bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal trends in behavioral risk and protective factors and their association with mortality rates: results from Brazil and Argentina
Authors: Santos Leonardo Pozza , Meller Fernanda de Oliveira , Amann Valeria Romina , Schäfer Antônio Augusto
Published: September 2020

Background: Despite available information on trends in behavioral factors for Brazil and Argentina, little is known about the association of these trends with mortality. Understanding this association is important to avoid early deaths. Therefore, we aimed to evaluate temporal trends in behavioral risk and protective factors in Brazil and Argentina, and to assess their association with overall and cause-specific mortality rates.Methods: Ecological study with data from two population surveys from Brazil and Argentina. Weighted prevalence of tobacco smoking, excessive alcohol consumption, fruit and vegetable consumption and physical activity for the 27 Brazilian state capitals and for the 23 Argentinean provinces were used as behavioral factors. Information on overall mortality as well as cardiovascular diseases and cancer mortality for the year 2015 was collected from national mortality banks of both countries. Estimated prevalence rates were used to describe trends in behavioral factors from 2006 to 2014 in Brazil, and from 2005 to 2013 in Argentina, while Pearson’s correlation and linear regression models were used to assess their association with overall and cause-specific mortality rates.Results: Brazil presented improvements in behavioral risk and protective factors: sharp decrease in tobacco smoking prevalence (from 15% to 9%), increase in regular fruit and vegetable consumption (from 28% to 36%), and increase in physical activity (45% to 51%). In Argentina, results were more disappointing: small reduction in tobacco smoking (from 55% to 50%) and decrease in physical activity (from 55% to 45%). In both countries, excessive alcohol consumption remained stable, with increase only among women. The association between behavioral factors and mortality showed that in those Brazilian capitals with higher prevalence of regular consumption of fruits and vegetables, there were lower overall mortality rates. Stratification by gender revealed that significant results were only found among women. Conclusion: Prevalence of regular consumption of fruits and vegetables increased in Brazilian capitals and was associated with lower overall mortality rate, suggesting a positive impact of Brazilian policies to improve dietary intake patterns on its population’s mortality. Approaches focusing on behavioral factors are especially needed in Argentina to reach similar results of those seen in Brazil.
Examining Relationship between Occupational Acid Exposure and Oral Health in Workplace
Authors: Chen Wei-Liang , Chen Yuan-Yuei , Wu Wei-Te , Lai Ching-Huang , Sun Yu-Shan , Wang Chung-Ching
Published: September 2020

Background: Acid mist can suspend in the air and enter the body via skin contact, the respiratory tract, or even oral intake, which pose various health hazards. Previous studies have shown that occupational exposure to acid mist or acidic solutions is a major risk factor for oral diseases. However, the findings are inconsistent and do not consider individual factors and lifestyles that may cause the same oral diseases. Therefore, we conducted a comprehensive oral health survey and collected detail information to confirm the effect of acidic solution exposure on worker’s oral health. Methods: From 4 acidic solution factories, a total of 309 subjects (157 in control and 152 in exposed group) was enrolled. All participants competed oral examinations and self-report questionnaire, including the decayed, missing, and filled teeth (DMFT) index, community periodontal index (CPI), loss of attachment (LA) index, and tooth erosion. Multivariate logistic regression analysis was used to determine the association between the acidic solution exposure and oral health.Results: The results showed that acid exposure was correlated with soft oral tissue injury rather than hard oral tissue in our survey. In the multivariate model (adjusted for sex, age, worked years, education level, mouthwash use, dental floss use, tooth brushing, mask use, smoking, drinking, chewing areca and dietary habits with acidic foods), significant relationships of acid exposure with LA score were observed (OR=2.32, 95% CI 1.03-5.26). However, the presence of acid exposure was not significantly associated with tooth erosion, DMFT, and CPITN.Conclusion: Our study highlighted that occupational acid exposure was an independent risk factor for periodontal health, especially LA. It is important to strengthen occupational hazard control, educate workers on oral disease and related factors, and raise the awareness of oral hygiene.
The prognostic significance of inflammation-based scores in patients with ampullary carcinoma after pancreaticoduodenectomy
Authors: Sun Shuxin , He Chaobin , Wang Jun , Huang Xin , Wu Jiali , Li Shengping
Published: September 2020

Background

Growing evidence indicates that systemic inflammatory response plays an important role in cancer development and progression. Several inflammatory markers have been reported to be associated with the clinical outcomes in patients with various types of cancer. This study was designed to evaluate the prognostic value of the inflammatory indexes in patients suffering from ampullary cancer (AC) who underwent pancreaticoduodenectomy (PD).

Methods

We retrospectively reviewed a database of 358 patients with AC who underwent PD between 2009 and 2018. R software was used to compare the area under the time-dependent receiver operating characteristic (ROC) curves (AUROCs) of the inflammation-based indexes, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI) and prognostic index (PI), in terms of their predictive value of survival. The survival differences of these indexes were compared by Kaplan-Meier method and univariate and multivariate analyses were performed to determine the prognostic factors of progress-free survival (PFS) and overall survival (OS).

Results

The estimated 1-, 2-, and 3-year OS and PFS rates were 83.9%, 65.8%, 55.2% and 58.0%, 42.8%, 37.8%, respectively, for the entire cohort. The survival differences were significant in terms of OS and PFS when they were stratified by these inflammation-based indexes. The comparisons of AUROCs of these inflammation-based indexes illustrated that NLR and PI displayed highest prognostic value, compared to other indexes. When NLR and PI were combined, NLR-PI showed even higher AUROC values and was identified as a significant prognostic factor in terms of OS and PFS.

