bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacovigilance of suspected or confirmed therapeutic ineffectiveness of artemisinin-based combination therapy: extent, associated factors, challenges and solutions to reporting
Authors: Kiguba Ronald , Ndagije Helen Byomire , Nambasa Victoria , Manirakiza Leonard , Kirabira Elijah , Serwanga Allan , Olsson Sten , Speybroeck Niko , Mukonzo Jackson
Published: October 2020

Background Therapeutic ineffectiveness of artemisinin-based combination therapy (ACT) increases the risk of malaria-related morbidity and mortality, and raises healthcare costs. Yet, little has been done to promote the pharmacovigilance (PV) of ACT ineffectiveness in sub-Saharan Africa, particularly in Uganda. This study aimed to determine the extent and associated factors of the past 6 months reporting of suspected or confirmed ACT therapeutic ineffectiveness by healthcare professionals (HCPs), and difficulties and potential solutions to the PV of ACT therapeutic ineffectiveness.Methods Survey of 685 HCPs conducted using a self-administered questionnaire from June to July 2018 in a nationally representative sample of public and private health facilities in Uganda. HCPs disclosed if they had spontaneously reported ACT therapeutic ineffectiveness to appropriate authorities in the previous 6 months. Multivariable logistic regression models were used to identify determinants of past 6-months, HCP-reported ACT therapeutic ineffectiveness.Results One in five (20%, 137/685; 95% CI: 17-23%) HCPs reported ACT therapeutic ineffectiveness to an appropriate authority in the previous 6 months. HCPs commonly reported ACT therapeutic ineffectiveness to immediate supervisors (72%, 106/147), mostly verbally only (80%, 109/137); none had ever submitted a written report of ACT therapeutic ineffectiveness to Uganda’s National Pharmacovigilance Centre. Common difficulties of reporting ACT therapeutic ineffectiveness were: unavailability of reporting procedures (31%, 129/421), poor follow-up of treated patients (22%, 93/421) and absence of reporting tools (16%, 68/421). Factors associated with reporting ACT therapeutic ineffectiveness in the past 6 months were: hospital-status (vs other; OR = 2.4, 95% CI, 1.41-4.21), HCPs aged under 25 years (OR = 2.2, 95% CI, 1.29-3.76), suspicion of ACT therapeutic ineffectiveness in the past 4 weeks (OR = 2.3, 95% CI, 1.29-3.92), receipt of patient-complaint(s) of ACT therapeutic ineffectiveness in the past 4 weeks (OR = 2.9, 95% CI, 1.62-5.12) and HCPs from northern (vs central; OR = 0.5, 95% CI, 0.28-0.93) and western (vs central; OR = 0.4, 95% CI, 0.17-0.77) parts of Uganda.Conclusion One in five HCPs reported ACT therapeutic ineffectiveness, mostly verbally to supervisors. The existing adverse drug reaction (ADR)-reporting infrastructure could be leveraged to promote the PV of ACT therapeutic ineffectiveness.
Overexpression of AtAHL20 causes delayed flowering in Arabidopsis via repression of FT expression
Authors: Tayengwa Reuben , Sharma-Koirala Pushpa , Pierce Courtney F. , Werner Breanna E , Neff Michael M
Published: October 2020

Background: The 29-member Arabidopsis AHL gene family is classified into three main classes based on nucleotide and protein sequence evolutionary differences. These differences include the presence or absence of introns, type and/or number of conserved AT-hook and PPC domains. AHL gene family members are divided into two phylogenetic clades, Clade-A and Clade-B. A majority of the 29 members remain functionally uncharacterized. Furthermore, the biological significance of the DNA and peptide sequence diversity, observed in the conserved motifs and domains found in the different AHL types, is a subject area that remains largely unexplored. Results: Transgenic plants overexpressing AtAHL20 flowered later than the wild type under both short and long days. Transcript accumulation analyses showed that 35S:AtAHL20 plants contained reduced FT, TSF, AGL8 and SPL3 mRNA levels. Similarly, overexpression of AtAHL20’s orthologue in Camelina sativa, Arabidopsis’ closely related Brassicaceae family member species, conferred a late-flowering phenotype via suppression of CsFT expression. However, overexpression of an aberrant AtAHL20 gene harboring a missense mutation in the AT-hook domain’s highly conserved R-G-R core motif abolished the late-flowering phenotype. Data from targeted yeast-two-hybrid assays showed that AtAHL20 interacted with itself and several other Clade-A Type-I AHLs which have been previously implicated in flowering-time regulation: AtAHL22, AtAHL27 and AtAHL29.Conclusion: We showed via gain-function analysis that AtAHL20 is a negative regulator of FT expression, as well as other downstream flowering time regulating genes. A similar outcome in Camelina sativa transgenic plants overexpressing CsAHL20 suggest that this is a conserved function. Our results demonstrate that AtAHL20 acts as a photoperiod-independent negative regulator of transition to flowering.
Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data
Authors: He Jingyi , Ghorveh Mohsen Ghiasi , Hurst Jillian H. , Tang Monica , Alhanti Brooke , Lang Jason E. , Goldstein Benjamin
Published: October 2020

