bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of heart disease and classifiers’ sensitivity analysis
Authors: Almustafa Khaled Mohamad
Published: July 2020

Background

Heart disease (HD) is one of the most common diseases nowadays, and an early diagnosis of such a disease is a crucial task for many health care providers to prevent their patients for such a disease and to save lives. In this paper, a comparative analysis of different classifiers was performed for the classification of the Heart Disease dataset in order to correctly classify and or predict HD cases with minimal attributes. The set contains 76 attributes including the class attribute, for 1025 patients collected from Cleveland, Hungary, Switzerland, and Long Beach, but in this paper, only a subset of 14 attributes are used, and each attribute has a given set value. The algorithms used K- Nearest Neighbor (K-NN), Naive Bayes, Decision tree J48, JRip, SVM, Adaboost, Stochastic Gradient Decent (SGD) and Decision Table (DT) classifiers to show the performance of the selected classifications algorithms to best classify, and or predict, the HD cases.

Results

It was shown that using different classification algorithms for the classification of the HD dataset gives very promising results in term of the classification accuracy for the K-NN (K = 1), Decision tree J48 and JRip classifiers with accuracy of classification of 99.7073, 98.0488 and 97.2683% respectively. A feature extraction method was performed using Classifier Subset Evaluator on the HD dataset, and results show enhanced performance in term of the classification accuracy for K-NN (N = 1) and Decision Table classifiers to 100 and 93.8537% respectively after using the selected features by only applying a combination of up to 4 attributes instead of 13 attributes for the predication of the HD cases.

Conclusion

Different classifiers were used and compared to classify the HD dataset, and we concluded the benefit of having a reliable feature selection method for HD disease prediction with using minimal number of attributes instead of having to consider all available ones.
Maternal effects shape the alternative splicing of parental alleles in reciprocal cross hybrids of Megalobrama amblycephala × Culter alburnus
Authors: Ren Li , Yan Xiaojing , Gao Xin , Cui Jialin , Yan Pengcheng , Wu Chang , Li Wuhui , Liu Shaojun
Published: July 2020

Background

Maternal effects contribute to adaptive significance for shaping various phenotypes of many traits. Potential implications of maternal effects are the cause of expression diversity, but these effects on mRNA expression and alternative splicing (AS) have not been fully elucidated in hybrid animals.

Results

Two reciprocal cross hybrids following hybridization of Megalobrama amblycephala (blunt snout bream, BSB) and Culter alburnus (topmouth culter, TC) were used as a model to investigate maternal effects. By comparing the expression of BSB- and TC- homoeologous genes between the two reciprocal cross hybrids, we identified 49–348 differentially expressed BSB-homoeologous genes and 54–354 differentially expressed TC-homoeologous genes. 2402, 2959, and 3418 AS events between the two reciprocal cross hybrids were detected in Illumina data of muscle, liver, and gonad, respectively. Moreover, 21,577 (TC-homoeologs) and 30,007 (BSB-homoeologs) AS events were found in the 20,131 homoeologous gene pairs of TBF3 based on PacBio data, while 30,561 (TC-homoeologs) and 30,305 (BSB-homoeologs) AS events were found in BTF3. These results further improve AS prediction at the homoeolog level. The various AS patterns in bmpr2a belonging to the bone morphogenetic protein family were selected as AS models to investigate the expression diversity and its potential effects to body shape traits.

Conclusions

The distribution of differentially expressed genes and AS in BSB- and TC-subgenomes exhibited various changes between the two reciprocal cross hybrids, suggesting that maternal effects were the cause of expression diversity. These findings provide a novel insight into mRNA expression changes and AS under maternal effects in lower vertebrates.
Discovery, identification, and functional characterization of long noncoding RNAs in Arachis hypogaea L.
Authors: Tian Haiying , Guo Feng , Zhang Zhimeng , Ding Hong , Meng Jingjing , Li Xinguo , Peng Zhenying , Wan Shubo
Published: July 2020

Background

Long noncoding RNAs (lncRNAs), which are typically > 200 nt in length, are involved in numerous biological processes. Studies on lncRNAs in the cultivated peanut (Arachis hypogaea L.) largely remain unknown.

Results

A genome-wide scan of the peanut (Arachis hypogaea L.) transcriptome identified 1442 lncRNAs, which were encoded by loci distributed over every chromosome. Long intergenic noncoding RNAs accounted for 85.58% of these lncRNAs. Additionally, 189 lncRNAs were differentially abundant in the root, leaf, or seed. Generally, lncRNAs showed lower expression levels, tighter tissue-specific expression, and less splicing than mRNAs. Approximately 44.17% of the lncRNAs with an exon/intron structure were alternatively spliced; this rate was slightly lower than the splicing rate of mRNA. Transcription at the start site event was the alternative splicing (AS) event with the highest frequency (28.05%) in peanut lncRNAs, whereas the occurrence rate (30.19%) of intron retention event was the highest in mRNAs. AS changed the target gene profiles of lncRNAs and increased the diversity and flexibility of lncRNAs, which may be important for lncRNAs to execute their functions. Additionally, a substantial number of the peanut AS isoforms generated from protein-encoding genes appeared to be noncoding because they were truncated transcripts; such isoforms can be legitimately regarded as a class of lncRNAs. The predicted target genes of the lncRNAs were involved in a wide range of biological processes. Furthermore, expression pattern of several selected lncRNAs and their target genes were examined under salt stress, results showed that all of them could respond to salt stress in different manners.

