bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Pv-aCO2 gradient and Pv-aCO2/Ca-vO2 ratio during Cardiac Surgery
Authors: Bouchacourt Juan Pablo , Hurtado Francisco Javier , Kohn Eduardo , Illescas Laura , Dubin Arnaldo , Riva Juan
Published: June 2020

Background. Arterial lactate, mixed venous O2 saturation and parameters derived from CO2 metabolism as the venous minus arterial CO2 partial pressure (Pv-aCO2) gradient and the ratio between this gradient and the arterial minus venous oxygen content (Pv-aCO2/Ca-vO2) were proposed as markers of tissue hypoperfusion and oxygenation. The main goals were to characterize their physiologic determinants of Pv-aCO2 difference, and the Pv-aCO2 /Ca-vO2 ratio and the interchangeability of the variables calculated from mixed and central venous samples. Methods. We made a sub-analysis of 35 cardiac surgery patients included in a previous investigation database. Parameters were measured or calculated: after anesthesia induction (T1), end of cardiac surgery (T2), and at 6-8 hours intervals after ICU admission (T3 and T4). Results. Macrohemodynamics was characterized by increased cardiac index and low systemic vascular resistances, after surgery (p<0.05). Hemoglobin, arterial pH, lactate, and systemic O2 metabolism showed significant but transient changes during the study (p<0.05). Pv-aCO2 remained high and without changes along the study, and Pv-aCO2/Ca-vO2 was also high and only decreased at T4 (p<0.05). A weak but significant correlation was observed both, globally and at each time interval, between Pv-aCO2 or Pv-aCO2/Ca-vO2 with factors that may affect the CO2 hemoglobin dissociation. Using a similar approach, a multilevel linear regression model with Pv-aCO2 and Pv-aCO2/Ca-vO2 as outcome variables showed a significant association for Pv-aCO2 with mixed venous O2 saturation (SvO2), and base excess (BE) (p<0.05), while Pv-aCO2/Ca-vO2 was significantly associated with Hb, SvO2 , and BE (p<0.05) but not with cardiac output. Measurements and calculations from mixed and central venous blood were not interchangeable. Conclusions. Since Pv-aCO2 and Pv-aCO2/Ca-vO2 could be influenced by different factors that affect the CO2 dissociation curve, these variables should be considered with caution during the hemodynamic management of cardiac surgery patients. Finally, central venous and mixed values were not interchangeable.
Prevalence of Depression among HIV Positive Adults on Anti-Retroviral Therapy in O.R. Tambo, Eastern Cape, South Africa: A cross-sectional descriptive study
Authors: Zimasa Dlulane Yola , Teke Apalata , Abaver Dominic Targema
Published: June 2020

Background Living with HIV/AIDS is associated with negative emotional and bodily symptoms; however, there is paucity of data on the prevalence and associated factors depression among this population. This study investigate the prevalence and factors contributing to depression among HIV patients on anti-retroviral therapy (ART) in O.R. Tambo Eastern Cape, South Africa. Method This cross-sectional descriptive study involve 334 adults receiving ART in the two Community Health Centers in OR Tambo District, Eastern Cape, South Africa. The Beck’s Depression Inventory (BDI-II) was used to collect data, in addition to a semi-structured questionnaire on coping mechanism and challenges in seeking help with depressive symptoms. Multiple logistic regression analysis were used to assess the factors associated with depression among the HIV patients. Results The prevalence of depression among the HIV patients receiving ART was 44%, and the majority of the patient’s depression fall within the borderline and moderate threshold. The prevalence of depression was significantly highest among females (71.0%; p < 0.0003) and unemployed (73.0%; p < 0.0014) HIV patients. Participants not benefiting from any form of social grant exhibited higher prevalence of depression (79%). Race (p=0.590), age (p=0.338) and married participants (p=0.511) show no statistical significant association between HIV and depression. Unadjusted logistic regression model show being female (OR = 1.99, 95% CI: 1.23-3.23; p < 0.003) and unemployed (OR =1.73, 95% CI: 1.08-2.77; p < 0.014) were significantly associated with a likelihood of depression. Majority of the participants who could express their feelings of HIV disease and challenges in accessing ART felt more depressed (85%) compared to those who could not express their feelings. Conclusion The rate of depression among HIV/AIDS patients receiving ART is high. Early detection of depression and the challenges associated with accessing treatment and treating would help in improving the compliance to treatment as well as quality of life.
ZSCAN25 and CYP2E1 Polymorphisms is Risk Factors for Ischemic Stroke in a Chinese Han Population: A Case Control Study
Authors: Yuan Haozheng , Fan Pei , Yao Li , Lv Yuying , Wei Haidong , Zheng Juan , Han Xinsheng
Published: June 2020

