bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of clinical practice guidelines’ utilization for the management of musculoskeletal disorders: A scoping review
Authors: Sorondo Delphine , Delpierre Cyrille , Côté Pierre , Salmi Louis-Rachid , Cedraschi Christine , Taylor-Vaisey Anne , Lemeunier Nadège
Published: December 2020

CONTEXT: Many clinical practice guidelines have been developed for the management of musculoskeletal disorders (MSDs). However, there is a gap between evidence-based knowledge and clinical practice, and reasons are poorly understood. Understanding why healthcare providers use clinical practice guidelines is essential to improve their implementation, dissemination, and adherence.AIM: To identify determinants of clinical practice guidelines’ utilization by health care providers involved in the assessment and management of MSDs.METHOD: A scoping review of the literature was conducted. Three databases were searched from inception to December 2019. Article identification, study design, methodological quality, type of healthcare providers, MSDs, barriers and facilitators associated with guidelines’ utilization were extracted from selected articles.RESULTS: 7667 citations were retrieved, and 43 articles were selected. 51% of studies were from Europe, and most were quantitative studies (64%) following a cross-sectional design (88%). Almost 80% of articles dealt with low back pain guidelines, and the most studied healthcare providers were general practitioners or physiotherapists. Five main barriers to guideline utilization were expressed by providers: 1) disagreement between recommendations and patient expectations; 2) guidelines not specific to individual patients; 3) unfamiliarity with “non-specific” term, or with the bio psychosocial model of MSDs; 4) time consuming; and 5) heterogeneity in guideline methods. Four main facilitators to guideline utilization were cited: 1) clinician’s interest in evidence-based practice; 2) perception from clinicians that the guideline will improve triage, diagnosis and management; 3) time efficiency; and 4) standardized language.CONCLUSION: Identifying modifiable determinants is the first step in developing implementation strategies to improve guideline utilization in clinical practice.
Pregnancy After Liver Transplant: Maternal and Perinatal Outcomes
Authors: Marzec Izabela , Słowakiewicz Aleksandra , Gozdowska Jolanta , Tronina Olga , Pacholczyk Marek , Lisik Wojciech , Durlik Magdalena
Published: December 2020

Background: Liver transplantation is a life-saving and successful therapeutic procedure which is more and more frequent worldwide, also among women of reproductive age. Consequently, there is an increasing number of reports of pregnancy following liver transplantation, but doubts still exist regarding preconception counseling and the the optimal method of managing pregnancy. The aim of this study was to report and evaluate pregnancy outcomes in women who had undergone liver transplantation.Methods: We retrospectively analyzed female patients after orthotopic liver transplantation who reported pregnancy and were under medical care of a single transplant center.Results: We identified 14 pregnancies in 10 women who had undergone liver transplantation (12 childbirths, one induced abortion due to fetal death in the first trimester, one pregnancy is still ongoing). Causes of transplantation include congenital or acquired disorders and the most common indication was autoimmune hepatitis (50%). The mean age at the point of transplantation was 28.5 (range 21–36), mean maternal age at pregnancy was 32 (range 26-43), and transplant-to-pregnancy interval was 4.07 years (range 1,5–7). The mean gestational week was 36.67 (range 31–40). Immunosuppression was maintained with combinations of prednisone (n=11), tacrolimus (n=13), and azathioprine (n=8) prior to and during pregnancy. Two pregnancies were unintended, so women took mycophenolate mofetil in the first weeks of gestation. Another two women stopped taking azathioprine due to increasing anemia. Maternal complications included increase of aspartate transaminase and alanine transaminase (n=2), anemia (n=4) and hyperthyroidism (n=2). Among the 12 childbirths, five (41,67%) were preterm. Only five women entered labor spontaneously, while seven (58,33%) had cesarean delivery.Conclusions: Pregnancy after liver transplantation can achieve relatively favorable outcomes. It does not influence women’s fertility and, during pregnancy, we report low rates of minor graft complications. A multidisciplinary team should be involved in contraceptive, fertility and consequently pregnancy counseling of female transplant recipients.
Alteration of Cortical Functional Networks in Default-Mode Network-Related Regions in Mood Disorders with Resting-State Electroencephalography
Authors: Kim Sungkean , Baek Ji Hyun , Shim Se-hoon , Kwon Young Joon , Lee Hwa Young , Yoo Jae Hyun , Kim Ji Sun
Published: December 2020

Studies comparing bipolar disorder (BD) and major depressive disorder (MDD) are scarce, and the neuropathology of these disorders is poorly understood. This study investigated source-level cortical functional networks using resting-state electroencephalography (EEG) in patients with BD and MDD. EEG was recorded in 35 patients with BD, 39 patients with MDD, and 42 healthy controls (HCs). Graph theory-based source-level weighted functional networks were assessed via strength, clustering coefficient (CC), and path length (PL) in six frequency bands. At the global level, patients with BD and MDD showed higher strength and CC, and lower PL in the high beta band, compared to HCs. At the nodal level, compared to HCs, patients with BD showed higher high beta band nodal CCs in the right precuneus, left isthmus cingulate, bilateral paracentral, and left superior frontal, belonging to the default-mode network (DMN); however, patients with MDD showed higher nodal CC only in the right precuneus compared to HCs. Although both MDD and BD patients had similar global level network changes, they had different nodal level network changes in DMN-related regions. Our findings might suggest more altered network in the DMN-related regions in patients with BD than in those with MDD.
Evaluation of the Foveal Avascular Zone in Familial Exudative Vitreoretinopathy Using Optical Coherence Tomography Angiography
Authors: Hasegawa Tetsuya , Hirato Misaki , Kobashi Chieko , Yamaguchi Aya , Takagi Rina , Tanaka Yoshiaki , Kaburaki Toshikatsu , Kakehashi Akihiro
Published: December 2020

