bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing Charlson and Elixhauser comorbidity indices with different weightings to predict in-hospital mortality: an analysis of national inpatient data
Authors: Sharma Narayan , Schwendimann René , Endrich Olga , Ausserhofer Dietmar , Simon Michael
Published: September 2020

Background: Understanding how comorbidity measures contribute to patient mortality are essential both to describe patient health status and to adjust for risks and potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, a different set of comorbidity weights might improve the prediction of in-hospital mortality. The present study, therefore, aimed to derive a set of new population-based Elixhauser comorbidity weightings, to validate and compare them against those of the Charlson and Elixhauser-based van Walraven weightings in an adult in-patient population-based cohort of general hospitals. Methods: Retrospective analysis was conducted with routine data of 102 Swiss general hospitals (2012–2017) for 6.09 million inpatient cases. To derive the population-based weightings for the Elixhauser comorbidity index, we randomly halved the inpatient data and validated the results of part 1 alongside the established weighting systems in part 2, to predict in-hospital mortality. Charlson and van Walraven weightings were applied to Charlson and Elixhauser comorbidity indices. Derivation and validation of weightings were conducted with generalized additive models adjusted for age, gender and hospital types. Results: Overall, the population-based weights’ c-statistic (0.867, 95% CI: 0.865–0.868) was consistently, yet minimally higher than Elixhauser-van Walraven’s (0.863, 95% CI: 0.862-0.864) and Charlson’s (0.850, 95% CI: 0.849–0.851) in the derivation and validation groups. The net reclassification improvement of new weights improved the predictive performance by 1.6% on the Elixhauser-van Walraven and 4.9% on the Charlson weightings.Conclusions: All weightings confirmed previous results with the national dataset. The new population-based weightings model improved slightly the prediction of in-hospital mortality in Swiss hospitals. The newly derive weights support patient population-based analysis of in-hospital mortality and seek country or specific cohort-based weightings.
The interplay between host genetics and the gut microbiome reveals common and distinct microbiome features for complex human diseases
Authors: Xu Fengzhe , Fu Yuanqing , Sun Tingyu , Jiang Zengliang , Miao Zelei , Shuai Menglei , Gou Wanglong , Ling Chuwen , Yang Jian , Wang Jun , Chen Yu-ming , Zheng Ju-Sheng
Published: September 2020

Background Interest in the interplay between host genetics and the gut microbiome in complex human diseases is increasing, with prior evidence mainly being derived from animal models. In addition, the shared and distinct microbiome features among complex human diseases remain largely unclear.Results This analysis was based on a Chinese population with 1,475 participants. We estimated the SNP-based heritability, which suggested that Desulfovibrionaceae and Odoribacter had significant heritability estimates (0.456 and 0.476, respectively). We performed a microbiome genome-wide association study to identify host genetic variants associated with the gut microbiome. We then conducted bidirectional Mendelian randomization analyses to examine the potential causal associations between the gut microbiome and complex human diseases. We found that Saccharibacteria could potentially decrease the concentration of serum creatinine and increase the estimated glomerular filtration rate. On the other hand, atrial fibrillation, chronic kidney disease and prostate cancer, as predicted by host genetics, had potential causal effects on the abundance of some specific gut microbiota. For example, atrial fibrillation increased the abundance of Burkholderiales and Alcaligenaceae and decreased the abundance of Lachnobacterium, Bacteroides coprophilus, Barnesiellaceae, undefined genus in family Veillonellaceae and Mitsuokella. Further disease-microbiome feature analysis suggested that systemic lupus erythematosus and chronic myeloid leukaemia shared common gut microbiome features.Conclusions These results suggest that different complex human diseases share common and distinct gut microbiome features, which may help reshape our understanding of disease aetiology in humans.
Efficient Protection of Probiotics for Delivery to the Intestinal tract by Cellulose Sulphate Encapsulation
Authors: Gunzburg Walter Henry , Aung Myo Myint , Toa Pauline , Ng Shirelle , Read Eliot , Tan Wee Jin , Brandtner Eva Maria , Dangerfield John , Salmons Brian
Published: September 2020

Background: Gut microbiota in humans and animals play an important role in health, aiding in digestion, regulation of the immune system and protection against pathogens. Changes or imbalances in the gut microbiota (dysbiosis) have been linked to a variety of local and systemic diseases, and there is growing evidence that restoring the balance of the microbiota by delivery of probiotic micro-organisms can improve health. However, orally delivered probiotic micro-organisms must survive transit through lethal highly acid conditions of the stomach and bile salts in the small intestine. Current methods to protect probiotic micro-organisms are still not effective enough.Results : We have developed a cell encapsulation technology based on the natural polymer, cellulose sulphate (CS) that protects members of the microbiota from stomach acid and bile. Here we show that six commonly used probiotic strains (5 bacteria and 1 yeast) can be encapsulated within CS microspheres. These encapsulated strains survive low pH in vitro for up to 4 hours without appreciable loss in viability as compared to their respective non-encapsulated counterparts. They also survive subsequent exposure to bile. The CS microspheres can be digested by levels of cellulase found in the human intestine, indicating one mechanism of release. Studies in mice that were fed CS encapsulated autofluorescing, commensal E. coli demonstrated release and colonization of the intestinal tract.Conclusion: Taken together, the data suggests that CS microencapsulation can protect bacteria and yeast from viability losses due to stomach acid, allowing the use of lower oral doses of probiotics and microbiota, whilst ensuring good intestinal delivery and release.
Time Taken to Resume Driving Following Hip Arthroscopy
Authors: Jo Suenghwan , Lee Sang Hong , Jang Se Woong , Choi Hyun Bai , Kim Ba Rom , Jeong Jae Han , Kim Soo Ah
Published: September 2020

