bluuebunny/crossref_metadata_2025 huggingface dataset:
Empathic Humanitarianism: Understanding the Motivations behind Humanitarian Work with Migrants at the US–Mexico Border
Authors: Gomez Ricardo , Newell Bryce Clayton , Vannini Sara
Published: January 2020

Executive Summary

The growing numbers of vulnerable migrants seeking shelter and refuge in the United States and Europe are finding increased racism and xenophobia as well as renewed efforts by humanitarian volunteers to offer them aid, sanctuary, and protection. This article sets forth a typology to better understand the motivations of volunteers working to help migrants in need of humanitarian assistance. Why do people go out of their way to offer humanitarian aid to someone they do not know and, in some cases, they will never meet? What are the drivers of altruistic behavior of humanitarian volunteers in the face of rising injustice, nationalism, and xenophobia?

In answer to these questions, we offer a typology centered on empathic concern, differentiating secular/faith-based motivations, and deontological/moral-virtue motivations, with particular behaviors in each of the four resulting categories: the Missionary Type, the Good Samaritan Type, the Do Gooder Type, and the Activist Type. We also suggest four additional self-centered (non-altruistic, or not-other-centered) types (Militant, Crusader, Martyr, and Humanitarian Tourist).

The nuances offered by this typology can help organizations working with migrants and refugees better understand and channel the enthusiasm of their volunteers and better meet the needs of the vulnerable populations they serve. This is especially important at a time when migration is being criminalized and when humanitarian aid is deemed unpatriotic, if not outright illegal. In the face of increased nationalistic and xenophobic messages surrounding migration, we need to articulate the altruistic humanitarian motivations of volunteers in the context of migration aid.

Our typology may also be used to understand altruistic behaviors in other contexts such as disaster relief, community organization and activism, international adoptions, or organ donations to strangers, among others, in which altruistic empathic concern can be an important motivation driving people to act for the well-being of distant others.
Refining prediction of major bleeding on antiplatelet treatment after transient ischaemic attack or ischaemic stroke
Authors: Hilkens Nina A , Li Linxin , Rothwell Peter M , Algra Ale , Greving Jacoba P
Published: January 2020

Introduction

Bleeding is the main safety concern of treatment with antiplatelet drugs. We aimed to refine prediction of major bleeding on antiplatelet treatment after a transient ischaemic attack (TIA) or stroke by assessing the added value of new predictors to the existing S2TOP-BLEED score.

Patients and methods

We used Cox regression analysis to study the association between candidate predictors and major bleeding among 2072 patients with a transient ischaemic attack or ischaemic stroke included in a population-based study (Oxford Vascular Study – OXVASC). An updated model was proposed and validated in 1094 patients with a myocardial infarction included in OXVASC. Models were compared with c-statistics, calibration plots, and net reclassification improvement.

Results

Independent predictors for major bleeding on top of S2TOP-BLEED variables were peptic ulcer (hazard ratio (HR): 1.72; 1.04–2.86), cancer (HR: 2.40; 1.57–3.68), anaemia (HR: 1.55; 0.99–2.44) and renal failure (HR: 2.20; 1.57–4.28). Addition of those variables improved discrimination from 0.69 (0.64–0.73) to 0.73 (0.69–0.78) in the TIA/stroke cohort (p = 0.01). Performance improved particularly for upper gastro-intestinal bleeds (0.70; 0.64–0.75 to 0.77; 0.72–0.82). Net reclassification improved over the entire range of the score (net reclassification improvement: 0.56; 0.36–0.76). In the validation cohort, discriminatory performance improved from 0.68 (0.62–0.74) to 0.70 (0.64–0.76).

Discussion and Conclusion

Peptic ulcer, cancer, anaemia and renal failure improve predictive performance of the S2TOP-BLEED score for major bleeding after stroke. Future external validation studies will be required to confirm the value of the STOP-BLEED+ score in transient ischaemic attack/stroke patients.
Embryonic cadmium exposure of male rats alters reproductive functions at adulthood, but without overt alterations in developmental and behavioral outcomes and metabolism
Authors: Samatha K , Girish BP , Reddy P Sreenivasula
Published: January 2020

The effects of exposure of pregnant rats to cadmium (Cd) on the developmental and behavioral outcomes, reproductive functions, and metabolism of their male progeny were evaluated. Rats (Wistar) were injected intraperitoneally with either 0.5 or 5.0 µg Cd/kg body weight from day 12 to day 19 of pregnancy. The male offspring were evaluated for their developmental outcomes and behavioral changes. All developmental and behavioral parameters assessed were comparable among the different groups. All male pups were allowed to develop until 100 days of age and evaluated for reproductive end points. The results revealed that although the body weights and relative weights of liver, brain, kidney, testis, and epididymis were not altered, reproductive parameters, including daily sperm production, epididymal sperm numbers, and concentrations of motile, viable, and hypo-osmotic tail-swelled sperm declined significantly in rats exposed to 0.5 and 5.0 µg Cd during embryonic development. In addition, plasma testosterone levels and activity levels of testicular steroidogenic enzymes also decreased in these rats. In the fertility study, although each male in the 0.5, 5.0 µg, and control groups produced a copulatory plug and impregnated a female, the mean number of implantations and live fetuses was reduced significantly in females mated with rats exposed to 0.5 and 5.0 µg Cd during the prenatal period. The general metabolism of the animals exposed to Cd during embryonic development was comparable with the controls as evidenced by no significant changes in the activity levels of succinate dehydrogenase, lactate dehydrogenase, glucose-6-phosphate dehydrogenase, glutamate dehydrogenase, aspartate aminotransaminase, and alanine aminotransaminases in the liver, kidney, and testis. The results thus suggest that maternal Cd exposure during embryonic development markedly affected the spermatogenesis, steroidogenesis, and fertility potential, but without alterations in the development, behavior, and metabolism.
Direct Synthesis of Graphene Dendrites on SiO2/Si Substrates by Chemical Vapor Deposition
Authors: Li Yingxian , Li Zhenhua , Li Qingbo , Tian Meng , Li Chunhui , Sun Li , Wang Jihua , Zhao Xian , Xu Shicai , Yu Fapeng
Published: January 2020

