bluuebunny/crossref_metadata_2025 huggingface dataset:
The Deep Structure and Rheology of a Plate Boundary-Scale Shear Zone: Constraints from an Exhumed Caledonian Shear Zone, NW Scotland
Authors: Lusk Alexander D. J. , Platt John P.
Published: September 2020

Below the seismogenic zone, faults are expressed as zones of distributed ductile strain in which minerals deform chiefly by crystal plastic and diffusional processes. We present a case study from the Caledonian frontal thrust system in northwest Scotland to better constrain the geometry, internal structure, and rheology of a major zone of reverse-sense shear below the brittle-to-ductile transition (BDT). Rocks now exposed at the surface preserve a range of shear zone conditions reflecting progressive exhumation of the shear zone during deformation. Field-based measurements of structural distance normal to the Moine Thrust Zone, which marks the approximate base of the shear zone, together with microstructural observations of active slip systems and the mechanisms of deformation and recrystallization in quartz, are paired with quantitative estimates of differential stress, deformation temperature, and pressure. These are used to reconstruct the internal structure and geometry of the Scandian shear zone from ~10 to 20 km depth. We document a shear zone that localizes upwards from a thickness of >2.5 km to <200 m with temperature ranging from ~450–350°C and differential stress from 15–225 MPa. We use estimates of deformation conditions in conjunction with independently calculated strain rates to compare between experimentally derived constitutive relationships and conditions observed in naturally-deformed rocks. Lastly, pressure and converted shear stress are used to construct a crustal strength profile through this contractional orogen. We calculate a peak shear stress of ~130 MPa in the shallowest rocks which were deformed at the BDT, decreasing to <10 MPa at depths of ~20 km. Our results are broadly consistent with previous studies which find that the BDT is the strongest region of the crust.
Catheter Ablation or Surgical Therapy in Moderate-Severe Tricuspid Regurgitation Caused by Long-standing Persistent Atrial Fibrillation. Propensity Score Analysis 
Authors: Wang Jiangang , Li Songnan , Ye Qing , Ma Xiaolong , Zhao Yichen , Han Jie , Li Yan , Zheng Shuai , Liu Kemin , He Meng , Yu Wen , Sun Junhui , Meng Xu
Published: September 2020

Background This study aimed to describe the mid-term outcomes of different treatments in patients with atrial fibrillation caused tricuspid regurgitation.Methods A retrospective study of patients diagnosed as atrial fibrillation caused moderate-severe tricuspid regurgitation undergoing ablation (n = 411) were reviewed. The surgical cohort (n = 114) underwent surgical ablation and tricuspid valve repair; the catheter cohort (n = 279) was selected from those patients who had catheter ablation. Results The estimated actuarial 5-year survival rates were 96.8% (95% CI: 92.95-97.78) and 92.0% (95% CI: 85.26-95.78) in the catheter and surgical cohort, respectively. Tethering height was showed as independent risk factors for recurrent atrial fibrillation and tricuspid regurgitation in both cohorts. A matched group analysis using propensity-matched was conducted after categorizing total patients by tethering height < 6mm and ³ 6mm. Kaplan–Meier analysis showed in patients with tethering height < 6mm, there were no differences in survival from mortality, stroke, recurrent atrial fibrillation and tricuspid regurgitation between two groups. In patients with tethering height ³ 6mm, there were significantly higher cumulative incidence of stroke (95% CI, 0.047–0.849; P = 0.029), recurrent atrial fibrillation (95% CI, 0.357–09738; P = 0.039) and tricuspid regurgitation (95% CI, 0.359–0.981; P = 0.042) in catheter group.Conclusions Atrial fibrillation caused tricuspid regurgitation resulted in less leaflets coaptation, which risk the recurrence of atrial fibrillation and tricuspid regurgitation. Patients whose tethering height was less than 6mm showed satisfying improvement in tricuspid regurgitation with the restoration of sinus rhythm after catheter ablation. However, in patients with severe leaflets tethering, the results favored surgical over catheter.
In vitro resynthesis of lichenization reveals the genetic background of symbiosis-specific fungal-algal interaction in Usnea hakonensis.
Authors: Kono Mieko , Kon Yoshiaki , Ohmura Yoshihito , Satta Yoko , Terai Yohey
Published: September 2020

Background: Symbiosis is central to ecosystems and has been an important driving force of the diversity of life. Close and long-term interactions are known to develop cooperative molecular mechanisms between the symbiotic partners and have often given them new functions as symbiotic entities. In lichen symbiosis, mutualistic relationships between lichen-forming fungi and algae and/or cyanobacteria produce unique features that make lichens adaptive to a wide range of environments. Although the morphological, physiological, and ecological uniqueness of lichens has been described for more than a century, the genetic mechanisms underlying this symbiosis are still poorly known.Results: This study investigated the fungal-algal interaction specific to the lichen symbiosis using Usnea hakonensis as a model system. The whole genome of U. hakonensis, the fungal partner, was sequenced by using a culture isolated from a natural lichen thallus. Isolated cultures of the fungal and the algal partners were co-cultured in vitro for three months, and thalli were successfully resynthesized as visible protrusions. Transcriptomes of resynthesized and natural thalli (symbiotic states) were compared to that of isolated cultures (non-symbiotic state). Sets of fungal and algal genes up-regulated in both symbiotic states were identified as symbiosis-related genes.Conclusion: From predicted functions of these genes, we identified genetic association with two key features fundamental to the symbiotic lifestyle in lichens. The first is establishment of a fungal symbiotic interface: (a) modification of cell walls at fungal-algal contact sites; and (b) production of a hydrophobic layer that ensheaths fungal and algal cells;. The second is symbiosis-specific nutrient flow: (a) the algal supply of photosynthetic product to the fungus; and (b) the fungal supply of phosphorous and nitrogen compounds to the alga. Since both features are widespread among lichens, our result may indicate important facets of the genetic basis of the lichen symbiosis.
CT, US and MRI of Xanthine Urinary Stones: In-Vitro and In-Vivo Analyses
Authors: Shamir Stephanie , Peng Qi , Schoenfeld Alan , Drzewiecki Beth , Liszewski Mark
Published: September 2020

