bluuebunny/crossref_metadata_2025 huggingface dataset:
Data from small cell neuroendocrine carcinoma of cervix: FIGO 2018 staging is more accurate than FIGO 2009
Authors: Zhang Yunqiang , Ding Jingxin , Hua Keqin
Published: August 2020

Background: To evaluate whether the addition of stage IIIC to the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system of cervical cancer is reasonable based on small cell neuroendocrine carcinomas of cervix (SCNEC) data.Methods: We retrospectively reviewed 64 SCNEC patients with FIGO 2009 stage IB–IIA from January 2014 to December 2018 at the author’s hospital.Results: Univariate analysis showed that FIGO 2018 was related to more prognostic factors than FIGO 2009. Multivariate analysis showed the FIGO stage and the degree of lymph node metastasis (LNM) were significantly related to the prognosis of SCNEC patients. The 5-year overall survival rate (OS) was 78.5% and 22.2% in stage I and II, respectively (FIGO 2009). In FIGO 2018, the 5-year OS was 74.1%, 60.2%, and 0% in stage I/II, IIIC1, and IIIC2, respectively. After IIIC stage was subgrouped by T factor (T1, limited to cervix and vagina; T2, parametrial involvement; T3, pelvic and abdominal cavity involvement), the 5-year OS of IIICT1,IIICT2, and IIICT3 was 83.3%, 30.0%, and 0%, respectively, (P=0.010); while by N factor (N1a and N1b, metastasis to pelvic with the rate ≤0.20 and >0.20; N1c, metastasis to the para-aortic), the 5-year OS of IIICN1a, IIICN1b, and IIICN1c was 80.0%, 26.7%, and 0%, respectively (P=0.016).Conclusion: Compared with FIGO 2009, FIGO 2018 can evaluate the prognosis of SCNEC patients more accurately after subdivision of stage IIIC by combining tumor local invasion factors or the degree and location of LNM.
Clinical Relevance of Oncogenic Driver Mutations Identified in Endometrial Carcinoma
Authors: Watanabe Takafumi , Nanamiya Hideaki , Kojima Manabu , Nomura Shinji , Furukawa Shigenori , Soeda Shu , Tanaka Daisuke , Isogai Takao , Imai Jun-ichi , Watanabe Shinya , Fujimori Keiya
Published: August 2020

Background: Endometrial carcinoma is a clinically heterogeneous disease characterized by a number of different histological subtypes, and its heterogeneity may be involved in the accumulation of multiple genetic alterations. The aim of this work is to investigate a comprehensive mutational profile of endometrial carcinoma tumors, and examine the correlations with somatic mutations and clinicopathological features or survival in endometrial carcinoma patients. Methods: A total of 100 surgical tumors were obtained from endometrial carcinoma patients who had undergone surgery at Fukushima Medical University Hospital between 2013 and 2017. Genomic DNA samples extracted form fresh-frozen tissues were analyzed using the Ion AmpliSeq Cancer Hotspot Panel v2 Kit covering 50 tumor-related genes.Results: Validated mutations were detected in 91 of the 100 tumors (91%) and identified in eight of the most frequently mutated genes, namely PTEN (57%), PIK3CA (51%) and TP53 (30%) KRAS (23%), CTNNB1 (21%), FBFR2 (13%), FBXW7(10%) and RB1 (9%). PTEN mutations correlated with young age (< 60), early-stage, endometrioid histology, non-recurrence and better overall survival. CTNNB1 mutations correlated with young age, endometrioid histology and better overall survival. On the other hands, TP53 mutations correlated with late-stage, non-endometrioid histology, high-grade, recurrence and worse overall survival. FBWX7 mutations correlated with late-stage, vascular invasion and lymph node metastasis. FGFR2 mutations correlated with deep (≥ 1/2) myometrial invasion. No statistically significant associations were found between clinicopathological characteristics or overall survival and PIK3CA, KRAS or RB1 mutations were found.Conclusion: Our study demonstrated that mutations in PTEN and CTNNB1 could be predictive biomarkers for favorable outcome, while mutations in TP53, FBXW7 and FGFR2 could be those for adverse outcome. Our comprehensive mutational profile is useful for understanding and evaluating the molecular characteristics of endometrial carcinoma patients, and will lead to the establishment of novel treatment strategies that improve the survival of patients with endometrial carcinoma in the future.
Development and external validation of a nomogram for predicting the effect of tumor size on cancer specific survival of resected gallbladder cancer: a population-based study.
Authors: Zhang Yaodong , Zhou Tao , Han Sheng , Wang Yirui , Chang Jiang , Jiang Wangjie , Wang Ziyi , Li Changxian , Li Xiangcheng
Published: August 2020

Background & Aims:
The impact of tumor size on account of the long-term survival results in gallbladder cancer (GBC) patients has been controversial. It is urgent necessary to identify the optimal cutoff value of tumor size in resected GBC, and we attempted to integrate tumor size with other prognostic factors into a prognostic nomogram to predict the cancer-specific survival (CSS) of GBC patients.
Methods
1639 patients with resected GBC were extracted from the Surveillance, Epidemiology and End Results (SEER) database. X-tile program was used to identify the optimal cutoff value of tumor size. A nomogram including tumor size was established to predict 1-, 3- and 5-year CSS based on the independent risk factors chosen by univariate and multivariable cox analyses. The precision of the nomogram for predicting survival was validated with Harrell’s concordance index (C-index), calibration curves, and receiver operating characteristic curve (ROC) internally and externally.
Results
Patients with GBC were classified into 1–13 mm, 14–63 mm and 64 mm subgroup based on the optimal cutoff for tumor size in terms of CSS. The nomogram according to the independent factors was well calibrated and displayed better discrimination power than 7th Tumor-Node-Metastasis (TNM) stage systems.
Conclusions
The results demonstrated that increased tumor size is closely associated with the worse CSS. Our novel nomogram, which outperforms the conventional TNM staging system, showed satisfactory accuracy and clinically practicality for predicting the outcome of resected GBC patients.
Study on the Independent Effect of Thyroid Hormone Based on Uric Acid Level on NAFLD
Authors: chao guanqun , Chen Liying
Published: August 2020