The long-standing interest in graphene has recently brought graphene-derived materials including graphene hydrogel, graphene fiber and graphene paper into sharp focus. These graphene-derived materials show outstanding properties in mechanics and physics. In this paper, for the first time, we demonstrate the novel synthesis of graphene dendrites on SiO2/Si substrates by chemical vapor deposition. The tree-like graphene dendrites with well-controlled morphology can be directly grown on both the Si and the SiO2 surfaces of the substrates by using methane and hydrogen as precursors. The graphene dendrites on SiO2/Si substrates can be directly used in the fabrication of the electronic device. The conductivity and the Hall mobility of graphene dendrites are ~ 286 Scm−1 and ~ 574 cm2(Vs)−1, respectively. Young’s modulus of graphene dendrites is up to 2.26 GPa. The developed method avoids the need for a metal substrate and is scalable and compatible with the existing semiconductor technology, making graphene dendrites be very promising in nanoelectronic applications.
Correction to: Archaic mitochondrial DNA inserts in modern day nuclear genomes
Authors: Bücking Robert , Cox Murray P. , Hudjashov Georgi , Saag Lauri , Sudoyo Herawati , Stoneking Mark
Published: January 2020

Following the publication of this article [1], the authors reported that the captions of Figs. 3 and 4 were published in the incorrect order, whereby they mismatch with their corresponding images.
Comparison of multiple algorithms to reliably detect structural variants in pears
Authors: Liu Yueyuan , Zhang Mingyue , Sun Jieying , Chang Wenjing , Sun Manyi , Zhang Shaoling , Wu Jun
Published: January 2020

Background

Structural variations (SVs) have been reported to play an important role in genetic diversity and trait regulation. Many computer algorithms detecting SVs have recently been developed, but the use of multiple algorithms to detect high-confidence SVs has not been studied. The most suitable sequencing depth for detecting SVs in pear is also not known.

Results

In this study, a pipeline to detect SVs using next-generation and long-read sequencing data was constructed. The performances of seven types of SV detection software using next-generation sequencing (NGS) data and two types of software using long-read sequencing data (SVIM and Sniffles), which are based on different algorithms, were compared. Of the nine software packages evaluated, SVIM identified the most SVs, and Sniffles detected SVs with the highest accuracy (> 90%). When the results from multiple SV detection tools were combined, the SVs identified by both MetaSV and IMR/DENOM, which use NGS data, were more accurate than those identified by both SVIM and Sniffles, with mean accuracies of 98.7 and 96.5%, respectively. The software packages using long-read sequencing data required fewer CPU cores and less memory and ran faster than those using NGS data. In addition, according to the performances of assembly-based algorithms using NGS data, we found that a sequencing depth of 50× is appropriate for detecting SVs in the pear genome.

Conclusion

This study provides strong evidence that more than one SV detection software package, each based on a different algorithm, should be used to detect SVs with higher confidence, and that long-read sequencing data are better than NGS data for SV detection. The SV detection pipeline that we have established will facilitate the study of diversity in other crops.
Interaction of camel Lactoferrin derived peptides with DNA: a molecular dynamics study
Authors: Pirkhezranian Zana , Tahmoorespur Mojtaba , Daura Xavier , Monhemi Hassan , Sekhavati Mohammad Hadi
Published: January 2020

Background

Lactoferrampin (LFampin), Lactoferricin (LFcin), and LFchimera are three well-known antimicrobial peptides derived from Lactoferrin and proposed as alternatives for antibiotics. Although the intracellular activity of these peptides has been previously demonstrated, their mode of action is not yet fully understood. Here, we performed a molecular dynamics simulation study to understand the molecular interactions between camel Lactoferrin derived peptides, including CLFampin, CLFcin, and CLFchimera, and DNA as an important intracellular target.

Results

Our results indicate that all three peptides bind to DNA, albeit with different propensities, with CLFchimera showing the highest binding affinity. The secondary structures of the peptides, modeled on Lactoferrin, did not undergo significant changes during simulation, supporting their functional relevance. Main residues involved in the peptide-DNA interaction were identified based on binding free energy estimates calculated over 200 ns, which, as expected, confirmed strong electrostatic interactions between DNA phosphate groups and positively charged peptide side chains. Interaction between the different concentrations of CLFchimera and DNA revealed that after binding of four copies of CLFchimera to DNA, hydrogen bonds between the two strands of DNA start to break from one of the termini.

