bluuebunny/crossref_metadata_2025 huggingface dataset:
How useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of Congo
Authors: Ghilardi Ludovica , Okello George , Nyondo-Mipando Linda , Chirambo Chawanangwa Mahebere , Malongo Fathy , Hoyt Jenna , Lee Jieun , Sedekia Yovitha , Parkhurst Justin , Lines Jo , Snow Robert W , Lynch Caroline A. , Webster Jayne
Published: September 2020

Background Declining malaria prevalence and pressure on external funding have increased the need for efficiency in malaria control in sub-Saharan Africa (SSA). Modelled Plasmodium falciparum parasite rate (PfPR) maps are increasingly becoming available and provide information on the epidemiological situation of countries. However, how these maps are understood or used for national malaria planning is rarely explored. In this study, the practices and perceptions of national decision-makers on the utility of malaria risk maps, showing prevalence of parasitaemia or incidence of illness, was investigated. Methods A document review of recent National Malaria Strategic Plans was combined with 64 in-depth interviews with stakeholders in Kenya, Malawi and the Democratic Republic of Congo (DRC). The document review focused on the type of epidemiological maps included and their use in prioritising and targeting interventions. Interviews (14 Kenya, 17 Malawi, 27 DRC, 6 global level) explored drivers of stakeholder perceptions of the utility, value and limitations of malaria risk maps. Results Three different types of maps were used to show malaria epidemiological strata: malaria prevalence using a PfPR modelled map (Kenya); malaria incidence using routine health system data (Malawi); and malaria prevalence using data from the most recent Demographic and Health Survey (DRC). In Kenya the map was used to target preventative interventions, including long-lasting insecticide-treated nets (LLINs) and intermittent preventive treatment in pregnancy (IPTp), whilst in Malawi and DRC the maps were used to target in-door residual spraying (IRS) and LLINs distributions in schools. Maps were also used for operational planning, supply quantification, financial justification and advocacy. Findings from the interviews suggested that decision-makers lacked trust in the modelled PfPR maps when based on only a few empirical data points (Malawi and DRC).Conclusions Maps were generally used to identify areas with high prevalence in order to implement specific interventions. Despite the availability of national level modelled PfPR maps in all three countries, they were only used in one country. Perceived utility of malaria risk maps was associated with the epidemiological structure of the country and use was driven by perceived need, understanding (quality and relevance), ownership and trust in the data used to develop the maps.
Can 68Ga-prostate specific membrane antigen positron emission tomography / computerized tomography provide an accurate lymph node staging for patients with medium / high risk prostate cancer? A Diagnostic Meta-Analysis
Authors: Peng Lei , Li Jinze , Meng Chuanyang , Li Jinming , You Chengyu , Tang Dandan , Wei Tangqiang , Xiong Wei , Li Yunxiang
Published: September 2020

Objective: This article aims to evaluate the diagnostic value of 68Gallium-PSMA positron emission tomography/computerized tomography (68Ga-PSMA PET/CT) for lymph node (LN) staging in patients with prostate cancer (PCa) by a meta-analysis of diagnostic tests.Methods: We systematically retrieved articles from Web of Science, EMBASE, Cochrane Database, PubMed. The time limit is from the creation of the database until June 2019, and Stata 15 was used for calculation and statistical analyses.Results: Sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR), diagnostic odds ratio (DOR) and 95% confidence intervals (CI) be used to evaluate the diagnostic value. A total of 10 studies were included in our meta-analysis, which included 701 individuals. The results of each consolidated summary are as follows: sensitivity of 0.84 (95% CI: 0.55-0.95), specificity of 0.95 (95% CI: 0.87-0.98), PLR and NLR was 17.19 (95% CI: 6.27, 47.17) and 0.17 (95% CI: 0.05-0.56), respectively. DOR of 100 (95% CI: 18-545), AUC of 0.97 (95% CI: 0.95-0.98). Conclusion: Our study demonstrates that 68Ga-PSMA PET/CT has a high overall diagnostic value for LN staging in patients with moderate and high-risk PCa. But our conclusions still require a larger sample size, multi-center prospective randomized controlled trial to verify.
Unmet mental health needs in the general population: perspectives of Belgian health and social care professionals
Authors: Rens Eva , Dom Geert , Remmen Roy , Michielsen Joris , Broeck Kris Van den
Published: September 2020

Background: An unmet mental health need exists when someone has a mental health problem but doesn’t receive formal care, or when the care received is insufficient or inadequate. Epidemiological research has identified both structural and attitudinal barriers to care which lead to unmet mental health needs, but reviewed literature has shown gaps in qualitative research on unmet mental health needs. This study aimed to explore unmet mental health needs in the general population from the perspective of professionals working with vulnerable groups. Methods: Four focus group discussions and two interviews with 34 participants were conducted from October 2019 to January 2020. Participants’ professional backgrounds encompassed social work, mental health care and primary care in one rural and one urban primary care zone in Antwerp, Belgium. A topic guide was used to prompt discussions about which groups have high unmet mental health needs and why. Transcripts were coded using thematic analysis.Results: Five themes emerged, which are subdivided in several subthemes: (1) socio-demographic determinants and disorder characteristics associated with unmet mental health needs; (2) demand-side barriers; (3) supply-side barriers; (4) consequences of unmet mental health needs; and (5) suggested improvements for meeting unmet mental health needs. Conclusions: Findings of epidemiological research were largely corroborated. Some additional groups with high unmet needs were identified. Professionals argued that they are often confronted with cases which are too complex for regular psychiatric care and highlighted the problem of care avoidance. Important system-level factors include waiting times of subsidized services and cost of non-subsidized services. Feelings of burden and powerlessness are common among professionals who are often confronted with unmet needs. Professionals discussed future directions for an equitable mental health care provision, which should be accessible and targeted at those in the greatest need. Further research is needed to include the patients’ perspective of unmet mental health needs.
Point-of-care 3D printing during the COVID-19 pandemic. What role does the manufacturing university hospital play?
Authors: Perez-Mañanes Ruben , José Sonia García de San , Desco-Menéndez Manuel , Sánchez-Arcilla Ignacio , González-Fernández Esmeralda , Vaquero-Martín Javier , González-Garzón Javier Pascau , Mediavilla-Santos Lydia , Trapero-Moreno Diego , Calvo-Haro José Antonio
Published: September 2020