Background: Resuming driving is a common concern among patients undergoing hip arthroscopy. The present study aimed to assess whether patients who had undergone right hip arthroscopy presented with poorer driving performance than patients with normal hips and to analyze the time required to regain preoperative driving performance. Methods: Forty-seven patients who had undergone right hip arthroscopy and consented to our test protocol were included in this study. Using an immersive driving simulator, the patients were tested for their brake reaction time (BRT), total brake time (TBT), and brake pedal depression (BPD) preoperatively and postoperatively. The first postoperative assessments were conducted when the patients could comfortably sit on the driving seat, and the follow-up assessments were conducted for 6 consecutive weeks at weekly intervals. The patients were divided into the following two groups based on the type of surgery that they underwent: the femoroacetabular impingement (FAI) surgery group and the simple hip arthroscopy (SA) group. Twenty healthy volunteers underwent driving assessments thrice at weekly intervals and constituted the control group. The braking parameters were compared between preoperative and postoperative measurements and among the FAI surgery, SA, and control groups. Results: The preoperative braking parameters of the patients who underwent arthroscopy did not differ significantly from those of the controls (p=0.373, 0.763, and 0.447 for the BRT, TBT, and BPD, respectively). All braking parameters returned to normal in 2 weeks in the FAI surgery group and in 1 week in the SA group. Conclusions: Our study suggests that the driving performance of patients who underwent right hip arthroscopy is comparable to that of individuals with normal hips and that the braking parameters may normalize to the preoperative state at 1 week after SA and 2 weeks after FAI surgery.
Sedation Practices for Routine Gastrointestinal Endoscopy: A Systematic Review of Recommendations
Authors: Dossa Fahima , Megetto Olivia , Yakubu Mafo , Zhang David D.Q. , Baxter Nancy N.
Published: September 2020

Background

Sedation is commonly used in gastrointestinal endoscopy; however, considerable variability in sedation practices has been reported. The objective of this review was to identify and synthesize existing recommendations on sedation practices for routine gastrointestinal endoscopy procedures.

Methods

We systematically reviewed guidelines and position statements identified through a search of PubMed, guidelines databases, and websites of relevant professional associations from January 1, 2005 to May 10, 2019. We included English-language guidelines/position statements with recommendations relating to sedation for adults undergoing routine gastrointestinal endoscopy. Documents with guidance only for complex endoscopic procedures were excluded.

We extracted and synthesized recommendations relating to: 1) choice of sedatives, 2) sedation administration, 3) personnel responsible for monitoring sedated patients, 4) skills and training of individuals involved in sedation, and 5) equipment required for monitoring sedated patients. We assessed the quality of included documents using the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool.

Results

We identified 19 guidelines and 7 position statements meeting inclusion criteria. Documents generally agreed that a single, trained registered nurse can administer moderate sedation, monitor the patient, and assist with brief, interruptible tasks. Documents also agreed on the routine use of pulse oximetry and blood pressure monitoring during endoscopy. However, recommendations relating to the drugs to be used for sedation, the healthcare personnel capable of administering propofol and monitoring patients sedated with propofol, and the need for capnography when monitoring sedated patients varied. Only 9 documents provided a grade or level of evidence in support of their recommendations.

Conclusions

Recommendations for sedation practices in routine gastrointestinal endoscopy differ across guidelines/position statements and often lack supporting evidence with potential implications for patient safety and procedural efficiency.

Registration Number

CRD42019141076
Comparison of unilateral and bilateral polymethylmethacrylate-augmented cannulated pedicle screw fixation for the management of lumbar spondylolisthesis with osteoporosis
Authors: Liu Yao-yao , Xiao Jun , Jin Huai-jian , Wang Zhong , Yin Xiang , Liu Ming-yong , Zhao Jian-hua , Liu Peng , Dai Fei
Published: September 2020