Conclusions

Importantly, our results revealed that there is no DNA-sequence preference for peptide binding, in line with a broad antimicrobial activity. Moreover, the results showed that the strength of the interaction between DNA and CLFchimera is concentration dependent. The insight provided by these results can be used for the rational redesign of natural antimicrobial peptides targeting the bacterial DNA.
Genome-wide association mapping revealed syntenic loci QFhb-4AL and QFhb-5DL for Fusarium head blight resistance in common wheat (Triticum aestivum L.)
Authors: Hu Wenjing , Gao Derong , Wu Hongya , Liu Jian , Zhang Chunmei , Wang Junchan , Jiang Zhengning , Liu Yeyu , Li Dongsheng , Zhang Yong , Lu Chengbin
Published: January 2020

Background

Fusarium head blight (FHB), primarily caused by Fusarium graminearum, is a major threat to wheat production and food security worldwide. Breeding stably and durably resistant cultivars is the most effective approach for managing and controlling the disease. The success of FHB resistance breeding relies on identification of an effective resistant germplasm. We conducted a genome-wide association study (GWAS) using the high-density wheat 90 K single nucleotide polymorphism (SNP) assays to better understand the genetic basis of FHB resistance in natural population and identify associated molecular markers.

Results

The resistance to FHB fungal spread along the rachis (Type II resistance) was evaluated on 171 wheat cultivars in the 2016–2017 (abbr. as 2017) and 2017–2018 (abbr. as 2018) growing seasons. Using Illumina Infinum iSelect 90 K SNP genotyping data, a genome-wide association study (GWAS) identified 26 loci (88 marker-trait associations), which explained 6.65–14.18% of the phenotypic variances. The associated loci distributed across all chromosomes except 2D, 6A, 6D and 7D, with those on chromosomes 1B, 4A, 5D and 7A being detected in both years. New loci for Type II resistance were found on syntenic genomic regions of chromsome 4AL (QFhb-4AL, 621.85–622.24 Mb) and chromosome 5DL (QFhb-5DL, 546.09–547.27 Mb) which showed high collinearity in gene content and order. SNP markers wsnp_JD_c4438_5568170 and wsnp_CAP11_c209_198467 of 5D, reported previously linked to a soil-borne wheat mosaic virus (SBWMV) resistance gene, were also associated with FHB resistance in this study.

Conclusion

The syntenic FHB resistant loci and associated SNP markers identified in this study are valuable for FHB resistance breeding via marker-assisted selection.
High frequency in vitro regeneration of adventitious shoots in daylilies (Hemerocallis sp) stem tissue using thidiazuron
Authors: Matand Kanyand , Shoemake Meordrick , Li Chenxin
Published: January 2020

Background

Daylilies are a lucrative crop used for its floral beauty, medicinal proprieties, landscaping, fire prevention, nutritional value, and research. Despite the importance, daylilies remain extremely challenging for multiplying in vitro. The response difficulty is exacerbated because a few good protocols for daylilies micropropagation are generally difficult to reproduce across genotypes. An efficient strategy, currently applied at Langston University, is to systematically explore individual tissues or organs for their potential to micropropagation. This article is a partial report of the investigation carried out under room environmental conditions and focuses on developing an efficient daylilies in vitro propagation protocol that uses the stem tissue as the principal explant.

Results

In less than three months, using thidiazuron, the use of the stem tissue as the in vitro experimental explant was successful in inducing multiple shoots several folds greater than current daylilies shoot organogenesis protocols. The study showed that tissue culture can be conducted successfully under unrestricted room environmental conditions as well as under the controlled environment of a growth chamber. It also showed that splitting lengthwise stem explants formed multiple shoots several folds greater than cross-sectioned and inverted explants. Shoot conversion rate was mostly independent of the number of shoots formed per explants. The overall response was explant and genotype-dependent. Efficient responses were observed in all thidiazuron treatments.

Conclusion

An efficient protocol, which can be applied for mass multiple shoots formation using the daylilies stem tissue as the main explant, was successfully developed. This could lead to a broad and rapid propagation of the crop under an array of environmental conditions to meet the market demand and hasten exogenous gene transfer and breeding selection processes.
Comparative transcriptome analysis reveals the response mechanism of Cf-16-mediated resistance to Cladosporium fulvum infection in tomato
Authors: Zhang Dongye , Bao Yufang , Sun Yaoguang , Yang Huanhuan , Zhao Tingting , Li Huijia , Du Chong , Jiang Jingbin , Li Jingfu , Xie Libo , Xu Xiangyang
Published: January 2020

Background

Leaf mold disease caused by Cladosporium fulvum is a serious threat affecting the global production of tomato. Cf genes are associated with leaf mold resistance, including Cf-16, which confers effective resistance to leaf mold in tomato. However, the molecular mechanism of the Cf-16-mediated resistance response is largely unknown.

Results

We performed a comparative transcriptome analysis of C. fulvum-resistant (cv. Ontario7816) and C. fulvum-susceptible (cv. Moneymaker) tomato cultivars to identify differentially expressed genes (DEGs) at 4 and 8 days post inoculation (dpi) with C. fulvum. In total, 1588 and 939 more DEGs were found in Cf-16 tomato than in Moneymaker at 4 and 8 dpi, respectively. Additionally, 1350 DEGs were shared between the 4- and 8-dpi Cf-16 groups, suggesting the existence of common core DEGs in response to C. fulvum infection. The up-regulated DEGs in Cf-16 tomato were primarily associated with defense processes and phytohormone signaling, including salicylic acid (SA) and jasmonic acid (JA). Moreover, SA and JA levels were significantly increased in Cf-16 tomato at the early stages of C. fulvum infection. Contrary to the previous study, the number of up-regulated genes in Cf-16 compared to Cf-10 and Cf-12 tomatoes was significantly higher at the early stages of C. fulvum infection.

