bluuebunny/crossref_metadata_2025 huggingface dataset:
Hygiene Along the Continuum of Care in the Early Post-Natal Period: An Observational Study in Nigeria
Authors: Nalule Yolisa , Buxton Helen , Flynn Erin , Oluyinka Olutunde , Sara Stephen , Cumming Oliver , Dreibelbis Robert
Published: September 2020

Background: Newborns delivered in healthcare facilities in low- and middle-income countries are at an increased risk of healthcare associated infections. Facility–based studies have focused primarily on healthcare worker behaviour during labour & delivery with limited attention to hygiene practices in post-natal care areas and largely ignore the wide variety of actors involved in maternal and neonatal care. Methods: This exploratory mixed-methods study took place in six healthcare facilities in Nigeria where 31 structured observations were completed during post-natal care, discharge, and the first six hours after return to the home. Frequency of hand hygiene opportunities and hand hygiene actions were assessed for types of patient care (maternal and newborn care) and the role individuals played in caregiving (healthcare workers, cleaners, non-maternal caregivers). Qualitative interviews with mothers were completed approximately 1 week after facility discharge.Results: Maternal and newborn care were performed by a range of actors including healthcare workers, mothers, cleaners and non-maternal caregivers. Of 291 hand hygiene opportunities observed at health facilities, and 459 observed in home environments, adequate hand hygiene actions were observed during only 1% of all hand hygiene opportunities. Adequate hand hygiene prior to cord contact was observed in only 6% (1/17) of cord contact related hand hygiene opportunities at healthcare facilities and 7% (2/29) in households. Discharge advice was infrequent and not standardised and could not be remembered by the mother after a week. Mothers reported discomfort around telling non-maternal caregivers to practice adequate hand hygiene for their newborn.Conclusions: In this setting, hand hygiene practices during post-natal care and the first six hours in the home environment were consistently inadequate. Effective strategies are needed to promote safe hand hygiene practices within the post-natal care ward and home in low resource, high-burden settings. Such strategies need to target not just mothers and healthcare workers but also other caregivers.
Longitudinal changes in sports activity from pre-diagnosis to first five years post-diagnosis: a prospective Chinese breast cancer cohort study
Authors: Lei Yuanyuan , Ho Suzanne C. , Kwok Carol , Cheng Ashley , Cheung Ka Li , Lee Roselle , Yeo Winnie
Published: September 2020

BackgroundTo compare change in level of physical activity between pre-and post- diagnosis of breast cancer in Chinese women.MethodsBased on an on-going prospective study consisting of a sample of Chinese women with breast cancer, a validated modified Chinese Baecke questionnaire was used to measure physical activity at baseline (12 months before cancer diagnosis), 18-, 36- and 60-months after diagnosis (over the previous 12 months before each interview).ResultsIn our cohort of 1462 Chinese women with a mean age of 52 years, the mean level of physical activity at post-diagnosis was 9.6 metabolic equivalent of task (MET)-hours/week, which was significantly higher than that at pre-diagnosis with mean level of 5.9 MET-hours/week ( P < 0.001). The mean levels of physical activity at 18-, 36- and 60-months follow-up were 9.9, 9.8 and 9.3 MET-hours/week, respectively. There was no significant difference between any two of the three follow-ups at post-diagnosis. The proportions of participant who met World Cancer Research Fund/ American Institute for Cancer Research (WCRF/AICR) recommendation before and after cancer diagnosis were both low, being 20.7% and 35.1%, respectively. Compared to pre-diagnosis, most of the patients improved or had no change on level of physical activity at post-diagnosis, with the respective proportion being 48.2% and 43.8%.ConclusionsAdherence to current lifestyle recommendation for cancer survivors, Chinese women with breast cancer significantly increased level of physical activity level after cancer diagnosis, and such improvement was sustained to five years post-diagnosis. The proportion of patients who met the exercise recommendation for cancer survivors was still low. Encouraging patients on the importance of durable high level of physical activity in breast cancer survivorship is warranted.
​Quantitative evaluation of hepatic integrin αvβ3 expression by positron-emission tomography imaging using 18F-FPP-RGD2 in rats with non-alcoholic steatohepatitis
Authors: Hiroyama Shuichi , Rokugawa Takemi , Ito Miwa , Iimori Hitoshi , Morita Ippei , Maeda Hiroki , Fujisawa Kae , Matsunaga Keiko , Shimosegawa Eku , Abe Kohji
Published: September 2020

Background Integrin αvβ3, which are expressed by activated hepatic stellate cells in non-alcoholic steatohepatitis (NASH), play an important role in the fibrosis. Recently, we reported that an RGD peptide positron emission tomography (PET) probe is useful as a predictor of hepatic fibrosis. Kinetic analysis of the RGD PET probe has been performed in tumours, but not in hepatic fibrosis. Therefore, we aimed to quantify hepatic integrin αvβ3 in a model of NASH by kinetic analysis using 18F-FPP-RGD2, an integrin αvβ3 PET probe.Methods 18F-FPP-RGD2 PET/CT scans were performed in control and NASH rats. Tissue kinetic analyses were performed using a one-tissue, two-compartment (1T2C) and a two-tissue, three-compartment (2T3C) model using an image-derived input function (IDIF) for the left ventricle. We then conducted correlation analysis between standard uptake values (SUVs) or volume of distribution (VT), evaluated using compartment kinetic analysis, and integrin αv or β3 protein expression.Results Biochemical and histological evaluation confirmed the development of NASH rats. Integrin αvβ3 protein expression and hepatic SUV were higher in NASH- than normal rats. The hepatic activity of 18F-FPP-RGD2 peaked rapidly after administration and then gradually decreased, whereas left ventricular activity rapidly disappeared. The 2T3C model was found to be preferable for 18F-FPP-RGD2 kinetic analysis in the liver. The VT (IDIF) for 18F-FPP-RGD2, calculated using the 2T3C model, was significantly higher in NASH- than normal rats and correlated strongly with hepatic integrin αv and β3 protein expression. The strengths of these correlations were similar to those between SUV60–90 min and hepatic integrin αv or β3 protein expression.Conclusions We have demonstrated that the VT (IDIF) of 18F-FPP-RGD2, calculated using kinetic modelling, positively correlates with integrin αv and β3 protein in the liver of NASH rats. These findings suggest that hepatic VT (IDIF) provides a quantitative assessment of integrin αvβ3 protein in liver.
NMR Elucidation of Nonproductive Binding Sites of Lignin Models with Carbohydrate-Binding Module of Cellobiohydrolase I
Authors: Tokunaga Yuki , Nagata Takashi , Kondo Keiko , Katahira Masato , Watanabe Takashi
Published: September 2020

