bluuebunny/crossref_metadata_2025 huggingface dataset:
Paul of Aegina (ca 625-690 ad): Byzantine Surgeon and Pioneer of Surgical Management of Congenital Atresia of the External Auditory Canal
Authors: Tsoucalas Gregory , Michaleas Spyros N. , Laios Konstantinos , Androutsos George , Karamanou Marianna
Published: July 2020

Diseases of the ear have been recorded and treated since ancient times. Ex-votos have been offered to heal deafness. Noninvasive treatments have evolved into minor, and later more advanced, surgical techniques to treat head and neck issues. Paul of Aegina (ca 625-690 ad) perfected his medical skills in the School of Alexandria in Egypt. His medical encyclopedia, Medical Compendium, described a broad series of surgical operations, including a chapter “On the atresia of the auditory canal,” which vividly described a surgical technique to open the ear canal. This surgery is particularly interesting, as it exceeds the limits of resection and amputation known at that time and describes a novel surgical technique. His innovative methods paved the way for future surgeons.
Dispersion of 24-mm staple fibers with foam
Authors: Asikainen Jaakko , Saharinen Erkki , Koponen Antti
Published: July 2020

In addition to carding and airlaid processes, nonwovens are produced from staple fibers by a wet-laid process. A drawback of this process is the necessity to use very dilute fiber suspensions to avoid fiber entanglement and consequent poor fiber web uniformity. As a result, flow volumes are very high and process speeds are rather low compared to water forming used in the paper and board industry. A promising option for making nonwovens is foam laying. The bubbles in foam keep the fibers apart until the foam is removed, and much higher fiber weight consistencies can be used compared to traditional wet laying. A key challenge in foam forming of nonwovens is to obtain uniform dispersion of the fibers in the foam. In this work, we studied this with 24-mm staple fibers, and analyzed the homogeneity of the obtained foams by making fibrous sheets from them in a laboratory sheet mold. We found that dispersion was highly dependent on the mixing conditions, such as mixing time, foam air content, and fiber weight consistency. Remarkably, excellent fiber disintegration and uniform sheets were obtained without mechanical pre-treatment of staple fibers, with fiber consistencies as high as 0.3%. By comparison, conventional wet-laid processes typically operate with fiber consistencies lower than 0.05%. Thus, at an industrial scale, foam forming promises production of uniform webs from stable fibers with clearly lower water volumes and possibly also higher machine speeds compared to conventional wet-laid forming.
Refugee return and state legitimization: Habsburgs, Ottomans, and the case of Bosnia and Herzegovina, 1875–1878
Authors: Manasek Jared
Published: July 2020

In the nineteenth century, refugee generation and other forms of ethnic cleansing were a new and central feature in the dismantling of European empires and nationalists’ efforts to territorialize popular sovereignty based on demographic homogeneity. With the 1878 Treaty of Berlin, Europe’s Great Powers sanctioned the territorial principle, but included minority protection clauses intended to maintain mixed populations. This article argues that these protection clauses enabled states to make sovereign claims based not only on population distribution as such, but on the ability to control population movement itself. In its effort to win international sanction—and even Ottoman support—to occupy and administer the Ottoman provinces of Bosnia and Herzegovina, the Habsburg government based its arguments almost exclusively on its promised ability to repatriate refugees and manage long-term migration in the provinces. The article shows that states’ claims of power over refugee movement were an essential element of nineteenth-century European diplomacy and an indispensable tool of domestic policy. In the face of nation-state formation and an emerging ideal of demographic homogeneity, the ability to re-establish mixed populations asserted not only state power, but the legitimacy of an ‘imperial’ model of demographic heterogeneity.
Risk factor analysis of nosocomial lower respiratory tract infection in influenza-related acute respiratory distress syndrome
Authors: Chen Wei-Chih , Kao Kuo-Chin , Sheu Chau-Chyun , Chan Ming-Cheng , Chen Yu-Mu , Chien Ying-Chun , Peng Chung-Kan , Liang Shinn-Jye , Hu Han-Chung , Tsai Ming-Ju , Fang Wen-Feng , Perng Wann-Cherng , Wang Hao-Chien , Wu Chieh-Liang , Yang Kuang-Yao , Lin Meng-Chih
Published: July 2020

Background:

Patients with severe influenza-related acute respiratory distress syndrome (ARDS) have high morbidity and mortality. Moreover, nosocomial lower respiratory tract infection (NLRTI) complicates their clinical management and possibly worsens their outcomes. This study aimed to explore the clinical features and impact of NLRTI in patients with severe influenza-related ARDS.

Methods:

This was an institutional review board approved, retrospective, observational study conducted in eight medical centers in Taiwan. From January 1 to March 31 in 2016, subjects were enrolled from intensive care units (ICUs) with virology-proven influenza pneumonia, while all of those patients with ARDS requiring invasive mechanical ventilation and without bacterial community-acquired pneumonia (CAP) were analyzed. Baseline characteristics, critical-illness data and clinical outcomes were recorded.