Objective:This study aims to further explain the correlation among NAFLD, hyperuricemia and thyroid function and to find independent risk factors for each other.Methods:Datas were obtained from subjects who underwent health examination in the Health promotion centre of Sir Run Run Shaw hospital of Zhejiang University from January 2017 to February 2019.The diagnosis of NAFLD was according to the clinical diagnosis of the Guidelines.Serum uric acid (SUA) >360 mol/L (female) and SUA>420 mol/L (male) were enrolled in the hyperuricemia group.R software was used for statistical analysis.Results:55,449 subjects were included in the analysis.Gender ratio, age, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, HbA1c, triglyceride, high-density lipoprotein, glutamate transaminase, glutamate transaminase, urea nitrogen, creatinine, FT3, FT4 and TSH were significantly different between the two groups.age, BMI, waist circumference, diastolic blood pressure, rapid blood glucose, HbA1c, total cholesterol, low-density lipoprotein, AST, and uric acid were all independent risk factors for NAFLD.In the normal uric acid group, variables other than systolic blood pressure and TSH were independent factors of NAFLD.In the hyperuricemia group, all variables except systolic blood pressure, FT4 and TSH were independent factors of NAFLD.Conclusion:The level of uric acid is related to the occurrence of NAFLD. Hyperuricemia is one of the independent risk factors of NAFLD.TSH level is not related to the occurrence of NAFLD, while FT3 and FT4 may be related to NAFLD.
High resolution diffusion weighted imaging for neoadjuvant chemotherapy assessment of nasopharyngeal carcinoma
Authors: Meng Tiebo , Wang Feixiang , Liu Jia , Dai Wei , Zhi Lanlan , Mo Xiaoguan , Han Cailan , Li Hui , Huang Wei , Ke Liangru , Xie Chuan-miao
Published: August 2020

Background

To evaluate the feasibility of high resolution diffusion weighted imaging (DWI) for the prediction about the response of neoadjuvant chemotherapy (NAC) in patients.
Methods

119 NPC patients who underwent magnetic resonance imaging (MRI) including readout-segmented diffusion weighted imaging (RESOLVE-DWI) before treatment enrolled in this study from September 2017 to December 2019, and all patients underwent follow-up MRI at 3 month after two cycles of NAC. Patients were classified into stable disease (SD), partial response (PR) or completed response (CR) based on Response Evaluation Criteria in Solid Tumors (RECIST). Apparent diffusion coefficient (ADC) values were measured from RESOLVE-DWI in the first MRI examination. The ADC values were compared between responders (CR and PR) and non-responders (SD) using Independent samples t-test, and the receiver operating characteristic curve (ROC) was calculated to assess the diagnostic efficacy.
Results

The ADC value of responders was significantly higher than that of non-responders (719.73 ± 100.44 × 10− 3 mm2/s and 583.28 ± 53.15 × 10− 3 mm2/s, p < 0.001, respectively). The area under the curve (AUC) was 0.879 with a sensitivity at 82.8%, and specificity at 84.6%.
Conclusions

The ADC value obtained by RESOLVE-DWI, with a high diagnostic accuracy for NAC assessment, could be used as a pretreatment imaging biomarker to predict the early response to NAC in NPC patients.
Analysis of the Misdiagnosis of a Case of Rectal Lymphoid Polyp: a Case Report
Authors: Lan Yong-Ting , Shang Hua , Wang Lin-Ping , Li Na , Zhao Jing , Ling Ting-Sheng
Published: August 2020

Background: Lymphoid polyps are rare benign lesions, mainly in the intestinal tract. But misdiagnosis always happen, because it is difficult to distinguish lymphoid polyp and lymphoma and laterally spreading tumour (LST) solely relying on endoscopic examination. Generally speaking, pathology can help us make a correct diagnosis, but in few cases advanced methods is necessary for diagnosis, such as immunohistochemistry and gene rearrangement. Case presentation: A 56-year-old female patient was admitted to the ward for endoscopic submucosal dissection (ESD) treatment. She was diagnosed with laterally spreading tumour (LST) in another hospital. Before ESD treatment, we performed a colonoscopy examination on the patient. The result pointed towards rectal lymphoma and did not support the diagnosis of LSTs of the rectum, so we did not perform ESD. Because of the possibility of missed diagnosis and misdiagnosis of common endoscopic biopsy, we performed endoscopic mucosal resection (EMR) biopsy. The results of postoperative pathology, immunohistochemistry and gene rearrangement supported the diagnosis of lymphoid polyps. Conclusions: The diagnosis of lymphoid polyps always depends on endoscopic examination and pathology. If necessary, advanced methods such as immunohistochemistry and gene rearrangement may be helpful.
WITHDRAWN: Anisotropic Textile Brace for Adolescent Idiopathic Scoliosis: Immediate in-brace effect and biomechanics
Authors: Queenie FOK , Yip Joanne , Yick Kit-lun , Sun-pui Ng , Liu Zude , Li Xinfeng
Published: August 2020

