bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence and Risk Factors of Illnesses Presumably Caused by A SARS-CoV-2 Infection in The General Population During The Lockdown Period: A Multi-Cohort Study.
Authors: Carrat Fabrice , Touvier Mathilde , Severi Gianluca , Meyer Laurence , Jusot Florence , Lapidus Nathanael , Rahib Delphine , Lydié Nathalie , Charles Marie-Aline , Ancel Pierre-Yves , Rouquette Alexandra , de Lamballerie Xavier , Zins Marie , Bajos Nathalie
Published: October 2020

Background Our main objectives were to estimate the incidence of illnesses presumably caused by SARS-CoV-2 infection during the lockdown period and to identify the associated risk factors.Methods Participants from 3 adult cohorts in the general population in France were invited to participate in a survey on COVID-19. The main outcome was possible COVID-19, defined as a sudden onset of cough, fever, dyspnea, ageusia and/or anosmia, that lasted more than 3 days and occurred during the 17 days before the survey. We used delayed-entry Cox models to identify associated factors.Results Between April 2, 2020 and May 12, 2020, 279,478 participants were invited, 116,903 validated the questionnaire and 106,848 were included in the analysis. Three thousand thirty-five cases of possible COVID-19 were reported during 62,099 person-months of follow-up. The cumulative incidences of possible COVID-19 were 6.2% (95% Confidence Interval (95%CI): 5.7%; 6.6%) on day 15 and 8.8% (95%CI 8.3%; 9.2%) on day 45 of lockdown. The risk of possible COVID-19 was lower in older age groups and higher in French regions with a high prevalence of SARS-CoV-2 infection, in participants living in cities >100,000 inhabitants (vs rural areas), when at least one child or adolescent was living in the same household, in overweight or obese people, and in people with chronic respiratory diseases, anxiety or depression or chronic diseases other than diabetes, cancer, hypertension or cardiovascular diseases. Conclusion The incidence of possible COVID-19 in the general population remained high during the first two weeks of lockdown, and decreased significantly thereafter. Modifiable and non-modifiable risk factors were identified.
Implementation and Sustainability Factors of Two Early-Stage Breast Cancer Conversation Aids in Diverse Practices
Authors: Schubbe Danielle , Yen Renata W. , Saunders Catherine H. , Elwyn Glyn , Forcino Rachel , O’Malley A. James , Politi Mary C. , Margenthaler Julie , Volk Robert J. , Sepucha Karen , Ozanne Elissa , Percac-Lima Sanja , Bradley Ann , Goodwin Courtney , Muijsenbergh Maria van den , Aarts Johanna WM , Scalia Peter , Durand Marie-Anne
Published: October 2020

BackgroundConversation aids can facilitate shared decision making and improve patient-centered outcomes. However, there are few examples of sustained use of conversation aids in routine care due to numerous barriers at clinical and organizational levels. We explored strategies that will promote the sustained use of two early-stage breast cancer conversation aids. We examined any differences in experiences and opinions between the two conversation aids and across socioeconomic strata. MethodsWe nested this study within a randomized controlled trial evaluating two early-stage breast cancer surgery treatment conversation aids, one text-based and one picture-based, across four health systems with socioeconomically diverse patient populations. We conducted semi-structured interviews with a sample of patient participants, purposively sampled across conversation aid assignment and socioeconomic status (SES), and collected observations and field-notes. We also interviewed trial surgeons and other stakeholders. We conducted a framework analysis of all interviews, notes, and observations with two independent coders using the NOrmalization MeAsure Development through Normalization Process Theory. We also conducted an inductive analysis. We conducted additional sub-analyses based on which conversation aid was used/received and patient SES. ResultsWe conducted 73 semi-structured interviews with 43 patients, 16 surgeons, and 14 stakeholders like nurses, cancer center directors, and electronic health record (EHR) experts. Patients and surgeons felt the conversation aids should be used in breast cancer care in the future and were open to various methods of giving and receiving the conversation aid (EHR, email, patient portal, before consultation). Patients of higher SES were more likely to note the conversation aids influenced their treatment discussion, while patients of lower SES noted more influence on their decision making. Intervention surgeons reported using the conversation aids did not lengthen their typical consultation time. Most intervention surgeons felt using the conversation aids was similar to their usual care after using it a few times, and most patients felt it appeared part of their normal routine. ConclusionsKey factors that will help guide the future sustained implementation of the conversation aids include adapting to existing clinical workflows, flexibility of use, patient characteristics and communication preferences.Trial registrationNCT03136367 at ClinicalTrials.gov
Thermolabile Drug Storage in an Ambulatory Setting
Authors: Pazo-Oubiña Fernando do , Alorda-Ladaria Bartomeu , Lobon Ana Gómez , Vallespir Bàrbara Boyeras , Estelrich Maria Margalida Santandreu , Puigserver Clara Martorell , Zamora María Gómez , Bosch Pere Ventayol , Sánchez Olga Delgado
Published: October 2020

