bluuebunny/crossref_metadata_2025 huggingface dataset:
A DNA Methylation-based Test for Esophageal Cancer Detection
Authors: Salta Sofia , Macedo-Silva Catarina , Miranda-Gonçalves Vera , Lopes Nair , Gigliano Davide , Guimarães Rita , Farinha Mónica , Sousa Olga , Henrique Rui , Jeronimo Carmen
Published: October 2020

Background: Esophageal cancer (ECa) is the 7 th most incident cancer and the 6 th leading cause of cancer-related death. Most patients are diagnosed with locally advanced or metastatic disease, enduring poor survival. Biomarkers enabling early cancer detection may improve patient management, treatment effectiveness, and survival, are urgently needed. In this context, epigenetic-based biomarkers such as DNA methylation are potential candidates. Methods: Herein, we sought to identify and validate DNA methylation-based biomarkers for early detection and prediction of response to therapy in ECa patients. Promoter methylation levels were assessed in a series of treatment-naïve ECa, post-neoadjuvant treatment ECa, and normal esophagus tissues, using quantitative methylation-specific PCR for COL14A1 , GPX3, and ZNF569 . Results: ZNF569 methylation ( ZNF569me) levels significantly differed between ECa and normal samples ( p <0.001). Moreover, COL14A1 methylation ( COL14A1me) and GPX3 methylation ( GPX3me) levels discriminated adenocarcinomas and squamous cell carcinomas, respectively, from normal samples ( p =0.002 and p =0.009, respectively). COL14A1me & ZNF569me accurately identified adenocarcinomas (82.29%) whereas GPX3me & ZNF569me identified squamous cell carcinomas with 81.73% accuracy. Furthermore, ZNF569me and GPX3me levels significantly differed between normal and pre-treated ECa. Conclusion: The biomarker potential of a specific panel of methylated genes for ECa was confirmed. These might prove useful for early detection and might allow for the identification of minimal residual disease after adjuvant therapy.
Risk factors for unplanned reintubation caused by acute airway compromise after general anesthesia: a case-control study
Authors: Chen Si , Zhang Yuelun , Che Lu , Shen Le , Huang Yuguang
Published: October 2020

Background: This study aimed to identify the risk factors and evaluate the prognosis of unplanned reintubation caused by acute airway compromise (AAC) after general anesthesia.Methods: This case-control study included surgical patients who underwent unplanned reintubation in the operating room and postanesthesia care unit after general anesthesia between January 1, 2014, and December 31, 2018. Cases due to AAC were matched 1:4 with randomly selected controls.Results: A total of 123,068 patients were included, and reintubation due to AAC was performed in 36 patients (approximate incidence 0.03%). Univariable analysis revealed that male sex, age >65, ASA physical status 3, sepsis, heart disease history, cerebral infarction history, Cormack Lehane grade, surgery type, fresh frozen plasma infusion, increased intubation duration, white blood cell count, and creatinine clearance rate were related to AAC-caused unplanned reintubation. Multivariable analysis revealed that age >65 (OR=7.50, 95% CI 2.47-22.81, P<0.001), ASA physical status 3 (OR=6.51, 95% CI 1.18-35.92, P=0.032), head-neck surgery (OR=4.94, 95% CI 1.33-18.36, P=0.017) or thoracic surgery (OR=12.56, 95% CI 2.93-53.90, P<0.001), a high fluid load (OR=3.04, 95% CI 1.16-7.99, P=0.024) and sepsis (OR=24.08, 95% CI 2.51-231.51, P=0.006) were associated with AAC-caused unplanned reintubation. AAC-caused unplanned reintubation patients had longer postoperative hospital (OR=5.26, 95% CI 1.57-8.95, P<0.001) and intensive care unit days (OR=3.94, 95% CI 1.69-6.18, P<0.001).Conclusions: Age>65, ASA physical status 3, head-neck or thoracic surgery, high fluid load and sepsis were found to be associated with AAC-caused unplanned reintubation.
Twin-Based Toughening Mechanisms In Pinna Nobilis Shell
Authors: Nalepka Kinga , Berent Katarzyna , Checa Antonio , Machniewicz Tomasz , Harris Adrian , Nalepka Paweł , Strąg Martyna , Maj Łukasz , Szkudlarek Aleksandra , Bieda Magdalena , Sztwiertnia Krzysztof
Published: October 2020

The shell structure of the Pinna nobilis species constitutes a model for others formed by bivalves of the Ostreida order. The outer part is built of monocrystalline columns whose axes remain parallel to the calcite c-axis. The present work reveals a new microstructure induced by mantle damage in the early stage of growth. The calcite c-axes, oriented perpendicularly to the strongly rough outer surface, deviate significantly from the shell thickness direction. The inclination angle is maintained up to the nacre layer. The transfer is made by the monocrystalline prisms which initially run along the c-axis and then deflect taking the thickness direction. They form coherent systems with low-energy twin boundaries. The uncovered twin relationships significantly improve the mechanical properties, as demonstrated using the nano-indentation and impact tests. Moreover, compression tests were performed, which confirms that the untypical structure exhibits a unique combination of high fracture toughness and strength.
Physical activity in Sahara Moroccan hemodialysis patients
Authors: bahadi abdelaali , lagtarna Hamza , benbria sanae , zajjari yassir , kabbaj Driss El , zemraoui nadir
Published: October 2020