Background: We aimed to explore the relationship between ZSCAN25 and CYP2E1 polymorphisms and Ischemic stroke (IS) susceptibility among a Chinese Han population.Methods: We enrolled 477 patients with IS and 480 age- and sex- matched health controls. Genotyping of the ZSCAN25 rs10242455, CYP2E1 rs2070672 and rs2515641 were performed by Agena MassARRAY platform. Odds ratio (OR) and 95% confidence interval (CI) were calculated by logistic regression analysis.Results: Rs10242455 (OR = 0.56, 95% CI: 0.34–0.93, p = 0.024) was associated with a reduced IS susceptibility, while rs2070672 (OR = 1.40, 95% CI: 1.12–1.75, p = 0.003) and rs2515641 (OR = 1.29, 95% CI: 1.01–1.64, p = 0.041) with an increased IS occurrence. Rs2070672 was observed to correlate with IS risk (OR = 4.06, p = 0.038) at age > 64 years, and rs10242455 (OR = 0.45, p = 0.021) and rs2070672 (OR = 3.28, p = 0.024) affected IS risk in males. In addition, rs10242455 (OR = 1.72, p = 0.014) was significantly associated with hypertension in IS patients.Conclusion: Our study firstly found that rs10242455 in ZSCAN25, rs2070672 and rs2515641 in CYP2E1 were associated with the occurrence of IS in a Chinese Han population.
Comparative Evaluation of the Diagnostic Performance Characteristics of a One-Step Urine Malaria Test (UMT) against Rapid Diagnostic Tests (RDT) in Febrile Patients from Fako Division, Cameroon
Authors: Awah Nforbugwe Achu Che , Nchotu Rengerline Bihnwi , Bongah Agnes Djema , Assob Jules Clement Nguedia
Published: June 2020

Background : Presently, all malaria diagnostic methods like: microscopy and Rapid Diagnostic Tests (RDT) are invasive as they depend on blood samples for malaria diagnosis. Hence this study was aimed at comparing the diagnostic performance characteristics of the novel Urine Malaria Test (UMT) to the currently used Blood RDT, and to find out the efficacy of this UMT in detecting low parasitaemia in the study population. Methodology : A cross sectional study involving 200 febrile participants, with no signs and symptoms of rheumatoid arthritis and kidney diseases, no history of hematuria, >15/µl leucocytes and urobilinogens of > 1 mg/dl in their urine, were recruited from the month of April to August 2017 in the Limbe and Buea Regional Hospitals. The main samples requested for analyses were urine and blood. Results : Using the blood smear microscopy as standard, out of the 200 participants, 93 (46.5%) were positive for P . malaria. UMT had a sensitivity and specificity of 82.41% and 83.48 while that of RDT was 84.09% and 83.03 respectively falciparum (CI: 72.80 to 92.05%, Kappa 0.665, p =0.001). The UMT had a lowest limit of detection of 140 parasites/μl which was similar to RDT. The PPV and NPV of UMT and RDT were (81.74% and 85.98%) and (80.04% and 87.28%), respectively. There was a close agreement between the RDT and UMT when compared to microscopy (83.5% and 83.0% respectively). Conclusion : The UMT kit that was evaluated in comparison to the blood based RDT, showed a lot of similarities using the blood smear microscopy as gold standard. Hence, it can be recommended for the prompt and accurate diagnosis of malaria in febrile patients.
Model Predicted Distribution of PM2.5 Exposure-Related Health Effects from Marcellus Shale Gas Development in Pennsylvania, 2005-2017
Authors: Banan Zoya , Gernand Jeremy M.
Published: June 2020

BackgroundDevelopment of Marcellus shale gas in recent years has turned into a public concern due to air quality changes and associated health impacts caused by emissions from shale gas development. Controlling standards and regulations were devised to provide health protection from exposure to such emissions, but health impact incidences have been reported in the areas where shale gas activities were prevailing. This study estimates the changes in expected health impacts associated to fine particulate matter (PM2.5) emissions from shale gas development in Pennsylvania between 2005 and 2017.MethodsThe change in incidence rates is estimated using a Gaussian plume model to simulate PM2.5 concentrations over time and distance and a health risk model to calculate the relative risk of exposure associated with different concentration levels.ResultsSimulation results indicate that PM2.5 emissions from shale gas development could increase the incidence of health outcomes at specific locations over the studied timespan and in case of asthma, this increase could be as high as 20,411 persons over 13-years.ConclusionThis study identifies the areas in Pennsylvania where more health risk assessment could be prioritized. An effective health-governing regulation should account for level of development activities as well as spatial characteristics (i.e., climate and population) of their vicinity to successfully provide health protection from air pollutants caused by shale gas development.
Predictive Model for Oral Mucositis of Nasopharyngeal Carcinoma Patients Receiving Chemo-radiotherapy
Authors: Li Peijing , Li Kaixin , Lin Huaming , Fang Jiaben , Yang Shuangyan , Shen Wei , Chen Jia , Zhang Jiang , Chen Xiaozhong , Hu Qiaoying , Tian Ye , Chen Ming , Chen Yuanyuan
Published: June 2020

Purpose To analyze risk factors for severe acute oral mucositis of nasopharyngeal carcinoma patients (NPCs) receiving chemo-radiotherapy and build predictive models.Methods 270 NPCs receiving radical chemo-radiotherapy were included. Oral mucosa structure was contoured by oral cavity contour (OCC) and mucosa surface contour (MSC) methods. Oral mucositis during treatment was divided into severe mucositis group (grade 3) and non-severe mucositis group (grade = 1, 2) according to RTOG criteria. Statistical analyses were completed by IBM SPSS Statistics 25.0 and IBM SPSS Modeler 18.0.ResultsIntermediate to high Vx (%) were strongly associated with severe oral mucositis (V40-V70(%)). Multivariate analysis showed that V55 (%) was the most important predictor for severe oral mucositis followed by overweight and retropharyngeal lymph node region irradiation (RLN). Two predictive models were built based on these two methods. AUC of OCC and MSC based model in training set were 0.786 both. Higher AUC of MSC-base model was observed in validation set when compared to OCC (0.721 vs. 0.622). Conclusion Dosimetric parameter is the most important predictive factors for severe oral mucositis in nasopharyngeal carcinoma patients during chemo-radiation. Of the two models generated in this study, performance of MSC-based model in validation data is mildly better than OCC.
Determining the Necessity of Applying N and P Fertilizer in a Mature Subtropical Torreya Grandis Orchard
Authors: Han Yini , Wang G.Geoff , Wu Tonggui , Ji Yongliang , Chen Wenjing , Jin Songheng
Published: June 2020

