bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving Mental Health Care for Unaccompanied Young Refugees Through A Stepped Care Approach Versus Usual Care+: Study Protocol of A Cluster Randomized Controlled Hybrid Effectiveness Implementation Trial
Authors: Rosner Rita , Sachser Cedric , Hornfeck Fabienne , Kilian Reinhold , Kindler Heinz , Muche Rainer , Müller Lauritz Rudolf Floribert , Thielemann Jonathan , Waldmann Tamara , Ziegenhain Ute , Unterhitzenberger Johanna , Pfeiffer Elisa
Published: September 2020

Background: More than half of the unaccompanied young refugees (UYRs) resettled in Europe report elevated levels of posttraumatic stress symptoms (PTSS) and comorbid symptoms. Earlier studies have highlighted the effectiveness of the trauma-focused preventive group intervention ‘Mein Weg’ (English ‘My Way’), and the feasibility of trauma-focused cognitive behavioral therapy (TF-CBT) for UYRs. Both interventions are deemed to be empirically supported treatments (ESTs). However, UYRs seldom receive ESTs or, in fact, any treatment at all. In view of the high need and the limited treatment resources available, a stepped-care approach is indicated but has not been evaluated so far. The purpose of this trial is to compare the stepped-care approach BETTER CARE with usual care enhanced with screening and indication (usual care+). Methods: In a cluster randomized controlled trial involving N = 540 UYRs living in up to N=54 child and youth welfare service (CYWS) facilities, BETTER CARE will be compared with usual care+. We will randomize clusters comprising a CYWS facility with at least one eligible psychotherapist. BETTER CARE consists of step 1) screening and indication and either step 2) preventive trauma-focused group intervention ‘Mein Weg’ delivered by trained CYWS staff or step 3) TF-CBT delivered by trained community therapists and supported by trained translators if necessary. Participants will be assessed 6 and 12 months after randomization. The primary outcome is the severity of PTSS after 12 months. Secondary outcomes are depressive and anxiety symptoms, quality of life, and proxy reported PTSS. Furthermore, drug use, health costs, benefits and long-term effects on integration/acculturation will be assessed. Discussion: The trial will directly integrate a stepped-care approach into existing structures of the German child welfare and (mental) health system. It could, therefore, serve as a blueprint for how to implement ESTs for UYRs. If successful, screening, prevention and intervention will be sustainably implemented in CYWS in southern Germany. Trial registration: German Clinical Trials Register, ID: DRKS00017453. Registered December 11th, 2019. URL: https://www.drks.de/drks_web/setLocale_EN.do
Relationship between sleep duration and sociodemographic characteristics, mental health and chronic diseases in individuals aged from 18 to 85 years old in Guangdong province of China: a population-based cross-sectional study
Authors: Chen Xie , Wang Shi-Bin , Li Xue-Li , Huang Zhuo-Hui , Tan Wen-Yan , Lin Hai-Cheng , Hou Cai-Lan , Jia Fu-Jun
Published: September 2020

Background: Sleep is vital for maintaining individual’s physical and mental health. Prior studies have reported close relationships between sleep duration and chronic diseases. However, in China, the prevalence of aberrant sleep duration and the associations between sleep duration and chronic conditions still merit studying in Guangdong province. This study aimed at examining the relationship between sleep duration and multiple dimensions of sociodemographic characteristics, mental health and chronic diseases in Guangdong province in China, with a large population-based data of individuals aged from 18 to 85 years old.Methods: This study aimed at analyzing the sociodemographic and clinical characteristics of the population in Guangdong province. Multistage stratified cluster sampling was applied for this study. 13,768 participants from Guangdong province were interviewed with standardized assessment tools, including Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder (GAD-7). Basic socio-demographic information, mental health and chronic diseases information were collected. Self-reported sleep duration was classified as three types: short (<7h), normative (7-9h) and long (≥9h). Results: The mean sleep duration was 6.75±1.11h. Short sleepers had a higher prevalence of chronic diseases, including anemia (6.2%, p=0.024), gout (2.8%, p=0.010), hyperlipidemia (3.9%, p=0.003) and low back pain (5.6%, p=0.020) than other types of sleeper. Multinomial logistic regression analysis revealed that short sleepers were more likely to have low income level, have depressive symptoms, be ex- or current drinkers and be overweight. Anemia, hyperlipidemia and low back pain were all risk factors for short sleep, while malignant tumor was risky for long sleep. Conclusions: Low income level, drinking status, being overweight, and chronic conditions may be associated with aberrant sleep duration in Guangdong province general population. Short sleepers have a higher risk of suffering from anemia, hyperlipidemia, and low back pain, while long sleepers are more likely to have malignant tumor. Health professionals should value the sleep patterns in general health care and attach importance to conduct further epidemiologic surveys to explore the relationship between sleep duration and health.
Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data
Authors: He Jingyi , Ghorveh Mohsen Ghiasi , Hurst Jillian H. , Tang Monica , Alhanti Brooke , Lang Jason E. , Goldstein Benjamin
Published: September 2020

