bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel Prognostic Role of Serum CA19-9 Identified in Colorectal Terminal Tumor Site and Tubular Adenocarcinoma
Authors: He Zhicheng , Hu Shudong , Chen Jijun , Cai Xianghai , He Yingying , Liu Shubai
Published: December 2020

It is still illusive that the origination and contribution of different primary tumor sites in Colorectal Cancer (CRC). A total 1039 consecutive CRC patient’s profiles were collected and investigated the prediction role of multiple biomarkers during survival period. The correlation and survival analysis were applied to explore the prognostic value of clinical traits (primary tumor sites, and tumor subtypes, the incidence rate) and multiple biomarkers. The sigmoid and rectum (73%) demonstrated the highest incidence rate among other primary tumor sites (27%). Tubular adenocarcinoma, mainly rise from the terminal bowel tumor sites, has significantly worse clinical outcome, lower 5-year survival rate and shorter overall survival time. Serum level of CA19-9 was significantly positive correlated with sigmoid and rectum originated-CRC (Cor =0.88, p=2.2e-16). Higher serum level of CA19-9 (>37 U/mL) was significantly associated with terminal tumor sites, tubular adenocarcinoma and tumor with non-infiltrating. It could be applied for the precise diagnosis of CRC and terminal bowel cancer, especially in the tubular adenocarcinoma. Therefore, terminal tumor sites (sigmoid and rectum) demonstrated potential prognostic value in early screening for CRC patients. CA19-9 could be a promising biomarker for the diagnosis of terminal colorectal cancer, especially for the Tubular adenocarcinomas originated from sigmoid and rectum, and improve the clinical outcome.
Associations between Post-Stroke Motor and Cognitive Function: A Cross-Sectional Study
Authors: Einstad Marte Stine , Saltvedt Ingvild , Lydersen Stian , Ursin Marie , Munthe-Kaas Ragnhild , Ihle-Hansen Hege , Knapskog Anne-Brita , Askim Torunn , Beyer Mona , Næss Halvor , Seljeseth Yngve , Ellekjær Hanne , Thingstad Pernille
Published: December 2020

BACKGROUND: Although both motor and cognitive impairments are frequently observed following stroke, these are often managed as distinct entities, and there is little evidence regarding how they are related. The aim of this study was to describe the prevalence of concurrent motor and cognitive impairments three months after stroke and to examine how motor performance was associated with memory, executive function and global cognition. METHODS: The Norwegian Cognitive Impairment After Stroke (Nor-COAST) study is a prospective multicentre cohort study including patients hospitalized with acute stroke. The National Institutes of Health Stroke Scale (NIHSS) was used to measure stroke severity, and function was measured by the Modified Rankin Scale (mRS). Motor and cognitive functions were assessed three months post-stroke using the Montreal Cognitive Assessment (MoCA), Trail Making Test Part B (TMT-B), 10-Word List Recall (10WLR), Short Physical Performance Battery (SPPB), dual-task cost (DTC) and grip strength. Cut-offs were set according to current recommendations. Associations were examined using linear regression with the cognitive tests as dependent variables and motor domains as covariates, adjusted for age, sex, education and stroke severity. RESULTS: Of 567 participants included, 242 (43%) were women, mean (SD) age was 72.2 (11.7) years, 416 (75%) had an NIHSS score ≤ 4 and 475 (84%) had an mRS score of ≤ 2. Prevalence of concurrent motor and cognitive impairment ranged from 9.5% for DTC and 10WLR to 22.9% for grip strength and TMT-B. The SPPB was associated with the MoCA (regression coefficient B=0.465, 95%CI [0.352, 0.578]), TMT-B (B=-9.494, 95%CI [-11.726, -7.925]) and 10WLR (B=0.132, 95%CI [0.054, 0.211]). Grip strength was associated with the MoCA (B=0.075, 95%CI [0.039, 0.112]), TMT-B (B=-1.972, 95%CI [-2.672, -1.272]) and 10WLR (B=0.041, 95%CI [0.016, 0.066]). Higher DTC was associated with more time needed to complete the TMT-B (B=0.475, 95%CI [0.075, 0.875]) but not with the MoCA or 10WLR.CONCLUSION: Three months after suffering mainly minor strokes, 30–40% of participants had motor or cognitive impairments, while 20% had concurrent impairments. Motor performance was associated with memory, executive function and global cognition. The identification of concurrent impairments could be relevant for preventing functional decline.Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02650531
Controlling potential landscape of heterostructured nanocrystals with interfacial polarization
Authors: Jeong Byeong Guk , Chang Jun Hyuk , Hahm Donghyo , Rhee Seunghyun , Park Myeongjin , Lee Sohoo , Kim Youngdu , Shin Doyoon , Park Jeong Woo , Lee Changhee , Lee Doh C. , Park Kyoungwon , Hwang Euyheon , Bae Wan Ki
Published: December 2020

The potential profile and the energy level offset of core/shell heterostructured nanocrystals (h-NCs) determine the photophysical properties and the charge transport characteristics of h-NC solids. However, limited material choices for heavy metal-free III-V/II-VI h-NCs pose challenges in comprehensive control of the potential profile. Herein, we present an unprecedented approach to such control by steering dipole moments at the interface of III-V/II-VI h-NCs. The controllable heterovalency at the interface is responsible for interfacial dipole moments that result in the vacuum-level shift, providing an additional knob for the control of optical and electrical characteristics of h-NCs. We capitalize on the atomic precision with which to synthesize h-NCs by correlating interfacial dipole moments to photochemical stability and optoelectronic performance of resulting h-NCs.
Peribulbar Sub-Tenon’s Anaesthesia With Levo-Bupivacaine and Cis-Atracurium Besilate in Ophthalmic Intraocular Surgery in Cat: Clinical Study.
Authors: costa giovanna , Nastasi Bernadette , Spadola Filippo , Leonardi Fabio , Musicò Marcello
Published: December 2020