Background Point-of-care (POC) manufacturing and distributed production represent a paradigm shift in the health system that is becoming critical during the COVID-19 pandemic. University hospitals are also taking on the role of manufacturers of custom-made solutions thanks to 3D printing technology. Case Description We present a monocentric observational study regarding the distributed manufacture of three groups of products during the period of the COVID-19 pandemic from 14 March to 10 May 2020: personal protective equipment, ventilatory support, and diagnostic and consumable products.Discussion and Evaluation Networking during this period has enabled the delivery of a total of 17,276 units of products manufactured using 3D printing technology. The most manufactured product was the face shields and ear savers, while the one that achieved the greatest clinical impact was the mechanical ventilation adapters and swabs. The products were manufactured by individuals in 57.3% of the cases, and our hospital acted as the main delivery node in a hub with 10 other hospitals. The main advantage of this production model is the fast response to stock needs, being able to adapt almost in real time.Conclusions The role of the manufacturing hospital allows the reconciliation of in-house and distributed manufacturing with traditional production, providing custom-made adaptation of the specifications, as well as maximum efficiency in the working and availability of resources, which is of special importance at critical times for health systems such as the current COVID-19 pandemic.
Evaluation of different airway tests to determine difficult intubation in apparently normal adult patients undergoing surgical procedures.
Authors: EL-Radaideh Khaled , Dheeb Ehab , Shboul Hamzeh , Garaibeh Saif , Bataineh Adel , Khraise Wail , Radaideh Basil EL
Published: September 2020

Background: Inadequate maintenance of a patient's airway represents a major cause of anesthesia-related morbidity and mortality. This study was designed to evaluate common preoperative clinical tests to determine the risk of difficult endotracheal intubation in apparent "normal" adult patients undergoing surgical procedures.﻿Methods: A prospective observational cohort study was performed on 160 consecutive adult patients undergoing surgical procedures at an academic medical center in Jordan from 20 May 2019 until 11 February 2020. Preoperative assessment of airway risk stratification was performed by the following clinical tests: the mandible protrusion test (MPT), thyromental (TMD) and sternomental (SMD) distances, inter-incisor gap (IIG), and the modified Mallampati tests with tongue protrusion (MMT-TP) and without tongue protrusion (MMT-NTP). Grade C on the MPT, TMD ≤ 6 cm, SMD ≤ 12 cm, and MMT grades III and IV were considered to be predictors of difficult endotracheal intubations. A modified Cormack-Lehane grading (MCLG) of laryngoscopic views with backward, upward, and right-sided pressure on the thyroid and cricoid cartilages (BURP) maneuver was also documented, with grades 2B, 3, and 4 considered to be difficult airways for intubation. Results: Fifteen patients (9.4%) were classified as MCLG 2B, 3, and 4, with age significantly associated with the MCLG grade (P = 0.028). The sensitivity and Youden's index of MMT-TP were found to be the lowest (40% and 0.29, respectively). The MPT was the most accurate and specific test (90.63% and 95.17%, respectively), with the highest PPV (50%), Youden's index (0.42), and area under the curve (AUC) (0.781). Bivariant analysis of MPT and the t-test of the mean TMDs and SMDs revealed significant associations between these airway tests and the difficulty of intubation (P values: < 0.001, 0.02, < 0.01, respectively). Conclusion: The MPT, with its highest accuracy, specificity, positive predictive value, and good sensitivity may be used as a routine screening test for preoperative prediction of difficult endotracheal intubations.
Effectiveness Of Fiberoptic Phototherapy Compared To Conventional Phototherapy In Treating Hyperbilirubinemia Amongst Term Neonates: A Randomized Controlled Trial
Authors: Joel Helvi Ndeshihala , Mchaile Deborah , Philemon Rune , Mbwasi Ronald , Msuya Levina
Published: September 2020