Conclusions

This study provided a resource of candidate lncRNAs and expression patterns across tissues, and whether these lncRNAs are functional will be further investigated in our subsequent experiments.
Correction to: SNP genotyping elucidates the genetic diversity of Magna Graecia grapevine germplasm and its historical origin and dissemination
Authors: De Lorenzis Gabriella , Mercati Francesco , Bergamini Carlo , Cardone Maria Francesca , Lupini Antonio , Mauceri Antonio , Caputo Angelo Raffaele , Abbate Loredana , Barbagallo Maria Gabriella , Antonacci Donato , Sunseri Francesco , Brancadoro Lucio
Published: July 2020

An amendment to this paper has been published and can be accessed via the original article.
Group testing performance evaluation for SARS-CoV-2 massive scale screening and testing
Authors: Nalbantoglu Ozkan Ufuk
Published: July 2020

Background

The capacity of the current molecular testing convention does not allow high-throughput and community level scans of COVID-19 infections. The diameter in the current paradigm of shallow tracing is unlikely to reach the silent clusters that might be as important as the symptomatic cases in the spread of the disease. Group testing is a feasible and promising approach when the resources are scarce and when a relatively low prevalence regime is observed on the population.

Methods

We employed group testing with a sparse random pooling scheme and conventional group test decoding algorithms both for exact and inexact recovery.

Results

Our simulations showed that significant reduction in per case test numbers (or expansion in total test numbers preserving the number of actual tests conducted) for very sparse prevalence regimes is available. Currently proposed COVID-19 group testing schemes offer a gain up to 15X-20X scale-up. There is a good probability that the required scale up to achieve massive scale testing might be greater in certain scenarios. We investigated if further improvement is available, especially in sparse prevalence occurrence where outbreaks are needed to be avoided by population scans.

Conclusion

Our simulations show that sparse random pooling can provide improved efficiency gains compared to conventional group testing or Reed-Solomon error correcting codes. Therefore, we propose that special designs for different scenarios could be available and it is possible to scale up testing capabilities significantly.
Management of work-related common mental disorders in general practice: a cross-sectional study
Authors: Rivière M. , Toullic Y. , Lerouge P. , Blanchon T. , Leroyer A. , Plancke L. , Prazuck T. , Melchior M. , Younès N.
Published: July 2020

Background

General practitioners (GPs) often manage individuals with work-related common mental disorders (CMD: depressive disorders, anxiety and alcohol abuse). However, little is known about the ways in which they proceed. The aim of this study is to analyze GPs’ management and patterns of referral to other health professionals of patients with work-related CMD and associated factors.

Method

We used data from a cross-sectional study of 2027 working patients of 121 GPs in the Nord – Pas-de-Calais region in France (April – August 2014). Statistical analyses focused on patients with work-related CMD detected by the GP and examined the ways in which GPs managed these patients’ symptoms. Associations between patient, work, GP and contextual characteristics and GPs’ management were explored using modified Poisson regression models with robust variance.

Results

Among the 533 patients with work-related CMD in the study, GPs provided psychosocial support to 88.0%, prescribed psychotropic treatment to 82.4% and put 50.7% on sick leave. Referral rates to mental health specialists and occupational physicians were respectively 39.8 and 26.1%. Several factors including patients’ characteristics (occupational and sociodemographic), GPs’ characteristics and environmental data were associated with the type of management used by the GP.

Conclusion

Our study emphasizes the major and often lonesome role of the GP in the management of patients with work-related CMDs. Better knowledge of the way GPs manage those patients could help GPs in their practice, improve patients care and be a starting point to implement a more collaborative care approach.
Use of resuscitation promoting factors to screen for tuberculosis infection in household-exposed children in The Gambia
Authors: van Loon W. , Gomez M. P. , Jobe D. , Franken K. L. M. C. , Ottenhoff T. H. M. , Coninx M. , Kestens L. , Sutherland J. S. , Kampmann B. , Tientcheu L. D.
Published: July 2020

Background

Interferon-γ release assays (IGRA) with Resuscitation promoting factor (Rpf) proteins enhanced tuberculosis (TB) screening and diagnosis in adults but have not been evaluated in children. Children often develop paucibacillary TB and their immune response differs from that of adults, which together affect TB disease diagnostics and immunodiagnostics. We assessed the ability of Rpf to identify infection among household TB-exposed children in The Gambia and investigated their ability to discriminate Mycobacterium tuberculosis complex (MTBC) infection from active TB disease in children.

Methods

Detailed clinical investigations were done on 93 household TB-exposed Gambian children and a tuberculin skin test (TST) was administered to asymptomatic children. Venous blood was collected for overnight stimulation with ESAT-6/CFP-10-fusion protein (EC), purified protein derivative and RpfA, B, C, D and E. Interferon gamma (IFN-γ) production was measured by ELISA in supernatants and corrected for the background level. Infection status was defined by IGRA with EC and TB disease by mycobacterial confirmation and/or clinical diagnosis. We compared IFN-γ levels between infected and uninfected children and between infected and TB diseased children using a binomial logistic regression model while correcting for age and sex. A Receiver Operating Characteristics analysis was done to find the best cut-off for IFN-γ level and calculate sensitivity and specificity.

