bluuebunny/crossref_metadata_2025 huggingface dataset:
ZBTB7A functioned as an oncogene in colorectal cancer
Authors: Wang Li , Zhang Meng-Xia , Zhang Mei-Fang , Tu Zi-Wei
Published: September 2020

Background: Despite zinc finger and BTB domain-containing 7A (ZBTB7A) documented importance in multiple tumors, the function and clinical value in Colorectal cancer (CRC) remain elusive. The aim of this study was to evaluate the functional roles and the clinical value of ZBTB7A in CRC progression. Methods: The level of ZBTB7A was detected in a large cohort of CRC patients (n=189) by immunohistochemistry (IHC), and we analyzed the diagnostic and prognostic value of the protein. In addition, the functional roles of ZBTB7A on CRC were explored in vitro and in vivo. Results: Survival analyses indicated that patients with high ZBTB7A expression made the prognosis worse (P=0.024). Functionally, knockdown of ZBTB7A could markedly inhibit tumor proliferation in vitro and in vivo, whereas ZBTB7A overexpression displayed the opposite results. Conclusions: ZBTB7A was associated with poor survival outcomes and functioned as an oncogene in CRC patients, indicating that it is a potential prognostic biomarker and therapeutic target for CRC patients.
Reductive dissolution of biogenic magnetite
Authors: Yamazaki Toshitsugu
Published: September 2020

Reductive dissolution of magnetite is known to occur below the Fe-redox boundary in sediments. In this study detailed processes associated with biogenic magnetite dissolution are documented. A sediment core from the Japan Sea was used for this purpose, in which reductive dissolution of magnetic minerals is known to start at depths of about 1.15 m and is mostly complete within a depth interval of about 0.35 m. Using first-order reversal curve diagrams, preferential dissolution of biogenic magnetite within this interval is estimated from the observation that a narrow peak that extends along the coercivity axis (central ridge), which is indicative of biogenic magnetite, diminishes downcore. Transmission electron microscopy is used to demonstrate that the sediments contain three magnetofossil morpho-types: octahedra, hexagonal prisms, and bullet-shaped forms. Within the reductive dissolution zone, partially etched crystals are commonly observed. With progressive dissolution, the proportion of bullet-shaped magnetofossils decreases, whereas hexagonal prisms become more dominant. This observation can be explained by the differences in resistance to dissolution among crystal planes of magnetite and the differences in surface area to volume ratios. Magnetofossil morphology may reflect the preference of magnetotactic bacterial lineages for inhabiting specific chemical environments in sediments. However, it could also reflect alteration of the original morphological compositions during reductive diagenesis, which should be considered when using magnetofossil morphology as a paleoenvironmental proxy.
Implementation Evaluation of a Multidisciplinary Blunt Chest Injury Care Bundle (ChIP): Fidelity of Delivery
Authors: Kourouche Sarah , Curtis Kate , Munroe Belinda , Lyons Jack , Carey Ian , Buckley Tom
Published: September 2020

Background: Ineffective or delayed treatment of patients with blunt chest wall injury results in high rates of morbidity and mortality. A blunt chest injury care bundle protocol (ChIP) was developed and implemented to improve evidence-based care for these patients at two regional hospitals in Australia. ChIP is an early notification system to notify specialist clinician ‘responders’ to prescribe and commence treatment for patients with blunt chest injury in the emergency department (ED). A multi-pronged implementation strategy developed using the Behaviour Change Wheel (BCW), including seven intervention functions and 15 behaviour change techniques, guided implementation. Fidelity to the implementation strategy was high, with 97.5% fully or partially implemented. Implementation fidelity is the extent to which an intervention has been implemented as intended; it affects the internal and external validity of implementation. This study evaluates the fidelity of intervention delivery (fidelity, dose and reach) at two hospitals. Methods: Pre-post implementation evaluation study. The characteristics of patients, rate of ChIP activations and components of ChIP received by eligible patients were compared pre (1 July 2015 to 21 November 2017) and post (22 November 2017 to 30 June 2019) intervention. Sample medians were compared using the non-parametric median test, with the 95% confidence of the difference estimated using the Hodges-Lehmann estimate. Differences in proportions for categorical data were compared with two-sample z-test. Logistic regression was used to adjust for group differences. Results: Overall, 97.1% of eligible patients received ChIP over the 19-month post-implementation period. Compared to the pre-implementation group the post-implementation group, were more likely to receive evidence-based treatments including high flow nasal cannula (OR=6.8 (4.8,9.6)), incentive spirometry in ED (OR=7.5 (3.2,17.6)), regular analgesia (OR=2.4 (1.5,3.8)), regional analgesia (OR=2.8 (1.5, 5.3)), Patient controlled analgesia (OR=1.8 (1.3,2.4)), and multiple specialist team reviews e.g. ICU liaison (OR=10.7 (6.9,16.7)). Conclusions: High fidelity of delivery was achieved and sustained for ChIP for the implementation of a complex intervention in the emergency context with a robust implementation plan based on theoretical frameworks. Findings from this evaluation can inform future implementation of ChIP and other multidisciplinary interventions in an emergency or acute care context. Trial registration: ANZCTR: ACTRN12618001548224, approved 17/09/2018
Development a quantitative segmentation model to assess the effect of comorbidity on patients with COVID-19
Authors: Zhang Cui , Yang Guangzhao , Cai Chunxian , Xu Zhihua , Wu Hai , Guo Youmin , Xie Zongyu , Shi Hengfeng , Cheng Guohua , Wang Jian
Published: September 2020