Background: Asthma exacerbations in children often require medications, urgent care, and hospitalization. Multiple environmental triggers have been associated with asthma exacerbations, including particulate matter 2.5 (PM2.5) and ozone, which are primarily generated by motor vehicle exhaust. There is mixed evidence as to whether proximity to highways increases risk of asthma exacerbations. Methods: To evaluate the impact of highway proximity, we assessed the association between asthma exacerbations and the distance of child’s primary residence to two types of roadways in Durham County, North Carolina, accounting for other patient-level factors. We abstracted data from the Duke University Health System electronic health record (EHR), identifying 6,208 children with asthma between 2014 – 2019. We geocoded each child’s distance to roadways (both 35 MPH+ and 55 MPH+). We classified asthma exacerbation severity into four tiers and fitted a recurrent event survival model to account for multiple exacerbations. Results: There was a no observed effect of residential distance from 55+ MPH highway (Hazard Ratio: 0.98 (95% confidence interval: 0.94, 1.01)) and distance to 35+ MPH roadway (Hazard Ratio: 0.98 (95% confidence interval: 0.83, 1.15)) and any asthma exacerbation. Even those children living closest to highways (less 0.25 miles) had no increased risk of exacerbation. These results were consistent across different demographic strata. Conclusions: While the results were non-significant, the characteristics of the study sample – namely farther distance to roadways and generally good ambient environmental pollution may contribute to the lack of effect. Compared to previous studies, which often relied on self-reported measures, we were able to obtain a more objective assessment of outcomes. Overall, this work highlights the opportunity to use EHR data to study environmental impacts on disease.
The spread of COVID-19 outbreak in the first 120 days: A comparison between Nigeria and seven other countries
Authors: Adebowale Ayo Stephen , Fagbamigbe Adeniyi Francis , Akinyemi Joshua Odunayo , Obisesan Olalekan K , Awosanya Emmanuel J , Afolabi Rotimi Felix , Alarape Selim A , Obabiyi Sunday O
Published: October 2020

Background: COVID-19 is an emerging global public health crisis. The increase in the daily COVID-19 confirmed cases in Nigeria is worrisome vis-a-vis its large and dense population. This study aims at assessing the pattern of spread in the first 120 days of COVID-19 case confirmation in Nigeria, and its comparison with seven other countries. Methods: Data extracted from the World Bank’s website were used for the descriptive assessment and modelling of COVID-19 disease using the first 120 days of the index case in Nigeria and seven other countries. Linear, quadratic, cubic and exponential methods of regression model were used to fit the data (α=0.05). Results: The COVID-19 growth pattern in Nigeria was similar to that of Egypt, Ghana and Cameroun; Nigeria COVID-19's daily death distribution was comparable to six of the other seven countries considered. There was an increasing trend in the daily COVID-19 confirmed cases in Nigeria. During the lockdown, the growth rate of COVID-19 in Nigeria was 5.85 (R2=0.728, p<0.001); however, it was 8.42 (R2=0.625, p<0.001) after the lockdown’s relaxation. Across all the countries investigated, the cubic polynomial model (CPM) provided the best fit for predicting COVID-19 cumulative cases and there was a clear deviation from the exponential growth model. Using the CPM, all things being equal, a 3-month (30 September 2020) prediction of COVID-19 cases in Nigeria was 155,467 (95% CI:151,111-159,824, p<0.001). Conclusions: An improvement in COVID-19 control measures and strict compliance with the COVID-19 recommended protocols are essential. A contingency plan is needed to provide care for the active cases in case the predicted target is realised.
High-throughput sequencing analysis of the rhizosphere arbuscular mycorrhizal fungi (AMF) community composition associated with Ferula sinkiangensis
Authors: Luo Yunfeng , Wang Zhongke , He Yaling , Li Guifang , Lv Xinhua , Zhuang Li
Published: October 2020

Background: Ferula sinkiangensis is an increasingly endangered medicinal plant. Arbuscular mycorrhiza fungi (AMF) are symbiotic microorganisms that live in the soil wherein they enhance nutrient uptake, stress resistance, and pathogen defense in host plants. While such AMF have the potential to contribute to the cultivation of Ferula sinkiangensis, the composition of AMF communities associated with Ferula sinkiangensis and the relationship between these fungi and other pertinent abiotic factors still remains to be clarified.Results: Herein, we collected rhizosphere and surrounding soil samples at a range of depths (0-20, 20-40, and 40-60 cm) and a range of slope positions (bottom, middle, top). These samples were then subjected to analyses of soil physicochemical properties and high-throughput sequencing (Illumina MiSeq). We determined that Glomus and Diversispora species were highly enriched in all samples. We further found that AMF diversity and richness varied significantly as a function of slope position, with this variation primarily being tied to differences in relative Glomus and Diversispora abundance. In contrast, no significant relationship was observed between soil depth and overall AMF composition, although some AMF species were found to be sensitive to soil depth. Many factors significantly affected AMF community composition, including organic matter content, total nitrogen, total potassium, ammonium nitrogen, nitrate nitrogen, available potassium, total dissolvable salt levels, pH, soil water content, and slope position. We further determined that Shannon diversity index values in these communities were positively correlated with total phosphorus, nitrate-nitrogen levels, and pH values (P<0.05), whereas total phosphorus, total dissolvable salt levels, and pH were positively correlated with Chao1 values (P<0.05). Conclusion: In summary, our data revealed that Glomus and Diversispora are key AMF genera found within Ferula sinkiangensis rhizosphere soil. These fungi are closely associated with specific environmental and soil physicochemical properties, and these soil sample properties also differed significantly as a function of slope position (P<0.05). Together, our results provide new insights regarding the relationship between AMF species and Ferula sinkiangensis, offering a theoretical basis for further studies of their development.
Pulmonary Benign Metastasizing Leiomyomas: a Case Series of 23 Patients at a Single Facility
Authors: Fan Rong , Feng Fengzhi , Yang Hua , Xu Kaifeng , Li Shanqing , You Yan , Wan Xirun , Zhu Lan
Published: October 2020