Results:

Among the 316 screened patients with severe influenza pneumonia, 250 with acute respiratory failure requiring intubation met the criteria of ARDS, without having bacterial CAP. Among them, 72 patients developed NLRTI. The independent risk factors for NLRTI included immunosuppressant use before influenza infection [odds ratio (OR), 5.669; 95% confidence interval (CI), 1.770–18.154], extracorporeal membrane oxygenation (ECMO) use after ARDS (OR, 2.440; 95% CI, 1.214–4.904) and larger corticosteroid dosage after ARDS (OR, 1.209; 95% CI, 1.038–1.407). Patients with NLRTI had higher in-hospital mortality and longer ICU stay, hospitalization and duration on mechanical ventilation.

Conclusion:

We found that immunosuppressant use before influenza infection, ECMO use, and larger steroid dosage after ARDS independently predict NLRTI in influenza-related ARDS. Moreover, NLRTI results in poorer outcomes in patients with severe influenza. The reviews of this paper are available via the supplemental material section.
Automotive leaf spring design and manufacturing process improvement using failure mode and effects analysis (FMEA)
Authors: Aized Tauseef , Ahmad Muhammad , Jamal Muhammad Haris , Mahmood Asif , Ubaid ur Rehman Syed , Srai Jagjit Singh
Published: July 2020

Nowadays human safety and comfort are the most considerable parameters in designing and manufacturing of a vehicle, that is why every organization ensures the quality and reliability of components used in the vehicle. Leaf spring is also a component of vehicle which plays an important role in human safety and comfort. It acts as a structural member and an integral part of suspension system. It is important to eliminate the failures in designing and manufacturing process of leaf springs because of its importance in functionality and safety of vehicle. In this research, failure mode and effects analysis has been used to analyze and reduce the risks of 42 possible failures that can occur in automotive leaf spring. It starts from determining, classifying, and analyzing all potential failures and then rating them with the help numeric scores. The four numeric scores namely severity, occurrence, detection, and Risk Priority Number (RPN) are used to find the high potential failures of semi-elliptical leaf springs. In the end, actions are recommended for RPN greater than 250, to increase quality and reliably of product.
The Application of Double Elastic Band Exercise in the 90/90 Arm Position for Overhead Athletes
Authors: Tsuruike Masaaki , Ellenbecker Todd S. , Lauffenburger Connor
Published: July 2020

Background:

Traditional exercises performed with the shoulder in the position of 90° abduction and external rotation with elbow flexion (90/90) while using a single elastic band showed moderate activity of both the lower trapezius (LT) and infraspinatus (IS) muscle. The purpose of this study was to investigate activity of the teres minor (TMi) and the LT muscles during standing external rotation exercise with the shoulder in the 90/90 position with 2 elastic bands in both the frontal and the scapular plane.

Hypothesis:

TMi, IS, and LT muscle activities will vary depending on whether the shoulder is positioned in the frontal or scapular plane with the application of 2 elastic bands. Also, the serratus anterior (SA) and teres major (TMa) muscles will produce different muscular activity patterns during exercises performed with 2 elastic bands in the frontal plane compared with the TMi and LT muscles.

Study Design:

Controlled laboratory study

Level of Evidence:

Level 4.

Methods:

A total of 21 collegiate baseball players volunteered to participate. The electromyography (EMG) activities of the TMi, IS, LT, SA, TMa, middle deltoid (MD), posterior deltoid, and upper trapezius (UT) muscles were measured with the 90/90 arm position during both isometric and oscillation resistance exercises with 2 elastic bands oriented in the frontal and scapular planes.

Results:

A significant difference was observed in EMG activity of both the TMi and the LT muscles between single and double elastic band applications in the frontal plane ( P < 0.05). In contrast, EMG activity of the IS, SA, and TMa muscles was significantly increased in the scapular plane compared with the frontal plane ( P < 0.05).

Conclusion:

The standing 90/90 position effectively increased both TMi and LT muscle EMG activity with the double elastic band in the frontal plane while minimizing UT and MD muscle activity. EMG activity of the IS, SA, and TMa muscles increased with exercise in the scapular plane as compared with the frontal plane.

Clinical Relevance:

Oscillation movement under double elastic band application differentiated external rotator muscle and scapular muscle activities between the frontal and scapular plane during the 90/90 exercise in the frontal plane compared with the scapular plane. Clinicians can utilize each of the scapular and frontal positions based on their desired focus for muscular activation.
Protecting vulnerable suspects in police investigations in Europe: Lessons learned from England and Wales and Belgium
Authors: Mergaerts Lore , Dehaghani Roxanna
Published: July 2020

This article provides an analysis of the provisions relating to vulnerable suspects, with a focus on adults, in England and Wales and in Belgium. In doing so, the various problems and lessons learned from each jurisdiction are examined. Situated within the context of how these provisions have been developed, both at a domestic level and at a European level, we argue that neither system offers an ideal approach to the vulnerability of suspects, but we also posit that the two jurisdictions can learn from one another in their approach. Herein, we suggest that both jurisdictions must do more to protect adult vulnerable suspects and offer potential avenues for improvement.
Sexual behaviors and its association with life skills among school adolescents of Mettu town, South West Ethiopia: A school-based cross-sectional study
Authors: Tesema Desalew , Tamirat Meseret , Tadele Afework
Published: July 2020

Background:

Adolescents need to have adequate life skills along with personal and social competencies to build responsible adults for healthy behavior. Works of literature agree that life skills improve adolescent’s cognitive, social, and emotional skills; however, there is a paucity of evidence on the association of life skills with sexual behaviors. Therefore, this study aimed to determine the association of life skills with sexual behavior among school adolescents aged 15–19 years in Mettu Town, South West Ethiopia.

