bluuebunny/crossref_metadata_2025 huggingface dataset:
Longitudinal bidirectional relationships between maternal depressive/anxious symptoms and children’s tics
Authors: Yagi Tomoko , Ando Shuntaro , Usami Satoshi , Yamasaki Syudo , Morita Masaya , Kiyono Tomoki , Hayashi Noriyuki , Endo Kaori , Iijima Yudai , Morimoto Yuko , Kanata Sho , Fujikawa Shinya , Koike Shinsuke , Kano Yukiko , Hiraiwa-Hasegawa Mariko , Nishida Atsushi , Kasai Kiyoto
Published: January 2021

Background: Previous studies have revealed an association between maternal depressive/anxious symptoms and children’s tics. However, the longitudinal relationships between these symptoms remain unclear. We examined the longitudinal relationships between maternal depressive/anxious symptoms and children’s tics across early adolescence in a population-based sample.Methods: The participants consisted of 3,171 children and their mothers from the Tokyo Teen Cohort (TTC) study, a population-representative longitudinal study that was launched in Tokyo in 2012. Maternal depressive/anxious symptoms and children’s tics were examined using self-report questionnaires at the ages of 10 (time 1, T1) and 12 (time 2, T2). A cross-lagged model was used to explore the relationships between maternal depressive/anxious symptoms and children’s tics.Results: Higher levels of maternal depressive/anxious symptoms at T1 were related to an increased likelihood of children’s tics at T2 (β = .06, p = .001). Furthermore, the presence of children’s tics at T1 was positively related to maternal depressive/anxious symptoms at T2 (β = .06, p = .001).Conclusions: These findings suggest a longitudinal bidirectional relationship between maternal depressive/anxious symptoms and children’s tics during early adolescence that may exacerbate each other over time and possibly create a vicious cycle. When an early adolescent has tics, it might be important to identify and treat related maternal depressive/anxious symptoms.
Self-adaptive control system for additive manufacturing using double electrode micro plasma arc welding
Authors: Li Nan , Fan Ding , Huang Jiankang , Yu Shurong , Yuan Wen , Han Miaomiao
Published: January 2021

Wire arc additive manufacturing (WAAM) has been investigated to deposit large-scale metal parts due to its high deposition efficiency and low material cost. However, in the process of automatically manufacturing the high-quality metal parts by WAAM, several problems about the heat build-up, the deposit-path optimization, and the stability of the process parameters need to be well addressed. To overcome these issues, a new WAAM method based on the double electrode micro plasma arc welding (DE-MPAW) was designed. The circuit principles of different metal-transfer models in the DE-MPAW deposition process were analyzed theoretically. The effects between the parameters, wire feed rate and torch stand-off distance, in the process of WAAM were investigated experimentally. In addition, a real-time DE-MPAW control system was developed to optimize and stabilize the deposition process by self-adaptively changing the wire feed rate and torch stand-off distance. Finally, a series of tests were performed to evaluate the control system’s performance. The results show that the capability against interferences in the process of WAAM has been enhanced by this self-adaptive adjustment system. Further, the deposition paths about the metal part’s layer heights in WAAM are simplified. Finally, the appearance of the WAAM-deposited metal layers is also improved with the use of the control system.
Release of pseudosyndactyly in recessive dystrophic epidermolysis bullosa using a dermal regeneration template glove – the Foggia experience.
Authors: Lembo Fedele , Parisi Domenico , Cecchinov Liberato Roberto , Ciancio Francesco , Innocenti Alessandro , Portincasa Aurelio
Published: January 2021

BACKGROUNDː Epidermolysis Bullosa (EB) comprises a heterogeneous group of rare genetic diseases associated with skin blistering caused by minimal trauma. A major and common EB subtype, recessive dystrophic EB (RDEB), is characterized by altered wound healing, inflammatory dysbalance and fibrotic changes associated with reduced to absent collagen VII. Because of its exposed position and its continued use in daily activities, the hand is constantly at risk of microtrauma and is therefore one of the organs most affected by the disease with highly disabling deformities that represent a challenging field in hand surgery practice. METHODSː The Authors present their experience in the microsurgical treatment of pseudosyndactylies comparing the classic dressing with vaseline gauze with an innovative “glove protocol” using Integra® dermal regeneration template. The endpoints analyzed were: healing times, hospital stay time, discomfort for the patient, free-recurrence interval, follow-up range and major complications. RESULTSː A total of 34 procedures were performed on 24 RDEB patients with hand deformities. Compared with the dressing with vaseline gauze, microsurgery followed by application of dermal regeneration template gloves allowed a significant reduction of hospital stay, healing time, and dressing pain as well as an increased recurrence-free interval. CONCLUSIONSː The microsurgical approach followed by our new protocol described in the study has been beneficial in providing consistent and successful long-term results for these patients. Key words : Epidermolysis Bullosa, Pseudosyndactyly, Hand, Dermal regeneration template.
Nutritional perspectives on sickle cell disease in Africa: A systematic review
Authors: Nartey Eunice Berko , Spector Jonathan , Adu-Afarwuah Seth , Jones Catherine L. , Jackson Alan A. , Ohemeng Agartha , Shah Rajiv , Koryo-Dabrah Alice , Kuma Amma Benneh-Akwasi , Hyacinth Hyacinth I. , Steiner-Asiedu Matilda
Published: January 2021

