bluuebunny/crossref_metadata_2025 huggingface dataset:
Berberine alters gut microbial function through modulation of bile acids
Authors: Wolf Patricia , Devendran Saravanan , Doden Heidi L. , Ly Lindsey K. , Moore Tyler , Takei Hajime , Nittono Hiroshi , Murai Tsuyoshi , Kurosawa Takao , Chlipala George E. , Green Stefan J. , Kakiyama Genta , Kashyap Purna , McCracken Vance J. , Gaskins H. Rex , Gillevet Patrick M. , Ridlon Jason M.
Published: September 2020

Background: Berberine (BBR) is a plant-based nutraceutical that has been used for millennia to treat diarrheal infections and in contemporary medicine to improve patient lipid profiles. Reduction in lipids, particularly cholesterol, is achieved partly through up-regulation of bile acid synthesis and excretion into the gastrointestinal tract (GI). The efficacy of BBR is also thought to be dependent on structural and functional alterations of the gut microbiome. However, knowledge of the effects of BBR on gut microbiome communities is currently lacking. Distinguishing indirect effects of BBR on bacteria through altered bile acid profiles is particularly important in understanding how dietary nutraceuticals alter the microbiome. Methods: Germfree mice were colonized with a defined minimal gut bacterial consortium capable of functional bile acid metabolism (Bacteroides vulgatus, Bacteroides uniformis, Parabacteroides distasonis, Bilophila wadsworthia, Clostridium hylemonae, Clostridium hiranonis, Blautia producta; B4PC2). Multi-omics (bile acid metabolomics, 16S rDNA sequencing, cecal metatranscriptomics) were performed in order to provide a simple in vivo model from which to identify network-based correlations between bile acids and bacterial transcripts in the presence and absence of dietary BBR.Results: Significant alterations in network topology and connectivity in function were observed, despite similarity in gut microbial alpha diversity (P = 0.30) and beta-diversity (P = 0.123) between control and BBR treatment. BBR increased cecal bile acid concentrations, (P < 0.05), most notably deoxycholic acid (DCA) (P <0.001). Overall, analysis of transcriptomes and correlation networks indicates both bacterial species-specific responses to BBR, as well as functional commonalities among species, such as up-regulation of Na+/H+ antiporter, cell wall synthesis/repair, carbohydrate metabolism and amino acid metabolism. Bile acid concentrations in the GI tract increased significantly during BBR treatment and developed extensive correlation networks with expressed genes in the B4PC2 community. Conclusions: This work has important implications for interpreting the effects of BBR on structure and function of the complex gut microbiome, which may lead to targeted pharmaceutical interventions aimed to achieve the positive physiological effects previously observed with BBR supplementation.
Early cardiac rehabilitation improved prognosis in patients with heart failure following acute myocardial infarction
Authors: Cai He , Cao Pengyu , Sun Wanqing , Zhang Xinying , Li Rongyu , Shao Wangshu , Wang Lin , Zou Lin , Zheng Yang
Published: September 2020

Background: Cardiac rehabilitation (CR) has been shown to improve exercise intolerance and QoL, and minimize re-hospitalizations in patients with congestive heart failure (CHF). However, studies on early CR in patients with acute myocardial infarction (AMI) who developed CHF following percutaneous coronary intervention (PCI) are rare. The purpose of this study is to evaluate the effectiveness of early CR on patients with CHF after AMI following PCI.Methods: Two hundred thirty-seven patients who developed heart failure after AMI following PCI were enrolled. Patients were divided into heart failure with reduced ejection fraction (HFrEF) group (n=55) and heart failure with mid-range ejection fraction (HFmrEF) group (n=182). Of the 237 patients, 78 (22 in HFrEF group and 56 in HFmrEF group) who accepted a two-week CR were further divided into two subgroups based on major adverse cardiovascular events (MACE). Key cardio-pulmonary exercise testing (CPX) variables that may affect the prognosis were identified among the CR patients.Results: Early CR significantly reduced cardiac death in patients with HFrEF (18.2% vs. 60.6%, P=0.02), and reduced re-hospitalization in patients with HFmrEF after AMI (3.6% vs. 21.4%, P=0.02). Serum potassium and CR ratio were independent risk factors for MACE in patients with both HFrEF and HFmrEF after AMI. In the CR group who developed MACE, there were more diabetics (22.2% vs. 66.7%, P=0.035), with higher serum potassium (3.96mmol/l vs. 4.31mmol/l, P=0.043), and lower PETCO2 at ventilatory threshold (VT) (P=0.016). PETCO2 at VT was an independent risk factor for re-hospitalization. The incidence of re-hospitalization was significantly lower when the PETCO2 at VT was greater than 33.5mmHg (0(0.00% vs. 6(13.64%), P=0.03).Conclusions: Early CR reduced the incidence of MACE in patients with heart failure after AMI following PCI. The PETCO2 at VT is an independent risk factor for re-hospitalization, and could be used as a key evaluating hallmark for early CR in patients who developed heart failure after AMI.
Tolvaptan-induced hypernatremia related to low serum potassium level accompanying high blood pressure in patients with acute decompensated heart failure.
Authors: Fukuoka Hidetada , Yachibana Koichi , Shinoda Yukinori , Minamisaka Tomoko , Inui Hirooki , Ueno Keisuke , Inoue Soki , Mine Kentaro , Ueda Kumpei , Hoshida Shiro
Published: September 2020