Background: Neonatal jaundice is one of the most common problems in newborns. Effective treatment of jaundice requires therapeutic intervention with phototherapy. Over recent years, several studies reported fiberoptic phototherapy to be less effective than conventional phototherapy in term neonates. Our study aimed to compare the effectiveness of fiberoptic phototherapy with a larger illuminated area and higher irradiance to conventional phototherapy methods. Methods: This was a randomized controlled trial conducted at Kilimanjaro Christian Medical Centre (KCMC). A total of 41 term neonates, less than 7 days of age with unconjugated hyperbilirubinemia were randomized. Thirteen (13) newborns were allocated to receive fiberoptic phototherapy, 13 to blue light conventional phototherapy and 15 to white light conventional phototherapy. Effectiveness was assessed by comparing the duration of phototherapy, bilirubin reduction rate and side effects of treatment. The data was analyzed with the independent t-test.Results: The mean overall bilirubin reduction rate was comparable in the fiberoptic phototherapy group (0.74%/h) and the blue light conventional phototherapy group (0.84%/h), with no statistically significant difference (p-value 0.124). However, white light conventional phototherapy had a significantly lower mean overall bilirubin reduction rate (0.29%/h) as compared to fiberoptic phototherapy (p-value <0.001). The mean treatment duration of phototherapy was 69 h, 68 h and 90 h in the fiberoptic, blue light conventional and white light conventional phototherapy groups respectively. Side effects such as loose stool and skin rash were noted in some participants who received conventional phototherapy. No side effects of treatment were noted in the fiberoptic phototherapy group.Conclusion: The effectiveness of fiberoptic PT and blue light conventional PT were comparable in terms of bilirubin reduction rate and treatment duration, whereas fiberoptic phototherapy was more effective than white light conventional PT, with a significantly lower bilirubin reduction rate and treatment duration. Fiberoptic phototherapy may mitigate side effects caused by conventional phototherapy.Trial registration: The Pan African Clinical Trial Registry, PACTR202004723570110. Registered 22nd April 2020- Retrospectively registered, http://www.pactr.org/
CCBlock based on deep learning for diagnosis COVID-19 in chest x-ray image
Authors: Al-Bawi Ali , Al-Kaabi Karrar Ali , Jeryo Mohammed , Al-Fatlawi Ahmad
Published: September 2020

Propose: Troubling countries one after another, the COVID-19 pandemic has dramatically affected the health and well-being of the world's population. The disease may continue to persist more extensively due to the increasing number of new cases daily, the rapid spread of the virus, and delay in the PCR analysis results. Therefore, it is necessary to consider developing assistive methods for detecting and diagnosing the COVID-19 to eradicate the spread of the novel coronavirus among people. Based on convolutional neural networks (CNNs), automated detection systems have shown promising results of diagnosing patients with the COVID-19 through radiography; thus, they are introduced as a workable solution to the COVID-19 diagnosis.Materials and Methods: Based on the enhancement of the classical visual geometry group (VGG) network with the convolutional COVID block (CCBlock), an efficient screening model was proposed in this study to diagnose and distinguish patients with the COVID-19 from those with pneumonia and the healthy people through radiography. The model testing dataset included 1,828 x-ray images available on public platforms. 310 images were showing confirmed COVID-19 cases, 864 images indicating pneumonia cases, and 654 images showing healthy people.Results: According to the test results, enhancing the classical VGG network with radiography provided the highest diagnosis performance and overall accuracy of 98.52% for two classes as well as accuracy of 95.34% for three classes.Conclusions: According to the results, using the enhanced VGG deep neural network can help radiologists automatically diagnose the COVID-19 through radiography.
Decompressive craniectomy combined with mild hypothermia in patients with large hemispheric infarction: A randomized controlled trial
Authors: Fan Linlin , Su Yingying , Zhang Yan , Ye Hong , Chen Weibi , Liu Gang
Published: September 2020

Background: To investigate the effects of decompressive craniectomy (DC) combined with hypothermia treatment on mortality and neurological outcomes in patients with large hemispheric infarction (LHI).Methods: Patients within 48 hours of symptom onset were randomized to the following three groups: the DC group, the DC plus head surface cooling (DCSC) group and the DC plus endovascular hypothermia (DCEH) group. Patients in the DC group were given standard medical treatment with a normothermic target temperature. Patients in the DCSC group received standard medical treatment plus 24-hour ice cap on the head for 7 days. Patients in the DCEH group were given standard medical treatment plus endovascular hypothermia with a target temperature of 34°C. The primary end-points were mortality and modified Rankin Scale (mRS) score at 6 months.Results: There were 9 patients in the DC group, 14 patients in the DCSC group and 11 patients in the DCEH group. The mortality rates of the DC, DCSC and DCEH groups at the time of discharge were 22.2% (2/9), 0% (0/14) and 9.1% (1/11), respectively. At 6 months, the mortality rates in the DC, DCSC and DCEH groups increased to 44.4% (4/9), 21.4% (3/14) and 45.5% (5/11), respectively (P=0.367). The most common cause of death after discharge was pneumonia (8 cases). Twelve cases (35.3%) achieved good neurological outcome (mRS 0-3) at 6 months. The proportions of good neurological outcome in the DC, DCSC and DCEH groups were 22.2% (2/9 cases), 42.9% (6/14 cases) and 36.4% (4/11), respectively. The DCSC group seemed to have higher proportion of good outcomes, but there was no significant difference between groups (p=0.598). Among survivors, endovascular hypothermia had a higher proportion of good outcome, still without significant difference (DC group, 2/5 cases, 40.0%; DCSC group, 6/11 cases, 54.5%; DCEH group, 4/6 cases, 66.7%; p=0.696). The incidence of complications in the DCEH group was higher than those of the DC and DCSC groups (18.9%, 12.0%, and 12.1%, respectively; P=0.025).Conclusions: There is still no evidence to confirm that hypothermia further reduces long-term mortality and improves neurological outcomes in LHI patients with DC. However, there is a trend to benefit survivors from hypothermia. A local cooling method may be a better option for DC patients, which has little impact on systematic complications.Clinical Trial Registration - Decompressive Hemicraniectomy Combined Hypothermia in Malignant Middle Cerebral Artery Infarct, ChiCTR-TRC-12002698. Registered 11 Oct 2012- Retrospectively registered, URL: http://www.chictr.org.cn.
Feasibility and long-term safety of Ho:YAG laser lithotripsy in broncholithiasis patients
Authors: Cheng Yuan , Wang Guangfa , Zhang Wei , Zhang Hong , Wang Xi
Published: September 2020

