bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of guidelines on sterility precautions during indwelling urethral catheterization at two acute-care hospitals in Sweden - a descriptive survey
Authors: Kulbay Aysel , Joelsson-Alm Eva , Tammelin Ann
Published: December 2020

Background: To support a uniform and evidence-based practice for indwelling urinary catheterization in adults The European association of Urology Nurses (EAUN) published guidelines for this procedure in 2012. The Swedish national guidelines are based on the sterility precautions advocated by EAUN. Nevertheless, some hospitals have local guidelines with other requirements concerning sterility and leave to staff to decide how to perform the catheterization. The aim of this descriptive survey was to investigate the nurses´ self-reported sterility precautions during indwelling urethral catheterization at two acute-care hospitals, where the local guidelines differ in their sterility requirements. The study also aimed to analyse factors affecting the participants´ conformity with sterility precautions in the EAUN-guidelines. Methods: A structured questionnaire with questions concerning the participant, working conditions and performance of indwelling urethral catheterization was left to 931 nurses in two acute care hospitals. Chi-square test, Fisher´s exact test and Mann-Whitney U-test were used for descriptive statistics. Logistic regression was used to analyse variables associated with practicing the sterility precautions in the EAUN-guidelines.Results: Answers were obtained from 852 persons (91.5%). A majority of the participants called their insertion technique “non-sterile”. Regardless of designation of the technique the participants said that the indwelling urinary catheter (IUC) should be kept sterile during procedure. In spite of that not everyone used sterile equipment to maintain the sterility of the catheter. The nurses´ conformity with all the sterility precautions in the EAUN-guidelines were associated with working at departments for surgery and cardiology (OR 2.35, 95% CI 1.69-3.26), use of sterile set for catheterization (OR 2.08, 95% CI 1.44-3.00), use of sterile drapes for dressing on insertion area (OR 1.87, 95% CI 1.21-2.89) and using the term “sterile technique” for indwelling urethral catheterization (OR 1.70, CI 1.15-2.51). Conclusions: The study showed that only 55-74% of the nurses practised one or more precautions that secured sterility of the IUC thus demonstrating a gap between the EAUN-guidelines and the actual performance. Compliance to disinfection of hands prior to the procedure was however around 90%. Healthcare-settings should ensure education and skill training to achieve sterile IUC-insertion according to the requirements in the EAUN-guidelines.
Associations between substandard housing and depression: Insights from the Korea Welfare Panel Study
Authors: KIM Selin , Jeong Wonjeong , Jang Bich Na , Park Eun-Cheol , Jang Sungin
Published: December 2020

Background: Housing is an important social determinant of health. Poor housing conditions are associated with a wide range of health conditions, including mental health. The study aimed to investigate the association between substandard housing and depression. Methods: We used panel data collected by the Korea Welfare Panel Study and a sample drawn from waves 11 (2016) to 13 (2018). Substandard housing was defined via three criteria: the minimum residential area and number of rooms by application, essential facility standards, and environmental standards. Depression was measured with the CESD-11. A generalized estimating equation model was used to investigate associations between substandard housing and CESD-11 scores. Results: Participants living in substandard housing have higher depression scores (male: β=0.63, female: β=0.40) than participants who do not live in substandard housing. Participants who do not meet environmental standards have higher depression scores (male: β=0.85, female: β=0.66) than participants who do not live in substandard housing; the findings are seen in both men and women. Conclusion: This study identified an association between substandard housing and depression by gender, and the results were significant. We found that among the three criteria, environmental standards are most likely to be associated with depression. In practical terms, we should consider improving environmental factors of housing to mitigate mental health issues related to substandard housing.
Genome-wide association of rice response to blast fungus identifies loci for robust resistance under high nitrogen.
Authors: Frontini Mathias , Boisnard Arnaud , Frouin Julien , Ouikene Malika , Morel Jean-Benoit , Ballini Elsa
Published: December 2020

Background: Nitrogen fertilization is known to increase disease susceptibility, a phenomenon called Nitrogen-Induced Susceptibility (NIS). In rice, this phenomenon has been observed in infections with the blast fungus Magnaporthe oryzae. A previous classical genetic study revealed a locus (NIS1) that enhances susceptibility to rice blast under high nitrogen fertilization. In order to further address the underlying genetics of plasticity in susceptibility to rice blast after fertilization, we analyzed NIS under greenhouse-controlled conditions in a panel of 139 temperate japonica rice strains. A genome-wide association analysis was conducted to identify loci potentially involved in NIS by comparing susceptibility loci identified under high and low nitrogen conditions, an approach allowing for the identification of loci validated across different nitrogen environments. We also used a novel NIS Index to identify loci potentially contributing to plasticity in susceptibility under different nitrogen fertilization regimes. Results: A global NIS effect was observed in the population, with the density of lesions increasing by 8%, on average, under high nitrogen fertilization. Three new QTL were identified. A rare allele of the RRobN1 locus on chromosome 6 provides robust resistance in high and low nitrogen environments. A frequent allele of the NIS2 locus, on chromosome 5, exacerbates blast susceptibility under the high nitrogen condition. Finally, an allele of NIS3, on chromosome 10, buffers the increase of susceptibility arising from nitrogen fertilization but increases global levels of susceptibility. This allele is almost fixed in temperate japonicas, as a probable consequence of genetic hitchhiking with a locus involved in cold stress adaptation. Conclusions: Our results extend to an entire rice subspecies the initial finding that nitrogen increases rice blast susceptibility. We demonstrate the usefulness of estimating plasticity for the identification of novel loci involved in the response of rice to the blast fungus under different nitrogen regimes.
Molecular cloning and characterization of GhERF105, a gene contributing to the regulation of gland formation in Upland cotton (Gossypium hirsutum L.)
Authors: Wu Chaofeng , Cheng Hailiang , Li Shuyan , Zuo Dongyun , Lin Zhongxu , Zhang Youping , Lv Limin , Wang Qiaolian , Song Guoli
Published: December 2020