BackgroundMore and thermolabile drugs are becoming available, and in most cases, these medications are dispensed to ambulatory patients. However, there is no regulation once medications are dispensed to patients and little is known with regard to what happens during transport and home storage. Previous studies suggest that these drugs are improperly stored. The present study was designed to determine the storage conditions of thermolabile drugs once they are dispensed to the patient in the Hospital Pharmacy Department.MethodsThis is a prospective observational study to assess the temperature profile of 7 thermolabile drugs once they are dispensed to ambulatory patients at a tertiary care hospital. A data logger was added to the medication packaging. Temperature was considered inappropriate if one of the following circumstances were met: any temperature record less than or equal to 0ºC or over 25ºC; temperatures between 0-2ºC or 8ºC-25ºC for a continuous period over 30 minutes. The time series of temperature measurements obtained from each data logger were analyzed as statistically independent variables. The data shown did not undergo any statistical treatment and must be considered directly related to thermal measurements.ResultsOne hundred and fourteen patients were included and 107 patients were available for the analysis. On the whole, a mean of 50.6 days (SD 18.3) were measured and the mean temperature was 6.88ºC (SD 2.93). Three data loggers (2.8%) maintained all the measurements between 2ºC and 8ºC with less than 3 continuous data (< 30 minutes) out of this range but no data over 25ºC or below or equal to 0ºC. 28 (26.2%) data loggers had at least one measurement below zero, 1 data logger had a measurement greater than 25ºC and 75 (70.1%) were between 0ºC and 2ºC and/or between 8º and 25ºC for more than 30 minutes.ConclusionsOnce dispensed to patients, most thermolabile drugs are improperly stored. Future studies should focus on clinical consequences and possible solutions.
Co-culture of Vel1-overexpressed Trichoderma asperellum and Bacillus amyloliquefaciens: An eco-friendly strategy to hydrolyze the lignocellulose biomass in soil to enrich the soil fertility, plant growth and disease resistance
Authors: Karuppiah Valliappan , Zhixiang Lu , Liu Hongyi , Vallikkannu Murugappan , Chen Jie
Published: October 2020

Background: Retention of agricultural bio-mass residues without proper treatment could affect the subsequent plant growth. In the present investigation, the co-cultivation of genetically engineered T. asperellum and B. amyloliquefaciens has been employed for multiple benefits including the enrichment of lignocellulose biodegradation, plant growth, defense potential and disease resistance. Results: The Vel1 gene predominantly regulates the secondary metabolites, sexual and asexual development as well as cellulases and polysaccharide hydrolases productions. Overexpression mutant of the Trichoderma asperellum Vel1 locus (TA OE-Vel1) enhanced the activity of FPAase, CMCase, PNPCase, PNPGase, xylanase I, and xylanase II through the regulation of transcription regulating factors and the activation of cellulase and xylanase encoding genes. Further, these genes were induced upon co-cultivation with Bacillus amyloliquefaciens (BA). The co-culture of TA OE-Vel1 + BA produced the best composition of enzymes and the highest biomass hydrolysis yield of 89.56 ± 0.61%. The co-culture of TA OE-Vel1 + BA increased the corn stover degradation by the secretion of cellulolytic enzymes and maintained the C/N ratio of the corn stover amended soil. Moreover, the TA OE-Vel1 + BA increased the maize plant growth, expression of defense gene and disease resistance against Fusarium verticillioides and Cohilohorus herostrophus. Conclusion: The co-cultivation of genetically engineered T. asperellum and B. amyloliquefaciens could be utilized as a profound and meaningful technique for the retention of agro residues and subsequent plant growth.
Satellite View of Vegetation Dynamics and Drivers Over Southwestern China
Authors: Yan Wei , Wang Hesong , Jiang Chao , Jin Shaofei , Ai Jinlong , Sun Osbert Jianxin
Published: October 2020

Background: Vegetation is a key component of terrestrial ecosystems. The dynamics of vegetation can be used as an indicator of vegetation health and ecosystem stability. However, the dynamics and responses of vegetation in Southwestern China remain unclear.Methods: Both monotonic and turning point approaches were used in trend analysis to understand the dynamics of vegetation. We applied partial correlation analysis and the relative importance of climatic factors to determine the drivers of vegetation dynamics. Residual trend analysis was applied to distinguish other drivers.Results: The annual mean NDVI generally increased at a rate of 0.0011 year−1 from 1982 to 2015, but much of the study area showed the opposite trend before and after the turning point during this period. The vegetation in the western part of the study area was degraded and increased significantly in the eastern part of the study area. An increasing trend that continued to an increasing trend (II) and a decreasing trend that changed into an increasing trend (DI) were two of the largest patterns of vegetation trends, and they were mainly distributed in the eastern part of the study area. An increasing trend that changed into a decreasing trend (ID) was mainly distributed in the western part of the study area, where the vegetation types were mainly evergreen needle-leaved and grassland. Temperature was the dominant climatic factor and had a positive correlation with vegetation in the eastern part of the study area. Temperature also had some negative correlations with vegetation in western mountainous areas where surface soils are prone to droughts. Solar radiation had a positive correlation with vegetation in the western part of the study area. In addition, the regions with more intensity human activities than other areas were concentrated in the eastern part of the study area.Conclusions: The spatial distribution and trend showed high heterogeneity over Southwestern China. Temperature was the dominant climatic factor. In the eastern part of the study area, human activities played an important role in vegetation greening.
Disparity in Physician-Patient Communication by Ethnicity: Evidence from Bangladesh
Authors: Zakaria Muhammad , Karim Rezaul , Rahman Murshida , Cheng Feng , Xu Junfang
Published: October 2020

