bluuebunny/crossref_metadata_2025 huggingface dataset:
Soforolipídios
Authors: Cadorin Glauber , Tschurtschenthaler Costa Jairo , Mauri da Cunha Marcelo , De Souza Barros Mariana , Pelegrino Vieira Dirceu , Souza André
Published: January 2021

Soforolipídios são glicolipídios surfactantes produzidos por meio de processos fermentativos por algumas leveduras, caracterizando-se como substâncias compostas por um açúcar dimérico (soforose) ligado a um ácido graxo hidroxilado. As propriedades surfactantes dos soforolipídios (biosurfactantes) têm despertado interesse industrial, uma vez que a maioria dos surfactantes empregados na indústria originam-se do petróleo a partir de síntese química, apresentando processos de fabricação e subprodutos nocivos ao meio ambiente. Biosurfactantes possuem alta biodegrabilidade, baixa toxicidade e habilidade de serem produzidos a partir de substratos de baixo custo e renováveis. Desta forma, biocompostos obtidos por organismos vivos apresentam uma série de aplicações em diversos setores econômicos. Os soforolipídios podem ser utilizados na formulação de detergentes de lavanderia, na recuperação de solos e de águas contaminadas. Apresentam também aplicações potenciais na indústria de alimentos e na indústria de cosméticos, onde é utilizado por apresentar boa compatibilidade com a pele. Em relação as vias metabólicas envolvidas na síntese de biosurfactantes, estas dependem da natureza do substrato utilizado. Apesar da grande aplicabilidade dos biosurfactantes, existem alguns fatores negativos associados a sua produção, entre eles: alto custo da produção em larga escala, dificuldade na obtenção de substâncias puras, necessidade de formulação de meios de cultivos complexos, pouco conhecimento acerca da regulação da síntese de biosurfactantes e formação de espuma, impedindo o rendimento de produção e dificultando o processo fermentativo. Isso traz a necessidade do desenvolvimento de estudos para viabilizar e intensificar a utilização dessas substâncias em substituição aos compostos sintéticos contribuindo para uma economia mais sustentável.
Os impactos dos fatores antrópicos nas praias da área de proteção ambiental (APA) Costa Brava em Balneário Camboriú, Santa Catarina, Brasil.
Authors: Baptista Marina , Bernardes Débora
Published: January 2021

A região costeira abriga ecossistemas de relevância ambiental, econômica e social. Com o crescimento urbano e a ocupação desordenada, vem sendo registrada a crescente degradação destes ecossistemas, provocando impactos na paisagem e linha de costa. Visando identificar os fatores que atuam na vulnerabilidade das praias da unidade de uso sustentável da Área de Proteção Ambiental (APA) Costa Brava, aplicou-se duas metodologias onde, na primeira, analisou-se cinquenta e quatro variáveis que compuseram os índices geomorfológico-sedimentar; de incidência marinha; de incidência eólica; das características da cobertura vegetal e de pressão de uso antrópico. Na segunda metodologia avaliou-se sete variáveis: altura da vegetação; tipos de barreiras; tipos de praia; linha de costa erosiva e progressiva; elevação relativa do nível médio do mar; altura de arrebentação da onda e variação relativa da maré. Na primeira metodologia as praias do Estaleiro norte, Pinho e Taquarinhas, enquadraram-se na categoria de vulnerabilidade baixa a intermediária (Classe II – 0.30 < IV < 0.45), e as praias do Estaleirinho, Estaleiro sul, Taquaras e Laranjeiras, na categoria de vulnerabilidade intermediária a alta (Classe III – 0.45 < IV < 0.60). Pela segunda metodologia foi possível classificar as praias de Taquarinhas, Estaleirinho e Laranjeiras em baixa vulnerabilidade; Taquaras, Pinho e Estaleiro em média vulnerabilidade. As praias evidenciaram sinais de degradação por forçantes naturais que atuam intensamente na região, consequentemente a ação antrópica mostrou potencializar a vulnerabilidade das praias presentes na costa.
Structure and dynamical steady state of the peeling mode in edge-localized mode-free, high-confinement tokamak plasmas
Authors: Kamiya Kensaku , Itoh Kimitaka , Aiba Nobuyuki , Oyama Naoyuki , Honda Mitsuru , Isayama Akihiko
Published: January 2021

Explosive dynamical events in controlled-nuclear-fusion devices (known as edge-localized modes) display many similarities to solar-flare events on the sun, revealing a new connection between laboratory plasma physics and astronomy. However, to date there has been no direct evidence for the peeling mode structure, due to the lack of decisive diagnostics. Here we report the first evidence for the structure and dynamical steady state of a peeling mode for low-n edge-harmonic oscillations (EHOs) in the quiescent H-mode. EHOs are dominated by the fundamental mode (1fEHO) at both the low- and high-field sides. 1fEHO edge perturbations are confirmed to have kink parity and exhibit the frozen-in-condition predicted by a linear stability analysis. The envelope signal of the 1fEHO mode exhibits repeated cycles of growth and damping to the order of a few hundred Hz associated with small changes in an edge gradient, and results are quantitatively consistent with a limit-cycle-oscillation model.
Efficacy and Safety of Levamisole Treatment in Clinical Presentations of Patients With COVID-19: A Double-Blind, Randomized, Controlled Trial
Authors: Roostaei Amir , Meybodi Zohre Akhoundi , Mosavinasab Seyed Rohollah , Karimzadeh Iman , Sahebnasagh Adeleh , Gholinataj Mohsen , Saghafi Fatemeh
Published: January 2021