Background : Highly efficient enzymatic saccharification of pretreated lignocellulose is a key step in achieving lignocellulosic biorefinery. Cellobiohydrolase I (Cel7A) secreted by Trichoderma reesei is an industrially used cellulase that possesses carbohydrate-binding module 1 (TrCBM1) at the C-terminal domain. The nonproductive binding of TrCBM1 to lignin significantly decreases the enzymatic saccharification efficiency and increases the cost of biomass conversion because of the additionally required enzymes. Understanding the interaction mechanism between lignin and TrCBM1 is essential for realizing a cost-effective biofuel production; however, the binding sites in lignin have not been clearly elucidated.Results: Three types of 13C-labeled β-O-4 lignin oligomer models were synthesized and characterized. The 2D 1H–13C heteronuclear single-quantum correlation (HSQC) spectra of the 13C-labeled lignin models confirmed that the three types of the 13C labels were correctly incorporated in the (1) aromatic rings and β positions, (2) α positions, and (3) methoxy groups, respectively. The TrCBM1 binding sites in lignin were analyzed by observing NMR chemical shift perturbations (CSPs) using the synthetic 13C-labeled β-O-4 lignin oligomer models. Obvious CSPs were observed in signals from the aromatic regions in oligomers bound to TrCBM1, whereas perturbations in the signals from aliphatic regions and methoxy groups were insignificant. These findings indicated that hydrophobic interactions and π–π stacking were dominating factors in nonproductive binding. The synthetic lignin models have two configurations whose terminal units were differently aligned and donated C(I) and C(II) . The C(I) ring showed remarkable perturbation compared with the C(II) , which indicated that the binding of TrCBM1 was markedly affected by the configuration of the lignin models. The long-chain lignin models (degree of polymerization (DP) 4.16–4.70) clearly bound to TrCBM1. The interactions of TrCBM1 with the short-chain lignin models (DP 2.64–3.12) were insignificant, indicating that a DP greater than 4 was necessary for TrCBM1 binding.Conclusion: The CSP analysis using 13C-labeled β-O-4 lignin oligomer models enabled the identification of the TrCBM1 binding sites in lignins at the atomic level. This specific interaction analysis will provide insights for new molecular designs of cellulase having a controlled affinity to cellulose and lignin for a cost-effective biorefinery process.
Global, regional, and national burdens of bladder cancer in 2017: estimates from the 2017 Global Burden of Disease study
Authors: He Hairong , Xie Hongjun , Chen Yule , Li Chengzhuo , Han Didi , Xu Fengshuo , Lyu Jun
Published: September 2020

Background: The aim of this study is to describe the prevalence and mortality of bladder cancer (BCa) using data obtained in the Global Burden of Disease study performed in 2017 (GBD 2017).Methods: Data on BCa for 2017, including prevalence, mortality, and disability-adjusted life years (DALYs), were obtained from GBD 2017 at the global, regional, and national levels. We also analyzed the association of BCa burden with the country development level.Results: There were 2.63 million BCa cases estimated from the GBD 2017 data, with 200,000 persons dying of BCa, resulting in 3.60 million DALYs in 2017. The age-standardized prevalence (ASP) of BCa was 32.91/100,000 persons, and age-standardized death rate (ASDR) was 2.57/100,000 persons. The ASP and ASDR of BCa were higher in males than in females, and higher in people older than 60 years. The ASP and ASDR of BCa were higher in Western Europe and Central Europe than in South Asia, Andean Latin America, and Central Latin America, and higher in countries with a higher sociodemographic index (SDI). Correlation analysis identified that the ASP and ASDR of BCa were positively correlated with the country SDI (P<0.0001 and ρ=0.68 for ASP, and P=0.0048 and ρ=0.20 for ASDR). In addition, 33.72% deaths and 36.80% DALYs caused by BCa could be attributed to smoking globally.Conclusion: The prevalence and mortality of BCa were very high in 2017, especially in high-SDI countries. Smoking-cessation strategies should be strengthened to control the burden associated with BCa.
Exposure risk of patients with chronic infectious wounds during the COVID-19 outbreak and its countermeasures
Authors: Zhou Haiying , Jin Qianjun , lu hui
Published: September 2020