Background: To evaluate the foveal avascular zone (FAZ) and retinal structure in familial exudative vitreoretinopathy (FEVR).Methods: Twenty FEVR eyes with stage 1 or 2 disease and 20 control eyes were evaluated. The central retinal thickness (CRT), inner retinal thickness (IRT), surface retinal vessel density (SRVD), and deep retinal vessel density (DRVD) were measured using optical coherence tomography. The FAZ area was calculated using ImageJ software. The equivalent spherical value (SE) and axial length (AL) were measured. Results: The CRT (232±26.75 vs. 213.15 ± 16.138 μm; p=0.0003) and IRT (17.44±13.28 vs. 1.85 ± 5.696 μm; p=0.0005) were thicker in the FEVR group than in the control group. The surface FAZ area (0.26±0.1 vs. 0.33 ± 0.1 mm2; p=0.006) and the deep FAZ area (0.36±0.1 vs. 0.43 ± 0.1 mm2; p=0.037) were smaller in the FEVR group than in the control group. The SRVD values did not differ among the sectors, but the DRVD was higher in the FEVR group except for the inferior sector (superior, p=0.02; inferior, p=0.4; temporal, p=0.001; nasal, p=0.02). The SE and AL did not differ between the two groups. There was no correlation between the surface and deep layer FAZ area and age, CRT, SE, and AL. The surface, deep FAZ area, and IRT were correlated negatively (surface, r = −0.57, p=0.008; deep layer FAZ area, r = −0.5, p=0.02).Conclusion: Eyes with FEVR has a smaller FAZ because the inner retina with the vascular structure remained in the fovea.
The Incidence, Risk Factors and Maternal and Foetal Outcomes of Uterine Rupture During Different Birth Policy Periods: An Observational Study in China
Authors: Zhou Yangwen , Mu Yi , Chen Peiran , Xie Yanxia , Zhu Jun , Liang Juan
Published: December 2020

Background: Currently, there are no studies on changes in the incidence of uterine rupture or maternal and foetal outcomes after uterine rupture during different birth policy periods in China. Moreover, the results of association studies of maternal age, parity and previous caesarean section number with the risk of maternal and foetal outcomes after uterine rupture have not been consistent. This research aims to conduct and discuss the above two aspects. Methods: We included singleton pregnant women with no maternal complications other than uterine rupture from January 2012 to June 2019 in China’s National Maternal Near Miss Surveillance System. Through Poisson regression analysis with a robust variance estimator, we compared the incidences of uterine rupture and maternal and foetal outcomes after uterine rupture during different birth policy periods in China and determined the relationship between maternal age, parity or previous caesarean section number and uterine rupture or maternal and foetal outcomes after uterine rupture. Results: This study included 8,637,723 pregnant women. The total incidences of uterine rupture were 0.13% (12,934) overall, 0.05% during the one-child policy, 0.12% during the partial two-child policy (aRR=1.96; 95% CI: 1.53-2.52) and 0.22% (aRR=2.89; 95% CI: 1.94 4.29) during the universal two-child policy. The maternal near miss and stillbirth rates after uterine rupture were respectively 2.35% (aRR=17.90; 95% CI: 11.81-27.13) and 2.12% (aRR=4.10; 95% CI: 3.19 5.26) overall, 5.46% and 8.18% during the first policy, 1.72% (aRR=0.60; 95% CI: 0.32-1.17) and 2.02% (aRR=0.57; 95% CI: 0.37-0.83) during the second policy, and 1.99% (aRR=0.90; 95% CI: 0.52-1.53) and 1.04% (aRR=0.36; 95% CI: 0.24-0.54) during the third policy. The risk of uterine rupture increased with parity and previous caesarean section number. Conclusion: Our findings suggest that the total and different characteristics risk of uterine rupture in China increased and the risk of stillbirth after uterine rupture improved from the one-child policy period to the universal two-child policy period. The risk of uterine rupture increased with parity and previous caesarean section number. The higher the parity and lower the previous caesarean section number was, the more serious the maternal and foetal outcomes would be.
Genetic Profiling in Heterogeneous High-Grade Adenoid Cystic Carcinoma Identifies NOTCH1 Inhibition as a Therapeutic Strategy
Authors: Wang Yu , Sun Bao , Zhang Chunye , Xia Ronghui , Wang Lizhen , Sun Jingjing , Gu Ting , Tian Zhen , Li Jiang
Published: December 2020