BackgroundIn late December 2019, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified as the cause of a series of pneumonia cases in China. Levamisole can show clinical benefits in management of COVID-19 by its immunomodulatory effect, but effect in clinical status of patients is unknown. We evaluated the efficacy of levamisole on clinical status of patients with COVID-19 on days 3, 7, and 14.MethodsThis prospective, double-blind, randomized, and controlled clinical trial was performed in 18- to 60-year-old patients with confirmed COVID-19 from late April 2020 to mid-August 2020. Patients were randomly assigned to two groups to receive a 5-day course of levamisole or placebo in combination with routine care. Results50 patients with COVID-19 were analyzed: 25 patients were in each group. More than half of the infected patients was men too (60%). On days 3 and 14, patients in Levamisole group had significantly better cough status distribution compared with Placebo (P=0.034 and 0.005, respectively). The difference in fever status on days 1, 3, 7, and 14 between two groups was not statistically significant (P > 0.05). There was significant differences between two groups in dyspnea over a median follow-up of 7th (P=0.015) and 14th (P=0.010) days after receiving the interventions. ConclusionThe results of the current study have overall demonstrated that patients receiving levamisole had significantly higher odds of having a better clinical status including cough and Dyspnea on day 14 than those receiving placebo, but with an effect-size of unsure clinical importance. The difference in the distribution of fever on days 3, 7, and 14 between two groups was not significant, suggesting that levamisole can efficiently improve the most clinical status of patients with COVID-19 infectious compared to placebo.Trial registration﻿The trial was registered as IRCT20190810044500N7 (19/09/2020).
Trends and Determinants of Catastrophic Health Expenditure in China 2010-2018: A National Panel Data Analysis
Authors: Liu Cai , Liu Zhao min , Nicholas Stephen , Wang Jian
Published: January 2021

Background: Catastrophic health expenditures (CHE) push households into poverty in China. We analyze the trends in incidence and intensity, and explore the determinants of CHE, and propose policy recommendation to address CHE.Methods: A unique 5-year national urban-rural panel database was constructed from China Family Panel Studies (CFPS) surveys. CHE incidence was measured by calculating headcount (percentage of households incurring CHE to the total household sample) and intensity was measured by overshoot (degree by which an average out of pocket health expenditure exceeds the threshold of the total sample). A linear probability model was employed to assess the trend in net effect of the determinants of CHE incidence and a random effect logit model was used to analyse the role of the characteristics of the household head, the household and household health utilization on CHE incidence.Results: CHE determinants vary across time and geographical location. From 2010 to 2018, the total, urban and rural CHE incidence all showed a decreasing tendency, falling from 14.7% to 8.7% for total households, 12.5% to 6.6% in urban and 16.8% to 10.9% in rural areas. CHE intensity decreased in rural (24.50% to 20.51%) and urban (22.31% to 19.57%) areas and for all households (23.61% to 20.15%). Inpatient services were the most important determinant of the incidence of CHE. For urban households, the random effect logit model identified household head (age, education, self-rated health); household characteristics (members 65+ years, chronic diseases, family size and income status); and healthcare utilization (inpatient and outpatient usage) as determinants of CHE. For rural areas, the same variables were significant with the addition of household head’s sex and health insurance.Conclusion: The incidence and intensity of CHE in China displayed a downward trend, but was higher in rural than urban areas. Costs of inpatient service usage should be a key point on intervention strategies to address CHE. The policy implications include improving the economic level of poor households, reforming health insurance and reinforcing pre-payment hospital insurance methods.
A Quantitative Evaluation of Empathy Using JSE-S Tool, Before and After a Medical Humanities Module, Amongst First-year Medical Students in Nepal
Authors: G.C. Krishna , Arjyal Amit , Douglas Amanda , Subedi Madhusudan , Gongal Rajesh
Published: January 2021

Background

Doctors’ empathy: the understanding of patients’ experiences, concerns and perspectives, is highly valued by patients yet often lacking in patient care. Medical humanities has been introduced within undergraduate curriculum to address this lack in empathy. There is a paucity of research on the impact of a course on medical humanities on the empathy of medical students, particularly in South Asia. Here we report on the impact of such an intervention in first-year medical students and aim to help outcome-based medical education and the evaluation and promotion of humanities within medical courses.
Methods

This study is a quantitative evaluation of student empathy before and after a Medical Humanities course. The study employs the Jefferson Scale of Empathy-Student version (JSE-S). Participants were first-year medical students at Patan Academy of Health Sciences, Nepal. All cohort students were invited to participate and written consent was obtained. Data were collected both prior-to and on-completion-of, a six-week Medical Humanities module. Pre- and post-module data were analyzed and the resulting empathy scores compared using the paired t-test or Wilcoxon Sign Rank test. Subgroup analysis was undertaken to determine the association of the score with gender and preferred future speciality.
Results

Sixty-two student responses were analyzed, 32 (52%) male. In the Pre-module scores females had a slightly higher mean score than males:108 and 103 respectively. Participants who preferred people-oriented specialities also scored higher than those preferring procedure and technology-oriented specialities: 107 and 103. There was a significant increase in mean score for the entire class from Pre-module to Post-module: 105 to 116, p-value of < 0.001. Mean scores rose from 103 to 116 in males, and from 108 to 116 in females. Participants preferring Procedure and Technology-Oriented specialities showed a significant increase in meanscores:103 to 117, and participants preferring People-Oriented specialities demonstrated a smaller increase:107 to 111.
Conclusion

