bluuebunny/crossref_metadata_2025 huggingface dataset:
A risk score based on pediatric Sequential Organ Failure Assessment predicts 90-day mortality in children with Klebsiella pneumoniae bloodstream infection
Authors: Li Shuang , Liu Jingxian , Chen Feng , Cai Kang , Tan Jintong , Xie Wei , Qian Rong , Liu Xiaoqin , Zhang Wenhong , Du Huimin , Liu Ying , Huang Lisu
Published: August 2020

Background: Klebsiella pneumoniae bloodstream infection (Kp-BSI) is a serious threat to pediatric patients. The objective of this study was to explore the risk factors, validate the prediction efficiency of pediatric Sequential Organ Failure Assessment (SOFA) and establish better early predictors of mortality in pediatric patients with Kp-BSI.Methods: All children diagnosed with Kp-BSI were included in this retrospective cohort study from January 2009 to June 2019. Basic characteristics, symptoms and physical examinations, treatments, laboratory statistics, and SOFA at the onset of Kp-BSI were recorded. The Cox proportional hazard model and receiver operating characteristic curves were used to assess the association between the variables and the 90-day mortality and their predictive value. DeLong’s test of receiver operating characteristic curves and integrated discrimination improvement index were used to determine the improvement in predictive capacity of the modified SOFA models. A predictive score was developed using multivariate logistic regression.Results: Of the 146 children enrolled, 33 (22.6%) patients died within 90 days. Hospitalization in the last six months, intra-abdominal source of infection, presence of organ failure, and altered levels of blood biomarkers, including C-reactive protein, albumin, and lactate were significant risk factors for 90-day mortality. The area under the curve (AUC) of SOFA for predicting 90-day mortality was 0.80 (95% CI 0.71–0.89). Moreover, we found that a prediction model combining SOFA with two other parameters, namely hospitalization in the last six months and intra-abdominal source of infection, was better at predicting mortality (AUC = 0.89, 95% CI 0.82–0.96; sensitivity = 0.86; specificity = 0.84). According to this novel risk model, we defined three statistically different groups: low-risk, medium-risk and high-risk groups, with an observed 90-day mortality of 5.4%, 35.7%, and 72.0%, respectively. With reference to the low-risk patients, the medium-risk and high-risk groups had a higher mortality, with hazard ratios of 8.36 (95% CI 3.60–27.83) and 20.27 (95% CI 7.47–54.95), respectively.Conclusions: The modified SOFA may be better than the original score to predict 90-day mortality in pediatric patients with Kp-BSI. Future prospective studies are required to validate this novel scoring system in external cohorts.
Efficient reaction deletion algorithms for redesign of constraint-based metabolic networks for metabolite production with weak coupling
Authors: Tamura Takeyuki
Published: August 2020

BackgroundMetabolic engineering strategies enabling the production of specific target metabolites by host strains can be identified in silico through the use of metabolic network analysis such as flux balance analysis. This type of metabolic redesign is based on the computation of reactions that should be deleted from the original network representing the metabolism of the host strain to enable the production of the target metabolites while still ensuring its growth (the concept of growth coupling). In this context, it is important to use algorithms that enable this growth-coupled reaction deletions identification for any metabolic network topologies and any potential target metabolites. A recent method using a strong growth coupling assumption has been shown to be able to identify such computational redesign for nearly all metabolites included in the genome-scale metabolic models of Escherichia coli and Saccharomyces cerevisiae when cultivated under aerobic conditions. However, this approach enables the computational redesign of S. cerevisiae for only 3.9% of all metabolites if under anaerobic conditions. Therefore, it is necessary to develop algorithms able to perform for various culture conditions.ResultsThe author developed an algorithm that could calculate the reaction deletions that achieve the coupling of growth and production for 91.3% metabolites in genome-scale models of S. cerevisiae under anaerobic conditions. Computational experiments showed that the proposed algorithm is efficient also for aerobic conditions and Escherichia coli. In these analyses, the least target production rates were evaluated using flux variability analysis when multiple fluxes yield the highest growth rate. To demonstrate the feasibility of the coupling, the author derived appropriate reaction deletions using the new algorithm for target production in which the search space was divided into small cubes (CubeProd).ConclusionsThe author developed a novel algorithm, CubeProd, to demonstrate that growth coupling is possible for most metabolites in S.cerevisiae under anaerobic conditions. This may imply that growth coupling is possible by reaction deletions for most target metabolites in any genome-scale constraint-based metabolic networks. The developed software, CubeProd, implemented in MATLAB, and the obtained reaction deletion strategies are freely available.
Nasal carriage of Staphylococcus aureus in farm animals and breeders in North of Morocco
Authors: Mourabit Nadira , Arakrak Abdelhay , Bakkali Mohammed , Zian Zeineb , Bakkach Joaira , Laglaoui Amin
Published: August 2020