Background: Xanthine urinary stones are a rare entity that may occur in patients with Lesch-Nyhan Syndrome receiving allopurinol. There is little literature describing imaging characteristics of these stones, and the most appropriate approach to imaging these stones is therefore unclear. We performed in-vitro and in-vivo analyses of xanthine stones using computed tomography (CT) at different energy levels, ultrasound (US), and magnetic resonance imaging (MRI). Methods: Five pure xanthine stones from a child with Lesch-Nyhan were imaged in-vitro and in-vivo. CT of the stones was performed at 80kVp, 100kVp, 120kVp and 140kVp and CT numbers of the stones were recorded in Hounsfield units (HU). US of the stones was performed and echogenicity, acoustic shadowing and twinkle artifact were assessed. MRI of the stones was performed and included T2-weighted, ultrashort echo-time (UTE)-weighted and T2/T1-weighted 3D bFFE sequences and signal was assessed. Results: In-vitro analysis on CT demonstrated that xanthine stones were radiodense and the average attenuation coefficient did not differ with varying kVp, measuring 331.0+/-51.7HU at 80kVp, 321.4+/-63.4HU at 100kVp, 329.7+/-54.2HU at 120kVp and 328.4+/-61.1HU at 140kVp. In-vivo analysis on CT resulted in an average attenuation of 354+/-35HU. On US, xanthine stones where echogenic with acoustic shadowing and twinkle artifact. On MRI, stones lacked signal on all tested sequences.Conclusion: Xanthine stone analyses, both in-vitro and in-vivo, demonstrate imaging characteristics typical of most urinary stones: dense on CT, echogenic on US, and lacking signal on MRI. Therefore, the approach to imaging xanthine stones should be comparable to that of other urinary stones.
The effect of dexmedetomidine with bupivacaine combination and only bupivacaine on sensory and motor block time and pain score in supraclavicular block
Authors: Sane Shahryar , Shokouhi Shahram , Golabi Parang , Rezaeian Mona , Haki Behzad Kazemi
Published: September 2020

Background: This study was designed to assess the effect of dexmedetomidine on the effect of dexmedetomidine with bupivacaine combination and only bupivacaine on sensory and motor block time, pain score, and hemodynamic variations in supraclavicular block in upper extremity orthopedic surgery.Methods: This prospective double-blind study was performed on 60 patients aged 20-60 years who were candidates for upper extremity orthopedic surgeries. The sensory block was evaluated using the pinprick method and motor block by the modified Bromage scale method. The post-operative pain was assessed by a visual analog scale. Results: The mean onset time of sensory and motor block in patients receiving bupivacaine alone was respectively 31.03± 9.65 min and 24.66 ± 9.2 min and in the dexmedetomidine receiving group was about 21.36±8.34 min and 15.93 ± 6.36 minutes. The changes in heart rate and mean arterial blood pressure was similar in both groups. The duration of sensory and motor block and the time of the first analgesia request in the intervention group were longer. Postoperative pain was lower in the intervention group for 24 hours (P = 0.001).Conclusion: The use of dexmedetomidine plus bupivacaine, without side effects, reduced the onset time of sense and motor blocks and increased the duration of numbness and immobility. Also, dexmedetomidine reduced postoperative pain significantly in use with bupivacaine for supraclavicular blocks.Trial registration: IRCT, IRCT20160430027677N15. Registered 05/28/2019, http:// https://www.irct.ir/trial/39463
Clinicopathological Characteristics and Endoscopic Features of Early Gastric Cancers Diagnosed After Helicobacter pylori Eradication: A Retrospective Study
Authors: Ishibashi Hideki , Takedatsu Hidetoshi , Tanabe Taro , Imakiire So , Matsuoka Hiroki , Yasuda Hideki , Sakisaka Hideto , Matsuoka Satoshi , Kayashima Yoshiyuki , Kuno Nobuaki , Abe Koichi , Funakoshi Sadahiro , Hirai Fumihito
Published: September 2020