Results

Interferon gamma production was significantly higher in infected (IGRA+, n = 45) than in uninfected (IGRA-, n = 20) children after stimulation with RpfA, B, C, and D (P = 0.03; 0.007; 0.03 and 0.003, respectively). Using RpfB and D-specific IFN-γ cut-offs (33.9 pg/mL and 67.0 pg/mL), infection was classified with a sensitivity-specificity combination of 73–92% and 77–72% respectively, which was similar to and better than 65–75% for TST. Moreover, IFN-γ production was higher in infected than in TB diseased children (n = 28, 5 bacteriologically confirmed, 23 clinically diagnosed), following RpfB and D stimulation (P = 0.02 and 0.03, respectively).

Conclusion

RpfB and RpfD show promising results for childhood MTBC infection screening, and both performed similar to and better than the TST in our study population. Additionally, both antigens appear to discriminate between infection and disease in children and thus warrant further investigation as screening and diagnostic antigens for childhood TB.
Induced neuroprotection by remote ischemic perconditioning as a new paradigm in ischemic stroke at the acute phase, a systematic review
Authors: Purroy Francisco , García Cristina , Mauri Gerard , Pereira Cristina , Torres Coral , Vazquez-Justes Daniel , Vicente-Pascual Mikel , Vena Ana , Arque Gloria
Published: July 2020

Background

Remote ischemic conditioning during cerebral ischemia (remote ischemic perconditioning, RIPerC) refers to the application of several cycles of brief ischemia and reperfusion (I/R) commonly to a limb, and it represents a new paradigm in neuroprotection with multiple mechanisms of action in ischemic stroke (IS) patients during acute phase. Some clinical trials just finished, and a few others are still ongoing; gather the current knowledge and pull it down to influence the present and future studies was the goal of this paper.

Methods

A systematic review of published research papers and/or registered clinical trials since 2000 was performed.

Results

Nineteen studies were identified and only four studies were completed. All of them have demonstrated that RIPerC is safe, feasible and well tolerated in IS patients. However, a high heterogeneity of clinical trial characteristics was observed: five (26.3%) randomized clinical trials (RCTs) included only thrombolytic-treated patients, three (15.8%) RCTs only thrombectomy-treated patients, and five (26.3%) RCTs required radiological confirmation of IS. Temporal inclusion criteria vary from 4 h to 48 h. Most of the clinical trials used 4 cycles of RIPerC in the upper non-affected limb. Interestingly, only three (16.7%) RCTs applied RIPerC during the transportation in the ambulance. Neuroimaging outputs were the main endpoints when endovascular therapy was applied; functional outcome is also the main endpoint in large-medium size studies.

Conclusions

This review summarizes the completed and ongoing clinical trials on RIPerC in IS patients, where RIPerC has been used alone or in combination with recanalization therapies. Ongoing clinical trials will provide new information on the best RIPerC intervention strategy and potentially improve the functional outcome of IS patients; definition of new RIPerC strategies would ideally aim at enhancing tissue preservation, promoting neurological recovery, and stratify patients to improve treatment feasibility.
Pregnant women’s clinical characteristics, intrapartum interventions, and duration of labour in urban China: a multi-center cross-sectional study
Authors: Gu Chunyi , Wang Xiaojiao , Zhang Zhijie , Schwank Simone , Zhu Chunxiang , Zhang Zheng , Qian Xu
Published: July 2020

Background

There is an increasing global trend towards the widespread over-medicalisation of labour and childbirth. The present study aimed to investigate pregnant women’s clinical characteristics, intrapartum interventions, duration of labour and its associated factors; and to compare the differences of these variables between nulliparas and multiparas in China.

Methods

A multi-center cross-sectional study was carried out in three tertiary hospitals of Fudan University in Shanghai, China. A total of 1523 participants were approched and assessed for eligibility. Data on women’s sociodemographic characteristics, intrapartum interventions, and duration of labour were measured and collected. Kaplan-Meier survival analysis was performed to present the curves of total duration of labour by parity. After z-transformation of labour duration, multivariable linear regression was used to control for confounding and to identify independent associations between potential associated factors and the primary outcome of labour duration.

Results

Overall, 1209 eligible women agreed to participate and were investigated. Rates of different intrapartum interventions were 27.4% in use of amniotomy, 37.9% in use of oxytocin, 53.0% in continuous electronic fetal monitoring, and 52.9% in epidural use, respectively. The curve of total duration of labour was significantly different between nulliparas and multiparas (P < .001). Of the 1209 participants, 983 (81.3%) women eventually achieved successful vaginal birth while 226 (18.7%) women ended in intrapartum caesarean section. The median duration of total stage of labour was significantly longer in the nulliparous group [9.38 (6.33,14.10) hours] than that in the multiparous group [5.08 (3.00,7.83) hours] (P < .001). The following factors were independently associated with longer duration of total stage of labour: epidural analgesia (P < .001), primiparity (P < .001), continuous electronic fetal monitoring (P = .035), and increased birth weight (P = .005).