Background: Upland cotton ( Gossypium hirsutum L.) is one of the most economically important crops worldwide . Cottonseed is a major significant source of fiber, feed, foodstuff, oil and biofuel products. However, the utilization of cottonseed is limited by the presence of small and darkly pigmented glands that contain large amounts of gossypol, which is toxic to human beings and other non-ruminant animals. To date,some progress has been made in the pigment gland formation, but the underlying molecular mechanism of pigment gland formation was still unclear. Results: In this study, we identified an AP2/ERF transcription factor named GhERF105 (Gh_A12G1784), which is involved in the regulation of gland pigmentation, from comparative transcriptome analysis of the leaf transcriptome from two pairs of glanded and glandless accessions, which are CCRI12 and CCRI12XW, L7 and L7XW. This gene encoded an ERF protein containing a converved AP2 domain localized in the nucleus with transcriptional activity., and it showed the high expression in glanded cotton accessions that contained much gossypol. Virus-induced gene silencing(VIGS) against GhERF105 caused the dramatic reduction in the number of glands and significantly lowered levels of gossypol in cotton leaves. GhERF105 showed the patterns of spatiotemporal and inducible expression in the glanded plants. Conclusions: These results suggest that GhERF105 contributes to the pigment gland formation and gossypol biosynthesis in partial organs of glanded plant. It also provides a potential molecular basis to generate ‘glandless-seed’ and ‘glanded-plant’ cotton cultivar.
Resilience as a predictor of Quality of Life in participants with borderline personality disorder before and after treatment.
Authors: Guillén Verónica , Tormo Mireia Esplugues , Fonseca-Baeza Sara , Botella Cristina , Baños Rosa , García-Palacios Azucena , Marco Jose Heliodoro
Published: December 2020

Background: Studies have suggested that psychotherapy improves the Quality of Life (QoL) of participants with Borderline Personality Disorder (BPD). However, there are no studies on the differential efficacy of treatments on the QoL of participants with BPD. Moreover, the relationship between QoL and resilience has rarely been studied in participants with BPD. Objectives: a) to examine whether people with BPD have worse QoL than the non-clinical population; b) to examine whether there are statistically significant differences between Dialectical Behavioural Therapy (DBT), Systems Training for Emotional Predictability and Problem Solving (STEPPS), or Cognitive Behavioural Therapy-Treatment at Usual (CBT-TAU) in the improvement of QoL; c) to examine whether participants show clinically significant improvements in QoL after treatment; d) to analyse whether resilience is associated with QoL before and after the BPD treatment; e) to analyse whether resilience is a predictor of QoL at pre-treatment and posttreatment. Method: The sample comprised 403 participants (n = 202 participants diagnosed with BPD and n = 201 non-clinical). Participants filled out the Quality of Life Index, Resilience Scale, and Beck Depression Inventory. The clinical participants received one of these possible treatments, DBT, STEPPS, or CBT-TAU. MANOVA and regression analyses were performed. Results: a) participants diagnosed with BPD had statistically significant lower resilience than the non-clinical population; b) all three forms of psychotherapy statistically improved QoL, but there were no statistically significant differences between DBT, STEPPS, and CBT-TAU in the improvement of QoL; c) participants did not show clinically significant improvements in QoL after treatment; d) resilience was associated with QoL before and after treatment; and e) resilience was a predictor of QoL before and after treatment. Conclusion: It is necessary to assess QoL and Resilience in studies on psychotherapy with BPD patients.
Tissue-Specific Transcriptome Analysis Reveals Lignocellulose Synthesis Regulation in Elephant Grass (Pennisetum purpureum Schum.)
Authors: Zhang Wenqing , Zhang Shengkui , Lu Xianqin , Li Can , Liu Xingwang , Dong Geyu , Xia Tao
Published: December 2020