Backgroundthis study aims to evaluate the efficacy of Levo-bupivacaine with the addition of a small dose of cisatracurium by sub-Tenon’s injection on akinesia and mydriasis. Then, to evaluate if such a small dose of cisatracurium could determine a systemic neuromuscular blockade, despite the way of administration. Forty cats were anesthetized for intra-ophthalmic surgery with butorphanol 0,2 mgkg-1, dexmedetomidine 15 mcg/kg and midazolam 0,2 mgkg-1 IM and intubated to receive oxygen and isofluorane by mechanical ventilation. The animals were divided in four groups. Group L received 1.25 mgkg-1 L-bupivacaine, administered by peribulbar injection; group CL received the same dose of L-bupivacaine, combined with 0.01mg/kg of cisatracurium; group C received 0.01 mg kg-1 of peribulbar cisatracurium; group GC received 0.01 mg kg-1 of cisatracurium intravenously. Physiological variables and oculomotor activity were measured before and up to 30 minutes after peribulbar injection.ResultsThe data below, expressed with median and range, show that physiological variables remained in the physiological range. Among the treatments, the LC group showed akinesia, higher midriasis and a decrasing intraocular pressure (IOP); the onset time of akinesia was significantly shorter in group LC than in group L 4(3/5) min and 8(6/10) min respectively, p=0.000; the duration of akinesia was longer in group LC than in group L, 70(68/72) and 60(57/63min), respectively p=0.000. In group C we observed the appearance of akinesia after 5(5/5) minutes from the peribulbar administration and it lasted for 20(20/20) minutes (p=0.000), compared to groups L and LC. In group GC we registered akinesia after 5(5/5) minutes, but the duration observed was shorter 5(5/6). In groups C and GC, additional L bupivacaine peribulbar injection was required. The train of four (TOF) was ≥ 0.9 throughout the study in all of the groups. ConclusionsA combination of cisatracurium and L-bupivicaine, used for peribulbar sub-Tenon’s anesthesia, provides effective akinesia, midriasis of the eye, shortens the onset of akinesia and prolongs its duration, thus providing excellent conditions for intra-ophthalmic surgery, without incurring in a systemic blockade.
Latex Agglutination Turbidimetric Immunoassay Versus Enzyme-Linked Immunosorbent Assay for Helicobacter pylori: An Observational Study.
Authors: Tokai Yoshitaka , Fujisaki Junko , Ishizuka Naoki , Osumi Hiroki , Namikawa Ken , Yoshimizu Shoichi , Horiuchi Yusuke , Ishiyama Akiyoshi , Yoshio Toshiyuki , Hirasawa Toshiaki , Miki Kazumasa , tsuchida Tomohiro
Published: December 2020

Background: Helicobacter pylori antibody levels in the blood are currently measured using an enzyme-linked immunosorbent assay (ELISA). In April 2016, FUJIFILM Wako Pure Chemical Corporation launched the “L-type Wako Helicobacter pylori antibody J” test, which is based on the latex agglutination turbidimetric immunoassay. In this study, we investigated the usefulness of the Wako test. Methods: We measured H. pylori antibody levels using both ELISA and Wako tests in 180 patients who underwent esophagogastroduodenoscopy at our hospital between September 2017 and February 2019. Ninety patients had H. pylori infections. We calculated the diagnostic accuracy, sensitivity, and specificity of each test and the concordance rate between the two tests. If the lower limits of 90% confidence intervals (CI) for each diagnostic validity exceeded the 85% threshold, the usefulness of the diagnostic test was confirmed. Results: Diagnostic accuracy, sensitivity, and specificity were 94.4% (90% CI; 90.8–97.0%), 94.4% (90% CI; 88.7–97.8%), and 94.4% (90% CI; 88.7–97.8%), respectively, using the Wako test, and 94.4% (90% CI; 90.8–97.0%), 88.9% (90% CI; 81.9–93.8%), and 100% (90% CI; 96.0–100%), respectively, using ELISA. The concordance rate between the two tests was high (κ = 0.8444). Conclusions: We confirmed the usefulness of the Wako test, especially when screening for H. pylori infection, due to its high sensitivity.Trial registration: We retrospectively registered the data of this study.
Association of VEGF Haplotypes with Breast Cancer Risk in North-West Indians
Authors: Sambyal Vasudha , Guleria Kamlesh , Kapahi Ruhi , Manjari Mridu , Sudan Meena , Uppal Manjit Singh , Singh Neeti Rajan
Published: December 2020

