bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-Pedicular Fixation Techniques for the Treatment of Spinal Deformity
Authors: Rosinski Alexander , Odeh Khalid , Ungurean Victor , Leasure Jeremi , Kondrashov Dimitriy
Published: May 2020

Background:

In recent years, the use of pedicle screws has become the gold standard for achieving stable, 3-column fixation of the spine. However, pedicle screw placement may not always be ideal, such as in adolescent idiopathic scoliosis, because of pedicle morphology. An understanding of the alternatives to pedicle screw fixation is therefore important in the treatment of patients with spinal deformity. The purpose of this article is to review the indications, advantages, disadvantages, and complications associated with non-pedicular fixation techniques of the thoracolumbar spine.

Methods:

Comprehensive literature searches of PubMed, Scopus, and Web of Science databases were performed for 10 methods of non-pedicular fixation. Articles published between January 1, 1990, and June 1, 2019, were considered. Non-English-language articles and studies involving fixation of the cervical spine were excluded from our review.

Results:

After reviewing >1,600 titles and abstracts pertaining to non-pedicular fixation, a total of 213 articles met our inclusion criteria. Non-pedicular fixation may be preferred in certain cases of spinal deformity and may provide stronger fixation in osteoporotic bone. The use of non-pedicular fixation techniques is often limited by the inability to place multilevel constructs on intact posterior elements. Additionally, some methods of non-pedicular fixation, such as spinous process tethering, primarily have utility for the end of constructs to minimize junctional problems.

Conclusions:

Pedicle screws remain the anchor of choice in spinal deformity surgery because of their ability to engage all 3 columns of the spine and provide safe correction in all 3 planes. Nevertheless, non-pedicular fixation may be useful in cases in which pedicle screw placement is extremely difficult.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Substitusi Lemak Susu dengan Virgin Coconut Oil terhadap Mutu Es Krim [The Substitution of Milk Fat with Virgin Coconut Oil to Ice Cream Quality]
Authors: Trivana Linda , Wungkana Jerry
Published: May 2020

In order to increase the diversity of coconut oil utilization, a study on the substitution of milk fat in premium ice cream grade with virgin coconut oil (VCO) has been done. The aim of this experiment is to obtain information about the effects of the substitution on pH, overrun, and sensory properties of premium ice cream. This research was conducted in the laboratory of Indonesian Center for Agricultural Post Harvest Research and Development on the period of April-June 2015. Premium ice cream with five different ratios of of milk fat and VCO (1:0), (1:1), (2:1), (1:2), (0:1) were made. The ice cream production involves mixing, pasteurization, homogenation, aging and freezing. The sensory result shows the non-dependent effect of ratio of 1:1 against 100% milk fat ice cream on all aspects of sensory except on roughness. Therefore, the best ratio for the substitution is at 1:1 ratio. The size of the ice crystals can be reduced by the addition of emulsifier. The pH of theice cream was found around 6.82-6.90. The Overrun value F0 (milk fat: VCO 1:0) and F2 (milk fat: VCO 1:1) accordance SNI (01-3713-1995) standards for household scale (30-50%), and overrun value F1 (milk fat:VCO 2:1) accordance for industy scale (70-80%).