This study provides evidence of the impact of a Medical Humanities course for increasing medical student empathy scores at an institution in Nepal. Teaching of Medical Humanities is an important contributor to the development of empathy in medical students and its widespread expansion in the whole of South Asia should be considered.
Clinical Features and Outcomes of Raoultella Terrigena Infections. A Single-center Experience from Karachi, Pakistan: A Retrospective Study
Authors: Ahmed Ishfaque , Nasir Nosheen , Jamil Bushra , Mahmood Syed Faisal
Published: January 2021

Objectives:Raoultella terrigena (formerly Klebsiella terrigena) is an environmental gram-negative rod. It may cause infections in humans, especially in the elderly and immunosuppressed patients. Moreover, this organism tends to be multi-drug resistant, limiting treatment options. Evidence on clinical presentation and outcomes of this infection is limited. We conducted this study to see its various clinical features, available treatment options, and associated clinical impacts of the R.terrigena infections. Methodology:We conducted a cross-sectional study on all adult patients with clinical specimens positive for Raoultella terrigena at a 700-bedded tertiary care hospital in Karachi, Pakistan, between January 2013 to December 2018. Results:There were 58 patients with R.terrigena in different cultures specimens identified. Amongst them n=12 (22.6%) were colonizers. The median age was 61.5 years (IQR=28), and most were male (60.9%). The most common infection site was the respiratory tract in 28.3%, followed by urinary tract infections, 26%, and central line-associated infections at 26.1%. Amongst infected cases, 37% were in septic shock, and of which 76.5% required vasopressors. 45.7% had respiratory failure requiring non-invasive ventilation in 47.6%, and mechanical ventilation in 52.4%. The previous history of multidrug-resistant organisms was present in 67.4% of patients and the history of prior antibiotics use within the last six months was present in 78.3%. 91.3% of isolates were resistant to piperacillin-tazobactam and meropenem, 65.2% were resistant to colistemethate. Eight patients lost to follow up. The majority of patients treated with combination therapy (n=31, 81.6%) and meropenem plus colistemethate was the most commonly used combination (n=11, 44%). The overall mortality rate was 44.7%. Conclusion: R.terrigena is a highly drug-resistant organism with a high mortality rate and causes hospital-acquired respiratory tract infections in most patients.
Arrival-Time Parametric Imaging in Contrast-Enhanced Ultrasound for Diagnosing Fibrosis in Primary Biliary Cholangitis
Authors: Yoshimine Naoyuki , Wakui Noritaka , Nagai Hidenari , Igarashi Yoshinori
Published: January 2021

Background: To investigate arrival-time parametric imaging (At-PI) in contrast-enhanced ultrasonography (CEUS) for diagnosing fibrosis in primary biliary cholangitis (PBC). Methods: Participants were 48 patients (male/female: 8/40; mean age, 60 ± 13 years) with PBC diagnosed by liver biopsy who underwent CEUS during 2009-2019. Of these, 27 (male/female: 4/23; mean age, 61 ± 13 years) who also underwent shear wave elastography (SWE) were further analyzed. SonazoidTM was intravenously injected and CEUS performed. Contrast dynamics of hepatic segment V and the right kidney were recorded. At-PI were generated from the recorded video clips. Contrast arrival time <5 s was displayed in red, and the ratio of red (ROR) area to the entire liver contrast-enhanced area was calculated. ROR and shear wave velocity (Vs) measured by SWE were compared by fibrosis stage (F0-F3), bile duct loss score, cholangitis activity, hepatitis activity (HA0-HA3), and disease stage (stage 1-4), as determined by liver biopsy.Results: ROR significantly differed between F0 and F2-F3 and between F1 and F2-3. Using ROR to diagnose ³F1 (³F2), area under the receiver operating characteristic curve (AUROC) was 0.77 (0.92) (cutoff, 36.7% [47.1%]; sensitivity, 0.75 [0.92]; specificity, 0.82 [0.81]). Vs significantly differed between F0 and F1, F0 and F2-3, and HA0 and HA1. For diagnosing ³F1 (³F2), Vs had AUROC of 0.84 (0.80) (cutoff, 1.23 m/s [1.40 m/s]; sensitivity, 0.75 [0.60]; specificity, 0.82 [0.86]).Conclusions: At-PI was useful for diagnosing fibrosis, especially F2 or worse, in PBC, suggesting that At-PI can correctly diagnose fibrosis regardless of hepatic inflammation.
Combination Inhibition Activity of Chlorhexidine and Antibiotics on Multidrug-Resistant Acinetobacter Baumannii in Vitro
Authors: Lin Fei , Yu Bin , Wang Qinghui , Yuan Mingyong , Ling Baodong
Published: January 2021