Background: Angiogenesis is a complex and coordinated process regulated by different growth factors and is one of the hallmark features of cancer. VEGF is one of the most important endothelial cell mitogen and has a critical role in normal physiological and tumor angiogenesis. The objective of this study was to investigate the potential association of haplotypes of six VEGF polymorphisms with breast cancer risk in North-West Indians. Methods: Samples of 250 breast cancer patients and 250 age and gender matched controls were genotyped for VEGF -2578C/A, -2549I/D, -460T/C, +405C/G, -7C/T and +936C/T polymorphisms. Haplotypes were generated to determine the better contribution of VEGF polymorphisms to breast cancer risk. Results: Haplotypes CDTCCC (OR = 0.56, 95%CI, 0.38-0.81; p = 0.003) and CDTGCC (OR = 0.63, 95%CI, 0.44-0.92; p = 0.018) of VEGF -2578C/A, -2549I/D, -460T/C, +405C/G, -7C/T and +936C/T polymorphisms were significantly associated with decreased risk of breast cancer. CDTCCC haplotype was also significantly associated with reduced risk of breast cancer in pre and post menopausal as well as both obese and non obese patients. Haplotype CDTGCC was marginally associated (p = 0.07) with reduced risk of breast cancer in non-obese patients as compared with non-obese controls where as haplotype AICGTC was marginally associated (p = 0.09) with reduced risk of breast cancer in obese patients when compared with non-obese patients. The CDTGCC haplotype was significantly associated with increased risk of breast cancer in premenopausal obese patients (OR = 1.98, 95%CI, 1.10-3.56; p = 0.02). Conclusions: Our data indicated that CDTCCC and CDTGCC haplotypes of VEGF -2578C/A, -2549I/D, -460T/C, +405C/G, -7C/T and +936C/T polymorphisms were significantly associated with breast cancer risk in North-West Indians. Further studies on multiethnic groups with larger sample size are required to confirm our results.
AMPlify: attentive deep learning model for discovery of novel antimicrobial peptides effective against WHO priority pathogens
Authors: Li Chenkai , Sutherland Darcy , Hammond S. Austin , Yang Chen , Taho Figali , Bergman Lauren , Houston Simon , Warren Rene , Wong Titus , Hoang Linda MN , Cameron Caroline , Helbing Caren , Birol Inanc
Published: December 2020

Antibiotic resistance is a growing global health concern prompting researchers to seek alternatives to conventional antibiotics. Antimicrobial peptides (AMPs) are emerging therapeutic agents with promising utility in this domain and using in silico methods to discover novel AMPs is a strategy that is gaining interest. Such methods can filter through large volumes of candidate sequences and reduce lab screening costs. Here we introduce AMPlify, an attentive deep learning model for AMP prediction, and demonstrate its utility in prioritizing peptide sequences derived from the Rana [Lithobates] catesbeiana (bullfrog) genome. We tested the bioactivity of our predicted peptides against a panel of bacterial species, including representatives from the World Health Organization’s “priority pathogens” list. Four of our novel AMPs were active against multiple species of bacteria, including a multi-drug resistant isolate of carbapenemase-producing Escherichia coli, demonstrating the utility of tools like AMPlify in our fight against antibiotic resistance.
Contrast Enhanced X-Ray Computed Tomography Imaging of Amyloid Plaques in Alzheimer Disease Rat Model on Lab Based Micro CT System
Authors: Kavkova Michaela , Zikmund Tomas , Kala Annu , Salplachta Jakub , Pena Stephanie Proskauer , Kaiser Josef , Jezek Karel
Published: December 2020

Amyloid plaques are small (~50 μm), highly-dense aggregates of amyloid beta (Aβ) protein in brain tissue, supposed to play a key role in pathogenesis of Alzheimer’s disease (AD). Plaques´ in vivo detection, spatial distribution and quantitative characterization could be an essential marker in diagnostics and evaluation of AD progress. However, current imaging methods in clinics possess substantial limits in sensitivity towards Aβ plaques to play a considerable role in AD screening. Contrast enhanced X-ray micro computed tomography (micro CT) is an emerging highly sensitive imaging technique capable of high resolution visualization of rodent brain. In this study we show the absorption based contrast enhanced X-ray micro CT imaging is viable method for detection and 3D analysis of Aβ plaques in transgenic rodent models of Alzheimer’s disease. Using iodine contrasted brain tissue isolated from the Tg-F344-AD rat model we show the micro CT imaging is capable of precise imaging of Aβ plaques, making possible to further analyze various aspects of their 3D spatial distribution and other properties.
Gastric Stump Cancer: Demanding a More Suitable Definition and TNM Staging System
Authors: Xu Jiannan , Liu Guangyao , Jin Xinghan , Wang Huijin , Zhu Lihua , Zhang Changhua , He Yu-long
Published: December 2020

BackgroundThe incidence of gastric stump cancer (GSC) following resection of gastric cancer has increase. However, the definition between GSC and recurrent gastric cancer (RGC) is still being debated. This study was conducted to compare the clinicopathological characteristics and outcome for this two groups.MethodsThe investigators retrospectively reviewed patients in the Surveillance Epidemiology and End Results (SEER) databases from 1975 to 2016 to identify patients who underwent resection of gastric cancer subsequently experienced metachronous gastric cancer. GSC was defined as cancer occurring in remnant stomach of ≥10 years after gastrectomy, while RGC was defined as <10 years after gastrectomy. T-test, Pearson χ2-test and Kaplan-Meier estimator method was used in the present study.ResultsAmong the 167,747 gastric cancer patients, 1,006 (0.6%) patients were diagnosed multiple gastric cancer, 93 patients met the GSC criterion, and 282 patients met the RGC criterion. The mean time interval between the initial cancer and second cancer for GSC was 13.34 years and 4.24 years for RGC. Male gender (P=0.003), younger age (60.1 years old vs. 65.9 years old, P<0.001) developed more frequently in GSC group. The median OS in GSC group was 20.0 months compared with 16.0 months for RGC group (p=0.302). Surgery treatment or not, the median OS have statistically significant (in RGC group, 64.0 months vs. 10.0 months, P＜0.001; 33 months vs. 13 months, P=0.014 in GSC group).ConclusionsIn our definition of GSC and RGC, the OS were not statistically significant and gastrectomy may be the appropriate treatment for this two groups. It may demand for a more suitable definition and TNM staging system for GSC.
Dzherelo (Immunoxel) as Adjunctive Therapy to Standard Antituberculosis Treatment in Patients with Pulmonary Tuberculosis: A Systematic Review and Meta-analysis of Clinical Trials
Authors: Kitenge Marcel , Phiri Bessie , Pheeha Sara M , Ogunrombi Modupe , Nyasulu Peter
Published: December 2020

