bluuebunny/crossref_metadata_2025 huggingface dataset:
Proteome-wide and lysine crotonylation profiling reveals the importance of crotonylation in chrysanthemum (Dendranthema grandiforum) under low-temperature
Authors: Lin Ping , Bai Hui-ru , He Ling , Huang Qiu-xiang , Zeng Qin-han , Pan Yuan-zhi , Jiang Bei-bei , Zhang Fan , Zhang Lei , Liu Qin-lin
Published: January 2021

Background: Low-temperature severely affects the growth and development of chrysanthemum which is one kind of ornamental plant well-known and widely used in the world. Lysine crotonylation is a recently identified post-translational modification (PTM) with multiple cellular functions. However, lysine crotonylation under low-temperature stress has not been studied. Results: Proteome-wide and lysine crotonylation of chrysanthemum at low-temperature was analyzed using TMT (Tandem Mass Tag) labeling, sensitive immuno-precipitation, and high-resolution LC-MS/MS. The results showed that 2017 crotonylation sites were identified in 1199 proteins. Treatment at 4 °C for 24 h and −4 °C for 4 h resulted in 393 upregulated proteins and 500 downregulated proteins (1.2-fold threshold and P < 0.05). Analysis of biological information showed that lysine crotonylation was involved in photosynthesis, ribosomes, and antioxidant systems. The crotonylated proteins and motifs in chrysanthemum were compared with other plants to obtain orthologous proteins and conserved motifs. To further understand how lysine crotonylation at K136 affected APX (ascorbate peroxidase), we performed a site-directed mutation at K136 in APX. Site-directed crotonylation showed that lysine decrotonylation at K136 reduced APX activity, and lysine complete crotonylation at K136 increased APX activity.Conclusion: In summary, our study comparatively analyzed proteome-wide and crotonylation in chrysanthemum under low-temperature stress and provided insights into the mechanisms of crotonylation in positively regulated APX activity to reduce the oxidative damage caused by low-temperature stress. These data provided an important basis for studying crotonylation to regulate antioxidant enzyme activity in response to low-temperature stress and a new research ideas for chilling-tolerance and freezing-tolerance chrysanthemum molecular breeding.
Evaluation of efficacy and safety of percutaneous transforaminal endoscopic surgery (PTES) for surgical treatment of calcified lumbar disc herniation: a retrospective cohort study of 101 patients
Authors: Wang Hao , Zhou Tianyao , Gu Yutong , Yan Zuoqin
Published: January 2021

Background: Percutaneous transforaminal endoscopy has been widely used to treat lumbar disc herniation (LDH), but the steep learning curve and difficulties in removing the calcified disc hinders the application of conventional endoscopy in treating calcified lumbar disc herniation (CLDH). In 2017, we first reported Percutaneous Transforaminal Endoscopic Surgery (PTES) as an easy-to-learn posterolateral transforaminal endoscopic technique to decompress the nerve root for LDH. We used our PTES technique to remove the calcified LDH and the purpose of this study is to evaluate the safety and efficacy of this technique.Methods: Forty-six patients with CLDH and fifty-five patients with uncalcified lumbar disc herniation (ULDH) underwent PTES to decompress the nerve root. Visual analogue scale was collected before the surgery, immediately, one week, one month, two months, three months, six months, 12 months and 24 months after surgery. The outcomes of MacNab classification were collected 24 months after surgery. Intra- and Post-operative complications were also recorded.Results: For CLDH patients, the VAS score was 9 (5-10) before operation, and then dropped to 2 (1-4) after surgery. VAS score continually decreased to 0 (0-3) at 24 months after surgery. 95.65% of CLDH patients showed excellent or good outcomes. ULDH group showed similar MacNab classification (94.55%) and VAS changing curve. The therapeutic effect of PTES in treating CLDH was as good as that in treating uncalcified patients.Conclusion: PTES is an effective and safe method to treat calcified lumbar disc herniation.
Persistently higher serum sCD40L levels are associated with outcome in septic patients
Authors: Liang Yingjian , Zhu Chengrui , Sun Yini , Li Zhiliang , Wang Liang , Liu Yina , Li Xin , Ma Xiaochun
Published: January 2021

Background: Soluble CD40 ligand (sCD40L) exhibits proinflammatory and procoagulant effects. Recent data indicated that sCD40L plays a significant role in septic patients. The aim of the present study was to determine sCD40L changes in surgical patients without sepsis (SWS) and in surgical sepsis patients (SS) during the first three days at intensive care unit (ICU) admission and to observe the association between sCD40L and mortality.Methods: Time changes in sCD40L levels were assessed for 3 days after ICU admission in 49 patients with SS and compared with 19 SWS patients. Serum sCD40L concentration was detected by ELISA. Survival at 28 days was used as the endpoint.Results: SS had significantly higher sCD40L levels than SWS and control patients. We observed an association between sCD40L levels ≥1028.75 pg/ml at day 2 and 28-day mortality (odds ratio = 7.888; 95% confidence interval = 1.758 to 35.395; P= 0.007). We could not discover any significant differences in gender, presence of septic shock, site of infection, length of stay in the ICU, PaO2/FiO2 ratio, incidence of AKI, ARDS, or type of surgery between nonsurvivors and survivors.Conclusions: Septic patients show persistently higher circulating sCD40L levels in the first three days at ICU admission, and the serum sCD40L levels are associated with the mortality of patients with sepsis; thus, serum sCD40L may be used as a reliable biomarker and therapeutic target in sepsis.
Improving the Accuracy of Text Classification using Stemming Method, A Case of Non-Formal Indonesian Conversation
Authors: Rianto Rianto , Mutiara Achmad Benny , Wibowo Eri Prasetyo , Santosa Paulus Insap
Published: January 2021