Background: The coronavirus disease 2019 (COVID-19) has brought a global disaster. Quantitative lesions may provide the radiological evidence of the severity of pneumonia and further to assess the effect of comorbidity on patients with COVID-19.Methods: 294 patients with COVID-19 were enrolled from February, 24, 2020 to June, 1, 2020 from six centers. Multi-task Unet network was used to segment the whole lung and lesions from chest CT images. This deep learning method was pre-trained in 650 CT images (550 in primary dataset and 100 in test dataset) with COVID-19 or community acquired pneumonia and Dice coefficients in test dataset were calculated. 50 CT scans of 50 patients (15 with comorbidity and 35 without comorbidity) were random selected to mark lesions manually. The results will be compared with the automatic segmentation model. Eight quantitative parameters were calculated based on the segmentation results to evaluate the effect of comorbidity on patients with COVID-19.Results: Quantitative segmentation model was proved to be effective and accurate with all Dice coefficients more than 0.85 and all accuracies more than 0.95. Of the 294 patients, 52 (17.7%) patients were reported having at least one comorbidity, 14 (4.8%) having more than one comorbidity. Patients with any comorbidity were older (P<0.001), had longer incubation period (P<0.001), were more likely to have abnormal laboratory findings (P<0.05) and be in severity status (P<0.001). More lesions (including larger volume of lesion, consolidation and ground-glass opacity) were shown in patients with any comorbidity than patients without comorbidity (all P<0.001). More lesions were found on CT images in patients with more comorbidities. The median volumes of lesion, consolidation and ground-glass opacity in diabetes mellitus group were largest among the groups with single comorbidity that had the incidence rate of top three.Conclusions: Multi-task Unet network can make quantitative CT analysis of lesions to assess the effect of comorbidity on patients with COVID-19, further to provide the radiological evidence of the severity of pneumonia. More lesions (including GGO and consolidation) were found in CT images of cases with comorbidity. The more comorbidities patients have, the more lesions CT images show.
Physicians’ prescribing behaviour and clinical practice patterns for allergic rhinitis management in Italy
Authors: Passalacqua Giovanni , Musarra Antonino , Senna Gianenrico , Bousquet Jean , Ferrara Carmen , Lonati Caterina , Canonica Giorgio Walter
Published: September 2020

Background: Despite availability of clinical guidelines, underdiagnosis, undertreatment, and poor adherence are still significant concerns in allergic rhinitis (AR) therapeutic management. We investigated clinical practice patterns and prescribing behavior of Italian healthcare professionals (HCPs) specialized in AR. Methods: One-hundred allergologists, 100 ear, nose and throat (ENT) specialists, and 150 general practitioners (GPs) were recruited. The survey assessed: socio-demographic, work experience, monthly caseload, prescription drivers. Next, HCPs were invited to retrospectively recover patients’ clinical data to investigate: AR clinical characteristics, therapy management, prescription patterns, patient adherence. Descriptive statistics, Chi-square, One-Way analysis of variance, and Two-Way Analysis of Variance were performed.Results: Allergologists visited more AR patients (31% of monthly caseload) than ENTs (21%, p<0.001), while GPs’ caseload was the lowest (6%). Clinical information of 2823 patients were retrieved of whom 1906 (67,5%) suffered from moderate/severe AR (discomfort score: 7,7±1,3) and 917 (32,4%) from mild AR (5.7±1.9). About one-third of mild patients had a discomfort score >=7. Main prescription drivers were “effective on all symptoms” (54,3% patients) and “quick symptom relief” (47,8%), whereas minor drivers were “affordable price” (13,4%) and “refundable” (8,7%). The most prescribed drugs were antihistamines and intranasal corticosteroids (79% and 55% prescriptions), followed by fixed-dose-combination of intranasal azelastine/fluticasone (19%). Polytherapy was the most common treatment strategy (59,6%). HCPs’ believe that the majority of the patients was adherent to treatment (88% with score>7).Conclusions: This survey describes the therapeutic approach adopted by Italian physicians to cope with AR and shows that HCPs underestimated AR severity and had a non-realistic perception of patients’ adherence. These findings suggest that further efforts are required to improve AR clinical management in Italy.
How The Biophilic Design Social Movement Informs Planning, Policy And Professional Practice
Authors: Soderlund Jana , Newman Peter
Published: September 2020

A new social movement called biophilic design has emerged over recent decades to enable greater connection between nature and urban populations to make biodiversity and natural systems a part of daily life in cities. Understanding the origins of this social movement can inform further progression, implementation and planning of biophilic design. The research methodology of immersion and heuristic inquiry within the social movement was used to create interviews with key people in the social movement’s origin and subsequent delivery. The results are presented using the three stages of a social movement: emergence, coalescence and mainstreaming. In each stage there are particular motivators and drivers that provide impetus to the movement which are outlined based on the responses of the participants. These were applied to the three stages of the social movement and translated into a framework of ten actions for mainstreaming the implementation of biophilic design into urban planning and policy as well as into professional practice.
Lidocaine alone or combined with Magnesium Sulfate stabilizes hemodynamic parameters during General Anesthesia without prolonging the Neuromuscular Blockade: a randomized, double-blind, controlled trial
Authors: Paula-Garcia Waynice N. , Oliveira-Paula Gustavo H , de Boer Hans D , Garcia Luís Vicente
Published: September 2020