Methods:

School-based cross-sectional study was employed among 372 school adolescents from 15 to 25 April 2016. A list of school adolescents aged 15–19 years old from students’ register was taken as a sampling frame. Then, simple random sampling was employed using computer-generated random numbers for final study participants’ selection. A pretested self-administered questionnaire was used. The data were entered into Epidata version 4.1 and analyzed using SPSS version 20. A bivariable and multivariable logistic regression analysis was carried out.

Results:

Ninety-one (24.5%) adolescents ever practiced sexual intercourse, of which 19.1% of them were exposed to risky sexual behaviors. Unfavorable life skill dimensions, that is, social (adjusted odds ratio = 3.71; 95% confidence interval = 1.64, 8.38), coping with emotions (adjusted odds ratio = 3.114; 95% confidence interval = 1.286, 7.542), and cognitive (adjusted odds ratio = 2.835; 95% confidence interval = 1.288, 6.239), were found to be statistically significant associations with risky sexual behaviors, after controlling for confounders, that is, use of psychoactive substance (adjusted odds ratio = 6.73; 95% confidence interval = 2.27, 19.87) and urban adolescents who dwell in a rental house (adjusted odds ratio = 4.05; 95% confidence interval = 1.59, 10.33) as compared to those living with families.

Conclusion:

Developing life skills helps adolescents make more reasoned and intentional choices sexually, which will result in fewer unwanted pregnancies, less sexually transmitted disease, and stronger relationships.
Combining diabetic foot and retinopathy screening: A step in the right direction? – a feasibility study
Authors: Lewis Jane EA , Morris Keith , Powell Thomas , Thomas Rebecca L , Owens David R
Published: July 2020

Objectives:

Peripheral artery disease is a major cardiovascular disease affecting more than 200 million people globally and up to 4 times more frequent in the diabetic population. It can lead to lower extremity amputations or revascularisation and is associated with an increased risk of myocardial infarction, stroke and early mortality. This novel cross-sectional study aimed to explore the feasibility and acceptability of incorporating diabetic foot screening at routine diabetic retinopathy screening appointments.

Methods:

Participants underwent foot screening during the interval between pupil dilatation and retinal photography as part of the eye screening procedure. Lower limb arterial assessment included ankle brachial index, pulse volume waveform and protective light touch sensation.

Results:

Of 364 participants invited, 88% (n = 321) met the inclusion criteria. About 26.4% (n = 86) had asymptomatic peripheral artery disease and 3% (n = 10) had peripheral sensory neuropathy. Binary logistical regression analysis identified age (p < 0.005), existing coronary heart disease (p < 0.005) and gender (p = 0.03) as predictors of peripheral artery disease.

Conclusion:

Incorporating foot examination during eye screening appointments is feasible and was well received by participants and staff alike. Undiagnosed early peripheral artery disease was evident in a third of the study population emphasising the benefit of introducing foot surveillance into eye screening appointments for the early identification of lower limb arterial disease and peripheral sensory neuropathy.
Diagnosis and clinical outcome following surgical resection of an intracranial grade III anaplastic gemistocytic astrocytoma in a cat
Authors: Murthy Vishal D , Liepnieks Molly L , Roy Melissa A , Woolard Kevin D , Sturges Beverly K , Li Chai-Fei
Published: July 2020

Case summary

A 10-year-old Maine Coon cat was presented for acute onset seizures and cerebrothalamic signs. An intracranial mass, suspected to be a meningioma, was diagnosed on MRI and surgically excised. Histopathology appeared consistent with an atypical meningioma. However, following rapid regrowth of the neoplasm, the patient was humanely euthanized 3 months later. On post-mortem histopathology, the neoplasm was diagnosed as a grade III anaplastic gemistocytic astrocytoma.

Relevance and novel information

Gemistocytic astrocytomas are rare brain tumors in the feline patient. This case represents the first report of a feline grade III anaplastic gemistocytic astrocytoma in the cerebrum of a cat with surgical excision and recurrence. The challenging nature of ante-mortem diagnosis and the guarded prognosis, despite surgical intervention, are presented in this report.
Spiritual Development as an Educational Goal
Authors: Moulin-Stożek Daniel
Published: July 2020

Purpose:

To inform current international debates about educating for wholeness and purpose, this article gives a critical analysis of spiritual development as a goal of state-funded schooling in England and Wales.

Design/Approach/Methods:

The analysis follows a history of ideas approach. Relevant texts are examined to understand how notions of “spiritual” and “development” were first combined and introduced into mass education, and how they have changed over time.

Findings:

The concept of spiritual development blends scientific conceptions of human development with a holistic, but ambiguous formative principle. This expedient, even paradoxical ideal, has resulted in confusion among practitioners and allowed for some considerable shift in policy.