Conclusions

Intrapartum medical interventions become common obstetric practices in urban China. Multifactorial variables independently associated with longer duration of labour were identified, including epidural analgesia, primiparity, continuous electronic fetal monitoring, and increased birth weight. Further research is required to validate these variables and to determine the modifiable factors for labour management. And models of care with lower intervention rates such as midwife-led models of care should be developed and implemented in China.
PODXL might be a new prognostic biomarker in various cancers: a meta-analysis and sequential verification with TCGA datasets
Authors: He Siying , Du Wenjie , Li Menglan , Yan Ming , Zheng Fang
Published: July 2020

ABSRACT

Background

Several studies have investigated the associations between the podocalyxin-like protein (PODXL) expression quantity or locations and cancers survival, but the results were far from conclusive. Therefore, we proceeded a meta-analysis on PODXL in various human cancers to find its prognostic value and followed confirmation using the TCGA datasets.

Methods

We performed a systematic search, and 18 citations, including 5705 patients were pooled in meta-analysis. The results were verified with TCGA datasets.

Results

Total eligible studies comprised 5705 patients with 10 types of cancer. And the result indicated that PODXL high-expression or membrane-expression were significantly related to poor overall survival (OS). However, subgroup analysis showed a significant association between high expressed PODXL and poor OS in the colorectal cancer, pancreatic cancer, urothelial bladder cancer, renal cell carcinoma and glioblastoma multiforme. Then, we validated the inference using TCGA datasets, and the consistent results were demonstrated in patients with pancreatic cancer, glioblastoma multiforme, gastric cancer, esophageal cancer and lung adenocarcinoma.

Conclusion

The result of meta-analysis showed that high expressed PODXL was significantly linked with poor OS in pancreatic cancer and glioblastoma multiforme, but not in gastric cancer, esophageal cancer or lung adenocarcinoma. And the membrane expression of PODXL might also associate with poor OS. PODXL may act as tumor promotor and may serve as a potential target for antitumor therapy.
Case report-immune recovery posterior scleritis in a HIV positive patient
Authors: Che Xin , Jiang Jing , Qian Yiwen , Li Qingjian , Zhang Yu , Wang Zhiliang
Published: July 2020

Background

Posterior scleritis is an uncommon vision-threatening disorder that is often recurrent and difficult to cure due to its complex etiology. In HIV patients, posterior scleritis may develop several months after significant rise in CD4+ T-lymphocyte, even after several years, which may be diagnosed as late-onset immune recovery scleritis.

Case presentation

Here we report a case of posterior scleritis in a HIV positive patient who presented with severe periocular pain and decreased vision in the left eye, with exudative retinal detachment and optic nerve involvement.

Conclusions

Early differential diagnosis of immune recovery posterior scleritis and intensive corticosteroids treatment, can prevent vision loss effectively in HIV patients.
Earthquake-related stressors associated with suicidality, depression, anxiety and post-traumatic stress in adolescents from Muisne after the earthquake 2016 in Ecuador
Authors: Gerstner Rebekka M. F. , Lara-Lara Fernando , Vasconez Eduardo , Viscor Ginés , Jarrin Juan D. , Ortiz-Prado Esteban
Published: July 2020

Background

The Ecuadorian earthquake in April 16th was the second strongest and deadliest in 2016 worldwide, with approximately one million people affected. In this paper, we analyzed the psychological impact and the relationship between mental health events and various earthquake-related stressors related to the earthquake, 9 months after the event.

Methods

We conducted an analytical cross-sectional study, applying an anonymous survey to 316 adolescents (13–19 years old) from Muisne, Ecuador. Suicidal tendency, depression, anxiety and post-traumatic stress (PTSD) were evaluated via the Child PTSD Symptom Scale (CPSS), Spence Children’s Anxiety Scale, Okasha Suicidality Scale, and the Center for Epidemiologic Studies Depression Scale (CES-D) and the adapted seven-questions earthquake-related stressors survey.

Results

We found a high prevalence of suicidal ideations and behavior, posttraumatic stress, depression and anxiety compared to international studies. Even though adolescents currently living in shelters had higher levels of anxiety, their suicidal tendency was significantly lower than those living in their own or their relatives’ home. Finally, the earthquake-related stressors were not associated with suicidality and mental health events, with the exception of economic damage suffered by the family.

Conclusions

High levels of depression, post-traumatic stress and anxiety among high-school students were found, especially among those who have suffered serious economic damage.

The economic impact in their families and high unemployment rates among their parents seems to be related to lack of hope and favorable perspectives for their future, situation that might lead to lead to emotional disturbances and psychological disorders. Although prolonged homelessness experience in shelters may be a stressful occurrence, might also be related with spiritual growth among adolescents, and may work as a protective factor against suicidal ideations and attempts.
Alterations in articular cartilage T2 star relaxation time following mechanical disorders: in vivo canine supraspinatus tendon resection models
Authors: Lee Dokwan , Hong Ki-Taek , Lim Tae Seong , Lee Eugene , Lee Ye Hyun , Park Ji Soon , Kim Woo , Oh Joo Han , Choi Jung-Ah , Song Yongnam
Published: July 2020

Background

The role of altered joint mechanics on cartilage degeneration in in vivo models has not been studied successfully due to a lack of pre-injury information. We aimed 1) to develop an accurate in vivo canine model to measure the changes in joint loading and T2 star (T2*) relaxation time before and after unilateral supraspinatus tendon resections, and 2) to find the relationship between regional variations in articular cartilage loading patterns and T2* relaxation time distributions.