Background: Cannulated pedicle screw (CPS) augmented by polymethylmethacrylate (PMMA) can achieve satisfactory clinical efficacy in the treatment of lumbar spondylolisthesis with osteoporosis. However, accurate application of CPSs will help to avoid the difficulty of screw revision and reduce the incidence of PMMA-related complications. This study aimed to investigate the mid-term efficacy of CPS compared to unilateral and bilateral applications in this common lumbar degenerative disease.Methods: Between May 2011 and May 2018, 50 patients with lumbar spondylolisthesis with osteoporosis who underwent posterior fixation and fusion using traditional pedicle screws or CPSs were included in the study. Patients were divided into two groups based on the application: the unilateral PMMA-augmented CPS group (UC, n = 29) and the bilateral PMMA-augmented CPS group (BC, n = 21). Operation time, blood loss, average hospitalization time, PMMA leakage, and other complications were recorded. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores were used to evaluate symptom recovery. Radiographic results were compared for intervertebral fusion and screw loosening.Results: There were no significant differences in the baseline data of the two groups.The VAS and ODI scores improved significantly after surgery (P < 0.05), with no significant differences between the groups (P > 0.05). The operation time and blood loss in the UC group were significantly lower than those in the BC group (P < 0.05). However, the loss of intervertebral disc height and Taillard index did not differ significantly between the groups. The rates of PMMA leakage in the UC and BC groups were 7.0% and 11.9%, respectively (P < 0.05). Bony fusion was achieved in all groups without screw loosening at the last follow-up. Only one patient experienced superficial infection in both groups, while cerebrospinal fluid leakage was observed in two patients in the BC group.Conclusions: Unilateral application of PMMA-augmented CPS may provide adequate clinical safety and effectiveness in the surgical treatment of lumbar spondylolisthesis with osteoporosis.
“There’s a Lot of Support”: Junior Doctors’ Experiences of the Medical Internship
Authors: Carlsson Yvonne , Nilsdotter Anna , Bergman Stefan , Liljedahl Matilda
Published: September 2020

Background: It is known that the transition from medical school to clinical work can be stressful. In some countries, an introductory service bridges the gap, introducing the doctor-to-be to clinical work. However, there is a lack of scientific knowledge about whether these introductory services serve their purpose as justifiable introductions. To address the gap, this paper aimed to explore experiences that junior doctors hold of the medical internship.Methods: Using a qualitative description approach, data was collected through twelve individual in-depth interviews with volunteering medical interns from three different hospital sites in Sweden. Data were verbatim transcribed and analysed by qualitative content analysis, generating categories and themes. Results: Four main themes were identified in our data. The interns felt increasingly comfortable as doctors (‘finding one’s feet’) through taking responsibility for patients while receiving necessary help and assistance (‘a doctor with support’). Although appreciative of getting an overview of the healthcare organisation (‘healthcare sightseeing’), interns were exhausted by repeatedly changing workplaces and felt stuck in a rigid framework (‘stuck at the zoo’).Conclusions: This study showed that the transition from medical student to clinical doctor does not necessarily have to be characterised by stress and mental exhaustion but can, with extensive support, provide a fruitful opportunity for interns to grow into their roles as doctors.
Nonintubated Minimally Invasive Chest Wall Stabilization for Multiple Rib Fractures: a Prospective, Single-arm Study
Authors: Zhao Weigang , Chen Yonglin , He Weiwei , Zhao Yonghong , Yang Yi
Published: September 2020

Background: Nonintubated video-assisted thoracoscopic surgery has been widely reported in the past decade, while nonintubated chest wall stabilization has not been reported previously. The aim of this study was to evaluate the safety and feasibility of nonintubated minimally invasive chest wall stabilization in patients with multiple rib fractures.Methods: We conducted a prospective, single-arm, observational study. In this prospective study, 20 consecutive patients with multiple rib fractures were treated using nonintubated minimally invasive chest wall stabilization.Results: Minimally invasive chest wall stabilization was mostly performed for lateral rib fractures in this study (n=8). The mean operation time was 92.5 minutes, and the mean blood loss was 49 ml. No patient required conversion to tracheal intubation. The mean extubation time of the laryngeal mask was 8.9 minutes; the mean postoperative fasting time was 6.1 hours; the mean postoperative hospital stay was 6.2 days; the mean amount of postoperative drainage was 97.5 ml; the mean postoperative pain score was 2.9 points at 6 hours, 2.8 points at 12 hours, and 3.0 points at 24 hours; and the mean postoperative nausea and vomiting score was 1.9 points at 6 hours, 1.8 points at 12 hours, and 1.7 points at 24 hours.Conclusions: Nonintubated minimally invasive chest wall stabilization is safe and feasible in carefully selected patients. Further studies with a large sample size are warranted.
Astragalus flavone ameliorates atherosclerosis and hepatic steatosis via improving lipid metabolism and inhibition of inflammation in apoE-/- mice
Authors: Ma Chuanrui , Zhang Jing , Yang Shu , Hua Yunqing , Su Jing , Shang Yuna , Wang Zhongyan , Feng Ke , Zhang Jian , Zhang Hao , Zhao Linna , Mao Jingyuan , Fan Guanwei
Published: September 2020