BackgroundDzherelo (Immunoxel) is one of the few approved immunomodulators that has been shown to produce positive treatment outcomes in patients with tuberculosis (TB). The aim of this review was to assess the effectiveness of Immunoxel used as adjunct therapy with conventional anti-TB therapy for the treatment of pulmonary TB. MethodsComprehensive search was conducted in different major databases: Pubmed (MEDLINE), EMBASE (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), SCOPUS (Elsevier). We also searched Google Scholar along with trial registries and hand-searched the reference list of identified original research as well as review articles. Conference proceedings of relevant TB and lung diseases annual conferences were also screened. Two independent authors extracted outcomes data using a standardized extraction form. Relative risk (RR), mean difference (MD) and standardised mean difference (SMD) with a 95% confidence interval (CI) were used as measures of effect. We assessed certainty of evidence using GRADE.ResultsSix clinical trials, which met the criteria for the review were identified and these provided data for the review. Overall results from the six trials that compared anti-tuberculosis treatment (ATT) alone versus ATT and Immunoxel, ATT and Placebo versus ATT and Immunoxel, showed an increased number of patients becoming sputum-negative in the Immunoxel group (RR 3.19; 95% CI 2.44 to 4.17; 488 participants). There was also great reduction in body temperature among patients receiving Immunoxel compared to ATT alone (MD -0.20, 95% CI -0.22 to -0.18, 345 participants). However, there were no differences in body weight changes across all the studies (MD 5.65; 95% CI: -0.80 to 12.11; 382 participants). ConclusionCurrent evidence indicates that the use of Immunoxel as an adjunctive treatment in patients with pulmonary tuberculosis has the potential to enhance the efficacy of anti-tuberculosis treatment. However, well-designed, conducted and adequately powered clinical trials are needed to establish the effectiveness of this adjunctive treatment. PROSPERO registration number: CRD42019127823
Genetic Composition and Evolution of the Prevalent Mycobacterium Tuberculosis Lineages 2 and 4 in the Chinese and Zhejiang Province Populations
Authors: Wu Beibei , Zhu Wenlong , Wang Yue , Wang Qi , Zhou Lin , Liu Zhengwei , Bi Lijun , Barun Mathema , Kreiswirth Barry N. , Chen Liang , Chen Songhua , Wang Xiaomeng , Wang Weibing
Published: December 2020

Background: There are seven human-adaptation lineages of Mycobacterium tuberculosis (Mtb). Tuberculosis (TB) dissemination is strongly influenced by human movements and host genetics. The detailed lineage distribution evolution of Mtb in Zhejiang Province is unknown. We aim to determine how different sub-lineages are transmitted and distributed within China and Zhejiang Province.Methods: We analyzed whole-genome sequencing data for a countrywide collection of 1154 isolates and a provincial collection of 1296 isolates, constructed the best-scoring maximum likelihood phylogenetic tree. Bayesian evolutionary analysis was used to calculate the latest common ancestor of lineages 2 and 4. The antigenic diversity of human T cell epitopes was evaluated by calculating the pairwise dN/dS ratios.Results: Of the Zhejiang isolates, 964 (74.38%) belonged to lineage 2 and 332 (25.62%) belonged to lineage 4. The distributions of the sub-lineages varied across the geographic regions of Zhejiang Province. L2.2 is the most ancient sub-lineage in Zhejiang, first appearing approximately 6897 years ago (95% HDI: 6513-7298). L4.4 is the most modern sub-lineage, first appearing approximately 2217 years ago (95% HDI: 1864-2581). The dN/dS ratios showed that the epitope and non-epitope regions of lineage 2 strains were significantly (P<0.001) more conserved than those of lineage 4.Conclusions: An increase in the frequency of lineage 4 may reflect its successful transmission over the last 20 years. The recent common ancestors of the sub-lineages and their transmission routes are relevant to the entry of humans into China and Zhejiang Province. Diversity in T cell epitopes may prevent Mycobacterium tuberculosis from being recognized by the immune system.
Smartphone Based Alerting of First Responders During The COVID-19 Pandemic
Authors: Ganter Julian , Damjanovic Domagoj , Trummer Georg , Busch Hans-Jörg , Baldas Klemens , Hänsel Mike , Mueller Michael Patrick
Published: December 2020