Backgrounds: Tolvaptan significantly increases urine volume in acute decompensated heart failure (ADHF); serum sodium level increases due to aquaresis in almost all cases. We aimed to elucidate clinical factors associated with hypernatremia in ADHF patients treated with tolvaptan.Methods: We enrolled 117 ADHF patients treated with tolvaptan in addition to standard therapy. We examined differences in clinical factors at baseline between patients with and without hypernatremia in the initial three days of hospitalization. Results: Systolic (p=0.045) and diastolic (p=0.004) blood pressure, serum sodium level (p=0.002), and negative water balance (p=0.036) were significantly higher and serum potassium level (p=0.026) was significantly lower on admission day in patients with hypernatremia (n=22). In multivariate regression analysis, hypernatremia was associated with low serum potassium level (p=0.034). Among patients with serum potassium level ≤3.8 mEq/L, the cutoff value obtained using receiver operating characteristic curve analysis, those with hypernatremia related to tolvaptan treatment showed significantly higher diastolic blood pressure on admission day (p=0.004).Conclusion: In tolvaptan treatment combined with standard therapy in ADHF patients, serum potassium level ≤ 3.8mEq/L may be a determinant factor for hypernatremia development. Among hypokalemic patients, those with higher diastolic blood pressure on admission may be carefully managed to prevent hypernatremia.
LAMP: disease classification derived from layered assessment on modules and pathways in the human gene network
Authors: Mi Zhilong , Guo Binghui , Yang Xiaobo , Yin Ziqiao , Zheng Zhiming
Published: September 2020

Background: Classification of diseases based on genetic information is of great significance as the basis for precision medicine, increasing the understanding of disease etiology and revolutionizing personalized medicine. Much effort has been directed at understanding disease associations by constructing disease networks, and classifying patient samples according to gene expression data. Integrating human gene networks overcomes limited coverage of genes. Incorporating pathway information into disease classification procedure addresses the challenge of cellular heterogeneity across patients. Results: In this work, we propose a disease classification model LAMP, which concentrates on the layered assessment on modules and pathways. Directed human gene interactions are the foundation of constructing the human gene network, where the significant roles of disease and pathway genes are recognized. The fast unfolding algorithm identifies 11 modules in the largest connected component. Then layered networks are introduced to distinguish positions of genes in propagating information from sources to targets. After gene screening, hierarchical clustering and refined process, 1726 diseases from KEGG are classified into 18 categories. Also, it is expounded that diseases with overlapping genes may not belong to the same category in LAMP. Within each category, entropy is applied to measure the compositional complexity, and to evaluate the prospects for combination diagnosis and gene-targeted therapy for diseases. Conclusions: In this work, by collecting data from BioGRID and KEGG, we develop a disease classification model LAMP, to support people to view diseases from the perspective of commonalities in etiology and pathology. Comprehensive research on existing diseases can help meet the challenges of unknown diseases. The results provide suggestions for combination diagnosis and gene-targeted therapy, which motivates clinicians and researchers to reposition the understanding of diseases and explore diagnosis and therapy strategies.
Identification of Novel Gene Mutations in Degenerative Lumbar Spinal Stenosis Using Whole Exome Sequencing in Chinese Population
Authors: Jiang Xin , Chen Dong
Published: September 2020

Degenerative lumbar spinal stenosis (DLSS) is a common lumbar disease requiring surgery. Previous studies indicate that genetic mutation may play a part in DLSS. However, there is scarcely specific study regarding the genetic study for DLSS. Whole exome sequencing (WES) is an effective strategy to search for disease-causing genes. To identify probable susceptible genes, we performed a WES in a cohort of 50 patients and 25 controls with DLSS. By bioinformatics analyses, we successfully identified several novel variants including HLA-DRB1, PARK2, ACTR8, AOAH, BCORL1, MKRN2, NRG4, NUP205, etc. To the best of our knowledge, this is the first genetic study of susceptibility genes with DLSS by WES in Chinese patients. In conclusion, our findings revealed that deleterious mutations in these genes may contribute to the development of DLSS.
Calcium-sensitive receptor expression differs between primary and secondary hyperparathyroidism
Authors: Yang Meng , Lu Yao , Zhang Ling , Song Aiping , Zhang Honglei , Pang Bo , Li Xin , Liu Jun , Sun Xiaoliang , Ji Haoyang , Huang Linping
Published: September 2020

Background: Calcium-sensitive receptor (CASR) plays an important role in the pathogenesis and progression of secondary hyperparathyroidism (SHPT). The purpose of this study is to examine the protein and gene expression characteristics of CASR in SHPT.Methods: Immunohistochemistry and real-time PCR were used to detect and compare the expression of CASR protein and genes in SHPT and primary hyperparathyroidism (PHPT) tissues.Results: CASR protein was down-regulated in SHPT and PHPT compared with normal parathyroid tissues (2.42±0.5 vs. 3.2±0.62, P<0.05; 1.8±0.83 vs. 3.2±0.62, P<0.05). Further, SHPT tissue showed higher expression of both CASR protein (2.42±0.5 vs. 1.8±0.83, P<0.05) and CASR gene (0.29±0.23 vs. 0.01±0.12, P<0.05) than PHPT tissue, respectively.Conclusion: The expression of CASR protein and gene in SHPT is higher than that in PHPT. This feature provides a theoretical basis and further ideas for studying the mechanism of CASR down-regulation.
Genetic and clinical phenotypic analysis of familial stapes sclerosis caused by a NOG mutation
Authors: Yu Rong , JIANG HONGQUN , LUO WU GEN
Published: September 2020