Background: Sickle cell disease (SCD), an inherited blood disorder, predominantly affects individuals in sub-Saharan Africa. Research linking its pathophysiology and nutritional status in African patients has not been previously described. This systematic review aimed to assess the landscape of studies in sub-Saharan Africa focused on nutritional aspects of SCD and highlight gaps in knowledge that could inform priority-setting for future research.Methods: The study was conducted using the Preferred Reporting items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. All original studies involving individuals with any phenotypic variant of SCD and at least one nutritional status outcome; and were conducted between January 1995 and November 2020 in Africa were included. ‘Nutritional status’ was defined by studies on dietary intake, measurements of growth/anthropometry, or nutritional biomarkers. Studies were included if they involved Databases used were Ovid Embase, Medline, Biosis and Web of Science. Results: The search returned 526 articles with 76 studies included in the final analyses. Most investigations (67%) were conducted in Nigeria. Studies were categorized into one of three main categories: descriptive studies of anthropometric characteristics (49%), descriptive studies of macro- or micronutrient intakes (41%), and interventional studies (11%). Findings consistently found growth impairment, especially among children and adolescents from sub-Saharan Africa. Studies assessing macro- and micronutrients generally had small sample sizes and were exploratory in nature. Only four randomized trials were identified, which measured the impact of lime juice, long-chain fatty acids supplementation, ready-to-use supplementary food, and oral arginine on health outcomes. Conclusions: The findings reveal a moderate number of descriptive studies, most with small sample sizes, that focused on various aspects of nutrition and SCD in African patients. There was a stark lack of interventional studies that could be used to inform evidence-based changes in clinical practice. Findings of investigations were generally consistent with data from other regional settings, describing a significant risk of growth faltering and malnutrition among individuals with SCD. There is an unmet need for clinical research to better understand the potential benefits of nutritional-related interventions for patients with SCD in sub-Saharan Africa in order to promote optimal growth and improve health outcomes.
Safety and feasibility of apheresis to harvest and concentrate parasites from subjects with induced blood stage Plasmodium vivax infection
Authors: ODEDRA Anand , Mudie Kari , Kennedy Glen , Watts Rebecca , Rossignol Emilie , Mitchell Hayley , Gower Jeremy , Rebelo Maria , Pava Zuleima , Pawliw Rebecca , Woolley Stephen , Lalloo David , Robinson Greg , Lynch Sean , Collins Katharine , Amante Fiona , McCarthy James
Published: January 2021

Background In the absence of a method to culture Plasmodium vivax, the only way to source parasites is ex vivo. This hampers many aspects of P. vivax research. This study aimed to assess the safety of apheresis, a method for selective removal of specific components of blood as a means of extracting and concentrating P. vivax parasites. MethodsAn iterative approach was employed across four non-immune healthy human subjects in single subject cohorts. All four subjects were inoculated with ~564 blood stage P. vivax (HMP013-Pv) and subjected to apheresis 10 to 11 days later. Blood samples collected during apheresis (haematocrit layers 0.5% to 11%) were tested for the presence and concentration of P. vivax by microscopy, flow cytometry, 18S rDNA qPCR for total parasites, and pvs25 qRT-PCR for female gametocyte transcripts. Safety was determined by monitoring adverse events. Malaria transmission to mosquitoes was assessed by membrane feeding assays. ResultsThere were no serious adverse events and no significant safety concerns. Apheresis concentrated asexual parasites by up to 4.9-fold (range: 0.9 - 4.9-fold) and gametocytes by up to 1.45-fold (range: 0.38 - 1.45-fold) compared to pre-apheresis densities. No single haematocrit layer contained >40% of all the recovered P. vivax asexual parasites. Ex vivo concentration of parasites by Percoll gradient centrifugation of whole blood achieved greater concentration of gametocytes than apheresis. Mosquito transmission was enhanced by up to 5-fold in a single apheresis sample compared to pre-apheresis. ConclusionThe modest level of parasite concentration suggests that the use of apheresis may not be an ideal method for harvesting P. vivax.
Partner’s emotional reaction to pregnancy mediates the relationship between pregnancy planning and prenatal mental health
Authors: Kazemi Ashraf , Ghaedrahmati Maryam , Kheirabadi Gholamreza
Published: January 2021

Background: An unplanned pregnancy may be followed by increased depression and anxiety. The aim of the present study was to evaluate the mediating role of partner’s emotional reaction to pregnancy (PERP) on the relationship between pregnancy planning and prenatal mental health.
Methods: This cross-sectional study was conducted on 303 healthy Iranian pregnant women during their third trimester. The levels of depression and anxiety were measured using the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory. The PERP score was also measured using a researcher-made questionnaire. The data were analyzed using the plug-in application PROCESS macro.
Results: The results showed that PERP score was reversely related to pregnancy planning and prenatal depression and anxiety. The direct effect of the pregnancy planning on depression (c=-.05) and anxiety levels (c= -.02) were not significant; but the indirect effect of pregnancy planning on depression (Point Estimate= -.379, CI: -.523 to -.250) and anxiety levels (Point Estimate=-.560, CI: -.741 to -.385) with the mediating role of PERP were significant.
Conclusions: The results indicated that the effect of pregnancy planning on prenatal mental health is mediated by PERP, and in unplanned pregnancy women need to receive positive reaction of their partners toward pregnancy so that they can preserve their mental health.
Rosaceae, Brassicaceae and Pollen Beetles: exploring relationships and evolution in an anthophilous beetle lineage (Nitidulidae, Meligethes-complex of genera) using an integrative approach
Authors: LIU MEIKE , HUANG MIN , CLINE ANDREW RICHARD , MANCINI EMILIANO , SCARAMUZZI ANDREA , PARADISI SIMONE , AUDISIO PAOLO , BADANO DAVIDE , Sabatelli Simone
Published: January 2021