Background: Physician-patient communication is the primary process by which medical decision-making occurs and health outcome depends. Physician-patient communication differences may partly from the ethnic disparities. To examine this problem, this study aims to explore whether physician-patient communication differs by ethnic in primary care medical consultations. Methods: The study was conducted among the Bengali and ethnic minority patients (N = 850) who visited the physician for medical consultations. Data were collected using a structured post-consultation questionnaire. T-test was conducted to compare the communication between the Bengali and ethnic minority patients. Multiple linear regression analyses were performed to identify the factors associated with favorable communication behavior from the physicians. Results: Bengali patients received more supportive communication behaviors from the Bengali doctors than that of ethnic minority patients including physicians’ cheerful greetings, encouraging patients to express health problems and asking questions, listening carefully, responding to the questions and concerns, explaining the patients about a medical test, medication, and probable side effects, discussing the treatment options, involved the patients in decisions and spending adequate time. Results of linear regression explored that respondents’ education year, internet use, knowledge on the health problem, having a pre-plan about the content of medical consultation, information seeking about the health problem, visiting female doctors, and quiet ambience of the doctor’s room are significantly associated with better PPCB score for the Bengali patients. In contrast, age, being the resident of an urban area, perception of affecting a minor health problem, having a pre-plan about the content of medical consultation, patients’ involvement in physicians’ decision-making about the treatment, and talking time resulted in better physician-patient communication for the ethnic minority patients. Conclusion: This study suggests for reducing the disparity in the socio-economic status of the ethnic minority people through development program and teaching healthcare providers how to use patient-centered communication skills to engage their patients is one solution to improve equity in the delivery of healthcare and make sure patients are receiving high-quality treatment, no matter their race or ethnicity.
"We're Actually More of a Likely Ally than an Unlikely Ally": Relationships Between Syringe Services Programs and Law Enforcement
Authors: Franco Carol Y. , Lee-Winn Angela , Brandspigel Sara , Alishahi Musheng , Brooks-Russell Ashley
Published: October 2020

Syringe Services Programs (SSPs) provide sterile needles and a range of health services (e.g., HIV and HEP-C testing, overdose prevention education, provision of naloxone) to a hard-to-reach population, including people who inject drugs (PWID), aiming to prevent the transmission of infectious diseases. We performed a qualitative needs assessment of existing SSPs in the state of Colorado in 2018-2019 to describe the SSP activities, needs, and barriers. We performed semi-structured interviews with key program staff of SSPs (n=11). All interviews were digitally recorded, transcribed, and validated. Qualitative researchers coded each transcript and maintained coding consistency through coding statistics (Kappa coefficient > 0.80) between coders. Memos were written to synthesize main themes. Nearly all the SSPs discussed their relationships with law enforcement at length. All SSPs viewed having a positive relationship with law enforcement as critical to the success of their program. Main factors that influence the quality of relationships between SSPs and law enforcement included: 1) alignment in agency culture, 2) support from law enforcement leadership, 3) police officers’ participation and compliance with the Law Enforcement Assisted Diversion (LEAD) program, which provides intensive case management for low-level drug offenders, and 4) implementation of the “Needle-Stick Prevention Law” and Drug Paraphernalia Law Exemption. All SSPs expressed a strong desire to have positive relationships with law enforcement and described how a collaborative working relationship was critical to the success of their programs. Our findings suggest effective strategies to foster relationships between SSPs and law enforcement as well as key barriers to address.
Induction a Rat Model of Premature Ovarian Insufficiency (POI) Using D Galactose Feeding During the Critical Periods of Development: an Experimental Protocol
Authors: Dovom Marzieh Roatami , Noroozzadeh Mahsa , Mosaffa Nariman , Piryaei Abbas , Zadevakili Azita , Abdollahifar Mohammad-Amin , Tehrani Fahimeh Ramezani
Published: October 2020

Introduction: Premature ovarian insufficiency (POI) affects about 1% of women of reproductive age, with no curative treatment. Several efforts have been made to develop an animal model of POI that mimics all manifestations of this disease; however, these models are limited due to increased mortality or high toxicity. Overall, well-developed animal models may improve our knowledge of diseases and can be suitable for identifying the underlying mechanisms and detecting the optimal treatment methods. In the present study, we aimed to present a functional rat model of POI, mimicking the clinical manifestations of POI in women. Materials and Methods: This experimental study was performed in two steps. In the first step (induction of the rat POI model), a total of 40 pregnant Wistar rats were randomly divided into four groups. Three experimental groups were fed galactose-enriched diets at days 3-15 of pregnancy (group 1); on the third day of pregnancy until the end of pregnancy (group 2); and on the third day of pregnancy until the end of the weaning period (group 3). Also, group 4 (control group) was fed a standard pellet during pregnancy and breastfeeding period. In the second step of the study, the ovarian morphology (microscopic and macroscopic), reproductive hormones, and immunological and metabolic characteristics of the female offspring were examined in all experimental groups and compared with the controls at three time points, that is, postnatal days (PNDs) 45, 105, and 180 of age.Results: In this study, we presented an optimal model of POI that highly mimics the clinical manifestations of this disease in women. Conclusion: A functional rat model of POI may be suitable for increasing our understanding of this disease and filling the knowledge gaps.
Combination Therapy With Remdesivir, Dexamethasone, and Tocilizumab in Patients With Severe Corona Virus Disease 2019 in Clinical Practice
Authors: Izumo Takehiro , Inomata Minoru , Kuse Naoyuk , Awano Nobuyasu , Tone Mari , Takada Kohei , Muto Yutaka , Fujimoto Kazushi , Ueda Akihiro , Hayashi Munehiro
Published: October 2020