Background: Helicobacter pylori (H. pylori) infection is an important risk factor for developing gastric cancer. However, even after H. pylori eradication, early gastric cancer (EGC) can develop. We elucidated the characteristics of EGCs diagnosed after H. pylori eradication. Methods: Thirty-six EGCs in 32 patients diagnosed after H. pylori eradication were defined as the eradication group (H. pylori-EG). The clinicopathological and endoscopic features were compared with those of 156 EGCs in 140 patients in the H. pylori-positive group (H. pylori-PG). Twenty-nine EGC lesions in the H. pylori-EG were further divided into two subgroups: the first included six lesions of no to mild atrophic mucosa around the EGC, and the second included 23 lesions of moderate to severe atrophic mucosa around the EGC. We compared them between the two subgroups. Results: Endoscopic features of EGCs in the H. pylori-EG were characterized as small (P = 0.049) and of the depressed type (P = 0.022) compared with those in the H. pylori-PG. EGCs in the H. pylori-EG were detected in the upper region of the stomach more frequently than those in the H. pylori-PG (P = 0.002). Submucosal ECGs in the H. pylori-EG were more likely to be seen in the no to mild atrophic mucosa subgroup (4/6, 67%) compared with the moderate to severe atrophic gastric mucosa subgroup (1/23, 4%) (P = 0.003). Conclusions: Careful follow-up endoscopies are necessary after H. pylori eradication.
The association of serum gamma-glutamyltransferase and the incidence of type 2 diabetes mellitus based on propensity score matching: a retrospective observational cohort study
Authors: Dong Buyuan , Ji Ziwei , He Leye , Chen Hao , Chen Mengxia , Feng Qian , Jin Rong , Hu Sunkuan
Published: September 2020

Background: Previous studies reported that gamma-glutamyltransferase (GGT) may play an important role in the development of diabetes. The purpose of this study is to demonstrate that GGT is an independent risk factor for diabetes and to explore whether the association between GGT and the incidence of diabetes is affected by age and gender in the general Japanese population.Methods: This study is a retrospective observational cohort study. The study included 15464 men and women with an average age of 43.71 years from the Japanese health checkup program at Murakami Memorial Hospital from 2004 to 2015. The serum gamma-glutamyltransferase was stratified by quartiles. Patients were stratified by gender and age. Results: After adjusting for potential confounders, each additional standard deviation (SD) of GGT increases the risk of diabetes by 9%. The hazard ratio (HR) is 1.09 and the confidence interval (CI) is (1.01, 1.17). Participants in the fourth quartiles (Q4,≥ 22IU/L) had a higher risk of diabetes than the first to third quartiles (Q1-Q3) of GGT (HR: 1.47, 95 % CI: 1.15-1.87). Compared with males with lower GGT activity, males aged 40 to 50 years with GGT activity in the fourth quantile had a 53% increased risk of diabetes mellitus. Conclusions: GGT was positively correlated with the incidence of diabetes in the Japanese population. Especially in males aged 40-50 y, the higher the GGT, the higher the risk of developing diabetes.
Wolbachia infection in wild mosquitoes (Diptera: Culicidae): implications for transmission modes and host-endosymbiont associations in Singapore
Authors: Ding Huicong , Yeo Huiqing , Puniamoorthy Nalini
Published: September 2020

Background: Wolbachia is an intracellular bacterial endosymbiont found in most insect lineages. In mosquitoes, the endosymbiont’s influence on host reproduction and arboviral transmission has spurred numerous studies aimed at using Wolbachia-infection as a vector control technique. However, there are several knowledge gaps in the literature and little is known about natural Wolbachia infection across species, transmission modes as well as the associations between various Wolbachia lineages and their hosts. This study aims to address these by exploring mosquito-Wolbachia associations and their evolutionary implications.Methods: We conducted tissue-specific PCR screening for Wolbachia infection in the leg, gut and reproductive tissues of wild mosquitoes from Singapore using the Wolbachia surface protein (wsp) molecular marker. Mosquito-Wolbachia associations were explored using three methods – a tanglegram, distance-based, and event-based method, and inferred instances of vertical transmission and host shifts.Results: Adult mosquitoes (271 specimens) representing 14 genera and 40 species were screened for Wolbachia. Overall, 21 species (51.2%) were found positive for Wolbachia, including Aedes (5 species) and Culex (5 species). Seven out of the 21 infected species were not previously reported: Aedes nr. fumidus, Aedes annandaelei, Uranotaenia obscura, Uranotaenia trilineata, Verrallina butleri, Verrallina sp., and Zeugnomyia gracilis. Wolbachia was predominantly detected in the reproductive tissues, an indication of vertical transmission. Despite this, Wolbachia infection rates vary widely within a mosquito host species. There is no clear signal of co-phylogeny between the mosquito hosts and the twelve putative Wolbachia strains observed in this study. Host shift events were also observed.Conclusions: Our results suggest that the mosquito-Wolbachia relationship is complex and that a combination of transmission modes and multiple evolutionary events likely explain the distribution of Wolbachia diversity observed across mosquito hosts. This has implications towards understanding Wolbachia’s diversity, ecology, and utility as a biocontrol method.
Characteristics of patients who access zero, one or multiple General Practices and reasons for their choices: a study in regional Australia.
Authors: Glenister Kristen Maree , Guymer John , Bourke Lisa , Simmons David
Published: September 2020