ABSTRAK

Untuk meningkatkan diversitas dalam pemanfaatan minyak kelapa, telah dilakukan penelitian substitusi lemak susu dalam produk es krim premium dengan minyak nabati. Tujuan penelitian ini adalah untuk mengetahui pengaruh subtitusi lemak susu dengan Virgin Coconut Oil (VCO) terhadap karakteristik sensori, pH, dan overrun es krim. Penelitian ini dilaksanakan di Laboratorium Pengolahan Hasil, Balai Besar Pascapanen pada bulan April-Juni 2015. Es krim dengan kandungan lemak minimal 12% dibuat dengan komposisi lemak susu: VCO (1:0), (1:1), (2:1), (1:2), (0:1). Proses pembuatan es krim meliputi 5 tahap, yaitu pencampuran bahan, pasteurisasi, homogenisasi, pematangan (aging), dan pembekuan. Hasil analisis sensori (tekstur, penampakan, dan kecepatan leleh), overrun, dan pH es krim diperoleh rasio lemak susu: VCO 1:1 memberikan pengaruh tidak berbeda nyata terhadap es krim dengan 100% lemak susu untuk semua parameter yang diamati, kecuali pada organoleptik tekstur “kasar oleh kristal es”. Oleh karena itu, lemak susu dapat digantikan dengan lemak nabati (VCO) dengan perbandingan 1:1 pada pembuatan es krim. Kristal es pada es krim dapat diatasi dengan penggunaan penstabil yang sesuai. Hasil analisis pH es krim diperoleh pH 6,82-6,90. Nilai overrun pada perlakuan F0 (lemak susu: VC0 1:0) dan F2 (lemak susu:VCO 1:1) sesuai dengan syarat mutu es krim berdasarkan SNI 01-3713-1995 untuk skala rumah tangga 30-50% dan F1 (lemak susu: VCO 2:1) sesuai skala industri 70-80%.

 
The erosion of glaciated mountains: evidence from hypsoclinometry
Authors: S. EVANS Ian
Published: May 2020

Mountain glaciation involves the erosion of cirques and troughs, which increase steep slopes but also produce gentle slopes in cirque floors and trough floors. This is expected to increase the variability of slope gradients at related altitudes. Taking a whole mountain range, its distributions of altitude and slope can be analysed to establish a signal of glacial modification. Frequency distributions of altitude (hypsometry) and gradient (clinometry) alone do not seem adequate. Taking these two variables together – hypsoclinometry, plotting slope gradient against altitude – is more promising. Frequency distributions of slope gradient at different altitudes are exemplified here for mountain ranges in British Columbia and Romania, together with altitudinal variations of steep or gentle slopes. Cirque headwalls give the clearest morphometric signature of glaciation. Steep (especially the steepest) slopes are concentrated at cirque altitudes, increasing mean, median, standard deviation (SD) and inter-quartile range (IQR) of gradients, especially above cirque floors. There is only a small increase in SD and IQR at cirque floor altitudes. Hypsometric maxima and increased proportions of gentle slopes at cirque floor altitudes are clear only in mountain ranges densely occupied by cirques. This relates to the small proportion of each cirque (about 28%) occupied by the floor. Concentrations of steep slope aspects in directions favoured by local glaciers provide further evidence of glacial modification. The most general morphometric effect of glaciation, however, is the increase in steep slopes at cirque headwall altitudes. Thus it is possible to rank mountain ranges by degree of glacial modification.
Multi–risk quantitative assessment in Reghin city, Transylvania, Romania
Authors: ROȘCA Sanda , BILAȘCO Ștefan , VESCAN Iuliu , FODOREAN Ioan , PETREA Dănuț , RUSU Raularian
Published: May 2020

Multi–risk assessment supposes an integrated analysis of various processes and phenomena generating risks across the territory, highlighting the individual and cumulative impact at different levels of analysis. This paper aims at creating an assessment model of multi–risk generated by the cumulative effects of landslides and floods, processes considered as significant in the study area, the administrative unit of the city of Reghin in the Transylvanian Basin. To obtain the multi–risk, two GIS spatial analysis models have been created. The first model means to identify the probability of landslide occurrence (built on GIS databases in vector and raster format, correlatively analysed by means of spatial analysis functions and equations), and is adapted according to legislative regulations stipulated in the Government Decision no. 447/2003. The second one is a database regarding the floodable area with a 1% probability in raster format, resulted from a nation–wide model created to identify the flooded areas.The multi–risk map was created using the mediation method, in which every class of individual (geomorphological or hydrological) hazard receives equal weight within the final result. As a consequence of applying the above–mentioned models, we obtained areas with different probabilities for cumulative risk processes, which are rendered as favourable or restrictive in terms of locating different structures (roads, settlements, functional areas, shopping centres). According to the degree of validation, these may be used for a more precise determination of the development areas and for territorial planning.
Cambios espaciales y socioeconómicos en la migración mexicana a Estados Unidos a inicios del siglo XXI (1994–2007)
Authors: Castillo Ramírez Guillermo , González Jorge
Published: May 2020