BackgroundLidocaine and magnesium sulfate have become increasingly utilisedin general anaesthesia. The present study evaluated the effects of these drugs, isolated or combined on the hemodynamic parameters as well as on the cisatracurium-induced neuromuscular blockade (NMB).MethodsAt a University hospital, 64 patients, ASA physical status I and II, undergoing elective surgery with similar pain stimulus, were randomly assigned to four groups. Patients received a bolus of lidocaine and magnesium sulfate before the tracheal intubation and a continuous infusion during the operation respectively: 3 mg.kg-1 and 3 mg.kg-1.h-1 (Lidocaine -L group), 40 mg.kg-1 and 20 mg.kg-1.h-1 (Magnesium - M group), equal doses of both drugs (Magnesium plus lidocaine - MLgroup) and, a equivalent volume of isotonic solution (Control - C group). Haemodynamic parameters and neuromuscular blockade features were continuously monitored until spontaneous recovery of the Traino of Four ratio (TOF=0.9).ResultsThe Lidocaine group presented a highly significant small hemodynamic fluctuation during the anesthesia induction and maintenance period (p<0.0001) with no change at NMB. The magnesium sulfate infusion alone or combined with lidocaine prolonged all the recovery characteristics (p< 0.0001). The onset time was not influenced by the studied drugs. The percentage of patients who achieved a TOF ratio of 90% without recovering the first Twich (T1-95%) was higher in the M and ML groups.ConclusionIntravenous lidocaine plays a significant role in the hemodynamic stability in patients under general anesthesia without exerting any additional impact on the NMB even combined with magnesium sulfate. Aside from prolonging all NMB recovery characteristics without altering the onset speed, magnesium sulfate enhances the TOF recovery rate without T1 recovery. Our findings may aid clinical decisions involving the use of these drugs by encouraging their association in multimodal anesthesia or other therapeutic purposes.Trial registration﻿NCT02483611 (registration date: 06-29- 2015).
Natural Infections With Different Plasmodium Species Induce Antibodies Reactive to A Chimeric Plasmodium Vivax Recombinant Protein
Authors: McCaffery Jessica N , Singh Balwan , Nace Douglas , Moreno Alberto , Udhayakumar Venkatachalam , Rogier Eric
Published: September 2020

Background: As malaria incidence and transmission in a region decreases, it becomes increasingly difficult to identify areas of active transmission. Improved methods for identifying and monitoring foci of active malaria transmission are needed in areas of low parasite prevalence in order to achieve malaria elimination. Serological assays can provide population-level infection history to inform elimination campaigns.Methods: A bead-based multiplex antibody detection assay was used to evaluate a chimeric P. vivax MSP1 protein (PvRMC-MSP1), designed to be broadly immunogenic for use in vaccine studies, to act as a pan-malaria serological tool based on its ability to capture IgG in plasma samples obtained from naturally exposed individuals. Samples from 236 US travelers with PCR confirmed infection status from all four major Plasmodium species infecting humans, P. falciparum, P. vivax, P. malariae, and P. ovale were tested for IgG capture using PvRMC-MSP1 as well as the four recombinant MSP1-19 kD isoforms representative of these Plasmodium species.Results: Regardless of infecting Plasmodium species, a majority of plasma samples from infected US travelers provided a high assay signal to the PvRMC-MSP1 chimeric protein. Most individuals that responded to the PmMSP1 or PoMSP1 antigen also responded to PvRMC-MSP1, with very few individuals responding to PmMSP1 or PoMSP1 antigens alone. When grouped by active infection, we observed that plasma from P. vivax-infected individuals produced increased assay signals in response to the PvRMC-MSP1 chimera as compared to the recombinant PvMSP1 for 89.5% (34/38) of individuals. PvRMC-MSP1 also showed improved ability to capture IgG antibodies from P. falciparum-infected individuals when compared to the capture by recombinant PvMSP1. Conclusions: These results support further study of designed antigens as an approach for increasing sensitivity or broadening binding capacity to improve existing serological tools for determining population-level exposure to Plasmodium species. Including both broad-reacting and Plasmodium species-specific antigen-coated beads in an assay panel could provide a nuanced view of population-level exposure histories, an extensive IgG profile, and detailed seroestimates. A more sensitive serological tool for detection of P. vivax exposure would aid malaria elimination campaigns in co-endemic areas and regions where P. vivax is the dominant parasite.
Querying Knowledge Graphs in Natural Language
Authors: Liang Shiqi , Stockinger Kurt , de Farias Tarcisio Mendes , Anisimova Maria , Gil Manuel
Published: September 2020

Knowledge graphs are a powerful concept for querying large amounts of data. These knowledge graphs are typically enormous and are often not easily accessible to end-users because they require specialized knowledge in query languages such as SPARQL. Moreover, end-users need a deep understanding of the structure of the underlying data models often based on the Resource Description Framework (RDF). This drawback has led to the development of Question-Answering (QA) systems that enable end-users to express their information needs in natural language. While existing systems simplify user access, there is still room for improvement in the accuracy of these systems. In this paper we propose a new QA system for translating natural language questions into SPARQL queries. The key idea is to break up the translation process into 5 smaller, more manageable sub-tasks and use ensemble machine learning methods as well as Tree-LSTM-based neural network models to automatically learn and translate a natural language question into a SPARQL query. The performance of our proposed QA system is empirically evaluated using the two renowned benchmarks - the 7th Question Answering over Linked Data Challenge (QALD-7) and the Large-Scale Complex Question Answering Dataset (LC-QuAD). Experimental results show that our QA system outperforms the state-of-art systems by 15% on the QALD-7 dataset and by 48% on the LC-QuAD dataset, respectively. In addition, we make our source code available.
PCAT-1 Facilitates Breast Cancer Progression via Enhancing Oxygen-independent Stability of Hypoxia-inducible Factor-1α
Authors: Wang Jianlong , Chen Xuyi , Zhang Ning , Gao Jianzhao , Liu Bin
Published: September 2020