Background: The objectives of this study were to determine for the first time, in Morocco, the nasal carriage rate, antimicrobial susceptibility profiles and virulence genes of Staphylococcus. aureus isolated from animals and breeders in close contact.Methods: From 2015 to 2016, 421 nasal swab samples were collected from 26 different livestock areas in Tangier. Antimicrobial susceptibility phenotypes were determined by disk diffusion according to EUCAST 2015. The presence of nuc , mec A, mec C, lukS/F-PV, and tst genes were determined by Polymerase Chain Reaction (PCR) for all isolates.Results: The overall S. aureus nasal carriage rate was low in animals (9.97%) and high in breeders (60%) with a statistically significant difference, (OR= 13.536; 95% CI = 7.070- 25.912; p< 0.001). In general, S. aureus strains were susceptible to the majority of antibiotics and the highest resistance rates were found against tetracycline (16.7% in animals and 10% in breeders). No Methicillin-Resistant S. aureus (MRSA) was detected in animals and breeders. A high rate of tst and lukS/F-PV genes has been recovered only from animals (11.9% and 16.7%, respectively).Conclusion: Despite the lower rate of nasal carriage of S. aureus and the absence of MRSA strains in our study, S. aureus strains harbored a higher frequency of tst and lukS/F-PV virulence genes, which is associated to an increased risk of infection dissemination in humans. This highlights the need for further larger and multi-center studies to better define the transmission of the pathogenic S. aureus between livestock, environment, and humans.
Exploring patient satisfaction after operative and nonoperative treatment for midshaft clavicle fractures: a focus group analysis
Authors: Tutuhatunewa Eric Danjel , Stevens Martin , Dams Olivier C. , Son Jeffrey van , Louhanepessy Rebecca D. , Krabbe Paul F.M. , Postma Maarten J. , Diercks Ron L.
Published: August 2020

Background There is no consensus on the optimal treatment for displaced midshaft clavicle fractures. Several studies indicate superior patient satisfaction in favour of operative reconstruction. It is unknown what drives superior satisfaction in this treatment group. The aim of this study was to explore patient satisfaction and identify contributors to patient satisfaction after operative and nonoperative treatment for displaced midshaft clavicle fractures in adults using a focus group approach. Methods Four face-to-face and two web-based focus groups were hosted. A total of 24 participants who were treated nonoperatively (n = 14) or operatively (n = 10) agreed to participate. Participants were selected using purposive sampling, ensuring variation in gender, age, treatment complications and outcomes. A question script was developed to systematically explore patient expectations, attitudes and satisfaction with different dimensions of care. All focus groups were voice-recorded and transcribed at verbatim. Thematic analysis was conducted on all face-to-face and web-based transcripts. Results The main emerging themes across treatment groups were; need for more information, functional recovery, speed of recovery and patient-doctor interaction. There was no difference in themes observed between operative and nonoperative focus groups. The lack of information was the most important complaint in dissatisfied patients. Conclusion Our study shows that informing patients about their injury, treatment options and expectations for recovery is paramount for overall patient satisfaction after treatment for a displaced midshaft clavicle fracture. Level of evidence: Level III, focus group study
An efficient bifunctional electrocatalyst of phosphorous carbon co-doped MOFs
Authors: Du Li , Lv Mengyuan , Liu Dandan , Song Huiyu
Published: August 2020

It is eager to develop high-performance and cheap bifunctional electrochemical catalysts for both of the ORR or OER for the energy crisis and environmental problems. Herein, we report a series of ZIF-derived Co-P-C co-doped polyhedral materials with a well-defined morphology. The optimized catalyst Co/P/MOFs-CNTs-700 exhibited favorable electrochemical activities with the lowest over potential of 420 mV to achieve the current density of 10 mA cm-2 for OER and the half potential of 0.8 V for ORR in 0.1 M NaOH. The performance can be well improved by doping phosphorous resource which greatly changed its morphology. Meanwhile, the doped carbon resources also improve the conductivity, which makes it a promising bifunctional electrochemical catalyst and can be comparable with the commercial electrocatalysts.
Climatology of Medium-Scale Traveling Ionospheric Disturbances (MSTIDs) Observed with GPS Networks in the North African Region
Authors: Oluwadare Temitope Seun , Jakowski Norbert , Valladares Cesar E. , Akala Andrew Oke-Ovie , Abe Oladipo E. , Alizadeh Mahdi M. , Schuh Harald
Published: August 2020

We present for the first time the climatology of medium-scale traveling ionospheric disturbances (MSTIDs) by using Global Positioning System (GPS) receiver networks on geomagnetically quiet days (Kp ≤ 3) over the North African region during 2008-2016. The ionospheric Total Electron Content (TEC) were estimated from the dual-frequency GPS measurements, and the TEC perturbations (dTEC) data were derived from the estimated TEC data. We focused on the TEC perturbations (dTEC) associated with medium-scale traveling ionospheric disturbances (MSTIDs) and statistically analyzed the MSTIDs characteristics, occurrence rate, diurnal and seasonal behavior as well as the interannual dependence. The oscillating wave-like pattern of MSTIDs showed a local and seasonal dependence of nighttime and daytime. The results showed that MSTIDs propagation direction is predominantly towards the South (equatorward), MSTIDs event period is (12 ≤ period ≤ 53 mins), and dominant amplitude (0.08 ≤ amp ≤ ~1.5 TECU), with a propagation velocity higher at daytime than nighttime. The amplitudes of the MSTIDs increase with solar activity. The study reveals that the spatio-temporal variation of MSTIDs depends on local time and solar activity. The study also shows that the disturbance occurrence time is dominant within the hours of (1200–1600 LT), and (1000–1400 LT) in December solstice at daytime for stations located in the Northwest (NW) and Northeast (NE) part of the African region, respectively. While at the nighttime, the MSTIDs exhibits variability in disturbance occurrence time around (NW: 2100–0200 LT) and (NE: 1900–0200 LT) in June solstice, but get extended to March equinox during solar maximum (2014). The mean phase velocity in daytime MSTIDs is higher than the nighttime in every season, except during June solstice. The study revealed that atmospheric gravity waves (AGWs) control the daytime MSTIDs occurrence for a selected day.
Genome wide association studies for japonica rice resistance to blast in field and controlled conditions
Authors: Volante Andrea , Tondelli Alessandro , Desiderio Francesca , Abbruscato Pamela , Menin Barbara , Biselli Chiara , Casella Laura , Singh Namrata , McCouch Susan R. , Tharreau Didier , Zampieri Elisa , Cattivelli Luigi , Valè Giampiero
Published: August 2020