Background: Meligethes are pollen-beetles associated with flowers of Rosaceae as larvae. This genus currently consists of 63 known species in two subgenera, Meligethes and Odonthogethes, predominantly occurring in the eastern Palaearctic. We analyzed 74 morphological and ecological characters (169 states) of all species, as well as of 11 outgroup species from 7 Meligethinae genera (including Brassicogethes), to investigate their phylogeny. We also conducted a parallel molecular analysis on 9 Meligethes, 9 Odonthogethes, 3 Brassicogethes and 2 Meligethinus species based on DNA sequence data from mitochondrial (COI, 16S) and nuclear (CAD) genes.Results: Morphological phylogenetic reconstructions supported the monophyly of the whole genus and clades corresponding to purported subgenera Meligethes s.str. and Odonthogethes. Main species-groups were mostly confirmed, however some unresolved polytomies remained. Molecular data placed members of Brassicogethes (including 42 mostly W Palearctic species associated with Brassicaceae) as sister to Odonthogethes, with this clade being sister to Meligethes s.str. This phylogenetic scenario suggests that monophyletic Meligethes s.str., Odonthogethes and Brassicogethes should be regarded alternatively as three subgenera of a monophyletic Meligethes, or three genera in a monophyletic genus-complex, with mutually monophyletic Brassicogethes and Odonthogethes. Molecular analyses estimated the origin of this lineage at ca. 14-15 Mya from a common stem including Meligethinus. Conclusions: We hypothesize that the ancestor of Meligethes specialized on Rosaceae in the Middle Miocene (likely in Langhian Age) and subsequently radiated during Late Miocene and Plio-Pleistocene maintaining a trophic niche on this plant family. This radiation was primarily due to geographic isolation in E Asiatic mountain systems. Combined evidence from morphology, ancestral state parsimony reconstruction of host-plant associations and molecular evidence suggested that Rosoideae (Rosa spp.) represented the ancestral hosts of Meligethes s.str., followed by an independent shift of ancestral Odonthogethes (ca. 9-15 Mya) on Rubus (Rosoideae) and members of Rosaceae Spiraeoideae. Other ancestral Odonthogethes probably shifted again on the unrelated plant family Brassicaceae (maybe 8-14 Mya in S China), allowing a rapid westward radiation of the Brassicogethes clade.
Temperament and character of patients with alcohol toxicity during COVID -19 pandemic
Authors: Estedlal AliReza , Mani Arash , Vardanjani Hossein Molavi , Kamali Mahsa , Zarei Leila , Heydari Seyed Taghi , Lankarani Kamran B
Published: January 2021

Background: Corona virus epidemic may be acts as a stressor or trauma that affects both physical health and mental health. People exhibited various reactive behaviors to confront with this stressful situation. In Iran, one of the common motives for alcohol consumption is to scape problems and cope with stresses. It has been shown that personality factors influence alcohol consumption, since they are associated with drinking motives. The main purpose of this study was to investigate the correlation between temperament and character and alcohol abuse. Methods: This cross-section study was conducted on 135 alcohol intoxicated patients admitted to emergency room in March 2020 and 255 participants who were randomly selected from public in Shiraz. A questionnaire consisted of TCI (Temperament and character inventory) and several questions about COVID-19 pandemic. It was completed by a trained interviewer using the matched answer technique. Demographic factors were self-reported. Results: Among the alcohol intoxicated group, 117 (86.7%) were males and 18(13.3%) were females. The mean age of the participants was 32.43±10.81 years. Among control group, 99 (38.8%) were males and 156 (61.2%) were females. The mean age of control group was 33.12±14.77 years. Alcohol toxicity was mostly observed among the young males (male/female ratio was 6.45). According to temperament and character index, mean scores of novelty seeking, harm avoidant, and self-transcendence were higher in the alcohol toxicity group than normal population (P<0.01). Mean scores of reward dependent, cooperativeness, and self-directedness were higher in normal population than the alcohol toxicity group (P<0.001). The mean score of persistence was not significantly different between methanol intoxicated and normal population groups (P=0.718). Conclusion: Alcohol intoxicated patients had higher scores of novelty-seeking and self-transcendence and lower scores of reward-dependency scores, cooperativeness and self-directedness. These scores are associated with higher likelihood of personality disorders.
Financial burden impact quality of life among Lymphatic Filariasis Patients
Authors: Asiedu Samuel Opoku , Kwarteng Alexander , Amewu Emmanuel Kobla Atsu , Kini Priscilla , Aglomasa Bill Clinton , Forkuor John Boulard
Published: January 2021