Background: Atherosclerosis is a major pathogenic factor in cardiovascular diseases during the aging process. Foam cell formation and endothelial dysfunction play a key role in the initiation and development of atherosclerosis, which are affected by lipid disorder and inflammation. Therefore, the drug for inhibition of endothelial dysfunction and the subsequent foam cell formation is a therapeutic approach for atherosclerosis treatment. Total flavone of Astragalus membranaceus (TFA) is extracted from Astragalus membranaceus that has protective effect on cardiovascular disease. However, the effect of TFA on atherosclerosis and the underlying mechanism remains unknown. Methods: In this study, we determined whether TFA could inhibit atherosclerosis; and uncovered the underlying molecular mechanisms. In vivo, apoE deficient mice were treated with TFA contained in high-fat diet for 16 weeks. After treatment, aorta, macrophage and serum samples were collected to determine atherosclerotic lesions, lipid metabolism, and expression of associated genes. Concurrently, we investigated the effect of TFA on monocyte adhesion, foam cell formation, endothelial activation, and macrophage polarization in vitro and in vivo. Results: TFA reduced atherosclerotic plaque size; and enhanced lesion stability by changing the composition of plaque. Moreover, foam cell formation and its accumulation in arterial wall were attenuated by TFA, which might be attributed to improved lipid disorder, reduced inflammation, and decreased monocyte adhesion to endothelial cells. Mechanistically, TFA reduced the expression of scavenger receptor, such as CD36 and SRA; promoted the expression of ATP-binding cassette transporter A1 and G1 (ABCA1/G1). More importantly, TFA reduced the expression of miR-33, a negative regulator of cholesterol efflux as well as positive mediator on inflammation; and concurrently reduced NFkB activity, by which de-repressed ABCA1/G1 activity and inhibited the inflammation. Conclusions: This study demonstrates that TFA can attenuate atherosclerosis via dual inactivation of miR-33 and NFkB signaling pathway and inhibition of scavenger receptors (CD36 and SRA), which suggests that TFA might be a novel therapeutic approach for inhibition of atherosclerosis.
Clinical Features of Anti-Synthetase Syndrome Associated Interstitial Lung Disease: A Retrospective Cohort in China
Authors: Xi ZHAN , Wei YAN , Ying WANG , Qing LI , Xuhua SHI , Yanli GAO , Qiao YE
Published: September 2020

BackgroundAntisynthetase Syndrome (ASSD) is a chronic autoimmune condition characterized by antibodies directed against an aminoacycl transfer RNA synthetase (ARS) along with a group of clinical features including the classical clinical triad: inflammatory myopathy, arthritis, interstitial lung disease (ILD). ASSD is highly heterogenous due to the different organs involvement, and ILD is the main cause of mortality and function loss, which presents as different patterns when diagnosed. We designed this retrospective cohort to describe the clinical features and disease behavior of the ASSD associated ILD. MethodsRetrospectively collected the data of 108 cases of ASSD associated ILD in Beijing Chaoyang Hospital since 2017.12 to 2019.3. Data was obtained from the Electronic Medical Record (EMR) system. Patients were divided into 5 groups according to the distinct Aminoacyl tRNA synthetases (ARS) antibodies. Results108 consecutive patients were recruited. 33 were with JO-1 positive and 30 were with PL-7 positive. 23 with EJ positive, 13 with PL12 positive and 9 with OJ positive. JO-1 group had a significant higher rate of mechanic’s hand (57.6%) than other 4 groups. Polymyositis/ Dermatomyositis (PM/DM) was diagnosed in 25 (23.1%) patients and no difference was observed among the 5 groups. The anti-PL7 positive group had a higher frequency of UIP pattern (13.3%) than other 4 groups but the difference was not significant, and EJ group had the most frequent OP pattern(78.2%), which was significantly higher than PL-7 group (P<0.001) and PL-12 group (P=0.025). The median follow-up time were 10.7 months. All received prednisone treatment, with or without immunosuppressants, and at the 6-month-follow up, the JO-1 group and EJ group had a significantly higher improvement of forced vital capacity that the other 3 groups (P<0.05), and PL-7 group had the lowest FVC improvement (P<0.05). The anti-Jo1-positive group and anti-EJ-positive group had significantly higher anti-RO52-positive occurrence than other 3 groups (P<0.05).ConclusionAnti PL-7 antibody had the same frequency as anti-JO1 in ASSD-ILD, in which the ILD pattern was different with distinct anti-ARS antibodies. All ASSD-ILD responded to therapy of steroids, with or without immunosuppressants. PL-7 group had a highest occurrence of UIP pattern, and significantly lower respondence to therapy.
Subconjunctival Use of Allogeneic Mesenchymal Stem Cells to Treat Chronic Superficial Keratitis in German Shepherd Dogs: Pilot Study.
Authors: Pereira Alexandre Luiz , Bittencourt Maura Wanderley , Barros Michele Andrade , Malago Rodolfo , Martins João Flávio Panattoni , Morais Bruna , Montiani-Ferreira Fabiano , de Vasconcellos Jose Paulo Cabral
Published: September 2020

Background: Chronic superficial keratitis (CSK) is an ocular condition in dogs characterized by corneal opacification leading to visual function impairment. The aim of this study was to evaluate the clinical effect of allogeneic mesenchymal stem cells (MSC) of adipose tissue in dogs with CSK.Results: The conventional treatment group received topical Prednisolone 1% and the experimental group received MSC on the order of 1x106 were injected via subconjunctival in the peri-limbal region at 0 and 30 days. The animals were followed for 110 days to monitor the clinical progression and the statistical analysis was performed. Comparison of initial and final images revealed that areas with neovascularization and inflammatory infiltrate regressed in most eyes in both the conventional and experimental groups at the end of the 110 days. The experimental group responded positively to MSC treatment, but bellow the response achieved by the conventional group. Some areas of opacity of the cornea become transparent after transplantation of MSC. No local or systemic side effects were observed.Conclusions: Stem cells treatment produced clinical improvement in patients with CSK after 110 days without use of any drug combination and any local or systemic side effects, even if the improvement obtained was less than that seen with conventional corticosteroid therapy.
Intrauterine growth restriction in a cohort of migrants in Germany
Authors: Ankert Juliane , Groten Tanja , Pletz Mathias W. , Mishra Sasmita , Seliger Gregor , Lobmaier Silvia M. , Costa Clarissa Prazeres da , Seidel Vera , von Weizsäcker Katharina , Jablonka Alexandra , Dopfer Christian , Schleenvoigt Benjamin Thomas
Published: September 2020