Conclusion

Specific inflammatory indexes, such as NLR, PLR and PI, were found to be able to predict the OS or PFS of patients. As a novel inflammatory index, the level of NLR-PI, which can be regarded as a more useful prognostic index, exhibited strong predictive power for predicting prognosis of patients with AC after PD procedure.
Metagenomic insights into the diversity of carbohydrate-degrading enzymes in the yak fecal microbial community
Authors: Gong Ga , Zhou Saisai , Luo Runbo , Gesang Zhuoma , Suolang Sizhu
Published: September 2020

Background: Yaks are able to utilize the gastrointestinal microbiota to digest plant materials. Although the cellulolytic bacteria in the yak rumen have been reported, there is still limited information on the diversity of the major microorganisms and putative carbohydrate-metabolizing enzymes for the degradation of complex lignocellulosic biomass in its gut ecosystem. Results: Here, this study aimed to decode biomass-degrading genes and genomes in the yak fecal microbiota using deep metagenome sequencing. A comprehensive catalog comprising 4.5 million microbial genes from the yak feces were established based on metagenomic assemblies from 92 Gb sequencing data. We identified a full spectrum of genes encoding carbohydrate-active enzymes, three-quarters of which were assigned to highly diversified enzyme families involved in the breakdown of complex dietary carbohydrates, including 120 families of glycoside hydrolases, 25 families of polysaccharide lyases, and 15 families of carbohydrate esterases. Inference of taxonomic assignments to the carbohydrate-degrading genes revealed the major microbial contributors were Bacteroidaceae, Ruminococcaceae, Rikenellaceae, Clostridiaceae, and Prevotellaceae. Furthermore, 68 prokaryotic genomes were reconstructed and the genes encoding glycoside hydrolases involved in plant-derived polysaccharide degradation were identified in these uncultured genomes, many of which were novel species with lignocellulolytic capability. Conclusions: Our findings shed light on a great diversity of carbohydrate-degrading enzymes in the yak gut microbial community and uncultured species, which provides a useful genetic resource for future studies on the discovery of novel enzymes for industrial applications.
Serious non-fatal unintentional injuries among in-school adolescents in Sri Lanka: results from the 2016 Sri Lankan Global School-Based Health Survey
Authors: Wickramasinghe Sashimali , Gunawardena Nalika , Punyadasa Dhanusha , Gunawardena Shanthi , Wickramasinghe Champika , Lokubalasooriya Ayesha , Peiris Renuka , Senanayake Sameera
Published: September 2020

Background Unintentional injuries among adolescents is a major public health problem the world over. A great majority of the annual deaths among adolescents is due to unintentional injuries; it is also the leading cause of death among adolescents in the world. The aim of this study was to estimate the incidence of injuries and their associated factors among school going adolescents aged 13-17 years using data from the most recent Global School-Based Health Survey (GSHS) conducted in Sri Lanka. Methods A cross-sectional survey was conducted using a self-administered questionnaire, among 3,262 adolescents attending government schools. The sample was selected through a two-staged cluster sampling technique. In the first stage, 40 schools were selected using probabilities proportional to school enrollment size, from all schools in the country that have classes in grades 8-12 . Then, from the selected schools, classes were selected using systematic equal probability sampling with a random start. The weighted prevalence was calculated, and logistic regression analysis was conducted in order to determine the correlates. Results During the 12 months before the survey, 35.8% (95% CI-30.7 - 41.1) of the students reported being seriously injured one or more times. The injuries were more common among males, but were equally common among the two different age groups (13-15 age group vs 16-17 age group). The most common type of injury was cut or stab wounds (5.5%), followed by broken bones/dislocated joints (5.3%). Multivariable analysis revealed that only a few factors were associated with injury, such as being of the male sex, being bullied, being physically attacked, and/or being in a physical fight. Conclusion This study demonstrated that the prevalence of serious unintentional injuries among school going adolescents is a major public health problem in Sri Lanka. This timely and comprehensive survey would help policy makers and researchers identify the unmet needs related to adolescent injuries. Furthermore, evidence generated form the study should be given due consideration when designing school-based interventions to prevent adolescent injuries.
Circulating Receptor Activator of Nuclear factor kB Ligand and triglycerides are associated with progression of lower limb arterial calcification in Type 2 Diabetes: a prospective, observational cohort study.
Authors: Bourron Olivier , Phan Franck , Diallo Mamadou Hassimiou , Hajage David , Aubert Carole-Elodie , Carlier Aurélie , Salem Joe-Elie , Funck-Brentano Christian , Kemel Salim , Cluzel Philippe , Redheuil Alban , Davaine Jean-Michel , Massy Ziad , Mentaverri romuald , Bonnefont-Rousselot Dominique , Gillery Philippe , Jaisson Stéphane , Vermeer Cees , Lacorte Jean-Marc , Bouziri Nesrine , Laroche Suzanne , Amouyal Chloé , Hartemann Agnès
Published: September 2020