BackgroundHuman lymphatic filarial pathology is the leading cause of disability and poverty among people living with the infection. The second goal of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) is to manage the disease's morbidity to improve patients' quality of life. Consequently, the current study assessed the overall quality of life of lymphatic filariasis (LF) pathology patients in some selected endemic communities in rural Ghana. MethodIn the present study, the Lymphatic Filariasis Quality of Life Questionnaire (LFSQQ) was used to evaluate the effect of lymphatic filariasis on the quality of life of people, with the disease in nine (9) communities in the Ahanta West District of the Western Region of Ghana where mass drug administration is being implemented for the past twenty years. Pearson’s correlation, linear regression, and one-way analysis of variance (ANOVA) analyses were used to assess the associations between the LFSQQ instrument domains.ResultsOf the 155 study participants recruited, 115 (74.19%) were females, and 40 (25.81%) males. A greater proportion of the study participants (40, 25.8%) were presented with stage two (2) lymphoedema, while only two patients had stage seven (7) lymphoedema. The average of the overall quality of life scores of study participants was 68.24. There was a negative Pearson correlation (r = -0.504, p-value < 0.001) between the stage of lymphoedema (severity of the disease) and the quality of life of the LF patients. In addition, a clear pattern of positive correlation (r = 0.71, p-value < 0.001) was observed between the disease burden and pain/discomfort domains of the study participants. Whereas the highest domain-specific score (85.03) was observed in the domain of self-care, we noted that the environmental domain, which consists of the financial status, was the lowest (45.94) among the study participants. ConclusionOur findings support previous works on the reduced quality of life among lymphatic filariasis patients with pathology. In this study, our results reveal a depressing financial condition among people presenting with late stages of LF pathologies, which eventually reduces their well-being.
Comparison of the predictive value of progesterone-related indicators for pregnancy outcomes of women undergoing the short-acting GnRH agonist long protocol: a retrospective study
Authors: Zhang Yangyang , Xu Yang , Wang Yuqiong , Xue Qing , Shang Jing , Yang Xiuli , Shan Xuemin
Published: January 2021

Background: There are many progesterone (P) elevation-related indicators for predicting pregnancy outcomes, including the serum P, P-to-oestradiol ratio (P/E2), P-to-follicle index (PFI), and P-to-mature oocyte index (PMOI); however, due to inconsistencies in study populations and controlled ovarian hyperstimulation (COH) protocols among studies, these indicators are controversial. Moreover, no researchers have included these four commonly used indicators in one study to compare their predictive efficacies. The objective of this study was to compare the predictive value of P-related indicators for pregnancy outcomes of women undergoing the short-acting GnRH agonist long protocol. Methods: A total of 612 infertile women undergoing IVF/ICSI were recruited for this study. Serum samples were obtained on the morning of HCG injection for serum P and E2 measurements. Transvaginal ultrasound was performed to determine the follicle count (≥ 14 mm in diameter). The number of mature oocytes was observed in the embryo laboratory after oocyte retrieval.Results: In cases of P<2.5 ng/ml, there was no significant difference in the serum P level or P/E2 between the pregnant group and the non-pregnant group. The PFI and PMOI of the pregnant group were significantly lower than those of the non-pregnant group. According to the stratified analysis of the ovarian response, only the PMI and PMOI of the pregnant women in the normal ovarian response group were lower than those of the non-pregnant women. To compare the predictive value of the PFI and PMOI in IVF/ICSI outcomes, the patients were divided into four groups. The good-quality embryo rate and clinical pregnancy rate were highest in Group A (low PFI and low PMOI) and lowest in Group D (high PFI and high PMOI). In the two groups with discordant PFI and PMOI, namely Group B (low PFI and high PMOI) and Group C (high PFI and low PMOI), the good-quality embryo rate and clinical pregnancy rate were not significantly different.Conclusions: The PFI and PMOI had equal value in predicting clinical pregnancy outcomes in the normal ovarian response group undergoing the short-acting GnRH agonist long protocol. Each clinical centre can choose one of the indicators according to their actual situation in clinical practice and establish individual cut-off values for PFI and PMOI based on their own hormonal measurements.
Partnership Among Hospitals To Reduce Healthcare Associated Infections: A Quasi-Experimental Study In Brazilian ICUs
Authors: de Melo Ladjane Santos Wolmer , de Abreu Maria Verônica Monteiro , Santos Bernuarda Roberta de Oliveira , Carreteiro Maria das Graças Washington Casimiro , de Albuquerque Maria Carolina Andrade Lins , de Souza Maria Fernanda Aparecida Moura , Vidal Claudia Fernanda de Lacerda , Lacerda Heloisa Ramos
Published: January 2021