Background: The evaluation of physical activity for chronic hemodialysis patients is a new approach for the patient global care. The objective of this work is to evaluate the physical activity in chronic hemodialysis patients and identify the risk factors associated with reduced physical activity. Methods: This is a prospective study during 6 months including 150 chronic hemodialysis patients in the Guelmim-Oued Noun Regionin moroccan sahara. We use Baecke's survey, translated and validated in Arabic local language. The socio-demographic, Clinical and biological data were completed during the interrogation and from the medical records of the patients. Results: The mean age of our patients was 54.6 +/- 16.4 years, with male predominance (59%). Most patients have a low education level and 60% were illiterate. Hypertension was found in 54% of our patients, diabetes in 39% and cardiovascular disease in 10% of patients. Low Physical activity was associated with gender (OR=4.05), age (OR=1.03) and education level (OR=0.2). Conclusions: Our work has met the various pre-established objectives, however other more specific studies must be conducted to better characterize the profile of physical activity in chronic hemodialysis patients.
Human Developmental Cell Atlas: milestones achieved and the roadmap ahead
Authors: Haniffa Muzlifah , Taylor Deanne , Linnarsson Sten , Aronow Bruce , Bader Gary , Camara Pablo , Camp J. Gray , Chédotal Alain , Copp Andrew , Etchevers Heather , Giacobini Paolo , Gottgens Berthold , Guo Guoji , Hupalowska Anna , James Kylie , Kirby Emily , Kriegstein Arnold , Lundeberg Joakim , Marioni John , Meyer Kerstin , Niakan Kathy , Nilsson Mats , Olabi Bayanne , Pe'er Dana , Regev Aviv , Rood Jennifer , Rozenblatt-Rosen Orit , Satija Rahul , Teichmann Sarah , Treutlein Barbara , Vento-Tormo Roser , Webb Simone
Published: October 2020

The Human Developmental Cell Atlas (HDCA), as part of the Human Cell Atlas, aims to generate a comprehensive reference map of cells during development. This detailed study of development will be critical for understanding normal organogenesis, the impact of mutations, environmental factors and infectious agents on congenital and childhood disorders, and the molecular cellular basis of ageing, cancer and regenerative medicine. In this perspective, we outline the challenges of mapping and modelling human development using state of the art technologies to create a reference atlas across gestation for scientific and clinical benefit. We discuss the potential value of HDCA to enhance human pluripotent stem cell-derived organoid model systems and, in turn, the use of organoids and animal models to inform HDCA. Finally, we provide a roadmap towards a complete atlas of human development.
Black carbon sanitary burden in the Indo-Gangetic plain: exposures, risks and mitigation
Authors: Verma Shubha , Ghosh Sanhita , Boucher Olivier , Wang Rong , Menut Laurent , Prasad K
Published: October 2020

A large discrepancy between simulated and observed black carbon (BC) surface concentrations over the densely populated Indo-Gangetic plain (IGP) has so far limited our ability to assess the magnitude of BC sanitary impacts in terms of population exposure, morbidity, and mortality. We evaluate these impacts using an integrated modeling framework, including a successfully predicted BC surface concentration in a high-resolution chemical transport model CHIMERE with observationally-constrained BC emissions, combined with consistent health functions for BC. Population exposure to BC is noteworthy, with more than 60 million people identified living over hotspots of BC concentration (wintertime mean > 20 μg m−3). A fraction of 62% of the total cardiovascular diseases mortality (CVM) burden for the megacity is found attributable to wintertime BC exposure. The semi-urban area has 50% of the CVM burden attributable to BC exposure in the total population over the IGP. More than 400 thousand lives can potentially be saved from CVM annually, by implementing prioritized emission reduction from the combustion of domestic biofuel in the semi-urban area, and diesel oil in transportation and coal in thermal power plant and brick kiln industries in megacities.
An isogenic cell line panel identifies major regulators of aberrant astrocyte proliferation in Down syndrome
Authors: Kawatani Keiji , Nambara Toshihiko , Nawa Nobutoshi , Yoshimatsu Hidetaka , Kusakabe Haruna , Hirata Katsuya , Tanave Akira , Sumiyama Kenta , Banno Kimihiko , Taniguchi Hidetoshi , Arahori Hitomi , Ozono Keiichi , Kitabatake Yasuji
Published: October 2020

Astrocytes exert adverse effects on the brains of individuals with Down syndrome (DS). Although a neurogenic-to-gliogenic shift in the fate-specification step has been reported, the mechanisms and key regulators underlying the accelerated proliferation of astrocyte precursor cells (APCs) in DS remain elusive. Here, we established an isogenic cell line panel, based on DS-specific induced pluripotent stem cells, the XIST-mediated transcriptional silencing system in trisomic chromosome 21, and genome/chromosome-editing technologies to eliminate phenotypic fluctuations caused by genetic variation. The transcriptional responses of genes observed upon XIST induction and/or downregulation were not uniform, and only a small subset of genes showed a characteristic expression pattern, which is consistent with the proliferative phenotypes of DS APCs. Comparative analysis and experimental verification using gene modification revealed dose-dependent proliferation-promoting activity of DYRK1A and PIGP on DS APCs. Our collection of isogenic cell lines provides a comprehensive set of cellular models for DS investigations.
Clinical Factors for Sudden Unexpected Death in Patients Undergoing Peritoneal Dialysis
Authors: Zhang Wen-Yu , Lee Wen-Chin , Chang Wen-Xiu , Cheng Ben-Chung , Wu Chien-Hsing , Hsu Tsuen-Wei , Chen Jin-Bor
Published: October 2020