Originality/Value:

Spiritual development in the English context provides a paradigmatic case by which to explore the integration of formative goals in the curriculum. While in some respects the English tradition of spiritual development represents something of its time and its unique cultural context, its underlying assumptions resonate with renewed international interest for educating for meaning and purpose.
Heparin-Induced Thrombocytopenia in COVID-19
Authors: Lingamaneni Prasanth , Gonakoti Sriram , Moturi Krishna , Vohra Ishaan , Zia Maryam
Published: July 2020

COVID-19 (coronavirus disease-2019) infection is a highly prothrombotic state, resulting from a dysregulation of the coagulation cascade. Therefore, thromboprophylaxis is strongly recommended in these patients, with some experts even advocating for therapeutic dosing to prevent thromboembolic events. Heparin-induced thrombocytopenia (HIT) is a well-known complication of heparin therapy. In this article, we report a case of HIT in a patient with COVID-19. A 63-year-old male presented with 1 week of dry cough and diarrhea. He had a positive nasopharyngeal COVID-19 reverse-transcriptase–polymerase chain reaction. On admission, the platelet count and liver function tests were within normal limits. During his hospitalization, he developed a right femoral deep venous thrombosis and was started on therapeutic anticoagulation. Due to worsening respiratory failure, he was intubated and mechanically ventilated. Between days 11 and 12 of hospitalization, platelet count dropped from 304 000 to 96 000 cells/µL. He had a high pretest probability for HIT with a 4T score of 6 and a positive anti-PF4/heparin antibody. Heparin drip was discontinued and was switched to argatroban. The serotonin release assay eventually returned positive, which confirmed the diagnosis of HIT. We also discuss potential overdiagnosis of HIT in COVID-19 through 4 cases with false-positive HIT antibodies.
Collagenous Gastritis: An Unusual Presentation With Tubular Shaped Stomach
Authors: Cortez Nathaly , Berzosa Manuel , Jacobs Adam , Bloom Michael
Published: July 2020

Collagenous gastritis is a rare histopathologic entity that causes marked subepithelial collagen deposition in the gastric mucosa. Clinical presentation is diverse, considering only less than 100 cases have been reported. However, we report a unique case of isolated collagenous gastritis in a 71-year-old female who presented with a 6-month history of dyspepsia and 27 kg weight loss. Her endoscopic findings revealed a tubular shaped stomach with diffuse gastric mucosal atrophy, findings that differ with previous case reports of a cobblestone pattern. Treatment remains unclear.
Effect of Leg Length–Evening Device on Perceived Balance in Patients Wearing a Controlled Ankle Motion Boot
Authors: Mehraban Nasima , Idarraga Alexander J. , Wu Kevin J. , Patel Milap S. , Vora Anand M. , Kadakia Anish R. , Lee Simon , Hamid Kamran S. , Bohl Daniel D.
Published: July 2020

Background:

Patients are often made weightbearing as tolerated (WBAT) in a controlled ankle motion (CAM) boot for the management of various foot and ankle conditions. The CAM boot causes a leg length discrepancy (LLD) between the booted (longer) and contralateral (shorter) lower extremities. This discrepancy can potentially cause balance problems, undue strain on joints, and discomfort in patients. We hypothesized that a leg length–evening orthotic placed on the plantar aspect of the contralateral shoe improves balance among patients who are WBAT in a CAM boot.

Methods:

Patients made WBAT in a CAM boot were randomized to either the leg length–evening orthotic intervention group or to a control group in which patients wore a normal shoe of their choice. Patients were followed for 2 weeks and asked a series of questions pertaining to balance and pain experienced at their knees, hips, and back. Balance was the primary outcome and was scored from 0 (no difficulty with balance) to 10 (great difficulty with balance). Of 107 subjects enrolled and randomized, 95 (88.8%) completed the study, satisfying the a priori sample size requirement of 94 patients. There were no differences in baseline characteristics between groups ( P > .05 for each).

Results:

Intervention patients reported less difficulty with balance than control patients (intention-to-treat analysis: 2.0±1.5 vs 3.2±1.8, P = .001; as-treated analysis: 2.1±1.7 vs 3.0±1.7, P = .009). Intervention and control patients did not differ with respect to pain experienced at their knees, hips, or back, or in a composite total pain score ( P > .05 for each).

Conclusion:

This multicenter randomized controlled trial found that adding a limb length–evening orthotic to the plantar aspect of the contralateral shoe in a patient that is WBAT in a CAM boot improved patient-reported self-assessment of balance. The trial was powered to identify a difference in the primary outcome measure of balance and may have been insufficiently powered to identify differences in knee, hip, back, or total pain.

Level of Evidence:

Level II, prospective comparative study.
Influence of excess alumina on mullite synthesized from pyrophyllite by spark plasma sintering
Authors: Sule Rasidi , Sigalas Iakovos
Published: July 2020

The influence of excess Al2O3 on 3:2 mullite produced from α-Al2O3 and pyrophyllite powder was examined. A mixture consisting of 28 wt.% dehydroxylated pyrophyllite and 72 wt.% α-Al2O3 was milled in an attrition mill. The milled powders were sintered by spark plasma sintering (SPS) at 1600°C for 10, 20 and 30 min. Subsequently, the samples were heated at 1350°C for 2 h to determine the influence of the excess Al2O3 on the microstructure. No glassy phase was detected in the sample containing 72 wt.% Al2O3 and sintered at 1600°C for 20 min. The sample with 72 wt.% Al2O3 had greater hardness and fracture toughness compared to 3:2 mullite. The greatest hardness and fracture toughness of 12.43 GPa and 2.71 MPa m–0.5, respectively, were obtained in the sample containing 72 wt.% Al2O3 sintered at 1600°C for 20 min.
Curative vs targeted therapy for SCD: does it make more sense to address the root cause than target downstream events?
Authors: Telen Marilyn J.
Published: July 2020