Background: Asthma exacerbations in children often require medications, urgent care, and hospitalization. Multiple environmental triggers have been associated with asthma exacerbations, including particulate matter 2.5 (PM2.5) and ozone, which are primarily generated by motor vehicle exhaust. There is mixed evidence as to whether proximity to highways increases risk of asthma exacerbations. Methods: To evaluate the impact of highway proximity, we assessed the association between asthma exacerbations and the distance of child’s primary residence to two types of roadways in Durham County, North Carolina, accounting for other patient-level factors. We abstracted data from the Duke University Health System electronic health record (EHR), identifying 6,208 children with asthma between 2014 – 2019. We geocoded each child’s distance to roadways (both 35 MPH+ and 55 MPH+). We classified asthma exacerbation severity into four tiers and fitted a recurrent event survival model to account for multiple exacerbations. Results: There was a no observed effect of residential distance from 55+ MPH highway (Hazard Ratio: 0.98 (95% confidence interval: 0.94, 1.01)) and distance to 35+ MPH roadway (Hazard Ratio: 0.98 (95% confidence interval: 0.83, 1.15)) and any asthma exacerbation. Conclusions: While the results were non-significant, the characteristics of the study sample – namely farther distance to roadways and generally good ambient environmental pollution may contribute to the lack of effect. Compared to previous studies, which often relied on self-reported measures, we were able to obtain a more objective assessment of outcomes. Overall, this work highlights the opportunity to use EHR data to study environmental impacts on disease.
Association between social capital and depression among older people: evidence from Anhui Province, China
Authors: Bai Zhongliang , Xu Zhiwei , Xu Xiaoru , Qin Xia , Hu Wenbiao , Hu Zhi
Published: September 2020

Background: To examine the relationship between social capital and depression among community-dwelling older adults in Anhui Province, China.
Methods: A cross-sectional study was conducted among older people selected from three cities of Anhui Province, China using a multi-stage stratiﬁed cluster random sampling method. Data were collected through questionnaire interviews and information on demographic characteristics, social capital, and depression was collected. The generalized linear model and classification and regression tree model were employed to assess the association between social capital and depression.
Results: Totally, 1,810 older people aged ≥ 60 years were included in the final analysis. Overall, all of the social capital dimensions were positively associated with depression: social participation (coefficient: 0.35, 95% CI: 0.22 - 0.48), social support (coefficient:0.18, 95% CI:0.07 - 0.28), social connection (coefficient: 0.76, 95% CI:0.53 - 1.00), trust (coefficient:0.62, 95% CI:0.33 - 0.92), cohesion (coefficient:0.31, 95% CI:0.17 - 0.44) and reciprocity (coefficient:0.30, 95% CI:0.11 - 0.48), which suggested that older people with higher social capital had a smaller chance to develop depression. A complex joint effect of certain social capital dimensions on depression was also observed. The association with depression and the combinative effect of social capital varied among older adults across the cities.
Conclusions: Our study suggests that improving social capital could aid in the prevention of depression among older adults.
Keywords : Social Capital, Depression, Elderly, Mental Health, China
Does postgraduate clinical training reduce empathy among Japanese trainee dentists? A multi-perspective assessment
Authors: Yoshida Toshiko , Watanabe Sho , Kono Takayuki , Taketa Hiroaki , Shiotsu Noriko , Shirai Hajime , Nakai Yukie , Torii Yasuhiro
Published: September 2020

Background: Enhancing empathy in healthcare education is a critical component of delivering better patient care; however, the decline of empathy among students has been frequently reported. It is especially common when the curriculum transitions to a clinical setting. However, some studies have questioned the significance and frequency of this decline. Thus, this study aimed to determine whether postgraduate clinical training reduced dental trainees’ empathy levels toward patients.Methods: This study included 64 trainee dentists at Okayama University Hospital and 13 simulated patients (SPs). The trainee dentists completed the Japanese version of the Jefferson Scale of Empathy for health professionals just before conducting initial medical interviews with SPs twice, at the beginning and the end of their clinical training. The SPs evaluated the trainees’ communication using an assessment questionnaire immediately after the interviews. The videotaped interview data were analyzed using the Roter Interaction Analysis System. Results: When comparing the results from the beginning and end of training, trainee dentists showed sustained levels of self-reported empathy, decreased communication behavior in the emotional responsiveness category, and an unchanged assessment in communication from the simulated patients.Conclusions: Overall, a one-year postgraduate dental training program neither reduced nor increased trainee dentists’ empathy levels. Providing regular education support in this area may help trainees foster their empathy.
Effect of Satisfaction With a Dental Appearance on the Psychosocial Impact of Dental Aesthetics Among Adolescents in Saudi Arabia: A Cross Sectional Study.
Authors: Ellakany Passent , Fouda Shaimaa , Alghamdi Maram , Bakhurji Eman
Published: September 2020

Background: Dental appearance affects facial beauty, social interaction and psychological well-being particularly among adolescents. The aim of the current study was to investigate the effect of dental appearance satisfaction on the psychosocial impact of dental esthetics among Saudi adolescents.Methods: A cross-sectional study was conducted in the Eastern Province of Saudi Arabia among students attending intermediate and high schools. Data was collected using the translated Arabic version of psychosocial impact of dental esthetics questionnaire (PIDAQ) and demographic variables including; gender, age, school grade, and parental level of education. Statistical analysis was performed by using logistic regression to assess the effect of demographical variables on PIDAQ and its domains at 5% significance level. Results: Females and participants’ fathers’ university education were statistically significantly having higher PIDAQ and aesthetic concern. Females were 70%, and those with fathers’ university education were 22% more likely to have a negative psychological impact. Females and those with mothers’ university education were less likely to have positive dental self-confidence. Conclusions: Most of adolescents exhibited satisfaction with their own smiles. Smile dissatisfaction in the remaining participants was related to teeth alignment, color and shape. Females and participants with fathers’ university education exhibited higher psychosocial impact than males and those with or without school education.
Microbiological Findings in Early and Late Implant Loss
Authors: Korsch Michael , Marten Silke-Mareike , Stoll Dominic , Prechtl Christopher , Dötsch Andreas
Published: September 2020