Background: The characteristics of elephant grass, especially its stem lignocellulose, are of great significance for its quality as feed or other industrial raw materials. However, the research on lignocellulose biosynthesis pathway and key genes is limited because the genome of elephant grass has not been deciphered.Results: In this study, RNA sequencing (RNA-seq) combined with lignocellulose content analysis and cell wall morphology observation using elephant grass stems from different development stages as materials were applied to reveal the genes that regulate the synthesis of cellulose and lignin. A total of 3852 differentially expressed genes (DEGs) were identified in three periods of T1, T2, and T3 through RNA-seq analysis. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of all DEGs showed that the two most abundant metabolic pathways were phenylpropane metabolism, starch and sucrose metabolism, which were closely related to cell wall development, hemicellulose, lignin and cellulose synthesis. Through weighted gene co-expression network analysis (WGCNA) of DEGs, a ‘blue’ module highly associated with cellulose synthesis and a ‘turquoise’ module highly correlated with lignin synthesis were exhibited. A total of 43 candidate genes were screened, of which 17 had function annotations in other species. Besides, by analyzing the content of lignocellulose in the stem tissues of elephant grass at different developmental stages and the expression levels of genes such as CesA, PAL, CAD, C4H, COMT, CCoAMT, F5H and CCR, it was found that the content of lignocellulose was related to the expression level of these structural genes.Conclusions: This study provides a basis for further understanding the molecular mechanisms of cellulose and lignin synthesis pathways of elephant grass, and offers a unique and extensive list of candidate genes for future specialized functional studies which may promote the development of high-quality elephant grass varieties with high cellulose and low lignin content.
Comparison of frontal alpha asymmetry among schizophrenia patients, major depressive disorder patients, and healthy controls
Authors: Jang Kuk-In , Lee Chany , Lee Sangmin , Huh Seung , Chae Jeong-Ho
Published: December 2020

Background: Electroencephalography (EEG) frontal alpha asymmetry (FAA) has been observed in several psychiatric disorders. Dominance in left or right frontal alpha activity remains inconsistent in patients with major depressive disorder (MDD), patients with schizophrenia, and healthy controls. This study compared FAA among patients with MDD and schizophrenia, and healthy controls.Methods: We recruited 20 patients with MDD, 18 patients with schizophrenia, and 16 healthy individuals. The EEG alpha frequency ranged from 8 Hz to 12 Hz. FAA was expressed as the difference between absolute power values of right and left hemisphere electrodes in the alpha frequency range (common-log-transformed frontal right- and left-hemisphere electrodes: F4–F3, F8–F7, FP2–FP1, AF4–AF3, F6–F5, and F2–F1). Hamilton depression and anxiety rating scales were evaluated in patients with MDD. Positive and negative syndrome scales were evaluated in patients with schizophrenia.Results: Patients with schizophrenia showed significantly lower left FAA than healthy controls (F4–F3, schizophrenia vs. healthy controls: -0.10 ± 0.04 vs. -0.05 ± 0.05). There were no significant differences in FAA between patients with schizophrenia and MDD as well as between patients with MDD and healthy controls.Conclusions: The present study suggests that FAA indicates a relatively lower activation of left frontal electrodes in schizophrenia. The left-lateralized FAA could be a neuropathological attribute in patients with schizophrenia, but a lack of sample size and information such as medication and duration of illness might obscure the interpretation and generalization of our findings. Thus, further studies to verify the findings would be warranted.
Prevalence and molecular characterization of Group B streptococcus in pregnant women from hospitals in Ohangwena and Oshikoto regions of Namibia.
Authors: Mukesi Munyaradzi , Haimbodi Erastus Lafimana , Moyo Sylvester Rodgers
Published: December 2020

BackgroundThe main purpose of this study was to investigate the prevalence rate, antimicrobial susceptibility patterns and molecular characteristics of Streptococcus agalactiae isolated from pregnant women at 35 weeks of gestation and above, who attended antenatal screening at selected hospitals in Ohangwena and Oshikoto regions of Namibia.ResultsOut of 210 women screened for GBS, 12 (5.7%) were colonised of which 25.0% were colonised rectovaginally, 58.0% vaginally and 17.0% rectally. No significant association was reported between GBS colonisation and maternal age, geographic location, marital status, education, employment, parity, still births and miscarriages (P values >0.05). Antimicrobial susceptibility was reported at 100% for ampicillin, penicillin & ceftriaxone. Resistance to tetracycline was reported at 100%. Tetracycline resistance gene tet(M) was present in 88.9% of the isolates only and none of the isolates presented with tet(O). Polysaccharide capsular type Ia was found in 9(50%) and Ib was found in 1(5.5%) of the total isolates. The remaining isolates were not typeable using PCR.ConclusionStreptococcus agalactiae’s positive rate was 5.7% among the pregnant women examined. Socio-demographic and obstetric factors had no influence on GBS colonisation (P values >0.05). No resistance was reported to ampicillin, penicillin and ceftriaxone. No sensitivity was reported to tetracycline. Fifty percent of the isolates were capsular type Ia, 5.5% were type Ib and 44.4% were not typeable using PCR. The study provides crucial information for informing policy in screening of GBS in pregnant women.
Epigenetic Immunomodulatory effect of Eugenol and Astaxanthin on Doxorubicin Cytotoxicity in Hormonal Positive Breast Cancer Cells
Authors: Fouad Mariam A. , Sayed-Ahmed Mohamed M. , Huwait Etimad A. , Hafez Hafez F. , Osman Abdel-Moneim Mahmoud
Published: December 2020