Background: Chlorhexidine is a widely used disinfectant in clinical settings and a broad-spectrum antimicrobial agent effective against aerobic and anaerobic bacteria. However, disinfectant resistant or non-susceptible bacteria, including antibiotic-resistant Acinetobacter baumannii, have been found. This study aimed to develop a new technique to prevent and control A. baumannii infection in the hospital setting. Methods: Chlorhexidine combined with minocycline, doxycycline, meropenem, imipenem, levofloxacin and ciprofloxacin were tested against the 30 multidrug-resistant and extremely drug-resistant A. baumannii clinical isolates. The checkerboard test was used to calculate the fractional inhibitory concentration index according to the minimum inhibitory concentration value for chlorhexidine combined with antibiotics. Results: The combination of chlorhexidine with minocycline, doxycycline, meropenem, or ciprofloxacin showed synergistic responses in all clinical isolates, and more than 50% of isolates showed FICI ≤ 0.5. However, chlorhexidine together with imipenem or levofloxacin showed indifferent responses in 10% and 3.33% clinical isolates, respectively. In all tests, combinations of chlorhexidine with each of the above six antibiotics showed synergistic and additive effects, and inhibited the clinical isolates.Conclusions: We concluded that, chlorhexidine combined with antibiotics could be used to control the risk of infection with A. baumannii.
Patterns of oxygen debt repayment in cardiogenic shock patients sustained with extracorporeal life support: a retrospective study
Authors: Ganushchak Yuri , Kurniawati Eva , Horst Iwan van der , Kuijk Sander van , Weerwind Patrick , Lorusso Roberto , Maessen Jos
Published: January 2021

Cardiogenic shock is the most frequent shock in cardiac intensive care, and cardiac dysfunction and sever hypoxia are often seen in critically ill patients. Inadequate organ and tissue perfusion and hypoxia result in anaerobic metabolism with hyperlactatemia and oxygen debt accumulation. However, the role of accumulated oxygen debt in course of cardiogenic shock and hypoxia is not clearly described. Here we first described the existence of several patterns of oxygen debt repayment in cardiogenic shock patients maintained by extracorporeal life support system. Oxygen debt was computed from the lactate concentration at five time points, covering the first 26 hours of ECLS. The patterns as the basic pathophysiological processes are independent from the cause of primary insult. The groups of patients classified to the specific patterns differed by survival rate from 51.5% to only 4.6%. It is very important that initial class does not predetermine the fate and can change in the course of treatment due to ‘between clusters migration’. We believe that our finding of patterns of oxygen debt repayment in cardiogenic shock patients may offer a new insights for a more rational, goal-directed treatment of such highly morbid conditions as hypoxia and cardiogenic shock.
Performance of A Metabolomic Biomarker Score Compared to Three Prognostic Scores in Chronic Heart Failure
Authors: McGranaghan Peter , Saxena Anshul , Düngen Hans-Dirk , Rubens Muni , Appunni Sandeep , Salami Joseph , Veledar Emir , Lacour Philipp , Blaschke Florian , Obradovic Danilo , Loncar Goran , Tahirovic Elvis , Edelmann Frank , Pieske Burkert , Trippel Tobias
Published: January 2021

The Cardiac Lipid Panel (CLP) is a novel panel of metabolomic biomarkers that has previously shown to improve the diagnostic and prognostic value for CHF patients. Several prognostic scores have been developed for cardiovascular disease (CVD) risk, but their use is limited to specific populations and precision is still inadequate. We compared a risk score using the CLP plus NT-proBNP to three commonly used risk scores: The Seattle Heart Failure Model (SHFM), Framingham Risk Score (FRS), and Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score. We included 280 elderly CHF patients from the Cardiac Insufficiency Bisoprolol Study in Elderly (CIBIS-ELD) trial. Cox Regression and hierarchical cluster analysis was performed. Integrated area under the curves (IAUC) was used as criterium for comparison. The mean (SD) follow-up period was 81 (33) months, and 95 (34%) subjects met the primary endpoint. The IAUC for FRS was 0.53, SHFM 0.61, MAGGIC 0.68, and CLP 0.78. Subjects were partitioned into three risk clusters: low, moderate, high with the CLP score showing the best ability to group patients into their respective risk cluster. A risk score composed of a novel panel of metabolite biomarkers plus NT-proBNP outperformed other common prognostic scores in predicting 10-year cardiovascular death in elderly ambulatory CHF patients. This approach could improve the clinical risk assessment of CHF patients.
Correlation between the geographical origin of Helicobacter pylori homB-positive strains and their clinical outcomes: a systematic review and meta-analysis
Authors: Karbalaei Mohsen , Keikha Masoud
Published: January 2021

Background
In general, all virulence factors of Helicobacter pylori (H. pylori) are involved in its infections. However, recent studies have shown that the homB gene is one of the virulence genes that affects the severity of the clinical results of this bacterium.
Methods
The main purpose of this study was to investigate the relationship between the presence of homB gene in H. pylori and the progression of its infection to peptic ulcer and gastric cancer. In the present study, we conducted a systematic search to collect all articles related to the effect of homB-positive strains on clinical outcomes. Finally 12 eligible studies according to our criteria were included in this meta-analysis and the effect of homB gene on gastric ulcer and gastric cancer diseases was evaluated by summary odds ratio.
Results
Current results showed that the homB-positive strains significantly increase the risk of peptic ulcer (OR: 1.36; 1.07–1.72 with 95% CIs), especially in western countries (OR: 1.61; 1.20–2.14 with 95% CIs). Moreover, we observed a positive association between the homB gene and risk of gastric cancer (OR: 2.10; 1.35–3.29 with 95% CIs). In addition, based on subgroup analysis, it was found that the presence of this gene in H. pylori strains increases the risk of gastric cancer in the Asian population (OR: 3.71; 1.85–7.45 with 95% CIs).
Conclusions
Overall, in the present study we found that homB gene is responsible for the progressing of primary infection to severe complications, in particular peptic ulcer in western countries and gastric cancer in Asian countries.
No Harmful Effects of Steroids in Severe Exacerbations of COPD Associated With Influenza
Authors: Studer Severin , Albrich Werner , Baty Florent , Rassouli Frank , Waldeck Frederike , Brutsche Martin
Published: January 2021