Background In managed orchards, fertilizer treatments facilitate both high productivity and environmental pollution. Because economic profit takes priority over environmental cost, increasing amounts of chemical nitrogen and phosphorus fertilizer have been used in mature subtropical Torreya grandis orchards. However, given the magnitude of global nitrogen deposition, it’s worth considering whether heavy fertilizer treatment is necessary.Methods To elucidate the balance between T. grandis nutrient demands and the fertilizer supply, we determined the C, N, and P foliar and soil concentrations ([C], [N], [P]) at five orchards undergoing long-term varied intensity fertilizer treatments.Results After documenting the dynamic variation of available plant nutrients and the corresponding resorption efficiency, we found that increasing the fertilizer supply elevated foliar [P], yet foliar [C] and [N] remained stable. Because T. grandis was already equipped with a high nutrient content, the increased foliar [P] levels decreased C:P and N:P ratios. These results demonstrate that extra fertilizer in the N-saturated environment disturbs P-limitation. Furthermore, we also found that fertilizer supply failed to improve carbon accumulation, which in addition to soil nutrient content and leaf [P], highly impacted productivity.Conclusions Thus, based on the results of this study, there are ample reasons to propose rejecting N addition in the present orchards, and we recommend organic management as a more conducive method to realize sustainable development.
Multidisciplinary approach to acute cholecystitis in a severely cardiopathic patient. Case report and review of literature
Authors: Pantalone Desire , Alemanno Giovanni , Stefàno PierLuigi , Pace Stefano Del , Romagnoli Stefano , Boninsegni Paolo , Maltinti Gherardo , Bruscino Alessandro , Bergamini Carlo , Martellucci Jacopo , Bonacchi Massimo , Talamucci Luca , Mondaini Francesco , Prosperi Paolo
Published: June 2020

Background. Acute cholecystitis in severely cardiopathic patient after major cardiac surgery represent a challenge for surgeons. Treatment with cholecystostomy could represent a chance for patients even if there are many topics of greatest debate about it: the technique of performing it (if transhepatic or transpapillary), the timing of optimal duration, the timing of drain removal, the need of further examinations before the removal as well as the timing for definitive surgery. We therefore deemed important to share our experience in the treatment of acute cholecystitis in a severe cardiopathic patient, while attempting to clarify all the major topics related to the management of percutaneous cholecystostomy through a literary review.Case presentation. A 58-year-old severly cardiopathic patient who had undergone surgery for hip replacement, developed an acute calcolous cholecystitis a few days after surgery to resolve which a percutaneous cholecystostomy was the chosen strategy. Two weeks after discharge, a cholangiography through the cholecystostomy and a MRI cholangiopancreatography revealed the presence of stones in the cystic duct and in the ductus choledochus. The definitive treatment was decided after consulting with a multidisciplinary team. An open cholecystectomy with simultaneous removal of the cholecystostomy, endoscopic removal of stones and sphincterotomy of the Oddi papilla was performed. The patient is currently healthy and his heart function is satisfactory. Conclusion. Although early cholecystectomy is the recommended choice for acute cholecystitis, a critically ill patients may benefit from a bridging therapy before definitive surgery. The multidisciplinary approach provided a safer solution for this frail patient.
Solitary mucosal neuroma in the maxillary incisor gingival papilla without multiple endocrine neoplasia type 2B (MEN 2B): a case report and literature review
Authors: Qiu Che , Wang Lizhen , Chen Huiwen , Song Zhongchen
Published: June 2020

Background

Mucosal neuroma (MN) is a benign neural tumor of peripheral nerves histologically characterized by irregular tortuous bundles of nerve cells with prominent perineurium that lie scattered throughout the submucosa. The tumor is usually associated with the multiple endocrine neoplasia type 2B (MEN 2B) but rarely occurs without the other components of MEN 2B. We present a case of solitary MN without MEN 2B that occurs in the maxillary incisor gingival papilla that has not been reported yet and review the literature.
Case presentation:

A 29-year-old woman presented to our outpatient department with an upper anterior teeth gingiva painless mass for 2-year. Intraoral examination revealed a small, tough, basal wide, well-defined mass in the labial gingival papilla between maxillary central incisor. Excisional biopsy showed that it was characterized by nerve bundles in various sizes surrounded by normal connective tissue in the submucosa under HE staining; Immunohistochemically, the mass showed strongly positive staining of S-100 protein, NSE,NF and weakly positive of EMA. The Laboratory examination and ultrasonography showed no signs of MEN 2B. In the first 6 months of follow-up, there was no evidence of recurrence and other components of MEN 2B. The patient was asymptomatic and she is still being followed up every 6 months. Based on these features, the lesion was finally diagnosed as a solitary gingival MN.
Conclusions