Background: The noggin protein encoded by the NOG gene can interfere with the binding of bone morphogenetic protein to its receptor, thus affecting bone and joint development. The symptoms include abnormal skeletal development and conductive deafness. Methods: In a retrospective study, clinical data of the proband and her family members, including 8 people and 50 healthy normal controls, were collected. Second-generation sequencing was performed on peripheral blood samples from them. Results: The sequencing analysis indicated that in the proband, the NOG gene had a c.532T>C mutation (cytosine deletion, NM_005450.6:c.532T>C), leading to an amino acid change. The proband's father, grandmother, second sister, and third sister also had this mutation, whereas family members with normal phenotypes did not have the mutation. Conclusion: Analysis of this family showed that the novel presentation of the c.532T>C mutation in the NOG gene resulted in syndrome-type autosomal dominant inheritance reflected in a mild clinical phenotype, which is of great importance for further studies of the clinical phenotype and pathogenesis of stapes sclerosis.
Micelles self-assembled by 3-O-β-D-glucopyranosyl latycodigenin enhance cell membrane permeability, promote antibiotic pulmonary targeting and improve anti-infective efficacy
Authors: Zhang Man , Ye Lili , Huang Hao , Cheng Dandan , Liu Kaixin , Wu Wenbo , Shen Fukui , Jiang Zhihong , Hou Yuanyuan , Bai Gang
Published: September 2020

Background: Nanoparticle-based pulmonary drug delivery systems are commonly developed and applied for drug-targeted delivery. They exhibit significant advantages compared to traditional pulmonary drug delivery systems. However, developing the formulation of each drug is a time-consuming and laborious task. Results: In this study, a universal lung-targeting nanoparticle was designed and constructed. The self-assembled micelles were composed of a platycodon secondary saponin, 3-O-β-D-glucopyranosyl platycodigenin 682 (GP-682), based on its specific amphiphilic structure. The GP-682 micelles exhibited a relatively stable zeta potential with a particle size between 60 and 90 nm, and the critical micelle concentration (CMC) value was approximately 42.3 μg/mL. Preincubation of GP-682 micelles markedly enhanced their cell membrane permeability and improved drug uptake in vitro. The results were visualized using fluorescent dye tracing, transmission electron microscopy (TEM) observations and the lactate dehydrogenase (LDH) release assay. The obtained benefits enhanced the distribution of levofloxacin (Lev) in mouse lung tissue and reduced antibiotics overdosing. The acute lung injury mouse model induced by the Pseudomonas aeruginosa PA 14 strain demonstrated that preinjection of GP-682 micelles before antibiotic administration resulted in a higher survival rate and anti-infective efficacy in vivo. It also caused reductions in pulmonary injury, bacterial invasion and cytokine expression compared with treatment with Lev alone. Conclusions: GP-682 micelles are another nanoparticle-based pulmonary drug delivery system and provide a new lung-targeting therapy option.
Cosmetic and functional results of a newly reconstructed thumb by combining the phalanx of second toe and the great toenail flap transplantation
Authors: Yin Yefeng , Tao Xiaomei , Li Yanzhao , Bao Buhe , Ying Ying , Bao Tuya , Wang Jiangning
Published: September 2020

BACKGROUND Microsurgical toe-to-hand transfer is a gold standard when it comes to repairing a thumb defect. Great toenail flap, thumbnail valva flap, free great toe and second toe transplantation are the common methods in thumb reconstruction. Second toe transplantation achieves good function, but poor aesthetics. Great toe transplantation achieves better aesthetics, but hindered walking, due to the foot’s loss of the great toe and moreover suboptimal thumb function. It is difficult to maintain both functional and aesthetic satisfaction in thumb reconstruction.METHODS We experimented with three different methods of toe to hand transfer. From October 2009 to July 2019, 30 patients with traumatic thumb defects received one of 3 different kinds of thumb reconstruction in our clinic according to their level of amputation. Divided evenly into three groups of ten, group one received a great toe transplantation, group two received a second toe transplantation, and group three received a combined great toenail flap and second toe phalanx transplantation. Each of the patients’ thumbs had different levels of amputation at the metatarsophalangeal joint (MPJ) or distal interphalangeal joint (DIPJ).RESULTS 1 patient suffered from a partial flap necrosis and received a groin flap to cover the defect. No other thumbs had any complications. The functional and aesthetic results of both the donor and the recipient sites were satisfactory. Results show that, for patients with traumatic thumb defects, the combined transfer of flap and 2nd toe phalanx was the best option.CONCLUSIONS Compared to the great toe or second toe transfer, combined free transfer of the great toenail flap and 2nd toe phalanx achieved a substantially better functional and aesthetic result in the thumb reconstruction.
Primary Care Nurses' Perceptions and Experiences of Patients Being Overweight, as well as Visions and Attitudes About Working with Lifestyle Issues: A Qualitative Interview Study
Authors: Ewe Marie Bräutigam , Hildingh Cathrine , Månsson Jörgen , Lydell Marie
Published: September 2020