Background: Pulmonary benign metastasizing leiomyoma (PBML) is a rare disease characterized by leiomyoma of benign histopathology existing in the lungs. Because of its rarity, limited literature with a single case or small number of cases has been regarding to the clinical course, pathology or management of PBML.Methods: A retrospective study was performed of all PBML cases diagnosed and managed at Peking Union Medical College Hospital (PUMCH) from 2001 to 2019. The clinical characteristics, pathology, treatment and outcomes of each case were studied.Results: There were 25 PBML patients identified in the 19-year period in PUMCH, and 23 patients’ data was analyzed. The median age at diagnosis was 46 years. There were 7 patients (30.4%) diagnosed with postmenopausal status. 2 patients (8.7%) had no uterine leiomyoma, and 3 patients (13.0%) had no gynecologic surgery history. Immunohistochemistry of most lesions demonstrated positive for desmin, SMA and Estrogen/Progesterone Receptors; and negative for S-100 were shown in 7 cases. After curative or diagnostic surgeries for the PBML, several treatments from observation to medical or surgical castration were performed. 9 premenopausal patients preserved their ovaries at first. At a median follow-up of 8 years, 3 patients finally had oophorectomy.Conclusions: PBML is a rare disease and should be treated by individualization according to the patients’ age, symptoms and extent of lesion. Curative surgery for patients with limited lesions can achieve the complete response. For patients that are young and asymptomatic, close observation is recommended as the first choice. All patients should undergo long-term surveillance.
Clinical profiles of subclinical disease among pulmonary tuberculosis patients: a prospective cohort study in South Korea
Authors: Min Jinsoo , Chung Chaeuk , Jung Sung Soo , Park Hye Kyeong , Lee Sung-Soon , Lee Ki Man
Published: October 2020

Background: Subclinical tuberculosis (TB) is a potential target for public health intervention because its early identification may reduce TB transmission. We aimed to describe the clinical and laboratory findings of subclinical disease among pulmonary TB patients and compared treatment outcomes for subclinical and active diseases.Methods: In this prospective cohort study, we enrolled adult patients aged ≥19 years with pulmonary TB between 2016 and 2018. Subclinical TB was defined as radiographic or microbiologic test results consistent with TB without clinical symptoms. We implemented a two-stage symptom assessment using a predefined TB symptom checklist. Demographic, clinical, and laboratory data were compared between subclinical and active diseases using multivariate binary logistic regression analysis. We evaluated treatment outcomes in the drug-susceptible cohort. Results: Among 420 enrolled patients, 81 (19.3%) had subclinical TB. Multivariate analysis showed that age <65 years was the only variable significantly associated with subclinical disease. Subclinical disease had a significantly lower proportion of acid-fast bacilli smear and culture positivity and multiple lobe involvement compared to active disease. The white blood cell counts, platelet counts, and C-reactive protein levels were significantly higher among patients with active disease than among those with subclinical disease. Among 319 patients with treatment success in the drug-susceptible cohort, six (1.9%) recurrent cases were identified, and all were active disease. Patients with subclinical disease had a higher proportion of favourable outcomes; however, its odds ratio was insignificant.Conclusions: Nearly one-fifth of tuberculosis cases were subclinical in South Korea. Despite its milder clinical presentation and lower level of inflammatory markers, the treatment outcomes of subclinical TB were not significantly different from that of active disease.
Muscles adaptation to aging and training: Architectural changes - A randomised trial
Authors: LÉTOCART Adrien J. , Mabesoone Franck , Charleux Fabrice , Couppé Christian , Svensson Rene B. , Marin Frédéric , Magnusson S. Peter , Grosset Jean-François
Published: October 2020