This study showed a rare solitary MN in the gingiva papilla without MEN 2B that has not been reported yet. The histopathological evaluation can be helpful in the differential diagnosis of MN. It is hoped that a greater understanding of solitary MN without MEN 2B in the oral cavity will avoid potential misdiagnosis, and contribute to determining the correct management, which appears to be complete surgical excision with close follow-up for recurrence and other components of MEN 2B surveillance.
Spared nerve injury causes sexually dimorphic mechanical allodynia and differential gene expression in spinal cords and dorsal root ganglia in rats
Authors: Ahlström Fredrik H.G. , Mätlik Kert , Viisanen Hanna , Blomkvist Kim B. , Liu Xiaonan , Lilius Tuomas , Sidorova Yulia , Kalso Eija Anneli , Rauhala Pekka V.
Published: June 2020

BACKGROUND Neuropathic pain (NP) is more prevalent in women. However, females are under-represented in animal experiments, and the mechanisms of sex differences remain inadequately understood. Using the spared nerve injury (SNI) model in rats, we characterized sex differences in behaviour, analysed dorsal root ganglion (DRG) and spinal cord (SC) tissues with transcriptomics and immunohistochemistry assays, and examined the proteome of cerebrospinal fluid (CSF). METHODS The study comprised two experiments, with male and female Sprague-Dawley rats subjected to SNI- and sham-surgeries. Mechanical and cold allodynias were assessed using von Frey filaments and the acetone test, respectively. Samples were extracted on Day 21 for CSF proteome and DRG and SC analysis for neuronal markers (IB4 and CGRP) and glial cell markers (IBA1 and GFAP), respectively, in Experiment I. Lumbar 4-5 DRGs and SC segments were collected for RNA-seq analysis on Day 7 in Experiment II. Differential gene expression in DRG and SC was calculated using DESeq2, and pathway analyses were conducted using iPathwayguide. RESULTS Females developed stronger mechanical allodynia in both experiments. Equivalent decreases in CGRP and IB-4 positive cell counts in DRG and increases in glial cells markers in the SC were seen in both sexes. No CSF protein showed change following SNI in any group. RNASeq of DRG and SC showed abundant changes in gene expression. Sexually dimorphic responses were found in genes related to T-cells (cd28, ctla4, cd274, cd4, prf1), other immunological responses (dpp4, c5a, cxcr2 and il1b), neuronal transmission (hrh3, thbs4, chrna4 and pdyn), plasticity (atf3, c1qc and reg3b), and others (bhlhe22, mcpt1l, trpv6). Analyses of biological processes revealed differences in T and B cell functions in DRG and neuronal processes in both DRG and SC. CONCLUSIONS We observed significantly stronger mechanical allodynia in females and many sexually dimorphic changes in gene expression, following SNI in rats. Several genes have previously been linked to NP, while some are novel. Our results suggest gene targets for further studies in the development of new, possibly sex-specific, therapies for NP and underline the importance of investigating NP in both sexes.
Unmet Needs and Quality of Life of Caregivers of Korean Breast Cancer Survivors: A Cross-Sectional Study
Authors: Lee Jong Won , Lee Jihyoun , Lee Min Hyuk , Lee Se Kyung , Kim Wan Sung , Jung So-Youn , Kim Zisun , Lee Juhyung , Youn Hyun Jo
Published: June 2020

Backgroud: As the survival rates of cancer patients have been increasing due to early diagnosis and technological advances in treatment, their caregiver burden has also emerged as an important issue. In view of this situation, this study aims to investigate the unmet needs and quality of life of caregivers of Korean breast cancer survivors.Methods: A multicenter cross-sectional interview survey was performed among 160 caregivers of Korean breast cancer survivors. Caregivers who gave written informed consent to participate completed the Comprehensive Needs Assessment Tool for Cancer Caregivers and EuroQol-5 Dimensions. Data were analyzed using the t-test, ANOVA and multiple regression analysis.Results: The mean age of the caregivers was 46.4 years, 44.4% (71/160) were spouses of patients, and 52.5% (84/160) were personally taking care of cancer survivors. Unmet needs were highest in the ‘healthcare staff’ domain (mean ± SD: 1.69 ±1.11), and the item with the highest level of unmet needs was ‘needed information about the current status of the patient’s illness and its future courses’ (1.98 ± 1.04). Unmet needs were correlated with age, educational level, marital status, employment, religion and psychosocial status. Poorer quality of life was closely related to higher levels of unmet needs. In multiple regression analysis, age, employment, religion, and levels of stress and despair were closely associated with unmet needs.
Tick Distribution and Detection of Babesia and Theileria Species in the East and South regions of Kazakhstan
Authors: Sang Chunli , Yang Meihua , Xu Bin , Liu Guangyuan , Yang Yicheng , Makhatov Bolatkhan , Hazihan Wurelihazi , Hornok Sándor , Wang Yuan-Zhi
Published: June 2020