Background: Sudden unexpected death (SUD) accounts for a significant proportion of overall mortality in patients undergoing peritoneal dialysis (PD).This study aimed to investigate the SUD clinical profiles in patients undergoing PD.Methods: Medical records from January 2009 to December 2018 were retrospectively reviewed in a hospital-facilitated PD center in Taiwan. Demographic data, laboratory parameters, comorbidities, drug history, physical performance status, cardiac function parameters, and peritoneal transport category were abstracted. Cox proportional hazard regression was used to determine hazard ratio(HR) in SUD clinical profiles in patients undergoing PD. Results: Based on 28 patients undergoing PD with SUD, 60 controls were matched for date of death on a 2:1 ratio for comparison. The incidence of diabetes and the prevalence of low physical performance status, analgesic drug use, concordant comorbidity number, mental health and chronic pain were higher in patients undergoing PD with SUD than in controls. In the cardiac function analysis, the QTc interval on the electrocardiogram was longer (467 vs. 453 ms, P=0.010) in patients undergoing PD with SUD than in controls. At 3 months before death, patients who experienced SUD demonstrated progressive lower serum potassium concentrations. Cox proportional hazard regression analysis revealed that diabetes [adjusted HR, 4.73; 95% confidence interval (CI), 2.75–8.14; P<0.001)] and mental health and chronic pain (adjusted HR, 2.07; 95% CI, 1.06–4.05; P=0.033) remain significant predictors for SUD in patients undergoing PD.Conclusions: Diabetes mellitus, mental health and chronic pain, incidence of hypokalemia before death are significant clinical factors for SUD in patients undergoing PD.
A Multimodal Pain Management Regimen Utilizing Adductor Canal Block in a Veterans Affairs Population Decreases Opioid Consumption Following Total Knee Arthroplasty.
Authors: Soehnlen Neil , Erb Eric , Kiskaddon Eric , Green Uthona , Froehle Andrew , Krishnamurthy Anil
Published: October 2020

Background: Ease of access to opioids in the perioperative period is a risk factor for subsequent opioid abuse. The purpose of this study was to quantify a decrease in opioid consumption following implementation of a new analgesic protocol after total knee arthroplasty (TKA). Methods: A retrospective cohort study was performed analyzing patients who underwent TKA at a Veterans Affairs medical center. Patients were divided into two groups by multimodal analgesic regimen: Analgesia with intraoperative general anesthesia, a patient controlled analgesia pump, and oral opioids (Traditional group) or analgesia with intraoperative spinal anesthesia, a multimodal medication regimen, and an adductor canal block (Protocol group). Results: A total of 533 TKAs were included. The intravenous morphine equivalent dose (MED) requirement was 178.2 ± 98.0 for Traditional and 12.0 ± 24.6 for Protocol groups (p < 0.001). Total opioid MED requirement was 241.7 ± 120.1 for Traditional and 74.8 ± 42.7 in Protocol groups (p < 0.001). The Protocol group required only 6.7% of the intravenous opioids and 30.9% of the total opioids used by the Traditional group. No difference in oral opioid requirements was found (p = 0.849). The Traditional group required more opioid refills at the first postoperative visit (p < 0.001). Conclusions: The described analgesic protocol resulted in significant decreases in intravenous and total opioid requirement, and lower rates of opioid prescriptions at the first postoperative visit. These findings demonstrate a decrease in opioid utilization with modern perioperative analgesia protocols and reinforce recommendations by the CDC and AAOS to decrease opioid exposure and access. Trial Registration: Not applicable
The Chloroplast Genome Comparative Characteristic of Artificial Breeding Tree, a Case About Broussonetia Kazinoki × Broussonetia Papyifera
Authors: zhang Wan , Yang Guiyan , Zhao Yunlin , Xu Zhenggang , Huang Huimin , Zhou Jiakang
Published: October 2020

Background: Broussonetia kazinoki × Broussonetia papyifera (ZJGS) is a hybrid species, which has a very complicated hybrid origin. Its excellent characteristics make it both ecological benefits and economically valuable.Results: This study aimes to further understand ZJGS and Moraceae taxa through the ZJGS chloroplast (cp) genome structure and the comparative with 12 closely related Moraceae species, especially the cross parent B. kazinoki and B. papyrifera. The analyses show that ZJGS cp genome is 160,903 bp in length. Among the 13 Moraceae species, the cp genome length of seven Broussonetia species (ranges from 160,239 bp to 162,594 bp) is larger than that of six Morus species (ranges from 158,459 bp to 159,265 bp). However, the average GC content of Broussonetia species is lower than that of Morus species, which is 35.72% and 36.26%, respectively. Compared with Moraceae species, the ZJGS cp genome has a high degree of sequence similarity with B. kazinoki and B. monoica. In the comparison of repeated sequences, ZJGS and its maternal species B. kazinoki shows similar simple sequence repeats (SSRs) frequency. Among the 77 shared protein-coding genes (PCGs) in Moraceae species, the obvious positive selection of Ka/Ks ratios acted on petD and rpl16 genes of B. kazinoki and B. papyrifera, respectively, and the Ka/Ks ratio > 3. Phylogenetic analysis based on shared PCGs from 28 species shows that ZJGS is closely related to maternal B. kazinoki.Conclusions: These findings provide data support for the origin of ZJGS hybridization, and provide genomic resources for future ZJGS resource development and molecular breeding.
Civil Society Monitoring of Hepatitis C Response Related to the WHO 2030 Elimination Goals in 35 European Countries
Authors: Maticic M , Pirnat Z , Leicht A , Zimmermann R , Windelinckx T , Jauffret-Roustide M , Duffell E , Tammi T , Schatz E
Published: October 2020