Background: Stemming has long been used in data pre-processing to retrieve information by tracking affixed words back into their root. In an Indonesian setting, existing stemming methods have been observed, and the existing stemming methods are proven to result in high accuracy level. However, there are not many stemming methods for non-formal Indonesian text processing. This study introduces a new stemming method to solve problems in the non-formal Indonesian text data pre-processing. Furthermore, this study aims to improve the accuracy of text classifier models by strengthening stemming method. Using the Support Vector Machine algorithm, a text classifier model is developed, and its accuracy is checked. The experimental evaluation was done by testing 550 datasets in Indonesian using two different stemming methods. Findings: The results show that using the proposed stemming method, the text classifier model has higher accuracy than the existing methods with a score of 0.85 and 0.73, respectively. These results indicate that the proposed stemming methods produces a classifier model with a small error rate, so it will be more accurate to predict a class of objects. Conclusion: The existing Indonesian stemming methods are still oriented towards Indonesian formal sentences, therefore the method has limitations to be used in Indonesian non-formal sentences. This phenomenon underlies the suggestion of developing a corpus by normalizing Indonesian non-formal into formal to be used as a better stemming method. The impact of using the corpus as a stemming method is that it can improve the accuracy of the classifier model. In the future, the proposed corpus and stemming methods can be used for various purposes including text clustering, summarizing, detecting hate speech, and other text processing applications in Indonesian.
Statistical analysis of ionospheric total electron content (TEC): Long-term estimation of extreme TEC in Japan
Authors: Nishioka Michi , Saito Susumu , Tao Chihiro , Shiota Daikou , Tsugawa Takuya , Ishii Mamoru
Published: January 2021

Ionospheric total electron content (TEC) is one of the key parameters for users of radio-based systems, such as the Global Navigation Satellite System, high-frequency communication systems, and space-based remote sensing systems, since total ionospheric delay is proportional to TEC through the propagation path. It is important to know extreme TEC values in readiness for hazardous ionospheric conditions. The purpose of this study is to estimate extreme TEC values with occurrences of once per year, ten years, and hundred years in Japan. In order to estimate the extreme values of TEC, a cumulative distribution function of daily TEC is derived using 22 years of TEC data from 1997 to 2018. The extreme values corresponding to once per year and ten years are 90 and 110 TECU, respectively, in Tokyo, Japan. On the other hand, the 22-year data set is not sufficient to estimate the once-per-hundred-year value. Thus, we use the 62-year data set of manually scaled ionosonde data for the critical frequency of the F-layer (foF2) at Kokubunji in Tokyo. First, we study the relationship between TEC and foF2 for 22 years and investigate the slab thickness. Then the result is applied to the statistical distribution of foF2 data for 62 years. The result shows that the once-per-100-year TEC is about 130-190 TECU at Tokyo. The value is also estimated to be 160-230 TECU in Kagoshima and 100-150 TECU in Hokkaido, in the southern and northern parts of Japan, respectively.
Thetha Nami : Participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and youth in rural South Africa
Authors: Shahmanesh Maryam , Okesola Nonhlanhla , Chimbindi Natsayi , Zuma Thembelihle , Mthiyane Nondumiso , Adeagbo Oluwafemi , Dreyer Jaco , Herbst Carina , Mdl Sakhile , McGrath Nuala , Harling Guy , Sherr Lorraine , Seeley Janet
Published: January 2021

Background: Despite effective biomedical tools, HIV remains the largest cause of morbidity/mortality in South Africa – especially among adolescents and young people. We used community-based participatory research (CBPR) informed by principles of social justice, to develop a peer-led biosocial intervention for HIV prevention in rural KwaZulu-Natal (KZN). Methods: Between March 2018 and September 2019 we used CBPR to iteratively co-create and contextually adapt a biosocial peer-led intervention to support HIV prevention. Men and women aged 18-30 years were selected by community leaders of 21 intervention implementation areas (izigodi) and underwent 20 weeks of training as peer-navigators. We synthesised quantitative and qualitative data collected during a 2016-2018 study into 17 vignettes illustrating the local drivers of HIV. During three participatory intervention development workshops and community mapping sessions, the peer-navigators critically engaged with vignettes, brainstormed solutions and mapped the components to their own izigodi. The intervention components were plotted to a Theory of Change which, following a six-month pilot and process evaluation, the peer-navigators refined. The intervention will be evaluated in a randomised controlled trial (NCT04532307).Results: Following written and oral assessments, 57 of the 108 initially selected participated in two workshops to discuss the vignettes and co-create the Thetha Nami (`talk to me’). The intervention. included peer-led health promotion to improve self-efficacy and demand for HIV prevention, referrals to social and educational resources, and aaccessible youth-friendly clinical services to improve uptake of HIV prevention. During the pilot the peer-navigators approached 6871 young people, of whom 6141 (89%) accepted health promotion and 438 linked to care. During semi-structured interviews peer-navigators described the appeal of providing sexual health information to peers of a similar age and background but wanted to provide more than just “onward referral”. In the third participatory workshop 54 peer-navigators refined the Thetha Nami intervention to add three components structured assessment tool to tailor health promotion and referrals; safe spaces and community advocacy to create an enabling environment; peer-mentorship and navigation of resources to improve retention in HIV prevention. Conclusion: Local youth were able to use evidence to develop a contextually adapted peer-led intervention to deliver biosocial HIV prevention.
Sequential bilateral Behçet’s neuroretinitis associated with prepapillary vitreous exudate: case report
Authors: Ksiaa Imen , Aoun Safa Ben , Zina Sourour , Nefzi Dhouha , Khochtali Sana , Khairallah Moncef
Published: January 2021