Background: To investigate how anatomical cross-sectional area and volume of quadriceps and triceps surae muscles were affected by ageing, and by resistance training in older and younger men, in vivo.Methods: The old participants were randomly assigned to moderate (O55, n=13) or high-load (O80, n=14) resistance training intervention (12 weeks; 3 times/week) corresponding to 55% or 80% of one repetition maximum, respectively. Young men (Y55, n=11) were assigned to the moderate-intensity strengthening exercise program. Each group received the exact same training volume on triceps surae and quadriceps group (Reps x Sets x Intensity). The fitting polynomial regression equations for each of anatomical cross-sectional area-muscle length curves were used to calculate muscle volume (contractile content) before and after 12 weeks using magnetic resonance imaging scans.Results: Only Rectus femoris and medial gastrocnemius muscle showed a higher relative anatomical cross-sectional area in the young than the elderly on the proximal end. The old group displayed a higher absolute volume of non-contractile material than young men in triceps surae (+96%). After training, Y55, O55 and O80 showed an increase in total quadriceps (+4.3%; +6.7%; 4.2% respectively) and triceps surae (+2.8%; +7.5%; 4.3% respectively) volume. O55 demonstrated a greater increase on average gains compared to Y55, while no difference between O55 and O80 was observed.Conclusions: Muscle loss with aging is region-specific for some muscles and uniform for others. Equivalent strength training volume at moderate or high intensities increased muscle volume with no differences in muscle volume gains for old men. These data suggest that physical exercise at moderate intensity (55 to 60% of one repetition maximum) can reverse the aging related loss of muscle mass.Trial registration: CPP-2016/52 (France) and on ClinicalTrials.gov (2016-A00534-47)
Sexual and reproductive health problems among Ugandan youth during the COVID-19 pandemic lockdown: An online cross-sectional study
Authors: Mambo Simon Binezero , Sikakulya Franck K. , Ssebuufu Robinson , Mulumba Yusuf , Wasswa Henry , Thompson Kelly , Rusatira Jean Christophe , Bhondoekhan Fiona , Kamyuka Louis K. , Akib Surat Olabisi , Kirimuhuzya Claude , Nakawesi Jane , Kyamanywa Patrick
Published: October 2020

BackgroundThe COVID-19 pandemic threatens access to sexual and reproductive health services. With global health emergencies, there is often a total reversal of priorities and access to sexual and reproductive health services may become challenging. The aim of this study was to establish the problems related to sexual and reproductive health among Ugandan youths during the COVID-19 lockdown. MethodsThis was an online cross-sectional study carried out from April 2020 to May 2020 in Uganda. An online questionnaire was used and participants aged 18years to 30 years recruited using the snowballing approach. The statistical analysis was done using STATA version 14.2.Results Out of 724 participants, 203 (28%) reported not having information and/or education concerning sexual and reproductive health (SRH). About a quarter of the participants (26.9%, n=195) reported not having testing and treatment services of sexually transmitted infections available during the lockdown. Lack of transport means was the commonest (68.7%) limiting factor to access to SRH services during the lockdown followed by the long distance from home to SRH facility (55.2%), high cost of services (42.2%) and curfew (39.1%). Sexually transmitted infections were the commonest (40.4%) problem related to SRH during the lockdown followed by unwanted pregnancy (32.4%) and sexual abuse (32.4%). The multivariate regression analysis shows that problems were more prevalent among the co-habiting youth [APR: 2.3 (1.6 - 3.29), p<0.001] followed by unemployed (volunteer or unpaid) [APR: 1.6 (1.03 - 2.64), p: 0.037] than in other participants. ConclusionsThe findings of this study show that Ugandan youths have accessing SRH information and services during the COVID-19 lockdown. Cohabiting and unemployed participants were the most affected. Lack of transport means and high cost of services were the major limiting factors to access SRH services among the youths. The findings call for concerted efforts from the Uganda government and international non-governmental organisations to ensure access and availability of SRH services for Ugandan youths during the COVID-19 lockdown.
QTL mapping for growth-related traits by constructing the first genetic linkage map in Simao pine
Authors: Wang dawei , Shi chen , Li Siguang , Tang Hongyan , He Chenzhong , Cai Nianhui , Duan Anan , Gong Hede
Published: October 2020

Background: Simao pine is one of the primary economic tree species for resin and timber production in southwest China. The exploitation and utilization of Simao pine are constrained by the relatively lacking of genetic information. Construction a fine genetic linkage map and detecting quantitative trait locis (QTLs) for growth-related traits is a prerequisite section of Simao Pine's molecular breeding program. Results: In our study, a high-resolution Simao pine genetic map employed specific locus amplified fragment sequencing (SLAF-seq) technology and based on an F1 pseudo-testcross population has been constructed. There were 11,544 SNPs assigned to 12 linkage groups (LGs), and the total length of the map was 2,062.85 cM with a mean distance of 0.37 cM between markers. According to the phenotypic variation analysis for three consecutive years, a total of seventeen QTLs for four traits were detected. Among 17 QTLs, there were six for plant height (Dh.16.1, Dh16.2, Dh17.1, Dh18.1-3), five for basal diameter (Dbd.17.1-5), four for needle length (Dnl17.1-3, Dnl18.1) and two for needle diameter (Dnd17.1 and Dnd18.1) respectively. These QTLs individually explained phenotypic variance from 11.0-16.3 %, and the logarithm of odds (LOD) value ranged from 2.52 to 3.87. Conclusions: In our study, a fine genetic map of Simao pine applied the technology of SLAF-seq has been constructed for the first time. Based on the map, a total of 17 QTLs for four growth-related traits were identified. It provides helpful information for genomic studies and marker-assisted selection (MAS) in Simao pine.
Reducing the use of physical restraints in home care - Development and feasibility testing of a multicomponent program to support the implementation of a guideline
Authors: Vandervelde Sara , Scheepmans Kristien , Milisen Koen , Achterberg Theo van , Vlaeyen Ellen , Flamaing Johan , de Casterlé Bernadette Dierckx
Published: October 2020