Background

Rice blast, caused by the fungus Pyricularia oryzae , represents the most damaging fungal disease of rice worldwide. Utilization of resistant cultivars represents a practical way to control the disease. Most of the rice varieties cultivated in Europe and several other temperate regions are severely depleted of blast resistance genes, making the identification of resistant sources in genetic background adapted to temperate environments a priority. Given these assumptions, a Genome Wide Association Study (GWAS) for rice blast resistance was undertaken using a panel of 311 temperate/tropical japonica and indica accessions adapted to temperate conditions and genotyped with 37,423 SNP markers. The panel was evaluated for blast resistance in field, under the pressure of the natural blast population, and in growth chamber, using a mixture of three different blast strains.

Results

The parallel screening identified 11 accessions showing high levels of resistance in the two conditions, representing potential donors of resistance sources harbored in rice genotypes adapted to temperate conditions. A general higher resistance level was observed in tropical with respect to temperate japonica varieties. The GWAS identified 14 Marker-Traits Associations (MTAs), 8 of which discovered under field conditions and 6 under growth chamber screening. Three MTAs were identified in both conditions; five MTAs were specifically detected under field conditions while three for the growth chamber inoculation. Comparative analysis of physical/genetic positions of the MTAs showed that most of them were positionally-related with cloned or mapped blast resistance genes or with candidate genes whose functions were compatible for conferring pathogen resistance. However, for three MTAs no obvious candidates or positional relationships were identified, raising the possibility that these loci harbor previously unidentified blast resistance genes.

Conclusions

We identified 14 MTAs for blast resistance using both field and growth chamber screenings. A total of 11 accessions showing high levels of resistance in both conditions were discovered. Combinations of loci conferring blast resistance were identified in rice accessions adapted to temperate conditions, thus allowing the genetic dissection of affordable resistances present in the panel. The obtained information will provide useful bases for both resistance breeding and further characterization of the highlighted resistance loci.
World Health Organization Grading Classification for Pancreatic Neuroendocrine Neoplasms: A Comprehensive Analysis from a Large Chinese Institution
Authors: Yang Min , Zeng Lin , Ke Neng-wen , Tan Chun-lu , Tian Bo-le , Liu Xu-bao , Xiang Bo , Zhang Yi
Published: August 2020

Background: Pancreatic neuroendocrine neoplasms (p-NENs) are a group of highly heterogeneous tumors with distinct clinicopathological features and long-term prognosis. In 2017, in order to better stratify patients into prognostic groups and predicting their outcomes, World Health Organization (WHO) officially updated its grading system for p-NENs which distinguished these neoplasms among Grading 1 (G1) pancreatic neuroendocrine tumors (p-NETs), G2 p-NETs, G3 p-NETs and G3 pancreatic neuroendocrine carcinomas (p-NECs). However, this new grading classification for p-NENs has not yet been rigorously validated.Methods: Data of patients who were surgically treated and histopathologically diagnosed as p-NENs at West China Hospital of Sichuan University from January 2002 to December 2018 were retrospectively collected and analyzed according the novel WHO 2017 grading classification.Results: We eventually enrolled 480 eligible patients with p-NENs in our present study, in which 150 patients with WHO 2017 G1 p-NETs, 158 with G2 p-NETs, 64 with G3 p-NETs and 108 with G3 p-NECs were identified. The estimated 5-year overall survival for patients with G1 p-NETs, G2 p-NETs, G3 p-NETs and G3 p-NECs was 75.8%, 58.4%, 35.1% and 11.1%, with a median survival time of 85.3mons, 67.4mons, 51.3mons and 26.8mons, respectively. Patients with G2 p-NETs present notably worse survival than those with G1 p-NETs (P=0.03). Survival of G3 p-NETs were significantly worse than that of G1 p-NETs or G2 p-NETs (P<0.001, P=0.023, respectively), as well as that when comparing G3 p-NECs with G1 p-NETs or G2 p-NETs (P<0.001, P<0.001, respectively). Patients with G3 p-NECs showed statistically shorter survival than those with G3 p-NETs (P<0.001). Both WHO 2017 and 2010 grading criteria could be independent predictor for the OS of p-NENs (P=0.016, P=0.022; respectively). The 95% confidence intervals of WHO 2017 grading classification (0.983-9.454) was slightly smaller than that of WHO 2010 criteria (0.201-13.374), indicating a relatively more accurate predicting ability for the prognosis of p-NENs.Conclusion: The WHO 2017 grading classification for p-NENs could successfully allocate patients into four groups with distinct clinical features and significant survival differences, which might be superior to the WHO 2010 criteria for its better prognostic stratification and more accurate predicting ability.
Minimum 3.5-year outcomes of operative treatment for Achilles tendon partial tears in the midportion and retrocalcaneal area
Authors: Lohrer Heinz
Published: August 2020