BackgroundPeople who inject drugs (PWID) account for the majority of new cases of hepatitis C virus (HCV) infection in Europe, however HCV testing and treatment for PWID remain suboptimal. With the advent of direct acting antivirals (DAAs) the World Health Organization (WHO) adopted a strategy to eliminate HCV as public health threat by 2030. To achieve this, key policies for PWID must be implemented and HCV continuum-of-care needs to be monitored. This study presents results of the first monitoring led by civil society that provide harm reduction services for PWID. MethodsIn 2019, harm reduction civil society organisations representing focal points of Correlation-European Harm Reduction Network in 36 European countries were invited to complete a 27-item online survey on four strategic fields: use/impact of guidelines on HCV testing and treatment for PWID, availability/functioning of continuum-of-care, changes compared to the previous year and, the role of harm reduction services and non-governmental organisations (NGOs) of PWID. A descriptive analysis of the responses was undertaken.ResultsThe response rate was 97.2%. Six countries reported having no guidelines on HCV treatment (17.1%). Twenty-three (65.7%) reported having treatment guidelines with specific measures for PWID; guidelines that impact on accessibility to HCV testing/treatment and improve access to harm reduction services in 95.6% and 86.3% of them, respectively. DAAs were available in 97.1% of countries; in 26.4% of them they were contraindicated for active drug users. HCV screening/confirmatory tests performed at harm reduction services/community centres, prisons and drug dependence clinics were reported from 80.0%/25.7%, 60.0%/48.6%, and 62.9%/34.3% of countries, respectively. Provision of DAAs at drug dependence clinics and prisons was reported from 34,3% and 42.9% of countries, respectively. Compared to the previous year, HCV awareness campaigns, testing and treatment on service providers’ own locations were reported to increase in 42.9%, 51.4% and 42.9% of countries, respectively. NGOs of PWID conducted awareness campaigns on HCV interventions in 68.9% of countries, and 25.7% of countries had no such support. ConclusionFurther improvements of continuum-of-care interventions for PWID are needed, which could be achieved by including harm reduction and PWID organisations in strategic planning of testing and treatment and in efforts to monitor progress towards WHO 2030 elimination goal.
Evaluation of Human Mammaglobin as a Biomarker of Circulating Tumor Cells in Breast Cancer and Clinical Verification
Authors: Xiao Chuanguang , Wang Xiaohong , Qiu Shusheng , Gu Wenyue
Published: October 2020

Cytokeratin (CK) is the gold standard marker for the differential diagnosis of epithelial circulating tumor cells (CTC), but the low expression of CK can lead to false negative results.In this study, the specificity and sensitivity of human breast globin (hMAM) as a tumor marker of CTC in peripheral blood of breast cancer patients were analyzed and aim to improve the CTC detection accuracy in breast cancer, enrich the candidate markers for clinical differential diagnosis of breast cancer CTC. EpCAM antibody modified liposome magnetic particles (ELMP) were prepared, and then their physicochemical properties were characterized. ELMP has high physicochemical stability and can efficiently enrich the CTC of epithelial breast cancer. We found hMAM is more consistent with clinical and pathological diagnosis results. To be noted, CK19 combined with hMAM method efficiently distinguish the separated CTC from breast cancer patients, furthermore, the specificity and sensitivity of CTC detection get promoted.
The Incidence, Risk Factors and Outcomes of Acute Kidney Injury in Critically Ill Patients Undergoing Emergency Surgery: A Prospective Observational Study
Authors: Hu Linhui , Gao Lu , Zhang Danqing , Hou Yating , He LinLing , Deng Yujun , Fang Heng , Zhang Huidan , Liang Yufan , Xu Jing , Chen Chunbo
Published: October 2020

BackgroundPostoperative acute kidney injury (AKI) is associated with higher morbidity, mortality, and economic burden. However, there is a lack of evaluation of postoperative AKI in highly heterogeneous critically ill patients undergoing emergency surgery. To explore the incidence, risk factors, and prognosis, to clarify the epidemiological status, and to improve the early identification and diagnosis of postoperative AKI, this study was taken.MethodsA prospective observational study was conducted in the general intensive care units of Guangdong Provincial People's Hospital from January 2014 to March 2018. Preoperative variables, intraoperative variables, postoperative variables, and postoperative prognosis data were collected. The diagnosis and staging of postoperative AKI were based on the Kidney Disease: Improving Global Outcomes criteria. They were divided into two groups according to whether postoperative AKI occurred: AKI group and non-AKI group. The baseline characteristics, postoperative AKI incidence, AKI stage, and in-hospital prognosis in all enrolled patients were analyzed prospectively. Multivariate logistic forward stepwise (odds ratio, OR) regression was used to determine the independent risk factors of postoperative AKI. Results were presented using the OR with 95% confidence intervals (CIs).ResultsA total of 383 critically ill patients undergoing emergency surgery, 151 (39.4%) patients among them developed postoperative AKI. Postoperative reoperation, postoperative Acute Physiology and Chronic Health Evaluation (APACHE II) score, postoperative serum lactic acid (LAC), postoperative serum creatinine (sCr) were independent risk factors for postoperative AKI in critically ill patients undergoing emergency surgery, with the adjusted OR (ORadj) of 1.854 ( 95% CI, 1.091 - 3.152), 1.059 ( 95% CI, 1.018 - 1.102), 1. 239 (95% CI, 1.047 - 1.467), and 3.934 (95% CI, 2.426 - 6.382), respectively. Duration of mechanical ventilation, renal replacement therapy, ICU and hospital mortality, ICU and hospital length of stay, total ICU and hospital costs were higher in the AKI group than in the non-AKI group.ConclusionsThe independent risk factors which included postoperative reoperation, postoperative APACHE II score, postoperative LAC, and postoperative sCr could improve the early diagnosis and prevention of postoperative AKI and identify the higher risk of adverse outcomes in critically ill patients undergoing emergency surgery.
Combination Analysis of NR3C1, MTHFR and IGFBP3 Gene Polymorphisms and DNA Methylation With Steroid-induced Osteonecrosis of the Femoral Head Risk in Chinese Han Population 
Authors: Huang Ronglan , Zhan Qinghao , Hu Wenbin , Yang Renmin , Cheng Nan , Han Yongsheng
Published: October 2020