The authors have requested that this preprint be withdrawn due to author disagreement.
The Psychometric Properties Persian version of the Hearing Handicap Inventory Screening Version (HHIE-S) Among Older Adults
Authors: Behboudi Leila , Chattu Vijay Kumar , Heizomi Haleh , Adelirad Fatemeh , Jafarabadi Mohammad Asghari , Allahverdipour Hamid
Published: September 2020

Background: there is a great need for a valid hearing loss measurement tool in the Persian language to help identify hearing handicap and potential communicational difﬁculties among Persian speaking older adults.Objectives: The present study was aimed to validate and adapt the original English version of Hearing Handicap Inventory for the Elderly (HHIE) into Persian language.Methods:A cross-sectional study was designed and data was collected from August to November 2019 in Tabriz, Iran among the older adults aged 60 years and above whose hearing loss had been confirmed by audiometry. Self-reporting and face-to-face interviews were the data collection methods in this study. The statistical analysis was performed using SPSS 26.0 (SPSS and STATA 14).Results: An exploratory factor analysis of data resulted in two factors, which included 9 of the 10 items and accounted for 87.00% of the variance. Cronbach’s alpha coefficient (0.85) and the test–retest reliability score (0.73) indicated good internal consistency.Conclusion : The results showed that HHIE-S is a valid and reliable tool for assessing hearing handicap among Persian speaking and Iranian older adults.
Diselenide Crosslinks for Enhanced and Simplified Oxidative Protein Folding
Authors: Mousa Reem , Hidmi Taghreed , Pomyalov Sergei , Lansky Shifra , Khouri Lareen , Shalev Debbie , Shoham Gil , Metanis Norman
Published: September 2020

The oxidative folding of proteins has been studied for over sixty years, providing critical insight into protein folding mechanisms. Hirudin, the most potent natural inhibitor of thrombin, is a 65-residue protein with three disulfide bonds, and is viewed as a folding model for a wide range of disulfide-rich proteins. Hirudin’s folding pathway is notorious for its highly heterogeneous intermediates and scrambled isomers, which plague its folding rate and yield in vitro. Aiming to overcome these limitations, we undertook a systematic investigation of diselenide bridges at native and non-native positions and investigated their effect on hirudin’s folding, structure and activity. Our studies demonstrated that, regardless of the specific positions of these substitutions, the diselenide crosslinks enhanced the folding rate and yield of the corresponding hirudin analogs, while reducing the complexity and heterogeneity of the process. Moreover, crystal structure analysis confirmed that the diselenide substitutions maintained the overall structure of the protein and left the function virtually unchanged. The choice of hirudin as a study model has implications beyond its specific folding mechanism, demonstrating the high potential of diselenide substitutions in the design, preparation and characterization of disulfide-rich proteins.
Ground-Space Observations of Pc5 Poleward Moving Auroral Arc Pulsations and Field-Line Resonances in the Post-Midnight Sector: THEMIS Observations
Authors: Sato Natsuo , Yukimatu Akira Sessai , Tanaka Yoshimasa , Tomoaki Tomoaki , Kadokura Akira
Published: September 2020

We investigate the Pc5 poleward moving auroral arc (PMAA) pulsations (~ 4–5 min period) using the ground-based all-sky imager network and the Time History of Events and Macroscale Interactions during Substorms (THEMIS) A, D, and E satellites, whose footprints were located near the PMAA in the post-midnight sector. The Pc5 PMAA pulsations considered herein occurred in conjunction with the enhancement of the magnetic and electric field oscillations observed near the equatorial plane of the magnetosphere. The magnetospheric oscillation signal displayed three-cycle oscillations, which correspond primarily to the PMAA pulsations. The value of coherence between the magnetospheric oscillations and the luminosity pulsations was higher than 0.9. Based on these observations, it is suggested that the PMAA pulsations and the magnetospheric field oscillations are initiated by the same physical mechanism and thus oscillate concurrently by the magnetosphere-ionosphere (M-I) coupling. The satellite data indicated a longer period of magnetospheric oscillations at the higher latitude site. On the other hand, the measured period of the PMAA pulsation was almost constant in the lower latitude region (~ 68.5°-70.0° MLAT), whereas in the higher latitude region (~ 70.0°-70.5° MLAT) it increased with increasing latitude. This signature demonstrates that the oscillations on the lower latitudinal side of the PMAA conformed with the monochromatic frequency field-line resonance (FLR) where the oscillation period was constant and independent of latitude, whereas the higher latitude side of the PMAA presented a multi-frequency FLR region where the period lengthened with increasing latitude. The Pc5 magnetic pulsations observed on the ground neither exhibited a clear coincidence with the PMAA pulsations nor with the magnetospheric magnetic oscillations. On the other hand, the H component of magnetic pulsations demonstrated a rather similar behavior to that of the ion pressure variation within the magnetosphere. The solar wind speed was significantly high, approximately 650 km/s, during this event. The magnetospheric magnetic and electric field oscillations could be triggered simultaneously in a wide region by an impulse such as rapid convection changes caused by the sudden variations of the interplanetary magnetic field (IMF) Bz, which was observed by the SuperDARN radar and the Geotail satellite.
Positive Predictive Value of ICD-10-CM Definitions for Adolescent Intentional Self-Harm: An Emergency Department Medical Record Review
Authors: Hansen Anna , Slavova Dessi , Cooper Gena , Zummer Jaryd , Costich Julia F
Published: September 2020