Background: COPD has large impact on patient morbidity and mortality worldwide. Acute exacerbations (AECOPD) are mostly triggered by respiratory infections including influenza. While corticosteroids are strongly recommended in AECOPD, they are potentially harmful during influenza. We aimed to evaluate if steroid treatment for AECOPD due to influenza may worsen outcomes.Methods: A retrospective analysis of a Swiss nationwide hospitalisation database was conducted identifying all AECOPD hospitalisations between 2012 and 2017. In separate analyses, outcomes concerning length-of-stay (LOS), in-hospital mortality, rehospitalisation rate, admission to intensive care unit (ICU), empyema and aspergillosis were compared between AECOPD during and outside influenza season; AECOPD with and without laboratory confirmed influenza; and AECOPD plus pneumonia with and without laboratory confirmed influenza. Results: Patients hospitalised for AECOPD during influenza season showed shorter LOS and fewer ICU admissions but higher rehospitalisation rates compared to those hospitalised outside influenza season. Patients with confirmed influenza infection had lower in-hospital mortality and rehospitalisation rates but higher risk for ICU admission than those without confirmed influenza. In patients with AECOPD plus pneumonia, there was a higher risk of ICU admission for those with laboratory-confirmed influenza compared to those without.Conclusions: Using different indicators for influenza as the likely cause of AECOPD, we found no consistent evidence of worse outcomes of AECOPD due to influenza. Assuming that most of these patients received corticosteroids, as it is accepted standard of care throughout Switzerland, this study provides important information and supports the current practice of using corticosteroids for AECOPD independent of the influenza status.
Effect of Intrauterine Recombinant Human Granulocyte Colony-stimulating Factor (rhG-CSF) Infusion on Pregnancy Outcomes in Patients With Repeated Implantation Failure During Freeze-Thaw Embryo Transfer Cycles: A Retrospective Cohort Study
Authors: Lyu Meng , Ma Xiaoling , Hu Junping , Zhan Hongjuan , Liu Lin
Published: January 2021

Background: Repeated implantation failure (RIF) is one of the difficulties that hinder the further improvement of clinical pregnancy rate by assisted reproductive technology. RIF has become an urgent clinical problem and hot research topic in the field of assisted reproduction, which is also a challenge for clinicians.Objective: The aim of this study was to evaluate the effects of intrauterine recombinant human granulocyte colony-stimulating factor(rhG-CSF) to improve implantation, clinical pregnancy, early abortion, multiple pregnancy and live birth rate(LBR) rate in women with RIF. Methods: A retrospective clinical analysis involving 142 women with RIF was conducted in the reproductive Medicine Center, the First Hospital of Lanzhou University between 1 January 2015 and 30 June 2018. They were divided into two groups: rhG-CSF group and control group, according to whether or not intrauterine rhG-CSF. In rhG-CSF group (n=47) granulocyte colony-stimulating factor (300 micrograms in 1 mL) was infused into the uterus within five minutes by embryo transfer cathete during the proliferative period of menstrual cycle before freeze-thaw embryo transfer(FET), while the control group was not given intrauterine perfusion. The implantation, clinical pregnancy, early abortion and multiple pregnancy were compared between the two groups. Results:The mean age for whole study group was 35.3±4.2 years old. There were no significant differences between demographic characteristics in two groups(p>0.05). The successful implantation (28.44% vs 12.44%, p=0.012), and clinical pregnancy (48.95% vs 27.35%, p=0.011) rates were significantly higher in the rhG-CSF group than in the control group. Binary logistic regression indicated that rhG-CSF treatment remained significantly associated with successful clinical pregnancy(OR=2.979, 95% CI=1.262-7.003).Conclusion: Intrauterine infusion of rhG-CSF can increase embryo implantation rate, clinical pregnancy rate in patients with RIF. In addition, the age and rhG-CSF are the independent risk factors affecting pregnancy outcomes.
Skeletal Muscle Area Is an Independent Predictor for Mortality in Elderly Patients With ANCA Associated Vasculitis
Authors: Zheng Xixi , Xia Peng , Li Jiaying , Zhang Gu-Mu-Yang , Yan Qin , Li Xuemei , Sun Hao , Chen Limeng
Published: January 2021

Objectives This study aims to investigate the relationship between baseline skeletal muscle area and infections or death in elderly AAV patients with renal involvement.Results A total of 57 AAV patients with renal involvement older than 65 years from a single center in China were enrolled. The mean age was 72.4 ±5.6 years. The baseline BVAS score was 17.04 ±4.40, and eGFR was 18.64 (7.63, 33.79) ml/min×1.73m2. Skeletal muscle area was calculated on CT at the third lumbar vertebra level. The mean muscle area was 102.68 ±24.41 cm2. After a median follow-up of 555 days, 29 patients experienced 36 episodes of severe infections. The median time to infection was 30 (15, 63) days. Ten patients died of infection, and two of fatal bleeding. The median time to death was 59 (26, 77) days. The muscle area correlates with age and BMI. Univariate Logistic regression showed that age (OR 1.11, P=0.044), muscle area (OR 0.97, P=0.008) and hsCRP (OR 1.01, P=0.017) were predictors of severe infection. In the multivariate Cox regression, muscle area (HR 0.97, P=0.022) independently predicted one-year mortality. Conclusion Elderly AAV patients have a high rate of infection and death during the first year following induction. Muscle area measured at L3 vertebrae level on non-contrast-enhanced CT is an independent predictor of 1-year infection and mortality.
T-Lymphocyte Subtyping: A Potential Diagnostic and Prognostic Indicator of Cytomegalovirus Infection in Sepsis Patients
Authors: Bai Guangxu , Wang Hao , Cui Na , Cheng Wei , Han Wen , Chen Jianwei
Published: January 2021