Sickle cell disease (SCD) places a heavy burden on a global and increasing population predominantly resident in resource-poor and developing countries. Progress continues to be made in preventing childhood mortality, and increasing numbers of chronically ill adults with disease are requiring care for disease sequelae. Curative therapies for SCD are therefore attractive to physicians and investigators focused on SCD. Gene therapies are being developed, and several are now in various stages of early-phase human clinical trials. However, we must also pursue avenues through which we can do the most good for the most people alive today. Such efforts include improving our understanding of disease mechanisms and which disease sequelae most strongly affect survival and interfere with quality of life. The pathways leading to disease sequelae are multiple, complex, and highly interactive. Four drugs have now been approved by the US Food and Drug Administration for SCD; however, each has a distinct mechanism and a measurable but limited effect on the many clinical sequelae of SCD. We therefore need to learn how to approach multi-agent therapy for SCD. The order of addition of each agent to treat a specific patient will need to be guided by response to previous therapy, risk factors identified for specific disease outcomes, and clinical studies to determine more comprehensively how the 4 currently approved drugs might interact and produce (or not) additive effects. Moreover, this will have to be accomplished with defined end points in mind, according to which pose the greatest threats to quality of life as well as survival.
Ischemic stroke in patients with POEMS syndrome
Authors: Feng Jun , Gao Xue-min , Zhao Hao , He Tian-hua , Zhang Cong-li , Shen Kai-ni , Zhang Lu , Cao Xin-xin , Qian Ming , Zhou Dao-bin , Li Jian
Published: July 2020

Polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes (POEMS) syndrome is associated with increased risk for ischemic stroke (IS). Because POEMS syndrome is rare, little is known regarding the underlying mechanism and prognosis for IS in patients in whom it occurs. The medical records of patients with POEMS syndrome were screened between January 2018 and January 2000 at Peking Union Medical College Hospital to identify those with IS. The baseline characteristics, IS features, and patient outcomes were analyzed. Forty-one (8.0%) of 510 POEMS patients were documented to have IS. Patients with IS were older, had a higher percentage of Overall Neuropathy Limitation Scale score >4, and had a higher level of fibrinogen compared with those who did not have IS. Ninety-three percent of IS events occurred before or within 3 months after a diagnosis of POEMS. Of 41 occurrences of IS, 29 (46.3%) were multifocal. Recurrent IS was observed in 13 (31.7%) of 41 patients, but not in patients with successful anti-plasma cell therapy. The 3-year overall survival rate in patients with IS was 71.0% and for those without IS, it was 88.5% (P = .002). We showed that 8.0% of POEMS patients had IS, and most IS events occurred in POEMS patients not being treated effectively. Having IS was a predictor of unfavorable prognosis. Early diagnosis, immediate initiation of treatment for POEMS, and control of POEMS syndrome is key to reducing the occurrence of IS, improving survival, and preventing recurrence of IS.
Survival outcomes in blastic plasmacytoid dendritic cell neoplasm by first-line treatment and stem cell transplant
Authors: Yun Seongseok , Chan Onyee , Kerr Daniel , Vincelette Nicole D. , Idrees Afshan , Mo Qianxing , Sweet Kendra , Lancet Jeffrey E. , Kharfan-Dabaja Mohamed A. , Zhang Ling , Sokol Lubomir
Published: July 2020

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy with dismal clinical outcomes. Conventional chemotherapies such cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) and hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone alternating with high-dose cytarabine and methotrexate (CVAD) have been commonly used for the BPDCN treatment until a recent study showed promising outcomes in patients treated with SL-401 (Tagraxofusp). In this single-institution retrospective study, we identified a total of 49 consecutive BPDCN patients. Among 42 patients who received treatment, hyper-CVAD regimen was associated with higher complete response rate compared with CHOP-based regimens or SL-401 (91% vs 50% vs 50%), although the difference did not achieve statistical significance. Furthermore, there was no significant overall survival (OS) difference between patients treated with SL-401 vs other chemotherapies as their first-line treatment (hazard ratio = 1.597; 95% CI, 0.460-5.548; P = .431). Of note, patients who received allogeneic stem cell transplant (allo-SCT) had significantly longer OS (hazard ratio = 0.160; 95% CI, 0.0453-0.56; P = .041). Extent of disease (skin vs bone marrow vs both) or younger age (<60 years old) did not have significant prognostic impact on OS. Collectively, our study confirmed the survival benefit of allo-SCT and suggests that conventional and intensive chemotherapies such as CHOP and hyper-CVAD as well as SL-401 would be comparable first-line choice for the BPDCN patients.
Evaluating metagenomics tools for genome binning with real metagenomic datasets and CAMI datasets
Authors: Yue Yi , Huang Hao , Qi Zhao , Dou Hui-Min , Liu Xin-Yi , Han Tian-Fei , Chen Yue , Song Xiang-Jun , Zhang You-Hua , Tu Jian
Published: July 2020

Background

Shotgun metagenomics based on untargeted sequencing can explore the taxonomic profile and the function of unknown microorganisms in samples, and complement the shortage of amplicon sequencing. Binning assembled sequences into individual groups, which represent microbial genomes, is the key step and a major challenge in metagenomic research. Both supervised and unsupervised machine learning methods have been employed in binning. Genome binning belonging to unsupervised method clusters contigs into individual genome bins by machine learning methods without the assistance of any reference databases. So far a lot of genome binning tools have emerged. Evaluating these genome tools is of great significance to microbiological research. In this study, we evaluate 15 genome binning tools containing 12 original binning tools and 3 refining binning tools by comparing the performance of these tools on chicken gut metagenomic datasets and the first CAMI challenge datasets.