Background: Lower limb arterial calcification is a frequent, underestimated but serious complication of diabetes. The DIACART study is a prospective cohort study designed to evaluate the determinants of the progression of lower limb arterial calcification in 198 patients with type 2 diabetes. Methods: Lower limb arterial calcification scores were determined by computed tomography at baseline and after a mean follow up of 31.20 +/-3.86 months. Serum RANKL (Receptor Activator of Nuclear factor kB Ligand) and bone remodeling, inflammatory and metabolic parameters were measured at baseline. The predictive effect of these markers on calcification progression was analyzed by a multivariate linear regression model. Results: At baseline, mean+/-SD and median lower limb arterial calcification scores were, 2364+/- 5613 and 527 respectively and at the end of the study, 3739 +/- 6886 and 1355 respectively. Using multivariate analysis, the progression of lower limb arterial log calcification score was found to be associated with (β coefficient [slope], 95%CI, p-value) baseline log(calcification score) (1.02, 1.00–1.04, p<0.001), triglycerides (0.11, 0.03–0.20, p=0.007), log(RANKL) (0.07, 0.02–0.11, p=0.016), previous ischemic cardiomyopathy (0.36, 0.15–0.57, p=0.001), statin use (0.39, 0.06–0.72, p=0.023) and duration of follow up (0.04, 0.01–0.06, p=0.004). Conclusion: In patients with Type 2 Diabetes, lower limb arterial calcification is frequent and can progress rapidly. Circulating RANKL and triglycerides are independently associated with this progression. These results open new therapeutic perspectives in peripheral diabetic calcifying arteriopathy.Trial registration: NCT02431234
Employment transitions for spouses of stroke survivors: Evidence from Swedish national registries
Authors: Persson Josefine , Hensing Gunnel , Bonander Carl
Published: September 2020

Background: The sudden occurrence of stroke often leads to impaired physical, emotional, and cognitive abilities. Many stroke survivors therefore require support from their family members. However, little is known about the effects of a stroke event on the spouses’ employment transition probabilities. The aim of this study was twofold 1) to investigate whether a first ever stroke has an effect on employment transition probabilities for employed and unemployed spouses and 2) to analyze whether heterogeneity with respect to age, gender, education and comorbidities influence the size of the effect. Method: Data for this population-based cohort study were extracted from Swedish national registries from 2005 to 2016. The national sample consisted of 1,818 spouses of first ever stroke survivors during 2010 and 2011, and 7,399 matched controls that were employed or unemployed during five years prior stroke onset. Effects of stroke on spousal employment transitions were analyzed using linear regression, stratified by employment status prior to stroke onset. Results: Employed spouses prior stroke onset reduced their employment by -1.3 percentage points (95% CI: -2.4, -0.2). The data also indicated that employed spouses with lower age, comorbid conditions, and low educational attainment may be at even greater risk of transitioning to unemployment. On the other hand, stroke events appear to have limited impact on spouses that were unemployed prior to stroke onset. Conclusion: The risk of transitioning to unemployment appears to increase after stroke onset for spouses of stroke survivors, and disadvantaged groups may be at even greater risk. Thus, it is important for policy-makers to implement interventions to ensure that these groups of spouses have the possibilities to combine their caregiving role and remaining in the labor market.
Evaluating the genetic effects of sex hormone traits on the development of mental traits: a polygenic score analysis and genome-wide genetic interaction analysis in UK Biobank cohort
Authors: Liang Xiao , Cheng ShiQiang , Ye Jing , Chu XiaoMeng , Wen Yan , Liu Li , Qi Xin , Jia YuMeng , Zhang Feng
Published: September 2020

Objective: To evaluate the genetic effects of sex hormone traits on the development of mental traits in middle-aged adults.Methods: The SNPs associated with sex hormone traits were derived from a two-stage genome-wide association study (GWAS). Four sex hormone traits were selected in the current study, including sex hormone-binding globulin (SHBG), testosterone, bioavailable testosterone and estradiol. The polygenic risk score (PRS) of sex hormone traits were calculated from individual-level genotype data of the United Kingdom (UK) Biobank cohort. We then used logistic and linear regression models to assess the associations between individual PRS of sex hormone traits and the frequency of alcohol consumption, anxiety, intelligence and so on. Finally, genome-wide genetic interaction study (GWGIS) was performed to detect novel candidate genes interacting with the sex hormone traits on the development of fluid intelligence and the frequency of smoking and alcohol consumption by PLINK2.0.Results: We observed positive association between SHBG and the frequency of alcohol consumption (b=0.0101, p=3.84×10–11) in middle-aged males and females. In addition, estradiol was positively associated with the frequency of alcohol consumption (b=0.0128, p=1,96×10–8), fluid intelligence (b=0.0084, p=1.90×10–2) and the frequency of smoking (b=0.0054, p=1.77×10–2) in middle-aged males. Moreover, SHBG was associated with the frequency of alcohol consumption (b=0.0067, p=2.60×10–3), fluid intelligence (b=0.0067, p=4.25×10–2) and anxiety (b=-0.0071, p=3.79×10–2) in middle-aged females. Finally, GWGIS identified one significant loci, Tenascin R (TNR) (rs34633780, p=3.45×10–8) interacting with total testosterone for fluid intelligence.Conclusion: Our study results support the genetic effects of sex hormone traits on the development of intelligence and the frequency of alcohol consumption in middle-aged adults in UK.
Non-contact restoration of missing parts of stone Buddha statue based on three-dimensional virtual modeling and assembly simulation
Authors: Jo Young Hoon , Hong Seonghyuk , Jo Seong Yeon , Kwon Yoon Mi
Published: September 2020