Background: A primary health care centre (PHCC) is often the first point of contact for overweight patients, and nurses play key roles in overweight and lifestyle management. Since overweight is an increasing problem and a challenge for PHCCs to handle, it is important to describe primary care nurses' perceptions and experience with overweight problems, as well as their visions and attitudes regarding working with lifestyle issues. Methods: This was a qualitative interview study. Thirteen nurses in PHCCs in the southwest of Sweden were interviewed with a semi-structured, face-to-face guide. The interviews were analysed using qualitative content analysis. Results: The nurses had a wish and a willingness to work more with overweight and lifestyle issues than they currently did due to a lack of priority, resources, time and education. They experienced overweight as an increasing problem and felt that society should do more to stop its development. They considered that meeting with the patient was the most important task at PHCCs. How the conversations were structured without pointers and in an individualized manner was crucial for weight management to strengthen the patients’ motivation to change. The nurses experienced that how to use and implement guidelines was unclear. They also asked for a national forum in Sweden for nurses working with overweight and lifestyle issues with lectures about the latest research in the area. Conclusions: The nurses considered overweight to be a complex condition that requires a holistic approach with individualized care. To make this approach possible, a wider range of efforts should be offered to patients through more group meetings, lectures, and digital solutions. The development of a multidisciplinary team with different professions working with this patient group was the nurses’ dream scenario. They wished for a preventive reception for pre-diabetic patients to save costs and suffering. Informing parents earlier about a healthy lifestyle at childcare centres in PHCCs and offering health examinations to promote preventive work were seen as good ideas. Implementing these suggestions in working with overweight and lifestyle issues could be a discussion among the management in PHCCs and for the decision makers in the region.
Continuous assessment of neuro-ventilatory drive during 12 hours of pressure support ventilation in critically ill patients 
Authors: Mussi Rosa Di , Spadaro Savino , Volta Carlo Alberto , Bartolomeo Nicola , Trerotoli Paolo , Staffieri Francesco , Pisani Luigi , Iannuzziello Rachele , Dalfino Lidia , Murgolo Francesco , Grasso Salvatore
Published: September 2020

Introduction: Pressure support ventilation (PSV) should allow spontaneous breathing with a “normal” neuro-ventilatory drive. Low neuro-ventilatory drive puts the patient at risk of diaphragmatic atrophy while high neuro-ventilatory drive may causes dyspnea and patient self-inflicted lung injury. We continuously assessed for 12 hours the electrical activity of the diaphragm (EAdi), a close surrogate of neuro-ventilatory drive, during PSV. Our aim was to document the EAdi trend and the occurrence of periods of “Low” and/or “High” neuro-ventilatory drive during clinical application of PSV. Method: In 16 critically ill patients ventilated in the PSV mode for clinical reasons, inspiratory peak EAdi peak (EAdiPEAK), pressure time product of the trans-diaphragmatic pressure per breath and per minute (PTPDI/b and PTPDI/min, respectively), breathing pattern and major asynchronies were continuously monitored for 12 hours (from 8 a.m. to 8 p.m.). We identified breaths with “Normal” (EAdiPEAK 5 - 15 mV), “Low” (EAdiPEAK < 5 mV) and “High” (EAdiPEAK >15 mV) neuro-ventilatory drive. Results: Within all the analyzed breaths (177.117), the neuro-ventilatory drive, as expressed by the EAdiPEAK, was “Low” in 50.116 breath (28 %), “Normal” in 88.419 breaths (50 %) and “High” in 38.582 breaths (22 %). The average times spent in “Low”, “Normal” and “High” class were 1.37, 3.67 and 0,55 hours, respectively (p < 0.0001), with wide variations among patients. Eleven patients remained in the “Low” neuro-ventilatory drive class for more than one hour, median 6.1 [3.9 - 8.5] hours and 6 in the “High” neuro-ventilatory drive class, median 3.4 [2.2 – 7.8] hours. The asynchrony index was significantly higher in the “Low” neuro-ventilatory class, mainly because of a higher number of missed efforts. Conclusions: We observed wide variations in EAdi amplitude and unevenly distributed “Low” and “High” neuro ventilatory drive periods during 12 hours of PSV in critically ill patients. Further studies are needed to assess the possible clinical implications of our physiological findings.
Fabrication of Polylactic Acid/Paclitaxel Nano Fibers by Electrospinning for Cancer Therapeutics 
Authors: Yu C. H. , Chan Vincent , Li Chuan , Hsieh J. H. , Lin P. H. , Tsai Ya-Hui , Chen Yun
Published: September 2020

Polylactic acid (PLA) is a thermoplastic and biodegradable polyester, largely derived from renewable resources such as corn starch, cassava starch and sugarcane. However, PLA is only soluble in a narrow range of solvents such as tetrahydrofuran, dioxane, chlorinated solvents and heated benzene. The limited choices of solvent for PLA dissolution have imposed singificant challenges in the development of specifically engineered PLA nanofibers with electrospinning techniques. Generally, the electrospun polymeric materials have been rendered with unique properties such as high porosity and complex geometry while maintaining its biodegradability and biocompatibility for emerging biomedical applications. In this study, a new anticancer drug delivery system composed of PLA nanofibers with encapsulated paclitaxel was developed by the electrospinning of the respective nanofibers on top of a spin-coated thin film with the same chemical compositions. Our unique approach is meant for promoting strong bonding between PLA-based nanofibers and their respective films in order to improve the prolonged release properties and composite film stability within a fluctuative phyiochemical environment during cell culture. PLA/paclitaxel nanofiber supported on respective polymeric films were probed by scanning electronic microscope, Fourier transform infrared spectrometer and water contact measurement for determining their surface morphologies, fibers’ diameters, molecular vibrational modes, and wettability, respectively. Moreover, PLA/paclitaxel nanofibers supported on respective spin-coated films at different loadings of paclitaxel were evaluated for their abilities in killing human colorectal carcinoma cells (HCT-116). More importantly, MTT assays showed that regardless of the concentrations of paclitaxel, the growth of HCT-116 was effectively inhibited by the prolonged release of paclitaxel from PLA/paclitaxel nanofibers. An effective prolonged delivery system of paclitaxel based on PLA nanofiber-based film has demonstrated exciting potentials for emerging applications as implantable drug delivery patch in post-surgical cancer eradication.
The New Zealand Podiatry profession – a workforce in crisis?
Authors: Carroll Matthew , Jepson Hannah , Molyneux Prue , Brenton-Rule Angela
Published: September 2020