Results

For chicken gut metagenomic datasets, original genome binner MetaBat, Groopm2 and Autometa performed better than other original binner, and MetaWrap combined the binning results of them generated the most high-quality genome bins. For CAMI datasets, Groopm2 achieved the highest purity (> 0.9) with good completeness (> 0.8), and reconstructed the most high-quality genome bins among original genome binners. Compared with Groopm2, MetaBat2 had similar performance with higher completeness and lower purity. Genome refining binners DASTool predicated the most high-quality genome bins among all genomes binners. Most genome binner performed well for unique strains. Nonetheless, reconstructing common strains still is a substantial challenge for all genome binner.

Conclusions

In conclusion, we tested a set of currently available, state-of-the-art metagenomics hybrid binning tools and provided a guide for selecting tools for metagenomic binning by comparing range of purity, completeness, adjusted rand index, and the number of high-quality reconstructed bins. Furthermore, available information for future binning strategy were concluded.
The molecular effect of a polymorphic microRNA binding site of Wolfram syndrome 1 gene in dogs
Authors: Koller Dora , Kubinyi Eniko , Elek Zsuzsanna , Nemeth Helga , Miklosi Adam , Sasvari-Szekely Maria , Ronai Zsolt
Published: July 2020

Background

Although the molecular function of wolframin remains unclear, the lack of this protein is known to cause stress in the endoplasmic reticulum. Some variants in the Wolfram Syndrome 1 gene (WFS1) were associated with various neuropsychiatric disorders in humans, such as aggressiveness, impulsivity and anxiety.

Results

Here we present an in silico study predicting a single nucleotide polymorphism (rs852850348) in the canine WFS1 gene which was verified by direct sequencing and was genotyped by a PCR-based technique. We found that the rs852850348 polymorphism is located in a putative microRNA (cfa-miR-8834a and cfa-miR-1838) binding site. Therefore, the molecular effect of allelic variants was studied in a luciferase reporter system that allowed assessing gene expression. We demonstrated that the variant reduced the activity of the reporter protein expression in an allele-specific manner. Additionally, we performed a behavioral experiment and investigated the association with this locus to different performance in this test. Association was found between food possessivity and the studied WFS1 gene polymorphism in the Border collie breed.

Conclusions

Based on our findings, the rs852850348 locus might contribute to the genetic risk of possessivity behavior of dogs in at least one breed and might influence the regulation of wolframin expression.
Wogonin inhibits in vitro herpes simplex virus type 1 and 2 infection by modulating cellular NF-κB and MAPK pathways
Authors: Chu Ying , Lv Xiaowen , Zhang Longfeng , Fu Xingli , Song Siwei , Su Airong , Chen Deyan , Xu Lianhong , Wang Yongfang , Wu Zhiwei , Yun Zhihua
Published: July 2020

Background

Wogonin, a natural flavonoid-like chemical compound, exhibits anti-inflammatory, antitumor, antiviral, neuroprotective, and anxiolytic effects by modulating a variety of cellular signaling pathways including PI3K-Akt, p53, nuclear factor κB (NF-κB), mitogen-activated protein kinase (MAPK) pathways. In this study, its antiviral effect against herpes simplex virus (HSV) type 1 and 2 (HSV-1 and HSV-2) replication was investigated.

Results

Wogonin suppressed HSV-2-induced cytopathic effect (CPE) and reduced viral mRNA transcription, viral protein synthesis, and infectious virion particle titers in a dose-dependent manner. A time-of-drug-addition assay demonstrated that wogonin acted as a postentry viral inhibitor. Wogonin also significantly reduced HSV-induced NF-κB and MAPK pathway activation, which has previously been demonstrated to be important for viral replication.

Conclusions

Our results suggest that the anti-herpes effect of wogonin may be mediated by modulation of cellular NF-κB and JNK/p38 MAPK pathways and imply that wogonin may be useful as an anti-HSV agent.
Functional probiotics of lactic acid bacteria from Hu sheep milk
Authors: Chen Taohong , Wang Leli , Li Qinxin , Long Yingjie , Lin Yuming , Yin Jie , Zeng Yan , Huang Le , Yao Tingyu , Abbasi Muhammad Nazeer , Yang Huansheng , Wang Qiye , Tang Congjia , Khan Tahir Ali , Liu Qiuyue , Yin Jia , Tu Qiang , Yin Yulong
Published: July 2020

Background

Probiotics are being considered as valuable microorganisms related to human health. Hu sheep is referred as one of the important sheep breeds in China. Goat milk produced by Hu sheep is characterized with high nutritional value and hypoallergenic in nature. Particularly, this milk contains plenty of milk prebiotic and probiotic bacteria. This study was aimed to scrutinize more bacterial strains from Hu sheep milk with potential probiotic activity.