El objetivo de este artículo es dar cuenta de las transformaciones de la migración México-Estados Unidos, en el contexto de las reformas estructurales neoliberales y del cambio de siglo (1994–2007). Mediante el análisis de censos, índices de intensidad migratoria y de recepción de remesas, este trabajo plantea la hipótesis de que, además de las transformaciones del volumen demográfico y de los perfiles socio-étnicos de los migrantes, hubo cambios socioeconómicos (otro perfil migrante y aumento de remesas) y sobre todo se consolidó la emergencia de otra configuración espacial/geográfica de la migración, caracterizada por otros lugares de origen y destino de la migración.
Consumo del desayuno escolar y su asociación con la ganancia de peso en niñas de San Luis Potosí
Authors: Ramírez-Ramírez Celina , Cuevas-Nasu Lucía , Morales-Ruán María del Carmen , Méndez Gómez-Humarán Ignacio , Galindo-Gómez Carlos
Published: May 2020

Objetivo. Evaluar el consumo del Desayuno Escolar Frío (DEF) y su asociación con la ganancia de peso en población preescolar y escolar beneficiaria en San Luis Potosí, México. Material y métodos. Se realizó un estudio longitudinal en 255 niñas y niños de 3 a 8 años. Se midió la ganancia de peso durante un año, y la ingesta energética total se estimó por medio de un cuestionario de frecuencia de consumo. La energía proveniente del DEF se dividió en terciles y su asociación con la ganancia de peso fue estimada a través de regresión lineal múltiple. Resultados. En los escolares, la interacción entre los terciles de energía del DEF y sexo mostró que las niñas del segundo y tercer tercil ganaban 500g (p=0.063) y 800g (p=0.015) más, respectivamente. Conclusión. Un mayor consumo de energía proveniente del desayuno escolar se asocia con un incremento en la ganancia de peso en niñas de edad escolar.
Vacunación canina y felina masiva en México: pobre rectoría y fallo de mercado
Authors: Hernández-Ávila Mauricio , Castro-Onofre María Magdalena , Cervantes-Trejo Arturo
Published: May 2020

Objetivo. Analizar la rectoría y los mecanismos de procuración de insumos en el contexto del Programa de Acción Específico de Prevención y Control de la Rabia Humana y la Semana Nacional de Vacunación Antirrábica canina y felina en México (SNVA-C). Material y métodos. La información se obtuvo mediante solicitudes al Instituto Nacional de Transparencia, Acceso a la Información y Protección de Datos Personales. Resultados. De 2009 a 2017 se aplicaron 158.9 millones de dosis de vacuna antirrábica canina y felina (VAR-CF) por un monto de compra aproximado de 1 915 MDP. Se documentó una débil rectoría que permite prácticas monopólicas y compras fragmentadas y directas. Las adquisiciones se han fincado con precios que varían entre entidades federativas y son significativamente más altos que los precios internacionales. Conclusión. Después de 30 años de operación de la SNVA-C en México, persisten pagos excesivos para la VAR-CF, los cuales son indicativos de una falla importante del mercado, caracterizada por nula competencia, información asimétrica y estructuras de incentivos desalineadas que impiden obtener un precio competitivo
Silvestre Félix Frenk Freund 1923-2020
Authors: Bourges Rodríguez Héctor
Published: May 2020

No disponible
Sarcopenic obesity and associations with mortality in older women and men – a prospective observational study
Authors: von Berens Åsa , Obling Sine R , Nydahl Margaretha , Koochek Afsaneh , Lissner Lauren , Skoog Ingmar , Frändin Kerstin , Skoglund Elisabeth , Rothenberg Elisabet , Cederholm Tommy
Published: May 2020