Background: A validated evidence-based guideline was developed to reduce physical restraint use in home care. However, the implementation of guidelines in home care is challenging. Therefore, this study aims to systematically develop and evaluate a multicomponent program for the implementation of the guideline for reducing the use of physical restraints in home care.Methods: Intervention Mapping was used to develop a multicomponent program. This method contains six steps. Each step comprises several tasks towards the design, implementation and evaluation of an intervention; which is theory and evidence informed, as well as practical. To ensure that the multicomponent program would support the implementation of the guideline in home care, a feasibility study of eight months was organized in one primary care district in Flanders, Belgium. A concurrent mixed methods design was used to evaluate the multicomponent program consisting of a knowledge test, focus groups and an online survey. Results: The Social Cognitive Theory and the Theory of Planned Behavior are the foundations of the multicomponent program. Based on modeling, active learning, guided practice, belief selection and resistance to social pressure, eight practical applications were developed to operationalize these methods. The key components of the program are: the ambassadors for restraint-free home care (n = 15), the tutorials, the physical restraint checklist and the flyer. The results of the feasibility study show the necessity to select uniform terminology and definition for physical restraints, to involve all stakeholders from the beginning of the process, to take time for the implementation process, to select competent ambassadors and to collaborate with other home care providers.Conclusions: The multicomponent program shows promising results. Prior to future use, further research needs to focus on the last two steps of Intervention Mapping (program implementation plan and developing an evaluation plan), to guide implementation on a larger scale and to formally evaluate the effectiveness of the multicomponent program.
Promoting healthy foods in the new digital era on Instagram: An experimental study on the effect of a popular real fit influencer versus a fictitious fit influencer on brand attitude and purchase intentions.
Authors: Folkvord Frans , Roes Elze , Bevelander Kris
Published: October 2020

Background: Most studies on social influencer marketing techniques have focused on the promotion of unhealthy foods whereas little is known about the promotion of healthier foods. The present experimental study investigated whether a popular real versus fictitious social influencer is more successful in promoting healthy food products. In addition, we examined the role of parasocial interaction as an underlying mechanism of healthy food product endorsement.Methods: We used a randomized between-subject design with 154 participants (mean age: 24.0 years). Viewers’ product attitude and purchase intention were tested after exposure to an Instagram post by a popular real ‘fit influencer’ (n = 77) or fictitious fit influencer (n= 77).Results: Results showed that parasocial interaction mediated the relation between the type of influencer and product attitude as well as purchase intention. Parasocial interaction was higher for participants exposed to the popular real fit influencer compared to the fictitious influencer, leading to higher healthy food brand attitude and purchase intention.Discussion: The findings showed that it is crucial for social influencers to establish a warm personal relationship and connection with the their followers when promoting a healthy product successfully. We suggest that the promotion of healthy foods could be more successful in public health when using popular social influencers.
Clinicopathologic Characteristics and Surgical Outcome of Synthetic Fiber Conjunctival Granuloma
Authors: Chen Zhang , Wang Tianyang , Pan Qintuo , Zhang Zhaoliang , Zhang Zongduan
Published: October 2020

Background: Until recently, synthetic fiber conjunctival granuloma (SFCG) is rarely reported and has been poorly understood. Our study was to explore the clinical features, histopathologic characteristics, surgical outcomes, and prognosis of SFCG after surgical excision. Methods: Retrospective review of clinical findings, histopathological and immunohistochemical studies identified 18 cases of SFCG. Specimens were routinely processed and stained with H&E. Immunohistochemical stains for GMS, PAS, CD68 and CK-pan were also performed.Results: Eighteen patients with an average age of 9.3±6.6 years had a tender white to red mass on the conjunctiva. All the lesions were completely removed, and none of the patients relapsed. Histologically, all of the specimens revealed inflammatory granulation tissues with a large number of inflammatory cells infiltration and the presence of synthetic fibers. Immunohistochemical stains were positive for CD68, CK, GMS and PAS. Conclusions: Synthetic fiber conjunctival granuloma is an uncommon lesion with foreign body sensation caused by inoculation of synthetic exogenous materials. These lesions are mostly unilateral and occur in the inferior conjunctival fornix. SFCGs are characterized by a large number of inflammatory cells infiltration and the presence of synthetic fibers. Surgical excision followed by topical corticosteroids has been clinically proven to be effective.
Association between serum lactate levels and mortality in patients with cardiogenic shock receiving mechanical circulatory support: a multicenter retrospective cohort study
Authors: Scolari Fernando , Schneider Daniel , Fogazzi Débora Vacaro , Gus Miguel , Rover Marciane Maria , Bonatto Marcely Gimenes , de Araújo Gustavo Neves , Zimerman André , Sganzerla Daniel , Goldraich Lívia Adams , Teixeira Cassiano , Friedman Gilberto , Polanczyk Carisi Anne , Rohde Luis Eduardo , Rosa Regis Goulart , Wainstein Rodrigo Vugman
Published: October 2020