BACKGROUND: A large number of cases of pneumonia caused by novel β-coronavirus emerged in Hubei Province, China, at the end of 2019 and demonstrated great potential for transmission. At present, known independent risk factors include age, diabetes and other chronic diseases, which may be similar to the patients with chronic wound, thus we try to explore the clinical characteristics, prognostic factors and management recommendation of patients with chronic infective wounds during the COVID-19 epidemic period. METHODS: In this single-center, retrospective observational study, we included all cases with chronic infective wounds that came to our hospital between the full outbreak of the COVID-19 in China (January 23, 2020) and the latest date prior to posting (20 April 2020). Demographic data, comorbidities, laboratory and imaging findings, consultation history and clinical outcomes (lesion cured, uncontrolled, amputated, etc. as of May 10, 2020) were collected for all individuals. Patients were subdivided into gangrene, traumatic infection and other types of soft tissue infection wound (including bedsores, gout ruptures, stab wounds and so on) according to the causes of wound and their disease-related information were compared group by group.RESULTS : Among the total 81 patients with chronic infective wounds, 60% were male, with a mean age of 60.8 years (SD 18.6), including 38 (47%) patients with traumatic infection, 29 (36%) gangrene cases, and 14 (17%) other soft tissue infection wounds. Common comorbidities are hypertension (32%), diabetes (32%), cardiovascular disease (24%), and kidney injury (12%), and the patients with gangrenes have the most comorbidities. As of May 10, 2020, there were 78 patients discharged and their average stay time is 15.8 days（SD 14.2）, while people still at the hospital is 39.7days（SD 8.7）much longer than the discharged and also has more comorbidities. But there is no significant difference in the hospitalization time of three types of wounds. And fortunately, none of all the patients were infected by coronavirus.CONCLUSION: The majority of patients with chronic wounds are severely ill with high risk of infection and poor prognosis, therefore management of patients with chronic wounds should be improved.
Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective study
Authors: Li hua , Ou Yufu , Xie Furong , Liang Weiguo , Tian Gang , Li Hongyu
Published: September 2020

Background: Although: percutaneous endoscopic lumbar discectomy (PELD) is increasingly being used to treat lumbar degenerative disease, the treatment of elderly patients with lumbar spinal stenosis (LSS) involves considerable uncertainty. The purpose of this study was to evaluate the safety and effectiveness of PELD for the treatment of LSS in elderly patients aged 65 years or older. Methods: In this retrospective review, 136 patients aged 65 years or older who underwent PELD to treat LSS were evaluated. The patients were divided into two groups, group A (age 65-74) and group B (age ≥ 75), and perioperative data were analyzed. The Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score, and MacNab classification were used to evaluate postoperative clinical efficacy. Results: All patients successfully underwent the operation with satisfactory treatment outcomes. Compared to preoperative scores, the self-reported scores for pain while performing daily activities were significantly improved in both treatment groups (P<0.05). No statistically significant between-group differences were observed in operation time, intraoperative blood loss, postoperative bed rest, and postoperative hospital stay (P > 0.05). The overall postoperative complication rate was similar between the two groups. Moreover, no statistically significant differences in VAS-back pain scores, VAS-leg pain scores, JOA scores, and MacNab classification were found between the groups at the 3-month and 1.5-year follow-up examinations (P>0.05). Conclusion: PELD is safe and effective for the treatment of LSS in elderly patients. Age is not a contraindication for decompressive lumbar spine surgery. PELD has advantages such as reduced trauma, fewer anesthesia-related complications, and a fast postoperative recovery. Elderly patients should be considered good candidates for lumbar decompression surgery using minimally invasive techniques.
Comparing Zirconia to Anterior Strip Crowns in Primary Anterior Teeth;A Randomized Clinical Trial
Authors: Alaki Sumer M , Abdulhadi Bashaer S , Abdullah Medhat A , Al-Alamoudi Najla M
Published: September 2020

Background: Providing restorations to anterior teeth in children is a challenging task due to the need for high esthetics, strength, and durability. Aim: this study was done to compare prefabricated primary zirconia with resin composite strip crowns on primary maxillary central and lateral incisors with regards to gingival health, plaque accumulation, recurrent caries, restoration failure, and opposing teeth wear over a period of 3, 6 and 12 months. Methods: Children attending the King Abdulaziz University, Faculty of Dentistry (KAUFD) clinics who needed restorations were screened for inclusion criteria. A total of 120 teeth were treated; 60 with zirconia and 60 with strip crowns. Randomization was done by simple random allocation using SPSS software version 20.0 (Armonk, NY; IBM Corp.). A simple descriptive statistic was used for analysis by Wilcoxon Signed-Rank test and Chi-square test. Level of significance was set at (α = 0.05) and level of confidence at (95%). Results: Zirconia crowns showed significantly less gingival bleeding at the 3- and 6-months follow up periods (p<0.006, p<0.001; respectively), less plaque accumulation at all follow up visits (p<0.001), no restoration failure (p<0.001), but more wear to opposing teeth (p<0.02). No significant difference was found between the two crowns with regards to recurrent caries (p<0.135).Conclusion: Based on our data we conclude that overtime teeth covered with zirconia crowns show better gingival health and less bleeding, plaque accumulation as well as less loss of material. On the other hand, zirconia can cause more loss of opposing tooth structure. Trial Registration: The presented research was registered retrospectively at ClinicalTrials.gov under registration number NCT03184012.
Understanding surgical antimicrobial prescribing behaviour in the hospital setting: a systematic review and meta-ethnography protocol
Authors: Parker Hazel , Frost Julia , Britten Nicky , Robinson Sophie , Mattick Karen
Published: September 2020