Background: The combined effect of sarcopenia and obesity, i.e., sarcopenic obesity, has been associated with disability and worse outcomes in older adults, but results are conflicting. The objectives of this study were to describe the prevalence of sarcopenic obesity (SO) in older adults, and to examine how the risk of mortality is associated with SO and its various components.Methods: Data were obtained from two Swedish population studies, the Gothenburg H70 Birth Cohort Studies of 521 women and men at the age of 75, and the Uppsala Longitudinal Study of Adult Men (ULSAM), which included 288 men aged 87 years. Sarcopenia was defined using the recently updated EWGSOP2 definition. Obesity was defined by any of three established definitions: body mass index ≥30 kg/m2, fat mass >30%/ >42% or waist circumference ≥88 cm/≥102 cm for women and men, respectively. The Kaplan-Meier survival curve and the Cox proportional hazard model were used for 10-year and 4-year survival analyses in the H70 and ULSAM cohorts, respectively.Results: SO was observed in 4% of the women and 11% of the men in the H70 cohort, and in 10% of the ULSAM male cohort. The 75-year-old women with SO had a higher risk (HR 3.25, 95% confidence interval (1.2-8.9)) of dying within ten years compared to those with a “normal” phenotype. A potential similar association with mortality among the 75-year-old men was not statistically significant. In the older men aged 87 years, obesity was associated with increased survival. Conclusions: SO was observed in 4-11% of community-dwelling older adults. In 75-year-old women SO appeared to associate with an increased risk of dying within ten years. In 87-year-old men, the results indicated that obesity without sarcopenia was related to a survival benefit over a four-year period.
Gender differences in the relationship between dietary energy and macronutrients intake and body weight outcomes in Chinese adults
Authors: Zhao Jian , Sun Jian , Su Chang
Published: May 2020

Background: To explore the gender differences in the relationship between dietary energy and macronutrients intake and body weight outcomes in Chinese adults.Methods: Data from the China Health and Nutrition Survey (CHNS, 2015) for10,898 participants aged 18-64 years. Three consecutive 24-h dietary recalls was used to assess the dietary intake. Quantile regression models for body mass index (BMI) and waist circumference (WC) were performed separately for each sex.Results: Adult males showed greater absolute intakes of energy and macronutrients as compared to females as per the body weight outcomes. A 10% increase in BMI resulted in an additional intake of 0.002-0.004 kcal/d of dietary energy, 0.032-0.057 g/d of fats, 0.039-0.084 g/d of proteins, and 0.018-0.028 g/d of carbohydrates across all quantiles in males (p < 0.05). A 10% increase in WC lead to an additional intake of 0.004-0.008 kcal/d of dietary energy, 0.051-0.052 g/d of carbohydrates across the entire quantile in males (p < 0.05), and an increased intake of 0.060-0.150 kcal/d of fat in females (p < 0.05).Conclusions: Dietary Fat intake could be the risk factor of abdominal obesity in women. The importance of gender- specific evidence should be considered before promoting macronutrient allocation for the prevention and treatment of obesity.
Overexpression of an endogenous type 2 diacylglycerol acyltransferase in the marine diatom Phaeodactylum tricornutum enhances lipid production and omega-3 Long Chain Polyunsaturated Fatty Acid content
Authors: Haslam Richard P. , Hamilton Mary L. , Economou Chloe K. , Smith Richard , Hassall Kirsty L. , Napier Johnathan A. , Sayanova Olga
Published: May 2020