BackgroundThe use of several promising drugs for coronavirus disease 2019 (COVID-19) has emerged. However, considering the pathophysiology of COVID-19, the effect of a single agent is limited. Hence, the current study aimed to compare the clinical outcomes between patients who received combination treatment with remdesivir, dexamethasone, and tocilizumab (RDT) and those who did not.MethodsPatients who received combination therapy with RDT at Japanese Red Cross Medical Center were included in the RDT group, and those who did not in the control group. The mortality rate and presence of severe adverse events were compared between the two groups.ResultsIn total, 46 patients (n = 29, control group and n = 17, RDT group) with severe COVID-19 were enrolled in this study. The 28-day mortality rate was significantly lower in the RDT group than in the control group, with 1 (6%) and 9 (31%) deaths recorded, respectively (P = 0.04). Further, both groups did not present with severe adverse events.ConclusionsInformation on the outcomes of combination therapy with RDT was considered useful for the treatment of severe COVID-19.
Roles of ROS and Cell Cycle Arrest in the Genotoxicity Induced by Gold Nanorod Core/silver Shell Nanostructure 
Authors: Wang Dan , Dan Mo , Ji Yinglu , Wu Xiaochun , Wang Xue , Wen Hairuo
Published: October 2020

To understand the genotoxicity induced in the liver by silver nanoparticles (AgNPs) and silver ions, an engineered gold nanorod core/silver shell nanostructure (Au@Ag NR) and humanized hepatocyte HepaRG cells were used in this study. The involvement of oxidative stress and cell cycle arrest in the DNA and chromosome damage induced by 0.4 - 20 µg.mL-1 Au@Ag NR were investigated by comet assay, γ-H2AX assay, and micronucleus test. Further, the distribution of Au@Ag NR was analyzed. Our results demonstrated that both Ag+ and Au@Ag NR led to DNA cleavage and chromosome damage (clastogenicity) in HepaRG cells, and that the Au@Ag NR retained in the nucleus may further release Ag+, aggravating the damages, which are mainly caused by cell cycle arrest and ROS formation. The results reveal the correlation between the intracellular accumulation, Ag+ ion release as well as the potential genotoxicity of AgNPs.
Interpretation Method of GATEM Data Based on PID Controller Iteration Downward Continuation Method  
Authors: Guan Shanshan , Zhu Yu , Du Bingxuan , Li Dongsheng , Wang Yuan , WU QIONG , Ji Yanju
Published: October 2020

The Ground-source Airborne Time-domain Electromagnetic (GATEM) system has advantages for high efficiency and complex areas such as mountainous zone. The widely used section interpretation method, ignoring the impact of flight height, which seriously affects the interpretation and imaging accuracy of shallow anomalies. The PID controller iteration downward continuation method is proposed. Based on the original continuation iteration method, the differential coefficient and integral coefficient are added. The result shows that the new method remarkably decreases the iteration number and the accuracy are verified by comparison with the numerical integration solution. The PID controller iteration downward continuation method is applied to the interpretation of GATEM data. For synthetic data, the after continuation interpretation results are closer to the true model than the z = 30 m interpretation results. The method is also applied to GATEM field data in Yangquan City, Shanxi Province, China. The interpretation performs using PID controller iteration downward continuation results in a reliable GATEM field.
Productivity and Profitability of Mechanized Deep Nitrogen Fertilization in Mechanical Pot-Seedling Transplanting Rice in South China
Authors: Li Lin , Zhang Zheng , Tian Hua , Ashraf Umair , Mo Zhaowen , Duan Meiyang , Wang Zaiman , Wu Tiaoyan , Tang Xiangru , Pan Shenggang
Published: October 2020

Background: The deep nitrogen (N) fertilization coupled with mechanical pot-seedling transplanting rice (DNF-MPT) is an effective alternative to traditional transplanted rice with broadcasting fertilizer, however, little is known about its effects on grain yield, nutrient accumulation, and economic profitability. In present study, a two-year field experiment was conducted in early seasons (March-July) of 2019 and 2020. All seedlings were transplanted by DNF-MPT, whereas four treatments were designed as: MD: mechanized deep placement of all fertilizers as base fertilizer; MDB: mechanized deep placement of 70% fertilizers as basal fertilizer, 30% broadcasting fertilizers at panicle initiation stage; MB: manual broadcasting of 40%, 30% and 30% fertilizers at the transplanting, tillering and panicle initiation stages, respectively; and CK: no fertilizer was applied during entire growth stages. Results: The results indicated that MD treatment substantially improved the grain yield by 33.48-36.35%, total nitrogen accumulation (TNA) by 26.38-44.15%, total phosphorus accumulation (TPA) by 28.72-30.23%, and total potassium accumulation (TKA) by 25.61-37.33%, respectively, compared with MB treatment. Deep placement of N fertilization treatments i.e., MD and MDB remarkably promoted root morphological indexes and total root dry weight. Furthermore, nitrate reductase (NR), glutamine synthetase (GS) activities and total chlorophyll content (total Chl) of leaves were also enhanced under deep placement of N fertilizer. Overall, the MD treatment had the highest benefit cost ratio (BCR) owing to high gross returns and low input costs. Conclusions: Deep placement of N fertilizer coupled with mechanical pot-seedling transplanting rice could be better alternative to conventional rice production system with more economic benefits.
Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention in Coronary Artery Disease Patients with Advanced Chronic Kidney Disease: A Chinese Single-Center Study
Authors: Li Yang , Rui Hongliang , Huang Zhuhui , Xu Xiaoyu , Liu Taoshuai , Zheng Jubing , Hou Xuejian , Xu Shijun , Dong Ran
Published: October 2020