Background
Rigid bracing is a universal effective treatment for scoliosis. However, body movement restriction and discomfort usually are its shortcomings. The purpose of this case series study was to investigate the feasibility of novel anisotropic textile braces with an artificial hinge adopting the direct three-point pressure system for the initial spinal correction and its biomechanics.
Methods
Five scoliotic female patients who were on average 12.2 years old with a BMI of 18.7, Risser grade of 1.6 and Cobb’s angle of 22.3˚ were recruited. The outcome measures are spinal correction, contour asymmetry, and interface pressure distribution of the brace. The correlation between the rate of in-brace correction and variables such as the Cobb’s angle, posterior trunk asymmetry index and interface pressure were studied.
Results
The initial in-brace rate of spinal correction ranged between 9.7% and 87%. The rate of correction based on posterior trunk asymmetry index ranged between 14.1% and 43.2%. The interface pressure from the brace ranged from 4.1 kPa to 25.6 kPa, which is comparable to that exerted by rigid braces. Based on the data in this study, no correlation was found between the in-brace rate of correction and the Cobb’s angle and the pressure exerted by the pads.
Conclusions
The main finding is that the anisotropic textile brace offers good initial in-brace correction through the application of the three-point pressure system with textile materials. Nevertheless, further follow-up work is recommended to investigate its long-term efficacy.
Trial registration:
This study was registered at ClinicalTrials.gov (NCT02271256 – Registration date 22nd October 2014).
Scattered migrating colony formation in the filamentous cyanobacterium, Pseudanabaena sp. NIES-4403
Authors: Yamamoto Hiroki , Fukasawa Yuki , Shoji Yu , Hisamoto Shumpei , Kikuchi Tomohiro , Takamatsu Atsuko , Iwasaki Hideo
Published: August 2020

Background
Bacteria have been reported to exhibit complicated morphological colony patterns on solid media, depending on intracellular, and extracellular factors such as motility, cell propagation, and cell-cell interaction. We isolated the filamentous cyanobacterium, Pseudanabaena sp. NIES-4403 (Pseudanabaena, hereafter), that forms scattered (discrete) migrating colonies on solid media. While the scattered colony pattern has been observed in some bacterial species, the mechanism underlying such a pattern still remains obscure.
Results
We studied the morphology of Pseudanabaena migrating collectively and found that this species forms randomly scattered clusters varying in size and further consists of a mixture of comet-like wandering clusters and rotating disks. Quantitative analysis of the formation of these wandering and rotating clusters showed that bacterial filaments tend to follow trajectories of previously migrating filaments at velocities that are dependent on filament length. Collisions between filaments occurred without crossing paths, which enhanced their nematic alignments, giving rise to bundle-like colonies. As cells increased and bundles aggregated, comet-like wandering clusters developed. The direction and velocity of the movement of cells in comet-like wandering clusters were highly coordinated. When the wandering clusters entered into a circular orbit, they turned into rotating disks, maintaining a more stable location. Disks may rotate for days, and the speed of cells within a rotating disk increases from the center to the outmost part of the disk. Using a minimal agent-based model, we reproduced some features of Pseudanabaena migrating clusters.
Conclusion
Based on these observations, we propose that Pseudanabaena forms scattered migrating colonies that undergo a series of transitions involving several morphological patterns. A minimal agent-based model is able to reconstruct some features of the observed migrating clusters.
Low-Dosage Ozonation in Gaseous VOCs Biofilter Promotes Community Diversity and Robustness
Authors: Yeung Marvin , Saingam Prakit , Xu Yang , Xi Jinying
Published: August 2020

BackgroundOzonation of biofilter is known for alleviating clogging and pressure drop issues while maintaining removal performances in biofiltration systems treating gaseous VOCs (Volatile Organic Compounds). The implications of ozone on the biofilter microbiome, in terms of biodiversity, community structure, metabolic abilities and dominant taxa correlated with performance remain largely unknown.MethodsThis study investigated two biofilter treating high concentration toluene operating in parallel, with one acting as control and the other exposed to low-dosage (200 mg/m3) ozonation. Microbial community diversity, metabolic rates of different carbon sources, functional predictions and microbial co-occurrence networks of both communities were examined. ResultsConsistently higher biodiversity of over 30% was observed with microbiome after ozonation, with increased overall metabolic abilities for amino acids and carboxylic acids. Relative abundance of species with reported stress tolerant and biofilm forming abilities significantly increased, with a consortium of changes in predicted biological pathways, including shifts in degradation pathways of intermediate compounds, while correlation of top OTUs and genus with performance indicators show diversifications in microbiota responsible for VOCs degradation. Co-occurrence network of the community shows a decrease in average path distance and average betweenness with ozonation. ConclusionShifts in major degrading species and increase in biodiversity could explain the consistent performance commonly seen in ozonation of biofilters despite the decrease in biomass. Increased presence of stress tolerant microbes in the microbiome coupled with decentralization of the co-occurrence network suggest that ozonation could not only provide amelioration for clogging issues but also provides a microbiome more robust to loading shocks seen in full-scale biofilters.
Porin Protein Could be A Vaccine Candidate Against Riemerella Anatipestifer for Ducks
Authors: Yang Hui , Zhang Haiwen , Liao Chenghong , Zhao Jianguo , Wang Jinhua , Wu Kebang , Han Qian , guan qingfeng
Published: August 2020