Conclusion

Our results provide new insight into the Cf-mediated mechanism of resistance to C. fulvum, especially the unique characteristics of Cf-16 tomato in response to this fungus.
Increased minimum alveolar concentration-awake of Sevoflurane in women of breast surgery with sleep disorders
Authors: Cao Yuanyuan , Zhang Lei , Peng Xiaohui , Wu Yun , Zhang Qunlin , Gu Erwei , Zhang Ye
Published: January 2020

Background

Sleep disorders are commonly encountered in clinic. Evidences showed that sleep deprivation may modulate the effectiveness of general anesthetics in rats. However, this phenomenon has not been explored in humans. The study aimed to investigate whether the hypnotic potency of sevoflurane in patients with sleep disorders differ from patients with normal sleep habits.

Methods

We recruited 44 patients scheduled for elective breast surgery and eventually analyzed 38 patients, including 19 subjects with normal sleep habits and 19 subjects with sleep disorders. According to the Dixon ‘up-and-down’ design, patients received sevoflurane at preselected concentrations starting at 1.0 vol%. After a steady-state period, a verbal command for testing awakening was performed. Based on the negative or positive response to the verbal command, we decreased or increased the concentration of sevoflurane by 0.2 vol% in the next patient accordingly. Plasma orexin-A was also measured before observation.

Results

The MACawake of sevoflurane was 0.80% [95% confidence interval (CI), 0.683–0.926%] in the sleep disordered group vs 0.60% [95% CI, 0.493–0.689%] in the control group. The relative median potency between groups was 0.750 (95% CI, 0.236–0.969). Patients with sleep disorders had significantly higher orexin-A levels than control (72.17 ± 18.24 vs. 36.16 ± 14.18 pg/mL). A significant, positive relationship was detected between orexin-A level and probability of awakening (OR = 1.081, 95% CI is 1.020–1.146, P = 0.008).

Conclusions

MACawake of sevoflurane is higher in mild-aged women of breast surgery with sleep disorders compared to those with normal sleep habits. The increased anesthetic requirement may be related to changes of orexin-A levels. These findings suggest that sleep may have a potential impact on clinical anesthesia, including changes of sensitivity to anesthetics or postoperative complications. Further research is needed to confirm this hypothesis.

Clinical trial registration

Chinese Clinical Trial Registry (ChiCTR1800016022), date of registration 07 May 2018.
Prevalence of malignant hyperthermia diagnosis in obstetric patients in the United States, 2003 to 2014
Authors: Guglielminotti Jean , Rosenberg Henry , Li Guohua
Published: January 2020

Background

The cost-benefit of stocking dantrolene in maternity units for treating malignant hyperthermia (MH) has been recently questioned because of the low incidence of MH crisis in the general population and the low utilization of general anesthesia in obstetrics. However, no study has examined the prevalence of MH susceptibility in obstetrics. This study aimed to assess the prevalence of MH diagnosis and associated factors in obstetric patients.

Methods

Data for this study came from the National Inpatient Sample from 2003 to 2014, a 20% nationally representative sample of discharge records from community hospitals. A diagnosis of MH due to anesthesia was identified using the International Classification of Diseases, Ninth Revision, Clinical Modification code 995.86. MH prevalence was estimated according to the delivery mode and patient and hospital characteristics.

Results

During the 12-year study period, 47,178,322 delivery-related discharges [including 15,175,127 (32.2%) cesarean deliveries] were identified. Of them, 215 recorded a diagnosis of MH, yielding a prevalence of 0.46 per 100,000 [95% confidence interval (CI), 0.40 to 0.52]. The prevalence of MH diagnosis in cesarean deliveries was 0.81 per 100,000 (95% CI, 0.67 to 0.97), compared with 0.29 per 100,000 (95% CI, 0.23 to 0.35) in vaginal deliveries (P <  0.001). Multivariable logistic regression revealed that cesarean delivery was associated with a significantly increased risk of MH diagnosis [adjusted rate ratio (aOR) 2.88; 95% CI, 2.19 to 3.80]. Prevalence of MH diagnosis was lower in Hispanics than in non-Hispanic whites (aOR 0.47; 95% CI, 0.29 to 0.76) and higher in the South than in the Northeast census regions (aOR 2.44; 95% CI, 1.50 to 3.96).

Conclusion

The prevalence of MH-susceptibility is about 1 in 125,000 in cesarean deliveries, similar to the prevalence reported in non-obstetrical surgery inpatients. The findings of this study suggest that stocking dantrolene in maternity units is justified.
Treatment outcome and its predictors among patients of acute heart failure at a tertiary care hospital in Ethiopia: a prospective observational study
Authors: Tirfe Mulubirhan , Nedi Teshome , Mekonnen Desalew , Berha Alemseged Beyene
Published: January 2020

Background

Acute heart failure is a rapid onset of new or worsening of signs and symptoms of heart failure that requires hospitalization or a visit to the emergency department. The aim of this study was to evaluate treatment outcome and determine factors that predict a poor treatment outcome in acute heart failure patients at a Tertiary Care Hospital in Ethiopia.

Methods

A prospective observational study design was used. Data were collected using a structured questionnaire as a tool. Outcome variables were assessed at the time of discharge from the hospital. Bivariate and multivariate logistic regression analyses were used to determine factors that predict in-hospital mortality. A p-value ≤0.05 was considered as statistically significant.