Background: Although the precise etiology of osteonecrosis of the femoral head (ONFH) has yet to be fully elucidated, it is known that nuclear receptor subfamily3, group C, member 1 (NR3C1), 5, 10-methylenetetrahydrofolate reductase (MTHFR) and insulin-like growth factor-binding protein 3 (IGFBP3) are related to the pathophysiology of steroid-induced osteonecrosis of the femoral head (SONFH). The expression of NR3C1, MTHFR and IGFBP3 are regulated by epigenetics and genetic profiles. Objective: The primary objective of this study was to investigated the association between NR3C1, MTHFR and IGFBP3 gene polymorphisms and DNA methylation status and SONFH.Methods: This case-control study included 79 patients with SONFH and 114 patients who took steroids but did not develop SONFH. We evaluated 5 single-nucleotide polymorphisms (SNPs) out of 3 genes in Chinese Han population. These SNPs were genotyped by improved multiplex ligation detection reaction (iMLDR). Methyltarget was used to test the methylation level of positive sites, the interaction between SNPs and DNA methylation level was analyzed using eQTLD technique.Results: We identified rs3110697 in the IGFBP3 gene that was potentially associated with a reduced risk of SONFH in the genotype (P=0.008; odds ratio [OR]: 0.741; 95% confidence intervals [CI]: 0.456–1.205) and in the recessive model (P=0.003; OR: NA; 95% CI: NA–NA). Furthermore, CpG sites with significant differences in methylation levels were screened as follows: IGFBP3_2-143, MTHFR_1-36, MTHFR_1-77, MTHFR_1-139, MTHFR_2-42, NR3C1_2-163, NR3C1_4-47, and the differences were statistically significant compared with the control group (p<0.05). A total of 10 pairs of linear regression tests of SNP and methylation sites were statistically significant (p<0.05).Conclusions: SONFH is a polygenic disorder in which a wide range of interactions between SNPs and DNA methylation levels may dominate the course of the disease.
Association of Screentime With Cognitive Delay In Preschool Children of Kerala, India
Authors: John Jijo Joseph , Joseph Reny , David Alice , Bejoy Ann , George Kalyan Varghese , George Lisa Mary
Published: October 2020

Background: Screen use is increasing rapidly among preschool children and excess screen use in these children has been associated with neurocognitive side effects and speech delay.Objectives: To look at patterns of screen use, determinants of excess screen use, and its association with socio-cognitive development among preschool children attending two kindergarten schools in urban Kerala.Methodology: A questionnaire-based survey was conducted among parents of children attending 2 urban kindergarten schools. Cognitive development was reported by the parents as per Werner David Development pictorial scale (WDDPS).Results: Of the 189 children included in the study, 89.4% had excess screen use (>1 hour per day) and the average use was 2.14 hours. Earlier age at introduction to screen (2.5 vs. 2.09 hours, p=0.01), meal-time screen use (OR 3.4, 95% CI 1.3-8.9), lack of parental co-viewing (2.19 vs. 1.96 hours, p=0.03), and receiving screen on demand (OR 3.7, 95% CI 1.3-10.8) were all significantly associated with excess screen use in pre-school children. Children with inconsistently supervised screen time had significantly more deficits as per WDDPS in attention (OR 3.2, 95% CI 1.3-8.2), intelligence (OR 4.1, 95% CI 1.3-13.3) and social skills (OR 15.3, 95% CI 1.9-121.2), compared to children whose screen use was consistently supervised.Conclusion: Screen time in the majority of preschool children is above the recommended limits, and consistent supervision by parents is seen in only half the preschool population. Inconsistently supervised screen time is associated with an increase in the time spent on screens, and significant cognitive delays in children.
Developing an intervention course to promote students’ well-being and studying in university context
Authors: Asikainen Henna , Katajavuori Nina
Published: October 2020

BackgroundThe purpose of this paper was to build an intervention course for university students which promotes both students’ well-being as well as their learning and study skills. Research has shown that psychological flexibility has a great effect on well-being as well as studying in higher educationCase presentationThe basis of our intervention course is to promote psychological flexibility and students’ study skills with the help of peer support and reflection.ConclusionsWe argue that an online, 8-week intervention course, which promotes both student well-being and their study skills, is a good way to support students in higher education and both aspects should be taken into account when supporting university students.
High flow nasal oxygen therapy to avoid intubation in SARS-CoV-2 pneumonia: A multicenter retrospective study
Authors: Bonnet Nicolas , Martin Olivier , Boubaya Marouane , Levy Vincent , Ebstein Nathan , Karoubi Philippe , Lambiotte Yacine Tandjaoui , Meersch Guillaume Van Der , Oziel johanna , Soulie Marie , Ghalayini Mohamed , Winchenne Anais , Zahar Jean Ralph , Ahmed Passem , Gaudry Stéphane , Cohen Yves
Published: October 2020