Three-dimensional (3D) digital technology is one of the most essential conservation methods that complements the traditional technique of the restoration of cultural artifacts. In this study, 3D scanning, virtual restoration modeling, and 3D printing were used as a non-contact approach for the restoration of a damaged stone seated Bodhisattva (stone Buddha statue). First, a three-dimensional model with an average point density of 0.2 mm was created by integrating the fixed high-precision scanning of the exterior and the handheld mid-precision scanning of the interior excavated hole. Through a 3D deterioration map of the stone Buddha statue, the area of the missing parts was measured as 400.1 cm 2 (5.5% of the total area). Moreover, 257.1 cm 2 (64.2% of the missing part area) of four parts such as the head, the surrounding area of the Baekho, the right ear, and the right eye, for which symmetry was applicable for modeling or there could be ascertainable historical evidence for the total missing parts, was selected for restoration. The virtual restoration of the missing parts of the stone Buddha statue was performed using a haptic modeling system in the following order. First, the location of the three fragments detached from the head was determined. Next, the reference model was selected, and its symmetrization and modification with respect to the original were conducted. Also, estimation modeling and outer shape description were performed through historical research and consultation with experts. The created virtual-restoration model’s (461 cm 3 ) heuristic-based assembly suitability was verified by design mock-up printing and digital–analog simulation. In particular, to address the assembly interference, the interface surface was modified and reprocessed several times. Accordingly, the final design mock-up’s volume size was decreased by 5.2% (437 cm 3 ). Photopolymerization 3D printing technology was used for the actual restoration of the stone Buddha statue and the layer thickness of the material used was set as 0.10 mm considering the surface roughness. Finally, the surface of the printed output was colored to prevent yellowing and joined to the missing part of the stone Buddha statue. This study presents a great case to shift from the traditional manual-contact method to the contactless digital method for the restoration of artifacts and is expected to largely contribute to increasing the usability of digital technologies in the restoration of cultural artifacts.
Transgenic and knockout analyses of Masculinizer and doublesex illuminated the unique functions of doublesex in germ cell sexual development of the silkworm, Bombyx mori
Authors: Yuzawa Tomohisa , Matsuoka Misato , Sumitani Megumi , Aoki Fugaku , Sezutsu Hideki , Suzuki Masataka
Published: September 2020

Background: Masculinizer (Masc) plays a pivotal role in male sex determination in the silkworm, Bombyx mori. Masc is required for male-specific splicing of B. mori doublesex (Bmdsx) transcripts. The male isoform of Bmdsx (BmdsxM) induces male differentiation in somatic cells, while females express the female isoform of Bmdsx (BmdsxF), which promotes female differentiation in somatic cells. Our previous findings suggest that Masc could direct the differentiation of genetically female (ZW) germ cells into sperms. However, it remains unclear whether Masc directly induces spermatogenesis of if it promotes male differentiation in germ cells indirectly by inducing the expression of BmdsxM. Results: In this study, we performed genetic analyses using a transgenic line that expressed Masc, as well as various Bmdsx knockout lines. Masc-expressing females express both BmdsxF and BmdsxM and have degenerated ovaries combined with testis-like tissues, which produce sperm. We found that Masc-expressing females with a homozygous mutation in BmdsxM showed normal development in ovaries. The formation of testis-like tissues was abolished in these females. In comparison, Masc-expressing females carrying a homozygous mutation in BmdsxF exhibited almost complete male-specific development in gonads and germ cells. These results suggest that BmdsxM can induce male development in germ cells and internal genital organs, while BmdsxF inhibits BmdsxM activity and represses male differentiation. To investigate whether MASC directly controls male-specific splicing of Bmdsx and identify RNAs that form complexes with MASC in testes, we performed RNA immunoprecipitation (RIP) using an anti-MASC antibody. We found that MASC formed a complex with AS1 lncRNA , which is a testis-specific factor involved in the male-specific splicing of Bmdsx pre-mRNA . Conclusions: Taken together, our findings suggest that Masc induces male differentiation in gonads and germ cells by enhancing the production of BmdsxM. Physical interaction between MASC and AS1 lncRNA may be important for the BmdsxM expression in the testis. Unlike Drosophila dsx, BmdsxM was able to induce spermatogenesis in genetically female (ZW) germ cells. To the best of our knowledge, this is the first report that the role of dsx in germ cell sexual development is different between insect species.
Connective tissue remodelling is differently modulated by Tocilizumab versus Methotrexate monotherapy in patients with early Rheumatoid Arthritis: the AMBITION study
Authors: Drobinski Patryk J. , Bay-Jensen Anne C. , Karsdal Morten A. , Sardar Samra , Siebuhr Anne S.
Published: September 2020