Background: Piroplasmosis, caused by Theileria and Babesia species, is an economically important tick-borne disease worldwide. However, little is known about the presence of Babesia spp. and Theileria spp. in ticks from different host species in Kazakhstan. Method: We collected adult ticks at 26 sampling sites in 16 districts in the East and South regions of Kazakhstan during 2016 - 2019. Tick species were identified according to morphological and molecular characteristics. Two fragments of the 18S ribosomal RNA (18S rRNA) were used to determine the species of piroplasms. The genotype characteristics of Babesia caballi and Theileria equi were analyzed further. Results: A total of 6107 adult ticks were collected, including 2920 Dermacentor marginatus, 1442 Argas persicus, 903 Hyalomma asiaticum, 464 Hyalomma scupense, 225 Hyalomma anatolicum, 122 Rhipicephalus turanicus, 16 Haemaphysalis erinacei and 15 Dermacentor reticulatus. In these ticks five species of piroplasms, i.e. Babesia occultans, Babesia caballi, Theileria ovis, Theileria annulata and Theileria equi, were detected. Theileria equi and Babesia caballi belonged to their E and A genotype, respectively.Conclusions: Apart from Dermacentor marginatus, three Hyalomma species predominate among ticks infesting herbivorous livestock in East and South regions of Kazakhstan. 16S ribosomal DNA (16S rDNA) phylogenic analysis showed that several tick species in Kazakhstan, as exemplified by D. marginatus and Ha. erinacei, were clustered together with conspecific ticks reported from China. Babesia occultans was found for the first time in D. marginatus in Kazakhstan. Altogether five piroplasm species were detected, indicating that enhanced control measures are necessary to prevent piroplasm infection of domestic animals in this region.
Pre-clinical Evaluation of a Variable Length and Conforming Peritoneal Dialysis Catheter Weighted Anchor: In Vitro Analysis and Cadaver Feasibility Study
Authors: Morris Christopher Scott , Johnston Gregory P. , DeSarno Michael J. , Badireddy Appala Raju
Published: June 2020

PurposePeritoneal dialysis (PD) catheters function best when residing within the retrovesical space of the peritoneal cavity, but they frequently migrate and fail. A novel variable length and conforming PD catheter weighted anchor to prevent migration has been evaluated.MethodsTest devices were placed in normal saline for 21 months. The effluent was periodically measured for heavy metals, including tungsten. The water-tight property of the device was also tested separately. Four cadavers were subjected to three-dimensional imaging and maneuvering to evaluate percutaneous insertion, function, stability within the retrovesical space, and percutaneous retrievability in 10 test devices.ResultsLiquid leakage was low, with a mean absorbance of the test device effluent saline of 0.015. Mean methylene blue absorbance of the test device was significantly lower than the positive control (p-value = 0.01). Leakage of tungsten from devices made with medical grade Silastic tubing was also low, with a mean of 0.362 µg/L in the effluent saline, compared to a background concentration of 0.166 µg/L. Each test device was successfully inserted into the retrovesical space and retrieved percutaneously and remained completely intact following placement and insertion. No test device migrated as shown on axial cone beam CT imaging. Mean flow times and volumes were satisfactory at 3 minutes and 0.92L, respectively, for all test devices. For all catheters, the mean flow rate was 312 cc/min. No significant difference was found between the pre-roll and post-roll mean flow rates of the test devices (p-value = 0.35).ConclusionThis PD catheter weighted anchor showed stability, with minimal leakage of tungsten. All test devices were successfully inserted and retrieved percutaneously, with no damage or migration, and mean flow rates were satisfactory. Further investigation is warranted.
Cutaneous Manifestations of COVID-19: A Systematic Review
Authors: Daneshgaran Giulia , Dubin Danielle P. , Gould Daniel J.
Published: June 2020

Background: The COVID-19 pandemic has affected 4.5 million people and killed over 300,000 patients. Although this virus primarily causes respiratory symptoms, an increasing number of cutaneous manifestations associated with this disease have been reported.Objective: The aim of this review was to collate and categorize the dermatologic findings reported in COVID-19 patients and identify specific lesions that may facilitate diagnosis and prognostication.Methods: A systematic review of the PubMed database was conducted on May 14th, 2020 using the search terms “Covid-19 skin,” “Covid-19 rash,” “Covid-19 exanthem,” and “Covid-19 chilblains.” Peer-reviewed publications containing original COVID-19 patient cases and a discussion of the associated cutaneous findings were included in the analysis.Results: The literature search identified 115 records, of which 34 publications describing 996 dermatologic patients were included. Case reports (n=15), case series (n=10) and observational studies (n=7) were the most common publication types. Pseudo-chilblains (PC) was the most frequent lesion identified (40.4% of cases), appearing in young adults (mean age, MA, 23.2 years) after the onset of extracutaneous COVID-19 symptoms (55/100 patients). Erythematous maculopapular rashes (EMR) affected 21.3% of patients, most frequently impacting middle-aged adults (MA 53.2 years) and occurring at the same time as non-cutaneous symptoms (110/187 patients). Vesicular rashes (VR) affected 13.0% of patients, appearing in middle-aged adults (MA 48.3 years) after the onset of other symptoms (52/84 patients). Urticarial rashes (UR) affected 10.9% of patients, appearing in adults (MA 38.3 years) and occurring at the same time as non-cutaneous symptoms (46/78 patients). Vascular rashes resembling livedo/purpura/necrosis (LPN) were uncommon (4% of cases), appearing in elderly patients (MA 77.5 years) and occurring at the same time as non-cutaneous COVID-19 symptoms (18/29 patients). Erythema multiforme-like eruptions (EME), although infrequent (3.7% of cases), affected mostly children (MA 12.2 years).Conclusions: VR may suggest an initial diagnosis of COVID-19, PC may be most appropriate for epidemiological uses, and LPN may be a useful prognostic marker for severe disease. As a potential correlate to disease severity, prognosis, or infectibility, it is critical that all health care professionals be well-versed in these increasingly common cutaneous manifestations of COVID-19.
Therapy of Early Endometrial Cancer Fertility preserving Management of Early Endometrial Cancer in a Patient Cohort at the Department of Women's Health at the University of Tuebingen
Authors: Andress Jürgen , Pasternak Jana , Weiss Martin , Walter Christina , Kommoss Stefan , Krämer Bernhard , Hartkopf Andreas , Brucker Sara Yvonne , Schönfisch Birgitt , Steinmacher Sahra
Published: June 2020