Objective: To describe a case of Behçet disease (BD) uveitis manifesting with sequential bilateral neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE). Material and Methods: A single case report documented with multimodal imaging.Results: A 37-year-old man developed neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but one year later a similar neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy. SS OCT showed at the acute phase in both eyes a typical “mushroom-shaped” prepapillary hyperreflectivity of the PIVE. SS OCTA demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects.Conclusion: Sequential bilateral neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.
Maternal Health Care Service utilization among Young Married Women in India, 1992-2016: Trends and determinants
Authors: Singh Pooja , Singh Kaushalendra Kumar , Singh Pragya
Published: January 2021

Background: Maternal deaths among young women (15-24 years) shares 38% of total maternal mortality in India. Utilizing maternal health care services can reduce a substantial proportion of maternal mortality. However, there is a paucity of studies focusing on young women in this context. This paper therefore aimed to examine the trends and determinants of full antenatal care (ANC) and skilled birth attendance (SBA) utilization among young married women in India.Methods: The study analysed data from the four rounds of National Family Health Surveys conducted in India during the years 1992–93, 1998–99, 2005–06 and 2015–16. Young married women aged 15-24 years with at least one live birth in the three years preceding the survey were considered for analysis in each survey round. We used descriptive statistics to assess the prevalence and trends in full ANC and SBA use. Pooled multivariate logistic regression was conducted to identify the demographic and socioeconomic determinants of the selected maternity care services.Results: The use of full ANC among young mothers increased from 27% to 46% in India, and from 9% to 28% in EAG (Empowered Action Group) states during 1992-2016. SBA utilization was 88% and 83% during 2015-16 by showing an increment of 20% and 50% since 1992 in India and EAG states, respectively. Findings from multivariate analysis revealed significant difference in the use of selected maternal health care services by maternal age, residence, education, birth order and wealth quintile. Additionally, Muslim women, women belonging to scheduled caste (SC)/ scheduled tribe (ST) social group, and women unexposed to mass media were less likely to utilize both the maternal health care services. Concerning the time effect, the odds of the utilization of full ANC and SBA among young women was found to increase over time.Conclusions: Utilization of full ANC remained unacceptably low, specifically in EAG states. Programmatic interventions, targeting women residing in EAG states, adolescents, illiterate, poor and Muslim and SC/ST women would help to increase full ANC utilization and to maintain the increasing trend of SBA use.
Computer-Based Alcohol Reduction Intervention for Alcohol-Using HIV/HCV Co-Infected Russian Women in Clinical Care: Study Protocol for a Randomized Controlled Trial
Authors: DiClemente Ralph J. , Brown Jennifer L. , Capasso Ariadna , Revzina Natalia , Sales Jessica M. , Boeva Ekaterina , Gutova Lyudmila V. , Khalezova Nadia B. , Belyakov Nikolay , Rassokhin Vadim
Published: January 2021