Background This is the first study to explore workforce data from the Podiatrists Board of New Zealand. The study analysed data from an online survey which New Zealand podiatrists complete as part of their application for an Annual Practising Certificate.Methods Survey responses between 2015 and 2019 were analysed. Data was related to work setting, employment status, work hours, location, professional affiliations, and number of graduates entering practice. Survey data was downloaded by a second party who provide data security for the Podiatrists Board of New Zealand workforce data. All data supplied for analysis were deidentified and could not be re-linked to an individual practitioner.Results In 2019 there were 430 podiatrists who held an Annual Practising Certificate. Eighty percent of podiatrists who work in New Zealand are in private practice, with 8% employed in the public health sector. Podiatrist’s work is a mix of general podiatry, diabetes care and sports medicine. The majority are self-employed (40%) or business owners (19%). Approximately 40% work between 31 to 40 hours per week and 46 to 50 weeks per year. The majority are female (67%) with most practising in the North Island (69%) and located in the Auckland region (33%). On average 76% of new graduates were issued an Annual Practising Certificate between 2015 and 2019.Conclusion The New Zealand podiatry profession is small and growing at a slow rate, consequently there is evidence of a workforce shortage. To maintain a per-capita ratio of podiatrists approximate to Australia and the United Kingdom an additional 578 podiatrists are required in the New Zealand workforce. There are not enough new graduate practitioners entering the workforce and once practising, the majority enter private practice in the face of limited public health employment opportunities.
Biomarker Discovery in Emergency Care – A Suggested Development Pathway
Authors: Coats Timothy J , Elwan Mohammed H
Published: September 2020

Background: Biomarkers are widely used in medical diagnosis with rigorous pathways for the identification, development. However, there are no published pathways for emergency care. Aim: We aim to synthesise the existing literature on biomarker development in order to produce a Biomarker Development Pathway for a physiological biomarker relevant to emergency care.Methods: Medline, BIOSIS, the National Center for Biotechnology Information databases and the Web of Science for relevant articles. Material published on websites was searched using two internet search engines (Google Scholar and Ask). Websites of organisations involved in biomarker development were also ‘hand searched’ for relevant information.Results: We identified 536 papers, of which 14 were relevant to the methodology of biomarker development. One additional paper was found by hand searching from websites.Conclusions: There were no papers that explored the specific requirements for the development of a physiological biomarker in emergency care. The biomarker development pathway published here will guide emergency care researchers in a sequential approach to biomarker development, enable description of the stage of their technology development in grant applications, and give technology development companies a clear route ‘downstream’ to clinical use.
The Effect of pH on Phosphorus Adsorption in Acidic Soils of Tsegede, Western Zone of Tigray, Ethiopia
Authors: Tareke Haile Alene , Woldetensai Gebreyohannes Girmay , Birhane fisseha Hadgu
Published: September 2020

Background: Although soils in the acidic soils of Tsegede (Skeletic Leptosols, Cambic Leptosols, Leptic Cambisols and Dystric Cambisols) are characterized by low available P contents, study on P adsorption characteristics is limited information. The purpose of this experiment was to evaluate P adsorption characteristics in different acidity ranges of soils. Material and method: Potassium dihydrogen phosphate (KH2PO4) was used for the adsorption isotherm studies by duplicating 3 g soil from each soil types at different acidity ranges of ten soil samples with 50 ml of P in 0.01 M CaCl2 solution having 0, 20, 40, 60, 80,100 mg P L-1. Langmuir and Freundlich adsorption isotherm models were used to describe adsorption processes and the relationships between P adsorption and soil properties were determined by correlation. Results: Phosphorus adsorption increased significantly with increasing P levels and it increased as soil pH declines. The maximum and minimum P-adsorptions were obtained from very strongly acidic Skeletic Leptosols and from moderately acidic Dystric Cambisols, respectively. Comparing the two models, Langmuir linear model showed a better fit to the tested soils compared to Freundlich model. The regression coefficients (R2) for the fitted Langmuir P adsorption isotherms were highly significant ranging from (0.955 to 0.999) and the adsorption maxima obtained from the Langmuir isotherm ranged from 357 mg P kg-1 soil in strongly acidic Dystric Cambisols to 2500 mg P kg-1 soil in very strongly acidic Skeletic Leptosols. The bonding energy (k) for Langmuir adsorption model varied from 0.012 to 2.8 L mg-1 and both the highest (2.8 L mg-1) and lowest (0.012 L mg-1) k values were obtained from strongly and moderately acidic Dystric Cambisols. The cation exchange capacity (CEC) and organic carbon (OC) were positively correlated with the Langmuir adsorption maxima (b) and negatively correlated with available P and soil pH. Conclusion: Increments of soil pH using different amendments and their proper management in soils are important in making productive use and higher dose of P is required by soils with higher fixation. Alternative P management strategies are also needed to reduce P adsorption and enhance P availability in such acidic soils in the study areas.
Research on PDMA communication system based on Complete Complementary Sequence
Authors: Li Shufeng , Su Baoxin , Jin Libiao
Published: September 2020