Background: Smartphone Alerting Systems (SAS) potentially reduce the resuscitation-free interval. Many of these systems invite lay persons, who a have been trained in Basic Life Support (BLS). The Freiburg alert system Region of Lifesavers (Region der Lebensretter, RDL) only registers first responders with a professional background (i.e. paramedics, nurses, physicians, medical students) and volunteers with at least 48 units training in emergency medicine. Here we describe the evolution of the RDL system during the pandemic.Methods: Due to a lack of personal protective equipment (PPE), the alert system had been stopped at the beginning of the COVID 19 pandemic on March 16th, 2020.The board of the charity organization operating RDL decided to design a concept for a safe restart. Following the raise of 34,000 Euros of private funds, 1,000 backpacks were equipped with FFP-2 mask, gloves, protective gown, safety glasses, mouth-nose protection, airway filter and ventilation bag/mask. Furthermore, the algorithm for first responders was adapted according to the ERC COVID guidelines. An online survey regarding volunteers’ willingness to help under different protective measures before, during and after the pandemic was conducted.Results: The system was restarted on May 26th, 2020. The number of volunteers newly registering for the system remained unchanged between 10 – 71 per month after restart of the system. The proportions of alarms with at least one first responder accepting among all activations of the system remained at approximately 50%, assuming that the volunteers being equipped with PPE felt safe during the COVID-19 pandemic. This was also confirmed by the results of the survey.Conclusions: During the ongoing pandemic, it is important to keep well-established first responder systems active, which can shorten the resuscitation-free interval. When PPE is provided for first responders, the readiness of the volunteers to remain active in the SAS is high.
Determinants of Gender Disparities in Scaling Up the First 90 Towards the UNAIDS 90-90-90 Targets in South Africa: Findings From the 2017 Household-based National Cross-sectional Survey
Authors: Jooste Sean , Mabaso Musawenkosi , Taylor Myra , North Alicia , Shean Yolande , Simbayi Leickness Chisamu
Published: December 2020

Background: The first 90 of UNAIDS 90–90–90 targets to have 90% of the people living with HIV know their status is an important entry point to the HIV treatment cascade and care continuum, but evidence shows that there is a large gap between males and females in this regard. It is therefore important to understand barriers and facilitators of achieving the first 90 target. This study examined determinants of the first 90 target among females and males in order to inform strategies aimed at improving the HIV cascade in South Africa.Methods: The data used in the analysis were obtained from a 2017 household-based cross-sectional nationally representative survey conducted using a multi-stage stratified cluster random sampling design. A series of hierarchical multiple logistic regression models were fitted to identify the determinants of the first 90 target by gender.Results: Overall, 84.8% of HIV-positive individuals aged 15 years and older were aware of their HIV status. Females were significantly more aware of their HIV status compared to males (88.7% vs 78.2%, p<0.001). Both females aged 25 to 49 years [aOR=3.20 (95% CI: 1.35–7.57), p=0.008], and 50 years and older [aOR=3.19 (95% CI: 1.04–9.76), p=0.042] and males aged 25 to 49 years [aOR=3.00 (95% CI: 1.13–7.97), p=0.028], and 50 years and older [aOR=7.25 (95% CI: 2.07–25.36), p=0.002] were significantly more likely to know their HIV status compared to those aged 15 to 19 years. Males with tertiary education level were significantly more likely to be aware of their HIV positive status [aOR=75.24 (95% CI: 9.07–624.26), p<0.001] compared to those with no education or with primary level education. Females with secondary [aOR=3.28 (95% CI: 1.20–8.99), p=0.021] and matric [aOR=4.35 (95% CI: 1.54–12.37), p=0.006] educational levels were significantly more likely to be aware of their HIV positive status, compared to those with no education or with primary level education.Conclusion: Significant progress has been made with regards to reaching the UNAIDS first 90 target. In this context achieving the first 90 target is feasible but there is a need for additional interventions to reach the males especially youth including those with no education or low levels of education.
Severe Sepsis With Septic Shock as a Consequence of a Severe Hospital-Acquired Pneumonia Resulting From Legionella Pneumophila in Children: A Case Series and Literature Review
Authors: Ding Min , Yang Chunfeng , Li Yu-mei
Published: December 2020

BackgroundLegionella pneumophila is responsible for hospital or community-acquired pneumonia in adults. Immunocompromised patients with Legionella pneumophila infection are associated with rapidly severe clinical course and high mortality rates. Legionella pneumophila infection is rare in children, especially combined with extrapulmonary manifestations. In this report, we describe 2 children of severe hospital-acquired pneumonia and septic shock resulting from Legionella pneumophila. Standardized metagenomics next-generation sequencing allowed early diagnosis. Appropriate antibiotic therapy and timely extracorporeal life support were effective in achieving complete recovery. This is the first report of children with septic shock related to Legionella pneumophila infections diagnosed by metagenomics next-generation sequencing and recovered successfully.Case presentationThere were 2 cases about septic shock resulting from Legionella pneumophila. One was a six-month girl with congenital biliary atresia who underwent liver transplantation. She was suspected for rejecting the liver and admitted to hospital. The other one was a five-year-old boy with Burkitt lymphoma who was in the end of early chemotherapy. They both presented with fever, cough or shortness of breath during hospitalization. And they were transferred to PICU because of worsening dyspnea and decreased blood pressure. Patients were diagnosed by severe sepsis with septic shock likely resulting from hospital-acquired pneumonia. Metagenomics next-generation sequencing indicated L. pneumophila in blood and sputum. Aggressive intravenous fluids resuscitation and vasopressors were initiated on arrival to PICU, and they were placed on mechanical ventilation and continuous renal replacement therapy. Intravenous antibiotic therapy followed by azithromycin. Finally, the patients recovered without any long-term sequelae.ConclusionsThough sepsis or sepsis shock caused by Legionella pneumophila is rare in children, it can occur at high-risk population. Metagenomics next-generation sequencing is useful for conforming hard-to-culture pathogens and severely ill patients. The report remind pediatric physicians that we should be aware that Legionella pneumophila can cause severe sepsis or sepsis shock, especially in immunocompromised children. It is significant to select appropriate samples and pathogen detection methods in the early stage of disease.
Comparative Genomics and Physiological Investigation Supported Safety, Cold Adaptation, Efficient Hydrolytic and Plant Growth-promoting Potential of Psychrotrophic Glutamicibacter Arilaitensis LJH19, Isolated from Night-Soil Compost
Authors: Borker Shruti , Thakur Aman , Kumar Sanjeet , Kumari Sareeka , Kumar Rakshak , Kumar Sanjay
Published: December 2020