Results

Based on 16S rRNA sequence analysis, pool of forty bacterial strains were identified and evaluated their antimicrobial activities against Staphylococcus aureus, enterohemorrhagic Escherichia coli (EHEC), Salmonella typhimurium, Listeria monocytogenes enterotoxigenic E. coli (ETEC) and Aeromonas caviae. Four out of these isolated strains demonstrated their efficient bacteriostatic ability and potential healthy properties. We also examined the safety aspects of these bacterial candidates including three Lactococcus lactis strains (named as HSM-1, HSM-10, and HSM-18) and one Leuconostoc lactis strain (HSM-14), and were further evaluated via in vitro tests, including antimicrobial activity, cell surface characteristics (hydrophobicity, co-aggregation, and self-aggregation), heat treatment, antibiotic susceptibility, simulated transport tolerance in the gastrointestinal tract, and acid/bile tolerance. The obtained results revealed that HSM-1, HSM-10, HSM-14, and HSM-18 showed high survival rate at different conditions for example low pH, presence of bovine bile and demonstrated high hydrophobicity. Moreover, HSM-14 had an advantage over other strains in terms of gastrointestinal tract tolerance, antimicrobial activities against pathogens, and these results were significantly better than other bacterial candidates.

Conclusion

Hu sheep milk as a source of exploration of potential lactic acid bacteria (LAB) probiotics open the new horizon of probiotics usage from unconventional milk sources. The selected LAB strains are excellent probiotic candidates which can be used for animal husbandry in the future. Rationale of the study was to utilize Hu sheep milk as a source of potential probiotic LABs. The study has contributed to the establishment of a complete bacterial resource pool by exploring the Hu sheep milk microflora.
Seed dormancy release of Halenia elliptica in response to stratification temperature, duration and soil moisture content
Authors: Chen Da Li , Luo Xin Ping , Yuan Zhen , Bai Meng Jie , Hu Xiao Wen
Published: July 2020

Background

Although the effect of cold stratification on seed dormancy release has been extensively studied for many species, knowledge of the role of stratifying temperature, soil moisture content and duration of stratification on seed dormancy release at the population level is limited. Here, we aimed to determine the response of seed dormancy release to these factors in six populations of Halenia elliptica.

Results

Seed dormancy release was more responsive to low than high temperatures, and no dormancy break occurred at 8 °C. Seed germination percentage increased first and then remained unchanged as stratifying soil moisture content increased from 0 to 24%. Seed dormancy release of populations from low altitude was more sensitive to increased stratifying temperature and decreased soil moisture content than those from high altitudes.

Conclusions

Temperature and soil moisture changes resulting from global warming could affect seed dormancy release and consequently seedling establishment. Thus, incorporating data on seed dormancy release involving temperature, soil moisture content and stratification duration is beneficial for predicting plant species regeneration, migration and coexistence in a scenario of climate change.
Relative contribution of muscle strength, lean mass, and lower extremity motor function in explaining between-person variance in mobility in older adults
Authors: Wages Nathan P. , Simon Janet E. , Clark Leatha A. , Amano Shinichi , Russ David W. , Manini Todd M. , Clark Brian C.
Published: July 2020

Background

Approximately 35% of individuals > 70 years have mobility limitations. Historically, it was posited lean mass and muscle strength were major contributors to mobility limitations, but recent findings indicate lean mass and muscle strength only moderately explain mobility limitations. One likely reason is that lean mass and muscle strength do not necessarily incorporate measures globally reflective of motor function (defined as the ability to learn, or to demonstrate, the skillful and efficient assumption, maintenance, modification, and control of voluntary postures and movement patterns). In this study we determined the relative contribution of lean mass, muscle strength, and the four square step test, as an index of lower extremity motor function, in explaining between-participant variance in mobility tasks.

Methods

In community-dwelling older adults (N = 89; 67% women; mean 74.9 ± 6.7 years), we quantified grip and leg extension strength, total and regional lean mass, and time to complete the four square step test. Mobility was assessed via 6-min walk gait speed, stair climb power, 5x-chair rise time, and time to complete a complex functional task. Multifactorial linear regression modeling was used to determine the relative contribution (via semi-partial r2) for indices of lean mass, indices of muscle strength, and the four square step test.

Results

When aggregated by sex, the four square step test explained 17–34% of the variance for all mobility tasks (p <  0.01). Muscle strength explained ~ 12% and ~ 7% of the variance in 6-min walk gait speed and 5x-chair rise time, respectively (p <  0.02). Lean mass explained 32% and ~ 4% of the variance in stair climb power and complex functional task time, respectively (p <  0.02). When disaggregated by sex, lean mass was a stronger predictor of mobility in men.

Conclusion

The four square step test is uniquely associated with multiple measures of mobility in older adults, suggesting lower extremity motor function is an important factor for mobility performance.

Trial registration

NCT02505529–2015/07/22.
Prevalence, related factors and maternal outcomes of primary postpartum haemorrhage in governmental hospitals in Kabul-Afghanistan
Authors: Shahbazi Sighaldeh Shirin , Nazari Adela , Maasoumi Raziyeh , Kazemnejad Anoshirvan , Mazari Ziba
Published: July 2020

Background

To determine the prevalence, related factors and maternal outcomes of primary PPH in governmental hospitals in Kabul Afghanistan.