Background Surgical specialities use extensive amounts of antimicrobials, and misuse has been widely reported, making them a key target for antimicrobial stewardship initiatives. Interventions informed by, and tailored to, a clear understanding of the contextual barriers to appropriate antimicrobial use are more likely to successfully improve practice. However, this approach has been under-utilised. Our aim is to synthesise qualitative studies on surgical antimicrobial prescribing behaviour (APB) in hospital settings to explain how and why contextual factors act and interact to influence APB among surgical teams. We will develop new theory to advance understanding and identify knowledge gaps to inform further research. Methods The meta-ethnography will follow the seven-phase method described by Noblit and Hare. We will conduct a comprehensive search using eight databases (AMED, CINAHL, EMBASE, MEDLINE, MEDLINE-in-process, Web of Science, Cochrane Library and PsycINFO) with no date restrictions; forwards and backwards citation searches; and contacting first authors of relevant papers. Studies will be dual screened and included if they use recognised qualitative methods and analysis; focus on contextual factors associated with surgical APB within hospital settings; are available in full in English; and are relevant to the research question. Any disagreements between reviewers will be resolved through discussion to reach consensus. Included studies will be read repeatedly to illuminate key concepts and the relationship between key concepts across studies. Then, key concepts will be sorted into conceptual categories or ‘piles’ which will be further abstracted to form a conceptual framework explaining surgical APB. During the synthesis, emerging interpretations will be discussed with stakeholders (including authors of included studies where possible; surgical and stewardship practitioners; and patient representatives) to ensure new knowledge is meaningful. Discussion This research has several strengths: (1) the protocol has been written with reference to established guidance maximising rigour and transparency; (2) the multi-disciplinary research team bring varied interpretative repertoires and relevant methodological skills; and (3) stakeholders will be involved to ensure that findings are relevant, and disseminated via suitable channels, to support improved patient care. Systematic review registrationThe meta-ethnography has been registered with the International Prospective Register of Systematic Reviews (PROSPERO); registration number CRD42020184343.
Nomogram-derived prediction of pathologic complete response (pCR) in breast cancer patients treated with neoadjuvant chemotherapy (NCT)
Authors: Pu Shengyu , Wang Ke , Liu Yang , Liao Xiaoqin , Chen Heyan , He Jianjun , Zhang Jian
Published: September 2020

BackgroundPrevious research results on the predictive factors of neoadjuvant chemotherapy (NCT) efficacy in breast cancer are inconsistent, suggesting that the ability of a single factor to predict efficacy is insufficient. Combining multiple potential efficacy-related factors to build a model may improve the accuracy of prediction. This study intends to explore the clinical and biological factors in breast cancer patients receiving NCT and to establish a nomogram that can predict the pathologic complete response (pCR) rate of NCT.MethodsWe selected 165 breast cancer patients receiving NCT from July 2017 to May 2019. Using pretreatment biopsy materials, immunohistochemical studies to assess estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 expression. The correlation between biological markers and pCR was analyzed. These predictors were used to develop a binary logistic regression model with cross-validation and to show the established predictive model with a nomogram.ResultsThe nomogram for pCR based on lymphovascular invasion, anemia (HB≤120 g/L), ER, Ki67 expression levels and NCT regimen had good discrimination performance (area under the curve [AUC], 0.758; 95% confidence interval [CI], 0.675-0.841) and calibration coordination. According to the Hosmer-Lemeshow test, the calibration chart showed satisfactory agreement between the predicted and observed probabilities. The final prediction accuracy of cross-validation was 76%.ConclusionsWe developed a nomogram based on multiple clinical and biological covariations that can provide an early prediction of NCT response and can help to quickly assess the individual benefits of NCT.
Person-centered, non-pharmacological intervention in reducing psychotropic medication use among residents with advanced dementia in Australian rural aged care homes
Authors: Parajuli Daya Ram , Kuot Abraham , Hamiduzzaman Mohammad , Gladman Justin , Isaac Vivian
Published: September 2020

BackgroundHigh rates of psychotropic medications are prescribed in aged care homes despite their limited effectiveness and associated adverse effects. We aim to evaluate the changes in prescription patterns for elderly residents with advanced dementia in the ‘Harmony in the Bush Dementia Study’. Harmony in the Bush is a person-centered model of dementia care in nursing homes, based on the principles of Progressively Lowered Stress Threshold and person-centered music intervention. MethodsOur larger study was a quasi-experimental design conducted in five rural nursing homes in Queensland and South Australia. Medication charts (n=31) were collected retrospectively from three Australian rural aged care facilities through contacting the facility managers. Medication data for each resident was collected from a three-month medication charts, pre-intervention, and post-intervention. Fifty-three staff participated in 31 semi-structured interviews and 8 focus groups at post-intervention, and at 1-month and 3-months follow up.ResultsThe median age of the participants was 83 years, and 68% of them were female. Polypharmacy was measured in 87% (n=27) of the participants. Hypertension, hyperlipidemia, diabetes, and the Alzheimer’s disease were the major comorbidities identified in residents. None of the residents received more than the maximum dose of psychotropic medications recommended by the guidelines. There was a reduction of 22.4% (77.4% vs 55%) in the use of at least any psychotropic medication, 19.6% (39% vs, 19.4%) reduction in antipsychotics and benzodiazepines (, 39% vs 19.4%), and 6.5% (42% vs 35.5%) reduction in antidepressants prescription medicines, when comparing residents’ medication charts data covering 3-months pre- and post-intervention However, these changes were not statistically significant, Additionally, there was a decreasing trend in the use of inappropriate use of medications. Psychotropic medications were prescribed in up to 43% and antidementia in 45% of participants for more than 6 months. Major themes extracted from qualitative data were reduced/decreased/cessation of medication use; introducing a rest period and the music intervention combination was an alternative approach for medications use, and resulting in less behaviors, and ultimately the less use of medications. ConclusionsOur findings indicate that the Harmony in the Bush model as a non-pharmacological approach reduces the prescription of psychotropic medications and inappropriate medications in rural nursing homes as supported by findings from both quantitative and qualitative data. Trial registration: ANZCTR, ACTRN12618000263291. Registered on 20th February 2018. http://www.ANZCTR.org.au/ACTRN12618000263291p.aspx).
Circulating Plasma Epstein–Barr virus DNA Load During the Follow-up Periods Predicts Recurrence and Metastasis in Nasopharyngeal Carcinoma
Authors: He Sha-sha , Yang Yun-ying , Wang Yan , Ren Yu-feng , Wang Cheng-tao , Zhu Mei-yan , Lu Li-xia , Chen Yong
Published: September 2020