OBJECTIVEAssociations between Rheumatoid Arthritis (RA) and effect of treatment at the tissue levels are poorly understood. We investigated the scope of released extracellular matrix (ECM) metabolites as a consequence of tissue remodeling in patients treated with Methotrexate (MTX) and Tocilizumab (TCZ) compared to placebo.METHODSTissue metabolites from 387 RA patients treated with either TCZ (8 mg/kg) or MTX monotherapy (7.5-20 mg/kg) were measured at baseline and 8-weeks sera by validated ELISA assays. The levels of collagen biomarkers (C1M, C2M, C3M and C4M) together with C-reactive protein (CRP) and CRP metabolite (CRPM) were investigated. Baseline levels of biomarkers have been compared with 72 age and gender matched healthy controls. Comparison between treatment and response groups were done by ANCOVA, Spearman’s correlation and Logistic regression adjusted for age, gender, BMI and disease duration.RESULTSC1M and C3M, were significantly (P<0.05) inhibited by TCZ and C3M by MTX (P<0.01) compared to placebo. C1M and C3M inhibition with TCZ was respectively 23% and 16% greater than that of MTX (P<0.01 and P<0.0001). C4M was inhibited by TCZ and MTX, but the effect of TCZ was 22% greater than MTX (P<0.0001). TCZ and MTX had minimal effect on C2M levels. MTX had no effect on CRP and CRPM, whereas TCZ reduced their levels to 69% and 27% from baseline. Investigated biomarkers revealed a significant (P<0.05) differences in biomarker profiles of MTX ACR50 treatment responders and non-responders. Change to week 8 in levels of C3M, C4M, CRP and CRPM in MTX patients correlated significantly (rho=0.41 to 0.18, P<0.0001 to 0.039) with change in disease activity (DAS28) at week 8, 16 and 24, whereas only CRP in TCZ patients (rho=0.32 to 0.21, P<0.0001 to 0.01).CONCLUSIONPatients receiving TCZ treatment for 8 weeks had higher suppression of tissue remodeling and inflammatory biomarkers over patients treated with MTX. Measured biomarkers enabled for a discrimination of biomarker profiles of ACR50 treatment responding patients and identification of those who benefit at the early time-point. Week 8 change in levels of C3M, C4M, CRP and CRPM significantly predicted clinical response to treatment and correlated with DAS28 at all time-points.NAME OF THE REGISTRY: A Study to Assess the Safety and Efficacy of Tocilizumab in Patients with Active Rheumatoid ArthritisTRIAL REGISTRATION NUMBER: NCT00109408DATE OF REGISTRATION: JULY 2005URL OF TRIAL REGISTRY RECORD: https://clinicaltrials.gov/ct2/show/NCT00109408
Calcitonin gene related peptide monoclonal antibody treats headache in patients with active idiopathic intracranial hypertension
Authors: Yiangou Andreas , Mitchell James , Vijay Vivek , Grech Olivia , Bilton Edward , Lavery Gareth , Fisher Claire , Edwards Julie , Mollan Susan , Sinclair Alexandra
Published: September 2020

BackgroundHeadache is the dominant factor for quality of life related disability in idiopathic intracranial hypertension (IIH) and typically has migraine-like characteristics. There are currently no evidence-based therapeutics for headache in IIH, and consequently this is an important unmet clinical need.Case seriesWe report a series of seven patients in whom headaches were the presenting feature of IIH the headaches had migraine-like characteristics, as is typical in many IIH patients. Papilledema settled (ocular remission) but headaches continued. These headaches responded markedly to erenumab, a monoclonal antibody targeted against the calcitonin gene related peptide (CGRP) receptor. Of note, there was a recurrence of raised ICP, as evidenced by a return of the papilloedema, however the headaches did not recur whilst treated with erenumab.ConclusionsThose with prior IIH who have their headaches successfully treated with CGRP therapy, should remain under close ocular surveillance (particularly when weight gain is evident) as papilloedema can re-occur in the absence of headache. These cases may suggest that CGRP could be a mechanistic driver for headache in patients with active IIH.
Medical interns’ reflections on their training in use of personal protective equipment.
Authors: Barratt Ruth , Wyer Mary , Hor Su-yin , Gilbert Gwendolyn L
Published: September 2020

Background The current COVID-19 pandemic has demonstrated that personal protective equipment (PPE) is essential, to prevent the acquisition and transmission of infectious diseases, yet its use is often sub-optimal in the clinical setting. Training and education are important to ensure and sustain the safe and effective use of PPE by medical interns, but current methods are often inadequate in providing the relevant knowledge and skills. The purpose of this study was to explore medical graduates’ experiences of the use of PPE and identify opportunities for improvement in education and training programmes, to improve occupational and patient safety.Methods This study was undertaken in 2018 in a large tertiary-care teaching hospital in Sydney, Australia, to explore medical interns’ self-reported experiences of PPE use, at the beginning of their internship. Reflexive groups were conducted immediately after theoretical and practical PPE training, during hospital orientation. Transcripts of recorded discussions were analysed, using a thematic approach that drew on the COM-B (capability, opportunity, motivation - behaviour) framework for behaviour. Results 80% of 90 eligible graduates participated. Many interns had not previously received formal training in the specific skills required for optimal PPE use and had developed potentially unsafe habits. Their experiences as medical students in clinical areas contrasted sharply with recommended practice taught at hospital orientation and impacted on their ability to cultivate correct PPE use. Conclusions Undergraduate teaching should be consistent with best practice PPE use, and include practical training that embeds correct and safe practices.
Infiltration and Sealing for Managing Non-Cavitated Proximal Lesions: A Systematic Review and Meta-Analysis
Authors: Chen Yuanyuan , Chen Dongru , Lin Huancai
Published: September 2020