Background: Healthcare-associated infections (HAIs) are relevant in developing countries where frequencies can be at least 3 times higher than in developed countries. The purpose of this research was to describe the intervention implemented in intensive care units (ICUs) to reduce HAIs through collaborative project and analyze the variation over 18 months in the incidence density (ID) of the three main HAIs: ventilator associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs) and catheter-related urinary tract infections (CAUTIs) and also the length of stay and mortality in these ICUs. Methods: A quasi-experimental study in 5 public adult clinical-surgical ICUs, to reduce HAIs, through interventions using the BTS-IHI “Improvement Model”, during 18 months. In the project, promoted by the Ministry of Health, Brazilian philanthropic hospitals of excellence (HE), those mostly private, certified as excellence and exempt from security contributions, regularly trained and monitored public hospitals in diagnostics, data collection and in developing cycles to improve quality and to prevent HAIs (bundles). In the analysis regarding the length of stay, mortality, the IDs of VAP, CLABSIs and CAUTIs over time, a Generalized Estimating Equation (GEE) model was applied for continuous variables, using the constant correlation (exchangeable) between assessments over time. The model estimated the average difference (β coefficient of the model) of the measures analyzed during two periods: a period in the year 2017 (prior to implementing the project) and in the years 2018 and 2019 (during the project).Result: A mean monthly reduction of 0.427 in VAP ID (p = 0.002) with 33.8% decrease at the end of the period and 0.351 in CAUTI ID (p = 0.009) with 45% final decrease. The mean monthly reduction of 0.252 for CLABSIs was not significant (p = 0.068). Length of stay and mortality rates had no significant variation. Conclusions: Given the success in reducing VAP and CAUTIs in a few months of interventions, the achievement of the collaborative project is evident. This partnership among public hospitals/HE may be applied to other ICUs including countries with fewer resources.Trial registration: Promoted by Brazilian Ministry of Health. Approved by the Hospital das Clínicas – UFPE Ethics Committee (No. 3,307,293).
Predictors associated with neurological recovery after anterior decompression with fusion for degenerative cervical myelopathy
Authors: Inose Hiroyuki , Hirai Takashi , Yoshii Toshitaka , Kimura Atsushi , Takeshita Katsushi , Inoue Hirokazu , Maekawa Asato , Endo Kenji , Furuya Takeo , Nakamura Akira , Mori Kanji , Kanbara Shunsuke , Imagama Shiro , Seki Shoji , Takahashi Kunihiko , Matsunaga Shunji , Okawa Atsushi
Published: January 2021

Background: Anterior decompression with fusion (ADF) has often been performed for degenerative cervical myelopathy (DCM) in patients with poor cervical spine alignment and/or anterior cord compression. We aimed to identify clinical and radiological predictors associated with neurological recovery after ADF.Methods: This post-hoc analysis from a prospective multicenter study included patients who were scheduled for ADF for DCM. The patients who received other surgeries (laminoplasty, posterior decompression and fusion) were excluded. The associations between baseline clinical and radiographic variables (age, sex, body mass index, etiology, cervical lordosis, range of motion, C7 slope, C2-7 sagittal vertical axis [SVA], thoracic kyphosis [TK], lumbar lordosis, sacral slope, SVA, pelvic tilt, T1 pelvic angle [TPA], the Japanese Orthopedic Association score for the assessment of cervical myelopathy [C-JOA], European Quality of Life Five Dimensions Scale [EQ-5D], Neck Disability Index [NDI], Physical Component Summary of the SF-36 [PCS], and Mental Component Summary of the SF-36) and the recovery rates as the outcome variables were investigated in the univariate regression analysis. Then, the independent predictors for increased recovery rates were evaluated using a stepwise multiple regression analysis.Results: In total, 37 patients completed the 1-year follow-up. The recovery rate was significantly correlated with SVA (p = 0.001) and TPA (p = 0.03). Univariate regression analyses showed that age (r = -0.92, p = 0.049), SVA (r = -0.57, p = 0.004) and PCS (r = -0.80, p = 0.03) score were significantly associated with recovery rate. Then, a stepwise multiple regression analysis identified the independent predictors of recovery rate after ADF as TK (p = 0.01), PCS (p = 0.03), and SVA (p = 0.03). According to this prediction model, the following equation was obtained: recovery rate = –8.26 + 1.17 × (TK) – 0.45 × (SVA) + 0.85 × (PCS) (p = 0.002, R2 = 0.44).Conclusion: Patients with lower TK, lower PCS score, and higher SVA were more likely to have poor neurological recovery after ADF. Therefore, patients with DCM and these predictors who undergo ADF should be warned about poor recovery and be required to provide adequate informed consent.
Age is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes. 
Authors: D'Ascanio Michela , Innammorato Marta , Pasquariello Lara , Pizzirusso Dario , Guerrieri Giulio , Castelli Silvia , Pezzuto Aldo , De Vitis Claudia , Anibaldi Paolo , Marcolongo Adriano , Mancini Rita , Ricci Alberto , Sciacchitano Salvatore
Published: January 2021

Background: The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the outcome of the disease in this group of patients, admitted to our Hospital in RomeMethods: This is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to May 2020, divided in two groups according to their age (Elderly: 65-80 years old; Very Elderly >80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding. The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. To assess significance among multiple groups of factors, we used the Bonferroni correction. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariate and Multivariate logistic regression were performed to estimate associations between age, comorbidities, provenance from long-stay residential care homes (LSRCH)s and clinical outcomes. Results: We found that Very Elderly patients had an increased mortality rate, also due to the frequent occurrence of multiple comorbidities. Moreover, we found that patients coming from LSRCHs appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease. Conclusion: We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes. To establish a correct risk stratification, comorbidities and information about provenience from LSRCHs should be considered.
Polytobacco Use Among a Nationally-Representative Sample of Black Adolescents 
Authors: Gilreath Tamika D. , Dangerfield Derek T. , Ishino Francisco A. Montiel , Hill Ashley V. , Johnson Renee M.
Published: January 2021