Background: Most people in Australia visit a General Practitioner each year and are free to choose their General Practitioner and/or practice on each occasion. A proportion of people visit multiple general practices, which can reduce continuity of care, a core value of general practice. Utilisation of multiple general practices is associated with metropolitan residence and younger age. However, it is unclear which factors are associated with utilisation of multiple general practices in rural areas, where there are often General Practitioner workforce shortages and higher proportions of patients who may benefit from continuity of care such as older people or those with chronic disease. The aim of this study was to compare the characteristics of people in a rural Australian area who accessed multiple general practices in the previous year with people who had accessed one practice or none.Methods: A cross-sectional survey assessed self-reported utilisation and perspective of general practice services, uses of multiple practices, associated reasons, lifestyle advice and screening services received in four regional Victorian towns. Households were randomly selected and residents aged 16+ were eligible to participate in the adult survey.Results: Most people had attended a single general practice (78.9%), while 14.4% attended more than one practice and 6.7% attended no practices in the previous 12 months. Compared with utilisation of a single general practice, multiple general practice attendance in the previous year was associated with younger age (adjusted odds ratio (aOR 95% confidence interval) 0.98 per year (0.97-0.99), residence in the regional centre aOR 2.90(2.22-3.78), emergency department (ED) attendance in the last 12 months aOR 1.65(1.22-2.21) and no out of pocket costs aOR 1.36(1.04-1.79)). Reasons for multiple general practice attendance were reported as availability of appointments, cost and access to specific services. Compared with multiple general practice attendance, those attending single practices reported more screening tests but similar frequency of lifestyle advice. People who accessed multiple practices were less likely to report very high satisfaction (51.7% vs 62.9% p<0.001) or excellent degree of confidence in their doctor (42.0% vs 49.8% p=0.006) than single practice attendees.Conclusions: Those attending single practices report higher satisfaction and confidence in their GP and were less likely to attend ED. Further studies are required to test whether increasing availability of appointments and reducing out-of-pocket expenses would increase single practice attendance and/or decrease healthcare costs overall.
Association between circulating microRNAs 486, 146b and 15b and serum betatrophin levels in obese; type 2 diabetic and non-diabetic children
Authors: Mohany khalid Mohammad , Alrugaie Osamah , Alwutayd Osama , Al-Nafeesah Abdullah , Saleem Tahia H.
Published: September 2020

Background: This study tested the association between serum levels of microRNA-486, -146b and -15b and betatrophin in normal and obese children with/without type 2 diabetes mellitus (T2DM).Methods: the study included 120 children; divided into three groups: G1 (50 healthy), G2 (35 obese) and G3 (35 obese with T2DM). The levels of microRNA-486, 146b and 15b and serum betatrophin were measured by their corresponding methods. Results: serum microRNA-486, -146b, -15b and betatrophin levels were significantly high in G3 followed by G2 then G1 (p=0.002, > 0.001, > 0.001, and > 0.001, respectively). Especially in G3, these levels correlated positively with the BMI percentile (r=0.44, 0.58, 0.38, and 0.46, p=0.007, > 0.001, 0.021, and 0.005, respectively), serum glucose (r=0.56, 0.49, 0.82, 0.60, and 0.42, p > 0.001, 0.003, > 0.001, and > 0.001, respectively) and HbA1c% (r=0.56, 0.39, 0.66, and 0.42, p > 0.001, 0.019, > 0.001, and 0.032, respectively) while, showed negative correlations with correlated with serum insulin levels (r=-0.37, -0.42, -0.58, and -0.41, p=0.021, 0.012, > 0.001 and 0.013, respectively) and with serum C-peptide levels (r=-0.76, -0.50, -0.35 and -0.42, p > 0.001, 0.002, 0.036 and 0.011, respectively). Serum betatrophin levels correlated positively with microRNA-486, -146b and -15b levels in G2 (r=0.35, 0.80, and 0.67, p= 0.036, > 0.001, and, > 0.001, respectively), and in G3 (r=0.57, 0.36, and 0.38, p > 0.001, 0.029 and, 0.023, respectively). Conclusions: Circulating microRNA-486, 146b and 15b increase significantly in obese children with T2DM and these levels correlate positively with serum betatrophin levels. Further studies are required to test the role of targeting of these microRNAs and betatrophin in the timely management of obesity and/or T2DM in children.
Promoting Sustainable Physical Activity Among Iranian Middle-Aged Women: An Interventional Study
Authors: Shariati Mohammad , Astaneh Houra Pourrajabali , Khedmat Leila , Khatami Farnaz
Published: September 2020

Background: The physical inactivity can enhance the risk of adverse health conditions such as non-communicable diseases, morbidity, and mortality among middle- and older-aged population. This study aimed to design, implement, and evaluate a conceptual model of physical activity (PA) promotion among Iranian middle-aged women (IMGW). Methods: An interventional study with 80 women aged 30-59 years in intervention and control groups was conducted in 2018-2019. The subjects referred to health centers were selected by the available convenience sampling method. The data collection tools including face-to-face interviews, body mass index (BMI) measurements, the four-question form of PA vital signs in the framework of the Iran's Package of Essential Non-communicable (IraPEN) program, and the questionnaire based on Health Belief Model (HBM) constructs were used to assess the IMGW' PA level (metabolic equivalent tasks (MET)-min/week). Results: The intervention led to a three-fold increase in the average PA (from 280.63 to 927.70 MET-min/week) of the intervention group. Although there was no significant difference in the BMI between both the groups before the intervention, this educational program decreased the mean BMI from 30.36 to 28.83 kg/m2 (p=0.01). The HBM-based perceived sensitivity/severity and self-efficacy values after the intervention were increased from 62.09 to 71.03% and from 27.01 to 83.15%, respectively (p<0.0001). No significant difference in the cue to action and perceived benefits and barriers after the intervention was found. Conclusion: The developed model through increasing the motivation of IMGW could remarkably improve the PA level with a decrease in their BMI.Trial register: Iranian Registry of Clinical Trials (IRCT): IRCT20200717048124N1 at 2020-08-05, retrospectively registered.
Self-poisoning with pesticides in Jiangsu Province, China: a cross-sectional study on 24,602 subjects
Authors: Wang Boshen , Han Lei , Wen Jinbo , Zhang Juan , Zhu Baoli
Published: September 2020