Riemerella anatipestifer(RA) is a gram-negative bacterium that is susceptible to poultry such as domestic ducks and geese. Young birds have a high mortality rate after infection. The resistance caused by the abuse of antibiotics is also getting worse. Since there are 25 serotypes of RA, and the cross-immunization between serotypes is weak, it is necessary to find a vaccine that has cross-immunization against multiple serotypes of RA. In this article, the bioinformatics analysis of RA Proin protein was conducted, and it was speculated that it has the potential of a subunit vaccine. The protein was recombinantly expressed and purified, and immunized with Cherry Valley Duck. The results show that the serum antibodies of the Porin protein immunized group were positive at 1:24300 for the porin protein and RA strains CH1. The serum could improve the killing effect of complement and phagocytic cells on RA. After the challenge, the survival rate of Cherry Valley Duck can be increased by 80%.
Circular RNA Expression Profiles and Features in NAFLD Mice: A Study Using RNA-Seq Data
Authors: Yuan Xinlu , Diao Jianjun , Du Anqing , Wen Song , Zhou Ligang , Pan Yangbin
Published: August 2020

Background: Nonalcoholic fatty liver disease (NAFLD) is primarily characterized by the hepatic cholesterol accumulation. Circular RNA (circRNA), one of noncoding RNA, involves in many liver diseases progression. However, no recent studies on circRNA expression profiles in NAFLD have been reported previously.Methods: A NAFLD mouse model was constructed by providing high-fat diet (HFD) for 32 weeks. The circRNAs expression profile in normal mice and NAFLD mice were determined using high-output RNA sequencing method and bioinformatics methods, while the differentially expressed circRNAs were confirmed using Sanger sequencing and qRT-PCR. The circRNA-miRNA network was also predicted. The biological functions of circRNAs were annotated by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG).Results: The results demonstrated the successful construction of NAFLD mice model by immunohistology and serology assay. In total, 93 dysregulated circRNAs were observed, including 57 upregulated circRNAs and 36 downregulated circRNAs, in the NAFLD group. The circRNA-miRNA network revealed the complex interaction between circRNAs and its potential miRNA targets in NAFLD. The characteristic of tissue-specific expression in circRNA was demonstrated. The differentially expressed circRNAs with important biological function were also annotated using GO and KEGG. Both DDAH1 and VAV3 genes were found to be associated with the NAFLD development.Conclusions: Taken together, this study demonstrated the circRNAs expression profile and features in NAFLD, which may provide potential biological markers for the pathogenesis of NAFLD.
Systemic Transplantation of Adult Multipotent Stem Cells Prevents Articular Cartilage Degeneration in a Mouse Model of Accelerated Ageing
Authors: Thompson Seth David , Pichika Rajeswari , Lieber Richard L , Lavasani Mitra
Published: August 2020

Background. Osteoarthritis (OA) is one of the most prevalent joint diseases of advanced age and is a leading cause of disability worldwide. Ageing is a major risk factor for the articular cartilage (AC) degeneration that leads to OA, and the age-related decline in regenerative capacity accelerates OA progression. Here we demonstrate that systemic transplantation of a unique population of adult multipotent muscle-derived stem/progenitor cells (MDSPCs), isolated from young wild-type mice, into Zmpste24 - / - mice (a model of Hutchinson-Gilford progeria syndrome, a condition marked by accelerated ageing), prevents ageing-related homeostatic decline of AC. Results. MDSPC treatment inhibited expression of cartilage-degrading factors such as pro-inflammatory cytokines and extracellular matrix-proteinases, whereas pro-regenerative markers associated with cartilage mechanical support and tensile strength, cartilage resilience, chondrocyte proliferation and differentiation, and cartilage growth, were increased. Notably, MDSPC transplantation also increased the expression level of genes known for their key roles in immunomodulation, autophagy, stress resistance, pro-longevity, and telomere protection. Our findings also indicate that MDSPC transplantation increased proteoglycan content by regulating chondrocyte proliferation. Conclusions. Together, these findings demonstrate the ability of systemically transplanted young MDSPCs to preserve a healthy homeostasis and promote tissue regeneration at the molecular and tissue level in progeroid AC. These results highlight the therapeutic potential of systemically delivered multipotent adult stem cells to prevent age-associated AC degeneration.
Single Nucleotide Polymorphisms Associated with Methotrexate-induced Nausea in Juvenile Idiopathic Arthritis
Authors: Kyvsgaard Nini , Mikkelsen Torben Stamm , Als Thomas D. , Christensen Anne Estmann , Corydon Thomas J. , Herlin Troels
Published: August 2020