BackgroundHigh-grade adenoid cystic carcinomas (ACCs), consisting mostly of the solid type along with the occasional high-grade transformation (ACC-HGT) type, are highly aggressive and heterogeneous tumors. Because of the rarity of the tumors, therapeutic strategy guided by genetic profiles based on next generation sequencing (NGS) has been not published on these tumors. MethodsForty-four tissues microdissected from 36 high-grade ACC cases (31 solid type ACCs and 5 ACC-HGTs) were included in our study. The preclinical efficiency of targeted drugs were evaluated in ACC patient-derived xenografts (PDXs) models.ResultsThe solid components from the 31 solid ACCs, were enriched for mutations of genes in the NOTCH (NOTCH1, 68%; SPEN 23%) and the chromatin-remodeling pathway and were absent of the myoepithelial cell differentiation. The cases with NOTCH1 mutation exhibited strong NCID expression, which was associated with poor distant metastasis-free survival. BRCA2 mutation was observed in 23% of solid ACCs, conferring sensitivity to PARP inhibitors. From 5 of the solid ACCs, the intratumor heterogeneity was delineated between the cribriform/tubular and the solid components. NOTCH1 and FGFR2 mutations as well as NOTCH2 amplification were restricted to the solid component indicating the clonal selection within the same tumor. From 2 aggressive solid ACCs the subclones evolved in progression for local relapse and distant metastasis, although they manifested close genomic resemblance to primary tumors. Five tumors of ACC-HGTs were characterized by a loss of biphasic ductal-myoepithelial differentiation in HGT area and enriched for alterations in the NOTCH, P53 and PI3K pathways. Guided by the genetic profiles, the preclinical efficiency of a gamma-secretase inhibitor BMS-906024 demonstrated robust antitumor effects in the PDX models with activating NOTCH1 mutation. ConclusionscThis is the first report to describe the intratumor heterogeneity within a solid ACC as well as the intertumor evolution of clones among the primary/recurrent/metastatic tumors. Different from conventional ACCs, high-grade ACCs should be approached with a distinct therapeutic strategy particularly targeting NOTCH1 by gamma-secretase inhibitors. Microdissecting the highest grade component guided by histology is a highly recommended tumor sampling strategy and facilitates the detection of key molecular targets.
Chemotherapy Agents Stimulate Cytotoxic T Cell Against Human Colon cancer Cells through Upregulation of the Transporter Associated with Antigen Processing
Authors: Liang Yi-Hsin , Tsai Jia-Huei , Cheng Yung-Ming , Chan Kuang-Yu , Hsu Wen-Ling , Lee Chang-Cheng , Chen Kuo-Hsing , Yeh Kun-Huei
Published: December 2020

Objectives: Single immunotherapy fails to demonstrate efficacy in patients with microsatellite stable (MSS) metastatic colorectal cancer (mCRC). Research on immune reactions before and after systemic agents for mCRC is warranted. Methods: Our study examined cell line models to compare the expression of immune surface markers on colon cancer cells before and after chemotherapy agents. We also elucidated mechanisms underlying the effects of chemotherapy agents on immune surface markers. We used real-world clinical samples with NanoString analysis and the Perkin-Elmer Opal multiplex system.Results: We established that chemotherapy agents, particularly 7-ethyl-10-hydroxycamptothecin (SN-38), the active metabolite of irinotecan, stimulated the expression of stimulatory MHC class I isotypes through stimulation the pathway of transporters associated with antigen processing 1 and 2 (TAP1 and TAP2) in cell line models. Application of infected cell protein 47 (ICP-47), a specific inhibitor of the TAP1/TAP2, significantly inhibited expression of TAP1/TAP2 and also inhibited the expression of the downstream MHC class I. We confirmed that the expression of major histocompatibility complex (MHC) class I, programmed death 1(PD-1), and programmed death ligand 1(PD-L1) significantly increased after first-line chemotherapy and targeted therapy in the samples of real-world patients with de novo mCRC.Conclusion: Our study provides new insights for novel immunotherapy combinations.
Comparative Transcriptomic Analysis of Thermally Stressed Arabidopsis thaliana Meiotic Recombination Mutants
Authors: Huang Jiyue , Wang Hongkuan , Wang Yingxiang , Copenhaver Gregory
Published: December 2020

Background: Meiosis is a specialized cell division that underpins sexual reproduction in most eukaryotes. During meiosis, interhomolog meiotic recombination facilitates accurate chromosome segregation and generates genetic diversity by shuffling parental alleles in the gametes. The frequency of meiotic recombination in Arabidopsis has a U-shaped curve in response to environmental temperature, and is dependent on the Type I, crossover (CO) interference-sensitive pathway. The mechanisms that modulate recombination frequency in response to temperature are not yet known. Results: In this study, we compare the transcriptomes of thermally-stressed meiotic-stage anthers from msh4 and mus81 mutants that mediate the Type I and Type II meiotic recombination pathways, respectively. We show that heat stress reduces the number of expressed genes regardless of genotype. In addition, msh4 mutants have a distinct gene expression pattern compared to mus81 and wild type controls. Interestingly, ASY1, which encodes a HORMA domain protein that is a component of meiotic chromosome axes, is up-regulated in wild type and mus81 but not in msh4. We also characterize 51 novel, previously unannotated transcripts, and show that their promoter regions are associated with A-rich meiotic recombination hotspot motifs. Conclusions: Our transcriptomic analysis of msh4 and mus81 mutants enhances our understanding of how the Type I and Type II meiotic CO pathway respond to environmental temperature stress and might provide a strategy to manipulate recombination levels in plants.
Genome-Wide Association Study of Actinidia Chinensis
Authors: Zhang Yu , Wang Yuexing , Zheng Shimao , Zhou Wanying , Zhang Wenhui , Wang Shengbao , Qu Dong
Published: December 2020