Background: Night-soil compost (NSC) has traditionally been conserving water and a source of organic manure in northwestern Himalaya. Lately, this traditional method is declining due to modernization, its unhygienic conditions, and social apprehensions. Reduction in the age-old traditional practice has led to excessive chemical fertilizers and water shortage in the eco-sensitive region. In the current study, a bacterium has been analysed for its safety, cold-adaptation, efficient degradation, and plant growth potential attributes for its possible application as a safe bioinoculant in psychrotrophic bacterial consortia for improved night-soil composting.Results: Glutamicibacter arilaitensis LJH19, a psychrotrophic bacterium, was isolated from the night-soil compost of Lahaul valley in northwestern Himalaya. The strain exhibited amylase (186.76 ± 19.28 U/mg), cellulase (21.85 ± 0.7 U/mg) and xylanase (11.31± 0.51 U/mg) activities at 10°C. Possessing efficient hydrolytic activities at low-temperature garners the capability of efficient composting to LJH19. Additionally, the strain possessed multiple plant growth-promoting (PGP) traits such as indole acetic acid production (166.11 ± 5.7 µg/ml), siderophore production (85.72 ±1.06 % psu), and phosphate solubilization (44.76 ± 1.5 µg/ml). Enhanced germination index and germination rate of pea seeds under the LJH19 inoculation further supported the bacterium's PGP potential. Whole-genome sequencing (3,602,821 bps) and genome mining endorsed the cold adaptation, degradation of polysaccharides and, plant growth-promoting traits of LJH19. Biosynthetic gene clusters for type III polyketide synthase (PKS), terpene, and siderophore supplemented the endorsement of LJH19 as a potential PGP bacterium. Comparative genomics within the genus revealed 217 unique genes specific to hydrolytic and PGP activity. Conclusion: The physiological and genomic evidence promotes LJH19 as a potentially safe bio-inoculant to formulate psychrotrophic bacterial consortia for accelerated degradation and improved night-soil compost.
Study of a New 5-DOF Parallel Mechanism for Multi-Directional 3D Printing
Authors: Wang Yesong , Lyu Changhuai , Liu Jiang , Zhang Jinguang , Jia Zhixin
Published: December 2020

This paper first designs a new 5-DOF parallel mechanism with 5PUS-UPU for multi-directional 3D printing, and then analyses its DOF by traditional Grubler-Kutzbach and motion spiral theory. It theoretically shows that the mechanism meets the requirement of 5 dimensions of freedoms including three-dimensional movement and two-dimensional rotation. Basing on this, the real mechanism is built, but unfortunately it is found unstable in some positions. Grassmann line geometry method is applied to analyze its unstable problem caused by singular posture, and then an improving method is put forward to solve it. With the improved mechanism, closed loop vector method is employed to establish the inverse position equation of the parallel mechanism, and kinematics analysis is carried out to get the mapping relationships between position, speed and acceleration of moving and fixed platform, Monte Carlo method is used to analyze the workspace of the mechanism, to explore the influencing factors of workspace, and then to get the better workspace. Finally an experiment is designed to verify the mechanism working performance to satisfy the spatial motion requirements of multi-directional 3D printing.
Sparse Autoencoder-Based Multi-Head Deep Neural Networks for Machinery Fault Diagnostics With Novelty Detection
Authors: Yang Zhe , Gjorgjevikj Dejan , Long Jian-Yu , Zi Yan-Yang , Zhang Shao-Hui , Li Chuan
Published: December 2020

Novelty detection is a challenging task for the machinery fault diagnosis. A novel fault diagnostic method is developed for dealing with not only diagnosing the known type of defect, but also detecting novelties, i.e. the occurrence of new types of defects which have never been recorded. To this end, a sparse autoencoder-based multi-head Deep Neural Network (DNN) is presented to jointly learn a shared encoding representation for both unsupervised reconstruction and supervised classification of the monitoring data. The detection of novelties is based on the reconstruction error. Moreover, the computational burden is reduced by directly training the multi-head DNN with rectified linear unit activation function, instead of performing the pre-training and fine-tuning phases required for classical DNNs. The addressed method is applied to a benchmark bearing case study and to experimental data acquired from a delta 3D printer. The results show that it is able to accurately diagnose known types of defects, as well as to detect unknown defects, outperforming other state-of-the-art methods.
Deep Learning Based Data Fusion for Sensor Fault Diagnosis and Tolerance in Autonomous Vehicles
Authors: Pan Huihui , Sun Weichao , Sun Qiming , Gao Huijun
Published: December 2020