Background:. The efficacy of high flow nasal canula oxygen therapy (HFNO) to prevent invasive mechanical ventilation (IMV) is not well established in severe coronavirus disease 2019 (COVID-19). The aim of this study was to compare the risk of intubation between two strategies of oxygenation (conventional oxygenation and HFNO) in critically ill COVID 19 patientsMethods: This was a multicenter retrospective case series witch took place in two intensive care units (ICU) of tertiary hospitals in the Paris region from March 11, to May 3, 2020. We enrolled consecutive patients hospitalized for COVID-19 and acute respiratory failure (ARF) who did not receive IMV at ICU admission. The primary outcome was the rate of IMV after ICU admission. Secondary outcomes were death at day 28 and day 60, length of ICU stay, ventilator-free days and number of patients with ventilator-free days >14 days. Data from the HFNO group were compared with those from the standard oxygen therapy (SOT) group.ResultsAmong 138 patients who met the inclusion criteria, 62 (45%) were treated with SOT alone, and 76 (55%) with HFNO. In HFNO group, 39/76 (51%) patients were intubated and 46/62 (74%) in SOT group. After using a standard logistic regression on the original sample, HFNO was associated with significantly lower rate IMV (OR [IC-95%] 0.37 [0.18 – 0.76] p = 0.007). After propensity score application, HFNO was still associated with a lower rate of intubation (OR [IC-95%] 0.31 [0.14-0.66] p = 0.002). Length of ICU stay and mortality at day 28 and day 60 did not significantly differ between HFNO and SOT groups after propensity score application. In a univariate analysis, ventilator-free days at days 28 was higher in HNFO group (21 days vs 10 days, p=0.005). The number of patients with ventilator free-days >14 days was higher in HFNO group after propensity score application (66% vs 39%; OR 3.91[1.91-7.99], p=0.0002).ConclusionsHigh flow nasal canula oxygen for ARF due to COVID-19 reduces the need for intubation.
Oryza sativa ObgC1 acts as a signaling hub that regulates DNA replication and ribosome biogenesis in chloroplast nucleoids
Authors: Chen Ji , Wang Li , Jin Xiaowan , Wan Jian , Zhang Lang , Je Byoung Il , Zhao Ke , Kong Fanlei , Huang Jin , Tian Mengliang
Published: October 2020

Background: The Spo0B-associated GTP-binding protein (Obg) GTPase, has diverse and important functions in bacteria, including morphological development, DNA replication and ribosome maturation. Homologs of the Bacillus subtilis Obg have been also found in chloroplast of Oryza sativa , but their primary roles remain unknown. Results: We clarify that OsObgC1 is a unique functional homolog of AtObgC. The mutant obgc1-d1 exhibited hypersensitivity to the DNA replication inhibitor hydroxyurea. Quantitative PCR results showed that the ratio of chloroplast DNA to nuclear DNA in the mutants was higher than that of the wild-type plants. After DAPI staining, OsObgC1 mutants showed abnormal nucleoid architectures. The specific punctate staining pattern of OsObgC1-GFP signal suggests that this protein localizes to the chloroplast nucleoids. Furthermore, loss-of-function mutation in OsObgC1 led to a severe suppression of protein biosynthesis by affecting plastid rRNA processing. It was also demonstrated through rRNA profiling that plastid rRNA processing was decreased in obgc1 -d mutants, which resulted in impaired ribosome biogenesis. The sucrose density gradient profiles revealed a defective chloroplast ribosome maturation of obgc 1-d1 mutants. Conclusion: Our findings here indicate that the OsObgC1 retains the evolutionarily biological conserved roles of prokaryotic Obg, which acts as a signaling hub that regulates DNA replication and ribosome biogenesis in chloroplast nucleoids.
Prognostic Prediction Models for Patients with Low Back Pain: Systematic Review Protocol
Authors: Silva Fernanda Gonçalves , Costa Leonardo Oliveira Pena , Hancock Mark J , Palomo Gabriele Alves , Costa Luciola da Cunha Menezes , Silva Tatiane da
Published: October 2020

Background: The prognosis of acute low back pain is generally favourable in terms of pain and disability; however, outcomes vary substantially between individual patients. Clinical prediction models help in estimating the likelihood of an outcome at a certain time point. There are existing clinical prediction models focused on prognosis for patients with low back pain. To date, there is only one previous systematic review summarising the discrimination of validated clinical prediction models to identify the prognosis in patients with low back pain of less than 3 months duration. The aim of this systematic review is to identify existing developed and/or validated clinical prediction models on prognosis of patients with low back pain of less than 3 months duration, and to summarise their performance in terms of discrimination and calibration. Methods: MEDLINE, Embase and CINAHL databases will be searched, from the inception of these databases until January 2020. Eligibility criteria will be: (1) prognostic model development studies with or without external validation, or prognostic external validation studies with or without model updating; (2) with adults aged 18 or over, with ‘recent onset’ low back pain (i.e. less than 3 months duration), with or without leg pain; (3) outcomes of pain, disability, sick leave or days absent from work or return to work status, and self-reported recovery; and (4) study with a follow-up of at least 12 weeks duration. The risk of bias of the included studies will be assessed by the Prediction model Risk Of Bias ASsessment Tool, and the overall quality of evidence will be rated using the Hierarchy of Evidence for Clinical Prediction Rules. Discussion: This systematic review will identify, appraise, and summarize evidence on the performance of existing prediction models for prognosis of low back pain, and may help clinicians to choose the best option of prediction model to better inform patients about their likely prognosis. Systematic review registration: PROSPERO reference number CRD42020160988
Development of A Mechanical Setup With Sensors to Determine Interfacial Phenomena Between Supersonic Steam Jet and Water
Authors: Khan Afrasyab , Sanaullah Khairuddin , Konstantinovich Spiridonov Evgeny , Fedorovna Darya Khabarova , Rigit Andrew Ragai Henry , Ullah Atta
Published: October 2020