Background: Epstein Barr virus DNA (EBV DNA) load has been identified as a prognostic factor in nasopharyngeal carcinoma, while the dynamic changes in the long period have not been explored. In this study, we evaluated EBV DNA kinetics and its role in the survival.Methods: We conducted a retrospective review of 900 NPC patients. Plasma EBV DNA levels were measured at various time points after treatment. The correlations of EBV kinetics with recurrence and metastasis were analyzed. After stratifying patients according to the EBV results, survival was compared using Kaplan–Meier estimates. 12 and 24-month landmark analyses for OS data were performed according to the EBV groups.Results: Patients with post-EBV < 2,500 copies/mL achieved better survival than the higher ones. Furthermore, patients with continuously elevated EBV DNA had significantly poorer OS (HR: 2.542, 95%CI: 2.077–3.111, P < 0.001), DMFS (HR: 2.970, 95%CI: 2.392–3.687, P < 0.001), LRFS (HR: 1.699, 95%CI: 1.072–2.692, P = 0.013), and PFS (HR:2.535, 95%CI: 1.987–3.233, P < 0.001) than patients with continuously normal EBV or those with elevated levels at any time-point. The 5-year OS with elevated EBV was lower than the remission group by the 12 and 24-month landmark analysis.Conclusions: Elevated EBV DNA after treatment was a better predictive indicator of survival than the baseline concentrations. Furthermore, continuously elevated EBV DNA after treatment indicated recurrence, metastasis and unfavorable prognosis for NPC. In addition, EBV DNA was predictable in the long follow-up time.
The Shape of Incident Shock Wave in Steady Axisymmetric Conical Mach Reflection
Authors: Ren Yu-Xin , Tan Lianhua , Wu zi-niu
Published: September 2020

For internal flow with supersonic inflow boundary conditions, a complicated oblique shock reflection may occur. Different from the planar shock reflection problem, where the shape of the incident shock can be a straight line, the shape of the incident shock wave in the inward-facing axisymmetric shock reflection in steady flow is an unknown curve. In this paper, a simple theoretical approach is proposed to determine the shape of this incident shock wave. The present theory is base on the steady Euler equations. When the assumption that the steam-lines are straight lines at locations just behind the incident shock is adopted, an ordinary differential equation can be derived, and the shape of the incident shock wave is given by the solution of this ordinary differential equation. The predicted curves of the incident shock wave at several inlet conditions agree very well with the results of the numerical simulations.
A combination of genome reduction and promoter engineering can enhance surfactin production by Bacillus amyloliquefaciens LL3
Authors: Zhang Fang , Huo Kaiyue , Song Xingyi , Quan Yufen , Gao Weixia , Wang Shufang , Yang Chao
Published: September 2020

Background: Genome reduction and metabolic engineering have emerged as intensive research hotspots for constructing the promising functional chassis and various microbial cell factories. Surfactin, a lipopeptide-type biosurfactant with broad spectrum antibiotic activity, has wide application prospects in anticancer therapy, biocontrol and bioremediation. Bacillus amyloliquefaciens LL3, previously isolated by our lab, contains an intact srfA operon in the genome for surfactin biosynthesis.Results: In this study, a genome-reduced strain GR167 lacking ~4.18% of the B. amyloliquefaciens LL3 genome was constructed by deleting some unnecessary genomic regions. Compared with the strain NK-1 (LL3 derivative, ΔuppΔpMC1), GR167 harbored faster growth rate, higher transformation efficiency, increased intracellular reducing power level and higher heterologous protein expression capacity. Furthermore, the promising chassis GR167 was engineered for enhanced surfactin production. Firstly, the iturin and fengycin biosynthetic gene clusters were deleted from GR167 to generate GR167ID. Subsequently, two promoters PRsuc and PRtpxi from LL3 were obtained by RNA-seq and promoter strength characterization, and then they were individually substituted for the native srfA promoter in GR167ID to generate GR167IDS and GR167IDT. The best mutant GR167IDS showed a 678-fold improvement in the transcriptional level of the srfA operon relative to GR167ID, and it produced 311.35 mg/L surfactin, with a 10.4-fold increase relative to GR167.Conclusions: The genome-reduced strain GR167 was advantageous over the parental strain in several industrially relevant physiological traits assessed and it was highlighted as a promising chassis for further genetic modification. In future studies, further reduction of the LL3 genome can be expected to create high-performance chassis for synthetic biology applications.
Identification of key pathways and hub genes in the myogenic differentiation of pluripotent stem cell: A bioinformatics and experimental study
Authors: Fei Wenyong , Liu Mingsheng , Zhang Yao , Cao Shichao , Wang Xuanqi , Xie Bin , Wang Jingcheng
Published: September 2020

Background: The regeneration of muscle cells from stem cells is an intricate process and various genes are included in the process as myoD, mf5, mf6 etc. The key genes and pathways in the differentiating stages is various. Therefore, the differential expression of key genes after 4weeks of differentiation were investigated in our study.