Background: With an estimated >800,000 suicide-related deaths and potentially several attempts for each death in the world. The purpose of this study was to determine the epidemiological characteristics of self-poisoning with pesticides within the Jiangsu province in China. Methods: Suicide rate was calculated the Routine Surveillance System by Jiangsu Provincial Center for Disease Control and Prevention, stratified by gender, age and region, combined with socioeconomic and agriculture-related factors to investigate trends in suicide over the study period. A logistic regression model was used to investigate the associations between pesticide types and pesticide-related deaths. Results: In recent years, Jiangsu Province has witnessed a decrease in pesticide self-poisoning cases and consequent deaths. Among all suicides by deliberate ingestion of pesticides, the proportion of cases were mainly in the age 40, accounting for 3.43% of all cases with pesticide suicide. The proportion of suicide due to pesticide poisoning in females was markedly higher than that in males ( p <0.001). Suicide using organophosphate and carbamate insecticides was most common, with 10,303 reported cases accounting for 42.02% of all suicides.Conclusions: For national responses to be effective, the characteristics of pesticide suicides should be comprehensively investigated for the formulation of corresponding prevention strategies. At present, more pesticide suicide prevention policies for the elderly people and women should be implemented, and stronger pesticide management policies should be implemented for rural areas.
Clinical Variables Responsible for Early and Late Diagnosis of Foreign Body Aspiration in Pediatrics Age Group
Authors: Goyal Samarth , Jain Shubhika , Rai Guruprasad , Vishnu Rajkamal , Kamath Ganesh Sevagur , Bishnoi Arvind Kumar , Gaude Yogesh , Kumara Vijaya , Joshi Harshil , Reddy Revanth
Published: September 2020

Background: Incidence of foreign body aspiration has been noticed predominantly in age group ranging from 12 months-3 years. Foreign body in the trachea is a medical emergency as presentation is in respiratory distress. Obstruction of only one main or distal bronchus, leads to severe cough, choking sensation and breathlessness. Without early intervention, it can lead to collapse, consolidation and pneumonia of the affected lung. Methods: We retrospectively analyzed 37 pediatric case records who presented from January 2014-December 2018 with foreign body aspiration. Our primary aim was to assess the parameters responsible for early and late diagnosis of foreign body aspiration. We concluded with a diagnostic algorithm for management of foreign body aspiration on the basis of this outcome.Results: Around 32.5% came with a history of aspiration, 43% were referred from the primary centers with a suspicion for the same and the rest came to our tertiary care hospital directly. Those who presented within a week came with complaints of wet cough, wheeze and tachypnea. Furthermore, those who came in after a week had a dry cough and fever as their main complaint. Majority of ingested foreign bodies was a vegetative type (80%) as compared to the non –vegetative.Conclusion: Unlike adults, foreign body aspiration in children is most commonly diagnosed on history, suspicion and clinical findings. Chest x ray has been the primary investigation of choice but in the majority of the cases it was normal with subtle changes. Early diagnosis is the key to avoid complication.
A cohort study to identify risk factors for malaria in Burkinabe children: implications for other high burden high impact countries
Authors: Yaro Jean Baptiste , Ouedraogo Alphonse , Ouedraogo Z Amidou , Diarra Amidou , Lankouande Malik , Agboraw Efundem , Worrall Eve , Toe Kobié Hyacinthe , Sanou Antoine , Guelbeogo W Moussa , Sagnon N’Fale , Ranson Hilary , Tiono Alfred B. , Lindsay Steven W , Wilson Anne L
Published: September 2020

Background: Progress in controlling malaria has stalled in recent years. Today the malaria burden is increasingly concentrated in a few countries, including Burkina Faso, where malaria is not declining. We carried out a cohort study to identify risk factors for malaria infection in children in south-west Burkina Faso, an area with high insecticide-treated net (ITN) coverage and insecticide-resistant vectors.Methods: Incidence of Plasmodium falciparum infection was measured in 252 children aged 5 to 15 years, using active and passive detection, during the 2017 transmission season, following clearance of infection. Demographic, socioeconomic, environmental and entomological risk factors, including use of ITNs and insecticide resistance were monitored.Results: During the six-month follow-up period, the overall incidence of P. falciparum infection, was 2.78 episodes per child (95% CI= 2.66-2.91) by microscopy, and 3.11 (95% CI= 2.95-3.28) by polymerase chain reaction. The entomological inoculation rate (EIR) was 80.4 infective bites per child over the six-month malaria transmission season. At baseline, 80.6% of children were reported as sleeping under an ITN the previous night, although at the last survey, 23.3% of nets were in poor condition and considered no longer protective. No association was found between the rate of P. falciparum infection and either EIR (Incidence Rate Ratio, IRR: 1.00, 95% CI: 1.00–1.00, p=0.08) or mortality in WHO tube tests when vectors were exposed to 0.05% deltamethrin (IRR: 1.05, 95% CI: 0.73–1.50, p=0.79). Travel history (IRR: 1.52, 95% CI: 1.45–1.59, p<0.001) and higher socio-economic status were associated with an increased risk of P. falciparum infection (IRR: 1.05, 95% CI: 1.00–1.11, p=0.04).Conclusions: Incidence of P. falciparum infection remains overwhelmingly high in the study area. Our findings suggest that because of the exceptionally high levels of malaria transmission in the study area, malaria elimination cannot be achieved solely by mass deployment of ITNs and additional control measures are needed.
Diagnostic value of [18F]FDG PET/MRI for staging in patients with ovarian cancer
Authors: Tsuyoshi Hideaki , Tsujikawa Tetsuya , Yamada Shizuka , Okazawa Hidehiko , Yoshida Yoshio
Published: September 2020