A specially configured mechanical setup with sensors which was designed to record minimal and increased fluctuations in temperature as evidence of Kelvin–Helmholtz (KH) instabilities by means of LM35 sensors and data acquisition. The generation and spread of KH instabilities in steam and water was accomplished first time by following temperature profiles around the steam’s jet interface with the surrounding water. The supersonic steam was driven into the water in a vessel by means of a specially designed supersonic nozzle at pressure changing from 1.5 to 3.0 bars. Whereas, the temperature of the water in the cylindrical column varied from 30 o C to 60 o C with a change of 5 o C each time when the measurements were performed. The acquisition setup was able to record temperatures across the steam jet in the vessel at a rate of 1 ms, and it could also provide the temperature readings within the vessel. Axial and radial temperature profiles being obtained from 6 temperature sensors positioned along the steam jet, revealed the instabilities being occurred across the interface among the steam and the water, the instabilities spread along the axis towards the vessel wall. However, these instabilities were influenced considerably due to the variation in water temperature in the column, along with change in steam’s pressure. Also, instabilities were affected as well due to the change in viscosity of water owing to change in its temperature.
A Vehicular Electronic Image Stabilization System Based on A Gasoline Model Car Platform
Authors: Zhang Ning , Yang Yuan , Wu Jian-Hua , Zhao Zi-Qian , Yin Guo-Dong
Published: October 2020

The image sequence captured by the vehicular camera vibrates due to the vehicle vibration or harsh road conditions. It greatly affects the subsequent image processing. As a video processing technology, electronic image stabilization (EIS) can solve this problem effectively. In this paper, a gasoline model car platform is established, which has rich vibration characteristics. Besides, high unevenness roads are selected to make the vibration problem more prominent. Considering vehicle demand, feature point detection and matching algorithm is applied to match images in the process of establishing EIS. In addition, the algorithm of eliminating mismatched feature points and the adaptive Kalman filter (AKF) is improved to make them more suitable for vehicle application. The experimental results show that the EIS developed in this paper meets the real-time requirements and can work normally in harsh road conditions. Since the platform and working scenarios are more extreme than the normal conditions, the EIS developed in this paper has high portability in the environment perception system of smart car.
Risk Evaluation on Security Personnel Managing Illegal Detainees In A Makeshift Covid-19 Low Risk Quarantine and Treatment Center
Authors: Rahman Anita Abd , Moideen Mohd Arshil , Anuar Erlendawati Mohd , Mahabot Fuad Ridha , Mustapha Wan Mohd Harith Wan , Rusli Mohammad Farhan
Published: October 2020

Background: The COVID-19 pandemic situation in Malaysia has resulted in a whole country approach where a newly built makeshift low risk Covid-19 treatment centre was chosen to house all COVID-19 positive illegal immigrants. In view of the desperate situation the detained illegal immigrants were in as the risks of them behaving aggressively, taking hostage, running away and escaping from the treatment centre were high this is the first time ever other governmental, non-governmental and security agencies worked alongside healthcare personnel in a biological hazard treatment centre while the clinical management was of no different than any other clinical setup in the country. This paper entails risk evaluation that needs to be considered to all the security personnel working in this centre as there was no precedent of similar situation in the country.Methodology: This is a semi-quantitative and integrated type of hazard identification, risk assessment and risk control (HIRARC) approach where it incorporates risk rating and severity rating to cover four elements, which are people, property, environment, and reputation. Total scores range from 1 to 25 and was further categorized into low, medium and high risk in a color-coded representation. The assessment was done for two weeks from 27th May 2020 till 11th June 2020.Result & Discussion: Four types of occupational and security hazards identified were physical, biological, psychological and ergonomics hazards. this evaluation serves as a good planning tool in optimizing the risk mitigation measures among security personnel working in a biological hazardous environment. Physical hazards with possible violence and riot scored the highest risk while ergonomic issues had the lowest rating. Appropriate control measures to mitigate all the potential risks were appropriately implemented through a solid multi-agencies’ collaborative effort.Conclusion: The mapping combination of existing hazard, risk rating and control was able to facilitate organization to prioritise future planning. With the fluidity of the COVID-19 pandemic, periodical evaluation is recommended to meet dynamic changes such as demands for frontliner manpower strength, the number of existing detainee patients in ward and the evolution of the COVID-19 infection itself in order to maintain safety and security for all.
Sustained Remission After Haploidentical Bone Marrow Transplantation in a Child With Refractory Systemic Juvenile Idiopathic Arthritis
Authors: Morelle Guillaume , Castelle Martin , Pinto Graziella , Breton Sylvain , Bendavid Matthieu , Boussard Charlotte , Mouy Richard , Bader-Meunier Brigitte , Semeraro Michaela , Faye Albert , Cavazzana Marina , Neven Bénédicte , Blanche Stéphane , Quartier Pierre , Moshous Despina
Published: October 2020