Background: Infiltration and sealing are micro-invasive treatments for arresting proximal non-cavitated caries lesions; however, their efficacies under different conditions remain unknown. This systematic review and meta-analysis aimed to evaluate the caries-arresting effectiveness of infiltration and sealing and to further analyse their efficacies across different dentition types and caries risk levels.Methods: Electronic databases (Cochrane Library, PubMed and Embase) were searched for published literature, and references were manually searched. Split-mouth randomized controlled trials (RCTs) to compare the effectiveness between infiltration/sealing and non-invasive treatments in proximal lesions were included. The primary outcome was obtained from radiographical readings. In total, 995 citations were identified, and 16 RCTs (21 articles) were included.Results: For subgroup analysis, infiltration and sealing reduced the odds of lesion progression (infiltration vs non-invasive: OR = 0.20, 95% CI: 0.15 to 0.29; sealing vs placebo: OR = 0.27, 95% CI: 0.18 to 0.41). For both primary and permanent dentitions, infiltration and sealing were more effective than non-invasive treatments (primary dentition: OR = 0.30, 95% CI: 0.20 to 0.45; permanent dentition: OR = 0.19, 95% CI: 0.13 to 0.27). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.19, 95% CI: 0.14 to 0.27). For patients with different risk levels, there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.23, 95% CI: 0.07 to 0.75; low to moderate risk: OR=0.38, 95% CI: 0.18 to 0.81; moderate to high risk: OR=0.17, 95% CI: 0.17 to 0.29; and high risk: OR=0.14, 95% CI: 0.07 to 0.26). Infiltration was superior to non-invasive treatments for patients at different caries risk levels (low risk: OR = 0.07, 95% CI: 0.02 to 0.22; low to moderate risk: OR=0.38, 95% CI: 0.18 to 0.81; moderate to high risk: OR=0.19, 95% CI: 0.09 to 0.38; and high risk: OR=0.14, 95% CI: 0.07 to 0.29).Conclusion: Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.
Earthquake hazard potential along the Panjal Thrust and the Zanskar Thrust, NW Himalaya
Authors: Bali Bikram Singh , Wani Ahsan Afzal
Published: September 2020

Kashmir basin is considered to be tectonically active where damaging earthquakes (historical and instrumental) and landslides have occurred. These geologic catastrophes make Kashmir valley prone to hazards. The fault bound Kashmir basin is marked by two mountain fronts: MF1 associated with the Panjal Thrust (PT) and Balapor Fault (BF) and MF2 associated with the Zanskar Thrust. These two structural units make Kashmir valley very susceptible to earthquakes. With this in view the whole basin was divided into 22 sub-basins. However only nine extreme north and south sub basins (five extreme southern and four northern extreme north) were studied to carry out relative tectonic activity of these two tectonic units. With the help of K-mean clustering of eight basin-related geomorphic indices (Hypsometric integral (Hi), Asymmetry factor (Af), Mountain front sinuosity (Smf), Basin shape (Circularity ratio (KA) and Elongation ratio (Eb)), Form factor (Ff), Bifurcation ratio (Rb) and Sinuosity index (Si) were calculated. The results of the geomorphic indices were correlated with the structural and seismic data after that they were grouped into low three (Class1), moderate (class2) and high (class3) relative tectonic activity zones based on the quantified geomorphic indices, earthquake data, structural data and field observations. The overall results infer the tectonic activity dies out towards the north of the Kashmir Valley. It was observed that the highest tectonic activity mostly corresponds to the sub basins in vicinity of the PT and BF stretching 100 Km from Shopian to Baramulla. The least tectonic activity was found to be associated with the ZT lying to the north and northeast part of the Kashmir Valley. The seismic frequency and the overall data analysis infer that the south and Southwestern side of the Kashmir has potential of moderate earthquake in future.
Land Management Criteria For Green Building Certification Systems In Turkey
Authors: Erdede Bilge , Bektaş Sebahattin
Published: September 2020

Background: The energy issue is of great importance for energy dependent countries like Turkey. Some legislative regulations such as the Energy Efficiency Law and the Energy Performance Regulation of Building have recently been made in our country. Although the Energy Performance Certificate for buildings has been put into practice , a national green building certification system is not available yet. The most widely used certification systems in the world are BREEAM (Bre Environmental Assessment Method) and LEED (Leadership in Energy and Environmental Design), which do not produce very realistic results. Therefore, it is essential to establish a national certification system. For this purpose, studies have been started by ÇEDBİK (the Turkish Green Building Council) and Mimar Sinan Fine Arts University (MSFAU). However, it has not yet been legally validated.Methods: In this study, a survey was conducted to highlight the importance of the category of land management, one of the criteria of the green building certification systems, and to identify sub-criteria under this title more objectively. Worldwide valid certification systems and parts of the certification systems regarding land management that are tried to be established in Turkey were examined to determine the survey questions and in line with this, a literature review was performed. The experts in Turkey were interviewed to gather ideas and insights. By listing the answers from these experts using the AHP method, the criteria and sub-criteria of land method were determined.Conclusions: In this study, a green building certification system to be established in our country was discussed under the category of land management to which great importance has been attached, especially by survey engineers, and the criteria under this category has been identified. A survey was conducted to determine these criteria, and the results were examined.The subcriteria of the category of land management were identified, and their weights were calculated. A sample program was written in the Microsoft Visual Studio Net 2013 programming language to determine the scores of buildings according to these weights.
Visualizations of SARS-CoV-2 Genomes on Genomic Index Maps
Authors: Zheng Jeffrey , Zhu Minghan , Qiao Mu , Zhou Yang
Published: September 2020