Methods

Rigid markers were implanted in the scapula and humerus of tested dogs. The movement of the shoulder bones were measured by a motion tracking system during normal gaits. In vivo cartilage contact strain was measured by aligning 3D shoulder models with the motion tracking data. Articular cartilage T2* relaxation times were measured by quantitative MRI scans. Articular cartilage contact strain and T2* relaxation time were compared in the shoulders before and 3 months after the supraspinatus tendon resections.

Results

Excellent accuracy and reproducibility were found in our in vivo contact strain measurements with less than 1% errors. Changes in articular cartilage contact strain exhibited similar patterns with the changes in the T2* relaxation time after resection surgeries. Regional changes in the articular cartilage T2* relaxation time exhibited positive correlations with regional contact strain variations 3 months after the supraspinatus resection surgeries.

Conclusion

This is the first study to measure in vivo articular cartilage contact strains with high accuracy and reproducibility. Positive correlations between contact strain and T2* relaxation time suggest that the articular cartilage extracellular matrix may responds to mechanical changes in local areas.
Systemic therapy for advanced clear cell renal cell carcinoma after discontinuation of immune-oncology and VEGF targeted therapy combinations
Authors: Ged Yasser , Gupta Ruby , Duzgol Cihan , Knezevic Andrea , Shapnik Natalie , Kotecha Ritesh , Voss Martin H. , Feldman Darren R. , Akin Oguz , Patil Sujata , Motzer Robert J. , Rini Brian I. , Lee Chung-Han
Published: July 2020

Background

Several phase 3 studies reported positive results for combinations of Immune-Oncology (IO) and Vascular Endothelial Growth Factor (VEGF) targeted therapies in patients with metastatic clear cell Renal Cell Carcinoma (ccRCC). However, there are limited data on outcomes to systemic therapy after IO-VEGF combinations.

Methods

A retrospective analysis was performed on patients with metastatic ccRCC treated at the Memorial Sloan Kettering Cancer Center and Cleveland Clinic who initiated systemic therapy post IO-VEGF including combinations with VEGF receptor (VEGFR) tyrosine kinase inhibitors (IO-TKI) and combinations with the anti-VEGF monoclonal antibody bevacizumab (IO-Bev). The study objectives were to evaluate the objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) on systemic therapy post IO-VEGF. RECIST v1.1 criteria were used to determine radiological responses and progression. Survival estimates were evaluated with the Kaplan-Meier methods and the log-rank test from the start of systemic therapy post IO-VEGF to the event of interest.

Results

A total of fifty-nine patients were treated post discontinuation of IO-VEGF regimens which included IO-Bev (n = 35; 59%) and IO-TKI (n = 24; 41%). Fifty-eight patients (98%) received IO-VEGF regimens as part of a clinical trial. Subsequent therapies included cabozantinib (n = 22; 37%), axitinib (n = 18; 31%), pazopanib (n = 4; 7%), lenvatinib and everolimus (n = 4; 7%), mTOR inhibitor monotherapy (n = 3; 5%), axitinib and dalantercept (n = 2; 3%), sunitinib (n = 1; 2%), sorafenib (n = 1; 2%), and treatment with agents on unreported clinical trials (n = 4; 7%). Patients treated on unreported clinical trials were excluded from the efficacy analysis. Post IO-VEGF, the ORR was 25% and median PFS was 12.0 months (95% CI, 8.2–24.5). Median OS was 24.5 months (95% CI, 12–NE) and 12 months OS rate was 63.3% (95% CI, 48.6–74.9). We observed no differences post IO-VEGF OS when comparing IO- TKI vs IO-Bev (Log-rank p = 0.73).

Conclusions

Post IO-VEGF, most patients received VEGFR-TKIs. In this setting, VEGFR-TKIs demonstrated clinical activity and remain a viable option for salvage therapy after progression on IO-VEGF.
Self-reported oral health problems and the ability to organize dental care of community-dwelling elderly aged ≥75 years
Authors: Bakker M. H. , Vissink A. , Spoorenberg S. L. W. , Wynia K. , Visser A.
Published: July 2020

Background

It is unclear how many community-dwelling elderly (≥75 years) experience oral health problems (e.g. pain, dry mouth, chewing problems) and how they manage their dental care needs. This study aimed to assess self-reported oral health problems in elderly who are frail or have complex care needs, and their ability to organize dental care when reporting oral pain.

Methods

Three thousand five hundred thirty-three community-dwelling elderly participating in the “Embrace” project were asked to complete questionnaires regarding oral status and oral health problems. Frailty was assessed with the Groningen Frailty Indicator (GFI). Intermed for Elderly Self-Assessment (IM-E-SA) was used to determine complexity of care needs. Next, elderly who reported oral pain were interviewed about their oral pain complaints, their need for dental care, and their ability to organize and receive dental care. For statistical analyses Chi2-tests and the one-way ANOVA were used.

Results

One thousand six hundred twenty-two elderly (45.9%) completed the questionnaires. Dry mouth (11.7%) and oral pain (6.2%) were most frequently reported. Among the elderly reporting oral pain, most were registered at a local dentist and could go there when needed (84.3%). Robust elderly visited the dentist independently (87%), frail (55.6%) and complex (26.9%) elderly more often required assistance from caregivers.