Objectives Aims to compare the contemporary and long-term outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in coronary artery disease (CAD) patients with advanced chronic kidney disease (CKD). Design Observational cohort study, single-center.Setting The largest cardiac surgery center in China.Participants 823 CAD patients with advanced CKD (eGFR<30 ml/min/1.73m2) were collected, including 247 patients who underwent CABG and 576 patients received PCI from January 2010 to February 2019. Main outcome measures The primary end point was all-cause death. The secondary end points included major adverse cardiac and cerebrovascular events (MACCEs), myocardial infarction (MI), stroke and revascularization.Results Multivariable Cox regression models were used for risk-adjustment and propensity score matching (PSM) was also performed. After PSM, the 30-day mortality rate in the CABG group was higher than that in the PCI group but without statistically significant (6.6%vs2.4%, p=0.0640). During the first year, patients referred for CABG had a hazard ratio (HR) of 1.42 [95% confidence interval (CI), 0.41–3.01] for mortality compared with PCI. At the end of the 5-year follow-up, CABG group had a HR of 0.58 (95%CI, 0.38-0.86) for repeat revascularization, a HR of 0.77 (95%CI, 0.52-1.14) for survival rate and a HR of 0.88(95%CI, 0.56-1.18) for MACCE as compared to PCI. Conclusions Our study suggests that among advanced CKD patients，CABG showed obviously lower risk for repeat revascularization and slightly better prognosis regarding to mortality and other adverse events compared with PCI during the long-term follow-up. At a mean pooled follow-up of one year, both mortality and MACCEs were comparable in both cohorts.
Surgery for Primary Giant Acinic Cell Carcinoma of Right Lung with Severe Mediastinal Deviation: A Case Report
Authors: Chen Xueyu , Zhang Nengchong , Luo Fangxiu , Zhu Lianggang
Published: October 2020

Background: Primary lung acinic cell carcinoma is very rare.Here we report a young female patient who suffered the largest primary lung acinic cell carcinoma and severe mediastinal deviation at the same time which has never been reported before.Case presentation: A 27-years-old married female patient presented with recurrent coughing and hemoptysis for more than ten years came to our hospital.A chest computed tomography was performed in our hospital and showed a giant space-occupying lesion in the hilum of right lung.After a thorough and detailed preoperative examination,the patient then was performed a radical right pneumonectomy and mediastinal lymph node dissection.The specimens and pathology showed that the size of the tumor was about 8.6×4.5×4.4cm.The morphology of the tumor cell under microscope demonstrate a primary acinic cell carcinoma of right lung.The immunohistochemistry of the tumor showed AE1/AE3(+), Ki-67(2% +), CK7(+), Calponin(+/-), Vimentin(+), CK19(+), a-ACT(+), PAS(partial+). The patient was discharged two weeks after the operation.So far,the patient has been followed-up for one year, all the clinical test indexes are normal and no evidence of tumor recurrence or metastasis was observed. Conclusions: The primary acinic cell carcinoma of lung in this case is the biggest one ever been reported.The patient also had a very rare condition of severe mediastinal deviation.After surgical treatment, the patient recovered uneventfully and had stable disease without recurrence after one year of follow-up.This case indicates that acinic cell carcinoma of lung is of low malignancy, the prognosis and therapy effect of surgical treatment are satisfied.
Can Enhancement Pattern and Enhancement Level on Biphasic Enhanced CT Distinguish Homogeneous Pheochromocytomas From Adenomas Without Lipid
Authors: An Yongyu , Tian Fengjuan , Lin Bin , Shao Meihua , Zhu Fangmei , Ji Hongli , He Linyang , Hu Qiuxiang , Wang Jian
Published: October 2020

