KB/*) dogs it can prevent the expression of the K locus, and the expressed coat color is solely determined by the A locus. In the absence of dominant black, eA/eA and eA/e genotypes result in the coat color patterns referred to in their respective breed communities as domino in Alaskan Malamute and other Spitz breeds, grizzle in Chihuahua, and pied in Beagle.
Conclusions
This study demonstrates a large genotype screening effort to identify the frequency and distribution of the MC1R R301C variant, one of the earliest mutations captured by canine domestication, and citizen science empowered characterization of its impact on coat color.
Mechanical Properties of TiO2 nanotubes investigated by AFM and FEM
Authors: Zhou Ji , Wang Zuozhang , Jiang Yunhong , Yang Zhongmei , Tian Qiong , Ding Yanhuai
Published: June 2020

The mechanical measurements of nanostructures are crucial to the development and processing of novel nanodevices. Herein, TiO2 nanotubes were synthesized from an electrospun method combined with subsequent heat-treatment. The elastic modulus and fracture strength of a single TiO2 nanotube were measured by atomic force microscopy (AFM). The effect of elastic modulus and dimensional size on the mechanical behaviors of the nanotubes was simulated by the finite element method (FEM).
Guided endodontic treatment of multiple teeth with dentin dysplasia: a case report
Authors: Krug Ralf , Volland Julian , Reich Sebastian , Soliman Sebastian , Connert Thomas , Krastl Gabriel
Published: June 2020

BackgroundTo report the outcome of guided endodontic treatment (GET) of a case of dentin dysplasia (DD) with pulp canal calcification (PCC) and apical periodontitis (AP) based on the use of a 3D-printed template designed by merging cone-beam computed tomography (CBCT) and surface scan data.Case presentationA 12-year old female with radicular dentin dysplasia type I (DD-1) presented for endodontic treatment. Radiography revealed PCC in all teeth and apical radiolucency in seven teeth (15, 12, 26, 36, 32, 31 and 46). Tooth 36 had the most acute symptoms and was thus treated first by conventional access cavity preparation and root canal detection. Despite meticulous technique, the distal and mesiolingual canals were perforated. The perforations were immediately repaired with mineral trioxide aggregate, and the decision was made to switch to guided endodontic treatment for the remaining 6 teeth. CBCT and intraoral surface scans were acquired and matched using coDiagnostix planning software (Dental Wings Inc.), the respective drill positions for root canal location were determined, and templates were virtually designed and 3D-printed. The template was positioned on the respective tooth, and a customized drill was used to penetrate the calcified part of the root canal and perform minimally invasive access cavity preparation up to the apical region. All root canals were rapidly and successfully located with the templates. At 1-year follow-up, clear signs of apical healing were present in all treated teeth. ConclusionsIn patients with dentin dysplasia, conventional endodontic therapy is challenging. GET considerably facilitates the root canal treatment of teeth affected by dentin dysplasia.
International Travel is Not a Significant Risk of Exposure for Patients at a Midwestern United States Travel Clinic
Authors: House Hans , Patel Pooja
Published: June 2020

The Novel Coronavirus (SARS-CoV-2) was introduced into the United States due to travel from Asia and Europe, although the extent of the spread of the disease was limited in the early days of the Pandemic. International travel may have played a role in the transmission of the disease into Iowa. Persons planning international travel likely modified their travel plans as a result of the viral outbreak. This study, documenting the travel destinations of patients from a clinic in Bettendorf, Iowa, seeks to determine how preferences for international travel changed as Coronavirus Disease (COVID-19) spread throughout the world and if any of these patients developed COVID-19 as a result of their travel. From October 2019 to March 2020, four hundred twelve (n=412) patients presented for pre-travel advice. Intended travel to the Western Pacific region (China, Japan, Korea, etc.) decreased dramatically during the study period. Of the 412 patients, only three (3) presented for COVID-19 testing during the follow-up period. Two (2) tested positive, and both of these infections were linked to workplace exposures and not due to travel. News of the growing pandemic and travel warnings likely altered patient’s travel plans and fewer intended travel to the most affected regions of the world in the early months of the COVID-19 pandemic. Travel was not a significant source of COVID-19 exposure for patients seen at this clinic.