Background: To evaluate the prognostic value of peak serum lactate and lactate clearance at several time points in cardiogenic shock treated with temporary mechanical circulatory support (MCS) using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or Impella CP®.Methods: Serum lactate and clearance were measured before MCS and at 1h, 6h, 12h, and 24h post-MCS in 43 patients at four tertiary-care centers in Southern Brazil. Prognostic value was assessed by univariable and multivariable analysis and receiver operating characteristic (ROC) curves for 30-day mortality.Results: VA-ECMO was the most common MCS modality (58%). Serum lactate levels at all time points and lactate clearance after 6h were associated with mortality on unadjusted and adjusted analyses. Lactate levels were higher in non-survivors at 6h, 12h, and 24h after MCS. Serum lactate > 1.55 mmol/L at 24h was the best single prognostic marker of 30-day mortality [area under the ROC curve = 0.81 (0.67-0.94); positive predictive value = 86%). Failure to improve serum lactate after 24h was associated with 100% mortality.Conclusions: Serum lactate was an important prognostic biomarker in cardiogenic shock treated with temporary MCS. Serum lactate and lactate clearance at 24h were the strongest independent predictors of short-term survival.
Decomposition and stabilization of the organic matter in an old-growth tropical riparian forest: effects of soil properties and vegetation structure
Authors: Fernandes Pedro , Souza Andrea Teixeira , Tanaka Marcel , Sebastiani Renata
Published: October 2020

Background: Nutrient cycling in tropical forests has large importance for primary productivity, and decomposition of litterfall is a major process influencing nutrient balance in forest soils. Although large-scale factors strongly influence decomposition patterns, small-scale factors can have major influences, especially in old-growth forests that have high structural complexity and strong plant-soil correlations. We evaluated decomposition rates and stabilization of soil organic matter using the Tea Bag Index in an old-growth riparian forest in southeastern Brazil to evaluate the effects of forest structure and soil properties on decomposition processes. These data sets were described separately using Principal Components Analysis (PCA). The main axes for each analysis, together with soil physical properties (clay content and soil moisture), were used to construct different structural equations models that evaluated the different parameters of the TBI, decomposition rates and stabilization factor. The best model was selected using Akaike’s criterion.Results: Forest structure and soil physical and chemical properties presented large variation among plots within the studied forest. Clay content was strongly correlated with soil moisture and the first PCA axis of soil chemical properties, and model selection indicated that clay content was a better predictor than this axis. Decomposition rates presented a large variation among tea bags (0.009 and 0.098 g g-1 day-1) and were positively related with forest structure, as characterized by higher basal area, larger trees, and tree density. The stabilization factor varied between 0.211 – 0.426 and was related to forest stratification and soil clay content. Conclusions: The old-growth forest studied presented high heterogeneity in both forest structure and soil properties at small spatial scales, that influenced decomposition processes and probably contributed to small-scale variation in nutrient cycling. Decomposition rates were only influenced by forest structure, whereas the stabilization factor was influenced by both forest structure and soil properties. Heterogeneity in ecological processes can contribute to the resilience of old-growth forests, highlighting the importance of restoration strategies focused on the spatial variation of ecosystem processes.
The influence of medical insurance and social security cards on the floating population's settlement intention
Authors: Li Yulin , Huang Lingling , Xiang Li , Dou Dongmei
Published: October 2020

Background: There are many studies on the factors influencing the floating population's intentions to settle down. Medical insurance and social security cards are an important incentive for the floating population to live a stable life in their current residence, but there are limited studies on the influence of medical insurance and social security cards on settlement intentions. Therefore, the purpose of this paper was to study the impact of basic medical insurance for urban employees and the decision as to whether to apply for individual social security cards on the settlement intentions of the floating population. As the willingness to settle has increased, the development of health management and public health in the place of residence has improved. Methods: Based on the 2017 survey data from the dynamic monitoring of China's floating population, we explored the influence of basic medical insurance for urban employees and social security cards on the floating population's settlement intentions with binary logistic regression and structural equation models. Additionally, this study also examined the comprehensive causal relationship, with social integration as the mediator variable. Results: The settlement intention of members of the floating population after participating in basic medical insurance for urban employees was 23.2 percent higher than that of those who did not participate. The decision as to whether to apply for a personal social security card is related to their settlement intention. The standardized regression coefficients among social insurance and security, social integration, and settlement intention were positive values, and the Z values of the overall effect, indirect effect, and direct effect were all greater than 1.96; the confidence interval of the indirect effect did not include 0. We found that this model is a partial intermediary model, with an intermediary ratio of 10.66 percent. Conclusions: This article highlights the important impact of basic medical insurance for urban employees and individual social security cards on the floating population. The conclusions of this study provide suggestions for the government to use when designing policies to enhance the settlement intentions of the floating population and to improve the development of public health undertakings.
Parathyroid carcinoma with sarcomatoid differentiation: A case report and literature review
Authors: Hu Liang , Xie Xiaojun
Published: October 2020

Background Parathyroid carcinoma (PC) is a rare thyroid tumor. PC with sarcomatoid differentiation(PCSD) is even rarer and its exact etiology remains unclear. We here report a case of PCSD, and present the clinicopathological features and pathological diagnosis and review the literature. Case presentation A 71-year-old man presented with a mass of 4.5 cm × 3.5 cm in the right neck. The tumor was composed of nest-like transparent cells, and the septum had heterotypic rhabdoid cells with sarcomatoid differentiation. Immunophenotype was as follows: MyoD1, myogenin and desmin were positive; clear cells were positive for CGA, Syn and GATA-3; and Ki-67 proliferation index was 40%. Hematoxylin and eosin staining and immunohistochemistry were performed. The patient was diagnosed with PCSD, and died 6 months after surgery.Conclusions PCSD is a rare type of primary parathyroid tumor with high malignancy and poor prognosis. Definitive diagnosis should be based on histopathological morphology and immunophenotype, and surgical treatment should be performed as soon as possible.
A Correlative Study on Social Support and Quality of Life in Patients After Adult Liver Transplantation
Authors: Xiao Qigui , Zhang Bo , Lu Huapeng , Lang Lan , Zhang Jiaoqiong , Yang Qingling , Ma Qingyong , Sha Huanchen
Published: October 2020