Objective The purpose of our study was to evaluate whether enhancement pattern and enhancement level on biphasic enhanced CT can distinguish homogeneous pheochromocytomas from adenomas without lipid and explore the value of percentage of peak enhancement (PPE) in differentiating the two entities.Methods We retrospectively analysed pathologically proven 17 pheochromocytomas and 34 adenomas. Both tumors were homogeneous without necro-cystic changes and hemorrhage. The inclusion criteria for adenomas without lipid in our study was that the mean attenuation values were greater than 10 HU and the minimum values were greater than 0 HU on unenhanced CT. Biphasic CT scan protocol consisted of unenhanced phase, arterial phase (25-35 seconds) and venous phase (60-80 seconds). The enhancement pattern, attenuation values on unenhanced and enhanced phases and PPE were compared between the two groups.Results Enhancement pattern was similar between the two groups (p>0.99), persistent enhancement pattern on venous phase was the most common in both tumors. The precontrast CT values of pheochromocytomas were significantly higher than that of adenomas without lipid (41 HU vs 37 HU, p=0.006). The enhancement level on arterial and venous phase of pheochromocytomas was greater than that of adenomas without lipid, but no significant differences were found (100 HU vs 85 HU, p=0.223; 103 HU vs 96 HU, p=0.905, respectively). The distribution of PPE of two entities was different. A range of 100%-240% of PPE can discriminate adenomas without lipid from pheochromocytomas, with sensitivity of 88.2%, specificity of 47.1%. Conclusion The enhancement pattern and enhancement level on biphasic enhanced CT could not distinguish homogeneous pheochromocytomas from adenomas without lipid. Further studies are needed to prove the potential value of PPE due to its low specificity.
The Potential of Adipokines in Identifying Multiple Trauma Patients at Risk of Developing Multiple Organ Dysfunction Syndrome
Authors: Haupt Julian , Krysiak Niels , Unger Marina , Bogner-Flatz Viktoria , Biberthaler Peter , Hanschen Marc , Griensven Martijn van , Haug Alexander T.
Published: October 2020

BackgroundMultiple organ dysfunction syndrome (MODS) and the consecutive multiple organ failure (MOF) are severe and dreaded complications with a high mortality in multiple trauma patients. The aim of this study was to investigate the potential of the adipokines leptin, resistin, interleukin-17A and interleukin-33 as possible biomarkers in the early posttraumatic inflammatory response and for identifying severely traumatized patients at risk of developing MODS.MethodsIn total, 14 multiple trauma patients with an injury severity score (ISS) ³ 16 as well as a control group of 14 non-multiple trauma patients were included in this study and blood samples were taken at the time points 0, 6, 24, 48 and 72h after admission. For the trauma patients, the SIRS and Denver MOF score were determined daily. The quantitative measurement of the plasma concentrations of the adipokines was performed using ELISA. ResultsIn the statistical analysis, the multiple trauma patients showed statistically significant higher plasma concentrations of leptin, resistin, IL-17A and IL-33 compared to the control group. In addition, there was a statistically significant positive correlation between the concentrations of resistin, IL-17A and IL-33 and the corresponding SIRS scores and between the concentrations of resistin, IL-17A and IL-33 and the corresponding Denver MOF scores. Finally, ROC curve analysis revealed that the adipokines leptin and IL-17A are suitable diagnostic markers for the discrimination between multiple trauma patients with and without MOF. ConclusionsThe results of this study may contribute to identify severely injured patients with a developing SIRS and MOF earlier, in order to adjust therapy strategies.
Maximum Standardized Uptake Value in Lymph Nodes Measured by 18F-FDG PET/CT Predicts the Outcome of Patients with Oesophagus Squamous Cell Carcinoma
Authors: Ren Wenjia , Chen Weiwei , Chen Yun , Liu Qi , Ai Dashan , Deng Jiaying , Zhao Kuaile
Published: October 2020

Background: To investigate the prognostic value of 18F–fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in esophagus squamous cell carcinoma (ESCC), PET/CT imaging characteristics were explored in the present study.Methods: Baseline PET/CT and clinical characteristics were collected in 125 patients with ESCC treated with radical radiotherapy from 2007–2016. The maximum standardized uptake value (SUVmax) of the primary gross tumour (SUVmax-T) and metastatic lymph node (SUVmax-N) were separately measured using X-tile. Overall survival (OS) and progression free survival (PFS) were estimated according to the Kaplan–Meier method. A multivariate Cox model was used to establish the independent prognostic factors.Results: The gross tumours presented higher 18F-FDG uptake than normal tissues with a median SUVmax-T of 12.5. The OS and PFS did not show significant differences between patients with SUVmax-T ≥ 12.5 and those with SUVmax-T <12.5 (P>0.05). However, patients with SUVmax-N ≥ 11 had a significantly worse OS and PFS than those with SUVmax-N <11 (P<0.05). A weak correlation was observed in SUVmax-T and SUVmax-N. The OS and PFS of patients with PET-negative LNs was significantly better than those with PET-positive LNs. However, the OS and PFS of patients with one or two PET-positive LNs were not significantly better than those with more than two PET-positive LNs. In the univariate analysis, cT stage, positive or negative lymph nodes on the PET-CT image and the SUVmax-N were established as significant prognostic factors for both OS and PFS. In multivariate analysis, SUVmax-N was proved to be an independent predictor for OS and PFS.Conclusions: SUVmax-N, but not SUVmax-T, is an independent prognostic indicator for patients with ESCC.
A Simple and Cost-effective Technique for Deep Inspiration Breath-hold Radiotherapy in Left-sided Breast Cancer Patients: A Retrospective Study
Authors: Koide Yutaro , Kitagawa Tomoki , Aoyama Takahiro , Shimizu Hidetoshi , Wakabayashi Kohei , Miyauchi Risei , Tanaka Hiroshi , Tachibana Hiroyuki , Kodaira Takeshi
Published: October 2020