Background: Russia has a high prevalence of HIV. In 2018, over one million persons were living with HIV (PLWH); over a third were women. A high proportion of HIV-infected women are co-infected with Hepatitis C virus (HCV); and many consume alcohol, which adversely affects HIV and HCV treatment and prognosis. In spite of the triple epidemics of alcohol use, HIV and HCV, and the need for interventions to reduce alcohol use among HIV/HCV co-infected women, evidence-based alcohol reduction interventions for this vulnerable population are limited. To address this gap, we developed a clinical trial to evaluate the efficacy of a computer-based intervention to reduce alcohol consumption among HIV/HCV co-infected women in clinical care. Methods: In this two-arm parallel randomized clinical trial, we propose to evaluate the efficacy of a culturally-adapted alcohol reduction intervention delivered via a computer for HIV/HCV co-infected Russian women. The study population consists of women 21-45 years old, with confirmed HIV/HCV co-infection who currently use alcohol. Intervention efficacy is assessed by a novel alcohol biomarker, ethyl glucuronide (EtG) and biomarkers of HIV and HCV disease progression. Women are randomized to trial conditions in a 1:1 allocation ratio, using a computer-generated algorithm to develop the assignment sequence, and concealment of allocation techniques to minimize assignment bias. Women are randomized to either: (1) the computer-based alcohol reduction intervention, or (2) the standard-of-care control condition. We will use an intent-to-treat analysis and logistic and linear generalized estimating equations to evaluate intervention efficacy, relative to the standard-of-care, in enhancing the proportion of women with a laboratory-confirmed negative EtG at each research study visit over the 9-month follow-up period. Additional analyses will evaluate intervention effects on HIV (viral load, and CD4+ levels), and HCV markers of disease progression (FibroScan).Discussion: The proposed trial design and analysis provides an appropriate conceptual and methodological framework to assess the efficacy of the computer-based intervention. We propose to recruit 200 participants. The intervention, if efficacious, may be an efficient and cost-effective alcohol reduction strategy that is scalable and can be readily disseminated and integrated in clinical care in Russia to reduce women’s alcohol consumption and enhance HIV/HCV prognosis.Trial registration: ClinicalTrials.gov, NCT03362476. Registered 5 December 2017, https://clinicaltrials.gov/ct2/show/NCT03362476
Effect of GreenshellTM Mussel on the Osteoarthritis Biomarkers and Inflammation in Healthy Postmenopausal Women: A Study Protocol for Randomized Double ‑ Blind Placebo ‑ Controlled Trial
Authors: Abshirini Maryam , Coad Jane , Wolber Frances M. , von Hurst Pamela , Miller Matthew R , Tian Hong Sabrina , Kruger Marlena C
Published: January 2021

Background: New Zealand Greenshell™ mussels (GSM; Perna canaliculus) has recently been shown to decrease cartilage degradation in a rat model of induced metabolic osteoarthritis (MetOA). However, this effect has not been investigated in human subjects. This study aims to determine the effect of GSM powder on biomarkers of cartilage metabolism, bone resorption, and inflammation in New Zealand healthy overweight/obese postmenopausal women. Method: Fifty overweight or obese (BMI 25-35 kg/m2) postmenopausal women (aged 55-75 years) will be recruited. They will be randomly assigned to receive 3 g/d whole meat GSM powder or placebo (sunflower seed protein) for 12 weeks. Data on socio-demographics, physical activity and dietary intake will be collected for each subject. Cartilage turnover biomarkers [(C-telopeptide of type II collagen (CTX-II), C-propeptide of type II procollagen (CPII), Cartilage oligomeric matrix protein (COMP)], and bone resorption marker (CTX-I) will be measured in blood and urine samples. Inflammatory status (hs-CRP and cytokine panel) will be assessed and iron status will be measured. Body composition including fat mass (FM), lean mass (LM) and fat percentage will be measured using dual-energy X-ray absorptiometry (DXA). Joint pain and knee function will be assessed using a 100 mm Visual Analogue Scale (VAS) and the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire, respectively.Discussion: This trial will be the first to explore the effects of whole meat GSM powder on cartilage turnover, bone resorption and inflammation biomarkers in overweight/obese postmenopausal women. The results from this trial will provide evidence on the efficacy of GSM in prevention of OA. Trial registration: The study was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) with the number ACTRN12620000413921p. Registration date: 27/03/2020. https://www.anzctr.org.au/Trial/Update/Step1_Update.aspx?id=379291
The spread of COVID-19 outbreak in the first 120 days: A comparison between Nigeria and seven other countries
Authors: Adebowale Ayo Stephen , Fagbamigbe Adeniyi Francis , Akinyemi Joshua Odunayo , Obisesan Olalekan K , Awosanya Emmanuel J , Afolabi Rotimi Felix , Alarape Selim A , Obabiyi Sunday O
Published: January 2021

Background: COVID-19 is an emerging public health emergency of international concern. The trajectory of the global spread is worrisome, particular in heavily populated countries such as Nigeria. The study objective was to assess and compare the pattern of COVID-19 spread in Nigeria and seven other countries during the first 120 days of the outbreak. Methods: Data was extracted from the World Bank’s website. A descriptive analysis was conducted as well as modelling of COVID-19 spread from day one through day 120 in Nigeria and seven other countries. Model fitting was conducted using linear, quadratic, cubic and exponential regression methods (α=0.05). Results: The COVID-19 spread pattern in Nigeria was similar to the patterns in Egypt, Ghana and Cameroun. The daily death distribution in Nigeria was similar to those of six out of the seven countries considered. There was an increasing trend in the daily COVID-19 confirmed cases in Nigeria. During the lockdown, the growth rate in Nigeria was 5.85 (R2=0.728, p<0.001); however, it was 8.42 (R2=0.625, p<0.001) after the lockdown was relaxed. The cubic polynomial model (CPM) provided the best fit for predicting COVID-19 cumulative cases across all the countries investigated and there was a clear deviation from the exponential growth model. Using the CPM, the predicted number of cases in Nigeria at 3-month (30 September 2020) was 155,467 (95% CI:151,111-159,824, p<0.001), all things being equal. Conclusions: Improvement in COVID-19 control measures and strict compliance with the COVID-19 recommended protocols are essential. A contingency plan is needed to provide care for the active cases in case the predicted target is attained.
High-intensity focused ultrasound enhances the cisplatin sensitivity to human non-small cell lung cancer in vitro and in vivo
Authors: Wang Liwei , Fan Huijun , Wang Haiyan , Bai Yunlu , Zhou Wenyan
Published: January 2021