Background: Achilles tendon partial tears are not easy to diagnose and to manage. Most frequently, they are located in the midportion and insertional area. These entities result from different pathologic pathways and different treatment strategies are applied. The outcome is rarely investigated. Methods: This study includes patients who underwent surgery for partial tears in the midportion or retrocalcaneal Achilles tendon area between the years 2009 and 2015 by a single surgeon. Patients were prospectively assessed preoperatively and 3, 6, and 12 months postoperatively, using the VISA-A-G questionnaire. The final retrospective follow-up was performed after a minimum of 3.5 years postoperatively. Forty-eight Achilles tendon partial tears at the level of the retrocalcaneal bursa (impingement lesions) and 27 midportion Achilles tendon partial tears were identified. After applying rigorous exclusion criteria, 21 and 16 cases, respectively, remained for the final follow-up. Results were analysed by inferential and descriptive statistics.Results: The VISA-A-G outcome scores improved significantly from preoperative to six months, 12 months, and final postoperative assessment. Preoperatively, the average VISA-A-G score was 42.1 (range, 18-73) for patients operated for Achilles tendon partial tears at the level of the retrocalcaneal bursa and 44.6 (range, 10-73) for the midportion Achilles tendon partial tear group, respectively. At final follow-up 88.8 (range, 15 to 100) and 96.9 (range, 71 to 100) were scored in the respective treatment groups. A repeated measures ANOVA determined that mean performance levels showed a statistically significant difference between measurements (p < 0.001). There was no systematic effect found between groups (p = 0.836).Conclusions: In Achilles tendon partial tears recalcitrant to conservative treatment, operative intervention is highly successful in most cases, irrespective of the level of the injury. Results were statistically equal when comparing the midportion and retrocalcaneal Achilles tendon partial tear groups. Trial registration: DRKS, DRKS00014266. Registered 06 April 2018. 'Retrospectively registered', https://www.drks.de/drks_web/navigate.do?navigationId=results .
Symbiotic microbiome Staphylococcus aureus from human nasal mucus modulates IL-33-mediated type 2 immune responses in allergic nasal mucosa
Authors: Jeon Yung Jin , Gil Chan Hee , Won Jina , Jo Ara , Kim Hyun Jik
Published: August 2020

Background: The host-microbial commensalism can shape the innate immune responses in respiratory mucosa and nasal microbiome also modulates front-line immune mechanism in the nasal mucosa. Inhaled allergens encounter the host immune system first in the nasal mucosa, and microbial characteristics of nasal mucus directly impact the mechanisms of initial allergic responses in nasal epithelium. However, the roles of the nasal microbiome in allergic nasal mucosa remain uncertain. We sought to determine the distribution of nasal microbiomes in allergic nasal mucosa and elucidate the interplay between nasal microbiome Staphylococcus species and Th2 cytokines in allergic rhinitis (AR) models.Results: Staphylococcus aureus (AR-SA) and S. epidermidis (AR-SE) were isolated from the nasal mucosa of patients with AR. The influence of nasal microbiome Staphylococcus species on allergic nasal mucosa was also tested with in vitro and in vivo AR models. Pyrosequencing data showed that colonization by S. epidermidis and S. aureus was more dominant in nasal mucus of AR subjects. The mRNA and protein levels of IL-33 and TSLP were significantly higher in AR nasal epithelial (ARNE) cells which were cultured from nasal mucosa of AR subjects, and exposure of ARNE cells to AR-SA reduced IL-33 mRNA and secreted protein levels. Particularly, ovalbumin-driven AR mice inoculated with AR-SA by intranasal delivery exhibited significantly reduced IL-33 in their nasal mucosa. In the context of these results, allergic symptoms and Th2 cytokine levels were significantly downregulated after intranasal inoculation of AR-SA in vivo AR mice. Conclusion: Colonization by Staphylococcus species was more dominant in allergic nasal mucosa, and nasal commensal S. aureus from subjects with AR mediates anti-allergic effects by modulating IL-33-dependent Th2 inflammation. The results demonstrate the role of host-bacterial commensalism in shaping human allergic inflammation.
The Efficacy and Safety of Indocyanine green- hyaluronic acid mixture (LuminoMarkTM) for Localization in Patients with Non-palpable Breast Lesions: A Multi-center Open-label Parallel Phase-2 Clinical trial
Authors: kim isaac , Choi Hee Jun , Ryu Jai Min , Lee Se Kyung , Yu Jong Han , Lee Jeong Eon , Nam Seok Jin , Shin Hyuk Jai , Kim Seok Won
Published: August 2020

Backgrounds

With increasing screening for breast cancer, non-palpable breast lesions are detected more frequently. A preoperative localization is very important for a minimal but accurate excision of a non-palpable breast lesion. The purpose of this study was to evaluate the efficacy and safety of indocyanine green(ICG)-hyaluronic acid mixture injection as a novel material for localization.