Background: Hormonal receptor positive (HR+) breast cancer is the most commonly diagnosed molecular subtype of breast cancer; which showed good response to doxorubicin (DOX)-based chemotherapy. Eugenol (EUG) and astaxanthin (AST) are natural compounds with proved epigenetic and immunomodulatory effects in several cancer cell lines. This study has been initiated to investigate the molecular mechanism (s) whereby EUG and AST could enhance DOX cytotoxicity in MCF7 cells.Methods: Cytotoxic activity of DOX alone and combined with either 1mM EUG or 40µM AST was performed using sulphorhodamine-B assay in MCF7 cells. Global histones acetylation and some immunological markers were investigated using ELISA, western blotting and quantitative RT-PCR techniques. Functional assay of multidrug resistance was performed using rhodamine 123 and Hoechst 3342 dyes. Flow cytometry with annexin V and propidium iodide were used to assess the change in cell cycle and apoptosis along with the expression of some differentiation, apoptosis and autophagy proteins. Results: DOX alone resulted in concentration-dependent cytotoxicity with IC50 of 0.5 μM. Both EUG and AST significantly increased DOX cytotoxicity which is manifested as a significant decrease in DOX IC50 from 0.5 μM to 0.088 μM with EUG and to 0.06 μM with AST. Combinations of DOX with 1mM EUG or 40 µM AST significantly increased the level of histones acetylation and histone acetyl transferase expression, while reduced the expression of aromatase and epidermal growth factor receptor (EGFR) when compared with 0.25 µM DOX alone. Also both combinations showed higher uptake of rhodamine but lower of Hoechst stains, along with increased the percentage of caspase 3, and decreased the expression of CK7 and LC3BI/II ratio. EUG combination induced IFγ but reduced TNFα causing shifting of cells from G2/M to S and G0/ G1 phases. Combination of DOX with EUG induced apoptosis through the higher BAX/ BCl2 ratio, while with AST was through the increase in caspase 8 expressions. Conclusion: EUG and AST potentiated the anticancer activity of DOX through epigenetic histones acetylation along with the immunonomodulation of different apoptotic approaches in MCF7 cells.
Spatio-temporal mapping of breast and prostate cancers in South Iran from 2014-2017
Authors: Montazeri Mahdieh , Hoseini Benyamin , Firouraghi Neda , Kiani Fatemeh , Raouf-Mobini Hosein , Biabangard Adele , Dadashi Ali , Zolfaghari Vahideh , Ahmadian Leila , Eslami Saeid , Bergquist Robert , Bagheri Nasser , Kiani Behzad
Published: December 2020

Background:The most common gender-specific malignancies are cancers of the breast and the prostate. In developing countries, cancer screening of all at risk is impractical because of healthcare resource limitations. Thus, determining high-risk areas might be an important first screening step. This study explores incidence patterns of potential high-risk clusters of breast and prostate cancers in southern Iran.Methods:This cross-sectional study was conducted in the province of Kerman, South Iran. Patient data were aggregated at the county and district levels calculating the incidence rate per 100,000 people both for cancers of the breast and the prostate. We used the natural-break classification with five classes to produce descriptive maps. A spatial clustering analysis (Anselin Local Moran’s I) was used to identify potential clusters and outliers in the pattern of these cancers from 2014 to 2017.Results:There were 1,350 breast cancer patients (including, 42 male cases) and 478 prostate cancer patients in the province of Kerman, Iran during the study period. After 45 years of age, the number of men with diagnosed prostate cancer increased similarly to that of breast cancer for women after 25 years of age. The age-standardised incidence rate of breast cancer for women showed an increase from 29.93 to 32.27 cases per 100,000 people and that of prostate cancer from 13.93 to 15.47 cases per 100,000 during 2014-2017. Cluster analysis at the county level identified high-high clusters of breast cancer in the north-western part of the province for all years studied, but the analysis at the district level showed high-high clusters for only two of the years. With regard to prostate cancer, cluster analysis at the county and district levels identified high-high clusters in this area of the province for two of the study years.Conclusions:North-western Kerman had a significantly higher incidence rate of both breast and prostate cancer than the average, which should help in designing tailored screening and surveillance systems. Furthermore, this study generates new hypotheses regarding the potential relationship between increased incidence of cancers in certain geographical areas and environmental risk factors.
Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda.
Authors: Ssekamatte Tonny , Isunju John Bosco , Muyanga Naomi , Buregyeya Esther , Mugambe Richard K , Wanyenze Rhoda K. , Bukenya Justine Nnakate
Published: December 2020

BackgroundTrans-women sex workers bear the greatest brunt of HIV and other sexually transmitted infections (STI). Trans-women are 49 times more at risk of HIV infections compared to the general population. However, they remain underserved and continue to grapple with access to and utilisation of HIV/STI prevention services. This study explored barriers to access and utilisation of HIV/STI prevention services and associated coping mechanisms. MethodsThis exploratory qualitative study was conducted among trans-women sex workers in the Greater Kampala Metropolitan area, Uganda. A total of 22 in-depth interviews, 6 key informant interviews and 9 focus group discussions were conducted to obtain data on barriers to access and utilisation of HIV and other STI prevention and care services, and coping strategies of trans-women sex workers. Data were analysed through thematic analysis using a hybrid of inductive and deductive approaches.ResultsIndividual level barriers to access and utilisation of HIV/STI prevention and care services included internalised stigma and low socio-economic status. Health system barriers included social exclusion and lack of recognition by other key population groups; stigmatisation by some healthcare providers; breach of confidentiality by some healthcare providers; limited hours of operation of some key population-friendly healthcare facilities; discrimination by straight patients and healthcare providers; stockout of STI drugs; inadequate access to well-equipped treatment centres and high cost of drugs. At community level, transphobia hindered access and utilisation of HIV/STI prevention and care services. The coping strategies included use of substitutes such as lotions, avocado or yoghurt to cope with a lack of lubricants. Herbs were used as substitutes for STI drugs, while psychoactive substances were used to cope with stigma and discrimination, and changing the dress code to hide their preferred gender identity. Conclusions Individual, community and health system level barriers hindered access and utilisation of HIV/STI prevention and care services among the trans-women sex workers. There is a need to create an enabling environment in order to enhance access to and utilisation of HIV/STI prevention and care services for trans-women sex workers through sensitisation of healthcare providers, other key population groups and the community at large on the transgender identity.
Mutation screening of the UBE3A gene in Chinese Han population with autism
Authors: Zhao Xue , Zhang Ran , Yu Shunying
Published: December 2020