BackgroundContext: Methotrexate (MTX) is a cornerstone in the treatment of juvenile idiopathic arthritis (JIA). MTX treatment is commonly associated with nausea. Large inter-individual variation exists in the level of MTX-induced nausea, possibly due to genetic factors. Purpose: To investigate whether MTX-induced nausea was associated with single nucleotide polymorphisms (SNPs) in genes encoding MTX-transporter proteins, a MTX metabolizing enzyme and a nausea receptor.FindingsMethods: Children aged ≥9 years treated with MTX for JIA were eligible. MTX-induced nausea was registered by the children’s completion of a nausea diary (min. 7 days) and the parents’ completion of the MTX intolerance severity score (MISS). The selected SNPs were: SLCO1B1 (rs4149056; rs4149081), SLCO1B3 (rs2117032), SLC19A1 (rs1051266), ABCC2 (rs2273697; rs3740066; rs717620), ABCB1 (rs2032582; rs1045642), MTHFR (rs1801131, rs1801133), HTR3A (rs1062613; rs1985242; rs1176713) and HTR3B (rs1176744). Results: Enrolled were 121 JIA patients (82 girls: 39 boys) with a median age of 13.3 years (IQR: 11.3-15.1). The median MTX dose was 9.7 mg/m2/week (IQR: 9.0-10.9). The median MTX treatment duration prior to enrolment was 340 days (IQR: 142-766). The SNP analysis was available for 119 patients. MTX intolerance was associated with the genotype distribution of rs1801133 (MTHFR) (p= 0.02). There was no additive effect of the minor alleles for any of the selected SNPs, nor any significant haplotype associations. Conclusion Summary: MTX-induced nausea may be influenced by genetic polymorphisms in a MTX metabolizing enzyme (rs1801133; MTHFR). Implications: Further analyses involving inclusion of larger cohorts are needed to understand the impact of SNPs on MTX-induced nausea in JIA.
Deciphering the Role of Physical Activity in Stress Management During A Global Pandemic in Older Adult Populations: A Systematic Review Protocol
Authors: Churchill Ryan , Riadi Indira , Kervin Lucy , Teo Kelly , Cosco Theodore
Published: August 2020

Background: The world has changed dramatically since the beginning of 2020 due to COVID-19. As a result of the pandemic, many older adults are now experiencing an increased and unprecedented amount of psychological stress. Physical activity has been found to be an evidence-based means of combating stress among older adults to promote their quality of life. Studies have demonstrated that those who are physically active experience fewer issues in regard to their mental health, specifically depression and anxiety disorders. Engagement in physical activity may exert a protective influence over stress inducing events and subsequent mental health outcomes. Due to the fact that exercise is inexpensive, non-invasive, and effective even via incremental increases in activity level, physical activity interventions should be investigated as an important therapy for reducing stress for older adults during this current pandemic. Methods: Four electronic databases will be searched to identify all randomized control trials that involve physical activity as an intervention to address stress management in older adults 50 years of age or older. Only peer reviewed and published journal articles will be reviewed. All studies will be assessed for bias using Cochrane’s risk of bias tool. A random effects meta-analysis will be investigated if sufficient evidence of homogenous research exists and the heterogeneity of effect sizes will be tabulated. Discussion: This review will determine the effectiveness of various physical activity interventions for the treatment of stress among the older adult population. This knowledge will help inform care aides, clinicians, family members, and older adults themselves of the most effective physical activity interventions in dealing with stress which is relevant to the ongoing pandemic. Registration: PROSPERO CRD42020192546 Keywords: Stress management, physical activity, pandemic, intervention, older adults, systematic review
Dental practice closure during COVID-19 and associated professional, practice and structural determinants: a multi-country survey
Authors: Abdelrahman Hams H , Atteya Sara M , Ihab Merna , Nyan Myat , Maharani Diah Ayu , Rahardjo Anton , Shaath Mohammed , Aboalshamat Khalid , Butool Sayda , Shamala Anas , Baig Lubna , Tantawi Maha El
Published: August 2020

Background: The outbreak of novel coronavirus disease (COVID-19) in China has influenced every aspect of life worldwide. Due to the characteristics of dental settings, the risk of cross infection may be high between dental practitioners and patients. Being on the list of high-risk professions, dentists are very much expected to develop severe anxiety about the current pandemic situation. In addition, the limited provision of services and closure of dental practices raised concerns among dental professionals about the financial consequences of this closure. Therefore, the study assessed the extent of dental practice closure in various countries around the world, factors associated with this closure and whether closure and associated factors differed between private and non-private sectors.Methods: From April to May 2020, a web-based survey was sent to dentists in several countries. The survey assessed professional factors, practice factors and country-level structural factors. Multilevel logistic regression was used to assess the association of practice closure with these factors. Effect modification due to private and non-private sectors was assessed. Results: Dentists (n= 3243) participated from 29 countries. The majority (75.9%) reported practice closure with significantly higher percentage in the private than non-private sector. Fears were associated with significantly higher likelihood of closure in private (OR= 1.54, 95%CI= 1.24, 1.92) and non-private sectors (OR= 1.38, 95%CI= 1.04, 1.82). Non-private, governmental sector dentists (OR= 0.54, 95%CI= 0.31, 0.94) and those in rural areas (OR= 0.58, 95%CI= 0.42, 0.81) and those in hospitals (overall OR= 0.60, 95%CI= 0.36, 0.99) reported low likelihood of closure. High likelihood of closure was reported by those in academia (OR= 2.13, 95%CI= 1.23, 3.71). More hospital beds were associated with lower likelihood of closure in the non-private sector (OR= 0.65, 95%CI= 0.46, 0.91) and private sector dentists in high income countries (HICs) reported less closure than in non-HICs (OR= 0.55, 95%= 0.15, 1.93).Conclusions: Most dentists reported practice closure because of COVID-19 with greater impact in the private than non-private sectors with professional, practice and country-level factors associated.
Examining Supports and Barriers to Breastfeeding through a Socio-Ecological Lens
Authors: Snyder Kailey , Hulse Emily , Dingman Holly , Cantrell Angie , Hanson Corrine , Dinkel Danae
Published: August 2020