Background Non-suicidal self-injury and suicide attempts are increasing problems among American adolescents. This study proposed a definition for identifying intentional self-harm injuries (ISHIs) in emergency department (ED) records coded with International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes and sought to estimate: (1) the definition’s positive predictive value (PPV) in a pediatric population treated in one Kentucky ED, and (2) the proportion of Intentional self-harm injuries (ISHIs) with intent to die (i.e., suicide attempt) that cannot be captured by ICD-10-CM codes and can only be identified by a medical record abstraction. Methods The study definition captured initial encounters for ISHIs based on first valid external cause-of-injury self-harm codes in the ICD-10-CM range X71-X83, T14.91, T36-T65, or T71. Medical records for a random sample of 207 ED discharge records were reviewed following a specified protocol. The PPV for the study definition was reported with its 95% confidence interval (95%CI). Results The estimated PPV for the study definition’s ability to capture true ISHIs was 88.9%, 95%CI (83.8%, 92.8%). The estimated percentage of ISHIs with intent to die was 45.9%, 95%CI (47.1%, 61.0%). The ICD-10-CM code “suicide attempt” (T14.91) captured only 7 cases, but coding guidelines allow assignment of this code only when the mechanism of the suicide attempt is unknown. Conclusions This study demonstrated a critical shortcoming in U.S. morbidity surveillance. The ICD-10-CM coding system and coding guidelines do not allow accurate identification of ISHIs with intent to die; modifications are needed to address this issue.
Application of Three-Dimensional Transesophageal Echocardiography in Preoperative Evaluation of Transcatheter Aortic Valve Replacement
Authors: Ding Peng , Xu Chennian , Liu Yang , Tang Jiayou , Jin Ping , Li Lanlan , Ma Yanyan , Lu Linhe , Yang Jian
Published: September 2020

BackgroundAnalysing the accuracy of 3D-TEE in preoperative evaluation of TAVR compared with CT when the error led by inconsistent software and method has been eliminated and the representativeness of sample has been improved, and exploring the influence of aortic root calcification on the accuracy of 3D-TEE in aortic annulus evaluations.MethodsPart I: 45 of 233 patients who underwent TAVR in the department of cardiovascular surgery in Xijing hospital from January 2016 to August 2019 were retrospectively studied. Mimics and multiplanar reconstruction method were used for evaluation based on 3D-TEE and CT. Annulus diameter - area derived (Da), annulus diameter - perimeter derived (Dp), annulus mean diameter, the left ventricular outflow tract (LVOT) diameter-Dp, the sinus tube junction (STJ) diameter-Dp and aortic sinus diameter were compared and analyzed. Part ii: 31 of 233 patients whose 3D-TEE and CT data were well preserved and in the required format were included. HU450 and HU850 were used as indicators to measure the severity of calcification, and spearman rank correlation and ROC curve was used to analyze the correlation between aortic root calcification and accuracy of 3D-TEE in aortic annulus measurement.ResultsThe measurement results based on 3D-TEE were significantly lower than those of CT (p<0.05), except for the STJ diameter-Dp in diastole (p=0.11). The correlation coefficient of the two groups was 0.699 ~ 0.954 (p < 0.01), which also indicated a significant correlation between the two groups.Bland-Altman plot showed that the ordinate values were mostly within the 95% consistency limit, the consistency of the two groups was good. By establishing the linear regression equation, the two groups can be inferred from each other. Spearman rank correlation analysis and ROC curve analysis showing that the influence of aortic calcification on the accuracy of 3D-TEE annulus evaluation was limited.ConclusionsWhlie evaluation based on 3D-TEE underestimated the results, we can deduce CT results from 3D-TEE as they obtain considerable correlation and consistency. Calcification in the aortic sinus did not affect the accuracy of 3D-TEE annulus evaluation.Trial registrationName: Surgery and Transcatheter Intervention for Structural Heart DiseasesNumber: NCT02917980URL : https://clinicaltrials.gov/ct2/results?term=NCT02917980
Trends, Spatial Pattern and Determinants of Skilled Birth Attendant Utilization in Ethiopia: Data from Ethiopian Demographic and Health Surveys (2005, 2011 and 2016).
Authors: Regassa Lemma Demissie , Tola Assefa , Tusa Biruk Shalmeno , Weldesenbet Adisu Birhanu
Published: September 2020