Introduction. Studies of the patterns of polytobacco use have increased. However, understanding the patterns of using multiple tobacco products among Black adolescents is minimal. This study identified the patterns of polytobacco use among U.S. Black adolescents. Methods. Latent class analysis (LCA) was used to identify patterns of adolescent polytobacco use among a representative sample of Black youth from the 2017 Youth Risk Behavior Survey (n=2,782). Ever and recent (past 30 day) use of cigarettes, electronic cigarettes, cigars, and dip or chewing tobacco were used as latent class indicators. Multinomial regression was conducted to identify the association if smoking adjusting for sex, age, grade, and marijuana use.Results. Most students were in the 9th grade (29%), e-cigarette users (21%) and were current marijuana users (25%). Three profiles of tobacco use were identified: Class 1: Non-smokers (81%), Class 2: E-cigarette Users (14%), and Class 3: Polytobacco Users (5%). Black adolescent Polytobacco users were the smallest class, but had the highest conditional probabilities of recent cigarette use, e-cigarette use, ever smoking cigars or chewing tobacco. Ever and current use of marijuana were associated with increased odds of being in the e-cigarette user versus non-smoker group, and current marijuana use was associated with increased odds of polytobacco use (aOR=24.61, CI=6.95-87.11). Conclusions. Findings suggests the need for targeted interventions for reducing tobacco use and examining the unique effects of polytobacco use on Black adolescents. Findings confirm a significant association of marijuana use with tobacco use.
A Survey on Generative Adversarial Networks for imbalance problems in computer vision tasks
Authors: Sampath Vignesh , Maurtua Iñaki , Martín Juan José Aguilar , Gutierrez Aitor
Published: January 2021

Any computer vision application development starts off by acquiring images and data, then preprocessing and pattern recognition steps to perform a task. When the acquired images are highly imbalanced and not adequate, the desired task may not be achievable. Unfortunately, the occurrence of imbalance problems in acquired image datasets in certain complex real-world problems such as anomaly detection, emotion recognition, medical image analysis, fraud detection, metallic surface defect detection, disaster prediction, etc., are inevitable. The performance of computer vision algorithms can significantly deteriorate when the training dataset is imbalanced. In recent years, Generative Adversarial Neural Networks (GANs) have gained immense attention by researchers across a variety of application domains due to their capability to model complex real-world image data. It is particularly important that GANs can not only be used to generate synthetic images, but also its fascinating adversarial learning idea showed good potential in restoring balance in imbalanced datasets.In this paper, we examine the most recent developments of GANs based techniques for addressing imbalance problems in image data. The real-world challenges and implementations of synthetic image generation based on GANs are extensively covered in this survey. Our survey first introduces various imbalance problems in computer vision tasks and its existing solutions, and then examines key concepts such as deep generative image models and GANs. After that, we propose a taxonomy to summarize GANs based techniques for addressing imbalance problems in computer vision tasks into three major categories: 1. Image level imbalances in classification, 2. object level imbalances in object detection and 3. pixel level imbalances in segmentation tasks. We elaborate the imbalance problems of each group, and provide GANs based solutions in each group. Readers will understand how GANs based techniques can handle the problem of imbalances and boost performance of the computer vision algorithms.
Protein Liposomes-Mediated Targeted Acetylcholinesterase Gene Delivery for Effective Liver Cancer Therapy
Authors: Wang Kai , Shang Fusheng , Chen Dagui , Cao Tieliu , Wang Xiaowei , Jiao Jianpeng , He Shengli , Liang Xiaofei
Published: January 2021

Effective methods to deliver therapeutic genes to solid tumors and improve their bioavailability are the main challenges of current medical research on gene therapy. The development of efficient non-viral gene vector with tumor-targeting has very important application value in the field of cancer therapy. Proteolipid integrated with tumor-targeting potential of functional protein and excellent gene delivery performance has shown potential for targeted gene therapy.Results: Herein, we prepared transferrin-modified liposomes (Tf-PL) for the targeted delivery of acetylcholinesterase (AChE) therapeutic gene to liver cancer. We found that the derived Tf-PL/AChE liposomes exhibited much higher transfection efficiency than the commercial product Lipo 2000 and shown premium targeting efficacy to liver cancer SMMC-7721 cells in vitro. In vivo, the Tf-PL/AChE could effectively target liver cancer, and significantly inhibit the growth of liver cancer xenografts grafted in nude mice by subcutaneous administration. Conclusion: This study proposed a transferrin-modified proteolipid-mediated gene delivery strategy for targeted liver cancer treatment, which has a promising potential for precise personalized cancer therapy.
Vagus nerve stimulation ameliorates L-NAME-induced preeclampsia-like symptoms in rats through inhibition of the inflammatory response
Authors: Zheng linmei , Tang Rong , Shi Lei , Zhong Mei , Zhou Zhongyi
Published: January 2021