Background Implants are a predictable and well-established treatment method in dentistry. Nevertheless, looking at possible failures of dental implants, early and late loss have to be distinguished. This study aimed at microbiological aspects on surfaces of implants, which had to be removed.Methods 53 specimens of implants from 49 healthy patients have been examined. The groups investigated were implants that had to be removed in the period of osseointegration (early loss) or after the healing period (late loss). Data about the microbiological colonialization of the implant was collected using amplification and high throughput sequencing of the 16S rRNA gene.Results Both early and late implant loss was associated with increased levels of Fusobacterium nucleatum and Porphyromonas gingivalis. Additionally. Late lost implants showed higher bacterial diversity and in addition higher abundances of Treponema denticola and Tannerella forsythia, while microbial communities of early loss implants were very heterogeneous.Conclusions Pathogens commonly associated with severe periodontitis were found around implants that were lost after a primarily uneventful osseointegration. P. gingivalis and F. nucleatum colonized the implant surface in early and late loss and could therefore be characteristic for implant loss in general. The reasons for early losses could be multifactorial. Trial registration This study was approved by the ethical review committee of the local medical association (Institutional Review Board of the Saarland Medical Council, Germany; ID: 232/12).
S100A8 and S100A9 in Saliva, Blood and Gingival Crevicular Fluid for Screening Periodontitis
Authors: Kim Hyun-Duck , Karna Sandeep , Shin YooJin , Vu Huong , Cho Hyun-Jae , Kim Sungtae
Published: September 2020

Background: Periodontitis is one of major oral diseases, which has no consensus on early screening tool. This study aimed to compare the association and screening ability of S100A8 and S100A9 in saliva, blood and gingival crevicular fluid (GCF) for periodontitis.Methods: We recruited 149 community Koreans, 50 healthy and 99 periodontitis. Using clinical attachment loss and a panoramic radiograph, stage II-IV of new classification of periodontitis proposed at 2018 was considered as periodontitis. Enzyme linked immunosorbent assay kit was used to quantify S100A8 and S100A9. T-test, ANCOVA, Mann-Whitney test and correlation analysis were applied to compare the relationship of S100A8 and S100A9 in saliva, blood, and GCF for periodontitis. Receiver operating characteristic curve was applied for screening ability.Results: Among S100A8 and S100A9 in saliva, blood and GCF, S100A8 in saliva was significantly higher in periodontitis participants than in healthy participants (p<0.05) and showed highest screening ability of 0.73 for periodontitis. However, S100A8 and S100A9 in GCF were significantly higher in healthy participants (p<0.05). Salivary S100A8 was positively correlated to blood S100A8 (r=0.21, p <0.05).Conclusion: Salivary S100A8 could be a potential diagnostic marker for periodontitis. Thus, S100A8 salivary kit will be useful for screening periodontitis.Summary sentence: Salivary S100A8 kit produced appropriate diagnostic ability for periodontitis and would be an efficient tool for early screening of periodontitis risk.
The influence of previous arthroscopic treatment on subsequent total knee arthroplasty: the comparison between bilateral knees of the same patient
Authors: XU Kui-shuai , SHEN Rui , WANG Cai-lin , CHU Yan , ZHAO Xia , TIAN Shao-qi , YU Teng-bo
Published: September 2020

PurposeTo explore whether previous arthroscopic knee surgery affects future total knee arthroplasty results or not.Methods A total of 36 patients with the previous arthroscopic treatment on one knee underwent subsequent bilateral total knee arthroplasty in our hospital from September 2013 to July 2017. Data on each patient were collected in regards to changes in postoperative clinical and functional scores, various other scores, as well as postoperative functional recovery and complications. We defined the knees with a previous arthroscopic history as group A, and the counter side as group B.The Knee Society clinical score, functional scores, ROM, FJS, VAS scores were assessed before and after surgery. Using the Kolmogorov-Smirnov Test to test the normality of continuous variables, and the chi-square test to compare the rate of reoperation and complications between two groups. For all statistical comparisons, P<0.05 was considered significant.ResultsThere were no statistically significance differences found in postoperative Knee Society clinical scores and functional scores between group A and group B, as well as in ROM, FJS, VAS scores and local complications. Conclusion There were no statistically significant differences found in postoperative functional recovery and complications in patients, who underwent total knee arthroplasty with previous knee arthroscopy.
A novel thermostable alkaline histamine oxidase from Glutamicibacter sp. N1A310, induced by histamine and its analogue betahistine
Authors: Sadeghi Hossein , Arjmand Sareh , Siadat Seyed Omid Ranaei , Fooladi Jamshid , Ebrahimipour Gholamhossein
Published: September 2020