Methods

We performed prospective clinical trial with female patients who underwent surgery for non-palpable breast lesion. 44 patients were sequentially assigned to the control group(localization with activated charcoal), test group 1(ICG-hyaluronic acid mixture 0.1ml), or test group 2(ICG-hyaluronic acid mixture 0.2ml) by 1:1:1 ratio.

Results

Most were over 40 years old, and there were no differences between three groups in age distribution. According to the pathologic results, fibroadenoma accounted for the largest share (38.6%, 17/44) and malignancy accounted for 11.4% (5/44). The marking rate on both breast lesions and excised specimens was over 86% in all groups, and there was no difference. However, skin pigmentation was only in the control group and the accuracy of resection (the greatest length in cm of the excised specimen divided by the greatest length in cm on the pre-operation ultrasound image, the value closer to 1 meant resection as much as the size on ultrasound image) was different significantly. The average was 3.7(range 1.2-13.3) in control group and 2.2 (1.0-4.2) in test 1 group and 2.1(1.0-4.2) in test 2 group.

Conclusion

ICG-hyaluronic acid mixture injection was superior to activated charcoal for localization in patients with non-palpable breast lesions.
Using Routine Health Information Data for Research in Low- and Middle-Income Countries: A Systematic Review
Authors: Hung Yuen Wai , Hoxha Klesta , Irwin Bridget R. , Law Michael R. , Grépin Karen Ann
Published: August 2020

Background: Routine health information systems (RHISs) support resource allocation and management decisions at all levels of the health system, as well as strategy development and policy-making in many low- and middle-income countries (LMICs). Although RHIS data represent a rich source of information, such data are currently underused for research purposes, largely due to concerns over data quality. Given that substantial investments have been made in strengthening RHISs in LMICs in recent years and that there is a growing demand for more real-time data from researchers, this systematic review builds upon the existing literature to summarize the extent to which RHIS data have been used in peer-reviewed research publications. Methods: Using terms ‘routine health information system’, ‘health information system’, or ‘health management information system’ and a list of LMICs, four electronic peer-review literature databases were searched from inception to February 20 2019: PubMed, Scopus, EMBASE, and EconLit. Articles were assessed for inclusion based on pre-determined eligibility criteria and study characteristics were extracted from included articles using a piloted data extraction form.Results: We identified 132 studies that met our inclusion criteria, originating in 37 different countries. Overall, the majority of the studies identified were from Sub-Saharan Africa and were published within the last five years. Malaria and maternal health were the most commonly studied health conditions, although a number of other health conditions and health services were also explored. Conclusions: Our study identified an increasing use of RHIS data for research purposes, with many studies applying rigorous study designs and analytic methods to advance program evaluation, monitoring and assessing services, and epidemiological studies in LMICs. RHIS data represent an underused source of data and should be made more available and further embraced by the research community in LMIC health systems.
The Samuel F. B. Morse Statue in Central Park: Scientific Study and Laser Cleaning of a 19th-Century American Outdoor Bronze Monument
Authors: Basso Elena , Pozzi Federica , Reiley Matthew C.
Published: August 2020

Many of Central Park’s bronze statues were coated with lacquer as a protective measure between the late 1970s and early 1990s. In several cases, these coatings outlasted their performance life and were no longer adequately protecting the sculptures. In 2010, a cyclical campaign to remove and refurbish the coatings provided an opportunity to closely assess the condition of de-coated surfaces and to develop suitable, sustainable treatment approaches. The Samuel F. B. Morse statue, created in 1870 by Byron Pickett, commemorates the 19 th -century painter and inventor known for the telegraphic code that bears his name. Initially, samples from this statue were collected on the field and analyzed with various techniques to characterize the degradation products that were heavily affecting its surface and the organic coatings used to protect the bronze. Various corrosion species, mainly sulfates and chlorides, were identified by X-ray powder diffraction, while pyrolysis – gas chromatography / mass spectrometry revealed that the organic coatings were based on mineral wax and acrylics. These results informed a decision to relocate the statue to a controlled workshop space to aid in the manipulation of the large figure and optimize cleaning by laser ablation. Treatment was monitored through three campaigns of analysis using portable X-ray fluorescence (pXRF) spectroscopy, performed on select locations, to characterize the extent of corrosion across the sculpture’s surface and monitor changes on the target areas throughout the cleaning. Following the initial phase of treatment, pXRF showed the substantial removal of iron- and lead-rich compounds from the brownish-toned coating and atmospheric pollution deposition. In the subsequent treatment phases, variations in the relative amounts of sulfates and chlorides were noted and further investigated through the examination of a cross section by means of scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM/EDS). Based on the findings of iron-containing pigments in the organic coating, a decision to apply a new, similar, translucent, brown-toned coating containing such coloring materials was made to achieve the desired visual nuance for the finish and provide additional corrosion inhibition to the bronze. Scientific analysis on the Morse statue has helped characterize its materials, methods of fabrication, and current conditions on a microscopic scale; in addition, it has guided the means and methodologies of treatment and relays essential information useful for future preservation.
E-Consults: an effective way to decrease clinic wait times in Rheumatology
Authors: Patel Veena , Stewart Diana , Horstman Molly
Published: August 2020