Background Preeclampsia is characterized by an excessive inflammatory response. Recent studies have shown that vagus nerve stimulation (VNS) has anti-inflammatory properties in vivo. This study aims to investigate whether VNS is safe for use during pregnancy and to explore the therapeutic potential and underlying mechanisms of VNS in PE. Methods Pregnant Sprague-Dawley rats were randomly chosen to receive N-nitro-L-arginine methyl ester (L-NAME)-containing water (preeclampsia-like mouse model) or saline (normal pregnancy control) daily at gestational days 14.5-20.5. VNS and the α7nAChR antagonist methyllycaconitine citrate (MLA, 1 mg/kg/d) were given daily at the same time. Results VNS decreased the high systolic blood pressure and urinary protein observed in the PE rats. In addition, VNS mitigated abnormal pregnancy outcomes. Moreover, VNS alleviated the inflammatory response by decreasing the levels of inflammatory cytokines. VNS significantly increased the expression of α7nAChR and attenuated the activation of NF-κB p65 in the placenta. Discussion Our findings indicate that maternal VNS treatment is safe during pregnancy and has a protective effect in a pregnant rat model of preeclampsia induced by L-NAME.
Muscles adaptation to aging and training: Architectural changes - A randomised trial
Authors: LÉTOCART Adrien J. , Mabesoone Franck , Charleux Fabrice , Couppé Christian , Svensson Rene B. , Marin Frédéric , Magnusson S. Peter , Grosset Jean-François
Published: January 2021

Background: To investigate how anatomical cross-sectional area and volume of quadriceps and triceps surae muscles were affected by ageing, and by resistance training in older and younger men, in vivo. Methods: The old participants were randomly assigned to moderate (O55, n=13) or high-load (O80, n=14) resistance training intervention (12 weeks; 3 times/week) corresponding to 55% or 80% of one repetition maximum, respectively. Young men (Y55, n=11) were assigned to the moderate-intensity strengthening exercise program. Each group received the exact same training volume on triceps surae and quadriceps group (Reps x Sets x Intensity). The fitting polynomial regression equations for each of anatomical cross-sectional area-muscle length curves were used to calculate muscle volume (contractile content) before and after 12 weeks using magnetic resonance imaging scans.Results: Only Rectus femoris and medial gastrocnemius muscle showed a higher relative anatomical cross-sectional area in the young than the elderly on the proximal end. The old group displayed a higher absolute volume of non-contractile material than young men in triceps surae (+96%). After training, Y55, O55 and O80 showed an increase in total quadriceps (+4.3%; +6.7%; 4.2% respectively) and triceps surae (+2.8%; +7.5%; 4.3% respectively) volume. O55 demonstrated a greater increase on average gains compared to Y55, while no difference between O55 and O80 was observed.Conclusions: Muscle loss with aging is region-specific for some muscles and uniform for others. Equivalent strength training volume at moderate or high intensities increased muscle volume with no differences in muscle volume gains for old men. These data suggest that physical exercise at moderate intensity (55 to 60% of one repetition maximum) can reverse the aging related loss of muscle mass.Trial registration: NCT03079180 in ClinicalTrials.gov. Registration date: March 14, 2017.
Optimization of orbital retraction during endoscopic transorbital approach via quantitative measurement of the intraocular pressure - [SevEN 006]
Authors: Kim Woo Hyun , Moon Ju Hyung , Kim Eui Hyun , Hong Chang Ki , Han Ji Sang , Hong Je Beom
Published: January 2021

Background: Increased use of the transorbital approach (TOA) warrants greater understanding of the risk of increased intraocular pressure (IOP) and intraorbital pressure (IORP) due to orbital compression. We aimed to investigate the changes in IOP and IORP in response to orbital retraction in TOA and establish a method for the continuous measurement of intraoperative IORP.Methods: We assessed nine patients who underwent TOA surgery from January 2017 to December 2019, in addition to five cadavers. IORP and IOP were measured using a cannula needle monitor, tonometer, cuff manometer, and micro strain gauge monitor.Results: In all nine clinical cases and five cadavers, increased physical compression of the orbit increased the IOP and IORP in a curvilinear pattern. In clinical cases, when the orbit was compressed 1.5 cm from the lateral margin in the sagittal plane, the mean IOP and IORP were 25.4±5.2 mmHg and 14±9.2 mmH2O, respectively. The IORP satisfactorily reflected the IOP (Pearson correlation coefficient=0.824, p<0.001).Conclusion: We measured IOP and IORP simultaneously during orbital compression to gain basic information on pressure changes. In clinical cases, the change in the IOP could be conveniently and noninvasively monitored using continuous IORP measurements.
A qualitative inquiry of access to and quality of primary healthcare in seven communities in East and West Africa (SevenCEWA): perspectives of stakeholders, healthcare providers and users
Authors: Ameh Soter , Akeem Bolarinwa Oladimeji , Ochimana Caleb , Oluwasanu Abayomi Olabayo , Mohamed Shukri F , Okello Samson , Muhihi Alfa , Danaei Goodarz
Published: January 2021