BackgroundThe incidence and mortality of non-small cell lung cancer (NSCLC) rank first among malignant tumors worldwide. Cisplatin (CDDP) is currently the first-line chemotherapy drug used in clinical practice. However, the underlying mechanism that NSCLC cells are resistant to CDDP has not been fully elucidated. Therefore, it is urgent to explore the exact function of chemotherapy resistance and improve the anti-tumor effect of CDDP treatment.MethodWe investigated the surviving fraction of H1299 and A549 cells treated with different High-intensity focused ultrasound (HIFU) and various CDDP concentrations. HIFU (400W/cm2) and CDDP (10 μM) were selected to probe the further function in H1299 and A549 cells. Flow cytometry, MTT, and colony formation assays were performed to evaluate the apoptosis and proliferative effect of HIFU and CDDP on NSCLC cells. Transwell assays were used to analyze the migration and invasion abilities of NSCLC cells with HIFU and CDDP treatments. Platinum (Pt) accumulation was further measured in H1299 and A549 cells with different treatments. Finally, An NSCLC patient-derived xenograft model was used to explore the effect of HIFU and CDDP on NSCLC tumor growth.ResultsHIFU combined with CDDP can markedly reduce the surviving rate and promote the apoptosis of NSCLC cells. Furthermore, co-treatment with HIFU and CDDP significantly inhibited the proliferation, colony formation, migration, and invasion of NSCLC cells compared to that with any single treatment. Moreover, the combined therapy can effectively promote Pt accumulation in NSCLC cells. Further functional analysis suggested that HIFU combined with CDDP can inhibit tumor growth in an NSCLC patient-derived xenograft model. Finally, the CDDP method effectively upregulated the expression level of apoptosis-related protein, cleaved-PARP, which could be further enhanced by the HIFU treatment.ConclusionOur results revealed that HIFU enhances the anti-NSCLC effect of CDDP both in vitro and in vivo, providing a promising combination therapy for clinical NSCLC treatment.
The feasibility of bedside ultrasound in confirmation of Endotracheal tube position in neonates compared with CXR 
Authors: Khalesi Nasrin , Dehgan Marzie , Zarei Elham
Published: January 2021

Background: Endotracheal intubation is a common procedure in the neonatal intensive care unit (NICU). Rapid and accurate confirmation of the endotracheal tube (ETT) position is critical . Routinely CXR is used for evaluation of ETT position that has some disadvantages . So there has been a considerable interest to find alternative modality with minimal complication and acceptable accuracy. The purpose of our study is the evaluation of ultrasound efficacy in confirmation of ETT position in neonates comparison to CXR.Methods: This cross-sectional study was conducted on 66 intubated neonates in NICU of Ali -Asghar children Hospital, between January 2018 and January 2019. To determine the ETT position, CXR and ultrasound were requested at the same time and only patients who could have an ultrasound immediately after intubation and without repositioning of tracheal tube between CXR and ultrasound were included in the study .Each neonate had a bedside ultrasound (US) with a high-frequency linear transducer. Accuracy, sensitivity, specificity, negative predicted value (NPV), positive predicted value (PPV) and Kappa agreement coefficient was used to compare the US and CXR results.Results: Sixty-six intubated neonates included in this study had a mean gestational age of 34.98 ±3.7 weeks and mean birth weight of 2284.7 ± 915g. US images were taken a mean of 3 ±0.6 h after CXR. The ETT was visualized by the US in all newborns examined.US revealed a sensitivity of 88% (95% CI, 68.78% to 97.45%), specificity of 84 % (95% CI, 63.92% 95.46%), PPV of 84.62% (95% CI, 68.89% to 93.18%), NPV of 87.50 % (95% CI, 70.49% to 95.35%), diagnostic accuracy of 86%(95% CI, 73.26% to 94.18%), positive likelihood ratio of 5.50 (95% CI 2.21 to 13.66), and Negative Likelihood Ratio of 0.14 (95% CI 0.05 to 0.46) compared to chest radiography. Overall, the Kappa value showed very good agreement in confirming the correct position of the tracheal tube placement (Kappa coefficient 0.72, p-value <0.001).The mean time taken for confirmation of ETT position by US 4 minutes and by CXR was 20 minutes.Conclusion: The findings of this study demonstrate ultrasound has acceptable accuracy for confirmation of ETT position in neonates and is a safer and faster method in comparison to CXR .
Anxiety amongst physicians during COVID-19: Cross-sectional study in Pakistan
Authors: Mahmood Qaisar Khalid , Jafree Sara Rizvi , Jalil Aisha , Nadir Syed Mujtaba Hasnain , Fischer Florian
Published: January 2021