Method: Three published gene expression profiles, GSE131125, GSE148994, GSE149055, about the comparisons of pluripotent stem cells to differentiated cells after 4 weeks were obtained from the Gene Expression Omnibus (GEO) database. Common differentially expressed genes (DEGs) were obtained for further analysis as proteinprotein interaction (PPI) network, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and GSEA analysis. After hub genes and key pathways were obtained, we manipulated in vitro cell research for substantiation as immunohistochemical staining and semi-quantitative analysis and quantitative real-time PCR.

Results: A total of 824 DEGs including 350 up-regulated genes and 474 down-regulated genes were identified in the three GSEs. 19 hub genes were identified from the PPI network. The GO and KEGG pathway analysis confirmed that myogenic differentiation at 4 weeks was strongly associated with pathway in cancer, PI3K pathway, actin cytoskeleton regulation and metabolic pathway, biosynthesis of antibodies and cell cycle. GSEA analysis indicated the differentiated cells were enriched in muscle cell development and myogenesis. Meanwhile, the core genes in each pathway were identified from the GSEA analysis. The in vitro cell research revealed that actin cytoskeleton and myoD were up-regulated after 4 weeks differentiation.

Conclusions: The research revealed the potential hub genes and key pathways after 4 weeks differentiation of stem cells which contribute to further study about the molecular mechanism of myogenesis regeneration. Paving a way for more accurate treatment for muscle dysfunction.
Choroidal Alterations of Sturge-Weber Syndrome Secondary Glaucoma and Non-glaucoma Port-wine Stain Patients Distinguished by Enhanced Depth Imaging Optical Coherence Tomography
Authors: Wu Yue , Huang Lulu , Liu Yixin , Xu Li , Guo Wenyi
Published: September 2020

Background: To evaluate the choroidal changes in Sturge-Weber syndrome (SWS) secondary glaucoma and non-glaucoma port-wine stain (PWS) patients by enhanced depth imaging optical coherence tomography (EDI-OCT).Methods: SWS and PWS patients who were over 3 years old and treated or screened at our ophthalmology department were included in the study. Baseline demographics, EDI-OCT and fundus photography data were collected from all patients.Results: Forty-six non-glaucoma PWS (NGPWS) patients and 35 SWS secondary glaucoma（SG）patients were included, with mean ages of 16.52±13.63 and 13.94±8.27 years, respectively (p>0.05). Among these patients, 2 exhibit bilateral PWS and unilateral glaucoma. Thus the two eyes of each person were divided into NGPWS group and SG group respectively. Twenty-one eyes had choroidal hemangiomas and 7 eyes had excessive thickening of the choroid without choroidal hemangiomas. Choroidal hemangiomas were only observed in ipsilateral eyes of SG patients. The choroidal thicknesses of the ipsilateral and contralateral eyes of NGPWS patients were 358.10±117.40 μm (45 eyes) and 288.20±79.04 μm (41 eyes), respectively (p<0.05). The choroidal thicknesses of the ipsilateral and contralateral eyes of SG patients were 511.40±242.10 μm (15 eyes) and 283.90±92.27 μm (29 eyes), respectively (p<0.05). Significant differences were found between the ipsilateral eyes of SWS and PWS patients (p<0.05). Six of 13 eyes (46%) with choroidal hemangiomas exhibited post-operative posterior segment complications. Conclusions: Non-glaucoma PWS and SWS secondary glaucoma patients had a thicker choroid in the ipsilateral eye. The trend was even more pronounced in SWS secondary glaucoma patients. Choroidal hemangiomas were only found in the ipsilateral eyes of SG. In addition, choroidal hemangioma was a risk factor for post-operative posterior segment complications in SWS patients.
Primary total hip arthroplasty using a short bone-conserving stem in young adult osteoporotic patients with Dorr type C femoral bone
Authors: Zhen Ping , Chang Yanfeng , Yue Heng , Chen Hui , Zhou Shenghu , Liu Jun , He Xiaole
Published: September 2020

BackgroundDorr Type C femoral bone exhibits a wide, stovepipe-shaped femoral canal and thin cortices in the proximal femur. Dorr C bone combined with severe osteoporosis is an important challenge in primary hip arthroplasty. In this study, we assessed the effects of short metaphyseal fitting cementless stems on preformatted primary total hip arthroplasties in young adult osteoporotic patients with this femoral presentation.MethodsA total of 42 hip arthroplasties were performed in 35 young patients (range 20 to 36 years) using a short Tri-lock bone preservation metaphyseal-fitting cementless femoral component between 2012 and 2017. The mean age at surgery of the 27 male (33 hips) and 8 female (9 hips) patients was 27.5 years (range 20.3 to 35.8 years). The mean body mass index (BMI) was 20.2 kg/m 2 (range, 16.8-23.2 kg/m 2 ). According to Dorr’s criteria, all 42 femora were classified as type C bone and all femurs suffered from severe osteoporosis (Singh index≤3).ResultsThe mean follow-up period was 5.5 years (range 3.0 to 8.0 years). The clinical and functional results improved for the Harris hip score, WOMAC, and UCLA activity scores. The Harris Hip score improved from 48.0 ± 8.0 (range 38.0 to 61.0) preoperatively to 87.0 ± 9.0 (range 77.0 to 92.0) at 12 months after surgery and 91.0 ± 8.0 (range 85.0 to 98.0) at final follow-up. The preoperative UCLA activity score was 3.0 ± 0.5 points (range, 1.0-4.0 points), which significantly improved to 7.5 ± 0.7 points (range 6.0 to 8.0 points) at the final follow-up. No patient exhibited thigh pain at the final follow-up. The mean stem-to-canal fill percentages were 97% ± 2.1% (anteroposterior view at midstem). For stem alignment, 40 hips (95.2%) of the femoral stem were positioned neutrally to 3° of varus with reference to the femoral shaft axis. The remaining two were positioned at 4° varus to 4° valgus. Radiographic evaluation showed good osteointegration of the implants in follow-up.ConclusionsBased on the tapered-wedge design and proximal porous coating, the shortened tapered conventional stem can achieve reliable stability through neck filling and metaphyseal fixation, which does not depend on the isthmus hoop stress. This stem was suitable in severe osteoporotic patients with Type C bones in young adults who presented with a correspondingly straightened femoral canal with a wide isthmus and thin cortex.
Voluntary Exercise in Mesothelioma: Effects on Tumour Growth and Treatment Response in a Murine Model
Authors: FISHER Scott A , Peddle-McIntyre Carolyn J , Burton Kimberley , Newton Robert U , Marcq Elly , Lake Richard A , Nowak Anna K
Published: September 2020