Background: A total of 74,936 SNPs were employed to carry out GWAS and post-GWAS of the fifty-six accessions, representing the two most valuable varieties of Actinidia chinensis, namely, A. chinensis var. chinensis and A. chinensis var. deliciosa, are mainly distributed in China. The percentage of heterozygous sites of A. chinensis var. deliciosa is higher than that of A. chinensis var. chinensis, which could be one of the reasons for A. chinensis var. deliciosa high disease resistance. LD decay distance of male plants is shorter than that of female plants. Results: Fifty-six accessions were divided into two subgroups. Analysis of molecular variance shows that the frequency of genetic variations within the population is 83.53% and 16.47% between populations. Fst between the two populations is 0.14, and Nm is 1.60. Set at α ≤ 0.05, a total of 327 SNPs and 260 haplotypes were related to the hispidus. A total of 246 proteins were annotated using GO and KEGG analyses, which indicated the membrane-related genes and stress-resistant metabolic pathways are related to the hispidus condition of leaves, stems, and peels of kiwifruit, which is also the result of the adaptation of A. chinensis var. deliciosa to its growth environment. Conclusions: Haplotype analysis showed that the evolution of is A. chinensis var. deliciosa later than that of A. chinensis var. chinensis.
Rare and Potentially Pathogenic Variants in Hydroxycarboxylic Acid Receptor Genes Identified in Breast Cancer Cases.
Authors: Sams Cierla McGuire , Shepp Kasey , Pugh Jada , Bishop Madison R. , Merner Nancy D.
Published: December 2020

Background: Three genes, clustered together on chromosome 12, comprise a group of Hydroxycarboxylic Acid Receptors (HCARs), HCAR1, HCAR2, and HCAR3. These paralogous genes encode different G-protein coupled receptors that are responsible for detecting glycolytic metabolites and controlling fatty acid oxidation. Though better known for regulating lipid metabolism in adipocytes, more recently HCARs have been functionally associated with breast cancer proliferation/survival; HCAR2 has been described as a tumor suppressor, and HCAR1 and HCAR3 as oncogenes. Thus, we sought to identify genetic variants in HCAR1, HCAR2, and HCAR3 that could potentially be associated with breast cancer. Methods: Due to the extreme homology between HCAR1, HCAR2, and HCAR3, primers were carefully designed to amplify each gene separately through nested PCRs followed by Sanger sequencing. Forty-six unrelated breast cancer cases were screened for rare, non-synonymous coding variants. Results: Upon screening, a total of four variants were identified in four different cases, each with estrogen receptor-positive (ER+) breast cancer. The variants were identified exclusively in HCAR1 and HCAR3. In HCAR1, two highly conserved and potentially damaging missense variants were identified, c.58C>G;p.Pro20Ala and c.721C>T;p.Leu241Phe. Statistical analyses revealed that c.58C>G;p.Pro20Ala was in significantly more cases than controls. In HCAR3, in addition to the breast cancer-associated missense variant c.560G>A;p.Arg187Gln, a frameshift mutation, c.1117delC;p.Gln373Lysfs*82, was detected that greatly extends the C-terminus and changes the secondary and tertiary protein structure. Conclusions: Due to the important role of HCARs in breast cancer, it is vital to understand how these genetic variants play a role in breast cancer risk and proliferation, as well as their consequences on treatment strategies. Due to the small sample size, additional and larger studies will be needed to validate these findings. Nevertheless, the identification of these potentially pathogenic variants supports the need to investigate their functional consequences.
Identification of Hub Genes Associated With Clinical Characteristics and Potential Therapy of Diabetic Nephropathy by Bioinformatics Analysis.
Authors: Xu Si , Li Xiaoning , Wu Sha , Yang Min
Published: December 2020

Background: To provide theoretical basis for the molecular mechanism of the development of diabetic nephropathy and targeted molecular therapy by screening expressed genes based on bioinformatic analysis. Methods: We analyzed diabetic nephropathy microarray datasets derived from GEO database. Perl and R programming packages were used for data processing and analysis and for drawing. STRING online database and Cytoscape software were utilized for protein-protein interaction network analysis and screened for hub genes. Also, WebGestalt was used to analyze the relationship between genes and microRNAs. Nephroseq online tool was used to visualize the correlation between genes and clinical properties.Results: We found 91 differentially expressed genes between diabetic nephropathy tissues and normal control tissues. Protein-protein interaction network analysis screened out 5 key modules and a total of 14 hub genes were identified by integration, also11 microRNAs were associated with hub genes. Especially mir29 could regulate COL6A3 and COL15A1.Conclusions: The internal biological information in diabetic nephropathy can be revealed by integrative bioinformatical analysis, providing theoretical basis for further research on molecular mechanism and potential targets for diagnosis and therapeutics of diabetic nephropathy.
Growth and Physiological Characteristics of Sassafras tzumu Hemsl. Seedlings Under Cadmium (Cd) Stress
Authors: Zhao Hongyi , Guan Juelan , Liang Qing , Zhang Xueyuan , Hu Hongling , Zhang Jian
Published: December 2020