Pattern division multiple access (PDMA) is a new non-orthogonal multiple access (NOMA) technology. It is proposed to meet the challenge of 5G large-scale connectivity and high-frequency spectral efficiency. Compared with traditional orthogonal multiple access (OMA), PDMA can support more users through the allocation of non-orthogonal resources. Due to perfect aperiodic correlation, complete complementary sequence (CCS) greatly improves the spectrum efficiency of the system. It has been widely used in wireless communication and radar sensing, and it still has research value in 5G. In order to apply the advantages of CCS to NOMA communication system, this paper proposes a system model of CCS spread spectrum coding based on PDMA. CCS is used as spread spectrum code to improve the performance of PDMA communication system. At the same time, on the basis of spread spectrum technology, this paper analyzes the average power allocation algorithm and water-filling power allocation algorithm, and a dynamic power allocation algorithm based on the transmission rate and practical application is proposed. The simulation results show that the system model can effectively improve the performance of the system.
Optimized sgRNA Design by Deep Learning to Balance the Off-Target Effects and On-Target Activity of CRISPR/Cas9
Authors: Lan Jie , Cui Yang , Wang Xiaowen , Song Guangtao , Lou Jizhong
Published: September 2020

Background: The CRISPR/Cas9 system derived from bacteria especially Streptococcus pyogenes (SpyCas9) is currently considered as the most advanced tool used for numerous areas of biological study in which it is useful to target or modify specific DNA sequences. However, low on-target cleavage efficiency and off-target effects impede its wide application.Results: Several different sgRNA design tools for SpyCas9 by using various algorithms have been developed, including linear regression model, support vector machine (SVM) model and convolutional neuron network model. While the deep insight into the sgRNA features contributing for both on-target activity and off-target still remains to be determined. Here, with public large-scale CRISPR screen data, we evaluated contribution of different features influence sgRNA activity and off-target effects, and developed models for sgRNA off-target evaluation and on-target activity prediction. In addition, we combined both activity and off-target prediction models and packaged them as an online sgRNA design tool, OPT-sgRNA. This tool is freely available via github repositories (https://github.com/Jie-lan/OPT-sgRNA).
Emergency Medical Staffs’ Knowledge and Attitude About Organ Donation After Cardiac Death
Authors: Kondori Jafar , Ghafouri Rouzbeh Rajaei , Zamanzadeh Vahid , Attari Ahmad Mirza Aghazadeh , Sheikhalipour Zahra
Published: September 2020

Background: Adverse attitudes and insufficient knowledge about organ donation after cardiac death among emergency staffs can have important consequences for the proper identification of potential donors, constant application of donation after cardiac death policies, and the relative strength of support for this type of donation. Therefore, this study was conducted to investigate the awareness and attitude of emergency personnel about organ donation after cardiac death.Methods: This descriptive study was carried out with the participation of 49 physicians and 145 nurses working in the emergency departments of educational and medical centers of Tabriz University of Medical Sciences. Nurses were selected by simple random sampling, and all physicians working in the emergency departments were included in the study. The questionnaire of Knowledge and Attitude regarding Organ Donation after Cardiac Death designed by Rodrigue et al. was used. Data were analyzed using descriptive statistics and independent samples t-test, one-way ANOVA, and chi-square test.Results: Most of the nurses (62.8%) and physicians (66.7%) had high level of knowledge about organ donation after cardiac death. The mean attitude score was 101.84 (SD: 9.88) out of 170 for nurses and 106.53 (SD: 11.77) for physicians. Physicians who had organ donation card had a more positive attitude toward organ donation after cardiac death.Conclusion: According to this study findings, knowledge and attitude of the emergency staffs about organ donation was high and positive. It is recommended to devise necessary guidelines for organ donation in Iranian emergency departments to help the personnel for introducing qualified people for organ donation or taking the necessary measures.
Boolean Implication Analysis Unveils Candidate Universal Relationships in Microbiome Data
Authors: Vo Daniella , Singh Shayal Charisma , Safa Sara , Sahoo Debashis
Published: September 2020