Background: Oleaginous microalgae represent a valuable resource for the production of high value molecules. Considering the importance of omega-3 long chain polyunsaturated fatty acids (LC-PUFAs) for human health and nutrition the yields of high value eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) require significant improvement to meet demand, however, the current cost of production remains high. A promising approach is to metabolically engineer strains with enhanced levels of triacylglycerols (TAGs) enriched in EPA and DHA.Results: Recently we have engineered the marine diatom Phaeodactylum tricornutum to accumulate enhanced levels of DHA in TAG. To further improve the incorporation of omega-3 LC-PUFAs in TAG we focused our effort on the identification of a type 2 acyl-CoA:diacylglycerol acyltransferase (DGAT) capable of improving lipid production and the incorporation of DHA in TAG. DGAT is a key enzyme in lipid synthesis. Following a diatom based in vivo screen of candidate DGATs, a native P. tricornutum DGAT2B was taken forward for detailed characterisation. Overexpression of the endogenous P. tricornutum DGAT2B was confirmed by qRT-PCR and the transgenic strain grew successfully in comparison to wildtype. PtDGAT2B has broad substrate specificity with preferences for C16 and LC-PUFAs acyl groups. Moreover, the overexpression of an endogenous DGAT2B resulted in higher lipid yields and enhanced levels of DHA in TAG. Furthermore, a combined overexpression of the endogenous DGAT2B and ectopic expression of a Δ5-elongase showed how iterative metabolic engineering can be used to increase DHA and TAG content, irrespective of nitrogen treatment.Conclusion: This study provides further insight into lipid metabolism in P. tricornutum and suggests a metabolic engineering approach for the efficient production of EPA and DHA in microalgae.
Social Networking Sites Utilization, Perceived Benefits and Potential for Improving Study Habits among Nursing Students in Five Countries
Authors: Valdez Glenn Ford D. , Cayaban Arcalyd Rose , AL-Fayyadh Sadeq , Korkmaz Mehmet , Obeid Samira , Sanchez Cheryl Lyn A , Ajzoon Muna B , Fouly Howeida , Cruz Jonas P
Published: May 2020

Background: The abundance of easy and accessible information and fast developing social networking sites (SNS) have proven the world is small and within reach. The great implication of this interconnectedness can be somehow attributed to the change in the learning and sharing environment, for the most part, something a classroom is lacking, and considering the potential implication of SNS in nursing education reveals that the benefit allows the students to communicate and interact with a wider audience and beyond the classroom. The aim of this study is to identify the extent of SNS utilization, the perceived benefits and the potential for improving study habits of nursing students in five countries (Israel, Iraq, Oman, Philippines and Turkey).Methods: The study is a quantitative cross-sectional study that determined the relationship between the utilization of SNS, the perceived benefits of SNS, and the potential for improving study habits among nursing students in the five participating countries (Israel, Iraq, Oman, Philippines, and Turkey). The basis of this paper is the careful analysis survey of responses from a sample of 1,137 students from an online hosting site. The online instrument focuses on the extent of utilization and benefits of SNS according to their accessibility, usability, efficiency and reliability.Results: Our findings, in correlation using Pearson’s r, reveals a significant positive correlation between the extent of possibly improving study habits and the extent of utilization of SNS in terms of the four domains, namely, accessibility (r=0.246), usability (r=0.377), reliability (r=0.287) and efficiency (r=0.387).Conclusion: It can be concluded that a significant positive correlation between students’ study habits and the extent of utilization of SNS, meaning that the more students devote themselves to study habits, the higher the level of SNS utilization. There are positive and negative implications in using SNS among nursing students, and there is greater potential in further improving the approaches to nursing education through adaptation of curricula based around the proper utilization of SNS.
Patients’ confidence in treatment decisions for early stage non-small cell lung cancer (NSCLC)
Authors: Pompili Cecilia , Holch Patricia , Rogers Zoe , Absolom Kate , Clayton Beverly , Franks Kevin , Bekker Hilary , Velikova Galina
Published: May 2020