Conclusions

Dry mouth and oral pain are most reported oral health problems among community-dwelling elderly. Elderly with complex care needs report most oral health problems. In case an elderly seeks dental treatment to alleviate an oral pain complaint, most elderly in this study were able to organize dental care and transport to the dentist. Frail and complex elderly often need assistance from caregivers to visit the dentist. Therefore caretakers should keep in mind that when frailty progresses, visiting a dentist may become more and more difficult and the risk for poor oral health increases.
Synergistic platelet inhibition between Omega-3 and acetylsalicylic acid dose titration; an observational study
Authors: Bagger Harald , Hansson Mattias , Kander Thomas , Schött Ulf
Published: July 2020

Background

Omega-3 and acetylsalicylic acid (ASA) are two widely used “over-the-counter” drugs. Previous research has shown multiple electrode aggregometry (MEA) can detect ASA and varying Omega-3 platelet inhibiting effects. Synergistic platelet inhibiting effects of ASA and Omega-3 have been found using other methods than MEA. The aim of this study was to investigate the antiplatelet effects of Omega-3, and ASA synergism with MEA.

Methods

Ten healthy male volunteers ingested Omega-3 (1260 mg/day) for 5 days. MEA was used to analyse platelet function before and after Omega-3 intake. Aggregation was initiated using three different agonists and measured as area under the curve (AUC): adenosine diphosphate (ADP), thrombin receptor activating peptide (TRAP) and arachidonic acid (ASPI). Two concentrations of ASA were dose titrated ex vivo to 2 out of 3 ASPI test cells in order to measure synergism between Omega-3 and ASA.

Results

Following 5 days Omega-3 intake, ADP, TRAP and ASPI AUC did not change significantly. In vitro ASA before Omega-3 intake, reduced ASPI AUC < 30 U, indicating a strong platelet inhibiting effect. Below this AUC level, the 5 days Omega-3 intake increased ASPI-AUC with the ex vivo added low dose ASA (P = 0.02) and high dose ASA (P = 0.04).

Conclusions

No synergism between ASA and Omega-3 was found using the MEA ASPI test. The surprising increase in ASPI-AUC following Omega-3 intake and ex vivo ASA suggest that there are methodological issuses with the MEA ASPI test.

Trial registration

Trial registration ISRCTN78027929. Registered 19 May 2015.
Qiliqiangxin reduced cardiomyocytes apotosis and improved heart function in infarcted heart through Pink1/Parkin -mediated mitochondrial autophagy
Authors: Zhou Junyang , Wang Zhixiao , He Yun , Luo Xinxia , Zhang Wenjun , Yu Li , Chen Xiuying , He Xiju , Yuan Yahong , Wang Xiaoli , Guo Xinrong , Tang Junming , Zhu Mingan , Li Dongsheng , Ding Yan
Published: July 2020

Background

Qiliqiangxin (QLQX) is a preparation refined from a traditional Chinese medicine compound. It plays an important role in protecting cardiac function after myocardial infarction (MI). However, the underline mechanism of QLQX action is not clear. The purpose of this study was to detect the effects of QLQX on mitophagy after MI.

Methods

Male FVB/NJ mice aged 8–10 weeks were underwent left coronary artery ligation and were orally administered either QLQX (0.25 g/kg/d) or saline. Twenty-eight days after surgical operation, the cardiac function of mice was detected by echocardiography. Electron Microscopy was used to observe the microstructure of cardiomyocytes. Myocardial apoptosis was examined by TdT-mediated dUTP Nick-End Labeling (TUNEL) and western blot. H9c2 cells were cultured in a hypoxic incubator chamber (5% CO2, 1% O2, 94% N2) for 12 h and pretreated with or without QLQX (0.5 mg/mL). The cell apoptosis, reactive oxygen species (ROS), mitochondrial membrane potential and mitophagy were detected.

Results

When compared to sham group, the cardiac function of MI mice decreased significantly, and their cardiomyocyte apoptosis and mitochondrial damage were more serious. These MI-induced cardiac changes could be reversed by QLQX treatment. In vitro experiments also confirmed that QLQX could protect cardiomyocytes from hypoxia-induced apoptosis and mitochondrial damage. Further study indicated that QLQX could increase the expression of Pink1 and Parkin in cardiomyocytes.

Conclusion

Qiliqiangxin could reduce cardiomyocytes apotosis and improved heart function in infarcted heart through Pink1-mediated mitochondrial autophagy.
Surgical workflow simulation for the design and assessment of operating room setups in orthopedic surgery
Authors: Neumann Juliane , Angrick Christine , Höhn Celina , Zajonz Dirk , Ghanem Mohamed , Roth Andreas , Neumuth Thomas
Published: July 2020

Background

The design and internal layout of modern operating rooms (OR) are influencing the surgical team’s collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Yet, there is no objective method for the assessment and design of operating room setups for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty.

Methods

With the help of computer simulation, a method for the design and assessment of enhanced OR setups was developed. New OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Thereby, a 3D graphical simulation representation enabled the strong involvement of clinical stakeholders in all phases of the design and decision-making process of the new setup alternatives.

Results

The implementation of improved OR setups reduces the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortens the procedure duration. Additionally, the ergonomics of the OR staff were improved.