Background15q11-13 region is one of the most complex chromosomal regions in the human genome. UBE3A is an important candidate gene of autism spectrum disorder (ASD), which located at the 15q11-13 region and encodes ubiquitin-protein ligase E3A. Previous studies about UBE3A gene and ASD have shown inconsistent results and few studies were performed in Chinese population. This study aimed to detect the genetic mutations of UBE3A gene in Chinese Han population with ASD and analyze genetic association between these variants and ASD.MethodsThe samples consisted of 192 patients with clinical diagnosis of autism according to the DSM-IV diagnostic criteria and 192 healthy controls. We searched for mutations at coding sequence (CDS) regions and their adjacent non-coding regions of UBE3A gene using the high resolution melting (HRM) and Sanger sequencing methods. We further increased sample size to validate the detected variants using HRM and conducted association analysis between case and control groups.ResultsA known single nucleotide polymorphism (T>C, rs150331504) located at the CDS4 and a known 5bp insertion/deletion variation (AACTC+/-, rs71127053) located at the intron region of the upstream 288bp of the CDS2 of UBE3A gene were detected using Sanger sequencing method. The ASD samples of case group were 391 for rs71127053, 384 for rs150331504 and 384 healthy controls, which were used to make an association analysis. The results of association analysis suggested that there were no significant difference about the allele and genotype frequencies of rs71127053 and rs150331504 between case and control groups after extending the sample size. Besides, rs150331504 is a synonymous mutation and we compared the secondary structure and minimum free energy (MFE) of mRNA harboring the allele T or C of rs150331504 using RNAfold software. We found that the centroid secondary structure apparently differs along with the polymorphisms of rs150331504 T>C, the results suggested that this variant might change the secondary structure of mRNA of UBE3A gene. We did not detect mutations in other coding regions of UBE3A gene. ConclusionsThese findings showed that UBE3A gene might not be a major disease gene in Chinese ASD cases.
Associations of education and work status with alcohol use and cessation among pregnant women in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study
Authors: Murakami Keiko , Obara Taku , Ishikuro Mami , Ueno Fumihiko , Noda Aoi , Kuriyama Shinichi
Published: December 2020

Background: There is inconsistent evidence on the associations of education and work status with alcohol use during pregnancy. We aimed to examine the associations of education and work status with alcohol use in early and middle pregnancy and alcohol cessation between early and middle pregnancy in Japan.Methods: This prospective study was part of the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017. Pregnant women were recruited at approximately 50 obstetric clinics and hospitals in Miyagi Prefecture in Japan. We analyzed 11592 pregnant women who completed the questionnaires administered in early pregnancy and middle pregnancy. Women were dichotomized as current drinkers or non-drinkers in both early and middle pregnancy. Multivariable logistic regression analyses were conducted to examine associations of education and work status with alcohol use in early and middle pregnancy, adjusting for age, income, psychological distress, and work status/education. Associations with alcohol cessation between early pregnancy and middle pregnancy were also examined.Results: Prevalence of alcohol use in early and middle pregnancy was 20.9% and 6.4%, respectively. Higher education was associated with alcohol use in early pregnancy and alcohol cessation during pregnancy; the odds ratios (ORs) of ≥university education compared with ≤high school education were 1.47 (95% confidence interval [CI], 1.30–1.66) and 1.31 (95% CI, 1.00–1.71), respectively. Work status was associated with alcohol use in both periods and alcohol cessation during pregnancy; for alcohol cessation, the OR of working in early pregnancy only compared with not working in both periods was 1.72 (95% CI, 1.03–2.88).Conclusions: Women with higher education were more likely to consume alcohol in early pregnancy and to cease between early pregnancy and middle pregnancy. Working women were more likely to consume alcohol throughout pregnancy in Japan.
Eye gaze differences in school scenes between preschool children and adolescents with high-functioning autism spectrum disorder and those with typical development
Authors: Ishizaki Yuko , Higuchi Takahiro , Yanagimoto Yoshitoki , Kobayashi Hodaka , Noritake Atsushi , Nakamura Kae , Kaneko Kazunari
Published: December 2020