BackgroundTreatment of broncholithiasis is complex, especially in the case of a large or transbronchial broncholith. Holmium-yttrium aluminum garnet (Ho:YAG) laser lithotripsy may be a useful treatment in broncholithiasis; however, as it is not yet common practice, the optimal parameters are unknown. MethodsWe performed a single-center retrospective analysis of the clinical data of 13 broncholithiasis patients who underwent Ho:YAG laser lithotripsy from May 2012 to October 2018.ResultsFor the 13 patients (2 males and 11 females), Ho:YAG laser lithotripsy was performed 17 times, in total. All procedures were performed under general anesthesia with rigid bronchoscopy. We initially set the Ho:YAG laser to a pulse frequency of 5 Hz and a pulse energy of 0.8 J, gradually increasing these as required. The pulse frequency range we employed was 5-15 Hz, and the pulse energy range was 0.8-1.6 J. All broncholiths were successfully extracted after lithotripsy, and all symptoms improved. Hemoptysis, bronchial esophageal fistula, and pneumonia were the most common complications; however, there were no long-term complications.ConclusionsHo:YAG laser lithotripsy is an effective and safe treatment for broncholithiasis, over a long-term follow up.
Driving stress and seismotectonic implications of the 2013 Mw5.8 Awaji Island earthquake, southwestern Japan, based on earthquake focal mechanisms before and after the mainshock
Authors: Imanishi Kazutoshi , Ohtani Makiko , Uchide Takahiko
Published: September 2020

A driving stress of the M w 5.8 reverse-faulting Awaji Island earthquake (2013), southwest Japan, was investigated using focal mechanism solutions of earthquakes before and after the mainshock. The seismic records from regional high-sensitivity seismic stations were used. Further, the stress tensor inversion method was applied to infer the stress fields in the source region. The results of the stress tensor inversion and the slip tendency analysis revealed that the stress field within the source region deviates from the surrounding area, in which the stress field locally contains a reverse-faulting component with ENE-WSW compression. This local fluctuation in the stress field is key to producing reverse-faulting earthquakes. The existing knowledge on regional-scale stress (tens to hundreds of km) cannot predict the occurrence of the Awaji Island earthquake, emphasizing the importance of estimating local-scale (< tens of km) stress information. It is possible that the local-scale stress heterogeneity has been formed by local tectonic movement, i.e., the formation of flexures in combination with recurring deep aseismic slips. The coseismic Coulomb stress change, induced by the disastrous 1995 M w 6.9 Kobe earthquake, increased along the fault plane of the Awaji Island earthquake; however, the postseismic stress change was negative. We concluded that the gradual stress build-up, due to the interseismic plate locking along the Nankai trough, overcame the postseismic stress reduction in a few years, pushing the Awaji Island earthquake fault over its failure threshold in 2013. The observation that the earthquake occurred in response to the interseismic plate locking has an important implication in terms of seismotectonics in southwest Japan, facilitating further research on the causal relationship between the inland earthquake activity and the Nankai trough earthquake. Furthermore, this study highlighted that the dataset before the mainshock may not have sufficient information to reflect the stress field in the source region due to the lack of earthquakes in that region. This is because the earthquake fault is generally locked prior to the mainshock. Further research is needed for estimating the stress field in the vicinity of an earthquake fault via seismicity before the mainshock alone.
Magnetic Resonance Imaging and Dynamic X-ray's correlations with Dynamic Electrophysiological Findings in Cervical Spondylotic Myelopathy: a retrospective cohort study.
Authors: Yu Zhengran , Lin Kaiyuan , Chen Jiacheng , Chen Kuan-Hung , Chen Yuguang , Guo Wei , Dai Yuhu , Zou Xuenong , Peng Xinsheng
Published: September 2020

Background: Dynamic somatosensory evoked potentials (DSSEP) can be used to disclose abnormalities of ascending sensory pathways at dynamic positions and diagnose cervical spondylotic myelopathy (CSM). However, radiographic tests including magnetic resonance imaging (MRI) and dynamic X-ray are used much more widely in the management of CSM. Our study aims to clarify the correlations between several radiographic parameters and the DSSEP results, and further determine their reliability with clinical data.Methods: We retrospectively enrolled 38 CSM patients with surgical intervention. DSSEP tests were performed before surgery. Amplitude ratios of DSSEP N13 and N20 waves at extension and flexion were calculated and recorded as N13_E, N20_E, N13_F, N20_F, respectively. Baseline severity was evaluated with the modified Japanese Orthopedic Association (mJOA) score and the Nurick grades. Prognosis was evaluated based on the 2-year recovery rate. Sagittal diameter and transverse areas of the cord and canal were measured and the the compressive ratios at the compressed site (Compression_Ratio), central (Central_Ratio), and 1/4-lateral points (1/4-Lateral_Compression_Ratio), and spinal cord/Canal Area Ratio were calculated. The intramedullary T2 hyperintensity patterns (Ax-CCM types) were also collected from MRI axial images. Dynamic X-rays were used to test for segmental instability of the cervical spine. The correlations between radiologic findings, DSSEP data, and clinical assessments were investigated.Results: We found that DSSEP N13_E and N13_F correlated with the Compression_Ratio, Central_Ratio, 1/4-Lateral_Compression_Ratio (Pearson, p<0.05) and Ax-CCM types (ANOVA, p<0.05) in MRI axial images and cervical segmental instability in dynamic X-ray (t-test, p<0.05). Apart from the 1/4-Lateral_Compression_Ratio, these radiographic parameters above also correlated with the baseline clinical assessments (Spearman or ANOVA or t-test, p<0.05) and postoperative recovery rate (Pearson or ANOVA or t-test, p<0.05).Conclusions: We found that the preoperative Compression_Ratio, Central_Ratio and 1/4-Lateral_Compression_Ratio in MRI and cervical segmental instability in dynamic X-ray could reflect the dynamic neural dysfunction of the spinal cord. Different Ax-CCM types corresponded to different DSSEP results at extension and flexion, suggesting divergent pathophysiology. These radiographic parameters could help evaluate disease severity and predict postoperative prognosis.Trial registration: The trial "动态诱发电位对脊髓型颈椎病诊断和预后评估(Dynamic Somatosensory Evoked Potentials for the diagnostic and prognostic evaluation for Cervical Spondylotic Myelopathy)" was retrospectively registered on April 30th, 2020 and the registration number is "伦审[2020]151号".
The additive effects of type 2 diabetes mellitus on left ventricular deformation and myocardial perfusion in essential hypertension: a 3.0T cardiac magnetic resonance study
Authors: Li Xue-Ming , Jiang Li , Guo Ying-Kun , Ren Yan , Han Pei-Lun , Peng Li-Qing , Shi Rui , Yan Wei-Feng , Yang Zhigang
Published: September 2020