Biogenic amines (BAs) are low molecular weight organic bases formed by natural amino acids decarboxylation and trigger an array of toxicological effects in humans and animals. Bacterial amine oxidases enzymes are determined as practical tools to implement the rapid quantification of BAs in foods. Our study set out to obtain a new efficient, amine oxidase enzyme for developing new enzyme-based quantification of histamine. The soils from different sources were screened using histamine as sole carbon and nitrogen sources, and histamine oxidase producing bacteria were selected and identified using specific primers for histamine oxidase (HOD) gene. The HOD gene of six strains, out of 26 isolated histamine-utilizing bacteria, were amplified using our designed primers. The HOD enzyme from Glutamicibacter sp. N1A3101, isolated from nettle soil, was found to be thermostable and showed the highest substrate specificity toward the histamine and with no detected activity in the presence of putrescine, cadaverine, spermine, and spermidine. Its oxidation activity toward tyramine was lower than other HOD reported so far. The isolated enzyme was stable at 60 °C for 30 min and showed pH stability ranging from 6–9. Furthermore, we indicated the induction of identified HOD activity in the presence of betahistine as well, with nearly equal efficiency and without the consumption of the substrate.
Reference Gene Selection for qRT-PCR Analyses of Luffa (Luffa cylindrica) Plants Under Abiotic Stress Conditions
Authors: chen mindong , wang bin , li yongping , zeng meijuan , liu jianting , ye xinru , zhu haisheng , wen qingfang
Published: September 2020

Background: Quantitative real-time PCR (qRT-PCR) is one of the preferred methods for analyzing gene expression, and selecting suitable internal reference genes is an important prerequisite for the application of this technology. However, no systematic studies have been conducted on reference genes in luffa, resulting in limited investigations of luffa gene expression. Results: In this study, seven reference genes ( ACT , TUA , TUB , EF-1α , GAPDH , UBQ , and 18S ) were selected, and their expression levels in luffa plants exposed to various simulated abiotic stresses [i.e., cold, drought, heat, salt, H 2 O 2 , and abscisic acid (ABA) treatments] were analyzed by qRT-PCR. The stability of the reference gene expression levels was validated using the geNorm, NormFinder, BestKeeper, and RefFinder algorithms. The results indicated that EF-1α was the most stably expressed and suitable reference gene overall and for the heat, cold, and ABA treatments. Additionally, UBQ expression was stable following the salt treatment, whereas TUB was identified as a suitable reference gene for H 2 O 2 and drought treatments. In contrast, GAPDH was revealed as an unsuitable reference gene overall and for the heat, salt, H 2 O 2 , ABA, and drought treatments. Regarding the cold treatment, TUA was identified as an unsuitable reference gene. The reliability of the selected reference genes was verified by analyzing the expression of copper/zinc superoxide dismutase ( Cu/Zn-SOD ) gene in luffa. When the most unstable reference genes were used for data normalizations, the resulting expression patterns had obvious biases when compared with the expression patterns for the most ideal reference genes used alone or combined. Conclusions: The study data were used to compile a list of suitable reference genes for qRT-PCR analyses of the gene expression in luffa plants exposed to abiotic stresses. This work may provide the basis for future qRT-PCR-based investigations of the transcription of important functional genes in luffa.
Prioritization of candidate causal genes in GWAS signals of asthma in UK Biobank
Authors: Valette Kim , Li Zhonglin , Bon-Baret Valentin , Chignon Arnaud , Bérubé Jean-Christophe , Eslami Aida , Lamothe Jennifer , Gaudreault Nathalie , Joubert Philippe , Obeidat Ma’en , Berge Maarten van den , Timens Wim , Sin Don , Nickle David , Hao Ke , Labbé Catherine , Godbout Krystelle , Côté Andréanne , Laviolette Michel , Boulet Louis-Philippe , Mathieu Patrick , Thériault Sébastien , Bossé Yohan
Published: September 2020

To identify susceptibility loci and candidate causal genes of asthma, we performed a genome-wide association study (GWAS) in UK Biobank on a broad asthma definition (n = 56,167 asthma cases and 352,255 controls). We then carried out functional mapping through transcriptome-wide association studies (TWAS) and Mendelian randomization in lung (n = 1,038) and blood (n = 31,684) tissues. The GWAS revealed 72 asthma-associated loci from 116 independent significant variants (PGWAS<5.0E-8). As expected, the yield of exonic variants associated with asthma was low, but nine were identified as potentially deleterious (CADD > 20) including a stop-gain mutation in the filaggrin (FLG) gene. The top lung TWAS gene on 17q12-q21 was GSDMB (PTWAS=1.42E-54). Other TWAS genes of interest include TSLP on 5q22, RERE on 1p36, CLEC16A on 16p13, and IL4R on 16p12, which all replicated in GTEx lung (n = 515). A novel risk locus was also revealed by the lung asthma TWAS on 1q23.3 with the putative gene encoding the gamma chain of the high-affinity IgE receptor (FCER1G, PTWAS=2.13E-6), which was also replicated in GTEx lung (PTWAS=3.71E-7). By testing a comprehensive set of cells and tissues, we then demonstrated that the largest fold enrichment of regulatory and functional annotations among asthma-associated variants was in the blood. We mapped 485 eQTL-regulated genes associated with asthma in the blood and 50 of them were shown to be causally associated with asthma by Mendelian randomization. Prioritization of druggable genes revealed known (IL4R, TSLP, IL6, TNFSF4) and potentially new therapeutic targets for asthma.
Prediction of Overall Survival for Early-stage Non-small Cell Lung Cancer via a Novel 7-gene Prognostic Signature and Allele Frequency Deviation (AFD)
Authors: AL-Dherasi Aisha , Liao Yuwei , Huang Qi-Tian , Wang Yichen , Hua Rulin , Mosiab Sultan AL , Zhang Jingkai , Yu Ying , Zhang Yu , Zhang Xuehong , Huang Chao , Sufiyan Sufiyan , Ge Dongcen , Bai Wanting , Liu Ruimei , Shao Yanyan , Li Yulong , Mousa Haithm , Shi Leming , Lv Dekang , Li Zhiguang , Liu Quentin
Published: September 2020