BACKGROUND: Early breastfeeding cessation is a societal concern given the massive benefits associated with breastfeeding for mother and child. More effective interventions are needed to increase breastfeeding duration. Prior to developing such interventions more research is needed to examine breastfeeding supports and barriers from the perspective of breastfeeding stakeholders. One such framework that can be utilized is Brofenbrenner’s Social Ecological Model. The purpose of this study was to examine supports and barriers to breastfeeding based on the Social Ecological Model. METHODS: A total of 49 representatives participated in a telephonic interview. Interviewees represented various levels of the model based on their current breastfeeding experience (i.e., mother or significant other) or occupation. A direct content analysis was performed as well as a constant comparative analysis to determine differences between level representatives. RESULTS: Common supports identified by all interviewees were in-hospital breastfeeding education (organizational level) and the existence of breastfeeding protection legislation (policy level). Barriers identified by all interviewees included a lack of support (interpersonal level), lack of hospital resources (organizational level) and lack of specificity within the existing breastfeeding protection legislation (policy level). Other identified supports and barriers varied by representatives for each level of the model. CONCLUSION: Breastfeeding organizations such as state and local coalitions should utilize this information to guide future strategy as well as develop interventions to eliminate the disparities between breastfeeding mothers’ perceptions and the stakeholders working to increase breastfeeding initiation and duration rate.
The Emergence of a New Form of Headache in COVID-19 Pandemic Era
Authors: Uygun Özge , Ertas Mustafa , Ekizoğlu Esme , Bolay Hayrunnisa , Özge Aynur , Orhan Elif Kocasoy , Çağatay Arif Atahan , Baykan Betül
Published: August 2020

BackgroundHeadache is the most common COVID-19-related neurological symptom. But, diagnostic clues of headache for COVID-19 infection are not well known. MethodsWe developed a detailed web-based questionnaire screening the characteristics and course of headaches besides clinical COVID-19 features. The participants were grouped according to being diagnosed with COVID-19 infection or not, and having previous or new-onset headaches. The COVID-19 related headache features and their associations with other clinical features were investigated. A binary logistic regression model was performed to differentiate the characteristics of headache related to COVID-19. Findings 3458 participants (2341 females;67.7%, 1495 healthcare workers;43.2%) with a mean age of 43.21±11.2 years experiencing headache during pandemic contributed to the survey. Among them, 262 participants had COVID-19 and 126(48.1%) were male. The rate of males in the group without COVID-19 was 31% (991 out of 3196 participants) showing significant gender difference between groups (p<0.000). COVID-19 related headaches were more closely associated with anosmia/ageusia and gastrointestinal complaints (RR=3.7 and RR=1.33, respectively), showed different characteristics like pulsating, pressing, and even stabbing quality. Logistic regression analyses showed that bilateral headache, duration over 72 hours, analgesic resistance and having male gender were significant variables to differentiate COVID-19 positive patients from those without COVID-19 (p<0.000 for all variables). A worsening of previous primary headaches due to the pandemic-related problems was not the rule in majority of patients.Interpretation Bilateral, long-lasting headaches, resistance to analgesics and having male gender were more frequent in people with COVID-19 in conjunction with the anosmia/ageusia and gastrointestinal complaints. These features may be helpful for COVID-19 diagnosis in the clinical evaluation of headache patients during the pandemic.Funding: This study was funded by Scientific Research Projects Coordination Unit of Istanbul University with a project number of GAP-36802.
Acute Tuberculosis pneumonia and COVID-19 in a patient vaccinated with Bacille Calmette-Guérin (BCG)
Authors: Luciani Michelangelo , Bentivegna Enrico , Spuntarelli Valerio , Guerritore Ludovica , Chiappino Dario , Nalli Gabriele , Proietta Maria , Porto Flavia Del , Martelletti Paolo , Sesti Giorgio
Published: August 2020

COVID-19 is a respiratory tract infection caused by the new coronavirus SARS-COV2, that can be complicated by acute distress respiratory syndrome and multiorgan failure. In light of the high rate of mortality associated with COVID-19, pharmacological and non-pharmacological strategies to prevent the infection are currently being tested. Among non-pharmacological preventive measures, vaccines represent one of the main resources for public health. It has been suggested that Bacille Calmette-Guérin (BCG) vaccine may protect individuals against infection from COVID-19 virus, and two clinical trials addressing this question are underway. Here, we report the case of a 32-year old woman, vaccinated with BCG when she was 1 year old, who was diagnosed with apical tuberculous pneumonia of the right lung along with COVID 19 pneumonia.
A critical appraisal of modern engineering science, and the changes required by the appraisal conclusions.
Authors: Adiutori Eugene F.
Published: August 2020