Background: The purpose of this study was to investigate the quality of life among adult liver transplantation patients and to explore the relationship between social support and quality of life in patients. Methods: This descriptive study contain 105 patients who underwent liver transplantation. The general information questionnaire, social support rating scale (SSRS), and post-liver transplant quality of life questionnaire (pLTQ) were used. The data analysis was conducted using SPSS 18.0 software, and independent t test, ANOVA, Pearson and correlation analysis were implemented. Results: The total score of social support in adult liver transplant patients was 45.35 ± 7.31, including subjective support dimension (26.84 ± 4.13), objective support (11.42 ± 3.40), and utilization of social support (7.09 ± 2.12). The total score of quality of life in adult liver transplant patients was 138.08 ± 26.31, including anxious (37.23 ± 9.86), physical function (26.60 ± 5.51), emotional function (21.23 ± 4.35), financial (12.59 ± 4.80), healthcare (24.89 ± 5.27), and complications (15.55 ± 3.38). The total score of social support was positively correlated with the total score of quality of life (r = 0.313), anxious (r = 0.299), physical function (r = 0.255), emotional function (r = 0.215), healthcare (r = 214), and complications (r = 217). Objective support was positively correlated with total score of quality of life (r = 0.246), anxious (r = 0.209), emotional function (r = 0.210) and complications (r = 0.293). Subjective support was positively correlated with total score of quality of life (r = 0.361), anxious (r = 0.404), physical function (r = 0.305), economy (r = 0.281), healthcare (r = 0.199), and complications (r = 0.238). Conclusions: There is a positive correlation between social support and quality of life after adult liver transplantation.
Acceptance and Risk Perception of COVID-19 Vaccine in Uganda: A Cross Sectional Study in Western Uganda
Authors: Echoru Isaac , Ajambo Patricia Decanar , Bukenya Edmund Mugabi
Published: October 2020

Background: Many countries have drawn their attention on developing Corona virus disease 2019 vaccine however there is less emphasis on whether this vaccine could be accepted in most of these countries. This study aimed to investigate acceptance and risk perception of COVID-19 vaccine in Uganda. Method: A simplified snowball sampling technique was used to select 1067 respondents of 18-70 years in western Uganda using an online questionnaire from July to September 2020. Vaccine acceptability and risk perception was assessed using odds ratio at 95% confidence interval using R software version 3.6.3. Results: The acceptance rate for vaccination against COVID-19 was (53.6%; 572/1067) with participants in the reference age group 18-20 (OR: 1; 95%CI: NA); males (OR: 2.1; 95%CI: 1.56-2.71; P=0.000); tertiary level of education (OR: 2.8; 95%CI: 1.25-6.11; P=0.009); students (OR: 3.19; 95%CI: 1.98-5.15; P=0.000) and non-salary earners (OR: 2.29; 95%CI: 1.53-3.44; P=0.000) significantly more likely to accept the vaccine. Results also showed that (46.4%; 495/1067) of the respondents were un-likely to accept the vaccine. About (44.6%; 476/1067) of the respondents were likely to accept vaccine clinical trials with participants in the reference age group 18-20 (OR: 1; 95%CI: NA), students (OR: 2.37; 95%CI: 1.49-3.77; P=0.000), marrieds (OR: 1.3; 95%CI: 1.03-1.69; P=0.028), and non-salary (OR: 1.56; 95%CI: 1.05-2.30; P=0.029) significantly more likely to accept clinical trials. There were (46.7%; 500/1067) of the respondents who perceived the vaccine as being risky with males (OR: 3.13; 95%CI: 2.33-4.21; P=0.000); students (OR: 2.59; 95%CI: 1.63-4.13; P=0.000); Civil servants (OR: 1.49; 95%CI: 0.98-2.25; P=0.063); and non-salary earners; (OR: 2.34; 95%CI: 1.57-3.47; P=0.000) who significantly perceived the vaccine as being more risky.Conclusion: The level of vaccine acceptance (53.6%) and risk perception (46.7%) was relatively average in western Uganda. In order to ensure successful vaccination process, the government needs to prioritize vaccine acceptance strategies especially among the risky group in the community.
4DVAR HF radar assimilation South of Africa
Authors: Couvelard Xavier , Messager Christophe , Penven Pierrick , Lattes Phillipe
Published: October 2020