Background: Migrant women may have an increased risk of adverse birth outcomes. This study analyses the occurrence of low birth weight, preterm birth and intrauterine growth restriction (IUGR) in pregnant migrants. Method: Cross-sectional study of 82 mother-child pairs of pregnant migrants attending medical care in Germany.Results: Median age was 27 years, 49% were of oriental-asian ethnicity and median year of migration was 2015. At least one previous pregnancy was reported in 76%. Delivery mode was caesarian section in 40%. Median gestational age was 39.7 weeks. Preterm birth occurred in 6.1%. Median gestational age for preterm birth was 32.3 weeks. Low birth weight (<2500 g) occurred in 6.1%. Birth weights below the 10th percentile of birth weight for gestational age were observed in 8.5% of the total cohort. Conclusions: Compared to German data no increased occurrence of low birth weight, preterm birth or IUGR was found. Of note, rate of caesarian section was higher than in the general population for reasons yet to be identified. The authors propose stratification according to migration status for the national documentation of birth outcomes in Germany.Trial registration: ClinicalTrails.gov, NCT03158298. Registered 18 May 2017 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03158298
The weight gain influence of pregnant women under different clinical conditions on weight at the birth of newborns.
Authors: Mariot Márcia Dornelles Machado , Kretzer Daniela Cortés , Nunes Isadora Musse , Goldani Marcelo Zubaran , Bernardi Juliana Rombaldi , Silva Clécio Homrich da
Published: September 2020

BACKGROUND: This study evaluate the influence of weight gain of pregnant women under different clinical conditions (Tobacco, Diabetes mellitus (DM), Hypertension, Intrauterine growth restriction (IUGR) and Control) on the birth weight of newborns. METHODS: This is an observational, longitudinal study nested in a prospective controlled cohort and conducted from 2011 to 2016 in three hospitals in the city of Porto Alegre (Brazil). Sociodemographic, prenatal (maternal gestational weight gain, among others) and perinatal (birth weight) data from 372 mother-child pairs were analyzed. Pearson's correlation was used to verify the relationship between gestational weight gain and birth weight. Multivariate regression was performed to determine the association between maternal weight gain in the presence of various health conditions and birth weight. RESULTS: There were no statistical differences in gestational weight gain in different health condition groups (p=0.092). However, women in the Hypertension group had a tendency to gain more weight (p = 0.097). Mothers in the intrauterine growth restriction group gained less weight. A positive correlation was observed between gestational weight gain and birth weight in the Tobacco (p = 0.003) and Control (p =0.001) groups, which remained positive only in the Control group after adjustment (p<0.004). CONCLUSIONS: Only weight gain in pregnant women without clinical changes during pregnancy seemed to influence the weight of the newborn. It is assumed that other factors, such as metabolic or nutritional, present among smoking, diabetes mellitus, hypertensive or with intrauterine growth restriction pregnant women have different modulations on the intrauterine environment and, therefore, exert a different influence on fetal growth.
Clinical Characteristics of COVID-19 Patients with Recurrent PCR Positivity After Hospital Discharge
Authors: Wang Kaige , Tian Panwen
Published: September 2020

Objective: This study aimed to investigate the clinical characteristics of COVID-19 patients with recurrent SARS-CoV-2 positivity after hospital discharge. Methods: This retrospective study included COVID-19 patients who were readmitted for recurrence of positive SARS-CoV-2 RNA. Univariate and multivariate analyses were performed to assess the risk factors associated to the duration of recurrent RNA positivity.Results: Among the 287 discharged COVID-19 patients, 33 (11.5%) patients with recurrent PCR positivity were included. Among these patients, 21 (63.7%) patients were female, their mean age was 48.7 (±19.7) years old. 22 (66.7%) patients were asymptomatic. The following clinical features were presented in other patients: cough, fatigue, sore throat, fever and expectoration. The chest CT findings revealed that 8 (24.2%) patients were characterized by deterioration compared to the previous results. The median duration of recurrent RNA positivity was 9.0 days (IQR, 6.0, 15.0). We found that increased serum SARS-CoV-2-specific IgG antibody titer, elevated serum creatinine level, and female gender were the risk factors for the prolonged duration of recurrent RNA positivity.Conclusion: SARS-CoV-2 turned positive in a minority of discharged patients with COVID-19. Most patients experienced mild clinical course. Increased IgG antibody titer, creatinine and female gender were correlated to the prolonged RNA clearance time.
Universal Differential Equations for Scientific Machine Learning
Authors: Rackauckas Christopher , Ma Yingbo , Martensen Julius , Warner Collin , Zubov Kirill , Supekar Rohit , Skinner Dominic , Ramadhan Ali , Edelman Alan
Published: September 2020