Background: Deep inspiration breath-hold (DIBH) radiotherapy is effective but requires specific devices for tracking the respiratory cycle or surface motion. There are some reports of DIBH without such devices. However, to the best of our knowledge, no study has evaluated all three components which are: setup accuracy, dose assessment, and treatment time. We evaluated the accuracy, effect of dose reduction on organs at risk (OARs), and the treatment time of our DIBH technique, which avoids the use of such devices.Methods: We analyzed 64 left-sided early breast cancer patients. Three-dimensional conformal radiotherapy treatment plans of 42.56 Gy in 16 fractions were created in free-breathing (FB) and DIBH settings. Thirty patients were evaluated for inter- and intra-fractional displacement. The treatment room entry-to-exit times were measured and retrospectively compared with those of 44 right breast cancer patients who received FB radiotherapy (Right-FB) in the same period. The volumes and dose metrics of the clinical target volume (CTV) and contoured OARs (HEART, left anterior descending artery [LAD], and LUNG) were compared between FB and DIBH.Results: The average inter-fractional, intra-fractional, and overall setup displacement were 2.32 ± 1.30, 0.55 ± 0.43, and 2.46 ± 1.24 mm, respectively. Compared to Right-FB, the medians of entry-to-exit times slightly increased in DIBH (9 vs 7 minutes, P = 3.95e-23). The LUNG volume in DIBH was 1.58 times larger than that in FB, but other volumes were not statistically different. Compared to FB, the median HEART, LAD, and mean LUNG doses decreased significantly in DIBH: 1.67 vs 0.71 (P = 9.72e-15), 13.0 vs 2.3 (P = 6.65e-15), and 2.42 vs 2.03 (P = 6.80e-8) Gy, respectively. CTV doses were not statistically different.Conclusions: With only minor setup errors, this simple and cost-effective DIBH technique is a feasible method. It can be easily tested for new facilities and is expected to accelerate the further clinical implementation.Trial registration:
An Application Deployment Approach for City IoT Applications in Resource-constrained Edge Computing Environments
Authors: Liu Jialei , Huang Quanzhen
Published: October 2020

With the development and utilization of more and more city Internet of Things (IoT) applications with high resource requirements, how to reduce the consumption of energy, processor resources and bandwidth resources in resource-constrained edge clouds while ensuring the execution delay of these applications is an urgent problem to be solved. Therefore, an optimal energy-bandwidth tradeoff deployment approach for city IoT application is proposed for resource-constrained edge clouds. In this approach, the city IoT applications are first divided into multiple collaborative tasks and offload to edge clouds. Secondly, a joint optimization model including energy consumption, resource wastage, resource load imbalance and bandwidth resource consumption is established for the task offloading scheme. Thirdly, the city IoT application deployment problem is optimized under the constraints of resource and execution delay. Finally, a comprehensive simulation test is conducted to analyze the deployment approaches from the aspects of performance and effectiveness. The experimental results show that our deployment approach is superior to other related approaches.
Contribution of Nontraditional Lipid Profiles to Hyperuricemia in a Hypertensive Population: Findings from the China Hypertension Registry Study
Authors: Yu Yu , Fang Wangsheng , Wang Dandan , Tao Yu , Li Minghui , Huang Xiao , Zhou Wei , Wang Tao , Zhu Lingjuan , Bao Huihui , Cheng Xiaoshu
Published: October 2020

Background: Current studies support nontraditional lipid profiles [total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio, triglyceride (TG)/HDL-C ratio, low-density lipoprotein cholesterol (LDL -C)/HDL-C ratio, non-high-density lipoprotein cholesterol (non-HDL-C)] as reliable indicators of cardiovascular disease, stroke and diabetes. However, whether nontraditional lipid profiles can be used as reliable markers for hyperuricemia (HUA) remains unclear due to limited research. The present study investigated the relationship of nontraditional lipid profiles with HUA in hypertensive patients.Methods: We analyzed data from 13,721 Chinese hypertensive population untreated with lipid-lowering drugs. The relationship between non-traditional lipid profiles and HUA was examined by multivariate logistic regression analysis and smooth curve fitting (penalized spline method).Results: The results showed that there were positive associations of TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio, and non-HDL-C with HUA, respectively (all P <0.001). Furthermore, nontraditional lipid profiles were converted from continuous variables to tertiles. Compared with lowest tertile, the multivariate adjusted ORs (95% CI) of TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio and non-HDL-C in highest tertile were 1.79 (1.62, 1.99), 2.09 (1.88, 2.32), 1.67 (1.51, 1.86), 1.93 (1.74, 2.13), respectively (all P <0.001).Conclusions: In Chinese hypertensive population, there were positive associations between nontraditional lipid profiles (TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio, and non-HDL-C) and HUA. Our findings further expand the scope of application of nontraditional lipid profiles. These novel and important results suggest that nontraditional lipid profiles can be used as potential and valuable indicators of HUA, and provide a new strategy for the prevention and treatment of HUA.
N-terminal Domain Regulates Steroid Activation of Elephant Shark Glucocorticoid and Mineralocorticoid Receptors
Authors: Katsu Yoshinao , Shari Islam MD , Lin Xiaozhi , Takagi Wataru , Urushitani Hiroshi , Kohno Satomi , Hyodo Susumu , Baker Michael E.
Published: October 2020