Introduction: Since 2000, Ethiopia has achieved considerable success in reduction of maternal and child mortality, but progress and distribution across the country in SBA remains unclear. This study aimed to assess the trend, spatial distribution, and determinants of skilled birth attendant utilization in Ethiopia. Methods: Data from time series community-based cross-sectional study design of Ethiopian Demography and Health Surveys (2005-2016 EDHS) were employed. Data was downloaded and extracted from DHS website (www.dhsprogram.com). Stata version 16.0 for statistical and Arc-GIS version 10.1 and Sat-Scan software’s were used for spatial analysis. Multilevel generalized linear model with binomial distribution was fitted to identify community and individual level factors associated with skilled birth attendant utilization. Adjusted odds ratio with 95% confidence interval used to report the association. Result: The trend of skilled birth attendant utilization has been increased from 5% in 2005 to 27% in 2016. Skilled birth was clustered with spatial variation across the country. The primary and secondary significant clusters of skilled birth attendants were located in Addis Ababa and Dire Dawa. Skilled birth attendant’s utilization was determined by residence, women’s educational level, partner’s educational level, age at first birth, maternal age at interview, and antenatal care were significantly associated with SBA utilization.Conclusion: The SBA utilization has shown a substantial increased and showed spatial variation in Ethiopia. We recommend strengthening maternal health programs with special emphasis for uneducated and women from rural parts of a country.
Calcitriol Combined With Budesonide Inhibits the Secretion and Expression of IL-33 in Mouse Airway Smooth Muscle Cells
Authors: Zhang Nan , Zhang Qian , Cai Qiujing , He Xuejia , Li Qingsu , Zhang Yamin , Zhu Weiwei
Published: September 2020

BackgroundBronchial asthma (asthma) is a chronic respiratory inflammatory disease characterized by reversible airflow limitation and high airway reactivity. Current studies generally show that airway remodeling is the pathologic structural basis for the occurrence of reversible airflow restriction and airway hyper reactivity[1] [2].In the above process, airway smooth muscle cell (ASMC) hyperplasia and hypertrophy are considered to be the main mechanisms of airway remodeling[3]. Calcitriol can be combined with budesonide to more effectively inhibit airway inflammation and airway remodeling and play its role in the treatment of asthma[4, 5]. MethodsThe mouse airway smooth muscle cells were divided into blank group, TGF-β1 group, SIS3 group, budesonide group,calcitriol group and drug co-treatment group[6]. The IL-33 concentration in supernatant of each group was detected by ELISA method, and the expression of Smad3, pSmad3 and IL-33 protein in each group was detected by Western blotting method[7].ResultsELISA showed that the concentration of IL-33 in the supernatant of cell culture in budesonide group was lower than that in the calcitriolgroup, and the concentration of IL-33 in the drugco-treatment group was lower than that in any single drugtreatment group.The expression level of Smad3 protein, pSmad3 protein and IL-33 protein of western blot in the drug co-treatment group were significantly decreased[8, 9].ConclusionsCalcitriol combined with budesonide can effectively decrease the expression and secretion of IL-33 in mouseairway smooth muscle cells byactivatingTGF-β1/Smad3 signaling pathway [10].
The Impact of Race on Postpartum Opioid Prescribing Practices: A Retrospective Cohort Study
Authors: McKinnish Tyler Ryan , Lewkowitz Adam K. , Carter Ebony B. , Veade Ashley E.
Published: September 2020

BackgroundTo identify the association between inpatient postpartum opioid consumption, race, and amount of opioids prescribed at discharge after vaginal or cesarean delivery. MethodsA total of 416 women who were prescribed an oral opioid following vaginal or cesarean delivery at a single tertiary academic institution between July 2018 and October 2018 were identified. Women with postoperative wound complications, third and fourth degree lacerations, cesarean hysterectomy, or a history of opioid abuse were excluded. The primary outcome was the number of oxycodone 5 mg tablets prescribed at discharge, stratified by race and mode of delivery. Only “Black” and “White” women were included in analyses due to low absolute numbers of other identities. Black women were compared to white women using multivariable logistic regression. Multiple sensitivity analyses were performed.ResultsThe median number of oxycodone tablets consumed during hospitalization following cesarean delivery was seven (IQR: 2.5–12 tablets) and following vaginal delivery was one (IQR: 0-3). White women were more likely to be older at delivery regardless of route (median 32 vs. 30 years for cesarean delivery, and 29 vs. 27 years for vaginal delivery; p<0.01 for both). White women undergoing cesarean delivery did so at a lower maternal BMI (31.6 vs. 34.5; p=0.02). White women were also significantly more likely to have private insurance and to experience perineal lacerations following vaginal delivery. The number of inpatient opioid tablets consumed, as well as the number prescribed at discharge, were not statistically different between Black and White women, regardless of mode of delivery. These findings persisted in sensitivity analyses.ConclusionAt our large, academic hospital the number of tablets prescribed at discharge had no association with patient race or inpatient usage regardless of mode of delivery.
Ethnobotanical research to assess the diversity of tree species used in wood carving in Southern Benin: Perspective for sustainable forest conservation.
Authors: Dossou-Yovo Hubert O. , Kindomihou Valentin , Sinsin Brice
Published: September 2020