Background: Microbiomes consist of bacteria, viruses, and other microorganisms, and are responsible for many different functions in both organisms and the environment. Some previous analyses of microbiomes focus on the relationships between specific microbiomes and a particular disease. These typically use correlation which is fundamentally symmetric with respect to pairs of microbes. Correlation focuses on the symmetry of the data distribution, and asymmetric data is often discarded as having a weak correlation. With all the data available on the microbiome, there is a need for a method that comprehensively studies microbiomes and how they are related to each other.Results: We collect publicly available datasets from human, environment, and animal samples to determine both symmetric and asymmetric Boolean relationships between a pair of microbes. We then find relationships that are potentially invariants, meaning they will hold in any microbe community. In other words, if we determine there is a relationship between two microbes, we expect the relationship to hold in almost all context. We discovered that certain pairs of microbes always exhibit the same relationship in almost all the datasets we studied, thus making them good candidates for universal relationships. Our results confirm known biological properties and seem promising in terms of disease diagnosis.Conclusions: Since the relationships are likely universal, we expect that they will hold in a clinical setting as well as in the general population. Strong universal relationships may provide insight on prognostic, predictive, or therapeutic properties of a clinically relevant disease. These new analyses may improve disease diagnosis and drug development in terms of accuracy and efficiency.
Gender-specific differences in related indicators of blood pressure in Chinese school-age children with overweight and obesity
Authors: He Hongmei , Yang Shujun , Qiu Na , Ding Yong , Qiao Ling , Luo Jiajia , Li Yuan , Luo Zengyou , Huang Yingsa , Pang Huishen , Ji Shaoping , Zhang Lu , Guo Xiangqian
Published: September 2020

Background

The effects of overweight and obesity on blood pressure in children may differ by sex. Previous studies have only shown the association between overweight and obesity and elevated blood pressure (EBP). The objective of this study is to further explore the association between elevated pulse pressure (EPP) and elevated mean arterial pressure (EMAP) and obesity in Chinese school-age children by gender.
Methods

We performed a cross-sectional study of 935 children between seven and twelve years old. Overweight and obesity were defined by body mass index and body composition. The adjusted population attributable risk was used to assess the effects of obesity on EBP, EPP and EMAP.
Results

The interaction of height or age and obesity was used to identify the effect of obesity on blood pressure independent of age and height. Boys with overweight and obesity had higher EBP, EPP and EMAP (P < 0.05). The multivariate logistic regression analysis showed that overweight and obesity had a greater impact on BP and MAP than PP, especially in boys [Odds ratio (OR) > 1]. EBP in 79% of boys and 76% of girls could be attributable to the visceral fat level. The interaction between blood pressure and height or age was modestly increased in children with overweight and obesity, especially in boys.
Conclusions

Independent of age and height, the effect of obesity on blood pressure was greater in boys than girls. Moreover, the effect was mainly on small arteries rather than large arteries.
Influence of Flow Rate, Fluid Temperature, and Extension Line on Hotline and S-Line Heating Capability: an in Vitro Study
Authors: Kim Hosu , Kim Tae Kyong , Yoo Sukha , Kim Jin-Tae
Published: September 2020

Background A fluid warmer can prevent hypothermia during the perioperative period. This study evaluated the heating capabilities of Hotline and Barkey S-line under different flow rates and initial fluid temperatures, as well as after the extension line installation. Methods We measured the temperature of a 0.9% sodium chloride solution at the fluid warmer outlet (TProx) and the extension line end (TDistal) with three different initial fluid temperatures (room, warm, and cold) and two flow rates (250 ml/hr and 100 mL/hr). Results At a 250 ml/hr flow rate, the TProx and TDistal values were observed to be higher in Hotline than in S-line when using a room-temperature fluid; similar results were observed for the cold fluid. Administration of the warm fluid was observed to significantly increase the TProx and TDistal values in S-line at rates of 250 ml/hr more than the administration of the cold and room-temperature fluids. At flow rates of 100 ml/hr, TDistal values were significantly lower than TProx values in both devices regardless of the initial fluid temperature. Conclusions Hotline outperformed S-line for warming fluids at a high flow rate with cold or room-temperature fluids. The administration of the initially warm fluid prevented a decrease in the fluid temperature at a high flow rate in S-line. However, at a low flow rate, the fluid temperature significantly decreased in both devices after passing through an extension line.
Assessing the Quality of Randomized Controlled Trials of Complex Regional Pain Syndrome Published in the Journal of Clinical Pain Medicine Field
Authors: Lee Seung Wook , Kim Kyu Shik , Chung Jae Hoon , Park Hyung Joon , Sohn Yong Seok , Jeon Woo Jae , Cho Sang Yun , Shin Woo Jong
Published: September 2020

Background: Complex regional pain syndrome is a disease characterized by chronic pain caused by tissue damage and worsens over time. The quality of randomized controlled trials on complex regional pain syndrome is low due to the rarity of the disease and difficulty in designing studies. Therefore, we evaluated the completeness of evidence by assessing the quality. Methods: We searched articles that were published between 1998 and 2017. The quality was assessed using the Jadad scale, van Tulder scale, and the Cochrane collaboration risk of bias tool.Results: A total of 72 articles on complex regional pain syndrome have been published. Only 31 articles were found to have a low risk of bias according to the Cochrane Collaboration. On the Jadad and van Tulder scale, 52 and 58 articles, respectively, were assessed as high quality. Only a few trials described the randomization method adequately and presented allocation concealment correctly. We also found that research trials with funding statements had higher Jadad scales than unfunded (P = 0.03). Furthermore, articles that described the sample size were of significantly higher quality (P < 0.01) than those that did not. Conclusions: There was no observed improvement in quality over time. In particular, the performance rate of the allocation concealment for the analyzed papers was low. In addition, we found that the number of high-quality articles increased when institutional review board approval was granted and funding provided. For the future, we recommend that researchers focus their efforts on conducting high-quality studies.
Diagnostic Accuracy of D-dimer Testing and the Revised Geneva Score in the Prediction of Pulmonary Embolism
Authors: Abolfotouh Mostafa A. , Almadani Khaled , Rowaily Mohammed A. Al
Published: September 2020