In the context of science, the well-known adage “a picture is worth a thousand words” might well be “a model is worth a thousand datasets.” Scientific models, such as Newtonian physics or biological gene regulatory networks, are human-driven simplifications of complex phenomena that serve as surrogates for the countless experiments that validated the models. Recently, machine learning has been able to overcome the inaccuracies of approximate modeling by directly learning the entire set of nonlinear interactions from data. However, without any predetermined structure from the scientific basis behind the problem, machine learning approaches are flexible but data-expensive, requiring large databases of homogeneous labeled training data. A central challenge is reconciling data that is at odds with simplified models without requiring "big data". In this work demonstrate how a mathematical object, which we denote universal differential equations (UDEs), can be utilized as a theoretical underpinning to a diverse array of problems in scientific machine learning to yield efficient algorithms and generalized approaches. The UDE model augments scientific models with machine-learnable structures for scientifically-based learning. We show how UDEs can be utilized to discover previously unknown governing equations, accurately extrapolate beyond the original data, and accelerate model simulation, all in a time and data-efficient manner. This advance is coupled with open-source software that allows for training UDEs which incorporate physical constraints, delayed interactions, implicitly-defined events, and intrinsic stochasticity in the model. Our examples show how a diverse set of computationally-difficult modeling issues across scientific disciplines, from automatically discovering biological mechanisms to accelerating the training of physics-informed neural networks and large-eddy simulations, can all be transformed into UDE training problems that are efficiently solved by a single software methodology.
An analysis of Dyadic relationship between Islamic Banks and Takaful Operators and their impact on Economic stability
Authors: Shabbir Malik Shahzad , Malik Adnan
Published: September 2020

Purpose

The objective of this study is examined the dyadic relationship between Islamic banks and takaful operators and their impact on economic stability of Pakistan. It is observed that Islamic finance industry demand increase from last one decade in Pakistan. The Islamic finance industry has significant importance in existing market through multidimensional contributions and deposits.
Design/Methodology/Approach:

This study takes five Islamic banks and five takaful companies operating in Pakistan from 2009 to 2017. This study implies panel data regression through random effect model (REM), fixed effect model (FEM) and generalized methods of moments (GMM) to better understand the time invariant and intercept value among variables.
Findings:

The results reveal with these remarks that Islamic banks have a relatively more positive and significant contribution toward economic stability as compared to takaful companies. Whereas, mean deviation of takaful operators is more near to the origin as compared to Islamic banks.
Originality/Value:

It is observed from last couple decades that Islamic finance industry has increased in capital inflows as relatively compared to conventional counterpart. This study is a comparative analysis between both Islamic banks and Takaful companies’ performances in Pakistan.
Predicting the COVID-19 Patients’ Status Using Chest CT Scan Findings: A Risk Assessment Model Based on Decision Tree
Authors: Talebi Atefeh , Borumandnia Nasrin , Jafari Ramezan , Pourhoseingholi Mohamad Amin , Jafari Nematollah Jonaidi , Ashtari Sara , Roozpeykar Saeid , Bashar Farshid R. , Vahedian-Azimi Amir
Published: September 2020

Background: The role of chest computed tomographic (CT) to diagnosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. The aim of this study is to use non-contrast chest computed tomography (CT) scan as a helpful tool in diagnosis quantification and follow-up of patients with COVID-19. Method: This study was performed on patients with COVID-19 who underwent chest CT scan at Baqiyatallah Hospital, Tehran, Iran. The age, gender, types of lesions, other specific signs of high-resolution computed tomography (HRCT), presence of diffuse opacity, underlying diseases, number of involved lobe and total opacity score of 1078 patients were evaluated. Decision tree (DT) model was used to analyze and establish a risk assessment model of critical and non-critical situation. Results: The bilateral distribution and multifocal lung involvement were 165 (97.6%) and 766 (84.3%) in critical patients, respectively. According to DT model, total opacity score, age, lesion types and gender were statistically significant predictors in critical patients. Moreover, the results showed that the accuracy, sensitivity and specificity of the DT model were 93.3%, 72.8% and 97.1%, respectively.Conclusions: The presented algorithm demonstrates the factors affecting the patient's condition. Also the model can predict the critical or non-critical situation of new cases. In addition, this model has the potential characteristics for clinical applications and can also identify high-risk subpopulations that need specific prevention.
Association of Plasma Low-Density Lipoprotein Receptor-Related Protein-1 (LRP1) with Undernutrition: A Case-Control Study in Bangladeshi Adults
Authors: Hasan Md. Mehedi , Fahim Shah Mohammad , Das Subhasish , Gazi Md. Amran , Mahfuz Mustafa , Ahmed Tahmeed
Published: September 2020