Background: Type 2 diabetes mellitus (T2DM) increases the risks of heart failure and mortality in patients with hypertension, however the underlying mechanism is unclear. This study aims to investigate the impact of coexisting T2DM on left ventricular (LV) deformation and myocardial perfusion in hypertensive individuals.Materials and Methods: Seventy hypertensive patients without T2DM [HTN(T2DM-)], forty patients with T2DM [HTN(T2DM+)] and 37 age- and sex-matched controls underwent cardiac magnetic resonance examination. Left ventricular (LV) myocardial strains, including global radial (GRPS), circumferential (GCPS) and longitudinal peak strain (GLPS), and resting myocardial perfusion indices, including upslope, time to maximum signal intensity (TTM), and max signal intensity (MaxSI), were measured and compared among groups by analysis of covariance after adjusting for age, sex, body mass index (BMI) and heart rate followed by Bonferroni’s post hoc test. Backwards stepwise multivariable linear regression analyses were performed to determine the effects of T2DM on LV strains and myocardial perfusion indices in patients with hypertension.Results: Both GRPS and GLPS deteriorated significantly from controls, through HTN(T2DM-), to HTN(T2DM+) group; GCPS in HTN(T2DM+) group was lower than those in both HTN(T2DM-) and control groups. Compared with controls, HTN(T2DM-) group showed higher myocardial perfusion, and HTN(T2DM+) group exhibited lower perfusion than HTN(T2DM-) group and controls. Multiple regression analyses considering covariates of systolic blood pressure, age, sex, BMI, heart rate, smoking, indexed LV mass and eGFR demonstrated that T2DM was independently associated with LV strains (GRPS: p=0.002, model R2=0.383; GCPS: p<0.001, model R2=0.472; and GLPS: p=0.002, model R2=0.424, respectively) and perfusion indices (upslope: p<0.001, model R2=0.293; TTM: p<0.001, model R2=0.299; and MaxSI: p<0.001, model R2=0.268, respectively) in hypertension. When both T2DM and perfusion indices were included in the regression analyses, both T2DM and TTM were independently associated with GRPS (p=0.044 and 0.017, model R2=0.390) and GCPS (p=0.002 and 0.001, model R2=0.424), and TTM but not perfusion indices was independently associated with GLPS (p=0.002, model R2=0.424). Conclusion: In patients with hypertension, T2DM had an additive deleterious effect on subclinical LV systolic dysfunction and myocardial perfusion, and impaired myocardial perfusion by coexisting T2DM was associated with deteriorated LV systolic dysfunction.
First report on molecular basis of potato leaf roll virus (PLRV) aggravation by combined effect of tuber and prevailing aphid
Authors: Kumar Ravi Ranjan , Ansar Mohammad , Rajani Kumari , Kumar Jitesh , Ranjan Tushar
Published: September 2020

Objective: The Potato Leaf Roll Virus (PLRV) is one of the most devastating virus causing severe yield losses worldwide in potato. The comprehensive observations were made to study the PLRV infestation in major potato growing areas of Bihar (India) and further detailed molecular basis of PLRV aggravation was established.Results: Although aphids population were found comparatively lower with maximum symptomatic plants, our molecular data further confirms the presence of PLRV in all possible symptomatic tissues such as tubers, shoots and leaves. For the first time, we have proposed molecular basis of aggravation of PLRV, where tuber acts as a reservoir during off-season and further transmitted by aphids.
Monitoring priority substances in biota under the Water Framework Directive: How effective is a tiered approach based on caged invertebrates? A proof of concept study targeting PFOS in French rivers.
Authors: Babut Marc , Fe Benoit J.D. , Jame Patrick , Assoumani Azziz , Lestremau François , Hette-Tronquart Nicolas , Miege Cécile , Perceval Olivier
Published: September 2020