Purpose: To evaluate the diagnostic potential of PET/MRI with 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) in ovarian cancer.Materials and Methods: Participants comprised 103 patients with suspected ovarian cancer underwent pretreatment [18F]FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI). Diagnostic performance of [18F]FDG PET/MRI and ceMRI for assessing the characterization and the extent of the primary tumor (T stage) and [18F]FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis.Results: Accuracy for the characterization of suspected ovarian cancer was significantly better for [18F]FDG PET/MRI (92.5%) [95% confidence interval (CI) 0.84–0.95] than for ceMRI (80.6%) (95%CI 0.72–0.83) (p <0.05). Accuracy for T status was 96.4% (95%CI 0.96–0.96) and 92.9% (95%CI 0.93–0.93) for [18F]FDG PET/MRI and ceMRI/ceCT, respectively. Patient-based accuracies for N and M status were 100% (95%CI 0.88–1.00) and 100% (95%CI 0.88–1.00) for [18F]FDG PET/MRI and 85.2% (95%CI 0.76–0.85) and 30.8% (95%CI 0.19–0.31) for ceCT and M staging representing significant differences (p<0.01). Lesion-based sensitivity, specificity and accuracy for N status were 78.6% (95%CI 0.57–0.91), 95.7% (95%CI 0.93–0.97) and 93.9% (95%CI 0.89–0.97) for [18F]FDG PET/MRI and 42.9% (95%CI 0.24–0.58), 96.6% (95%CI 0.94–0.98) and 90.8% (95%CI 0.87–0.94) for ceCT. Conclusions: [18F]FDG PET/MRI offers better sensitivity and specificity for the characterization and M staging than ceMRI and ceCT, and diagnostic value for T and N staging equivalent to ceMRI and ceCT, suggesting that [18F]FDG PET/MRI might represent a useful diagnostic alternative to conventional imaging modalities in ovarian cancer.
A Multi-Objective Model-Based Vertical Handoff Algorithm for Heterogeneous Wireless Networks
Authors: Wang Shumin , Deng Honggui , Xiong Rujing , Liu Gang , Liu Yang , Liu Hongmei
Published: September 2020

An optimized algorithm based on multi-objective optimization model is proposed to solve the problem that existing vertical handoff algorithms do not comprehensively consider the impact of users and the network during handoff process. We build Markov chain model of base station to calculate a more accurate network state. Then a multi-objective optimization model is derived to maximize the value of the network state and the user data receiving rate. The multi-objective genetic algorithm NSGA-II is finally employed to turn the model into a final vertical handoffff strategy. The results of the simulation for throughput and blocking rate of networks demonstrate our algorithm significantly increases the system throughput and reduces the blocking rate compared with the existing vertical switching strategy.
Validation of a Health Promotion Program for Infertile Couples with Unsuccessful Treatment: A Delphi Study
Authors: Zagami Samira Ebrahimzadeh , Janghorban Roksana , Bazaz Seyed Mojtaba Mousavi , Amirian Maliheh , Roudsari Robab Latifnejad
Published: September 2020

Background: Designing a health promotion program for infertile couples with unsuccessful treatment can play an important role in promoting their health in physical, social, psychological, and spiritual dimensions. There are different techniques for validation of programs. In this study, the Delphi technique was used to validate a health promotion program developed for infertile couples with unsuccessful treatment.Purpose: Validating the health promotion program for infertile couples with unsuccessful treatment using the Delphi technique.Methods: In this study, three rounds of Delphi were conducted with attendance of 17 specialists in different fields to validate the content of a health promotion program, which was developed based on a grounded theory study, review of literature, and focus group discussion. The selection of specialists was done by purposive and snowball sampling. In the first round of Delphi, the experts were asked to give feedback on the program draft. After analysis of the first round data and adding the new suggestions, in round two, members were asked to grade the value of statements based on the Likert scale to state their agreement. In the third round, the discussion on disagreements and reaching consensus was accomplished. Results: The program was validated by all participants with 6 main themes and 45 strategies including the stakeholders' awareness and attitude (11 strategies), fair financial participation (4 strategies), improving the executive process (6 strategies), psychological and counseling support (11 strategies), resolving legal, managerial, religious and ethical challenges (6 strategies), and logistic facilities (7 strategies) at a consensus level of at least 70%.Conclusions: The validated program proposes clear and functional strategies for implementation of a health promotion program for infertile couples with unsuccessful treatment.
Morphological and molecular characterization of Sarcocystis wenzeli in chickens (Gallus gallus) in China
Authors: Pan Jing , Ma Chunli , Huang Zhumei , Ye Yulong , Zeng Hongxia , Deng Shuangsheng , Hu Junjie , Tao Jianping
Published: September 2020