Until the nineteenth century, engineering science was founded on a view of dimensional homogeneity that required the following:· Parameters must not be multiplied or divided.· Dimensions must not be assigned to numbers.· Equations must be dimensionless. This view made it impossible to create equations such as the laws of modern engineering science. Modern engineering science is founded on Fourier’s view of dimensional homogeneity. His view allows the following, and makes it possible to create equations such as the laws of modern engineering science:· Parameters may be multiplied or divided.· Dimensions may be assigned to numbers.· Equations may or may not be dimensionless.Fourier did not prove the validity of his view of dimensional homogeneity. He merely stated that his view of dimensional homogeneity is equivalent to unspecified axioms left behind by the ancient Greeks. Presumably, his colleagues accepted his unproven view because it enabled him to solve problems they were unable to solve. A critical appraisal of Fourier’s unproven view of dimensional homogeneity results in the following conclusions:· Parameters cannot rationally be multiplied or divided. Only the numerical values of parameters can rationally be multiplied or divided.· Dimensions cannot rationally be assigned to numbers. If dimensions could be assigned to numbers, any equation could be regarded as dimensionally homogeneous.· Equations are inherently dimensionless because symbols in parametric equations can rationally represent only numerical value.The appraisal and the changes in modern engineering science required by the appraisal conclusions are presented in the text.
Selection of Reference Genes for Transcription Studies on Adventitious Root Induction in Olive (Olea Europaea L.) Microshoots Considering Co-expression and Average Transcriptional Stability
Authors: Noceda Carlos , Peixe Augusto , Arnholdt-Schmitt Birgit
Published: August 2020

BackgroungSelection of reference genes (RGs) for normalization of PCR-gene expression data includes two crucial steps: determination of the among-sample transcriptionally more stable genes and subsequent choosing of the most suitable genes as internal controls. Both steps can be carried-out through generally accepted strategies each having different strengths and weaknesses. The present study proposes to reinforce normalization of gene expression data by integrating and adding analytical revision at critical steps of those accepted procedures. Especially crucial is to counterbalance a higher representative number of RGs with a correspondent increase in their average transcriptional instability or a generalised co-expression trend among the samples. This methodological study used in vitro olive adventitious rooting as an experimental system, since the underlying morphogenetic process -wich is common to diverse species- is still not completely understood.ResultsFirstly, RG candidates were ranked according to transcriptional stability following a simple statistical method that reduces biasing effects of concomitant, systematic biological variations associated to experimental conditions, such as the variations caused by gene co-regulation. Those types of systematic co-variation are unconsidered by several popular ad hoc informatics programmes. To select the adequate genes among those already ranked, an algorithm of one of the ad hoc informatics programmes (GeNorm) was adapted to allow partial automatization of RG selection for any strategy of transcriptional-gene stability ordering. In order to delve into the resulting possible RG sets suitability for inter-assay comparisons and technical-error compensation, separate statistics were formulated. The achieved results were compared with those obtained by standard stability ranking methods. Finally, a double evaluation was performed to accurately contrast two choice RG sets. The whole strategy was applied to a panel considering several independent factors, but the suitability of the obtained putative RG sets was tested for cases restricted to fewer variables. H2B, OUB and ACT are valid for normalization in transcriptional studies on olive microshoot rooting when comparing treatments, time points and assays.ConclusionsThe set of genes identified as internal reference is now available for wider expression studies on any target gene in similar biological systems. The overall methodology aims to constitute a guide for general application.
Follistatin-like 1 (FSTL1) is a Prognostic Biomarker and Correlated with Immune Cell Infiltration in Gastric Cancer
Authors: Li Li , Huang Shanshan , Yao Yangyang , Chen Jun , Li Junhe , Xiang Xiaojun , Deng Jun , Xiong Jianping
Published: August 2020

Background: Follistatin-like 1 (FSTL1) plays a central role in the progression of tumor and tumor immunity. However, the effect of FSTL1 on the prognosis and immune infiltration of gastric cancer (GC) remains to be elucidated.Method: The expression of FSTL1 data was analyzed in Oncomine and TIMER databases. Analyses of clinical parameters and survival data were conducted by Kaplan-Meier plotter and immunohistochemistry. Western blot assay and real‐time quantitative PCR (RT-qPCR) was using to analyzed protein and mRNA expression, respectively. The correlations between FSTL1 and cancer immune infiltrates was analyzed by Tumor Immune Estimation Resource (TIME), Gene Expression Profiling Interactive Analysis (GEPIA) and LinkedOmics database.Results: The expression of FSTL1 was significantly higher in GC tissues than in normal tissues, and bioinformatic analysis and Immunohistochemistry (IHC) indicated that high FSTL1 expression significantly correlated with poor prognosis in GC. Moreover, FSTL1 was predicted as an independent prognostic factor in GC patients. Bioinformatics analysis results suggested that FSTL1 mainly involved in tumor progression and tumor immunity. And significant correlations were found between FSTL1 expression and immune cell infiltration in GC.Conclusion: The study effectively revealed useful information about FSTL1 expression, prognostic values, potential functional networks and impact of tumor immune infiltration in GC. In summary, FSTL1 can be used as a biomarker for prognosis and evaluating immune cell infiltration in GC.
Maternal Dietary Linoleic Acid Altered Intestinal Barrier Function in Domestic Pigeons (Columba Livia)
Authors: Xu Qianqian , Zou Xiaoting , Dong Xinyang
Published: August 2020