Background: This research aimed at assessing the diversity of timber species used in wood carving in southern Benin, identify various sources of woods as well as their ranking as most used. We also stated the relative importance of species of which woods were recorded as the most used. The scarcity or availability of species woods and their causes in recent years were assessed and carvers’ willingness to contribute to species conservation was documented. With a perspective of sustainable forest conservation, the impact of this activity on forests was assessed throughout the paper. Methods: A preliminary survey was conducted to determine the number of wood carvers in three districts of Southern Benin. Then, a semi-structured questionnaire served to collect data from twelve wood carvers. Various percentage of carvers were calculated and we determine the Use Value of the most used species woods in order to assess their relative importance. Results: Twenty-two species were used in wood carving with most species having red or yellow wood. The purchase of wood in industrial markets was the predominant source followed by the direct purchase from plantation and tree owners. Diospyros mespiliformis, Chlorophora excelsa,Tectona grandis and Gmelina arborea were species of which woods were most However, Gmelina arborea and Chlorophora excelsa exhibited the highest Use Value meaning their relative importance in terms of diversity of uses. All carvers reported the scarcity of woods and the destruction of forests and plantations for logging were the main cause; 25% of them own plantations of G. arborea and A. auriculiformis. Carvers indicated their willingness to have plantations of T. grandis and G. arborea for personal use and trade. Promoting reforestation and timber species plantation through sustainable tools is needed, and sensitizing them about forest conservation.Conclusions: A diversity of species are used in carving in Southern Benin, the most used species being D. mespiliformis, C. excelsa, T. grandis and G. arborea. Gmelina arborea and C. excelsa had the highest Use Value. Carvers indicated their willingness to contribute to species plantation and conservation. Wood carving impacts on forest fragmentation and there is a need to promote reforestation and plantation, and to provide carvers with tools for plantation management.
Effectiveness of Involvement of Community Health Workers in Identification and Referral of Persons Living With Epilepsy in Rural Rwanda
Authors: Sebera Fidele , Dedeken Peter , Kayirangwa Jeannine , Umwiringirwa Josiane , Kajeneza Delphine , Reis Nicole Alves dos , Teuwen Dirk Edward , Boon Paul
Published: September 2020

IntroductionAs part of an interventional study on epilepsy and depression as co-morbidity, persons living with epilepsy (PwE) were enrolled in villages associated with three health centers (HCs) in the Musanze district, Rwanda. Due to slower than expected enrolment based on an estimated prevalence of 47.7‰, we engaged Community Healthcare Workers (CHWs) in the identification and referral of PwE. MethodsCHWs of villages associated to three HC participated in a one-day training on epilepsy and on the Kinyarwanda version of the Limoges epilepsy screening questionnaire. CHWs returned to their villages and identified persons responding positive to one or more questions. After one week, CHWs accompanied possible PwE to their respective HC for clinical evaluation and diagnosis of epilepsy by neurologistsResults A total of 1308 patients screened positive. Clinical diagnosis of epilepsy was confirmed in 589. We observed an unexpected effect of an additional 93 non-screened patients also presenting to HCs, all confirmed with epilepsy. The number of PwE increased from 48 persons prior to the intervention to 682 (a 14.2-fold increase). In the Gataraga, Kimonyi and Karwasa HC, the patient number increased from 18 to 161, 11 to 193 and 19 to 328, respectively. Relative increases at each HC were 8.9-, 17.5- and 17.3-fold, respectively. Conclusion This observation illustrates that involving CHWs, equipped with an easy-to-administer screening tool, enhances possible case detection and decreases epilepsy diagnosis and treatment gaps. The involvement of CHWs impacted the lives of many PwE. Study supported by: UCB Pharma
HIV Prevention at Drug Shops: Awareness and Attitudes Among Shop Dispensers and Young Women About Oral Pre-Exposure Prophylaxis and The Dapivirine Ring in Shinyanga, Tanzania
Authors: Tubert Julia , Packel Laura , Hunter Lauren A. , Mfaume Rashid , Njau Prosper , Ramadhani Angela A. , Liu Jenny X. , McCoy Sandra I.
Published: September 2020

Background: HIV risk remains high among adolescent girls and young women (AGYW, ages 15-24) in Tanzania. Many AGYW experience stigma and provider bias at health facilities, deterring their use of HIV prevention services. Privately-owned drug shops, ubiquitous in many communities, may be an effective and accessible channel to deliver HIV prevention products to AGYW, including oral pre-exposure prophylaxis (PrEP) and the dapivirine vaginal ring. Methods: In July-August 2019, we enrolled 26 drug shops in Shinyanga, Tanzania in an ongoing study to create “girl-friendly” drug shops where AGYW can access HIV self-testing and contraception. At baseline, all shop dispensers were given basic information about oral PrEP and the dapivirine ring and were asked about their interest in stocking each. During the next 3-5 months, we surveyed AGYW (n=56) customers about their interest in oral PrEP and the ring. Results: Among dispensers, the median age was 42 years and 77% were female. Overall, 42% of dispensers had heard of a medication for HIV prevention. Almost all dispensers reported some interest in stocking oral PrEP (92%) and the dapivirine ring (96%). Most (85%) reported they would provide oral PrEP to AGYW who requested it. Among AGYW customers, the median age was 17 years; 18% of AGYW were married and 7% had children. Only 20% of AGYW had heard of a medication to prevent HIV, yet 64% and 43% expressed some interest in using oral PrEP and the dapivirine ring, respectively, after receiving information about the products. PrEP interest was higher among AGYW who were partnered and had children.Conclusions: Despite low prior awareness of PrEP among shop dispensers and AGYW, we found high levels of interest in oral PrEP and the dapivirine ring in both groups. Community-based drug shops represent a promising strategy to make HIV prevention more accessible to AGYW.
The Effect of Zinc and/or Herbal Nutraceuticals on Rumen Fermentation, Microbiota and Histopathology in Lambs
Authors: Petrič Daniel , Mravčáková Dominika , Kucková Katarína , Kišidayová Svetlana , Cieslak Adam , Szumacher-Strabel Malgorzata , Huang Haihao , Kolodziejski Pawel , Lukomska Anna , Slusarczyk Sylwester , Čobanová Klaudia , Varadyova Zora
Published: September 2020