Conclusion

The developed simulation method was evaluated in the actual intraoperative setting and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.
Increased expression of CDKN1A/p21 in HIV-1 controllers is correlated with upregulation of ZC3H12A/MCPIP1
Authors: de Azevedo Suwellen S. D. , Ribeiro-Alves Marcelo , Côrtes Fernanda H. , Delatorre Edson , Spangenberg Lucia , Naya Hugo , Seito Leonardo N. , Hoagland Brenda , Grinsztejn Beatriz , Veloso Valdilea G. , Morgado Mariza G. , Souza Thiago Moreno L. , Bello Gonzalo
Published: July 2020

Background

Some multifunctional cellular proteins, as the monocyte chemotactic protein-induced protein 1 (ZC3H12A/MCPIP1) and the cyclin-dependent kinase inhibitor CDKN1A/p21, are able to modulate the cellular susceptibility to the human immunodeficiency virus type 1 (HIV-1). Several studies showed that CDKN1A/p21 is expressed at high levels ex vivo in cells from individuals who naturally control HIV-1 replication (HIC) and a recent study supports a coordinate regulation of ZC3H12A/MCPIP1 and CDKN1A/p21 transcripts in a model of renal carcinoma cells. Here, we explored the potential associations between mRNA expression of ZC3H12A/MCPIP1 and CDKN1A/p21 in HIC sustaining undetectable (elite controllers–EC) or low (viremic controllers–VC) viral loads.

Results

We found a selective upregulation of ZC3H12A/MCPIP1 and CDKN1A/p21 mRNA levels in PBMC from HIC compared with both ART–suppressed and HIV–negative control groups (P≤ 0.02) and higher MCPIP1 and p21 proteins levels in HIC than in HIV-1 negative subjects. There was a moderate positive correlation (r ≥ 0.57; P ≤ 0.014) between expressions of both transcripts in HIC and in HIC combined with control groups. We found positive correlations between the mRNA level of CDKN1A/p21 with activated CD4+ T cells levels in HIC (r ≥ 0.53; P ≤ 0.017) and between the mRNA levels of both CDKN1A/p21 (r = 0.74; P = 0.005) and ZC3H12A/MCPIP1 (r = 0.58; P = 0.040) with plasmatic levels of sCD14 in EC. Reanalysis of published transcriptomic data confirmed the positive association between ZC3H12A/MCPIP1 and CDKN1A/p21 mRNA levels in CD4+ T cells and monocytes from disparate cohorts of HIC and other HIV-positive control groups.

Conclusions

These data show for the first time the simultaneous upregulation of ZC3H12A/MCPIP1 and CDKN1A/p21 transcripts in the setting of natural suppression of HIV-1 replication in vivo and the positive correlation of the expression of these cellular factors in disparate cohorts of HIV-positive individuals. The existence of a common regulatory pathway connecting ZC3H12A/MCPIP1 and CDKN1A/p21 could have a synergistic effect on HIV-1 replication control and pharmacological manipulation of these multifunctional host factors may open novel therapeutic perspectives to prevent HIV-1 replication and disease progression.
Lessons learned through respectful maternity care training and its implementation in Ethiopia: an interventional mixed methods study
Authors: Asefa Anteneh , Morgan Alison , Bohren Meghan A. , Kermode Michelle
Published: July 2020

Background

Improving respectful maternity care (RMC) is a recommended practice during childbirth as a strategy to eliminate the mistreatment of women and improve maternal health. There is limited evidence on the effectiveness of RMC interventions and implementation challenges, especially in low-resource settings. This study describes lessons learned in RMC training and its implementation from the perspectives of service providers’ perceptions and experiences.

Methods

Our mixed methods study employed a pre- and post-intervention quantitative survey of training participants to assess their perceptions of RMC and focus group discussions, two months following the intervention, investigated the experiences of implementing RMC within birthing facilities. The intervention was a three-day RMC training offered to 64 service providers from three hospitals in southern Ethiopia. We performed McNemar’s test to analyse differences in participants’ perceptions of RMC before and after the training. The qualitative data were analysed using hybrid thematic analysis. Integration of the quantitative and qualitative methods was done throughout the design, analysis and reporting of the study.

Results

Mistreatment of women during childbirth was widely reported by participants, including witnessing examinations without privacy (39.1%), and use of physical force (21.9%) within the previous 30 days. Additionally, 29.7% of participants reported they had mistreated a woman. The training improved the participants’ awareness of the rights of women during childbirth and their perceptions and attitudes about RMC were positively influenced. However, participants believed that the RMC training did not address providers’ rights. Structural and systemic issues were the main challenges providers reported when trying to implement RMC in their contexts.

Conclusion

Training alone is insufficient to improve the provision of RMC unless RMC is addressed through a lens of health systems strengthening that addresses the bottlenecks, including the rights of providers of childbirth care.
Ethnobotanical study on medicinal plants used by Mulam people in Guangxi, China
Authors: Hu Renchuan , Lin Chunrui , Xu Weibin , Liu Yan , Long Chunlin
Published: July 2020

Background

The Mulam are an ethnic group native to Guangxi, and nearly 80% of the Mulam population lives in Luocheng Mulam Autonomous County, northern Guangxi, southern China. They have accumulated rich medicinal folk knowledge through practice and experience in their long-term struggles with disease and the harsh natural environment. However, their traditional medicinal knowledge is threatened due to a lack of written records, conservative inheritance patterns, and rapid economic development. Therefore, the investigation and documentation of medicinal plants and their associated indigenous wisdom are necessary.