Background. Pulmonary embolism (PE) diagnosis can sometimes be challenging due to the disease having nonspecific signs and symptoms at the time of presentation. The aim of the present study was to evaluate the validity of the D-dimer in combination with the revised Geneva score (RGS) in prediction of Pulmonary embolism.Methods. This is a retrospective study of 2010 patients with suspected PE who had undergone both D-dimer testing followed by chest CT angiography (CTPA). The predictive accuracy of D-dimer, adjusted D-dimer and the revised Geneva score were calculated. ROC curve was applied to allocate the optimum RGS cutoff for PE prediction.Results. Of all patients, the mean age was 52.2±20.2 years, two-thirds (65.1%) were females, with previous history of; DVT or PE (2%), surgery and/or fracture of lower limb (6.9%), active malignant conditions (14.4%), unilateral lower limb pain (0.6%), and hemoptysis (0.7%).The overall prevalence of PE was 16%. It was 0% in the low, 25.8% in intermediate and 88.9% in high clinical probability categories of RGS. Both conventional and age-adjusted D-dimer thresholds showed significant level of agreement (kappa=0.081, p<0.001), high sensitivity (94% & 92.8%), high NPV (91.2% & 91.4%), low specificity (12.3% & 15.3) and low PPV (17.5% & 17.8%), respectively. Combination of the age-adjusted D-dimer threshold and RGS at a cut-off of 5 points would provide 100% sensitivity and 61.7% specificity 34.1% PPV, 100% NPV and 0.87 AUC. At a RGS cutoff <5 points, PE could be have been excluded in 64.2% of patients with an abnormal age-adjusted D-dimer threshold without further imaging.Conclusion. Conventional and age-adjusted D-dimer tests showed high levels of agreement in prediction of PE, high sensitivity and low specificity. RGS has a good performance in PE prediction. Application of a clinical decision rule, using the revised Geneva score, and age adjusted D-dimer threshold could increase the number of patients in whom PE could be excluded without further imaging.
An Accidental Bronchial Obstruction Caused by Detached Cuff: Case Report and Literature Review
Authors: Zhu Kaibin , Bu Jianlong , Liu Mengfeng , He Changjun , Lang Yaoguo , Xu Shidong
Published: September 2020

Background The airway obstructions are usually caused by secretions, mucus plugs, blood clots, malposition of bronchial blockers (BBs) cuff or twist of the tube by oral biting. In this paper, we report a case of accidental bronchial obstruction as a result of a cuff detaching from the BBs catheter.Case presentation A 48-year-old male was admitted to our department due to small cell lung cancer. He had received two cycles of neoadjuvant chemotherapy with etoposide plus cisplatin and was scheduled a right upper lobe resection by thoracotomy. During the surgery, the patient was intubated with an 8.0-mm internal diameter BBs tube (Univent tube). When the anesthesiologist tried to remove the BBs towards the end of surgery, the cuff got detached accidentally and obstructed the airway leading to improper expansion of the middle lobe. This condition was determined later by the 6.0-mm bronchoscope and the cuff was removed with forceps. Conclusions We report this case aiming to remind other colleagues that the cuff detachment in the surgical procedure is still a potentially fatal incident even it rarely happens nowadays. It is important to check the BBs apparatus meticulously through the whole operative procedure. The routine use of 4.0-mm bronchoscope should be highly recommended during the entire airway management when a bronchial obstruction is suspected.
Association factors with severe cases and antiviral drug assessment in patients with COVID-19
Authors: Gong Xiaowei , Guo Xianfeng , Kang Shiwei , Li Yan , Gao Haixiang , Yuan Yadong
Published: September 2020

Background

Due to the latent onset of novel coronavirus disease 2019 (COVID-19), it is important to identify patients with increased probabilities for disease progression early in order to implement timely medical strategies. This study aimed to identify the factors associated with severe COVID-19 and evaluate the current antiviral drugs, especially in severe patients.
Methods

This was a retrospective observational study performed at the No. 7 Hospital of Wuhan (Wuhan, China) with hospitalized patients confirmed with COVID-19 from January 11 to March 13, 2020. Multivariable logistic regression analysis was used to identify the associated factors of severe COVID. Treatment of antivirus drugs were collected and evaluated.
Results

Of the 550 patients, 292 (53.1%) were female and 277 (50.4%) were ≥ 60 years old. The most common symptom was fever (n = 372, 67.7%), followed by dry cough (n = 257, 46.7%), and dyspnea (n = 237, 43.1%), and fatigue (n = 224, 40.7%). Among the severe patients, 20.2% required invasive ventilator support and 18.0% required non-invasive ventilator. The identified risk factors for severe cases were: age ≥ 60 years (odds ratio (OR) = 3.02, 95% confidence interval (CI): 1.13–8.08, P = 0.028), D-dimer > 0.243 µg/ml (OR = 2.734, 95%CI: 1.012–7.387, P = 0.047), and low oxygenation index (OR = 0.984, 95%CI: 0.980–0.989, P < 0.001). In severe cases, the benefits of arbidol alone was 73.3%, which was better than ribavirin (7/17, 41.2%, P = 0.029).
Conclusions

Age ≥ 60 years, D-dimer > 0.243 µg/ml, and lower oxygenation index were associated with severe cases. Arbidol might provide more clinical benefits in treating patients with severe COVID-19 compared with other antiviral drugs.