Background: Ensuring safety and wellbeing of healthcare providers is crucial, particularly during times of a pandemic. In this study, we aim to identify the determinants of anxiety in physicians on duty in coronavirus wards or quarantine centers. Methods: We conducted a cross-sectional quantitative survey with an additional qualitative item. Five constructs of workload, exhaustion, family strain, feeling of protection, and anxiety were measured using items from two validated tools. Modifications were made for regional relevance. Factor analysis was performed showing satisfactory Cronbach alpha results. Overall, 103 physicians completed the questionnaire. Results: T-test results revealed significant associations between gender and anxiety. Structural equation modeling identified that high workload contributed to greater exhaustion (β=0.41, R2=0.17, p<0.001) and greater family strain (β=0.47, R2=0.22, p<0.001). Exhaustion (β=0.17, p<0.005), family strain (β=0.34, p<0.001), and feelings of protection (β=-0.30, p<0.001) significantly explained anxiety (R2=0.28). Qualitative findings further identified specific needs of physicians with regard to protective equipment, compensation, quarantine management, resource allocation, security and public support, governance improvement, and health sector development. Conclusions: It is imperative to improve governmental and social support for physicians and other healthcare providers during the corona pandemic. Immediate attention is needed to reduce anxiety, workload, and family strain in frontline practitioners treating coronavirus patients, and to improve their (perceptions of) protection. This is a precondition for patient safety.
Broad-range and Effective Detection of Human Noroviruses by Colloidal Gold Immunochromatographic Assay Based on the Shell Domain of the Major Capsid Protein
Authors: Xu Meng , Lu Feifeng , Lyu Chenang , Wu Qingping , Zhang Jumei , Tian Peng , Xue Liang , Xu Ting , Wang Dapeng
Published: January 2021

Background: Human noroviruses (HuNoVs) are a major cause of nonbacterial gastroenteritis in all age groups worldwide. HuNoVs can be detected in vitro using molecular assays such as RT-PCR and RT-qPCR. However, these molecular-based techniques require special equipment, unique reagents, experienced personnel, and extended time to obtain results. Besides, the diversity of viral genotypes is high. Therefore, methods that are rapid, broad-range and effective in the detection of HuNoVs are desiderated for screening the feces or vomit of infected people during outbreaks.Results: In this study, a colloidal-gold-based immunochromatographic assay (ICA) was developed for effective detection of HuNoVs in clinical samples. Monoclonal antibodies (MAbs) against the shell (S) domain in the major capsid protein of HuNoVs were used in the ICA. The limitations of detection for HuNoVs in clinical samples were 1.2×106 genomic copies per gram of stool sample (gc/g) and 4.4×105 gc/g for genogroup I and II (GI and GII) HuNoVs, respectively. A total of 122 clinical samples were tested for HuNoVs by ICA and compared against RT-qPCR. The relative sensitivity, specificity and agreement of ICA was 84.2 % (95% CI: 83.6-84.8 %), 100.0 % (95 % CI: 98.5-100.0 %) and 87.7 % (95% CI: 85.6-89.8 %), respectively. No cross-reaction with other common enteric viruses or bacteria was observed. The ICA detected a broad range of genotypes, including GI.1, GI.3, GI.4, GI.6, GI.14, GII.2, GII.3, GII.4, GII.6, GII.13, and GII.17 HuNoVs.Conclusions: This study demonstrates that ICA targeting the S domain of VP1 is a promising candidate for effectively identifying the different genotypes of HuNoVs in clinical samples with high sensitivity and specificity.
Low serum parathyroid hormone is a risk factor for peritonitis episodes in incident peritoneal dialysis patients: a retrospective study
Authors: Yang Yuqi , Da Jingjing , Jiang Yi , Yuan Jing , Zha Yan
Published: January 2021

Background: Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear.Methods: We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH<150pg/mL; middle-PTH group, PTH=150-300pg/mL; high-PTH group, PTH>300pg/mL.Results: During a median follow-up of 29.5 (interquartile range 16-49) months, the incidence rate of peritonitis was 0.10 episodes per patient-year. Gram-positive organisms were the most common causative microorganisms (36.2%), and higher percentage of Gram-negative organisms was noted in patients with low PTH levels. Low PTH levels were associated with older age, higher eGFR, higher hemoglobin, calcium levels and lower phosphate, alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014-2.663, P=0.044].Conclusions: Low PTH levels are independently associated with peritonitis in incident PD patients.
Brief problem-solving therapy for antenatal depressive symptoms in primary care in rural Ethiopia: protocol for a randomised, controlled feasibility trial
Authors: Bitew Tesera , Keynejad Roxanne , Myers Bronwyn , Honikman Simone , Medhin Girmay , Girma Fikirte , Howard Louise , Sorsdahl Katherine , Hanlon Charlotte
Published: January 2021