In this paper, comprehensive cases are visualized by {C1, C2, C3, C4} four modules of the MAS. Four sets of SARS-CoV-2 genomes with 20, 128, 381 and 1337 cases were processed to be represented as a series of genomic index maps in four entropies: combinatorial, integrated, mean and topological entropies, respectively. Typical samples and explanations are described. Multiple levels of hierarchical representations are illustrated.
Coagulation Factor XII protects neurons from apoptosis by triggering a crosstalk between HGFR/c-Met and EGFR/ErbB1 signaling pathways
Authors: Garnier Eugénie , Levard Damien , Ali Carine , Hommet Yannick , Crepaldi Tiziana , Comoglio Paolo , Rubio Marina , Vivien Denis , Lizarrondo Sara Martinez de , Docagne Fabian
Published: September 2020

Background Factor XII (FXII) is a serine protease that participates in the intrinsic coagulation pathway. Several studies have shown that plasmatic FXII exert a deleterious role in cerebral ischemia and traumatic brain injury by promoting thrombo-inflammation. Nevertheless, the direct impact of FXII on neuronal cell fate remains unknown.Methods We investigated whether FXII influenced neuronal death induced in vivo by stereotaxic injection of N-methyl-D-Aspartate (NMDA) and in vitro by serum deprivation of cultured neurons.Results We found that FXII reduced brain lesions induced in vivo and protected cultured neurons from apoptosis through a growth factor-like effect. This mechanism was triggered by direct interaction with epidermal growth factor (EGF) receptor, activation of this receptor and engagement of anti-apoptotic intracellular pathways. Interestingly, the “proteolytically” active and two-chain form of FXII, αFXIIa, exerted additional protective effects by converting the pro-form of hepatocyte growth factor (HGF) into its mature form, which in turn activated HGF receptor (HGFR/c-Met) pathway. Lastly, the use of non-proteolytic FXII (αFXIIa-PPACK) unveiled an alternative EGFR and HGFR co-activation pathway, through co-receptor transphosphorylation. Conclusion This study describes novel mechanisms of action of FXII and discloses neurons as target cells for the protective effects of single and double-chain forms of FXII.
Human airway organoids model SARS-CoV-2 high infectiousness and evasion of interferon response
Authors: Zhou Jie , Chiu Man Chun , LI Cun , Liu Xiaojuan , Zhao Xiaoyu , Wang Dong , Wei Yuxuan , Chu Hin , Cai Jian-Piao , Yip Cyril Chik-Yan , Poon Vincent , Chan Ivy , Wong Kenneth Kak-Yuen , Chan Jasper Fuk-Woo , Chen Zhiwei , Chen Honglin , Clevers Hans , Yuen Kwok-Yung
Published: September 2020

SARS-CoV-2 is more infectious and transmissible in humans than SARS-CoV, despite the genetic relatedness and sharing the same cellular receptor. We sought to assess whether human airway organoids can model SARS-CoV-2 infection in the human airway and elucidate the cellular basis underlying its higher transmissibility. We demonstrate that SARS-CoV-2 can establish a productive infection in human airway organoids, in which ciliated cell and basal cell are infected. Wildtype SARS-CoV-2 carrying a furin cleavage motif exhibits comparable replication kinetics to a mutant virus without the motif. Human airway organoids sustain higher replication of SARS-CoV-2 than SARS-CoV, whereas interferon response is more potently induced in the latter than the former. Overall, human airway organoids can model SARS-CoV-2 infection and recapitulate the disposable role of furin cleavage motif for virus transmission in humans. SARS-CoV-2 stealth growth and evasion of interferon response may underlie pre-symptomatic virus shedding in COVID-19 patients, leading to its high infectiousness and transmissibility.
Ten- Year-Old Female with Dieulafoy Lesion Treated with Therapeutic Endoscopy And Literature Review
Authors: Chen Ying , Sun Mei , Teng Xu
Published: September 2020

Background There are many causes of sudden gastrointestinal bleeding in children, Dieulafoy lesion is very rare. This vascular abnormality can be fatal without appropriate treatment.Case presentation Retrospective analysis of the clinical manifestations, endoscopic features and treatment of a Chinese child with Dieulafoy lesion and review relevant literatures.Result A 10-year-old girl was admitted to hospital with sudden massive hematemesis and melena. Abdominal CT revealed suspected submucosal bleeding in the stomach. Finally the disease was diagnosed due to the typical manifestations with endoscopy. Meanwhile, we used electrocoagulation and hemoclips to hemostasis under endoscopy. No recurrence of hematemesis identified during the 4-weeks follow-up.Conclusion Dieulafoy lesion in children is rare cause of sudden gastrointestinal hemorrhage. But differential diagnosis cannot ignore it. Endoscope is the optimize choice for diagnosis and treatment.
Comparative Transcriptome Analysis of NaCl and KCl Stress Response in Malus Hupehensis Rehd. Provide Insight Into the Regulation Involved in Na+ and K+ Homeostasis
Authors: Li Yuqi , Zheng Xiaodong , Tian Yike , Ma Changqing , Yang Shaolan , WANG CAIHONG
Published: September 2020