Results

Out of the 169 patients, the median age of patients with acute heart failure was 34 years (IQR = 23 to 50) and median hospital stay was 4.0 days (IQR = 3.0 to 6.0). The leading precipitating factor and underlying disease at the time of admission were pneumonia (47.5%) and chronic rheumatic heart disease (48.5%), respectively. The in-hospital mortality was found to be 17.2%. Smoking (adjusted odds ratio (AOR) = 8.7, p = 0.006), diabetes mellitus (AOR = 10.2, p = 0.005), pulmonary hypertension (AOR = 4.3, p = 0.016), and the presence of adverse drug events (AOR = 4.2, p = 0.003) were predictors of in-hospital mortality.

Conclusion

High in-hospital mortality was observed among acute heart failure patients admitted to a Tertiary Care Hospital in Ethiopia. Smoking, diabetes mellitus, pulmonary hypertension and the presence of adverse drug events were predictors of in-hospital mortality.
World Health Organization (WHO) antibiotic regimen against other regimens for the treatment of leprosy: a systematic review and meta-analysis
Authors: Lazo-Porras Maria , Prutsky Gabriela J. , Barrionuevo Patricia , Tapia Jose Carlos , Ugarte-Gil Cesar , Ponce Oscar J. , Acuña-Villaorduña Ana , Domecq Juan Pablo , De la Cruz-Luque Celso , Prokop Larry J. , Málaga Germán
Published: January 2020

Background

To evaluate the effectiveness and safety of the World Health Organization antibiotic regimen for the treatment of paucibacillary (PB) and multibacillary (MB) leprosy compared to other available regimens.

Methods

We performed a search from 1982 to July 2018 without language restriction. We included randomized controlled trials, quasi-randomized trials, and comparative observational studies (cohorts and case-control studies) that enrolled patients of any age with PB or MB leprosy that were treated with any of the leprosy antibiotic regimens established by the WHO in 1982 and used any other antimicrobial regimen as a controller. Primary efficacy outcomes included: complete clinical cure, clinical improvement of the lesions, relapse rate, treatment failure. Data were pooled using a random effects model to estimate the treatment effects reported as relative risk (RR) with 95% confidence intervals (CI).

Results

We found 25 eligible studies, 11 evaluated patients with paucibacillary leprosy, while 13 evaluated patients with MB leprosy and 1 evaluated patients of both groups. Diverse regimen treatments and outcomes were studied. Complete cure at 6 months of multidrug therapy (MDT) in comparison to rifampin-ofloxacin-minocycline (ROM) found RR of 1.06 (95% CI 0.88–1.27) in five studies. Whereas six studies compare the same outcome at different follow up periods between 6 months and 5 years, according to the analysis ROM was not better than MDT (RR of 1.01 (95% CI 0.78–1.31)) in PB leprosy.

Conclusion

Not better treatment than the implemented by the WHO was found. Diverse outcome and treatment regimens were studied, more statements to standardized the measurements of outcomes are needed.
Predictors for gram-negative monomicrobial necrotizing fasciitis in southern Taiwan
Authors: Huang Tsung-Yu , Peng Kuo-Ti , Hsiao Cheng-Ting , Fann Wen-Chih , Tsai Yao-Hung , Li Yen-Yao , Hung Chien-Hui , Chuang Fang-Yi , Hsu Wei-Hsiu
Published: January 2020

Background

Necrotizing fasciitis (NF) is a rare and life-threatening necrotizing skin and soft-tissue infection. Infectious pathogens of NF must be detected early and treated rapidly to prevent loss of limb or a fatal outcome. This study aimed to detect more reliable predictors between gram-negative and gram-positive monomicrobial NF of limbs.

Methods

A total of 100 patients with limb monomicrobial NF were diagnosed prospectively from April 2015 to July 2018. These monomicrobial NF pathogens can be divided into gram-negative and gram-positive groups according to the result of Gram staining and final bacterial reports. Data such as demographics, seawater or seafood contact history, infectious location, comorbidities, presenting signs and symptoms, and laboratory findings were recorded and compared.

Results

A total of 55 patients were infected with gram-negative organisms and 45 patients with gram-positive organisms. Among the 55 cases of monomicrobial gram-negative NF, 48 (87.3%) were caused mainly by Vibrio spp. (38, 69.1%) and Aeromonas spp. (10, 18.2%). A higher incidence of chronic kidney disease, cerebrovascular accident, tachypnea, and septic shock; a higher rate of band forms of leukocytes of more than 3%, serum lactate of more than 20 mg/dL, and C-reactive protein level of less than 150 mg/dL; prolonged prothrombin time; and a lower fibrinogen level were observed in patients with gram-negative infection. In a multivariate analysis, a higher incidence of seawater or seafood contact history (odds ratio [OR]: 66.301; 95% confidence interval [CI]: 7.467–588.702), a higher rate of hyperlactatemia (OR: 7.904; 95% CI: 1.231–50.744), and a low fibrinogen level (OR: 1.013; 95% CI: 1.004–1.023) indicated gram-negative infection.

Conclusions

In southern Taiwan, NF of limbs mainly affected the lower limbs, exhibited monomicrobial infection, and was predominated by gram-negative bacteria. Gram-negative monomicrobial NF of limbs often occurred in individuals with the more seawater or seafood contact history, hyperlactatemia, and low fibrinogen levels.
Cryptococcal antigenemia is associated with meningitis or death in HIV-infected adults with CD4 100–200 cells/mm3
Authors: Wykowski James , Galagan Sean R. , Govere Sabina , Wallis Carole L. , Moosa Mahomed-Yunus , Celum Connie , Drain Paul K.
Published: January 2020

Background

Cryptococcal antigen (CrAg) screening with fluconazole prophylaxis has been shown to prevent cryptococcal meningitis and mortality for people living with HIV (PLWH) with CD4 < 100 cells/mm3. While cryptococcal meningitis occurs in individuals with CD4 100–200 cells/mm3, there is limited evidence that CrAg screening predicts cryptococcal meningitis or mortality among this group with moderate immunosuppression. Current IDSA and WHO clinical guidelines recommend restricting CrAg screening to PLWH with CD4 < 100 cells/mm3.