Background: Despite a high prevalence of antenatal depression in low- and middle-income countries, there is very little evidence for contextually adapted psychological interventions delivered in rural African settings. The aims of this study are: (1) to examine the feasibility of procedures for a future fully powered efficacy trial of contextually adapted brief Problem Solving Therapy (PST) for antenatal depression in rural Ethiopia, and (2) to investigate the acceptability, fidelity and feasibility of delivery of PST in routine antenatal care. Methods: Design: A randomized, controlled, feasibility trial and mixed method process evaluation. Participants: Consecutive women attending antenatal clinics in two primary care facilities in rural Ethiopian districts. Eligibility criteria: 1) Disabling levels of depressive symptoms (Patient Health Questionnaire (PHQ-9) score of five or more and positive for the 10th disability item); 2) gestational age 12-34 weeks; 3) aged 16 years and above, 4) planning to live in the study area for at least six months; 5) no severe medical or psychiatric conditions. Intervention: Four sessions of adapted PST delivered by trained and supervised antenatal care staff over a maximum period of eight weeks. Control: enhanced usual care (EUC). Sample size: n=50. Randomisation: individual randomisation stratified by intimate partner violence (IPV). Allocation: central phone allocation. Outcome assessors and statistician masked to allocation status. Primary feasibility trial outcome: dropout rate. Primary future efficacy trial outcome: change in PHQ-9 score, assessed nine weeks after recruitment. Secondary outcomes: anxiety symptoms, trauma symptoms, intimate partner violence, disability, healthcare costs at 9 weeks; postnatal outcomes (perinatal and neonatal complications, onset of breast feeding, child health) assessed 4-6 weeks postnatal. Other trial feasibility indicators: recruitment, number and duration of sessions attended. Audio-recording of randomly selected sessions and in-depth interviews with purposively selected participants, healthcare providers and supervisors will be analysed thematically to explore the acceptability and feasibility of the trial procedures and fidelity of the delivery of PST. Discussion: The findings of the study will be used to inform the design of a fully-powered efficacy trial of brief PST for antenatal depression in routine care in rural Ethiopia. Trial registration: The protocol was registered in the Pan-African clinical trials registry, (PACTR): registration number: PACTR202008712234907 on 18/08/2020; URL: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9578 Funding: This work is supported through the DELTAS Africa Initiative [DEL-15-01].
A Quantitative Discriminant Method of Elbow Point for the Optimal Number of Clusters in Clustering Algorithm
Authors: Shi Congming , Wei Bingtao , Wei Shoulin , Wang Wen , Liu Hai , Liu Jialei
Published: January 2021

Clustering, a traditional machine learning method, plays a significant role in data analysis. Most clustering algorithms depend on a predetermined exact number of clusters, whereas, in practice, clusters are usually unpredictable. Although the Elbow method is one of the most commonly used methods to discriminate the optimal cluster number, the discriminant of the number of clusters depends on the manual identification of the elbow points on the visualization curve. Thus, experienced analysts cannot clearly identify the elbow point from the plotted curve when the plotted curve is fairly smooth. To solve this problem, a new elbow point discriminant method is proposed to yield a statistical metric that estimates an optimal cluster number when clustering on a dataset. First, the average degree of distortion obtained by the Elbow method is normalized to the range of 0 to 10. Second, the normalized results are used to calculate the cosine of intersection angles between elbow points. Third, this calculated cosine of intersection angles and the arccosine theorem are used to compute the intersection angles between elbow points. Finally, the index of the above computed minimal intersection angles between elbow points is used as the estimated potential optimal cluster number. The experimental results based on simulated datasets and a well-known public dataset (Iris Dataset) demonstrated that the estimated optimal cluster number obtained by our newly proposed method is better than the widely used Silhouette method.
Identification and Analysis of Long Non-coding RNAs and mRNAs in Chicken Macrophages Infected with Avian Infectious Bronchitis Coronavirus
Authors: Li Hao , Cui Pengfei , Fu Xue , Zhang Lan , Yan Wenjun , Zhai Yaru , Lei Changwei , Wang Hongning , yang xin
Published: January 2021

Background: Avian infectious bronchitis virus (IBV) is a gamma coronavirus that severely affects the poultry industry worldwide. Long non-coding RNAs (lncRNAs), a subset of non-coding RNAs with a length of more than 200 nucleotides, have been recently recognized as pivotal factors in the pathogenesis of viral infections. However, little is known about the function of lncRNAs in host cultured cells in response to IBV infection.Results: We used next-generation high throughput sequencing to reveal the expression profiles of mRNAs and lncRNAs in IBV-infected HD11 cells. Compared with the uninfected cells, we identified 153 differentially expressed (DE) mRNAs (106 up-regulated mRNAs, 47 down-regulated mRNAs) and 181 DE lncRNAs (59 up-regulated lncRNAs, 122 down-regulated lncRNAs) in IBV-infected HD11 cells. Moreover, gene ontology (GO) and pathway enrichment analyses indicated that DE mRNAs and lncRNAs were mainly involved in cellular innate immunity, amino acid metabolism, and nucleic acid metabolism. In addition, 2,640 novel chicken lncRNAs were identified, and a competing endogenous RNA (ceRNAs) network centered on gga-miR-30d and miR-146a-5p was established. Conclusions: We identified expression profiles of mRNAs and lncRNAs during IBV infection that provided new insights into the pathogenesis of IBV.
Distinction between vaginal and cervical microbiota in high-risk human papilloma virus infected women in China
Authors: Zhang Zhan , Li Ting , Zhang Dai , Zong Xiaonan , Bai Huihui , Bi Hui , Liu Zhaohui
Published: January 2021