Background: This study aimed to investigate the use of T-lymphocyte subtyping as a diagnostic and prognostic marker for cytomegalovirus (CMV) infection in sepsis patients.Methods: We assessed T-lymphocyte subtyping and other commonly used clinical parameters in sepsis patients upon admission to the intensive care unit (ICU), and evaluated their potential impact on diagnosis and outcomes of CMV infection.Results: Among 599 sepsis patients, 82 were diagnosed with CMV infection. The 28-day mortality was significantly higher in CMV-infected than non-CMV-infected patients (20.7% vs. 9.9%). Both CD28+CD8+ and CD8+ T-cell counts could be combined with natural killer cell count, Acute Physiology and Chronic Health Evaluation II score, and immunoglobulin G as independent risk factors for CMV infection. Among 82 CMV-infected sepsis patients, 51 were assessed to have CMV-DNA negative conversion, while the other 31 were persistently positive for CMV DNA. The CD8+ and CD28+CD8+ T-cell counts were both independent risk factors for CMV-DNA negative conversion, with the latter having the better predictive ability. Lower CD28+CD8+ T-cell count was associated with higher 28-day mortality in CMV-infected sepsis patients. The CMV-DNA negative conversion and 28-day mortality of CMV-infected sepsis patients could be predicted using cutoff values of 151 (74.5% sensitivity and 87.1% specificity) and 64.5 (52.9% sensitivity and 92.3% specificity) CD28+CD8+ T cells/ml at ICU admission, respectively. Conclusions: Sepsis patients with CMV infection had higher 28-day mortality than those without CMV infection. CD28+CD8+ T-cell count was significantly higher in patients with CMV-DNA negative conversion than in those with persistently positive CMV DNA, and lower cell count was significantly associated with higher 28-day mortality. Therefore, CD28+CD8+ T-cell count may be a potential marker for early diagnosis of CMV infection and outcome prediction.Trial registration: Peking Union Medical College Hospital, registered at chictr.org.cn (identifier ChiCTR-ROC-17010750)
A Quantitative Risk Assessment to Evaluate the Efficacy of Mitigation Strategies to Reduce Highly Pathogenic Avian Influenza (HPAI) Virus, Subtype H5N1 (HPAI H5N1) in the Menoufia Governorate, Egypt
Authors: Elsobky Yumna , Nganwa David , Afandi Gamal El , Byomi Ahmed , Reddy Gopal , Abdalla Ehsan
Published: January 2021

BackgroundThe poultry industry in Egypt has been suffering from endemic highly pathogenic avian influenza (HPAI) virus, subtype H5N1 since 2006. However, the emergence of H9N2, H5N8, and H5N2 in 2011, 2016, and 2019 respectively, has aggravated the situation. Our objective was to evaluate how effective are the mitigation strategies by a Quantitative Risk Assessment (QRA) model utilizing daily outbreak data of HPAI-H5N1stratified by different epidemic waves from 2006 to 2016 are in Egypt. ResultsUtilizing the epidemiologic problem-oriented approach methodology, a conceptual scenario tree was drawn based on the knowledgebase. Monte Carlo simulations of QRA parameters were ran utilizing @Risk software. In poultry farms, the likelihood of poultry still having a high Prevalence Rate (PR) after failure of mitigation strategies such as vaccination, passive, and active surveillance, in 90% of the time, these mitigations will fail 48% of the time. Failure of efficacy of these mitigations will raise PR to 70% with missed vaccination, while failure in detection by surveillance will raise it to 99%. In backyard poultry, the likelihood of still having a high HPAI-H5N1 PR in three different poultry types due to failure of passive and active surveillance varies between domestic, mixed and reservoir. In mixed poultry, the probability of HPAI-H5N1 not detected by surveillance was higher with a mean and a SD of 16.8 x 10-3 and 3.26 x 10-01 respectively. The sensitivity analysis ranking for the likelihood of HPAI-H5N1 in poultry farms due to missed vaccination, failure to be detected by passive and active surveillance was examined. In poultry farms, increasing vaccination by 1 SD will decrease the PR by 14%, in active surveillance by 12% and in passive surveillance by 6%, respectively. while in backyard, the active surveillance had high impact in decreasing the PR by 16% in domestic poultry. Whereas the passive surveillance had less impact in decreasing PR by 14% in mixed poultry and 3% in domestic poultry. ConclusionIt could be concluded that the applied strategies were not efficient in controlling the spread of the HPAI-H5N1 virus. Public health officials should take into consideration the evaluation of their control strategies in their response.
Genome-Wide Detection of Allele Frequency Change and Quantitative Trait Loci for Respiratory Disease and Immune-Related Traits in Landrace Pigs Selected for Mycoplasmal Pneumonia of Swine Resistance
Authors: Uemoto Yoshinobu , Ichinoseki Kasumi , Matsumoto Toshimi , Oka Nozomi , Takamori Hironori , Kadowaki Hiroshi , Kojima-Shibata Chihiro , Suzuki Eisaku , Okamura Toshihiro , Aso Hisashi , Kitazawa Haruki , Satoh Masahiro , Uenishi Hirohide , Suzuki Keiichi
Published: January 2021