Background: There has been considerable confusion concerning the number and classification of Sarcocystis spp. in chickens. Scarce nucleotide data of Sarcocystis spp. from chickens are provided in GenBank. The study aimed to investigate the morphological and molecular characteristics of Sarcocystis spp. found in chickens in China.Methods: Tissues from 33 chickens were collected in 2019. Sarcocysts were observed using light (LM) and transmission electron microscopy (TEM). Individual sarcocysts from different chickens were selected for DNA extraction, and five loci, 18S rDNA, 28S rDNA, ITS-1 region (ITS-1), the mitochondrial cox1 gene (cox1), and the apicoplastic rpoB gene (rpoB) , were amplified from each sarcocyst, sequenced and analyzed.Results: Only S. wenzeli was found in 14 of 33 (42.4%) chickens. Under LM, the sarcocysts were microscopic and exhibited palisade-like villar protrusions measuring 1.5–2.8 μm. Ultrastructurally, the sarcocyst wall contained numerous stubby hill-like villar protrusions. The protrusions included scattered microtubules, which extended from the tips of the protrusions into the ground substance. The five loci were successfully sequenced and deposited in GenBank. At 18S rDNA, ITS-1 and cox1, the most similar sequences in GenBank were those of Sarcocystis sp. obtained from the brains of chickens, i.e., 99.9–100%, 98.1–98.5% and 99.3% identity, respectively. The five loci (18S rDNA, 28S rDNA, ITS-1, cox1and rpoB) showed different levels of interspecific sequence similarity with other closely related species of Sarcocystis (e.g., 99.8%, 99.0–99.2%, 89.3-89.7%, 98.5%, and 97.5%, respectively, with S. anasi). Phylogenetic analysis based on four of the loci (18S rDNA, cox1, rpoB and ITS-1) revealed that S. wenzeli formed an independent clade with Sarcocystis spp. that employ geese or ducks as intermediate hosts and canines as the known or presumed definitive host.Conclusions: The sequences of 28S rDNA and rpoB reported here constitute the first records of genetic markers of Sarcocystis spp. in chickens. Based on molecular analysis, S. wenzeli might be responsible for the neurological disease in chickens, and ITS-1 and rpoB are more suitable for discriminating it from closely related Sarcocystis spp. Phylogenetic analysis revealed that S. wenzeli presents a close relationship with Sarcocystis spp. in geese or ducks.
Patient Participation in Cancer Network Governance: A Six-year Case Study
Authors: Tremblay Dominique , Touati Nassera , Usher Susan , Bilodeau Karine , Pomey Marie-Pascale , Lévesque Lise
Published: September 2020

Background: Patient participation in decision-making has become a hallmark of responsive healthcare systems. Cancer programs in many countries have formally committed to involving people living with and beyond cancer (PLC) at multiple levels of network-based services. However, PLC participation in the governance of these networks remains highly variable for reasons that are, as yet, poorly understood. This study explores how PLC participation takes shape within cancer network governance. Methods: This case study, using a qualitative approach in a natural setting, aimed to identify mechanisms that enable PLC participation in governance. It was conducted over six years in four local cancer networks in Québec (Canada), where PLC representation was prescribed by the Cancer Directorate. Data were collected from documents, meeting observations, and interviews with actors (n=89) involved in national and local cancer governance committees: policymakers, managers, clinicians and PLC. These data were triangulated and iteratively analysed according to a framework based on functions of collaborative governance in the network context. Results: Main mechanisms enabling PLC participation are: 1) emphasis on patient-centred care as a network objective; 2) opportunities to shape mandated PLC representation into participation; and 3) recognition of PLC knowledge in decision-making. The shared vision of person-centred care facilitates PLC participation. The quality of participation improves through changes in how committee meetings are conducted, and through the establishment of a national forum in which PLC pool their experience, develop skills and establish a common voice on priority issues. PLC knowledge is especially valued around particular challenges such as designing integrated care trajectories and overcoming barriers to accessing care. These three mechanisms interact to enable PLC participation in governance and are activated to varying extents in each local network context.Conclusions: This study reveals that mandating PLC representation on governance structures is a powerful context element enabling participation, but that it also delineates which governance functions are open to influence from PLC participation. While the activation of mechanisms is context dependent, the insights from this study in Québec are transferable to cancer networks in other jurisdictions seeking to embed PLC participation in decision-making.
Long non-coding RNA PTPRG-AS1 promotes cell tumorigenicity in epithelial ovarian cancer by decoying microRNA-545-3p and consequently enhancing HDAC4 expression
Authors: Shi Juanjuan , Xu Xijian , Zhang Dan , Zhang Jiuyan , Yang Hui , Li Chang , Li Rui , Wei Xuan , Luan Wenqing , Liu Peishu
Published: September 2020