Background: High-risk human papilloma virus (hrHPV) is regarded as the main causal factor of cervical precancer and cancer when persistent infection is left untreated. Previous researches have confirmed that the vaginal microbiota was associated with HPV infection and the development of cervical lesions. A very recent study has revealed the microbiota at different parts of the female genital tract was closely related but different from each other. To analyze the distinction between vaginal and cervical microbiota of hrHPV(+) women in China, one hundred subjects were recruited including 20 healthy controls without HPV infection, 32 with other hrHPV(+), 38 with HPV16/18(+) and 10 with cervical carcinoma. Vaginal and cervical microbiota were separately tested through next-generation sequencing technology (NGS) targeting the variable region (V3-V4) of bacterial ribosome 16S rRNA gene. Results: HrHPV(+) subjects tend to be accustomed to vaginal douching (p =0.001), show more frequent usage of sanitary pads (p =0.007), have more sex partners (p =0.047), be more sexually active (p =0.025) and more diversed in ways of contraception (p =0.001). Alpha diversity of cervical microbiota was higher than that of vagina. Cervical microbiota consisted a lower percentage of Firmicutes and a higher percentage of Proteobacteria compared to the vagina at the phylm level. Sphingomonas of α-Proteobacteria was almost below detection limit in the vagina whereas accounted for five to ten percent at hrHPV(-) cervix (P＜0.001) and reversely associated with hrHPV infection (P＜0.05). Pseudomonas of γ-Proteobacteria could hardly be seen in the normal vagina and shared a little bit percentage in the normal cervix, but significantly higher in the HPV16/18 infected (P＜0.001) and cancerous cervix (P＜0.05). BV associated anaerobes like Gardnerella, Prevotella, Atopobium and Sneathia did not exhibit cervical specificity.Conclusions: Cervical microbiota has its uniqueness from that of vagina in bacterial communities presenting a higher proportion of Proteobacteria, of which Pseudomonas is positively while Sphingomonas was negatively associated with hrHPV infection and cervical cancer. It is of great improtance to deeply explore the cervical microbiota of hrHPV infected women.
Sociodemographic, health-related, and social predictors of subjective well-being among Chinese oldest-old: a national community-based cohort study
Authors: Cheng Gang , Yan Yan
Published: January 2021

Background: There is still a lack of a relatively comprehensive multifactor analysis of subjective well-being (SWB) among Chinese oldest-old. This study aimed to explore sociodemographic, health-related, and social predictors of SWB among Chinese oldest-old using a large and representative sample.Methods: The study included 49,069 individuals aged 80 and older from the Chinese Longitudinal Healthy Longevity Survey, a prospective, nationwide, community-based study conducted from 1998 to 2014. SWB was measured by eight items covering life satisfaction, positive affect (optimism, happiness, personal control, and conscientiousness), and negative affect (anxiety, loneliness, and uselessness). Generalized estimating equation models were used to explore the predictors of SWB.Results: We found that age, gender, ethnic group, education, primary occupation before retirement, current marital status, and place of residence were sociodemographic predictors of SWB among the Chinese oldest-old. The health-related predictors included self-rated health, visual function, hearing function, diet quality, smoking status, drinking status, and exercise status. SWB was influenced by some social factors, such as the number of biological siblings, the number of children, leisure activities, financial independence, and access to adequate medical service. In particular, self-rated health, access to adequate medical services, exercise status, and place of residence exert a stronger effect than other factors.Conclusions: SWB in the oldest-old is influenced by a large number of complex sociodemographic, health-related, and social factors. Special attention should be paid to the mental health of centenarians, women, rural residents, widowed, physically disabled, and childless oldest-old people. Relevant agencies can improve physical activities, leisure activities, financial support, and medical services to promote the well-being of the oldest-old.
Acupuncture for Comorbid Mild-Moderate Depression and Chronic Musculoskeletal Pain: Study Protocol for A Randomized Controlled Trial
Authors: Li sheng , Liu Jing , Huang Jianpeng , Luo Ding , Wu Qian , Ning Baile , Chen Ling , Liu Jianhua , Fu Wen-Bin
Published: January 2021

Background: Depression and Chronic musculoskeletal pain (CMSP) are the leading causes of global years lived with disability diseases. Moreover, they often commonly coexist, which made a great difficult to diagnosis and treatment. A safe and effective treatment was urgently need. Previous studies showed that acupuncture was a cost-effective treatment for simple depression or CMSP. But limited evidence showed that acupuncture was effective for depression comorbid CMSP. Methods: This is a randomized, sham acupuncture-controlled trial with three arms: real acupuncture (RA), sham acupuncture (SA) and healthy control (HC). 48 depression combined CMSP participants and 12 healthy people will be recruited from GDTCM hospital and randomized 2:2:1 to RA, SA, HC group. The patients will receive RA or SA intervention for 8 weeks, and HC will not receive any intervention. Upon completion of the intervention, there is a 4 weeks follow-up. The primary outcome measures will be severity of depression and pain which assessed by Hamilton depression rating scale (HAMD-17) and brief pain inventory (BPI), respectively. The secondary outcome measures will be cognitive function, and quality of life which measured by Montreal cognitive assessment (MoCA), P300 and world health organization quality of life (WHOQOL-BREF). In addition, the correlation between brain derived neurotrophic factor (BDNF) and symptoms will also be determined. Discussion: The aim of this study is to evaluate the clinic efficacy and underlying mechanism of acupuncture on depression comorbid CMSP. This study will provide a convenient and cost-effectively means for future prevention and treatment of combined depression and CMSP.Trial registration: This study pre-registered at 2th Feb 2018, at Chinese Clinical Trail Registry (ChiCTR1800014754). The study is on the recruiting status.