Background: Some patients with systemic juvenile idiopathic arthritis (SJIA) and severe, refractory disease achieved remission through intensive immunosuppressive treatment followed by autologous hematopoietic stem cell transplantation (HSCT). However, disease relapsed in most cases. More recently selected SJIA patients received allogenic HSCT from a HLA-identical sibling or a HLA matched unrelated donor. While most transplanted patients achieved sustained SJIA remission off-treatment, the procedure-related morbidity was high.Case report: A girl presented SJIA since the age of 15 months with a severe disease course. She was refractory to the combination of methotrexate and steroids to anti-interleukin (IL)-1, then anti-IL-6, tumor necrosis factor alpha inhibitors, and thalidomide. Therefore, allogenic HSCT was considered. In the absence of any possible HLA matched donor, a multidisciplinary team carefully assessed risks and benefits of a transplant procedure with an alternative donor. Given the high disease burden and important treatment-related toxicity the indication for a haploidentical HSCT from her mother was validated. The patient received a T replete bone marrow graft at the age of 3.7 years. Conditioning regimen contained Rituximab, Alemtuzumab, Busulfan, and Fludarabine. Cyclophosphamide at D+3 and +4 post HSCT was used for graft-versus-host-disease prophylaxis, followed by Cyclosporin A and Mycophenolate Mofetil. Post HSCT complications included severe infections, grade 3 intestinal graft-versus-host-disease, autoimmune thyroiditis, and immune thrombocytopenia. Three years after HSCT, the child is alive and well, notwithstanding persistent hypothyroidy requiring substitution. Immune thrombocytopenia had resolved. Most importantly, SJIA was in complete remission, off immunosuppressive drugs.Conclusion: Allogenic HSCT may be a therapeutic option, even with a HLA haplo-identical alternative donor, in patients with inflammatory diseases such as SJIA. Despite increased experience with this treatment, the risk of life-threatening complications restrains its indication to selected patients with severe, refractory disease.
Comparison of Postoperative Complications Between Robotic and Laparoscopic Rectal Cancer Surgery
Authors: bo Tang , lei xiong , ai junhua , huang zhixiang , shi jun , li taiyuan
Published: October 2020

Objective: Robotic and laparoscopic surgery for rectal cancer have been applied in clinic for decades, nevertheless, which surgical approach has a lower rate of postoperative complications is still inconclusive. Therefore, the aim of this meta-analysis is to compare the postoperative complications between robotic and laparoscopic rectal cancer surgery based on randomized controlled trials.Methods: Randomized controlled trials (until May 2020) which compared robotic and laparoscopic rectal cancer surgery were searched through PubMed, EMbase, Cochrane library, CNKI, Wan Fang databases and CBM. Data regarding sample size, clinical and demographic characteristics, overall postoperative complications, and the incidence of anastomotic leakage、incision infection、bleeding、 ileus、respiratory complications、 urinary complications、unscheduled reoperation 、perioperative mortality were extracted. The results were analyzed using RevMan v5.3.Results: Seven randomized controlled trials which included 507 robotic and 516 laparoscopic rectal cancer surgery cases were included. Meta-analysis showed that the overall postoperative complications [Z=1.1，OR=1.18，95% CI (0.88-1.57), P=0.27], anastomotic leakage [Z=0.96, OR=1.27, 95% CI (0.78-2.08), P=0.34], incision infection [Z=0.18, OR=1.05, 95% CI (0.61-1.79), P=0.86], bleeding [Z=0.19, OR=0.89, 95% CI (0.27-2.97), P=0.0.85], ileus [Z=1.47, OR=0.66, 95% CI (0.38-1.15), P=0.14], respiratory complications [Z=0.84, OR=0.64, 95% CI (0.22-1.82), P=0.40], urinary complications [Z=0.66, OR=1.22, 95% CI (0.67-2.22),P=0.51], unscheduled reoperation [Z=0.14, OR=0.91, 95% CI (0.26-3.20), P=0.89], perioperative mortality [Z=0.28, OR=0.79, 95% CI (0.15-4.12), P=0.78] were similar between robotic and laparoscopic rectal surgery.Conclusion: Robotic surgery for rectal cancer was comparable to laparoscopic surgery with respect to postoperative complications.
Expectations and Needs of Socially Disadvantaged Patients for Navigational Support of Primary Health Care Services
Authors: Piemeu Carine Sandrine Ngo Bikoko , Loignon Christine , Dionne Émilie , Paré-Plante Andrée-Anne , Haggerty Jeannie , Breton Mylaine
Published: October 2020

Background: Primary healthcare is the main entry to the health care system for most of the population, even for specialized care. In 2014, it was estimated that about 25% of the population in Quebec (Canada) did not have a regular primary healthcare provider. In 2017, after the introduction of a centralized waiting list to enroll unattached patients with a family doctor, nearly 540,000 patients, many of whom were socially disadvantaged, remained on the list. Socially disadvantaged patients often have more health problems, more complex care needs, and more difficult to accommodate life situations (e.g. two or more jobs, no work accommodation, care responsibilities, low income, lack of social network). They can also lack the skills needed to navigate a constantly evolving and complex healthcare system and, consequently, misuse the system. To overcome this problem, a partnership of health system managers, family physician leaders, community agents, and researchers designed, implemented, and evaluated a navigational support initiative. This study aimed to describe and understand the expectations and needs of socially disadvantaged patients towards navigational support interventions to improve their access to healthcare. Methods: A descriptive qualitative study rooted in an international multi-site participatory study (IMPACT) was conducted with socially disadvantaged patients. Semi-structured individual face-to-face and telephone interviews were conducted with patients recruited at universal public primary health care clinics in Montérégie, some of whom received the evaluated navigational service. A thematic analysis was performed using NVivo 11 software. Results: Sixteen patients living in socially deprived contexts were recruited. Three main expectations of patients for navigational support were identified: communication expectations (support to understand providers and to be understood by them, provision of communication tips, and help to improve communication between providers); relational expectations (emotional or psychosocial support); and pragmatic expectations (information on available community resources, information about the clinic, tips and tools for medical appointments, and physical support to navigate the health care system).Conclusions: Our study contributes to the literature by identifying the many expectations socially disadvantaged patients have related to navigational services. This information can be used for navigational intervention design.