The oceanic circulation south of Africa is characterized by a complex dynamics with a strong variability due to the presence of the Agulhas current and numerous eddies. The area of interest of this paper, is also the location of several natural gas fields under seafloor which are targeted for drilling and exploitation.The complex and powerful ocean currents induce significant issues for ship operations at the surface as well as under the surface for deep sea operations. Therefore, the knowledge of the state of the currents and the ability to forecast them in a realistic manner could greatly enforce the safety of various marine operation. Following this objective an array of HF radar systems was deployed to allow a detailed knowledge of the Agulhas currents and its associated eddy activity. It is shown in this study that 4DVAR assimilation of HF radar allow to represent the surface circulation more realistically. Two kind of experiments have been performed, a one-month analysis and two days forecast. The one-month 4DVAR experiment have been compared to geostrophic currents issued from altimeters and highlight an important improvement of the geostrophic currents. Furthermore, despite the restricted size of the area covered with HF radar, we show that the solution is improved almost in the whole domain, mainly upstream and downstream of the HF radar's covered area. We also show that while benefits of the assimilation on the surface current intensity is significantly reduced in the first 6 hours of the forecast, the correction in direction persists after 48 hours.
Influence of Lawns on the Summer Thermal Environment and Microclimate of Heritage Sites: A Case Study of Fuling Mausoleum, China
Authors: Wang Xiaoyu , Liu Peng , Xu Gongwen
Published: October 2020

The thermal environment and microclimate of heritage sites has been severely impacted by rapid urbanization. This study collected various meteorological measurement data as a reference for computational fluid dynamics (CFD) simulation settings. Then CFD was applied to simulate the impact of lawns on the thermal environment and microclimate of Fuling Mausoleum. We found that lawns and soil can cool the air through evaporation, and thus have a specific cooling effect on the bricked ground. After lawns were planted, the bricked ground temperature decreased by 1.56–17.54°C than that before lawns were planted at 14:00, a decrease of 2.68%–24.20%. Under normal circumstances, when the wind speed or relative humidity increased, the ground temperature dropped. Greenbelt vegetation can adjust the microclimate and human thermal comfort indicators. The consistency of the difference between the actual measurement and the CFD simulation results shows that CFD simulation can thus accurately reflect the internal temperature field distribution if the selection of simulation parameters is reasonable. Theoretical calculation and analysis, experimental measurement research, and modern computer simulation analysis methods applied together constitute a complete system for studying modern physical environmental problems and can provide reliable and economic results.
Walking Stability in Patients With Benign Paroxysmal Positional Vertigo: An Objective Assessment Using Wearable Accelerometers and Machine Learning
Authors: Zhang Yuqian , Wang He , Yao Yifei , Liu Jianren , Sun Xuhong , Gu Dongyun
Published: October 2020

Background: Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular disorders leading to balance difficulties and increased fall risks. This study aims to investigate the walking stability of BPPV patients in clinical settings and propose a machine-learning-based classification method for determining the severity of gait disturbances of BPPV. Methods: Twenty-seven BPPV outpatients and twenty-seven healthy subjects completed level walking trials at self-preferred speed in clinical settings while wearing one accelerometer on the head and one on the lower trunk. Temporo-spatial variables and six walking stability related variables (root mean square (RMS), harmonic ratio (HR), gait variability, step/stride regularity, and gait symmetry) derived from the acceleration signals were analyzed. A support vector machine model (SVM) based on the gait variables of BPPV patients were developed to classify the BPPV severity of gait disturbances. Results: The results showed that BPPV patients employed a conservative gait and significantly reduced walking stability compared to the healthy controls. Significant different mediolateral HR at the lower trunk and anteroposterior step regularity at the head were found in BPPV patients among mild, moderate, and severe DHI (dizziness handicap inventory) subgroups. SVM classification achieved promising accuracies with area under the curve (AUC) = 0.87, 0.80, and 0.95 respectively for classifying the three stages of DHI subgroups. Conclusions: Results suggested that the proposed gait analysis that is based on the coupling of wearable accelerometers and machine learning provides an objective approach for assessing gait disturbances and handicapping effects of dizziness imposed by BBPV.Trial registration: The trial was registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn) on March 29, 2018. Registration number: ChiCTR1800015432 (http://www.chictr.org.cn/showproj.aspx?proj=25587).
Important risk factors for gallstones after laparoscopic gastrectomy: A retrospective study
Authors: Fujita Shohei , Kimata Masaru , Matsumoto Kenji , Sasakura Yuichi , Terauchi Toshiaki , Furukawa Junji , Ogata Yoshiro , Kobayashi Kenji , Shinozaki Hiroharu
Published: October 2020

Background: The frequency of gallstones is higher in patients who have undergone gastrectomy than in the general population. While there have been some studies of gallstone formation after open gastrectomy, there are few reports of gallstones after LG. This study aimed to evaluate the incidence of gallstones after laparoscopic gastrectomy. Methods: We retrospectively reviewed the records of 184 patients who underwent laparoscopic gastrectomy between January 2011 and May 2016 at Saiseikai Utsunomiya Hospital. After gastrectomy, abdominal ultrasonography was generally performed every 6 months until 5 years later. Patients who underwent simultaneous cholecystectomy or with an observation period of < 24 months were excluded from the study. Ninety patients were ultimately analyzed. Laparoscopic cholecystectomy was performed whenever biliary complications occurred.Results: Gallstones were detected after laparoscopic gastrectomy in 27 of the 90 (30%) cases. Multivariate analysis identified Roux-en-Y reconstruction and male sex as significant risk factors for gallstones after gastrectomy. Symptomatic gallstones after laparoscopic cholecystectomy were found in 6 cases (6/27, 22%), and all patients underwent laparoscopic cholecystectomy.Conclusion: Roux-en-Y reconstruction was identified as a significant risk factor for gallstones after laparoscopic gastrectomy.