Environmental perception is one of the key technologies to realize autonomous vehicles. Autonomous vehicles are often equipped with multiple sensors to form a multi-source environmental perception system. Those sensors are very sensitive to light or background conditions, which will introduce a variety of global and local fault signals that bring great safety risks to autonomous driving system during long-term running. In this paper, a real-time data fusion network with fault diagnosis and fault tolerance mechanism is designed. By introducing prior features to realize the lightweight of the backbone network, the features of the input data can be extracted in real time accurately. Through the temporal and spatial correlation between sensor data, the sensor redundancy is utilized to diagnose the local and global condence of sensor data in real time, eliminate the fault data, and ensure the accuracy and reliability of data fusion. Experiments show that the network achieves the state-of-the-art results in speed and accuracy, and can accurately detect the location of the target when some sensors are out of focus or out of order.
mTOR inhibitor Treats Autistic-like Behaviors in Tsc2+/- rats but not following Developmental Status Epilepticus
Authors: Petrasek Tomas , Vojtechova Iveta , Klovrza Ondrej , Tuckova Klara , Vejmola Cestmir , Rak Jakub , Sulakova Anna , Kaping Daniel , Bernhardt Nadine , de Vries Petrus , Otahal Jakub , Waltereit Robert
Published: December 2020

Background: Tuberous Sclerosis Complex (TSC), a multi-system genetic disorder often associated with Autism Spectrum Disorder (ASD), is caused by mutations of TSC1 or TSC2, which lead to constitutive overactivation of mammalian Target of Rapamycin (mTOR). In several Tsc1+/- and Tsc2+/- animal models, cognitive and social behavior deficits were reversed by mTOR inhibitors. However, phase II studies have not yet shown amelioration of ASD and cognitive deficits in individuals with TSC during mTOR inhibitor therapy. We asked here if developmental epilepsy, common in the majority of individuals with TSC, but absent in most animal models, could explain the discrepancy. Methods: At postnatal day P12, developmental status epilepticus (DSE) was induced in male Tsc2+/- (Eker) and wild-type rats, establishing four experimental groups including controls. In adult animals (n = 36), behavior was assessed in the paradigms of social interaction test, elevated plus-maze, light-dark test, Y-maze and novel object recognition. Electroencephalographic (EEG) activity was recorded in a separate set of animals (n = 18). The testing was carried out before medication (T1), during treatment with the mTOR inhibitor everolimus (T2) and after washing-out (T3). Results: Both Tsc2+/- mutation and DSE caused social behavior deficits and epileptiform EEG abnormalities (T1). Everolimus led to persistent improvement of the social deficit induced by Tsc2+/-, while deficits related to DSE did not respond to everolimus (T2, T3). Conclusions: These findings may contribute to an explanation why ASD symptoms in individuals with TSC, where comorbid early-onset epilepsy is common, were so far in clinical studies not reliably ameliorated by mTOR inhibitors.
Obesity Is Associated with Severe Disease and Mortality in Patients with Coronavirus Disease 2019 (COVID-19)
Authors: Cai Zixin , Yang Yan , Zhang Jingjing
Published: December 2020

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to global research with the aim of predicting which people are at greatest risk of developing severe disease and dying. The aim of this meta-analysis was to determine the associations between obesity and the severity of and mortality due to COVID-19. Methods: We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies evaluating the associations of obesity with COVID-19 . Odd risks (ORs) and 95% confidence intervals (CIs) were calculated using random- or fixed-effects models. Results: Thirty-eight studies involving 621502 patients were included. Compared with nonobese patients, obese patients had a significantly increased risk of infection (OR 3.19, 95% CI 1.45-7.03; I2 = 98.3%), hospitalization (OR 1.77, 95% CI 1.61-1.95; I2 = 43.8%), clinically severe disease (OR 2.88, 95% CI 1.99-4.16; I2 = 49.9%), mechanical ventilation (OR 1.66, 95% CI1.42-1.94; I2 = 41.3%), intensive care unit (ICU) (OR 2.06, 95% CI1.49-2.85; I2 = 71.4%), and mortality (OR 1.48, 95% CI 1.18-1.85; I2 = 80.8%). Conclusion: Patients with obesity may have a greater risk of developing severe COVID-19 and dying. Therefore, it is important to increase awareness of these associations with obesity in COVID-19 patients.
Evaluation of Health Care Providers’ Use of the ‘Exercise and Depression Toolkit’: a Case Study.
Authors: Glowacki Krista , Zumrawi Daniah , Michalak Erin , Faulkner Guy
Published: December 2020

Background: Exercise is now recommended as a primary treatment for mild-moderate depression in Canada. The ‘Exercise and Depression Toolkit’ was developed to help health care providers (HCP) integrate these treatment guidelines into practice. The purpose of this study was to evaluate acceptability and perceived effectiveness of the toolkit in practice by HCPs working with individuals with depression. Methods: A case study design was utilized. The toolkit was given to 6 HCPs to use in practice for four weeks. Pre- and post-intervention phone interviews were conducted, and weekly logs were provided to track use and satisfaction of interactions with individuals with depression when using the toolkit. The study was conceptually guided by a hybrid theoretical approach using the Diffusion of Innovation Theory and the Theoretical Framework of Acceptability.Results: All HCPs used the toolkit at least once. Participants viewed their interactions when using the toolkit to be successful (considering individuals’ receptiveness, its usefulness and general satisfaction.) The average success score for all participants was 5.5/7. HCPs found the toolkit to be acceptable. All participants (n=6) viewed the toolkit as having relative advantage in helping them to discuss exercise with individuals with depression, and as relatively simple and easy to use (not complex) and adaptable to their practice needs (having trialability). Participants liked the toolkit and had mostly positive things to say about it. Participants had mixed feelings about whether changes in the people they worked with (such as mood and activity levels) could be observed (observability) and whether the toolkit changed their belief in their ability to recommend or discuss exercise (self-efficacy). Recommended dissemination strategies were adopted in promoting the toolkit. Conclusions: Future work should address observability and the ability for health care providers to see other providers using it, as well as effectiveness considering outcomes for people with depression such as mood and activity changes. The results of this initial evaluation seem promising for uptake and future adoption of the toolkit by health care providers working with adults with depression in Canada.
A Systematic Review and Meta-Analysis of Deep Brain Stimulation for Progressive Supranuclear Palsy
Authors: Wen Yafei , Jiao Bin , Zhou Yafang , Shen Lu
Published: December 2020