Objective: There is substantial evidence that exercise can safely reduce the risk of cancer and improve survival in different human cancer populations. Long latency periods associated with carcinogen‑induced cancers like asbestos induced mesothelioma provide an opportunity to implement exercise as an intervention to delay or prevent disease development. However, there are limited studies investigating the ability of exercise to prevent or delay cancer, and exercise as a preventive strategy has never been assessed in models with a known carcinogen. We investigated the potential of voluntary exercise (VE) to delay development of asbestos related disease (ARD) in our well-characterised, asbestos induced MexTAg model of mesothelioma.Results: Asbestos exposed MexTAg mice were given continuous or delayed access to VE and ARD assessed over time. We found that the addition of VE did not affect ARD development in asbestos exposed MexTAg mice. However, non‑asbestos exposed, aged matched control mice participated in significantly more VE behaviours, suggesting subclinical development of ARD after asbestos exposure had a greater impact on VE participation than age alone. These data highlight the importance of model choice and the potential limitation that some pre‑clinical studies may not accurately represent the clinical paradigm, particularly in the context of prevention studies.
Apparent density, trypanosome infection rates and host preference of tsetse flies in the sleeping sickness endemic focus of Northwestern Uganda
Authors: Opiro Robert , Opoke Robert , Angwech Harriet , Nakafu Esther , Oloya Francis A. , Openy Geoffrey , Njahira Moses , Macharia Mercy , Echodu Richard , Malinga Geoffrey M. , Opiyo Elizabeth A.
Published: September 2020

Background: African trypanosomiasis, caused by protozoa of the genus Trypanosoma and transmitted by the tsetse fly, is a serious parasitic disease of humans and animals. Reliable data on the vector distribution, feeding preference and the trypanosome species they carry is pertinent to planning sustainable control strategies.Methodology: We deployed 109 biconical traps in 10 villages in two districts of northwestern Uganda to obtain information on the apparent density, infection rates and blood meal sources of tsetse flies. A subset (272) of the collected samples was analyzed for detection of trypanosomes species and sub-species using a nested PCR protocol based on primers amplifying the Internal Transcribed Spacer (ITS) region of ribosomal DNA. 34 blood-engorged adult tsetse midguts were analyzed for blood meal sources by sequencing of the mitochondrial cytochrome c oxidase 1 (COI) and cytochrome b (cytb) genes. Results: Out of the 109 traps deployed, we captured 622 Glossina fuscipes fuscipes tsetse flies (269 males and 353 females). Apparent density (AD) ranged from 0.6 to 3.7 flies/trap/day in the two districts. 29 (10.7%) of the flies were infected with one or more trypanosome species. Infection rate was not significantly associated with neither age group (χ2 = 5.001, df=2, 0.082), sex of the fly (χ2 = 0.099, df = 1, p = 0.753), district of origin (χ2= 0.629, df = 1, p = 0.428) nor village (χ2= 9.252, df = 9, p = 0.414). Nested PCR revealed several species of trypanosomes: T. vivax (6.62%), T. congolense (2.57%), and T. brucei and T. simiae each at 0.73%. Blood meal analyses revealed five principal vertebrate hosts, namely, cattle (Bos taurus), humans (Homo sapiens), Nile monitor lizard (Varanus niloticus), African mud turtle (Pelusio schapini) and the African Savanna elephant (Loxodonta africana).Conclusion: We found a moderately high infection rate of 10.78%, with all infections attributed to trypanosome species that are causative agents for the animal disease only. However, more validation using large-scale passive and active screening of human and tsetse samples should be done. Cattle and humans appear to be the most important tsetse hosts in the region and should be considered in the design of interventions.
Development of humanized tri-specific nanobodies with potent neutralization for SARS-CoV-2
Authors: Dong Jianbo , Huang Betty , Wang Bo , Titong Allison , Kankanamalage Sachith Gallolu , Jia Zhejun , Wright Meredith , Parthasarathy Pannaga , Liu Yue
Published: September 2020