Background:Endometrial cancer ranges among the most common gynecologic cancers worldwide. As the incidence of causing risk factors increases it is also becoming more prevalent in younger, premenopausal women who havent´ completed family planning yet. Our study aimed to investigate the oncologic and reproductive outcome of a conservative treatment with progestin agents in early stage grade 1 endometrial cancer (G1EC), grade 2 endometrial cancer (G2EC) or complex atypical hyperplasia (CAH) in young premenopausal women. Methods:Women treated for early stage endometrial cancer or atypical hyperplasia of the endometrium with a conservative therapy between 2006 and 2018 were enrolled in this retrospective analysis. Progestin agents were orally administered on a daily basis for 3 months for at least one cycle. Endometrial tissue was obtained by hysteroscopy and Dilatation & Curettage (D&C) being performed before and after end of treatment. Therapeutic response was assessed by pathological examination.Results:A total of 14 patients were included. After treatment with progestin agents, 11 of these patients initially showed a complete or partial response. Three patients with early stage endometrial cancer did not respond. Of the three patients with initially diagnosed atypical hyperplasia, none showed any remaining disease later. Of the 8 patients with initially diagnosed endometrial cancer, who had responded to first treatment, 3 patients were re-diagnosed with endometrial cancer later. One patient with initial endometrial cancer became pregnant but aborted in the 10th week. Conclusion:Due to its good efficacy progestin agents offer a feasible therapeutic option in the fertility preserving treatment of early stage endometrial cancer in young premenopausal women. However, recurrence rate remains high in early stage endometrial cancer. Therefore, a close follow-up is mandatory, also in responders. Patients should be informed of limitations and risks of conservative treatment. Yet after completion of family planning, hysterectomy should be performed.
The effectiveness of interactive mobile health technologies in improving antenatal care service utilization in Dodoma region, Tanzania: A quasi experimental study
Authors: MASOI THERESIA JOHN , Kibusi Stephen M. , Ernest Alex , Lilungulu Athanase G.
Published: June 2020

Background

Antenatal care provides a platform for important health care functions during pregnancy, including health promotion, screening, and diagnosis and disease prevention. Timely and appropriate utilization of antenatal care can prevent complications and ensure better maternal and newborn health care. The aim of this study was to assess the effectiveness of interactive mobile health technologies in improving antenatal care service utilization in Dodoma region, Tanzania

Methods

A controlled quasi-experimental study was carried. Random selection of participants was employed to achieve a sample size of 450 pregnant women (Intervention=150 and Control=300). Interventions were matched to controls by gravidity and gestational age at a ratio of 1:2.The intervention group was enrolled in an interactive mobile messaging system and received health education messages. The control group continued with the standard antenatal care services being offered in local clinics. Pregnant women were followed from their initial visit to the point of delivery. Independent two-sample T-tests and logistic regression were used to test the effect of the intervention.

Results

The mean age of the participants was found to be 25.6 years with a range of 16 to 48 years. 77.3% of participants in the intervention group utilize ANC services as compared to 57.7% in the control group. The mean score was (M=2.77, SD 0.420) in the intervention group against (M=2.58, SD=0.495) in the control with (t=4.172, P<0.01) at 95% CI . Interactive SMS alert system,was observed to be effective on improving Antenatal care service utilization (AOR=2.164, P<0.05, 95% CI=1.351-3.466) as compared to conventional Antenatal care health education given in our health facilities.

Conclusion

The Interactive mobile health technologies used in this study has the potential of empowering pregnant women through greater access to information and in improving antenatal care service utilization in our setting.
Nucleation Heat Treatment on the Crystalline Fraction and Crystal Morphology of Lamav Cad Lithium Disilicate
Authors: Vallerini Bruna de Freitas , Villas-Bôas Mariana de Oliveira Carlos , Pinelli Lígia Antunes Pereira
Published: June 2020

Thus, this study aimed to evaluate the influence of different nucleation heat treatments on the crystalline fraction and crystal morphology of the LS2 LaMaV CAD. Discs (12 mm diameter x 1.2 mm thickness) of LS2 LaMaV CAD and IPS e.max CAD (C, control group, n=3) were made. LS2 LaMaV CAD discs were annealed at 380oC/2h followed by different nucleation heat treatments in which time and temperature were varied composing 4 groups (n=3): T1 (1h30/500oC), T2 (3h/500oC), T3 (6h/500oC) and T4 (6h/480oC). Scanning Electron Microscopy images were obtained to characterize the microstructure and to quantify the crystalline fraction using the ImageJ software. X-ray diffraction with Rietveld refinement was performed. ANOVA one-way with Tukey post-hoc test (a = 0.05) was used to analyze the ImageJ images and the Rietveld refinements for X-ray diffraction data. X-ray diffraction analysis showed peaks of approximately 86% of lithium disilicate for all groups. The morphology of crystals was in lath-shaped and homogeneous format for all groups; the group that most resembled the C group was T1. The crystalline fraction (%) was: C = 59.33 ± 0.47, T1 = 61.63 ± 0.61, T2 = 61.07 ± 1.09, T3 = 56.39 ± 0.32, and T4 = 57.48 ± 0.90, all the groups were statistically different to the C group. It was concluded that the nucleation temperature influenced the size and quantity of the crystals of lithium disilicate; treatment that showed the best result was that that received nucleation treatment for 1 hour and 30 minutes at 500ºC.
Hiv-1 Gag Gene Mutations, Treatment Response and Drug Resistance to Protease Inhibitors: A Systematic Review and Meta-analysis Protocol
Authors: NKA ALEX DURAND , Teto Georges , Santoro Maria-Mercedes , Ndze Valantine Ngum , Takou Désiré , Dambaya Beatrice , Semengue Ezechiel Ngoufack Jagni , Fabeni Lavinia , Perno Carlo-Federico , Colizzi Vittorio , Ceccherini-Silberstein Francesca , Fokam Joseph
Published: June 2020