Background: Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease and currently no effective symptomatic or neuroprotective treatment is available for PSP. Deep brain stimulation (DBS), as a neurosurgical procedure, plays an important role in a range of neurological and psychiatric disorders. However, there are no systematic investigations about the DBS in PSP patients. Objective: We performed a systematic review and meta-analysis to evaluate the safety and efficacy of DBS for PSP. Methods: PubMed, EMBASE, Cochrane library, Chinese National Knowledge Infrastructure and Wan Fang databases were systematically searched without time restrictions. We assessed the data between DBS-OFF and DBS-ON groups, as measured by the Unifed Parkinson Disease Rating Scale (UPDRS). Results: Of 154 identified studies, 13 were eligible and were included in our meta-analysis (N = 36 participants). A reduction of UPDRS Ⅲ scores under DBS-ON conditions was observed, but the differences yielded no statistical significance. Conclusion: Since part of PSP patients could benefit from DBS, we speculate that DBS may become a safe and promising tool for PSP in axial symptoms as well as non-motor symptoms though further investgations are needed. Our findings will provide design strategies for following clinical trials and ultimately help improve the clinical application of DBS in PSP patients.
Patient and Caregiver Experiences of Living With Acute Hepatic Porphyria in the UK: A Mixed-Methods Study
Authors: Gill Liz , Burrell Sue , Chamberlayne John , Lombardelli Stephen , Mora Jordanna , Mason Nicola , Schurer Marieke , Merkel Madeline , Meninger Stephen , Ko John
Published: December 2020

BackgroundThis study used quantitative and qualitative research methods to analyze how acute hepatic porphyria (AHP) affects patients with varying annualized porphyria attack rates (AARs). The overall impact of AHP on patients and caregivers, including their quality of life, was explored. The nature and treatment of acute attacks, experiences of long-term heme arginate treatment and access to other appropriate treatment, as well as the extent of, and treatment for, chronic symptoms, were also included within this study. MethodsPatient and caregiver data were collected via an online survey of members of the British Porphyria Association, followed by an optional one-hour telephone interview. ResultsThirty-eight patients and 10 caregivers responded to the survey. Of those, 10 patients and three caregivers completed follow-up interviews. Overall, 19 patients (50%) had experienced an acute attack within the previous two years, and the severity and types of symptoms experienced during or between acute attacks varied considerably. There was no clear definition among patients or caregivers of a ‘mild’ or ‘severe’ attack. Treatment used to manage attacks also varied, and previous experience with hospital care while managing an attack also affected whether a patient chose to return to hospital or manage the attack at home. Managing the attack at home is therefore not a signifier of the severity of the attack itself. Ninety-four percent of patients also experienced chronic symptoms, which were as varied as acute attacks. Pain was the predominant chronic symptom and was managed with opioids in severe cases. Regardless of AAR, porphyria heavily impacted the daily lives of patients and caregivers. Although patients experiencing frequent attacks generally endured a greater impact on their daily life, patients with less frequent attacks also experienced impacts on all domains (social, pain, discomfort, mobility, diet, relationship with family, relationships, psychological wellbeing, finances, employment and study). Caregivers were most affected in finance, relationships with family and employment domains, and just over half of the caregivers reported a moderate impact on their psychological wellbeing. Conclusions/implications﻿The burden of illness with AHP is high across all patients, regardless of frequency of attacks, and AHP negatively affects patients and caregivers alike.
Clinical Outcome of COVID 19 Patients After Hospitalization: Observational Study from a Tertiary Care Hospital, PAKISTAN
Authors: Ishaque Sadia , Syed Beenish , Akhter Saima , Safeer Talha , Hashmi Atif , Mansoor Yousra , khawaja Shahroz , Durrani Noureen
Published: December 2020

Introduction: The outbreak of novel coronavirus (COVID-19) is a public health emergency that had caused disastrous results in more than 100 countries. Method: This observational study is conducted with aim to track the course of clinical outcomes of the course of COVID 19 patients after discharge. Demographics, baseline characteristics of COVID-19 patients discharged from May till August 2020, in Liaquat National hospital Karachi, Pakistan were collected and analyzed by reviewing the medical records retrospectively. Post-hospitalization data related to clinical outcomes were obtained by following up the patients for 4 weeks. Results: Total 96 records of discharged patients were reviewed. Mean age of them was 53.83 ± 12.89 years with male predominance (78.1%). Out of 96 patients, 19(19.8%) patients were asymptomatic at the time of discharge whereas 77(80.2%) had improved symptoms. The frequent symptoms at time of discharged was fatigue (69.8%) followed by shortness of breath (34.4%). Over the follow-up of 4 weeks, there was significant reduction in symptoms from discharge to 4th week excluding first week only. Patients were found to have significantly improved chest x-ray findings from discharge to first week of follow-up. Out of 77 symptomatic patients, 50(64.9%) patients were found to be asymptomatic while 27(35.1%) were persistently symptomatic on fourth week of the discharge with most frequent symptom of fatigue (33%) followed by shortness of breath (18%).Conclusion: There was significant recovery in most of the COVID 19 survivors after discharge, confirmed by reduction in the symptoms and radiological improvement.