Methods

We conducted a prospective cohort study of PLWH 18+ years who had not initiated ART in South Africa. We followed participants for 14 months to determine onset of cryptococcal meningitis or all-cause mortality. At study completion, we retrospectively tested stored serum samples for CrAg using an enzyme immunoassay (EIA). We calculated CD4-stratified incidence rates of outcomes and used Cox proportional hazards to measure associations between CrAg positivity and outcomes.

Results

We enrolled 2383 PLWH, and 1309 participants had serum samples tested by CrAg EIA. The median CD4 was 317 cells/mm3 (interquartile range: 173–491 cells/mm3). By CD4 count at baseline, there were 209 individuals with a CD4 count of 100–200 cells/mm3 and available CrAg test results. Of these, four (1.9%) tested positive. Two of four (IR: 58.8 per 100 person-years) CrAg+ participants and 11 of 205 (IR: 5.6 per 100 person-years) CrAg- participants developed cryptococcal meningitis or died for an overall rate of death or cryptococcal meningitis that was 10.0-times higher for those who were CrAg+ (95% confidence interval: 2.2–45.3). Among those with CD4 < 100 cell/mm3 and CrAg EIA test results (N = 179), ten (5.6%) participants tested CrAg+. Among this group, seven of ten (IR: 137.6 per 100 person-years) CrAg+ participants and 26 of 169 (IR: 17.8 per 100 person-years) CrAg- participants developed cryptococcal meningitis or died, for a rate of death or cryptococcal meningitis that was 6.3-times higher for those who were CrAg+ (95% confidence interval: 2.7–14.6).

Conclusions

Although few PLWH with moderate immunosuppression screened CrAg positive, a positive CrAg test was predictive of increased risk of cryptococcal meningitis or death. Similar to those with a CD4 < 100 cell/mm3, systematic CrAg screening may reduce morbidity and mortality in PLWH with CD4 100–200 cells/mm3.
Uterine and placental blood flow indexes and antinuclear autoantibodies in unexplained recurrent pregnancy loss: should they be investigated in pregnancy as correlated potential factors? A retrospective study
Authors: Bruno Valentina , Ticconi Carlo , Martelli Federica , Nuccetelli Marzia , Capogna Maria Vittoria , Sorge Roberto , Piccione Emilio , Pietropolli Adalgisa
Published: January 2020

Background

The potential role of antinuclear antibodies (ANA) in recurrent pregnancy loss (RPL) pathogenesis is still debated, although some evidences suggest that they could affect pregnancy outcome, leading to a higher miscarriage rate in these patients. A hypothesized mechanism is through changes in uterine flow in pre-conceptional stage, by modifying endometrial receptivity in RPL. However, scant data are available, in pregnancy, about their role in RPL placental perfusion, also in relation to its potential treatments, such as low molecular weight heparin (LMWH). The aim of this study is to retrospectively further investigate the correlation between two-dimensional (2D) and three-dimensional (3D) uterine and placental flow indexes and the presence or the absence of ANA in women with unexplained RPL (uRPL), treated or not treated with LMWH.

Methods

2D Doppler measurement of pulsatility index (PI) of the uterine arteries and 3D ultrasonography determination of vascularization index (VI), flow index (FI) and vascularization flow index (VFI) was carried out with the aid of the virtual organ computer-aided analysis (VOCAL) technique in LMWH treated (n 24) and not treated-uRPL patients (n 20) and in the relative control group (n 27), each group divided in ANA+ and ANA- subgroups. Serum assay for the presence of ANA was performed in all women.

Results

No differences were found in PI, VFI and VI values, by comparing the different groups. A difference in VI values was found for ANA- patients between RPL women not treated with LMWH and the treated ones (p = 0,01), which have lower VI values and similar to controls. By considering only ANA- treated and not treated RPL patients, the ROC curve shows an area of 0,80 and at the VI cut-off of 11,08 a sensitivity of 85% and a specificity of 67%.

Conclusions

LMWH could exert a potential beneficial effect in restoring the physiological blood flow supply in terms of VI in uRPL ANA- status, suggesting to include ANA and VI investigations in the RPL diagnostic algorithm in a research context, since further studies are needed to clarify this challenging hypothesis in order to try to ameliorate ANA and abnormal placental vascularization negative influence on RPL pregnancy outcome .
Correction to: TOPK promotes metastasis of esophageal squamous cell carcinoma by activating the Src/GSK3β/STAT3 signaling pathway via γ-catenin
Authors: Jiang Yanan , Zhang Jing , Zhao Jimin , Li Zhenzhen , Chen Hanyong , Qiao Yan , Chen Xinhuan , Liu Kangdong , Dong Ziming
Published: January 2020

Following publication of the original article [1], the authors reported the errors in Fig. 1C and D, Fig. 2, Fig. 4B and C and Fig. 6D and E.
Healthy Options: study protocol and baseline characteristics for a cluster randomized controlled trial of group psychotherapy for perinatal women living with HIV and depression in Tanzania
Authors: Smith Fawzi Mary C. , Siril Hellen , Larson Elysia , Aloyce Zenaice , Araya Ricardo , Kaale Anna , Kamala Janeth , Kasmani Muhummed Nadeem , Komba Amina , Minja Anna , Mwimba Angelina , Ngakongwa Fileuka , Somba Magreat , Sudfeld Christopher R. , Kaaya Sylvia F.
Published: January 2020

Background

Perinatal women accessing prevention of mother-to-child transmission of HIV (PMTCT) services are at an increased risk of depression; however, in Tanzania there is limited access to services provided by mental health professionals. This paper presents a protocol and baseline characteristics for a study evaluating a psychosocial support group intervention facilitated by lay community-based health workers (CBHWs) for perinatal women living with HIV and depression in Dar es Salaam.