Background: Apple is among the most widely cultivated perennial fruit crops worldwide. It is sensitive to salt stress, which seriously affects the growth and productivity of apple trees by destroying the homeostasis of Na+ and K+. Previous studies focused on the molecular mechanism underlying NaCl stress. However, signaling transduction under KCl stress has not been thoroughly studied. Results: We comprehensively analyzed the salt tolerance of Malus hupehensis Rehd., which is a widely used rootstock in apple orchards, by using RNA-Seq. Roots and leaves were treated with NaCl and KCl. Based on mapping analyses, a total of 762 differentially expressed genes (DEGs) related to NaCl and KCl stress in the roots and leaves were identified. The Gene Ontology (GO) terms were enriched in ion transmembrane transporter and oxidoreductase activity under NaCl and KCl stress. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways focused on the plant hormone signal transduction and mitogen-activated protein kinase signaling pathway. We also screened out 28 candidate genes from 762 DEGs and verified their expression by quantitative reverse transcription polymerase chain reaction (qRT-PCR). All of these enriched genes were closely related to NaCl and KCl stress and take part in mediating the Na+ and K+ homeostasis in M. hupehensis. Conclusions: This transcriptome analysis provides a valuable resource for elucidating the signaling pathway of NaCl and KCl stress and is a substantial genetic resource for discovering genes related to the NaCl and KCl stress response of M. hupehensis.
Nasal carriage rate, antimicrobial susceptibility patterns and associated risk factors of methicillin-resistant Staphylococcus aureus among prisoners in Dessie town, Northeast Ethiopia
Authors: Mamo Getinet , Belachew Teshome , Ferede Getachew
Published: September 2020

Background

The prevalence of Methicillin-resistant S. aureus (MRSA) within the general public has caused outbreaks in groups of people in close quarters such as military barracks, gyms, day care centres and correctional facilities. Correctional facilities are of particular importance for spreading MRSA, as inmates are often in close proximity and have limited access to hygienic products and clean clothing. In Ethiopia, there is a limited number of studies about methicillin-resistant S. aureus in the prison setting. Therefore, this study aimed to determine nasal carriages rate, antimicrobial susceptibility patterns, and associated risk factors of MRSA among prisoners in Dessie town, Northeast Ethiopia.
Methods

An institution-based cross-sectional study was conducted from January 1 to March 30/2020 on 329 prisoners. Nasal swabs were collected and processed on blood agar and Mannitol salt agar plates. The isolates were identified as S. aureus based on morphology, coagulase test, and mannitol salt agar fermentation. Disk diffusion antibiotic susceptibility tests were performed according to the guidelines of the Clinical and Laboratory Standards Institute. Methicillin-resistance by S. aureus was confirmed by using cefoxitin (30 µg). Data entry and statistical analysis was done using SPSS Version 20.
Results

Out of the 329 prisoners, 115(35%) carried S. aureus, of which 35/115 (30.4%) were MRSA. Therefore, 10.64% of all prison inmates were identified as MRSA carriers. MRSA carriage rate was highest among the age groups of 24–34 and 35–45, which was 12 (34.3). Penicillin showed the highest rate of resistance among MRSA and MSSA isolates (100%). The multi-drug resistance rate was very high (50.4%). Among 115 S. aureus isolates, about 2(7.4%) showed inducible Clindamycin resistance.
Conclusion

The high rate of nasal MRSA carriage among prisoners found in this study is alarming and highlights the need for adjusted infection control measures to prevent MRSA transmission within inmates or to the community during their discharge.
Evidence for complex fixed points in pandemic data
Authors: Cacciapaglia Giacomo , Sannino Francesco
Published: September 2020

Epidemic data show the existence of a region of quasi-linear growth (strolling period) of infected cases extending in between waves. We demonstrate that this constitutes evidence for the existence of near time-scale invariance that is neatly encoded via complex fixed points in the epidemic Renormalisation Group approach. As a result we achieve a deeper understanding of multiple wave dynamics and its inter-wave strolling regime. Our results are tested and calibrated against the COVID-19 pandemic data. Because of the simplicity of our approach that is organised around symmetry principles our discovery amounts to a paradigm shift in the way epidemiological data are mathematically modelled.
Genomic and multi-tissue proteomic integration for understanding the biology of disease and other complex traits
Authors: Cruchaga Carlos , Yang Chengran , Farias Fabiana Geraldo , Ibanez Laura , Sadler Brooke , Fernandez Maria Victoria , Wang Fengxian , Bradley Joseph , Eiffert Brett , Bahena Jorge , Budde John , Li Zeran , Dube Umber , Sung Yun Ju , Mihindukulasuriya Kathie , Morris John , Fagan Anne , Perrin Richard , Benitez Bruno , Rhinn Herve , Harari Oscar
Published: September 2020

Understanding the tissue-specific genetic architecture of protein levels is instrumental to understand the biology of health and disease. We generated a genomic atlas of protein levels in multiple neurologically relevant tissues (380 brain, 835 cerebrospinal fluid (CSF) and 529 plasma), by profiling thousands of proteins (713 CSF, 931 plasma and 1079 brain) in a large and well-characterized cohort. We identified 274, 127 and 32 protein quantitative loci (pQTL) for CSF, plasma and brain respectively. cis-pQTL were more likely to be shared across tissues but trans-pQTL tend to be tissue-specific. Between 44% to 68.2% of the pQTL do not colocalize with expression, splicing, methylation or histone QTLs, indicating that protein levels have a different genetic architecture to those that regulate gene expression. By combining our pQTL with Mendelian Randomization approaches we identified potential novel biomarkers and drug targets for neurodegenerative diseases including Alzheimer disease and frontotemporal dementia. Here we present the first multi-tissue study yielding hundred of novel pQTLs. This data will be instrumental to identify the functional gene from GWAS signals, identify novel biological protein-protein interactions, identify novel potential biomarkers and drug targets for complex traits.