Background: To evaluate the effect of E-consults on wait times and resource utilization for positive antinuclear antibody (ANA) referrals in outpatient rheumatology.Methods: We conducted a pre-post study of E-consult implementation for positive ANA referrals. We retrospectively reviewed “positive ANA” referrals from 1/2015-3/2017. A statistical process control chart was created to display monthly average wait times for in-person clinic visits and to identify special cause variation. Final Diagnoses, wait times and resource utilization were recorded and compared between E-consults and in-person referrals.Results: There were 139 referrals for positive ANA with 126 occurring after E-consult implementation in August 2015. Forty-four percent (55/126) of referrals were E-consults; 76% did not have an in-person visit after initial electronic rheumatology recommendation. A control chart demonstrated special cause variation in the form of a shift from June 2016 – January 2017, suggesting a temporal association between decreased wait times and the implementation of E-consults. Eleven patients were diagnosed with ANA-associated rheumatic disease; the majority of patients (73%, 86/139) did not have a rheumatologic diagnosis. Overall E-consults utilized more labs than in-person visits, but this was not statistically significant. In-person visits utilized more imaging studies, which was statistically significant. Conclusion: E-consults are an effective way to address positive ANA consults without significant increase in resource utilization and were temporally associated with decreased wait times for in-person visits.
Influence of influenza A virus in COVID-19 patients: A retrospective cohort study
Authors: Cheng Yuan , Ma Jing , Wang He , Wang Xi , Hu Zhanwei , Li Haichao , Zhang Hong , Liu Xinmin
Published: August 2020

Background and objective: Coronavirus disease (COVID-19) is currently an urgent global issue, but we cannot ignore the impact of influenza A since there is an overlap of infection time and region and similar clinical manifestations and chest computed tomography (CT) images for influenza A and COVID-19 infections. We compared patients who had a COVID-19 infection and co-infection with the influenza A virus.Methods: We retrospectively reviewed patients who met the inclusion criteria for this study.Results: There were 213 patients included in this study, of whom 106 were females and 107 were males, with a median age of 63 years. All patients were diagnosed with COVID-19 and were subsequently divided into influenza positive (n = 97) and influenza negative (n = 116) groups according to the serum test results for the influenza A IgM antibody. The two groups had similar symptoms, outcomes, CT manifestation and CT scores, except for lymphadenopathy (6.2% in the influenza positive group vs. 14.7% in the negative group, P = 0.047). However, in the subgroup analysis, male or younger patients (age <= 60 years) in the influenza negative group had higher CT scores than patients in the influenza positive group (P < 0.05).Conclusions: COVID-19 patients who had co-infection with the influenza A virus showed similar symptoms, outcomes, CT manifestation and CT scores to influenza negative patients. However, male patients and younger patients had higher CT scores in the influenza negative group.
Uncovering the Mechanism of Shenlian Capsules in the Treatment of Non-small Cell Lung Cancer by System Pharmacology
Authors: Fu Wanjin , Gong Ajuan , Yu Bin , Wei Xin , Chen Yong , Zhou Renpeng , Lu Chao , Hu Wei
Published: August 2020

Background: Shenlian Capsule is a Chinese medicine compound approved by the China Food and Drug Administration (CFDA) for the treatment of advanced non-small cell lung cancer(NSCLC). However, due to its complex constituents, cause its effective active compounds and main action mechanisms for treating diseases are still not fully clear. The purpose of this work is to explore the active ingredients and mechanisms of Shenlian Capsule treatment NSCLC through a system pharmacological approach. Methods: First, a database of Shenlian Capsule chemical composition was constructed by retrieving Chinese herbal medicine data. Absorption, distribution, metabolism and excretion (ADME) methods were used to screen potential active compounds. Predict active compound targets with a large-scale molecular network target prediction technology. Clustering of active compounds obtained through cluster analysis by MECODE plug-in, each cluster obtains the main pathways through enrichment analysis method. To get all targets related to survival in NSCLC, the survival related targets were intersected with the compounds target (C-T) network to get the survival related targets for Shenlian Capsule. Finally, a batch molecular docking technique was used to verify the effect of active compounds of Shenlian Capsule on survival-related targets.Results: The Shenlian Capsule C-T network was constructed with 117 potential compounds and 47 targets. Treatment of NSCLC with Shenlian Capsule through enrichment analysis may involve multiple pathways such as anti-inflammatory, immune regulation, regulation of cell cycle, apoptosis, antiviral, cell hypoxia, angiogenesis and so on. Shenlian Capsule has eight survival-related genes in non-small cell lung adenocarcinoma (LUAD) and two survival-related genes in non-small cell squamous cell lung carcinoma (LUSC). It is known through molecular docking that the active compound has lower energy after conformation with survival-related genes, and has lower binding energy and stable binding.Conclusion: In this study, the potential compounds of active compounds in Shenlian Capsule were first predicted using network pharmacology technology. Through the enrichment analysis, the main pathways of the role of Shenlian Capsule were outcropped. Secondly, by combining bioinformatics and network pharmacology, Shenlian Capsule can be regulated to target survival-related targets. Finally, the molecular docking technique shows the relationship between active compounds and survival-related targets after docking. This work provided a scientific basis for the clinical role of Shenlian Capsule in the treatment of NSCLC, provided a research basis for further clarifying the active ingredients and mechanism of Shenlian Capsule in the treatment of NSCLC.
CP Poly(A) RNA Binding Immunity via Outside-in Glycosyltransfer with MT of BTRC-Activating L12535 and PIN1 Subnetworks for Cognition in PFC|CD14
Authors: Wang Lin , Chen Qingchun , Feng Haitao , Jiang Minghu , Huang Juxiang , Jiang Zhenfu
Published: August 2020