Background: The genetic improvement of disease resistance in pig has been well-received. Identification of a quantitative trait locus (QTL) related to a chronic respiratory disease such as Mycoplasmal pneumonia of swine (MPS) and immune-related traits is important for understanding the genomic background of disease resistance and to apply marker-assisted selection. The objective of this study was to understand the influence of genomic factors on respiratory disease and immune-related traits in MPS-selected pigs.Results: A total of 874 Landrace purebred pigs, which were selected based on MPS resistance, were genotyped using the Illumina PorcineSNP60 BeadChip, and were then used for genomic analyses. First, we performed genome-wide association studies (GWAS) to detect a novel QTL for a total of 22 performance, respiratory disease, and immune-related traits using additive and nonadditive genetic effects. Second, we evaluated the changes in allele frequency due to selection for MPS resistance and compared the putative selected regions with the detected QTL. GWAS detected a total of 11 genome-wide significant single nucleotide polymorphisms (SNPs) with an additive effect in five traits and a total of three significant SNPs with a nonadditive effect in three traits. Most of these detected QTL regions were novel regions with some candidate genes located in them. With regard to a pleiotropic region among traits, only five of these detected QTL regions overlapped among traits. Changes in allele frequencies at the many putative selected regions were spread across the whole genome and overlapped with the detected QTL. Some of these selected regions were the ones that contained the detected QTL for MPS score and other traits.Conclusion: These results suggest that a closed-line breeding population is a useful target population to refine and confirm QTL regions by integrating the results of GWAS and allele frequency changes. The study provides new insights into the genomic factors that affect respiratory disease and immune-related traits in pigs.
Blood and urinary cytokine balance and renal outcomes at cardiac surgery
Authors: McBride Willam , Kurth Mary Jo , Domanska Anna , Watt Joanne , McLean Gavin , Joseph Jijin , Lamont John , Fitzgerald Peter , Ruddock Mark
Published: January 2021

BACKGROUND
Increased perioperative pro-inflammatory biomarkers, renal hypoperfusion and ischemia reperfusion injury (IRI) heighten cardiac surgery acute kidney injury (CS-AKI) risk. Increased urinary anti-inflammatory cytokines attenuate risk. We evaluated whether blood and urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation, hypoperfusion and IRI are increased in CS-AKI patients.
METHODS
Preoperative and 24-hour postoperative blood and urinary pro-inflammatory and anti-inflammatory cytokines, blood VEGF and H-FABP (hypoperfusion biomarkers), and MK, a biomarker for IRI, were measured in 401 cardiac surgery patients. Pre- and postoperative concentrations of biomarkers and selected ratios thereof, were compared between non-CS-AKI and CS-AKI patients.
RESULTS
Compared with non-CS-AKI, blood pro-inflammatory (pre- and post-op TNFα, IP-10, IL-12p40, MIP-1α, NGAL; pre-op IL-6; post-op IL-8, MK) and anti-inflammatory (pre- and post-op sTNFsr1, sTNFsr2, IL-1RA) biomarkers together with urinary pro-inflammatory (pre- and post-op uIL-12p40; post-op uIP-10, uNGAL) and anti-inflammatory (pre- and post-op usTNFsr1, usTNFsr2, uIL-1RA) biomarkers, were significantly higher in CS-AKI patients. Urinary anti-inflammatory biomarkers, when expressed as ratios with biomarkers of inflammation (blood and urine), hypoperfusion (blood H-FABP and VEGF) and IRI (blood MK) were decreased in CS-AKI. In contrast, blood anti-inflammatory biomarkers expressed as similar ratios with blood biomarkers were increased in CS-AKI.
CONCLUSIONS
The urinary anti-inflammatory response may protect against the injurious effects of perioperative inflammation, hypoperfusion and IRI. These finding may have clinical utility in bioprediction and earlier diagnosis of CS-AKI and informing future therapeutic strategies for CS-AKI patients.
Zinc Oxide Nanoparticles Alleviate The Arsenic Toxicity and Decrease The Accumulation of Arsenic in Rice(Oryza Sativa L.)
Authors: Yan Shiwei , Wu Fan , Zhou Song , Yang Jianhao , Tang Xianjin , Ye Wenling
Published: January 2021

Background: Rice is particularly effective, compared to other cereals, at accumulating arsenic(As), a nonthreshold, class 1 human carcinogen in shoot and grain. Nano-zinc oxide is gradually used in agricultural production due to its adsorption capacity and as a nutrient element. An experiment was performed to explore the effects of zinc oxide nanoparticles (nZnO) on arsenic (As) toxicity and bioaccumulation in rice. Rice seedlings were treated with different levels of nZnO (0, 10, 20, 50, 100 mg/L) and As (0, and 2 mg/L) for seven days. Results:The research showed that 2 mg/L of As treatment represented a stress condition, which was evidenced by phenotypic images, seedling dry weight, chlorophyll, and antioxidant enzyme activity of rice shoot. The addition of nZnO (10-100 mg/L) enhanced the growth and photosynthesis of rice seedlings. As concentrations in the shoots and roots were decreased by a maximum of 40.7% and 31.6% compared to the control, respectively. Arsenite [As(III)] was the main species in both roots (98.5-99.5%) and shoots (95.0-99.6%) when exposed to different treatments. Phytochelatins (PCs) content up-regulated in the roots induced more As(III)-PC complexed and reduced As(III) mobility for transport to shoots by nZnO addition. Conclusion:The results confirmed that nZnO could improve rice growth and decrease As accumulation in shoots, and it performs best at a concentration of 100mg/L.
Simplified Matrix Focusing Imaging Algorithm for Ultrasonic Nondestructive Testing
Authors: Zhao Xinyu , Ma Zemin , Zhang Jiaying
Published: January 2021