Background : This study aims to describe and test a tiered approach for assessing compliance to Environmental Quality standards (EQSs) for priority substances in biota in line with the European Water Framework Directive. This approach is based on caged gammarids and trophic magnification factors (TMFs) at the first tier, with fish analysed at the second tier at sites predicted to exceed the EQS at the first tier. A dataset was implemented by monitoring perfluorooctane sulfonate (PFOS) in caged gammarids exposed at 15 sites in French rivers, and in fish muscle and rest-of- body from the same sites. Isotopic ratios (d 13 C and d 15 N) were also measured in gammarids and fish. Two scenarios were developed to compare measured PFOS concentrations in fish against predicted concentrations based on measures in caged gammarids and TMFs. Scenario (1) compared measured PFOS concentrations in fish fillets with predicted PFOS concentrations based on measured concentrations in caged gammarids and d 15 N. Scenario (2) tested whether or not EQS exceedance was correctly predicted based on measured concentrations in caged gammarids and trophic levels (TLs) from wild fish and gammarid populations.
Results : d 13 C and d 15 N variations showed that caged gammarids used local food resources during exposure in the field. PFOS concentrations in gammarids were fairly variable through time at each site. In fish, concentrations ranged from <1 ng g -1 to 250 ng g -1 (wet weight). After adjustment to the TL at which the EQS is set, 12 sites were above the EQS for PFOS. In scenario (1), predicted concentrations were almost correct at 7 sites out of 15. Most incorrect predictions were overestimations that were slightly improved by applying a lower (neutral) TMF. In scenario (2) we tested several variants for parameters involved in the predictions. The most efficient combination yielded two wrong predictions out of 15. This result was obtained with a higher (more conservative) TMF value, mean concentrations in gammarids from several field exposures during a year, and a TL for gammarids at the median of the distribution in French rivers.
Conclusion : The proposed tiered approach was thus efficient. However, the number of sites was relatively limited, and the dataset was biased towards EQS exceedance. The tiered approach warrants further validation.
DV-DVFS: Merging Data variety and DVFS Technique to Manage the Energy Consumption of Big Data Processing
Authors: Ahmadvand Hossein , Foroutan Fouzhan , Fathy Mahmood
Published: September 2020

Data variety is one of the most important features of Big Data. Data variety is the result of aggregating data from multiple sources and uneven distribution of data. This feature of Big Data causes high variation in the consumption of processing resources such as CPU consumption. This issue has been overlooked from previous work. To overcome the mentioned problem, in the present work, we used Dynamic Voltage and Frequency Scaling (DVFS) to reduce the energy consumption of computation. To this goal, we consider two types of deadlines as our constraint. Before applying the DVFS technique to computer nodes, we estimate the processing time and the frequency needed to meet the deadline. In the evaluation phase, we have used a set of data sets and applications. The experimental results show that our proposed approach surpasses the other scenarios in processing real datasets. Based on the experimental results in this paper, DV-DVFS can achieve up to 15% improvement in energy consumption.
SCN11A Gene Deletion Causes Sensorineural Hearing Loss by Impairing the Ribbon Synapses and Auditory Nerves
Authors: Zu Mian , Guo Wei-wei , Cong Tao , Ji Fei , Zhang Shi-li , Zhang Yue , Song Xin , Sun Wei , He David Z.Z. , Shi Wei-guo , Yang Shiming
Published: September 2020

Background: The SCN11A gene, encoded Nav1.9 TTX resistant sodium channels, is a main effector in peripheral inflammation related pain in nociceptive neurons. The role of SCN11A gene in the auditory system has not been well characterized. We therefore examined the expression of SCN11A in the murine cochlea, the morphological and physiological features of Nav1.9 knockout (KO) ICR mice. Results: Nav1.9 expression was found in the primary afferent endings beneath the inner hair cells (IHCs). The relative quantitative expression of Nav1.9 mRNA in modiolus of wild-type (WT) mice remains unchanged from P0 to P60. The number of presynaptic CtBP2 puncta in Nav1.9 KO mice was significantly lower than WT. In addition, the number of SGNs in Nav1.9 KO mice in the basal turn was also lower than WT, but not in the apical and middle turns. There was no lesion in the somas and stereocilia of hair cells in Nav1.9 KO mice. Nav1.9 KO mice showed higher and progressive ABR threshold at 16 kHz, a significant increase in CAP thresholds, while no changes in cochlear microphonics (CM). Conclusions: These data suggest a role of Nav1.9 in regulating the function of ribbon synapses and the auditory nerves. The impairment induced by Nav1.9 gene deletion mimics the characters of cochlear synaptopathy.
Effect of vitamin A on intestinal mucosal injury in pediatric patients receiving hematopoietic stem cell transplantation and chemotherapy: a quasai-randomized trial
Authors: Pattanakitsakul Ploy , Chongviriyaphan Nalinee , Pakakasama Samart , Apiwattanakul Nopporn
Published: September 2020

Objective: Vitamin A is involved in maintenance of gut mucosal integrity and normal immune function. However, it is unclear whether these functions of vitamin A have any beneficial effects in patients undergoing hematopoietic stem cell transplantation (HSCT). In this study, we aimed to examine the potential protective effect of vitamin A supplementation on gastrointestinal (GI) mucosal integrity in HSCT recipients using plasma citrulline as a surrogate marker of intestinal integrity.Results: We performed a quasi-randomized trial in 30 pediatric patients undergoing HSCT. Half (n = 15) of the patients received a single high dose of vitamin A (200,000 IU) before the conditioning regimen was given, and half (n = 15) did not. Clinical data of patients who developed post-transplant complications were recorded for 60 days after HSCT. There were no significant differences in mean plasma citrulline levels on day 7 after HSCT between the treatment and control groups (5.8 vs. 5.9 µmol/L, respectively). The incidence of mucositis and other complications were not different between the two groups within 60 days of HSCT. Vitamin A supplementation prior to HSCT in pediatric patients had no clinical benefit in protecting GI mucosal integrity.
Variation of MicroRNA Expression in the Human Placenta Driven by Population Identity and Sex of the Newborn
Authors: Guo Song , Huang Shuyun , Jiang Xi , Hu Haiyang , Han Dingding , Moreno Carlos S , Fairbrother Genevieve L , Hughes David A , Stoneking Mark , Khaitovich Philipp
Published: September 2020