Background: Studies revealed that LRP1 plays pivotal role in adipogenesis, whereas silencing of LRP1 expression can cause inhibition of adipogenesis in animal model and contribute to reduced body size. Therefore a reduction in the level of adipocytic LRP1 might have a role on weight loss. But there is no study that has explored the role of LRP1 on weight loss of human adults. However, it is not feasible to examine the role of adipocytic LRP1 on weight loss due to invasive collection procedure of adipose tissue. But plasma LRP1 can fill that void as it is a biomarker of adipocytic LRP1. Therefore, the aim of this study was to investigate the relationship of plasma low-density lipoprotein receptor-related protein-1 (LRP1) with undernutrition.Methods: A total of 270 Bangladeshi slum-dwelling adults (135 cases, BMI < 18.5 kg/m2 and 135 controls, BMI 18.5-24.9 kg/m2) were enrolled. Their socio-economic, demographic, anthropometric and biomedical data were collected. Plasma LRP1, C-reactive protein (CRP), alpha-1 acid glycoprotein (AGP), and ferritin levels were measured by ELISA, hemoglobin by Hemocue and zinc by atomic absorption spectrometry.Results: The median (IQR) values of plasma LRP1, CRP, AGP, Hemoglobin, zinc and ferritin were 1673.1 (1382.5- 1886.2) ng/ml, 2.1 (0.9 – 4.4) mg/L, 75.8 (62.9 – 95.9) mg/dL, 13.2 (12 – 14.3) g/dL, 0.74 (0.7 – 0.8) mg/L, 59.9 (26.4 – 123.2) ng/mL in healthy participants and 707.7 (588.6- 839.9) ng/ml, 0.8 (0.2 – 1.7) mg/L, 64.7 (52.9 – 86.9) mg/dL, 12.4 (11.4 – 13.4) g/dL, 0.71 (0.6 – 0.8) mg/mL, 43.7 (19.9 – 80.2) ng/mL in undernourished participants, respectively. A strong positive correlation (r = 0.70, p <0.05) between LRP1 and body mass index (BMI) was found. Multivariable logistic regression analysis revealed a positive association between low plasma LRP1 (Adj. OR= 0.98, CI = 0.98, 0.99 and p < 0.05) and undernutrition. Conclusions: The study found that increased level of LRP1 is associated with increased BMI, whereas lower level can contribute to low BMI.
Photonic Transformers
Authors: Douvidzon Mark , Maayani Shai , Nagar Harel , Admon Tamir , Shuvayev Vladimir , Yang Lan , Deych Lev , Roichman Yael , Carmon Tal
Published: September 2020

Largely-deformed1–4 microcavities5 support instabilities suppression6 chaotic ray-dynamics7, directional-emission8–10, and momentum transfer11 for nonlinear optics, but such deformations are generally possible only by fabricating discrete sets of resonators. In contrast, optical tweezers12–17 permit continuous large changes18–28, such as deformations from spherical dielectrics to triangular ones25. We report on transformable micro-photonic devices that change their functionality while operating. Assisted by computerized holographic-tweezers, we gradually deform the shape and change the functionality of a droplet whispering-gallery cavity. For example, we continuously deform hexagonal cavities to rectangular ones, and demonstrate switching to directionally emitting mode-of-operation, or splitting a resonant mode to a 10-GHz separated doublet. A continuous trend of improving spatial light modulators and tweezers suggests that our method is scalable to control the shape and functionality of many individual devices. We also demonstrate optional solidification proving the feasibility of transformers-enabled applications, including in printing 3D optical-circuits and multiwavelength optical-networks.
Novel Phytoconstituents of an Aqueous Pod Extract of Prosopis Cineraria (L.) Druce Attenuate Atherosclerotic Plaque and Hypercholesterolemia in Rabbits
Authors: Ram Heera , Jaipal Noopur , Kumar Pramod , Charan Jaykaran , Kashyap Priya , Kumar Suresh , Singh Garima , Dixit Anshuman , Hashem Abeer , Alqarawi Abdulaziz A , Abd_Allah Elsayed Fathi , Singh Bhim Pratap
Published: September 2020

Background and objectives: The pod of Prosopis cineraria traditionally used in several ailments and key component of traditional food recipe of the Panchkuta of western Rajasthan, India. The current study was targeted to assess ability of phytoconstituents of aqueous pod extract of Prosopis cineraria to inhibit HMG-CoA reductase activity and regress atherosclerotic plaque were investigated in in-vitro, in-vivo, and in-silico studies. Material and Methods: LCMS, GCMS, and FTIR analysis were used to characterize the phytoconstituents of the test extract. Accordingly, the in-vitro, in-vivo and in-silico assessments were performed by following the standard methods. Results: The phytochemical results shown the presence of cloprostenol, cinecromen, and dirithromycin as leading compounds. Accordingly, in-vivo assay of test extract shown HMG-CoA inhibition activity by 78.1 % (IC50 was 0.03 μg/ml). Hypercholesterolemia was induced in rabbits through oral supplementation of a high fat diet (21 % fat) with cholesterol powder supplementation. Administration of the test extract caused significant (𝑃 ≤ 0.001) improvement in the lipid profile and antioxidant levels in the test rabbits, relative to the hypercholesterolemic control rabbits. Subsequently, the reductions in the atherosclerotic plaque and improvement in lumen volume were pointedly observed in the treated groups. In-silico analyses of molecular docking and ADMET revealed significant interactions and druggability profile. Conclusion: It can be stated that the phytoconstituents of aqueous pod extract of Prosopis cineraria have the capacity to inhibit HMG-CoA reductase and regress the atherosclerotic plaque which may be beneficial to the treatment of hypercholesterolemia.
DLDTI: A learning-based framework for drug-target interaction identification using neural networks and network representation
Authors: Zhao Yihan , Zheng Kai , Guan Baoyi , Guo Mengmeng , Song Lei , Gao Jie , Qu Hua , Wang Yuhui , Shi Dazhuo , Zhang Ying
Published: September 2020