Background: The aim of this study was to investigate the effect of diets containing organic zinc and a mixture of medicinal herbs on rumen microbial fermentation and histopathology in lambs.Methods: Twenty-eight lambs were divided into four groups: unsupplemented animals (Control), animals supplemented with organic zinc (Zn, 70 mg Zn/kg diet), animals supplemented with a mix of dry medicinal herbs (Herbs, 100 g DM/d) and animals supplemented with both zinc and herbs (Zn+Herbs). Each lamb was fed a basal diet composed of meadow hay (700 g DM/d) and barley (300 g DM/d). Fumaria officinalis L. (FO), Malva sylvestris L. (MS), Artemisia absinthium L. (AA) and Matricaria chamomilla L. (MC) were mixed in equal proportions. The lambs were slaughtered after 70 days of the experiment. The rumen content was used to determine the fermentation parameters in vitro and in vivo and to quantify the microbes by molecular and microscopic methods. Samples of fresh rumen tissue were used for histopathological evaluation.Results: Quantitative analyses of the bioactive compounds identified 3.961, 0.654, 6.482 and 12.084 g/kg DM phenolic acids and 12.211, 6.479, 0.349 and 2.442 g/kg DM flavonoids in FO, MS, AA and MC, respectively. The alkaloids content in FO was 6.015 g/kg DM. The effect of diets on values of total gas, methane and n-butyrate in vitro was observed (P < 0.046 and P < 0.001, respectively). Relative quantification by real-time PCR revealed a decrease in the total rumen bacterial population in the lambs in the Zn and Zn+Herbs groups (P < 0.05). A shift in the relative abundance of Ruminococcus albus, Streptococcus bovis, Butyrivibrio proteoclasticus and R. flavefaciens was observed in the Zn group. Morphological observation showed focal mixed infiltration of inflammatory cells within the lamina propria of the rumen in the Zn+Herbs group. Conclusion: The effect of the organic zinc and the herbal mix on rumen fermentation parameters in vitro was not confirmed in vivo because the rumen microbiota of lambs probably adapted to the zinc-supplemented diets. However, long-term supplementation of a diet combining zinc and medicinal herbs can diminish the health of the ruminal epithelium of lambs.
Radiographic Bone Texture Analysis Using Deep Learning Models for Early Rheumatoid Arthritis Diagnosis
Authors: Huang Yun-Ju , Shun Miao , Zheng Kang , Lu Le , Lu Yuhang , Lin Chihung , Kuo Chang-Fu
Published: September 2020

BackgroundRheumatoid arthritis (RA) is characterized by altered bone microarchitecture (radiographically referred to as ‘texture’) of periarticular regions. We hypothesize that deep learning models can quantify periarticular texture changes to aid in the classification of early RA.MethodsThe second, third, and fourth distal metacarpal areas from hand radiographs of 892 early RA and 1236 non-RA patients were segmented for the Deep Texture Encoding Network (Deep-TEN; texture-based) and residual network-50 (ResNet-50; texture and structure-based) models to predict the probability of RA. The performances were measured using the area under the curve of the receiver operating characteristics curve (AUROC). Multivariate logistic regression was used to estimate the odds ratio (OR) with 95% confidence intervals (CIs) for RA.ResultsThe AUROC for RA was 0.69 for the Deep-TEN and 0.73 for the ResNet-50 model. The positive predictive values of a high texture score to classify RA using the Deep-TEN and ResNet-50 models were 0.64 and 0.67, respectively. High mean texture scores were associated with age- and sex-adjusted ORs (95% CI) for RA of 3.42 (2.59–4.50) and 4.30 (3.26–5.69) using the Deep-TEN and ResNet-50 models, respectively. The moderate and high RA risk groups determined by the Deep-TEN model were associated with adjusted ORs (95% CIs) of 2.48 (1.78–3.47) and 4.39 (3.11–6.20) for RA, respectively, and those using the ResNet-50 model were 2.17 (1.55–3.04) and 6.91 (4.83–9.90), respectively.ConclusionFully automated quantitative assessment for periarticular texture by deep learning models can help the classification of early RA.
Adult post COVID-19 multisystem inflammatory syndrome and thrombotic microangiopathy
Authors: Boudhabhay Idris , Rabant Marion , Coupry Louis-Marie , Marchal Armance , Roumenina Lubka T , El-Karoui Khalil , Monchi Mehran , Pourcine Franck
Published: September 2020

Background: The coronavirus disease 2019 pandemic has affected millions of people worldwide but medium and long-term consequences are unknown. Clinical series of Kawasaki-like multisystem inflammatory syndrome in children (MIS-C), occurring after SARS-Cov-2 spreading, have been recently described. Case presentation: We describe a case of post COVID-19 MIS in a 46-year-old man, with biopsy-proven renal thrombotic microangiopathy (TMA). Specific complement inhibition with Eculizumab was initiated promptly and lead to a dramatic improvement of renal function. Conclusion: Our case suggests that post COVID-19 MIS is not restricted to children and that TMA could play a central role in the pathophysiology of this syndrome