Background: Ras suppressor protein 1 (L12535) and peptidylprolyl cis/trans isomerase NIMA-interacting 1 (PIN1) common molecular and knowledge subnetworks containing microtubule associated protein 1B-MAP1B_1 (upstream) related to cognition by references were identified in human left hemisphere, based on our established significant high expression beta-transducin repeat containing E3 ubiquitin protein ligase (BTRC)-activating downstream Gene (protein) reconstruction network inference (GRNInfer) and Database for Annotation, Visualization and Integrated Discovery (DAVID).Results: Our results show the common molecules exostosin-like glycosyltransferase 2 (EXTL2) interaction with MAP1B_1 both activating TERF1_1 with HSP90AB1 from BTRC-activating downstream GRNInfer database; The common biological process and molecular function of MAP1B_1, TERF1_1 as microtubule (MT) binding; HSP90AB1 as poly(A) RNA binding; BTRC, HSP90AB1, PIN1 as innate immune response from BTRC-activating downstream DAVID database; The common cellular component of EXTL2 at integral component of membrane; MAP1B_1, HSP90AB1, TERF1_1 at cytoplasm (CP); The common tissue distributions of L12535 and PIN1 in Prefrontal Cortex (PFC), PB cluster of differentiation (CD)14+Monocytes.Conclusions: We propose and mutual positively verify CP poly(A) RNA binding immunity via outside-in glycosyltransfer with MT of BTRC-activating L12535 and PIN1 subnetworks for cognition in PFC|CD14.
The Mechanism of Prevention and Treatment of Maxing Shigan Decoction on Pulmonary Heart Injury Caused by Novel Coronavirus Pneumonia
Authors: Liu Dongling , Su Jing , Hou Wenqian , Ren Weiyu , Zheng Yijun , Ning Yanmei , Jin Xiaojie , Liu Yongqi
Published: August 2020

Background

To explore the mechanism of Maxing Shigan Decoction in the treatment of myocardial injury and lung injury through network pharmacology and molecular docking technology.
Methods

In Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), a Bioinformatics Analysis Tool for Molecular mechANism of Traditional Chinese Medicine (BATMAN-TCM) and the Comparative Toxicogenomics Database, National Center for Biotechnology Information database, Online Mendelian Inheritance in Man database, the compounds and targets of each drug in Maxing Shigan Decoction and the targets of “acute lung intervention” and “myocardial injury” diseases were searched. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed by the DAVID database. GOLD 5.1 was used for molecular docking.
Results

Maxing Shigan Decoction includes 327 compounds and 2722 targets, including 30 key targets. 2125 items were obtained by GO enrichment analysis, including 2047 items of Biological Process, 28 items of Cell Composition and 50 items of Molecular Function. The KEGG pathway was enriched to obtain 149 pathways. The results of molecular docking showed that Gancaonin H and Licorice Glycoside E were well combined with Angiotensin-Converting Enzyme 2-A (ACE2-A) and Angiotensin-Converting Enzyme 2-B (ACE2-B), respectively, and Licorice was well combined with Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) and Interleukin 6 (IL-6). Supraene is an active compound of Ephedra. It has good binding with ACE2-A, ACE2-B, GM-CSF and IL-6, respectively. (6Z, 10E, 14E, 18E)-2, 6, 10, 15, 19, 23- hexamethyletracosa-2, 6, 10, 14, 18, 22- hexaene are the active compounds of Almond, which are well combined with ACE2-A, ACE2-B, GM-CSF and IL-6.
Conclusion

Maxing Shigan Decoction may act on ACE2, GM-CSF and IL-6 targets through the active compounds Supraene of Ephedra, and Almond (6Z, 10E, 14E, 18E)-2, 6, 10, 15, 19, 23-hexamethyletracosa-2, 6, 10, 14, 18, 22-hexaene. Gancainin H and licorice Glycide E are the active compounds of Licorice, act on A and B sites of ACE2 respectively, and Glycyrin acts on GM-CSF and IL-6 targets, coordinating multiple signal pathways to play anti-inflammatory and antiviral roles to prevent and treat lung and heart injury caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).
Metabolic Syndrome and Mental Health in Posttraumatic Stress Disorder Patients
Authors: SHAHMIRI Hassan , TAGHVA Arsia , EBRAHIMI Mohammad-Reza , URIMI Seyyed Behnam HASHEMI , RAHNEJAT Amir-Mohsen
Published: August 2020

Background: Posttraumatic stress disorder (PTSD) is an abnormal physiologic and psychological reaction in person with severe traumatic history. In recent studies, the relationship between PTSD and some other disease apparently unrelated to psychological situations such as cardiovascular diseases, diabetes, and metabolic syndrome has been revealed. Thus, the aim of this study was to survey the prevalence of metabolic syndrome and mental health in PTSD patients. Methods: The research design was retrospective cohort study. Subjects were consisted of 142 Iran-Iraq war veterans with PTSD (age: 40-60 years) and the control group was consisted of 153 veterans without PTSD. Data was collected using questionnaires, physical exams and laboratory tests.Results: Prevalence of metabolic syndrome was 45.1%in PTSD group and 17% in control group. In addition blood pressure, triglyceride and fasting blood sugar in PTSD group were significantly higher than control group (p<0.05). Also, PTSD patients had significant high rates of psychiatric disorders.Conclusion: PTSD patients are more prone to metabolic syndrome and psychiatric disorders than control group.
Network Pharmacological Analysis of Huanglian Jiedu Decoction for Anti- Atherosclerosis
Authors: Wu Kerui , Jiang Lu , Huang Lanlin , He Yaxing , Yan Xia , Wang Dawei
Published: August 2020