Background: Drug repositioning, the strategy of unveiling novel targets of existing drugs could reduce costs and accelerate the pace of drug development. To elucidate the novel molecular mechanism of known drugs, considering the long time and high cost of experimental determination, the efficient and feasible computational methods to predict the potential associations between drugs and targets are of great aid.Methods: A novel calculation model for drug-target interaction (DTI) prediction based on network representation learning and convolutional neural networks, called DLDTI， was generated. The proposed approach simultaneously fuses the topology of complex networks and diverse information from heterogeneous data sources, and copes with the noisy, incomplete, and high-dimensional nature of large-scale biological data by learning the low-dimensional and rich depth features of drugs and proteins. The low-dimensional feature vectors were used to train DLDTI to obtain the optimal mapping space and to infer new DTIs by ranking candidates according to their proximity to the optimal mapping space. More specifically, based on the results from the DLDTI, we experimentally validate the predicted targets of tetramethylpyrazine (TMPZ) on atherosclerosis progression in vivo.Results: The experimental results show that the DLDTI model achieves promising performance under 5-fold cross-validations with AUC values of 0.9172, which is higher than the methods using different classifiers or different feature combination methods mentioned in this paper. For the validation study of TMPZ on atherosclerosis, a total of 288 targets were identified and 190 of them were involved in platelet activation. The pathway analysis indicated signaling pathways, namely PI3K/Akt, cAMP and calcium pathways might be the potential targets. Effects and molecular mechanism of TMPZ on atherosclerosis were experimentally confirmed in animal models.Conclusions: DLDTI model can serve as a useful tool to provide promising DTI candidates for experimental validation. Based on the predicted results of DLDTI model, we found TMPZ could attenuate atherosclerosis by inhibiting signal transductions in platelets. The source code and datasets explored in this work are available at https://github.com/CUMTzackGit/DLDTI.
Evaluation of Different Functional Antioxidant Groups and Protein Responses in Asian Seabass (Lates calcarifer Bloch, 1970) as an Early Indication of Fish Health in Aquaculture Farms.
Authors: Hassan Mohamad Sofi Abu , Jaafar Siti Nur Tahirah , Yusoff Nurulnadia , Azmi Nik Nurasyikin Nik
Published: September 2020

The study was conducted to investigate the organ-specific antioxidants and protein damages responses in Lates calcarifer inhabiting different aquaculture farms that susceptible to different threat of pollutions. Enzymes at the front line of antioxidant system superoxidase dismutase (SOD) and catalase (CAT) evidenced to work together but respond differently in different body compartment. High SOD responses were followed with lower CAT responses observed in muscle (p < 0.05) with opposite responses exhibited by both gill and liver. The responses of SOD and CAT in muscle also showed a significant strong correlation to each other (Setiu Wetland: 0.91, Semerak: 0.79) (p < 0.01). The glutathione-dependent enzymes, glutathione-s-transferase (GST) and glutathione reductase (GR) in body compartments responded with a strong correlation to each other especially in muscle (Tumpat; muscle: 0.89, gill: 0.95 and liver: 0.54 (p < 0.01, p < 0.05), (Setiu Wetland; muscle: 0.72 (p < 0.01) and Semerak; muscle: 0.79 (p < 0.01). Opposite results were found for both protein damages biomarkers, thiols (-SH-) and carbonyl (-CH-) in comparison to biomarkers responses. In contrary to (-SH-) inconsistent results were observed for the (-CH-) with muscle found to be most oxidised. The responses of SOD, CAT, GST, GR, thiols and carbonyl were all computed into the same scale through Integrated Biomarker Score (IBR) to classify each aquaculture farms based on biomarkers responses. There was a slight variation in deviation score (A) between organs within the range of (5-7). However, Tumpat overall showed the highest IBR score and significantly higher (p < 0.05) than Setiu Wetland with a total score of combining responses score in all three organs (IBR: 84, muscle: 31, gill: 24, and liver: 29) followed by intermediate score in Semerak (IBR: 72, muscle: 23, gill: 23 and liver: 26) and Setiu Wetland (IBR: 59, muscle: 18, gill: 23 and liver: 18). These results indicated that the responses of antioxidant enzymes and protein damages in L.calcarifer from different organs are heterogeneous. Therefore, biomarkers should be selected based on their sequential groups in the antioxidant system for a better explanation of the oxidative stress evaluation in fish.
Examining the impact of Exports and Exchange rate on Economic Growth of Turkey
Authors: Muhammad Iftikhar , Shabbir Malik Shahzad
Published: September 2020

Purpose

This study intends to analyze the long-run and short-run relationships along with the identification of causal links between exports, economic growth, and exchange rate in Turkey.
Data/Design:

This study uses auto-regressive distributed lags (ARDL) and Granger causality over time series monthly data from the year 2010–2018. The results indicate that exports are significantly positively related to economic growth while the exchange rate is found to be negatively related to economic growth.
Findings:

Moreover, findings from the test of Granger causality indicate that a unidirectional causal association is found from exports to foreign direct investment and economic growth and from economic growth to foreign direct investment. The Granger causality results indicate that an increase in exports accelerates the economic growth of Turkey and a change in growth rate and exchange rate leads to a change in foreign direct investment.
Originality of work:

The overall findings suggest that exports should be promoted along with the liberal-investment economic policies to boost the overall economic growth in Turkey.