Background Due to the late and poor prognosis of non-small lung cancer(NSCLC), the mortality of patients is high, underlines the need to identify a credible prognostic marker for NSCLC patients. The aim of our study is to examine the association of allele frequency deviation (AFD) with the patient's survival, as well as identification and validation of a new prognostic signature to predict NSCLC overall survival(OS).Methods First, we developed a new algorithm to calculate AFD from whole-exome sequencing(WES) data, then we compared the predictability of the patient's survival between AFD, tumor mutation burden (TMB) and change of variants allele frequency (dVAF). Second, we overlapped the differentially expressed genes (DEGs) from our data with the genes associated with the survival of The Cancer Genome Atlas (TCGA) database to confirm all genes significantly related to the survival of lung cancer. We identified 149 genes, 31 of which are new genes and have not been reported for lung cancer, that was used to develop a new prognostic model. Lung cancer adenocarcinoma (LUAD) data from the TCGA database was used to validate the gene-signature model. The prognostic model relating to the genes was established and validated in training and LUAD validation groups.Results There was a significant association found between the high AFD value and poor survival among non-small cell lung cancer (NSCLC) patients. A novel seven genes (UCN2, RIMS2, CAVIN2, GRIA1, PKHD1L1, PGM5, CLIC6) were obtained through multivariate Cox regression analysis and significantly associated with NSCLC patients survival. Cox regression analysis confirmed that AFD and 7-gene signature are an independent prognostic marker in NSCLC patients. The AUC for 5-year survival in AFD and the AUC for 3-year survival in both training and validation groups were greater than 0.7.Conclusion As a result, AFD and 7-gene signatures were identified as new independent predictive factors used for predicting the survival among NSCLC patients.
Phages from Ganges River curtail in vitro biofilms and planktonic growth of drug resistant Klebsiella pneumoniae in a zebrafish infection model
Authors: Sundaramoor Niranjana Sri , Thothathri Subramanian , Bhaskaran Muthu Meenakshi , GaneshPrasad ArunKumar , Nagarajan Saisubramanian
Published: September 2020

Bacteriophages are a promising alternative for curtailing infections caused by multi drug resistant (MDR) bacteria. The objective of the present study is to evaluate phage populations from water bodies to inhibit planktonic and biofilm mode of growth of drug resistant Klebsiella pneumoniae in vitro and curtail planktonic growth in vivo in a zebrafish model. Phage specific to K. pneumoniae (MTCC 432) was isolated from Ganges river (designated as KpG). One-step growth curve, in vitro time kill curve study and in vivo infection model were performed to evaluate the efficacy of phage against planktonic growth. Crystal violet assay and colony biofilm assay was done to determine the action of phages on biofilms. KpG phages had a greater burst size, better bactericidal potential and enhanced inhibitory effect against biofilms formed at liquid air and solid air interfaces. In vivo injection of KpG phages revealed that it did not pose any toxicity to zebrafish as evidenced by liver/brain enzyme profiles and by histopathological analysis. In vitro time kill assay showed a 3 log decline and a 6 log decline in K. pneumoniae colony counts, when phages were administered individually and in combination with streptomycin, respectively. The muscle tissue of zebrafish, infected with K. pneumoniae and treated with KpG phages showed a significant 2 log decline in bacterial counts relative to untreated control. Our study reveals that KpG phages has the potential to curtail plantonic and biofilm mode of growth in vivo in higher animal models.
Cost-effectiveness analysis of initial nonoperative management versus emergency laparoscopic appendectomy for acute complicated appendicitis
Authors: Sugiura Kiyoaki , Suzuki Keiichi , Umeyama Tomoshige , Omagari Kenshi , Hashimoto Takeo , Tamura Akihiko
Published: September 2020