SARS-CoV-2 is a newly emergent coronavirus that causes COVID-19, which has adversely impacted human health and has led to a pandemic. There is an unmet need to develop therapies against SARS-CoV-2 due to its severity and lack of treatment options. A promising approach to combat COVID-19 is through the neutralization of SARS-CoV-2 by therapeutic antibodies. Previously, we described a strategy to rapidly identify and generate llama nanobodies (VHH) from naïve and synthetic humanized VHH phage libraries that specifically bind the S1 SARS-CoV-2 spike protein, and block the interaction to the ACE2 human receptor. In this study, we then used computer-aided designed and constructed multi-specific VHH antibodies fused to human IgG1 Fc domains based on the epitope predictions for leading VHHs. The resulting tri-specific VHH-Fc antibodies show more potent S1 binding, S1/ACE2 blocking, and SARS-CoV-2 pseudovirus neutralization than the bi-specific VHH-Fcs or combination of individual monoclonal VHH-Fcs. Furthermore, protein stability analysis of the VHH-Fcs show favorable developability features, which enable them to be quickly and successfully developed into therapeutics against COVID-19.
Uncomplicated falciparum malaria among schoolchildren in Bajil district of Hodeidah governorate, west of Yemen: Association with anaemia and underweight
Authors: Alwajeeh Talal S , Abdul-Ghani Rashad , Allam Amal F. , Farag Hoda F. , Khalil Safia S.M. , Shehab Amel Y. , El-Sayad Mona H. , Alharbi R.A. , Al Shaia S.R. , Azazy Ahmed A.
Published: September 2020

Background Malaria, malnutrition and anaemia are major public health problems in Yemen, with Hodeidah being the most malaria-afflicted governorate. To address the lack of relevant studies, this study was conducted to determine the prevalence of Plasmodium falciparum and its relation to nutritional status and haematological indices among schoolchildren in Bajil district of Hodeidah governorate, west of Yemen. Methods This cross-sectional study was conducted among 400 schoolchildren selected randomly from four schools in Bajil district. Data about demographic characteristics, risk factors and anthropometric measurements of age, height and weight were collected. Duplicate thick and thin blood films were prepared, stained with Giemsa and examined microscopically for malaria parasites. The density of P. falciparum asexual stages was estimated on thick films. EDTA-blood samples were examined for the haematological indices of haemoglobin (Hb) and blood cell counts. Results P. falciparum was prevalent among 8.0% (32/400) of schoolchildren with a mean parasite density of 244.3 299.3/µl of blood and most infections showing low-level parasitaemia, whereas Plasmodium vivax was detected in one child (0.25%). Residing near water collections was a significant independent predictor of falciparum malaria [adjusted odds ratio (AOR) = 2.6, 95.0% CI: 1.20–5.72; p = 0.016] in schoolchildren. Mild anaemia was prevalent among more than half of P. falciparum-infected schoolchildren and significantly associated with falciparum malaria (AOR = 5.8, 95.0% CI: 2.39–14.17; p <0.001), with a mean Hb concentration of 10.7 1.0 g/dL. Although the mean values of the total white blood cells, monocytes and platelets were significantly lower in infected than non-infected schoolchildren, they were within normal ranges. More than half of the children were malnourished, with stunting (39.3%) and underweight (36.0%) being the most prevalent forms of malnutrition; 6.3% of children were wasted. Underweight (AOR = 5.3, 95.0% CI: 2.09–13.62; p <0.001) but not stunting or wasting, was a significant predictor of falciparum malaria among schoolchildren. Conclusion Asymptomatic falciparum malaria is prevalent among schoolchildren in Bajil district of Hodeidah Governorate, with predominance of low parasitaemic infections and significant association with mild anaemia and underweight. Residence near water collection is a significant predictor of infection with falciparum malaria among schoolchildren. Further studies among children with severe malaria and those with high parasite densities are recommended.
Diagnostic value of 18F-FDG PET/MRI for staging in patients with ovarian cancer
Authors: Tsuyoshi Hideaki , Tsujikawa Tetsuya , Yamada Shizuka , Okazawa Hidehiko , Yoshida Yoshio
Published: September 2020

Purpose: To evaluate the diagnostic potential of PET/MRI with 18F-fluorodeoxyglucose (18F-FDG) in ovarian cancer.Materials and Methods: Participants comprised 103 patients with suspected ovarian cancer underwent pretreatment 18F-FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI). Diagnostic performance of 18F-FDG PET/MRI and ceMRI for assessing the characterization and the extent of the primary tumor (T stage) and 18F-FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis.Results: Accuracy for the characterization of suspected ovarian cancer was significantly better for 18F-FDG PET/MRI (92.5%) [95% confidence interval (CI) 0.841–0.950] than for ceMRI (80.6%) (95%CI 0.715–0.830) (p <0.05). Accuracy for T status was 96.4% (95%CI 0.964–0.964) and 92.9% (95%CI 0.929–0.929) for 18F-FDG PET/MRI and ceMRI/ceCT, respectively. Patient-based accuracies for N and M status were 100% (95%CI 0.883–1.000) and 100% (95%CI 0.884–1.000) for 18F-FDG PET/MRI and 85.2% (95%CI 0.758–0.852) and 30.8% (95%CI 0.188–0.308) for ceCT and M staging representing significant differences (p<0.01). Lesion-based sensitivity, specificity and accuracy for N status were 78.6% (95%CI 0.571–0.913), 95.7% (95%CI 0.932–0.972) and 93.9% (95%CI 0.893–0.966) for 18F-FDG PET/MRI and 42.9% (95%CI 0.240–0.581), 96.6% (95%CI 0.943–0.984) and 90.8% (95%CI 0.868–0.941) for ceCT. Conclusions: Use of 18F-FDG PET/MRI offers better sensitivity and specificity for the characterization and M staging than ceMRI and ceCT, and diagnostic value for T and N staging equivalent to ceMRI and ceCT, suggesting that 18F-FDG PET/MRI might represent a useful diagnostic alternative to conventional imaging modalities in ovarian cancer.