The effects of cadmium stress on the growth and physiological characteristics of Sassafras tzumu Hemsl. were studied in pot experiments. Five Cd levels were tested (CT: 0 mg/kg, Cd5: 5 mg/kg, Cd20: 20 mg/kg, Cd50: 50 mg/kg, and Cd100: 100 mg/kg). The growth and physiological characteristics of the sassafras seedlings in each level were measured. The results showed that soil Cd had negative influences on sassafras growth and reduced the net growth of plant height and the biomass of leaf, branch and root. The contents of hydrogen peroxide and malondialdehyde increased with increasing cadmium concentration; this indicated that cadmium stress had a certain effect on the peroxidation of the inner cell membranes in the seedlings that resulted in damage to the cell membrane structure. Superoxide dismutase activity increased in treatments Cd50 and Cd100 compared to that in the other treatments, while peroxidase activity increased steadily with increasing cadmium concentration; these results suggest that peroxidase is likely the main protective enzyme involved in the reactive oxygen removal system in sassafras seedlings. The increase in proline content with increasing cadmium concentration indicated that cadmium stress induced proline synthesis to resist osmotic stress in the seedlings. Compared to that in CT, the soluble sugar content declined under the different treatments. The soluble protein content first increased and then decreased with increasing cadmium stress. At different levels of cadmium stress, the chlorophyll content in the seedlings first increased and then decreased, and it was higher in the Cd5 and Cd20 treatments than that in the CT treatment. These results reflect that cadmium has photosynthesis-promoting effects at low concentrations and photosynthesis-suppressing effects at high concentrations. The photosynthetic gas exchange parameters and photosynthetic light-response parameters showed downward trends with increasing cadmium concentration compared with those in CT; these results reflect the negative effects of cadmium stress on photosynthesis in sassafras seedlings.
Poor Linkage to Care for HIV-positive OVC with Disabled Caregivers: A Longitudinal Study in Tanzania
Authors: Bajaria Shraddha , Exavery Amon , Toroka Noreen , Abdul Ramadhani
Published: December 2020

BackgroundDespite extensive efforts to scale up counseling and testing services and care and treatment clinics (CTCs) in Tanzania, linkage between points of diagnosis and CTCs needs to be improved for children. Studies have looked at barriers such as lack of trained health providers, poor referral system, economic costs or distance to health facilities, but fewer assessed the association between caregivers’ vulnerability such as disability and linkage of orphans and vulnerable children (OVCs) in their care to health facilities. This study describes the magnitude of caregivers’ disability and assesses its relationship with successful linkage to care of their OVC living with HIV/AIDS in Tanzania.Methods Data for this analysis come from the USAID Kizazi Kipya project in 79 councils of Tanzania. Data on HIV risk, service use and ART adherence among OVC aged 0-19 years were collected during the project’s quarterly routine data collection (Oct 2017-Sep 2018). Characteristics of caregivers were collected during the project beneficiary screening and enrollment process. Generalized estimating equation models were used to analyze the factors that are associated with linkage of 14,538 HIV positive OVC to CTC, who were taken care of by 11,834 caregivers. ResultsThe majority of caregivers (70%) were females, had completed primary education (67%), 54% were married or cohabiting. Of all the OVC, 3% were living with disabled caregivers; of whom 89% were physically disabled while the rest were mentally disabled. OVCs living with disabled caregivers were less likely to be linked to care (OR 0.76, 95% CI 0.58, 0.99). Factors positively associated with OVC linkage to care were high caregivers education level (OR 1.99, 95% CI 1.51, 2.63) and OVC living with a HIV positive caregivers (OR 1.25, 95% CI 1.12, 1.41). OVC living in household with high socio-economic status were less likely to be linked to care (OR 0.76, 95% CI 0.67, 0.86) than those in low-SES households.ConclusionThese results suggest HIV positive OVC living with disabled caregivers had poor linkage to care. The findings highlight the need to focus attention to the disabilities-led household to promote inclusion and improve access to the HIV services.
Yield, Nutrient Quality and Water and Phosphorus Recovery Efficiencies of Alfalfa under Different Drip Irrigation and Phosphorus Levels in Northern Xinjiang, China
Authors: Liu Junying , Li Shengyi , Sun Yanliang , Liu Xuanshuai , Lu Weihua , Ma Chunhui , Zhang Qianbing
Published: December 2020

Rational water and fertilizer management have an important impact on alfalfa production. This research aimed to explore the effects of water and phosphorus (P) fertilizer on hay yield, nutrient quality, water-use efficiency (WUE) and phosphorus-recovery efficiency (PRE) of each cut of alfalfa under drip irrigation and to determine the best water and P interaction model for high quality and yield of alfalfa. In this study, different irrigation levels, i.e., 5.25, 6.0, and 6.75 ML ha-1 (referred to as W1, W2, W3, respectively), and P fertilizer levels (0, 50, 100, and 150 kg P2O5 ha-1 referred to as P0, P1, P2, P3, respectively) were set to determine the hay yield and nutrient quality of each cut of alfalfa under drip irrigation and to calculate WUE and PRE. The hay yield of each cut of alfalfa increased first and then decreased with increased P fertilizer under the same irrigation amount, and there was no significant difference among different irrigation treatments with respect to the hay yield of alfalfa. The crude protein (CP) reached a maximum under the W2P2 treatment. WUE decreased gradually with an increasing irrigation amount under the same P application. The WUE of alfalfa increased first and then decreased with the increase of P application under the same irrigation amount, and WUE was 0.20%–4.75% (2016) and 1.31%–6.22% (2017) higher in the P treatments than in the non-phosphorus treatments. PRE decreased gradually with increasing P application under the same irrigation amount. Therefore, we conclude that moderate irrigation (6.0 ML ha-1) and P fertilizer (100 kg P2O5 ha-1) combined with application, the alfalfa has higher WUE and PRE, and can significantly promote the alfalfa hay yield and nutrient quality of each cut.
Perception of women toward childbirth positions among women on postnatal unit at Jimma Medical Center, Jimma town, South West Ethiopia: A Phenomenological Qualitative Study
Authors: Jiregna Bikila , Demeke Tigist , Sewmehone Enatfenta , Nemera Gugsa
Published: December 2020