Background Long non-coding RNA PTPRG antisense RNA 1 (PTPRG-AS1) deregulation has been reported in various human malignancies and identified as an important modulator of cancer development. Few reports have focused on the detailed role of PTPRG-AS1 in epithelial ovarian cancer (EOC) and its underlying mechanism. This study aimed to determine the physiological function of PTPRG-AS1 in EOC. A series of experiments were also performed to identify the mechanisms through which PTPRG-AS1 exerts its function in EOC. Methods Reverse transcription-quantitative polymerase chain reaction was used to determine PTPRG-AS1 expression in EOC tissues and cell lines. PTPRG-AS1 was silenced in EOC cells and studied with respect to cell proliferation, apoptosis, migration, and invasion in vitro and tumor growth in vivo. The putative miRNAs that target PTPRG-AS1 were predicted using bioinformatics analysis and further confirmed in luciferase reporter and RNA immunoprecipitation assays. Results Our data verified the upregulation of PTPRG-AS1 in EOC tissues and cell lines. High PTPRG-AS1 expression was associated with shorter overall survival in patients with EOC. Functionally, EOC cell proliferation, migration, invasion in vitro, and tumor growth in vivo were suppressed by PTPRG-AS1 silencing. In contrast, cell apoptosis was promoted by loss of PTPRG-AS1. Regarding the mechanism, PTPRG-AS1 could serve as a competing endogenous RNA in EOC cells by decoying microRNA-545-3p (miR-545-3p), thereby elevating histone deacetylase 4 (HDAC4) expression. Furthermore, rescue experiments revealed that PTPRG-AS1 knockdown-mediated effects on EOC cells were, in part, counteracted by the inhibition of miR-545-3p or restoration of HDAC4. Conclusions PTPRG-AS1 functioned as an oncogenic lncRNA that aggravated the malignancy of EOC through the miR-545-3p/HDAC4 ceRNA network. Thus, targeting the PTPRG-AS1/miR-545-3p/HDAC4 pathway may be a novel strategy for EOC anticancer therapy.
Prenatal and Postnatal Diagnosis and Phenotype of 8p23.2p22 Duplication in One Family
Authors: Shi Panlai , Wang Conghui , Zheng Yuting , Kong Xiangdong
Published: September 2020

Background Distal 8p duplication is rare, but clinically significant.Methods A family has an induced labor fetal (II-2) for increased nuchal translucency (3.5mm) at 12 weeks gestation and detecting a 16.22Mb deletion of 8p23.2p22 by copy number variation sequencing (CNV-seq). Hence, the family requested family analysis and prenatal diagnosis of subject II-3. All family members underwent CNV-seq, karyotyping and FISH testing.Results II-1 and II-3 were found to have a 16.22Mb duplication of 8p23.2p22, containing the 8p23.1 duplication syndrome region, inherited from their father, a carrier with a translocation of 8p22 and 22q13. It’s confirmed that duplication site was located on chromosome 22p13 by combining the results of CNV-seq, karyotype and FISH. II-1 is a 7.5 year old boy. At one month old, he was diagnosed with a ventricular septal defect and treated using surgically at age four. His growth and intelligence developed well, and he performed well in school. His primary issue is an inability to distinguish between the flat tongue and warped tongue in speech. II-3 had a normal ultrasonic index until 26 weeks gestation. The family wants keep the pregnancy, providing us with the opportunity to evaluate the effects of 8p23.2p22 duplication in comparison with the brother (II-1).Conclusion Our study makes a significant contribution to the literature because this relatively rare condition can have significant phenotypical consequences, and an understanding of the inheritance and variability of phenotypes caused by this mutation is essential to an increased understanding of the condition.
Hindsight is 2020 Vision: A Characterisation of the Global Response to the COVID-19 Pandemic
Authors: Warne David , Ebert Anthony , Drovandi Christopher , Hu Wenbiao , Mira Antonietta , Mengersen Kerrie
Published: September 2020

Background The global impact of COVID-19 and the country-specific responses to the pandemic provide an unparalleled opportunity to learn about different patterns of the outbreak and interventions. We model the global pattern of trajectories of reported COVID-19 cases during the primary response period, with the aim of learning from the past to prepare for the future. Methods Using Bayesian methods, we analyse the response to the COVID-19 outbreak for 158 countries for the period 22 January to 9 June 2020. This encompasses the period in which many countries imposed a variety of response measures and initial relaxation strategies. Instead of modelling specific intervention types and timings for each country explicitly, we adopt a stochastic epidemiological model including a feedback mechanism on virus transmission to capture complex nonlinear dynamics arising from continuous changes in community behaviour in response to rising case numbers. We analyse the overall effect of interventions and community responses across diverse regions. This approach mitigates explicit consideration of issues such as period of infectivity and public adherence to government restrictions. Results Countries with the largest cumulative case tallies are characterised by a delayed response, whereas countries that avoid substantial community transmission during the period of study responded quickly. Countries that recovered rapidly also have a higher case identification rate and small numbers of undocumented community transmission at the early stages of the outbreak. We also demonstrate that uncertainty in numbers of undocumented infections dramatically impacts the risk of second waves. Our approach is also effective at pre-empting potential second waves and flare-ups. Conclusions We demonstrate the utility of modelling to interpret community behaviour in the early epidemic stages. Two lessons learnt that are important for the future are: i) countries that imposed strict containment measures early in the epidemic fared better with respect to numbers of reported cases; and ii) broader testing is required early in the epidemic to understand the magnitude of undocumented infections and recover rapidly. We conclude that clear patterns of containment are essential prior to relaxation of restrictions and show that modelling can provide insights to this end.