Background: Some mutations in the HIV-1 Gag gene are known to confer resistance to ritonavir-boosted protease inhibitors (PI/r), but their clinical implications remain controversial and most genotyping algorithms only consider the protease gene to evaluate resistance to PI/r. Thus, a thorough analysis of existing findings would provide a better understanding on the role of HIV-1 Gag gene on the resistance to PI/r, by characterizing genotypic co-variations between Gag-mutations/polymorphisms and mutations of the protease region.Methods: We will include randomized and non-randomized trials, cohort and cross-sectional studies published in English and French (from 2012 onwards), and relevant conference reports on PI/r HIV-1 Gag gene resistance associated mutations. Hand searching of the reference lists of relevant reviews will be conducted and we will also look for the aforementioned conference abstracts. PUBMED, EMBASE, CENTRAL, CINAHL databases will be used to conduct the searches. We will include studies of adults and/or children exposed to PI/r based therapies; and we will exclude studies of patients with specific co-morbidities such as tuberculosis or opportunistic infections. Primary outcomes will be “the rate of viral suppression”, “the proportion of patients with immune recovery” and “the level of drug resistance” on protease PI/r-based regimens. Secondary outcomes will be “HIV-1 Gag gene non polymorphic mutations according to PI/r based-regimens” and “viral subtypes/recombinants”. Two reviewers will independently screen titles and abstracts, assess the full texts for eligibility and extract data. If data permits, random effects models will be used where appropriate. Subgroup and additional analyses will be conducted to explore the potential sources of heterogeneity.Discussion: This study will help to better understand the implications of the Gag gene mutations ofPI/r-based ART response for HIV positive individuals, for a potential consideration in algorithms interpreting HIV drug resistance for clinical management.Prospero registration number: CRD42019114851
Development a Nomogram to Predict Prognosis in Severe and Critically Ill Patients with COVID-19
Authors: Tan Weiping , Zhu Ying , Yi Hui , Lin Yingyu , Liu Yumei , Wu Zhentian , Si Xiang , Tang Mimi , Hu Chunlin , Liu Yongjun , Yang Yi , Chen Zhenguang , Liu Dayue , Liu Yangli , Guo Yubiao , Jiang Ke , Wan Li , Kuang Yukun , Luo Yifeng
Published: June 2020

Background: The number of deaths caused by COVID-19 are on the rising worldwide. This study focused on severe and critically ill COVID-19, aim to explore independent risk factors associated with disease severity and to build a nomogram to predict patients’ prognosis.Methods: Patients with laboratory-confirmed COVID-19 admitted to the Union Hospital, Tongji Medical College and Hankou Hospital of Wuhan, China, from February 8th to April 6th, 2020. LASSO Regression and Multivariate Analysis were applied to screen independent factors. COX Nomogram was built to predict the 7-day, 14-day and 1-month survival probability.Results: A total of 115 severe [73 (63.5%)] and critically ill [42 (36.5%)] patients were included in this study, containing 93 (80.9%) survivors and 22 (19.1%) non-survivors. For disease severity, D-dimer [OR 6.33 (95%CI, 1.27-45.57], eosinophil percentage [OR 8.02 (95%CI, 1.82-45.04)], total bilirubin [OR 12.38 (95%CI, 1.24-223.65)] and lung involvement score [OR 1.22 (95%CI, 1.08-1.40)] were the independent factors associated with critical illness. Troponin [HR 9.02 (95%CI, 3.02, 26.97)] and total bilirubin [HR 3.16 (95%CI, 1.13, 8.85)] were the independent predictors for patients’ prognosis. Troponin≥26.2 ng/L and total bilirubin＞20 μmol/L were associated with poor prognosis. The nomogram based on the independent risk factors had a C-index of 0.92 (95%CI, 0.87, 0.98) for predicting survival probability. The survival nomogram validated in the critically ill patients had a C-index of 0.83 (95%CI: 0.75, 0.94).Conclusions: In conclusion, in severe and critically ill patients with COVID-19, D-dimer, eosinophil percentage, total bilirubin and lung involvement score were the independent risk factors associated with disease severity. The proposed survival nomogram accurately predicted prognosis. The survival analysis may suggest that early incidence of multiple organ dysfunction may be an important predictor of poor prognosis.
Clinical and Radiological Features of Patients with Coronavirus Disease 2019
Authors: Chen Hui Juan , Qiu Jie , Wu Biao , Wang Zhen Ping , Chen Yang , Chen Feng
Published: June 2020