Orthologs of human glucocorticoid receptor (GR) and human mineralocorticoid receptor (MR) first appear in cartilaginous fishes. Subsequently, the MR and GR diverged to respond to different steroids: the MR to aldosterone and the GR to cortisol and corticosterone. We report that cortisol, corticosterone and aldosterone activate full-length elephant shark GR, and progesterone, which activates elephant shark MR, does not activate elephant shark GR. However, progesterone inhibits steroid binding to elephant shark GR, but not to human GR. Together, this indicates partial functional divergence of elephant shark GR from the MR. Deletion of the N-terminal domain (NTD) from elephant shark GR (truncated GR) reduced the response to corticosteroids, while truncated and full-length elephant shark MR had similar responses to corticosteroids. Swapping of NTDs of elephant shark GR and MR yielded an elephant shark MR chimera with full-length GR-like increased activation by corticosteroids and progesterone compared to full-length elephant shark MR. Elephant shark MR NTD fused to GR DBD+LBD had similar activation as full-length MR, indicating that the MR NTD lacked GR-like NTD activity. We propose that NTD activation of human GR evolved early in GR divergence from the MR.
Effects of Covid-19 confinement on the mental health of children and adolescents in Spain
Authors: Ordóñez-Camblor Nuria , Pizarro-Ruiz Juan Pablo
Published: October 2020

In Spain, in order to control COVID-19 transmission, one of the strictest confinement measures in the world for children and teenagers has been implemented. From 14 March to 26 April 2020 underage Spaniards were not allowed to leave their homes, except for reasons of force majeure. This could have consequences on their mental health in both the short and the long term. Thus, the aim of the present study was to explore the consequences of confinement on the mental health of Spanish children and teenagers, at the time when minors had been locked down in their homes between 8 and 10 days. The sample was composed of 590 confined Spanish children and teenagers between 8 and 18 years old. The scales of Depression, Self-esteem, Anxiety, Problems with Emotional Regulation, Rage Control Problems, Integration and Social Competence, Somatic Complaints, Rebellious Behaviour, as well as Awareness of the Problems of the Assessment System for Children and Adolescents (SENA) were used.The results revealed that, during confinement, children and adolescents showed emotional and behavioural alterations. This study, as far as we know, is the first one to explore the psychological consequences of lockdown in minors while it was taking place, with them being the ones directly assessed.
Examination of Agricultural Income Inequality in the European Union
Authors: Kiss Lívia Benita
Published: October 2020

The significant roles of agriculture in the economic development of a country are determinative. It has already made a substantial contribution to the economic prosperity of advanced countries. Its role in the economic development of less developed countries is of vital importance. The share of the population working in agriculture is declining as countries develop. While less than 5% of the population does in rich countries work in agriculture, more than two-thirds of the people in poor countries. It is predominantly the huge productivity increase that makes this reduction in labor possible. The aim of the study is to provide a comprehensive picture of the situation of agriculture in the European Union from 2010 to 2019, with a particular focus on agricultural income and labor force developments. The number of employed in agriculture has decreased globally (by almost -14%) and in the European Union (by nearly -19%). The added value of agriculture has grown at a similar rate worldwide (by almost +22%) and in the European Union (by almost +23%). Indicators of agricultural income showed indicator A an increase of 25.56%, indicator B 39.11% and index C 20.39% in 2017 compared to 2010. In 2019 the gross value added in agriculture was the most significant in Germany, Spain, France, and Italy. Together, the four countries accounted for 42% gross value added in agriculture of EU-28. Indicator A, B and C of agricultural income showed in 2019 the most significant positive change in Bulgaria, in Denmark and Romania. Employment in agriculture was the highest in Poland and Romania in 2019. Several reasons can explain the differences in the development of agricultural performance in each European Union country. These reasons can be grouped. On the one hand, the location varies from country to country. Due to their different locations, their climatic, natural and ecological conditions are different. Another important difference is the size of the states. On the other hand, the structure and organization of society are different. Thirdly, the economic situation and status of each country are different.

Keywords: Agriculture, Labor, Income, Inequality, European Union.
The Observational Research Study with the Trends in Healthcare Training and Leadership Ethics in The United States
Authors: Probst Terrence D. , Kasztelnik Karina
Published: October 2020

This paper summarizes how healthcare training has an influence on the leadership ethics in the U.S. This article includes four primary sections. The first section is the background to the problem, which provides a historical overview of the research on the problem being studied and justifies the need for this study. The second section provides the theoretical foundation models and theories which frame the variables and the research questions. The third section provides an in-depth discussion of various factors related to the problem statement, ultimately providing the population, the variables, the methodology, and the design. The fourth section synthesizes the prior three sections justifying the ten strategic points that frame the study. The methodology is the systematization literature review within this context and approaches for underling current trends in healthcare training in the U.S. Little is known regarding the association between ongoing healthcare refresher training and the severity of among direct patient care staff. This calls for the evaluation of leadership within the healthcare industry and the various strategies employed in finding out how to fund and implement ongoing healthcare refresher trainings for staff members. There is a scarcity of literature focusing on the characteristics of the implementation of healthcare protocols that impact the effectiveness of the programs. The results of the critical review article with analysis both authors can be useful for any business around the World to support and the improvement management decisions.

Keywords: Healthcare, Health Care Leadership, Ethics, Training, Management.