Background: The women have been giving birth at health facilities without considering their preference of birth positions. Accordingly, they routinely positioned at lithotomy position as standard medical practices during normal vertex vaginal childbirths, which results in negative maternal and neonatal outcomes. Thus, this study aimed to understand women’s perception of birth positions.Objective: To explore perception of women toward child birthing positions among women on postnatal unit at Jimma Medical Center, Jimma town, Ethiopia 2020.Methods and Materials: A descriptive phenomenological approach was employed among women from postnatal and maternity care providers were selected purposively. The audio was transcribed, translated, coded, and categorized to respective identified themes. Then, thematized by Archive for Technology, Lifeworld and Everyday Language.text interpretation (ATLAS.ti version 8) software for thematic analysis in triangulation with the quantitative findings.Results: The women and health care providers were responded on factors affecting the use of alternative birth positions in the health facility. The women were positioned at common supine positions due to women’s lack of awareness about birth positions, women’s passivity to respect their decision-making on their position of preference, and health care professionals’ knowledge and skill gaps on alternative childbirth positions.Conclusion and recommendations: The women were coerced and adopted birth positions directed by health care providers. Therefore, health care providers’ practice should be intensified through the provision and implementation of evidence-based alternative birth positions.
Multivalent Nanoparticle-Based Vaccines Protect Hamsters Against SARS-CoV-2 After a Single Immunization
Authors: Chiba Shiho , Frey Steven J. , Halfmann Peter J. , Kuroda Makoto , Maemura Tadashi , Kawaoka Yoshihiro , Kane Ravi S.
Published: December 2020

The COVID-19 pandemic continues to wreak havoc as worldwide SARS-CoV-2 infection, hospitalization, and death rates climb unabated. Effective vaccines remain the most promising approach to counter SARS-CoV-2. Yet, while promising results are emerging from COVID-19 vaccine trials, the need for multiple doses and the challenges associated with the widespread distribution and administration of vaccines remain concerns. Here, we engineered the coat protein of the MS2 bacteriophage1,2 and generated nanoparticles displaying multiple copies of the SARS-CoV-2 spike (S) protein. The use of these nanoparticles as vaccines generated high neutralizing antibody titers and protected Syrian hamsters3 from a challenge with SARS-CoV-2 after a single immunization with no infectious virus detected in the lungs. This nanoparticle-based vaccine platform thus provides protection after a single immunization and may be broadly applicable for protecting against SARS-CoV-2 and future pathogens with pandemic potential.
Trans-Oral Endoscopic Thyroid Surgery and Trans-Areola Endoscopic Thyroid Surgery: Which Offers A Better Quality of Life?
Authors: Shen Shuang , Hu Xiaochi , Qu Rui , Guo Youming , Luo Libo , Chen Xin
Published: December 2020

Background: Endoscopic thyroidectomy via the oral vestibular approach (ETVOA) and endoscopic thyroidectomy via the areola approach (ETAA) are becoming more favored in China. Compared with conventional open surgery, both methods avoid the scarring on the neck, but only ETVOA obviates scarring of the skin, which may helps patients achieve a better quality of life (QOL). However, the benefit of the QOL from this technique has not been adequately investigated, therefore this study compared the QOL outcomes between ETVOA and ETAA. Methods: We enrolled 131 patients in this study. ETAA surgery and ETVOA surgery were performed in 74 patients and 57 patients, respectively. These patients were followed up at 2 weeks, 4 weeks, and 8 weeks, and their QOL was evaluated using a thyroid surgery-specific questionnaire and a short-form health survey (SF-36). Results: There were no differences in clinical characteristics such as gender, age, body mass index (BMI), and tumor size between the two groups. The volume of intraoperative blood loss, cost of hospitalization, and complications between the two procedures showed no differences. Compared with ETAA, ETVOA has a longer operation time, no drainage, and shorter hospital stay. In the QOL questionnaire, several parameters in ETVOA were better. The satisfaction scores of patients undergoing ETVOA were higher. In addition, the cosmetic satisfaction in patients who received ETOVA was significantly better than that of patients who underwent ETAA. The degree of neck movement disorder in patients with ETVOA was milder. Patients who received ETVOA had higher score on the SF-36. Conclusions: Compared with ETAA, ETVOA can acquire better cosmetic results and make patients quick return to normal life.Patients who underwent ETVOA achieved high-level QOL.
Low Temperature Chemical Synthesis of Intermetallic TiFe Nanoparticles for Hydrogen Absorption
Authors: Kobayashi Yasukazu , Yamaoka Shohei , Yamaguchi Shunta , Hanada Nobuko , Tada Shohei , Kikuchi Ryuji
Published: December 2020

Nanosizing of TiFe hydrogen storage alloy is conducted to facilitate its activation. Here, pure intermetallic TiFe nanoparticles (45 nm) were prepared using chemical reduction of oxide precursors at 600 °C, which is the lowest temperature ever used in chemical synthesis. This was achieved using a strong reducing agent (CaH2) in a molten LiCl. When used for hydrogen absorption, the obtained nanoparticles surprisingly exhibited almost no hydrogen absorption. The results demonstrated that TiFe nanoparticles are more difficult to activate than the bulk powder because the oxidized surface layers of the nanoparticles become stabilized, which prevents the morphological change necessary for their activation.
Prizes Signal Scientific Revolutions
Authors: Jin Ching , Ma Yifang , Uzzi Brian
Published: December 2020