Method

Ethnobotanical data were collected from 12 villages and five communities in Luocheng County from January 2013 to April 2017. A total of 128 informants were interviewed through semistructured interviews, field observations, group discussions, and guided field walks. Quantitative indices such as use categories, preference ranking exercises, the informant consensus factor (ICF), and the fidelity level (FL) were used to evaluate the importance of medicinal plant species. Additionally, group discussions were conducted about the conservation of and threats to medicinal plants and traditional knowledge.

Results

A total of 456 medicinal plant species from 350 genera and 132 families were recorded and documented in our ethnobotanical investigation. Most of them (335 species, 73.47%) were obtained from wild habitats. Most of the documented species (246) were herbaceous (54%), followed by shrubs, with 76 species (17%), lianas, with 75 species (16%), and trees, with 59 species (13%). The most common method of administration was oral administration, which was used for 390 species (62.70%). The most common method of preparation was decoction (316 species, 54.11%). The plants were used to treat 312 human diseases in 12 disease categories, and most of the categories had a high ICF value. The highest ICF value was recorded for gynecological ailments (0.92), followed by nervous and psychosomatic problems (0.90) and digestive system diseases (0.89). Traditional medicinal knowledge and medicinal plants are under threat due to conservative inheritance processes and anthropogenic pressures for various reasons.

Conclusion

A rich diversity of medicinal plants is distributed in the Mulam area, and these plants play an important role in healthcare among the Mulam people. Mulam people are skilled in using the plants in their surroundings to treat diseases in their daily lives. However, their traditional medicinal knowledge and medicinal plants are greatly threatened by rapid economic development for various reasons. Thus, policies and practices for the conservation of medicinal plants and the associated traditional knowledge are necessary.
Genomic analysis of the domestication and post-Spanish conquest evolution of the llama and alpaca
Authors: Fan Ruiwen , Gu Zhongru , Guang Xuanmin , Marín Juan Carlos , Varas Valeria , González Benito A. , Wheeler Jane C. , Hu Yafei , Li Erli , Sun Xiaohui , Yang Xukui , Zhang Chi , Gao Wenjun , He Junping , Munch Kasper , Corbett-Detig Russel , Barbato Mario , Pan Shengkai , Zhan Xiangjiang , Bruford Michael W. , Dong Changsheng
Published: July 2020

Background

Despite their regional economic importance and being increasingly reared globally, the origins and evolution of the llama and alpaca remain poorly understood. Here we report reference genomes for the llama, and for the guanaco and vicuña (their putative wild progenitors), compare these with the published alpaca genome, and resequence seven individuals of all four species to better understand domestication and introgression between the llama and alpaca.

Results

Phylogenomic analysis confirms that the llama was domesticated from the guanaco and the alpaca from the vicuña. Introgression was much higher in the alpaca genome (36%) than the llama (5%) and could be dated close to the time of the Spanish conquest, approximately 500 years ago. Introgression patterns are at their most variable on the X-chromosome of the alpaca, featuring 53 genes known to have deleterious X-linked phenotypes in humans. Strong genome-wide introgression signatures include olfactory receptor complexes into both species, hypertension resistance into alpaca, and fleece/fiber traits into llama. Genomic signatures of domestication in the llama include male reproductive traits, while in alpaca feature fleece characteristics, olfaction-related and hypoxia adaptation traits. Expression analysis of the introgressed region that is syntenic to human HSA4q21, a gene cluster previously associated with hypertension in humans under hypoxic conditions, shows a previously undocumented role for PRDM8 downregulation as a potential transcriptional regulation mechanism, analogous to that previously reported at high altitude for hypoxia-inducible factor 1α.

Conclusions

The unprecedented introgression signatures within both domestic camelid genomes may reflect post-conquest changes in agriculture and the breakdown of traditional management practices.
Establishment of reference range of CD4 T-lymphocyte in healthy Nepalese adults
Authors: Mishra Shravan Kumar , Shrestha Lilee , Pandit Roshan , Khadka Sundar , Shrestha Bimal , Dhital Subhash , Sharma Saroj , Sharma Mukunda , Mahato Raj Kumar , Shakya Geeta , Das Manandhar Krishna
Published: July 2020

Objective

CD4 T lymphocytes are the most widely used cellular markers to assess the course of HIV infection, clinical staging and, monitoring the effect of antiretroviral therapy. The regional reference range for Eastern, Central and Western development region of Nepal had already been established whereas the same was still lacking in Mid-western and Far-western development region. The objective of this study was to establish reference range of CD4 T lymphocyte in the remaining two development regions and finally the national reference range using data from previous study.

Results

The average values (mean ± SD) of CD4 and CD3 T cell in present study was (819 ± 294) cells/μl and (1546 ± 532) cells/μl, respectively. The absolute CD4 T cell (914 ± 303) and CD3 T cell (1671 ± 560) count in female were significantly higher than those from male, CD4 (757 ± 270) and CD3 (1465 ± 499) (p value-0.000). National reference value of CD4 was determined to be (798 ± 335) cells/μl for healthy Nepalese adults.