Full matrix focusing method has been proved with the advantages of good signal-to-noise ratio and high-resolution image. However, it is still suffering from the problems of the time-consuming data acquisition and processing. In order to solve the problem, two kind simplified matrix focusing methods are provided in this paper. One is a triangular matrix focusing algorithm based on the principle of reciprocity for the multi-channel ultrasonic system. The other is a trapezoidal matrix focusing algorithm based on the energy weight of the different channel to the imaging area. In order to prove the validity of the provided algorithms, both side-drilled hole and oblique crack defects are used for the imaging comparation. The results show that the imaging quality of the triangular matrix focusing algorithm is basically consistent to that of the full matrix focusing method, and the imaging quality of the trapezoidal matrix focusing algorithm can be slightly reduced as the amount of multi-channel data decreases. In addition, both data acquisition and computational efficiency using the provided algorithms have been improved significantly.
Epidemiology of Skeletal Trauma and Skull Fractures in Children Younger Than 1 Year in Shenzhen: A Retrospective Study of 664 Patients
Authors: Deng Hansheng , Qiu Xin , Su Qiru , Zeng Shuaidan , Han Shuai , Li Shicheng , Cui Zhiwen , Zhu Tianfeng , Xiong Zhu , Tang Gen , Tang Shengping
Published: January 2021

Background: Unintentional injury is one of the top three causes of death for infants. However, the epidemiological studies of skeletal trauma and skull fractures in infants younger than 1 year were poorly understood in China. Therefore, our study aimed to examine accidental and emergency attendance in infants under 1 year. It also tried to determine the prevalence and severity of accident types in infants and to propose ways to reduce such accidents.Methods: A retrospective analysis was performed on the epidemiological characteristics of infants younger than 1 year with skeletal trauma and skull fractures who visited the Shenzhen Children's Hospital from 2016 to 2019. Their age, gender, fracture site and type, mechanism of injury, length of visit, length of hospital stay, hospitalization cost, and treatment methods were analyzed.Results: A total of 664 infants were included, the median age was 187days (IQR,90-273days), including 394 males and 270 females. The top three fracture sites were the skull (430 sites, 63.70%), long bones of the limbs (168 sites, 24.89%), and clavicle (53 sites, 7.85%). The top three causes of injury were locomotion injuries (256 cases, 38.55%), falls or trips (from beds, tables, chairs, etc.) (130 cases, 19.58%), and birth injuries (97 cases, 14.61%). The number of fracture cases was 101 in the 1-28d group (15.21%), which reached a trough of 29 cases in the 29-60d group (4.37%), and a peak of 190 cases (28.61%) in the 151-240d group. The interval between injury and visiting our hospital was ≤72h in 554 cases.Conclusion: Special attention should be given to the epidemiological characteristics of fractures in infants under 1 year of age, and appropriate outreach should be implemented. For example, health education should be provided especially for frequently occurring locomotion injuries, and prompt access to specialist medical care should be recommended for skull fractures, which are prone to delayed treatment. In addition, multidisciplinary collaboration should be implemented in trauma care, while also promoting the establishment of trauma centers in specialist children’s hospitals with a stronger capacity to treat pediatric trauma, and a regional system for pediatric trauma treatment.
Experiences and factors associated with transphobic hate crimes among transgender women in the San Francisco Bay Area: comparisons across race
Authors: Gyamerah Akua , Baguso Glenda , Santiago-Rodriguez Edda , Sa'id Aria , Arayasirikul Sean , Lin Jess , Turner Caitlin , Taylor Kelly , McFarland Willi , Wilson Erin , Wesson Paul
Published: January 2021

BackgroundTrans women experience high rates of gender-based violence (GBV). Little is understood about factors that shape transphobic hate crimes (a form of GBV) and racial/ethnic variation in these experiences. To contextualize GBV risk and police reporting, we examined self-reported types and correlates of transphobic hate crimes by racial/ethnic group of trans women in the San Francisco Bay Area.MethodsFrom 2016-2018, trans women participated in an HIV epidemiological study. Data analyses (N=629) examined self-reported experiences of transphobic hate crimes by race/ethnicity, and whether hate crimes were reported to the police. Chi-square tests and simple logistic regression examined sociocultural and gender identity factors associated with transphobic violence experiences and police reporting. ResultsAbout 45.8% of participants reported ever experiencing transphobic hate crime; only 48.9% of these were reported to the police. Black (47.9%) and Latina (49.0%) trans women reported a higher prevalence of battery with a weapon; White (26.7%) and trans women of “other” race/ethnicities (25.0%) reported a higher prevalence of sexual assault (p=0.001). Having one’s gender questioned, history of sex work, homelessness as a child and adult, and a history incarceration were associated with higher odds of experiencing transphobic hate crime. Trans women who felt their gender identity questioned had lower odds of reporting a hate crime to the police compared to those did not feel questioned. ConclusionsA high proportion of trans women experienced transphobic hate crime, with significant socio-structural risk factors and racial differences by crime type. However, crimes were underreported to the police. Interventions that address structural factors can yield violence prevention benefits.