BackgroundAnalysis of lymphocyte cell lines revealed substantial differences in the expression of mRNA and microRNA (miRNA) among human populations. The extent of such population-associated differences in actual human tissues remains largely unexplored. The placenta is one of the few solid human tissues that can be collected in substantial numbers in a controlled manner, enabling quantitative analysis of transient biomolecules such as RNA transcripts. Here, we analyzed microRNA (miRNA) expression in human placental samples derived from 36 individuals representing four genetically distinct human populations: African Americans, European-Americans, South Asians, and East Asians. All samples were collected at the same hospital following a unified protocol, thus minimizing potential biases that might influence the results.ResultsSequence analysis of the miRNA fraction yielded 938 annotated and 70 novel miRNA transcripts expressed in the placenta. Of them, 82 (9%) of annotated and 11 (16%) of novel miRNAs displayed quantitative expression differences among populations, generally reflecting reported genetic and mRNA-expression-based distances. Several co-expressed miRNA clusters stood out from the rest of the population-associated differences in terms of miRNA evolutionary age, tissue-specificity, and disease-association characteristics. Among three non-environmental influenced demographic parameters, the second largest contributor to miRNA expression variation after population was the sex of the newborn, with 32 miRNAs (3% of detected) exhibiting significant expression differences depending on whether the newborn was male or female. Male-associated miRNAs were evolutionarily younger and correlated inversely with the expression of target mRNA involved in neuron-related functions. In contrast, both male and female-associated miRNAs appeared to mediate different types of hormonal responses. Demographic factors further affected reported imprinted expression of 66 placental miRNAs: the imprinting strength correlated with the mother’s weight, but not height. ConclusionsOur results showed that among 12 assessed demographic variables, population affiliation and fetal sex had a substantial influence on miRNA expression variation among human placental samples. The effect of newborn-sex-associated miRNA differences further led to expression inhibition of the target genes clustering in specific functional pathways. By contrast, population-driven miRNA differences might mainly represent neutral changes with minimal functional impacts.
Suspected Heparin-Induced Thrombocytopenia in a COVID-19 Patient on Extracorporeal Membrane Oxygenation Support: A Case Report.
Authors: Phan Xuan T. , Nguyen Tuan Huu , Tran Tung T. , Huynh Thu-Hien T. , Hoang Thuy-Ha T. , Nguyen Vinh-Chau V. , Pham Thao N. T.
Published: September 2020

Background: Extracorporeal membrane oxygenation (ECMO) support can be life-saving in critically ill COVID-19 patients. However, there are many complications associated with this procedure, including Heparin-induced thrombocytopenia (HIT.) Despite its rarity in ECMO cases, HIT can lead to devastating consequences and is difficult to manage. Case presentation: In this report, we present a case of a COVID-19 patient on ECMO support who was diagnosed with HIT and required intensive treatment. Initially, HIT was only suspected due to newly-developed thrombocytopenia and oxygenator dysfunction, with thrombi observed later. Regarding his treatment, since there was no recommended replacement to heparin available to us at the time of diagnosis, we decided to use rivaroxaban temporarily. No adverse events were recorded during that period. The patient was able to make a full recovery. Conclusion: HIT may jeopardize patient’s care during ECMO. As COVID-19 may bring about a surge in the number of patients requiring ECMO support, we need consented guidance to optimize treatment in this specific situation.
Expanded circulating follicular dendritic cells facilitate immune responses in chronic HBV infection
Authors: Li Xiaoyi , Zhang Qifan , Zhang Wanyue , Ye Guofu , Ma Yanchen , Wen Chunhua , Gu Shuqin , Tang Libo , Li Yongyin
Published: September 2020

Background: The restoration of host hepatitis B virus (HBV)-specific antiviral immunity is an effective strategy for hepatitis B recovery. Follicular dendritic cells (FDCs) play a crucial role in immune regulation. The goal of the present study was to investigate the characteristics and functions of FDCs in chronic HBV infection. Methods: The frequencies of FDCs in peripheral blood, liver, and spleen were measured in patients with chronic HBV infection. Isolated FDCs from splenic tissues of HBV-related liver cirrhosis-induced hypersplenism patients were cultured with autologous intrasplenic CD4+ T cells and CD19+ B cells. Results: We observed that patients with chronic HBV infection had a significantly increased frequency of circulating FDCs compared to that of healthy controls. Additionally, the frequency of circulating FDCs was positively correlated with that of intrahepatic and intrasplenic counterparts. Moreover, positive correlations were observed between the frequencies of circulating FDCs and plasmablast and memory B cells, as well as C-X-C motif chemokine receptor type 5 (CXCR5)+CD4+ T cells and CXCR5+CD8+ T cells. Notably, in vitro experimental results demonstrated that FDCs derived from splenic tissues of chronic HBV patients facilitated interferon-γ and interleukin-21 production from autologous intrasplenic CD4+ T cells and promoted the proliferation of autologous intrasplenic CD19+ B cells.Conclusions: Expanded FDCs in patients with chronic HBV infection may favor host immune responses against HBV. The identification of this unique population of cell may contribute to a better understanding of the immune regulatory mechanisms associated with chronic HBV infection and provide a potential immunotherapeutic target for this disease.
Early postpartum dyslipidemia and its potential predictors during pregnancy in women with a history of gestational diabetes mellitus
Authors: Pei Ling , Xiao Huangmeng , Lai Fenghua , Li Zeting , Li Zhuyu , Yue Shufan , Chen Haitian , Li Yanbin , Cao Xiaopei
Published: September 2020