Methods

An observational study was designed to determine the prevalence, related factors and maternal outcomes of primary PPH in governmental hospitals in Kabul-Afghanistan. The population of this study consisted of all women who gave birth to a child between August and October 2018. The structured checklist was used to collect the data from patients who were suffering from primary PPH.

Results

Among the 8652 women who were observed, 215 (2.5%) of them suffered from primary PPH and 2 (0.9%) of them died under caesarean section. The most common related factors of primary PPH were uterine atonia (65.6%), previous PPH (34.9%), prolonged labor (27%), genital tract trauma (26.5%), and induction of labor (20.5%). The most common maternal outcomes of primary PPH were respiratory failure (7%), hysterectomy (6%), and hypovolaemic shock (5.1%).

Conclusions

According to our findings, the major cause of postpartum bleeding was uterine atonia. Therefore, postpartum care of women is essential, especially for those with previous PPH and prolonged labor that require more attention.
Low dose environmental radon exposure and breast tumor gene expression
Authors: Peng Cheng , DuPre Natalie , VoPham Trang , Heng Yujing J. , Baker Gabrielle M. , Rubadue Christopher A. , Glass Kimberly , Sonawane Abhijeet , Zeleznik Oana , Kraft Peter , Hankinson Susan E. , Eliassen A. Heather , Hart Jaime E. , Laden Francine , Tamimi Rulla M.
Published: July 2020

Background

The International Agency for Research on Cancer classified radon and its decay-products as Group-1-human-carcinogens, and with the current knowledge they are linked specifically to lung cancer. Biokinetic models predict that radon could deliver a carcinogenic dose to breast tissue. Our previous work suggested that low-dose radon was associated with estrogen-receptor (ER)-negative breast cancer risk. However, there is limited research to examine the role of radon in breast cancer biology at the tissue level. We aim to understand molecular pathways linking radon exposure with breast cancer biology using transcriptome-wide-gene-expression from breast tumor and normal-adjacent tissues.

Methods

Our study included 943 women diagnosed with breast cancer from the Nurses’ Health Study (NHS) and NHSII. We estimated cumulative radon concentration for each participant up-to the year of breast cancer diagnosis by linking residential addresses with a radon exposure model. Transcriptome-wide-gene-expression was measured with the Affymetrix-Glue-Human-Transcriptome-Array-3.0 and Human-Transcriptome-Array-2.0. We performed covariate-adjusted linear-regression for individual genes and further employed pathway-analysis. All analyses were conducted separately for tumor and normal-adjacent samples and by ER-status.

Results

No individual gene was associated with cumulative radon exposure in ER-positive tumor, ER-negative tumor, or ER-negative normal-adjacent tissues at FDR < 5%. In ER-positive normal-adjacent samples,PLCH2—reached transcriptome-wide-significance (FDR < 5%). Gene-set-enrichment-analyses identified 2-upregulated pathways (MAPK signaling and phosphocholine biosynthesis) enriched at FDR < 25% in ER-negative tumors and normal-adjacent tissues, and both pathways have been previously reported to play key roles in ionizing radiation induced tumorigenesis in experimental settings.

Conclusion

Our findings provide insights into the molecular pathways of radon exposure that may influence breast cancer etiology.
The support and information needs of adolescents and young adults with cancer when active treatment ends
Authors: Lea Sarah , Martins Ana , Fern Lorna A. , Bassett Matthew , Cable Maria , Doig Gary , Morgan Sue , Soanes Louise , Whelan Michael , Taylor Rachel M.
Published: July 2020

Background

The end of active treatment is a period of high stress for young people with cancer, but limited literature exists about their information and support needs during this phase. This study aimed to understand the needs of young people with cancer, how these needs are currently being met, and how best to provide information and support at the end of active treatment.

Methods

This was a multi-stage, mixed methods study exploring the end of treatment experience from the perspectives of young people, and the healthcare professionals caring for them. Semi-structured interviews were undertaken with healthcare professionals, which informed a survey administered nationally. Subsequently, semi-structured interviews were conducted with young people. These combined results informed a co-design workshop to develop recommendations.

Results

Telephone interviews were conducted with 12 healthcare professionals and 49 completed the online survey. A total of 11 young people aged 19–26 years (female = 8; 73%) were interviewed. The stakeholder workshop was attended by both healthcare professionals (n = 8) and young people (n = 3). At the end of treatment young people experience numerous ongoing physical issues including pain, fatigue and insomnia; in addition to a range of psychosocial and emotional issues including anxiety, fear of recurrence and isolation. The top three priorities for end of treatment care were: earlier provision and preparation around on-going impact of cancer and cancer treatment; standardised and continued follow-up of young people’s emotional well-being; and development of more information and resources specific to young people.

Conclusion

The access and availability of appropriate information and sources of support at the end of treatment is variable and inequitable. Young people’s needs would be more effectively met by timely, structured and accessible information, and support provision at the end of treatment to both prepare and enable adaptation across their transition to living with and beyond cancer. This will require both organisational and practical adjustments in care delivery, in addition to a renewed and updated understanding of what the ‘end of treatment’ transition process means.