Background: Confirmed cases of coronavirus disease 2019 (COVID-19) is still increasing, detailed analysis of confirmed cases may be beneficial for disease control.Methods: To describe the clinical and radiological findings of patients confirmed with COVID-19 infection in Haikou, China.Results: A total of 67 patients confirmed with COVID-19 infection were included in this study. 50 were imported cases. Most infected patients presented with fever and cough. The typical CT findings of lung lesions were bilateral, multifocal lung lesions (52[78%]), with subpleural distribution, and more than two lobes involved (51[78%]). 54 (81%) patients of COVID-19 pneumonia had ground glass opacities. Consolidation was in 30 (45%) patients, crazy paving pattern or interlobular thickening in 17 (25%), adjacent pleura thickening in 23 (34%) patients. Additionally, baseline chest CT did not reveal positive CT findings in 7 patients (23%), but 3 patients presented unilateral ground glass opacities at follow-up. Importantly, the follow-up CT findings were fitted well with the clinical outcomes.Conclusions: Chest CT could be used as an important tool for early diagnosis of COVID-19, monitoring the disease evolution, judging the treatment effectiveness and predicting the clinical outcomes.
Identification and analysis of oil candidate genes revealed the molecular basis of oil accumulation in Gossypium hirsutum L. for cottonseed biofuels development
Authors: zhang zhibin , Gong Juwu , Zhang Zhen , Gong Wankui , Li Junwen , Shi Yuzhen , Liu Aiying , Ge Qun , Pan Jingtao , Fan Senmiao , Deng Xiaoying , Li Shaoqi , Chen Quanjia , Yuan Youlu , Shang Haihong
Published: June 2020

Background

Cottonseed oil is increasingly becoming a promising target for biodiesel production with its high content of unsaturated fatty acids as greenhouse gases emission and global warming become more severe. However, the molecular regulatory basis of cottonseed oil accumulation is still unclear so far, and it is necessary to identify vital genes and regulators involved in oil accumulation during developing cottonseed ovules.
Results

In this study, a recombinant inbred line (RIL) population, developed from a cross between upland cotton cultivars 0-153 and sGK9708, was used to detect quantitative trait loci (QTLs) associated with cottonseed oil content and further identify candidate factors regulating cottonseed lipid synthesis. A total of 39 QTLs located on eighteen different chromosomes were identified across eight different environments. Of these, five QTLs were stable in at least three environments. By integrating candidate gene approach and physical mapping data, we preliminary obtained 43 candidate genes potentially involved in carbon metabolism, fatty acid (FA) synthesis and transcription, and triacylglycerol (TAG) synthesis around the stable QTLs. KEGG pathway enrichment analysis and local BLAST with Arabidopsis oil-related genes, as well as transcriptome analysis further showed that 19 candidate genes, expressed during developing cottonseed ovules, could influence cottonseed oil accumulation. Transcription factors (TFs) and microRNAs (miRNAs) regulatory network analyses suggested six genes, two core miRNAs (ghr-miR2949b and ghr-miR2949c), and one TFs GhHSL1 were considered to be closely associated with cottonseed lipid content.
Conclusions

The study provides an unprecedented level of insight from QTL mapping and regulatory network analysis to reveal the oil accumulation mechanism in developing cottonseed ovules through the construction of a detailed oil accumulation model. Moreover, the present study of cottonseed oil also lays a foundation for further oil production improvement in oil crops, and contributes to renewable energy production for solving the energy shortage and stabilizing greenhouse gases at a certain extent.
Cloud Network Slicing: A systematic mapping study from scientific publications
Authors: Almeida Leandro , Maciel Paulo Ditarso , Verdi Fabio Luciano
Published: June 2020

Cloud Network Slicing is a new research area that brings together cloud computing and network slicing in an end-to-end environment. In this context, understanding the existing scientific contributions and gaps is crucial to driving new research in this field. This article presents a complete quantitative analysis of scientific publications on the Cloud Network Slicing, based on a systematic mapping study. The results indicate the situation of the last ten years in the research area, presenting data such as industry involvement, most cited articles, most active researchers, publications over the years, main places of publication, as well as well-developed areas and gaps. Future guidelines for scientific research are also discussed.
Improving TDWZ Correlation Noise Estimation: A Deep Learning based Approach
Authors: Tiến Vũ Hữu , Nguyen Thi Huong Thao , Vu Van San , HoangVan Xiem
Published: June 2020

Transform domain Wyner-Ziv video coding (TDWZ) has shown its benefits in compressing video applications with limited resources such as visual surveillance systems, remote sensing and wireless sensor networks. In TDWZ, the correlation noise model (CNM) plays a vital role since it directly affects to the number of bits needed to send from the encoder and thus the overall TDWZ compression performance. To achieve CNM with high accurate for TDWZ, we propose in this paper a novel CNM estimation approach in which the CNM with Laplacian distribution is adaptively estimated based on a deep learning (DL) mechanism. The proposed DL based CNM includes two hidden layers and a linear activation function to adaptively update the Laplacian parameter. Experimental results showed that the proposed TDWZ codec significantly outperforms the relevant benchmarks, notably by around 35% bitrate saving when compared to the DISCOVER codec and around 22% bitrate saving when compared to the HEVC Intra benchmark while providing a similar perceptual quality.
Does Multimedia Technology Facilitate Pragmatics Awareness among Teenage Learners? A Case of Secondary-School Students
Authors: BABAYİĞİT Mehmet Veysi
Published: June 2020

This study aims to raise awareness among teenage learners of the difference between direct and indirect “speech acts” in pragmatics through multimedia technology. In a case study with 35 participants between the ages of 13 and 15, the data-collection process consisted of pre-tests, multimedia technology, and post-tests. Pre- and post-tests comprised the same ten questions about speech acts. The participants engaged in explicit learning with a smart board and projector in order to understand the distinction between the direct and indirect speech act. The results indicate that the participants were able to grasp pragmatics awareness and that they were greatly motivated to learn through multimedia technology.