Background: Children with autism spectrum disorder (ASD) may experience difficulty adapting to daily life in a preschool or school settings and are likely to develop psychosomatic symptoms. For a better understanding of the difficulties experienced daily by preschool children and adolescents with ASD, this study investigated differences in eye gaze behavior in the classroom environment between children with ASD and those with typical development (TD).Methods: The study evaluated 30 children with ASD and 49 children with TD. Participants were presented with images of a human face and a classroom scene. While they gazed at specific regions of visual stimuli, eye tracking with an iView X system was used to evaluate and compare the duration of gaze time between the two groups.Results: Compared with preschool children with TD, preschool children with ASD spent less time gazing at the eyes of the human face and the object at which the teacher pointed in the classroom image. Preschool children with TD who had no classroom experience tended to look at the object the teacher pointed at in the classroom image.Conclusion: Children with ASD did not look at the human eyes in the facial image or the object pointed at in the classroom image, which may indicate their inability to analyze situations, understand instruction in a classroom, or act appropriately in a group. This suggests that this gaze behavior of children with ASD causes social maladaptation and psychosomatic symptoms. A therapeutic approach that focuses on joint attention is desirable for improving the ability of children with ASD to adapt to their social environment.
Enhanced in vitro production of diosgenin in shoot cultures of Dioscorea deltoidea by elicitation and precursor feeding
Authors: Nazir Romaan , Gupta Suphla , Kumar Vijay , Gupta Ajai Prakash , Dwivedi Padmanabh , Dey Abhijit , Malik Tabarak , Pandey Devendra Kumar
Published: December 2020

Background: Dioscorea deltoidea (Family: Dioscoreaceae) is a critically endangered medicinal plant widely used in traditional medicine and pharmaceutical industries for the preparation of appropriate drugs. The present study was conducted to investigate the effect of different elicitors such as salicylic acid (SA), methyl jasmonate (MeJa), jasmonic acid (JA) and abscisic acid (ABA) on the synthesis of diosgenin production in D. deltoidea shoot cultures. In addition, the effect of different precursors (squalene, β-sitosterol, and cholesterol) was also demonstrated. Results: Results showed that precursors significantly influenced diosgenin production as compared to elicitors. Application of SA (200 µM) showed highest diosgenin production (0.912% DW) following 4 h of incubation time, whereas MeJA (100 µM) exhibited 0.814% DW of diosgenin content following 8 h of incubation time. Among precursors, β-sitosterol at 200 µM produced maximum diosgenin content (1.006% DW) followed by 100 µM squalene (0.947% DW) harvested after 5th day of the precursor addition. Interestingly, cholesterol showed low diosgenin production, but significant than control cultures. Finally response surface methodology (RSM) was conducted to see the interactive effect of best elicitors and precursors concentration for better yield of diosgenin and biomass.Conclusions: The results revealed that exposure to different elicitors and precursors have a significant influence on accumulation of diosgenin in D. deltoidea shoot cultures. The optimized conditions for SA and β-sitosterol for the better yield of diosgenin and biomass were found to be 165 µM, 150 µM and 170 µM, 140 µM respectively.
Clinical characteristics and outcomes of Influenza A and B virus infection in adult Australian hospitalised patients
Authors: Sharma Yogesh , Horwood Chris , Hakendorf Paul , Thompson Campbell
Published: December 2020

Background Influenza B is often perceived as a less severe strain of influenza. The epidemiology and clinical outcomes of influenza B have been less thoroughly investigated in hospitalised patients. The aim of this study was to describe clinical differences and outcomes between influenza A and B admitted over period of four years. Methods We retrospectively collected data of all laboratory confirmed influenza patients ³18 years at two tertiary hospitals in South Australia. Patients were confirmed as influenza positive if they had a positive polymerase-chain-reaction (PCR) test of a respiratory specimen. Complications during hospitalisation along with inpatient mortality were compared between influenza A and B. In addition, 30 day mortality and readmissions were compared. Logistic regression model compared outcomes after adjustment for age, Charlson index, sex and creatinine levels. Results Between January 2016-March 2020, 1846 patients, mean age 66.5 years, were hospitalised for influenza. Of whom, 1630 (88.3%) had influenza A and 216 (11.7%) influenza B. Influenza B patients were significantly younger than influenza A. Influenza A patients were more likely be smokers with a history of chronic obstructive pulmonary disease (COPD) and ischaemic heart disease (IHD) than influenza B. Complications, including pneumonia and acute coronary syndrome (ACS) were similar between two groups, however, septic shock was more common in patients with influenza B. Adjusted analyses showed similar median length of hospital stay (LOS), in hospital mortality, 30-day mortality and readmissions between the two groups. Conclusions Influenza B is less prevalent and occurs mostly in younger hospitalised patients than influenza A. Both strains contribute equally to hospitalisation burden and complications. Trial registration Australia and New Zealand Clinical Trial Registry (ANZCR) no ACTRN12618000451202 date of registration 28/03/2018
Is Preexisting Mental Illness Associated with Lower Patient Satisfaction for Older Trauma Patients? A Cross-sectional Descriptive Study
Authors: McGraw Constance , Pekarek Jennifer , Redmond Diane , Vogel Rebecca , Tanner Allen , Bar-Or David
Published: December 2020