Background: This study aimed to analyze the incidence of early postpartum dyslipidemia and its potential predictors in women with a history of gestational diabetes mellitus (GDM).Methods: This was a retrospective study. 589 women diagnosed with GDM were enrolled and followed up at 6–12 weeks after delivery. A 75g oral glucose tolerance test (OGTT) and lipid levels were performed during mid-trimester and the early postpartum period. Participants were divided into the normal lipid group and dyslipidemia group according to postpartum lipid levels. Demographic and metabolic parameters were analyzed. Multiple logistic regression was performed to analyze the potential predictors for early postpartum dyslipidemia. A receiver operating characteristic curve (ROC) was calculated to determine the cut-off values.Results: A total of 38.5% of the 589 women developed dyslipidemia in early postpartum and 60% of them had normal glucose metabolism. Delivery age, systolic blood pressure (SBP), glycated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C) were independent predictors of early postpartum dyslipidemia in women with a history of GDM. The cut-offs of maternal age, SBP, HbA1c values, and LDL-C levels were 35 years, 123mmHg, 5.1%, and 3.56 mmol/L, respectively. LDL-C achieved a balanced mix of high sensitivity (63.9%) and specificity (69.2%), with the highest area under the receiver operating characteristic curve (AUC) (0.696). When LDL-C was combined with age, SBP, and HbA1c, the AUC reached to 0.733.Conclusions: A lipid metabolism evaluation should be recommended in women with a history of GDM after delivery, particularly those with a maternal age > 35 years, SBP > 123 mmHg before labor, HbA1c value > 5.1%, or LDL-C levels > 3.56 mmol/L in the second trimester of pregnancy.
Can Pre-Trained Convolutional Neural Networks be used as Feature Extractors for Video-based Neonatal Sleep and Wake Classification?
Authors: Awais Muhammad , Long Xi , Yin Bin , chen Chen , Akbarzadeh Saeed , Abbasi Saadullah Farooq , Irfan Muhammad , Lu Chunmei , Wang Xinhua , Wang Laishuan , Chen Wei
Published: September 2020

Objective: In this paper, we propose to evaluate the use of a pre-trained convolutional neural networks (CNNs) as a features extractor followed by the Principal Component Analysis (PCA) to find the best discriminant features to perform classification using support vector machine (SVM) algorithm for neonatal sleep and wake states using Fluke® facial video frames. Using pre-trained CNNs as feature extractor would hugely reduce the effort of collecting new neonatal data for training a neural network which could be computationally very expensive. The features are extracted after fully connected layers (FCL’s), where we compare several pre-trained CNNs, e.g., VGG16, VGG19, InceptionV3, GoogLeNet, ResNet, and AlexNet.Results: From around 2-h Fluke® video recording of seven neonate, we achieved a modest classification performance with an accuracy, sensitivity, and specificity of 65.3%, 69.8%, 61.0%, respectively with AlexNet using Fluke® (RGB) video frames. This indicates that using a pre-trained model as a feature extractor could not fully suffice for highly reliable sleep and wake classification in neonates. Therefore, in future a dedicated neural network trained on neonatal data or a transfer learning approach is required.
Elevated Eosinophil Count Is Related With Lower Anti-Factor Xa Activity In COVID-19 Patients
Authors: Ari Selma , Can Veysi , Demir Ömer Furkan , Ari Hasan , Ağca Fahriye Vatansever , Melek Mehmet , Çamcı Sencer , Dikiş Özlem Şengören , Huysal Kağan , Türk Tamer
Published: September 2020

Introduction: Despite prophylactic anticoagulant treatments, thrombotic complications may develop in patients with Coronavirus disease 2019 (COVID-19). This study aimed to evaluate the factors influencing anti-Factor Xa activity in COVID-19 patients receiving low molecular weight heparin (LMWH). Materials and methods: We prospectively evaluated 80 COVID-19 patients, diagnosed using polymerase-chain-reaction test, who were admitted to our clinic and administered LMWH; LMWH (enoxaparin) was applied according to the weight, D-dimer levels, and clinical condition of patients. Anti-Factor Xa activity in blood, drawn 4h after the 3rd dose of LMWH, were measured and a activity of <0.2 IU/ml was considered subprophylactic. Patients were followed up clinically and anti-Factor Xa activity were re-examined before discharge. Results:Groups 1 and 2 included 13 and 67 patients with subprophylactic (mean±SD: 0.18±0.06) and prophylactic (mean±SD: 0.43±0.23) anti-Factor Xa activity, respectively. The proportion of eosinophils in patients was significantly higher in group 1 than in group 2 (mean±SD; 2.96±2.55 vs 0.90±1.28; p=0.001). At the time of discharge the eosinophilic proportion of patients was significantly higher (eosinophil %, mean±SD; 3.06±1.49 vs 2.07±1.92; p=0.001) but the activated partial thromboplastin time was significantly lower (22.34±1.38 vs 24.38±3.58; p=0.01) in group 1 than in group 2. Of 14 patients with eosinophil content >4%, 6 were in group 1 ((6/13) 46.2%) while 8 were in group 2 ((8/63) 11.9%); (p=0.009), and all had a D-dimer level <1µg/mL (p=0.03). ROC analysis for the presence of anticoagulation at subprophylactic level revealed an area under curve of 0.79 (95% CI:0.64-0.93); p=0.001).Conclusions: Elevated eosinophil count is related to lower anti-factor Xa activity in patients with COVID-19 receiving LMWH. (NCT04507282)