Background
Although evidence regarding the safety and efficacy of nonoperative management is growing, the best treatment strategy for acute complicated appendicitis remains controversial. We aimed to evaluate the cost-effectiveness of treatment strategies in complicated appendicitis patients. This study sought to determine the most cost-effectiveness strategy from the health care-payer's perspective
Methods
The primary outcome was an incremental cost effectiveness ratio (ICER) using nonoperative management with or without interval laparoscopic appendectomy (ILA) as the intervention compared with operative management with emergency laparoscopic appendectomy (ELA) alone as the control. Model variables were abstracted from a literature review, and from data from the hospital records of Tochigi Medical Center. Cost-effectiveness was evaluated using an ICER. We constructed a Markov model to compare treatment strategies for complicated appendicitis in otherwise-healthy adults, over a time horizon of a single year. Uncertainty surrounding model parameters was assessed via one-way- and probabilistic-sensitivity analyses. Threshold analysis was performed using the willingness-to-pay threshold set at the World Health Organization's criterion of $107,690.
Results
Three meta-analysis were included in our analysis. Operative management cost $6,075 per patient. Nonoperative management with interval laparoscopic appendectomy (ILA) cost $984 more than operative management and produced only 0.005 more QALYs, resulting in an ICER of $182,587. Nonoperative management without ILA cost $235 more than operative management, and also yielded only 0.005 additional QALYs resulting in an ICER of $45,123 per QALY. Probabilistic sensitivity analysis with 1,000 draws resulted in average ICER of $172,992 in nonoperative management with ILA and $462,843 in Nonoperative management without ILA. The threshold analysis demonstrated that regardless of willingness-to-pay, nonoperative management without ILA would not be most cost-effective strategy
Conclusions
Nonoperative management with ILA and Nonoperative management without ILA were not cost-effective strategies compared with operative management to treat complicated appendicitis. Based on our findings, operative management remains the standard of care and nonoperative management would be reconsidered as a treatment option in complicated appendicitis from economic perspective.
Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Case Report
Authors: Chai Xiaoshan , Ding Hui , Zhou Peng , Mei Xilong , Li XiaoXue , Tao Guangshi
Published: September 2020

Background: Low-grade endometrial stromal sarcoma (ESS) is rare mesenchymal neoplasm, which has an indolent history with late recurrences. ESS usually spread through the lymph nodes and venous system but very seldom involve large vessels or the heart.Case presentation: A 38-year-old Chinese woman was admitted to our department due to pelvic mass found on physical examination. The superior and inferior vena cava CT angiography (CTA) showed an enlarged uterine as well as low density image in the left internal iliac vein, the left common iliac vein, the inferior vena cava, the left renal vein adjacent to the heart and the right atrium, with a range of 110*16mm. The filling defect of right atrium was about 30*14mm. The three-dimensional computed tomography reconstruction showed that the mass originated from the uterine and invaded into the reproductive vein, subsequently extended along the inferior vena cava to the right atrium. Needle biopsy of the pelvic mass was performed and the tissue indicates smooth muscle. The preoperative diagnosis was intravascular leiomyomatosis and the patient underwent radical resection: thrombectomy and total hysterectomy with bilateral salpingo-oophorectomy. Postoperative histopathology revealed low grade endometrial stromal sarcoma. Microscopically, the tumors in both original uterine lesions and intravascular and intracardiac metastases shared morphologic features characterized by neoplastic cells similar to proliferative-phase endometrial stromal cells, in which small spiral artery differentiation was recognized and tumor tissue showed invasive growth pattern by inserting into the surrounding smooth muscle. Immunohistochemistry showed tumor cells were reactive to Estrogen Receptor, Progesterone Receptor,CD10. Primary uterine foci showed cyclin D1(5%+) and Ki-67(20%+),whereas metastatic lesions of the intracardiac and the intravascular component identified cyclin D1(negative) and Ki-67(2%+). The patient is alive without evidence of recurrence 3 months after surgery.Conclusions: Distant metastasis of low-grade endometrial stromal sarcoma is rare, especially involving large vessels or the heart. This case demonstrates that malignant tumor metastasis should be considered as a differential diagnosis of intracardiac and intravascular masses. The treatment rely on multidisciplinary cooperation.
Local Community Knowledge and Perceptions towards Amphibians in Urban and Rural Settings: Tools for Biological Conservation
Authors: Vergara-Ríos Danny , Montes-Correa Andrés Camilo , Urbina-Cardona J. Nicolás , De Luque-Villa Miguel Antonio , Cattan Pedro E. , Granda Hernan Dario
Published: September 2020

Background Human perceptions determine the degree to which people can coexist with biodiversity. It is, therefore, important to identify the sociodemographic factors that determine these local perceptions to adjust amphibian conservation strategies. In this research, the effect of the urban or rural location where people live, as well as their gender, age and educational level, concerning the knowledge and perceptions about amphibians was determined.Methods The data were collected through individual semi-structured surveys, which sought to evaluate changes in the perceptions, of 401 participants, about amphibians. We measured seven response variables through the Likert scale, which ranges from 1 (totally disagree) to 5 (totally agree): composition of taxonomic groups, number of known taxonomic groups, species composition of anurans, number of species of anurans, level of importance of amphibians in nature, positive perceptions about amphibians and negative beliefs about amphibians. For each response variable, a Bray-Curtis matrix was generated and multivariate analysis of variance (PERMANOVA).Results Ninety-two percent of people correctly recognized frogs and toads as amphibians, but there was confusion in classifying caecilians and salamanders within this group, or including reptiles (lizards, turtles and snakes) within the group of amphibians. This confusion was more evident for women from urban locality. No one recognized the five native species shown in the study, although the inhabitants of the rural locality recognized more species than those of the urban locality. Positive perceptions of amphibians varied between urban and rural locality for young adults, people with a high school education level, and people without formal education. Negative beliefs varied between urban and rural locations for women, adolescents, young adults, and professionals with undergraduate studies. Half of the people accepted information on the conservation of amphibians.Conclusion Positive perceptions of people about amphibians should be used as a flag to strengthen environmental educational strategies that seek to change negative attitudes about this group. Field activities are crucial to consolidating the positive perceptions of people about amphibians, mainly in urban locations. The results suggest that amphibian conservation plans that aim to inform and educate the public should be focused differently for age groups, genders, and educational level for people in urban and rural locations.
Efficient Isolation of Protoplasts from Rice Calli With Pause Points and its Application in Transient Gene Expression and Genome Editing Assays
Authors: Poddar Snigdha , Tanaka Jaclyn , Cate Jamie H. D. , Staskawicz Brian , Cho Myeong-Je
Published: September 2020