Methods

A cluster randomized controlled trial (RCT) is conducted comparing: 1) a psychosocial support group intervention; and 2) improved standard of mental health care. The study is implemented in reproductive and child health (RCH) centers providing PMTCT services. Baseline characteristics are presented by comparing sociodemographic characteristics and primary as well as secondary outcomes for the trial for intervention and control groups. The trial is registered under clinicaltrials.gov (NCT02039973).

Results

Among 742 women enrolled, baseline characteristics were comparable for intervention and control groups, although more women in the control group had completed secondary school (25.2% versus 18.2%). Overall, findings suggest that the population is highly vulnerable with over 45% demonstrating food insecurity and 17% reporting intimate partner violence in the past 6 months.

Conclusions

Baseline characteristics for the cluster RCT were comparable for intervention and control groups. The trial will examine the effectiveness of a psychosocial support group intervention for the treatment of depression among women living with HIV accessing PMTCT services. A reduction in the burden of depression in this vulnerable population has implications in the short-term for improved HIV-related outcomes and for potential long-term effects on child growth and development.

Trial registration

The trial is registered under clinicaltrials.gov (NCT02039973). Retrospectively registered on January 20, 2014.
Magnitude of sedentary behavior and associated factors among secondary school adolescents in Debre Berhan town, Ethiopia
Authors: Mohammed Osman Yimer , Tesfahun Esubalew , Mohammed Abdurahman
Published: January 2020

Background

Sedentary life style is becoming increasingly common in this industrial age due to changes on the way people manufacture, transport and communicate. Sedentary lifestyle is associated with chronic diseases (diabetes, cardiovascular disease, and cancer), depression, obesity and premature mortality. The objective of this study was to assess the magnitude and associated factors of sedentary behavior.

Methods

School based cross sectional study was conducted among 580 students from April 20 to May 10, 2019 in secondary schools in Debre Berhan City Administration. Sedentary behavior was measured using time spent on four activities (watching TV/Video, listening to music, surfing internet and playing games). Adolescents are considered sedentary if they spend two or more hours in one or all listed activities per day. Data was entered to Epidata version 4.2.2.1 and exported to SPSS version 20 for analysis.

Result

A total of 580 (44.3% male and 55.7% female) students participated in this study. The magnitude of sedentary behavior (≥2 h per day) was 65.5% (95% CI = 61.32% - 69.08). Family monthly income greater than 8000 birr (AOR: 6.42, 95%CI = 2.18–18.78), maternal education (AOR: 5.12, 95%CI = 1.09–23.83), access to TV (AOR: 4.87, 95%CI = 1.99–11.87), access to mobile internet (AOR: 2.37, 95% CI = 1.14–4.93) and utilization of social media (AOR: 2.98, 95%CI = 1.43–6.17) were positively associated with adolescent sedentary behavior.

Conclusion

The prevalence of sedentary behavior was high among adolescents of Debre Berhan town. Therefore, schools in the town should work towards creating awareness on the wise use of screen based entertainments.
Social values for health technology assessment in Canada: a scoping review of hepatitis C screening, diagnosis and treatment
Authors: O’Keefe-Markman Caroline , Lea Kristina Dawn , McCabe Christopher , Hyshka Elaine , Bubela Tania
Published: January 2020

Background

Health care system decision makers face challenges in allocating resources for screening, diagnosis and treatment of hepatitis C. Approximately 240,000 individuals are infected with the hepatitis C virus (HCV) in Canada. Populations most affected by HCV include Indigenous people, people who inject drugs, immigrants and homeless or incarcerated populations as well as those born between 1946 and 1965. Curative but expensive drug regimens of novel direct acting antivirals (DAAs) are available. We aim to identify social values from academic literature for inclusion in health technology assessments.

Methods

We conducted a scoping review of academic literature to identify and analyze the social values and evidence-based recommendations for screening, diagnosis and treatment of HCV in Canada. After applying inclusion/exclusion criteria, we abstracted: type of intervention(s), population(s) affected, study location, screening methods, diagnostics and treatments. We then abstracted and applied qualitative codes for social values. We extracted social value statements and clustered them into one of 4 categories: (1) equity and justice, (2) duty to provide care, (3) maximization of population benefit, and (4) individual versus community interests.

Results

One hundred and eighteen articles met our inclusion criteria on screening, diagnosis and treatment of HCV in Canada. Of these, 54 (45.8%) discussed screening, 4 (3.4%) discussed diagnosis and 60 (50.8%) discussed treatment options. Most articles discussed the general population and other non-vulnerable populations. Articles that discussed vulnerable populations focused on people who inject drugs. We coded 1243 statements, most of which fell into the social value categories of equity and justice, duty to provide care and maximization of population benefit.