BackgroundLinoleic acid (LA) is predominantly essential for poultry. Deficiency of LA in poultry were manifested in various aspects such as retarded growth and reduced resistance to disease. The effects of LA on intestinal health in vitro and in mammals has been studied, whereas research related to the effects of LA on intestine health in poultry was scanty. Intestinal health and immune function play an important role in pigeon squab growth. Considering squabs are fed by their parents, the purpose of this study was to explore the effects of maternal dietary LA on intestinal barrier function in squabs by determining intestinal morphology, gene expression of tight junction protein, immune cytokines, and microbial flora.ResultsA completely randomized design with a control group, 1% dietary LA supplementation group, 2% dietary LA supplementation group, and 4% dietary LA supplementation group was used. Six squabs from each treatment were randomly sampled at 21 posthatch. Results indicated that LA supplementation improved intestinal morphology as reflected by increased villus height, villus area and the ratio of villus to crypt, and the promotion at dosage of 1% was most significant. Besides, 1% LA supplementation elevated distribution density of goblet cell in intestine, and strengthened tight junction between enterocytes by up-regulating claudin3 and occludin gene expression, but down-regulating claudin2 gene expression. Moreover, 1% LA supplementation reduced secretion of pro-inflammation cytokines and increased anti-inflammation cytokines partly. The diversity index Chao1 of intestinal microbiota in 1% LA supplementation group was higher than other groups. And Butyrivibrio as beneficial bacteria was the biomarker of LA1%. However, excessive (4%) LA supplementation led to adverse impact on intestinal immunity and microbiota.ConclusionsMaternal dietary LA in three levels all could improve intestinal morphology in squabs. Therein, appropriate dosage (1%) supplementation might enhance mucosal protection and epithelium barrieer in squabs, and furthermore consolidated intestine immunity and luminal microbial environment. However, excessive (4%) LA supplementation might lead to adverse impact on immunity and microbiota. Maternal dietary LA might alter intestinal barrier function in pigeon squabs in a dose-dependent manner.
Using Behavioral Insights to Design Implementation Strategies in Public Mental Health Settings: a Qualitative Study of Clinical Decision-Making
Authors: Last Briana S , Schriger Simone H , Timon Carter E. , Frank Hannah E , Buttenheim Alison M. , Rudd Brittany N , Fernandez-Marcote Sara , Comeau Carrie , Shoyinka Sosunmolu , Beidas Rinad S.
Published: August 2020

Background: Trauma focused-cognitive behavioral therapy (TF-CBT) is an evidence-based intervention for youth with posttraumatic stress disorder. An important component of TF-CBT is the trauma narrative (TN), a phase in the intervention in which youth are guided to process the memories, thoughts, and feelings associated with their traumatic experience(s). Previous work has shown that only half of TF-CBT clinicians complete the TN with their clients. Drawing from the behavioral insights literature—an interdisciplinary field studying judgment and decision-making—the present study seeks to understand what determines clinician use of the TN and to generate strategies that target these determinants. Methods: Through semi-structured qualitative interviews, we sought the perspectives of trained TF-CBT clinicians working in public mental health settings across the city of Philadelphia (n=17) to understand their decisions to use the TN with clients. We analyzed the qualitative data using a coding approach informed by the behavioral insights literature. We used an iterative process of structured hypothesis generation, aided by a behavioral insights guide, and rapid validation informed by behavioral insights to uncover the determinants of TN use. We then generated implementation strategies that targeted these determinants using the “Easy Attractive Social Timely” framework, a behavioral insights design approach. Results: We generated and validated three broad themes about what determines clinician implementation of the TN: decision complexity, clinician affective experience, and agency norms. We hypothesized the behavioral insights that underlie these implementation determinants and generated a list of nine behavioral insights strategies that theoretically may facilitate TN implementation. Conclusions: Our study investigated why an effective component of an evidence-based intervention is often neglected. We leveraged robust scientific theories and empirical regularities from the behavioral insights literature to understand clinician perspectives on TN implementation. These factors were theoretically linked to implementation strategies. Our work revealed the potential for using behavioral insights in the diagnosis of evidence-based intervention determinants and the design of implementation strategies.
Spectrum of Movement Disorders in GNAO1 Encephalopathy: in-depth Phenotyping and Literature Review
Authors: Kim Soo Yeon , Shim YoungKyu , Ko Young Joon , Park Soojin , Jang Se Song , Lim Byung Chan , Kim Ki Joong , Chae Jong-Hee
Published: August 2020

Background
GNAO1 encephalopathy is a rare neurodevelopmental disorder characterized by distinct movement presentations and early onset epileptic encephalopathy. Here, we report the in-depth phenotyping of genetically confirmed patients with GNAO1 encephalopathy, focusing on movement presentations.
Results
Six patients who participated in Korean Undiagnosed Disease Program were diagnosed to have pathogenic or likely pathogenic variants in GNAO1 using whole exome sequencing. All medical records and personal video clips were analyzed with a literature review. Three of the 6 patients were male. Mean follow-up duration was 39 months (range, 7–78 months) and age at last examination was 8.0 years (range, 3.3–16.9 years). Initial complaints were hypotonia or developmental delay in 5 and right-hand clumsiness in 1 patient, which were noticed at 20 months of age on average (range, 0–75 months). All patients showed global developmental delay and 4 had severely retarded development. Five patients (5/6, 83.3%) had many different movement symptoms with various onset and progression. The symptoms included stereotyped hands movement, non-epileptic myoclonus, dyskinesia, dystonia and choreoathetosis. Whole exome sequencing identified 6 different variants in GNAO1. Three were novel de novo variants and atypical presentation was noted in a patient. One variant turned out to be inherited from patient’s mother who had mosaic variant. Distinct phenotypes in patients with variant p.Glu246Lys and p.Arg209His were elucidated by in-depth phenotyping and literature review.
Conclusions
We reported 6 patients with GNAO1 encephalopathy showing an extremely diverse clinical spectrum on video. Some characteristic movement features identified by careful inspection may also provide important diagnostic insight and practice guidelines.