Background: An efficient in vivo transient transfection system using protoplasts is an important tool to study gene expression, metabolic pathways, and multiple mutagenesis parameters in plants. Although rice protoplasts can be isolated from germinated seedlings or cell suspension culture, preparation of those donor tissues can be inefficient, time consuming, and laborious. Additionally, the lengthy process of protoplast isolation and transfection needs to be completed in a single day. Results: Here we report a protocol for isolation of protoplasts directly from rice calli, without using seedlings or suspension culture. The method is developed to employ discretionary pause points during protoplast isolation and prior to transfection. Protoplasts maintained within a sucrose cushion partway through isolation, for completion on a subsequent day, per the first pause point, are referred to as S protoplasts. Fully isolated protoplasts maintained in MMG solution for transfection on a subsequent day, per the second pause point, are referred to as M protoplasts. Both S and M protoplasts, 1 day after initiation of protoplast isolation, had minimal loss of viability and transfection efficiency compared to protoplasts 0 days after isolation. S protoplast viability decreases at a lower rate over time than that of M protoplasts and can be used with added flexibility for transient transfection assays and time-course experiments. The protoplasts produced by this method are competent for transfection of both plasmids and ribonucleoproteins (RNPs). Cas9 RNPs were used to demonstrate the utility of these protoplasts to assay genome editing in vivo. Conclusion: The current study describes a highly effective and accessible method to isolate protoplasts from callus tissue induced from rice seeds. This method utilizes donor materials that are resource-efficient and easy to propagate, permits convenience via pause points, and allows for flexible transfection days after protoplast isolation. It provides an advantageous and useful platform for a variety of in vivo transient transfection studies in rice.
Senescent Accelerated Prone 8 (SAMP8) Mice as A Model of Age Dependent Neuroinflammation
Authors: Fernández Andrés , Quintana Elena , Velasco Patricia , de Andrés Belén , Gaspar Maria Luisa , Liste Isabel , Vilar Marcal , Mira Helena , Cano Eva
Published: September 2020

Background: Aging and age related diseases are strong risk factors for the development of neurodegenerative diseases. Neuroinflammation (NIF), as the brain's immune response, plays an important role in aged associated degeneration of central nervous system (CNS). The need of animal models that will allow us to understand and modulate this process is required for the scientific community. Methods: We have analyzed aging-phenotypical and inflammatory changes of brain myeloid cells (bMyC) in a senescent accelerated prone aged (SAMP8) mouse model, and compared with their resistant to senescence control (SAMR1). We have performed morphometric methods to evaluate the architecture of cellular prolongations and analyzed Iba1+ clustered cells with aging. To analyse specific constant brain areas we have performed stereology measurements of Iba1+ cells in the hippocampal formation. We have isolated bMyC from brain parenchyma (BP) and choroid plexus and meningeal membranes (m/Ch), and analyzed their response to systemic LPS- driven inflammation.Results: Aged 10 month old SAMP8 mice presents many of the hallmarks of aging-dependent neuroinflammation when compared with their senescence resistant control (SAMR1); ie, increase of protein aggregates, presence of Iba1+ clusters, but not increase in the number of Iba1+ cells. We have further observed and increased of main inflammatory mediator IL-1β, and augment of border MHCII+Iba1+ cells. Isolated CD45+ bMyC from brain parenchyma (BP) and choroid plexus and meningeal membranes (m/Ch) have been analyzed showing that there is not significant increase of CD45+ from the periphery. Our data support that aged-driven pro-inflammatory cytokine interleukin 1 beta (IL1β) transcription is mainly enhanced in CD45+BP cells. Furthermore, we are showing that LPS-driven systemic inflammation produces inflammatory cytokines mainly in the border bMyC, sensed to a lesser extent by the BP bMyC, and is enhanced in aged SAMP8 compared to control SAMR1.Conclusion: Our data validate the SAMP8 model to study age-associated neuroinflammatory events, but careful controls for age and strain are required. These animals show morphological changes in their bMyC cell repertoires associated to age, corresponding to an increase in the production of main pro inflammatory cytokines such as IL-1β, which predispose the brain to an enhanced inflammatory response after LPS-systemic challenge.
A Cost Analysis to Address Issues of Budget Constraints on the Implementation of the Indoor Residual Spray Program in Two Districts of Maputo Province, Mozambique
Authors: Canana Neide
Published: September 2020