Background: The purpose of this study was to examine if satisfaction with care differs among older trauma patients with and without preexisting mental illness (PMI+/PMI-).Methods: Data from two level I trauma centers were examined 11/2016-12/2017. Trauma patients ≥55 years were included and satisfaction of those who had a diagnosis of mental illness prior to the trauma admission (PMI+) to those without a diagnosis (PMI-) (n=299; 62 PMI+ and 237 PMI-) were compared. Enrolled patients completed the Family Satisfaction with Advanced Care Cancer Scale Patient Survey (FAMCARE-P13) prior to discharge. Associations between mental illness status and patient baseline characteristics, overall mean satisfaction, and mean satisfaction by question were compared. Generalized linear models adjusted for differences in patient satisfaction by mental illness status. Analyses were stratified by hospital to account for the interaction between hospital and mental illness status.Results: Compared to PMI- patients, PMI+ patients were more likely to be younger, female, have multiple comorbidities, and to report lower overall satisfaction with care. Among PMI+ patients, the most common diagnoses were depression and anxiety. After adjustment, PMI+ was associated with lower patient satisfaction at hospital 1; after examining individual questions lower satisfaction was associated with information provided on procedures and questions surrounding “Physical care.” Conversely, PMI+ did not affect satisfaction at hospital 2 after adjustment.Conclusions: At hospital 1, room for improvement was identified in providing information about prognosis and procedures, symptom management, and continuity of care. Reexamining practices for older PMI+ trauma patients is warranted.
A collagen membrane influences bone turnover marker in vivo after bone augmentation with xenogenic bone
Authors: Staedt Henning , Dau Michael , Schiegnitz Eik , Thiem Daniel G.E. , Tagadiuc Olga , Palarie Victor , Ottl Peter , Al-Nawas Bilal , Kammerer Peer W
Published: December 2020

Background: The aim was to compare early biochemical and histological osseous healing of chronic mandibular defects regenerated with bovine bone substitute with and without collagen membrane in vivo. Methods: Eight weeks after formation of a lateral full-thickness perforating bone defect in the mandible of 40 rabbits, bovine bone substitute with (“+”;n=20) and without (“-“;n=20) collagen membrane was applied. Blood and bone was collected 24, 72 hours, 7, 14 and 21 days after surgery. Total acid phosphatase, bone acid phosphatase, total alkaline phosphatase and bone alkaline phosphatase activities were compared between groups. Formation of new bone was quantified histologically for all time points.Results: Twenty-four hours after surgery, bone alkaline phosphatase was significantly elevated in “+” group when compared to “-“ (p=0.012). After 72 hours, all bone turnover markers except for total acid phosphatase (p=0.078) where significantly elevated in “+” (all p<0.05). 14 days after surgery, the significant highest values for all bone turnover markers were detected in “-“ (all p<0.05). A significant difference in favor of group “-“ could also be detected after 3 weeks in terms of both acid phosphatases (p<0.05). In histology, no significant differences could be detected.Conclusion: Bone regeneration with bovine bone substitute material and collagen membrane shows a significantly earlier bone remodeling activity but does not seem to influence formation of new bone in histological samples.
Emotional states of different obesity phenotypes: A sex-specific study in a west-Asian population
Authors: Mehrabi Fahimeh , Amiri Parisa , Cheraghi Leila , Kheradmand Ali , Hosseinpanah Farhad , Azizi Fereidoun
Published: December 2020

Background: The present study aimed to investigate the relationship of obesity phenotypes with depression, anxiety, and stress among adults in the Tehran Lipid and Glucose Study (TLGS)."Methods: Depression, anxiety, and stress levels of participants from the TLGS were examined among different obesity phenotypes in this cross-sectional study. Weight, height, and waist circumferences of participants were measured. Obesity was defined as body mass index (BMI) ≥30 kg/m², and metabolically unhealthy status based on having metabolic syndrome (MetS) or type 2 diabetes. Four obesity phenotypes were defined: 1) Metabolically Healthy Non-Obese (MHNO), 2) Metabolically Healthy Obese (MHO) 3) Metabolically Unhealthy Non-Obese (MUNO), and 4) Metabolically Unhealthy Obese (MUO). Emotional states of different obesity phenotypes were assessed by the Persian version of depression, anxiety, and stress scale-21 items (DASS-21). Ordinal logistic regression analysis was used to compare sex-specific odds ratios of depression, anxiety, and stress in different obesity phenotypes. Results: The mean age of 2469 men and women was 46.2±15.9 and 45.6±14.7, respectively. In total, women were more likely to experience higher levels of depression (30.5%), anxiety (44.2%), and stress (43.5%) symptoms compared to men. After adjusting for potential confounders, compared to MHNO men, the odds of experiencing higher anxiety levels were significantly greater in metabolically unhealthy men whether they were obese (OR: 1.78, 95% CI: 1.25-2.54; P=<0.001) or non-obese (OR: 1.61, 95% CI: 1.17-2.21; P= <0.001), and also in MUO women (OR: 1.73, 95% CI: 1.28-2.34; P=<0.001) compared to MHNO women. Moreover, the odds of experiencing higher stress levels were significantly greater in MUNO men (OR: 1.40, 95% CI: 1.02-1.90; P=0.04) compared to MHNO men, and in MUO women (OR: 1.45, 95% CI: 1.07-1.96; P=0.02) compared to MHNO women. No difference in having higher levels of depression was observed in either sex. Conclusions: Our results showed that men and women with various obesity phenotypes experience different anxiety and stress levels. While MUO women and all metabolically unhealthy men experienced more anxiety and stress levels than MHNO individuals, none of the obesity phenotypes were associated with depression. These findings provide insight into recognizing the psychological consequences of different phenotypes of obesity.
Sorafenib as a Second-Line Treatment in Metastatic Renal Cell Carcinoma in Mexico: A Prospective Cohort Study
Authors: Martin-Aguilar Ana Elena , Núñez-López Haidé Nayeli , Ramirez-Sandoval Juan C.
Published: December 2020