Background: Universal health coverage is one of the Sustainable Development Goal targets known to improve population health and reduce financial burden. There is little qualitative data on access to and quality of primary healthcare in East and West Africa. The aim of this study was to describe the viewpoints of healthcare users, healthcare providers and other stakeholders on health-seeking behaviour, access to and quality of healthcare in seven communities in East and West Africa.Methods: A qualitative study was conducted in four communities in Nigeria and one community each in Kenya, Uganda and Tanzania in 2018. Purposive sampling was used to recruit: 155 respondents (mostly healthcare users) for 24 focus group discussions, 25 healthcare users, healthcare providers and stakeholders for in-depth interviews and 11 healthcare providers and stakeholders for key informant interviews. The conceptual framework in this study combined elements of the Health Belief Model, Health Care Utilisation Model, four ‘As’ of access to care, and pathway model to better understand the a priori themes on access to and quality of primary healthcare as well as health-seeking behaviours of the study respondents. A content analysis of the data was done using MAXQDA 2018 qualitative software to identify these a priori themes and emerging themes.Results: Access to primary healthcare in the seven communities was limited, especially use of health insurance. Quality of care was perceived to be unacceptable in public facilities whereas cost of care was unaffordable in private facilities. Health providers and users as well as stakeholders highlighted shortage of equipment, frequent drug stock-outs and long waiting times as major issues, but had varying opinions on satisfaction with care. Use of herbal medicines and other traditional treatments delayed or deterred seeking modern healthcare in the Nigerian sites. Conclusions: There was a substantial gap in primary healthcare coverage and quality in the selected communities in rural and urban East and West Africa. Alternative models of healthcare delivery that address social and health inequities, through affordable health insurance, can be used to fill this gap and facilitate achieving universal health coverage.
Psychosocial characteristics and HIV-related risky sexual behaviors among cisgender, transgender, and gender non-conforming MSM in China
Authors: Duan Zhizhou , Wang Liyin , Guo Menglan , Ding Changmian , Huang Danqin , Yan Hong , Wilson Amanda , Li Shiyue
Published: January 2021

Background: While a growing number of studies focus on men who have sex with men (MSM), they typically ignore the heterogeneity of gender minorities within the MSM population. The recognition of new sub-groups among gender minorities (i.e., transgender and gender non-conforming), who also identify as MSM, play a considerable role in new HIV infections in China. Information on the psychosocial factors and HIV-related risky sexual behaviors requires further consideration to understand the prevalence of HIV infection among MSM within these gender minority sub-groups.Methods: From September 2017 to January 2018, MSM were recruited in Wuhan, Nanchang, and Changsha cities in China. Participants were asked to fill out a structured self-administered questionnaire to assess depression, perceived social support, resilience, identity concealment, and HIV-related risky sexual behaviors. Results: A total of 715 MSM completed the structured questionnaire, the number of gender minorities identifying as MSM were 63 and accounted for 8.8% of the population. Compared to the cisgender MSM population, transgender MSM were more likely to have a one-night stand/occasional partners (AOR= 3.49, 95% CI =1.02-11.98), to have sex after drug use in the past six months (AOR=2.57, 95%CI =1.05-6.29), and to have reported a significantly lower likelihood of identity concealment (mean difference=-3.30, 95%CI=-5.86, -0.74, P=0.01).Conclusions: The findings highlight the significance of providing targeted interventions for different gender minorities within the MSM population. Research is required to further understand the relationship between gender identity, psychosocial characteristics, and HIV-related risky sexual behaviors.
A signature of seven immune-related genes predicts overall survival in male gastric cancer patients
Authors: Xu Xin , Lu Yida , Wu Youliang , Wang Mingliang , Wang Xiaodong , Wang Huizhen , Chen Bo , Li Yongxiang
Published: January 2021

Background: Gastric cancer (GC) has a high mortality rate and is one of the most fatal malignant tumours. Male sex has been proven as an independent risk factor for GC. This study aimed to identify immune-related genes (IRGs) associated with the prognosis of male GC.Method: RNA sequencing and clinical data were obtained from The Cancer Genome Atlas (TCGA) database. Differentially expressed IRGs between male GC and normal tissues were identified by integrated bioinformatics analysis. Univariate and multivariate Cox regression analyses were applied to screen survival-associated IRGs. Then, GC patients were separated into high- and low-risk groups based on the median risk score. Furthermore, a nomogram was constructed based on the TCGA dataset. The prognostic value of the risk signature model was evaluated by Kaplan-Meier curve, receiver operating characteristic (ROC), Harrell’s concordance index and calibration curves. In addition, the gene expression dataset from the Gene Expression Omnibus (GEO) was also downloaded for external validation. The relative proportions of 22 types of infiltrating immune cells in each male GC sample were evaluated using CIBERSORT.Results: A total of 276 differentially expressed IRGs were screened, including 189 up-regulated and 87 down-regulated genes. Subsequently, a seven-IRGs signature (LCN12, CCL21, RNASE2, CGB5, NRG4, AGTR1 and NPR3) was identified to be significantly associated with the overall survival (OS) of male GC patients. Survival analysis indicated that patients in the high-risk group exhibited a poor clinical outcome. The results of multivariate analysis revealed that the risk score was an independent prognostic factor. The established nomogram could be used to evaluate the prognosis of individual male GC patients. Further analysis showed that the prognostic model had excellent predictive performance in both TCGA and validated cohorts. Besides, the results of tumour-infiltrating immune cell analysis indicated that the seven-IRGs signature could reflect the status of the tumour immune microenvironment.Conclusions: Our study developed a novel seven-IRGs risk signature for individualized survival prediction of male GC patients.