Objective: We aimed to predict the possible active components,key targets and pathways of Huanglian Jiedu Decoction(HLJDD) for anti-atherosclerosis. Methods: The TCMSP database was searched to obtain the active components and targets of HLJDD, the GeneCards and OMIM databases were searched to obtain related targets of atherosclerosis, and we obtain the intersection targets of them, which are the potential targets of HLJDD for anti-atherosclerosis.Application of Cytoscape 3.6.0 software to build a herbal-active ingredient-potential target regulation network.We perform protein-protein interaction(PPI) network analysis of potential targets through STRING 11.0 database and obtain the key targets,and the results of PPI network of key targets were visualized by Cytoscape3.6.0 software. Gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of the key targets were performed using STRING11.0 database, and we finally constructed the possible pharmacological network of HLJDD for anti-atherosclerosis .Results: We finally obtained 14 key active ingredients of HLJDD, 65 key targets of anti-atherosclerosis, and 14 key active ingredients corresponded to 52 of these targets. These targets are mainly involved in biological processes such as reaction to organic substance, reaction to chemical stimulation,etc.They mainly involved in biological signaling pathways such as pathways in cancer,IL-17 signaling pathway,etc. Conclusion: HLJDD may act on 52 key targets such as PTGS2, HSP90AA1 and RELA through 14 key active ingredients, and influence the signaling pathways including fluid shear stress and atherosclerosis,PI3K-Akt signaling pathway,IL-17 signaling pathway,AGE-RAGE signaling pathway in diabetic complications,TNF signaling pathway,etc.Thus, it may play an anti-atherosclerosis role by inhibiting inflammatory reaction, oxidative stress and improving hemodynamics,etc.
Long-term Condition Management for Prisoners: exploring prevalence and compliance with QOF monitoring
Authors: Wright Nat , Hankins F , Hearty P , Allott D , Allgar V
Published: August 2020

Background: Long-term conditions (LTCs) are a significant cause of morbidity and mortality and prisoner populations have a disproportionately high prevalence of risk factors for LTCs. The size and mean age of the prison population has increased rapidly in recent years. The UK Quality Outcomes Framework (QOF) is a national standardised framework embedded in community general practice with financial remuneration linked to assessment and ongoing review of key clinical outcomes pertaining to LTCs. However, healthcare in prisons in England is not linked to financial remuneration through the QOF framework and prison clinicians are not mandated to adhere to the framework.Methods: Secondary data analysis of data extracted from the prison primary care record pertaining to patient self-report of LTC, level of confirmation by supporting evidence and compliance with QOF monitoring frameworks. Results: 17% of the sample had at least one LTC, the most common condition being asthma, confirmed in 12% of the sample. Having an LTC was associated with female gender and increasing age. Prevalence rates for the other LTCs were hypertension 3%, epilepsy was 3%, coronary heart disease 2%, diabetes 2% and chronic obstructive pulmonary disease 1%. Just 34% of the eligible sample had had a QOF template completed. Higher rates of completion were associated with younger age and there were also statistically significant inter-prison differences. Conclusion: There is a pressing need to embed standardised QOF monitoring systems within an integrated community/prison commissioning framework supported by connectivity between prison and community primary care records of not just the summary care record but also all activity related to QOF compliance. Amongst prisoner populations, there is high prevalence of risk factors for long-term conditions. This research quantifies the burden of disease and highlights under-developed systems for monitoring. There is an opportunity to enhance connectivity between community and prison GP settings to facilitate seamless monitoring of QOF outcomes.
Durable Control of HIV-1 Using a Staphylococcus aureus Cas9-Expressing Lentivirus Co-Targeting Viral Latency and Host Susceptibility
Authors: Chavez Leonard , Reddy Nishith , Raymond Kyle , Bouzidi Mohamed , Desai Shivani , Dossani Zain , Sperber Hannah , Theiler James , Korber Bette , Pillai Satish
Published: August 2020

CRISPR/Cas9 gene editing has the potential to revolutionize the clinical management of HIV-1 infection, and may eliminate the need for antiretroviral therapy (ART). Current gene therapies attempt to either excise HIV-1 provirus or target HIV-1 entry receptors to prevent infection of new cells. Using a viral dynamic model, we determined that combining these two interventions, in the presence or absence of ART, significantly lowers the gene editing efficacy thresholds required to achieve an HIV-1 cure. To implement this dual-targeting approach, we engineered a single lentiviral vector that simultaneously targets multiple highly-conserved regions of the provirus and the host CXCR4 coreceptor, and developed a novel coculture system enabling real-time monitoring of latent infection, viral reactivation, and infection of new target cells. Simultaneous dual-targeting depleted HIV-1-infected cells with significantly greater potency than vectors targeting either virus or host independently, highlighting its potential as an HIV-1 cure strategy.