Background: Sequential inhibition of the vascular endothelial growth factor (VEGF) pathway with sorafenib could be useful for patients with metastatic renal cell carcinoma (RCC). Our aim was to determine the activity and tolerability of sorafenib as a second-line therapy in advanced RCC initially treated with a different VEGF-tyrosine kinase inhibitor (TKI). Methods: A prospective observational cohort in Mexico (2012–2019). We included 132 subjects with metastatic RCC and who had progression despite treatment with sunitinib. The primary end-point was time to disease progression as evaluated every 12–16 weeks. Results: The mean age of the cohort was 59 years (interquartile range [IQR] 50-72), 96 (73%) were men, and 48 (36%) had a favorable prognosis according to the IMDC (International Metastatic RCC Database Consortium) prognostic model. The median progression-free survival (PFS) and overall-survival after the introduction of sorafenib treatment was 8.6 months (95% confidence interval [CI]: 6.7–10.5) and 40 months (95% CI: 34.5–45.4) respectively. The median overall survival from RCC diagnosis to death was 71 months (95% CI: 58.2–83.8). On multivariable analyses, age >65 years was associated with a longer PFS (HR 0.51; 95% CI: 0.31-0.86; p = 0.018). The median PFS in subjects aged >65 years was longer compared to subjects ≤65 years (14.0 [95% CI: 9.2–18.8] vs . 7.2 months [95% CI: 5.3–9.1]; p = 0.012). Adverse events grade ≥3 associated with sorafenib occurred in 38 (29%) patients. Conclusion: Sequential inhibition of VEGF with sorafenib as a second-line treatment may benefit patients with metastatic RCC, especially in subjects >65 years old.
Feasibility and Outcome of Metacognitive Therapy for Major Depressive Disorder: A pilot study
Authors: Winter Lotta , Schweiger Ulrich , Kahl Kai G.
Published: December 2020

Background: Several studies have shown the effectiveness of Metacognitive Therapy (MCT) in treating different mental disorders. Most of these studies were performed in English speaking countries using the original English version of the manual. Our study aimed to examine the feasibility of the translated MCT manual in a sample of German patients with major depressive disorder.Methods: 20 outpatients (6 male, 14 female, mean age 42.1y) with major depressive disorder were included. The main outcome was drop-out rate and satisfaction with the treatment; secondary outcomes were changes in metacognitive beliefs assessed with the metacognitive questionnaire 30 (MCQ-30), and symptom reduction measured with the Beck Depression Inventory-2 sum score (BDI-2).Results: No drop-outs during the treatment and the follow-up phase were observed. Patients and therapists were highly satisfied with MCT treatment. The MCQ-30 significantly declined over the treatment course, paralleled by a significant reduction of the BDI-2 sum scores (from 29 ± 8.6 at T0 to 8.4 ± 9.6 at the end of treatment).The average treatment duration was 10 ± 4 sessions. Conclusions: Applying the German version of the manual for Metacognitive Therapy proved to be feasible in the treatment of depressed patients in an outpatient setting. The treatment was well tolerated by German patients. Outcome in terms of reduction of depressive symptoms was good. Remarkable is the comparably short treatment duration which should be investigated further in future studies.Trial registration: German Clinical Trials Register (DRKS): DRKS00023644, 17.11.2020 (retrospectively registered).
Development of Targeted Therapy Therapeutics to Sensitize Triple-Negative Breast Cancer Chemosensitivity Utilizing Bacteriophage phi29 Derived Packaging RNA
Authors: Zhang Long , Mu Chaofeng , Zhang Tinghong , Yang Dejun , Wang Chenou , Chen Qiong , Tang Lin , Fan Luhui , Liu Cong , Shen Jianliang , Li Huaqiong
Published: December 2020

Background To date, triple-negative breast cancer (TNBC) treatment options are limited because of the loss of target receptors and, as a result, are only managed with chemotherapy. What is worse is that TNBC is frequently developing resistance to chemotherapy. By using small interfering RNA (siRNA)-based therapeutics, our recent work demonstrated X-box-binding protein 1 (XBP1) was linked to human epidermal growth factor receptor 2 positive (HER2+) breast cancer development and chemoresistance. Given the instability, off-target effects, net negative charge, and hydrophobicity of siRNA in vivo utilization and clinical transformation, its use in treatment is hampered. Thus, the development of a siRNA-based drug delivery system (DDS) with ultra-stability and specificity is necessary to address the predicament of siRNA delivery.Results Here, we assembled RNase resistant RNA nanoparticles (NPs) based on the 3WJ structure from Phi29 DNA packaging motor. To improved targeted therapy and sensitize TNBC to chemotherapy, the RNA NPs were equipped with an epidermal growth factor receptor (EGFR) targeting aptamer and XBP1 siRNA. We found our RNA NPs could deplete XBP1 expression and suppress tumor growth after intravenous administration. Meanwhile, RNA NPs treatment could promote sensitization to chemotherapy and impede angiogenesis in vivo.Conclusions The results further demonstrate that our RNA NPs could serve as an effective and promising platform not only for siRNA delivery but also for chemotherapy-resistant TNBC therapy.