Scientific revolutions affect funding, investments, and technological advances, yet predicting their onset and projected size and impact remains a puzzle. We investigated a possible signal predicting a topic’s revolutionary growth – its association with a scientific prize. Our analysis used original data on nearly all recognized prizes associated with 11,539 scientific topics awarded between 1960 and 2017 to examine the link between prizes and a topic’s unexpected growth in productivity, impact, and talent. Using difference-in-differences regressions and counterfactuals of matched prizewinning and non-prizewinning topics, we found that in the year following the receipt of a prize, a topic experiences an onset of extraordinary growth in impact and talent that continues into the future. At between five to 10 years after the prize year, prizewinning topics are 38% more productive and 31% more impactful in citations, retain 53% more incumbents, and gain 35% more new entrants and 46% more star scientists than their non-prizewinning peer topics. While prizewinning topics grow unexpectedly fast in talent and impact, funding does not drive growth; rather, growth is positively associated with the recency of work on the topic, discipline-specific rather than general awards, and prize money. These findings advance understanding of scientific revolutions and identify variations in prize characteristics that predict the timing and size of a topic’s revolutionary growth. We discuss the implications of these findings on how funding agencies and universities make investments and scientists commit time and resources to one topic versus another, as well as on the quality of research.
Predictive Values of Multiple Non-Invasive Markers for Myocardial Fibrosis in Hypertrophic Cardiomyopathy Patients With Preserved Ejection Fraction
Authors: Li Yumin , Liu Jia , Cao Yukun , Han Xiaoyu , Shao Guozhu , Zhou Xiaoyue , Gu Jin , Liu Tong , Cui Yue , Shi Heshui
Published: December 2020

Myocardial fibrosis assessed by late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) is associated with cardiovascular outcomes in hypertrophic cardiomyopathy (HCM) patients, but little is known about the utility of non-invasive markers for detecting LGE. This study aims to explore the association between cardiacspecific biomarkers, CMR myocardial strain, left ventricular (LV) hypertrophy and LGE in HCM patients with preserved ejection fraction (EF) and investigate the predictive values of these indexes for LGE. We recruited 33 healthy volunteers and 86 HCM patients with preserved EF to undergo contrast-enhanced CMR examinations. In total, 48 of 86 HCM patients had the presence of LGE. Serum high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro b-type natriuretic peptide (Nt-proBNP) levels were elevated in LGE-positive patients compared with LGE-negative patients. The LGE-positive patients had lower global longitudinal (GLS) and circumferential (GCS) strains than the LGE-negative group and the healthy controls. The LGE% was independently associated with the Nt-proBNP levels, GCS, MWT and beta-blocker treatment. In the receiver operating characteristic curve analysis, the combined parameters of Nt-proBNP≥108 pg/mL and MWT≥17.3 mm had good diagnostic performance for LGE, with a specificity of 81.3% and sensitivity of 70.0%. These data indicate that serum Nt-proBNP is a potential biomarker associated with LGE% and, combined with MWT, were useful for identifying myocardial fibrosis in HCM patients with preserved EF. Additionally, LV GCS may be a more sensitive indicator for reflecting the presence of myocardial fibrosis than GLS.
Effect of Process Parameters on Density and Mechanical Behaviour of a Selective Laser Melted 17-4PH Stainless Steel Alloy
Authors: Huang Liang , Cao Yan , Li Gaohong , Li Yao , Dang Yunpeng , Wang Yuanfei
Published: December 2020

17-4 PH stainless steel alloy has been widely used in the field of defense industry such as weapon equipment, aerospace, nuclear energy and so on because of its high strength, high toughness, high temperature resistance and corrosion resistance. In order to meet the flexible manufacturing requirements of multi-variety small batch complex structure products with lower cost and higher efficiency, Selective laser melted 17-4PH stainless steel alloy has become the focus of research in the field of rapid alloy manufacturing in recent years. This paper studied the density characteristics and the distribution characteristics of holes and spheroidization phenomena of 17-4 PH pre-alloyed powder subjected to multidimensional temperature conduction under selective laser melting, and the mechanism of defect generation under temperature conduction is proposed. Finally, the optimal selection of the combination of different process parameters waere carried out by orthogonal test, and it was found that the comprehensive mechanical behaviour of the 17-4 PH stainless steel alloy after formed exceeded the ASTM A564 standard (the yield strength is 1132 MPa, the tensile strength is 1323 MPa, the elongation is 16.6%).
Analysis of cellular senescence in gingival tissues and gingival fibroblast cultures
Authors: Furukawa Masae , Matsuda Kazunari , Kurosawa Mie , Wang Jingshu , Watanabe Maki , Aoki Yu , Shikama Yosuke , Matsushita Kenji
Published: December 2020

Senescence in periodontal tissues may be involved in the pathogenesis of periodontitis. In this study, we analyzed cellular senescence in gingival tissues of aged mice and in gingival fibroblast cultures and investigated the relationship of cellular senescence with the pathogenesis of periodontal disease. The proportions of senescence-associated β-galactosidase (SA-β-gal)-positive cells and the mRNA expression levels of p16 and p21 in gingival tissues and gingival fibroblasts from 20-month-old mice were significantly higher than those in gingival tissues and gingival fibroblasts from 10-week-old mice. The mRNA expression levels of IL-1β and TNF-α as well as the numbers of total macrophages and M1 macrophages were increased in gingival tissues of aged mice. Expression of these senescence-associated molecules was also increased in long-term passaged or hydrogen peroxide-stimulated human gingival fibroblasts; however, it was significantly suppressed by treatment with the senolytic drug ABT-263. These results suggest that cellular senescence can be induced in gingival fibroblasts in culture as was observed in gingival tissues of aged mice. An increase in senescent cells in the gingiva may be associated with the pathogenesis of periodontitis in part through activating an inflammatory response in periodontal tissues.
Finite Element Analysis of Cornea and Lid Wiper During Blink, With and Without Contact Lens
Authors: R Vivek , S Meenatchi , Thomas Rinu , Ve Ramesh , Pai Raghuvir , Khader Shah Mohammed Abdul , Hazarika Manali , Poojary Rakshath , H Girish
Published: December 2020