Background : Over the past few years, the capacity of the government of Mozambique to sustain the operational cost of Indoor Residual Spraying (IRS) is facing numerous challenges due to restrictions of the Official Development Assistance (ODA), an external aid scheme of financing from the Mozambican government budget. Objectives: The objective of the study was to estimate the cost of IRS operationalization in two districts of Maputo Province (Matutuíne and Namaacha) in Mozambique, in 2014. Methods: The cost analysis followed an “ingredients based” approach from the provider perspective. The cost information was collected retrospectively, and both economic and financial costs were calculated. Results were tested using a “one-way” deterministic sensitivity analysis. Results : From the economic analysis, Matutuíne and Namaacha on average totaled an annual economic cost of US$117,351.34, with an average economic cost per household sprayed of US$16.35, and an average economic cost per person protected of US$4.09. In the financial analysis, both districts faced an average total annual financial cost of US$69,174.83, an average financial cost per household sprayed and per person protected of US$9.84 and US$2.46, respectively. Our findings indicate that vehicles, personnel salaries, and IRS consumables were components with a substantial cost for IRS operationalization. Conclusions : For our results, with resource constraints, it is important to focus on operationalizing IRS within the available budget by respecting the right timing for scheduled IRS spraying rounds and by paying attention to cost drivers in order to reduce the costs.
Systematic Comparison of High-Throughput Single-Cell RNAseq Methods for Immune Cell Profiling
Authors: Li Chi-Ming Kevin , Yamawaki Tracy M , Lu Daniel R , Ellwanger Daniel C , Bhatt Dev , Manzanillo Paolo , Zhou Hong , Yoon Oh-Kyu , Homann Oliver , Wang Songli
Published: September 2020

Background: Elucidation of immune populations with single-cell RNA-seq has greatly benefited the fieldof immunology by deepening the characterization of immune heterogeneity and leading to thediscovery of new subtypes. However, single-cell methods inherently suffer from limitations in therecovery of complete transcriptomes due to the prevalence of cellular and transcriptional dropoutevents. This issue is often compounded by limited sample availability and limited prior knowledge ofheterogeneity, which can confound data interpretation.Results: Here, we systematically benchmarked seven high-throughput single-cell RNA-seq methods. Weprepared 21 libraries under identical conditions of a defined mixture of two human and two murinelymphocyte cell lines, simulating heterogeneity across immune-cell types and cell sizes. We evaluatemethods by their cell recovery rate, library efficiency, sensitivity, and ability to recover expressionsignatures for each cell type. We observed higher mRNA detection sensitivity with the 10x Genomics 5’v1 and 3’ v3 methods. We demonstrate that these methods have fewer drop-out events whichfacilitates the identification of differentially-expressed genes and improves the concordance of singlecellprofiles to immune bulk RNA-seq signatures.Conclusion: Overall, our characterization of immune cell mixtures provides useful metrics, which canguide selection of a high-throughput single-cell RNA-seq method for profiling more complex immunecellheterogeneity usually found in vivo.
Significance between Air pollutants, Meteorological Factors and COVID-19 Infections: Probable Evidences in India
Authors: Sahoo Mrunmayee M
Published: September 2020

SARS-CoV-2 (Coronavirus) disease represents the causative agent with a potentially fatal risk which is having great global human health concern. Earlier studies suggested that air pollutants and meteorological factors were considered as the risk factors for acute respiratory infection, which carries harmful pathogens and affects the immunity. The study intended to explore the correlation between air pollutants, meteorological factors and the daily reported infection cases caused by novel coronavirus in India. The daily positive infected cases, air pollution and meteorological factors in 288 districts were collected from January 30, 2020 to April 23, 2020 in India. Speraman’s correlation and generalised additive model were applied to investigate the correlations of four air pollutants (PM2.5, PM10, NO2 and SO2) and eight meteorological factors (Temp, DTR, RH, AH, AP, RF, WS and WD) with COVID-19 infected cases. The study indicated that a 10 µg/m3 increase during (Lag0-14) in PM2.5, PM10 and NO2 was resulted in 2.21% (95%CI: 1.13 to 3.29), 2.67% (95% CI: 0.33 to 5.01) and 4.56 (95% CI: 2.22 to 6.90) increase in daily counts of COVID 19 infected cases respectively. However, only 1 unit increase in meteorological factor levels in case of daily mean temperature and DTR during (Lag0-14) associated with 3.78% (95%CI: 1.81 to 5.75) and 1.82% (95% CI: -1.74 to 5.38) rise of COVID-19 infected cases respectively. In addition, SO2 and relative humidity were negatively associated with COVID-19 infected cases at Lag0-14 with decrease of 7.23% (95% CI: -10.99 to -3.47) and 1.11% (95% CI: -3.45 to 1.23) for SO2 and for relative humidity respectively. The study recommended that there is significant relationship between air pollutants and meteorological factors with COVID-19 infected cases, which substantially explain the effect of national lockdown and suggested positive implications for control and prevention of the spread of SARS-CoV-2 disease.
The Impact of COVID-19 on Students' Marks: A Bayesian Hierarchical Modeling Approach
Authors: Tomal Jabed , Rahmati Saeed , Boroushaki Shirin , Jin Lingling , Ahmed Ehsan
Published: September 2020

Due to COVID-19, universities across Canada were forced to undergo a transition from classroom-based face-to-face learning and invigilated assessments to online-based learning and non-invigilated assessments. This study attempts to empirically measure the impacts of COVID-19 on students’ marks from eleven science, technology, engineering, and mathematics (STEM) courses using a Bayesian linear mixed effects model fitted to longitudinal data. The Bayesian linear mixed effects model is designed for this application which allows student-specific error variances to vary. The novel Bayesian missing value imputation method is flexible which seamlessly generates missing values given complete data. We observed an increase in overall average marks for the courses requiring lower-level cognitive skills according to Bloom's Taxonomy and a decrease in marks for the courses requiring higher-level cognitive skills, where larger changes in marks were observed for the underachieving students. About half of the disengaged students who did not participate in any course assessments after the transition to online delivery were in special support.