Conclusion

The academic literature identified an expanded set of social values to be taken into account by resource allocation decision makers in financially constrained environments. In the context of hepatitis C, authors called for greater consideration of equity and justice and the duty to provide care in making evidence-based recommendations for screening, diagnosis and treatment for different populations and in different settings that also account for individual and community interests.
The association between believing staying active is beneficial and achieving a clinically relevant functional improvement after 52 weeks: a prospective cohort study of patients with chronic low back pain in secondary care
Authors: Riis Allan , Karran Emma Louise , Thomsen Janus Laust , Jørgensen Anette , Holst Søren , Rolving Nanna
Published: January 2020

Background

According to clinical guidelines, advice to stay active despite experiencing pain is recommended to patients with non-specific low back pain (LBP). However, not all patients receive guideline-concordant information and advice, and some patients still believe that activity avoidance will help them recover. The purpose was to study whether guideline-concordant beliefs among patients and other explanatory variables were associated with recovery. The main aim was to investigate whether believing staying active despite having pain is associated with a better functional outcome.

Methods

This was a prospective cohort study involving adults with non-specific LBP referred from general practices to the Spine Centre at Silkeborg Regional Hospital, Denmark. Patients reported on their beliefs about the importance of finding the cause, the importance of diagnostic imaging, perceiving to have received advice to stay active, pain duration, pain intensity, and STarT Back Tool. Agreeing to: ‘An increase in pain is an indication that I should stop what I’m doing until the pain decreases’ adjusted for age, gender, and education level was the primary explanatory analysis. A 30% improvement in the Roland Morris Disability Questionnaire (RMDQ) score after 52 weeks was the outcome.

Results

816 patients were included and 596 (73.0%) agreed that pain is a warning signal to stop being active. Among patients not considering pain as a warning signal, 80 (43.2%) had a favourable functional improvement of ≥30% on the RMDQ compared to 201 (41.2%) among patients considering pain a warning signal. No difference was found between the two groups (adjusted P = 0.542 and unadjusted P = 0.629). However, STarT Back Tool high-risk patients had a less favourable functional outcome (adjusted P = 0.003 and unadjusted P = 0.002). Chronic pain was associated with less favourable functional outcome (adjusted P < 0.001 and unadjusted P < 0.001), whereas beliefs about finding the cause, diagnostic imaging, perceiving to have received advice to stay active, or pain intensity were not significantly associated with outcome.

Conclusions

Holding the single belief that pain is a warning signal to stop being active was not associated with functional outcome. However, patients characterised by having multiple psychological barriers (high-risk according to the STarT Back Tool) had a less favourable functional outcome.

Trial registration

Registered at ClinicalTrials.gov (registration number: NCT03058315), 20 February 2017.
Finally, a step forward in nomenclature of subchondral nonneoplastic bone lesions
Authors: Postma William Fulton , Micheaelson Evan , Keeling Laura
Published: January 2020

This paper is a commentary on the article entitled “Nomenclature of Subchondral Nonneoplastic Bone.

Lesions1” by Gorbachova, Amber, Beckmann, Bennett, Chang, Davis, Gonzalez, Hansford, Howe, Lenchik, Winalski, and Bredella. The purpose of this commentary is to provide an orthopaedic perspective on the aforementioned article and critique their analysis and proposal regarding nomenclature of subchondral bone lesions. It provides an overview and a section by section evaluation of a well-designed and executed article.
Production, purification and characterization of recombinant human R-spondin1 (RSPO1) protein stably expressed in human HEK293 cells
Authors: Levin Gabriel , Koga Bruna Andrade Aguiar , Belchior Gustavo Gross , Carreira Ana Claudia Oliveira , Sogayar Mari Cleide
Published: January 2020

Background

The R-Spondin proteins comprise a family of secreted proteins, known for their important roles in cell proliferation, differentiation and death, by inducing the Wnt pathway. Several studies have demonstrated the importance of RSPOs in regulation of a number of tissue-specific processes, namely: bone formation, skeletal muscle tissue development, proliferation of pancreatic β-cells and intestinal stem cells and even cancer. RSPO1 stands out among RSPOs molecules with respect to its potential therapeutic use, especially in the Regenerative Medicine field, due to its mitogenic activity in stem cells. Here, we generated a recombinant human RSPO1 (rhRSPO1) using the HEK293 cell line, obtaining a purified, characterized and biologically active protein product to be used in Cell Therapy. The hRSPO1 coding sequence was synthesized and subcloned into a mammalian cell expression vector. HEK293 cells were stably co-transfected with the recombinant expression vector containing the hRSPO1 coding sequence and a hygromycin resistance plasmid, selected for hygrorand subjected to cell clones isolation.

Results

rhRSPO1 was obtained, in the absence of serum, from culture supernatants of transfected HEK293 cells and purified using a novel purification strategy, involving two sequential chromatographic steps, namely: heparin affinity chromatography, followed by a molecular exclusion chromatography, designed to yield a high purity product. The purified protein was characterized by Western blotting, mass spectrometry and in vitro (C2C12 cells) and in vivo (BALB/c mice) biological activity assays, confirming the structural integrity and biological efficacy of this human cell expression system. Furthermore, rhRSPO1 glycosylation analysis allowed us to describe, for the first time, the glycan composition of this oligosaccharide chain, confirming the presence of an N-glycosylation in residue Asn137 of the polypeptide chain, as previously described. In addition, this analysis revealing the presence of glycan structures such as terminal sialic acid, N-acetylglucosamine and/or galactose.

Conclusion

Therefore, a stable platform for the production and purification of recombinant hRSPO1 from HEK293 cells was generated, leading to the production of a purified, fully characterized and biologically active protein product to be applied in Tissue Engineering.