Contact Lens-related Discomfort (CLD) is one of the major problems in about 50% of contact lens users. It is a symptom of a variety of conditions such as Lid Wiper Epitheliopathy (LWE), Superior Epithelial Arcuate Lesion (SEAL), Limbal Stem Cell Deficiency (LSCD), Superior Limbic Keratoconjunctivitis (SLK) and dry eye disease; which affect the quality of life. Hence, it is essential to investigate the underlying cause of CLD. During a blink, the under surface of the eyelid tends to interact with the cornea and the conjunctiva. The presence of a contact lens can add to the biomechanical changes on these surfaces. To estimate these changes with and without a contact lens, a Finite Element Model (FEM) of the eyelid wiper, eyeball and contact lens was developed using COMSOL Multiphysics®. Biomechanical properties such as von Mises stress and displacement were calculated. Our study concluded that large stress formed in the lid wiper could be the reason for the occurrence of LWE and SLK without contact lens in the eye. When the contact lens was in situ, large stress was found in the superior 1.3mm of the cornea which could be responsible for the development of SEAL and superior LSCD.
Efficacy and Predictability of Muller's Muscle-conjunctival Resection with Different Tarsectomy Lengths for Unilateral Blepharoptosis Treatment
Authors: Yeh So Hung , Laio Shu-Lang , Wei Yi-Hsuan
Published: December 2020

Background: To investigate the efficacy and predictability of Muller's muscle-conjunctival resection (MMCR) with different lengths of tarsectomy for the treatment of unilateral mild-to-moderate blepharoptosis.Methods: A retrospective study of patients who underwent MMCR with tarsectomy for unilateral mild-to-moderate blepharoptosis between January 2016 and December 2019 was performed. Individuals with adequate photographic documentation and good levator function were included. Data on age, gender, surgical designs, pre-operative and post-operative marginal reflex distance 1 (MRD1) and tarsal platform show (TPS), and complications were retrieved. Results: Sixty patients underwent 8-mm MMCR with 1- or 2-mm tarsectomy; 53 patients (88.3%) showed postoperative symmetry of MRD1 within 1 mm. The average postoperative improvement in MRD1 was 2.15±0.8 mm. Thirty-two patients received 8-mm MMCR with 1-mm tarsectomy (group 1), and 28 patients underwent 8-mm MMCR with 2-mm tarsectomy (group 2). In group 1, postoperative symmetry rate was 90.6%, and the mean elevation of MRD1 was 1.66±0.6 mm. In group 2, postoperative symmetry rate was 85.7%, and the mean elevation of MRD1 was 2.72±0.6 mm. Both groups showed postoperative symmetry of TPS and significant improvement in eyelid position (p<0.0001). No complications or overcorrections were noted.Conclusions: MMCR with tarsectomy was proven to be a safe, rapid, and effective method for patients with mild-to-moderate ptosis. Predictability and symmetry of the outcome were statistically confirmed. We further suggest a 2.1-mm expected MRD1 elevation as a cut point for choosing between 1- or 2-mm tarsectomy.
A Qualitative Exploration of the Experience and Quality of Life of Patients, and their Family Carers, Admitted to a Specialist Eye Hospital with Microbial Keratitis
Authors: Tranter Shelley Anne , Cabrera-Aguas Maria , Riddell Mandy Lee , McCulloch Joanna , Riley Therese , Watson Stephanie , Perry Lin
Published: December 2020

Background: Microbial keratitis is a vision-threatening condition requiring intensive treatment. Understanding patients’ and carers’ experience during and after hospitalisation can inform improvements in care and outcomes. This study explored the vision-related quality of life, and the experiences of patients with microbial keratitis and their family carers when admitted to a quaternary referral eye hospital in Australia Methods: The study employed mixed methods, including qualitative interviews and a survey in hospital and a telephone interview post-discharge. A convenience sample was recruited of 33 patients with microbial keratitis who presented to hospital between March and October 2017, and 10 of their family carers. Semi-structured interviews were audiotaped, transcribed verbatim, coded and analysed using thematic analysis. Patient participants completed the National Eye Institute Visual Functioning Questionnaire – 25 (NEIVFQ-25).Results: Qualitative analyses identified two main themes: Saving sight, with subthemes of costs of saving sight, and travel and transportation; Safe-guarding home and normal life with subthemes of family, work and pastimes. A group mean NEIVFQ-25 score of 74 was similar to other ophthalmic disease groups but pain scores were higher.Conclusion: Findings provide insights into the experiences and often unspoken concerns of microbial keratitis patients and their family carers, revealing the priority and the associated costs of saving sight, and the implications for family and lifestyles. These patients reported similarly reduced vision-related quality of life but greater pain compared to other ophthalmic groups. Findings point to ways to improve their experience and potentially reduce the high rates of unplanned representations of this patient group.