Background In early-stage Non-Small Cell Lung Cancer (NSCLC) patients, little is known about how to measure patient participation in Shared-Decision Making (SDM). We examined the psychometric properties and clinical acceptability of the Decision Self-Efficacy scale (DSE) in a cohort of patients undergoing to Stereotactic Ablative Radiotherapy (SABR) or Video-assisted Thoracoscopic Surgery (VATS) to capture patient involvement in treatment decisions. Methods In the context of a prospective longitudinal study (Life after Lung Cancer-LiLAC) involving 244 patients with early-stage NSCLC, 158 (64.7%) patients completed the DSE either on paper or electronically online prior to treatment with SABR or VATS pulmonary resection. DSE psychometric properties were examined using: principal components analysis of item properties and internal structure, and internal construct validity; we also performed a sensitivity analysis according to Eastern Cooperative Oncology Group Performance Status (ECOG PS), gender, age and treatment received (VATS or SABR) difference. Results Exploratory factor analysis using polychoric correlations substantiated that the 11 item DSE is one scale accounting for 81% of the variance. We calculated a value of 0.96 for Cronbach’s alpha for the total DSE score. DSE scores did not differ by gender ( p =0.37), between the two treatment groups (p=0.09) and between younger and older patients ( p =0.4). However, patients with an ECOG PS >1 have a DSE mean of 73.8 (SD 26) compared to patients with a PS 0-1 who have a DSE mean of 85.8 (SD 20.3 p =0.002). Conclusion Findings provide preliminary evidence for the reliability and validity of the DSE questionnaire in this population. However, future studies are warranted to identify the most appropriate SDM tool for clinical practice in the lung cancer treatment field.
Drug retention of 7 biologics and tofacitinib in biologics-naïve and biologics-switched patients with rheumatoid arthritis -The ANSWER cohort study-
Authors: Ebina Kosuke , Hirano Toru , Maeda Yuichi , Yamamoto Wataru , Hashimoto Motomu , Murata Koichi , Takeuchi Tohru , Shiba Hideyuki , Son Yonsu , Amuro Hideki , Onishi Akira , Akashi Kengo , Hara Ryota , Katayama Masaki , Yamamoto Keiichi , Kumanogoh Atsushi , Hirao Makoto
Published: May 2020

Background: This multi-center, retrospective study aimed to clarify retention rates and reasons for discontinuation of 7 biological disease-modifying antirheumatic drugs (bDMARDs) and tofacitinib (TOF), one of the janus kinase inhibitors, in bDMARDs-naïve and bDMARDs-switched patients with rheumatoid arthritis (RA). Methods: This study assessed 3,897 patients and 4,415 treatment courses with bDMARDs and TOF from 2001 to 2019 (2,737 bDMARDs-naïve patients and 1,678 bDMARDs-switched patients [59.5% switched to their second agent], female 82.3%, baseline age 57.4 years, disease duration 8.5 years; rheumatoid factor positivity 78.4%; Disease Activity Score in 28 joints using erythrocyte sedimentation rate 4.3; concomitant prednisolone [PSL] dose 6.1 mg/day [42.4%], and methotrexate [MTX] dose 8.5 mg/week [60.9%]). Treatment courses included abatacept (ABT; n=663), adalimumab (ADA; n=536), certolizumab pegol (CZP; n=226), etanercept (ETN; n=856), golimumab (GLM; n=458), infliximab (IFX; n=724), tocilizumab (TCZ; n=851), and TOF (n=101/only bDMARDs-switched cases). Drug discontinuation reasons (categorized into lack of effectiveness, toxic adverse events, non-toxic reasons, or remission) and rates were estimated at 36 months using the Gray’s test, and statistically evaluated after adjusted by potential clinical confounders (age, sex, disease duration, concomitant PSL and MTX usage, starting date, and number of switched bDMARDs) using the Fine-Gray model. Results: Cumulative incidence of drug discontinuation for each reason was as follows: lack of effectiveness in the bDMARDs-naïve group (from 13.7% [ABT] to 26.9% [CZP]; P<0.001 between agents) and the bDMARDs-switched group (from 18.9% [TCZ] to 46.1% [CZP]; P<0.001 between agents). Toxic adverse events in the bDMARDs-naïve group (from 4.6% [ABT] to 11.2% [ETN]; P<0.001 between agents) and the bDMARDs-switched group (from 5.0% [ETN] to 15.7% [TOF]; P=0.004 between agents). Remission in the bDMARDs-naïve group (from 2.9% [ETN] to 10.0% [IFX]; P<0.001 between agents) and the bDMARDs-switched group (from 1.1% [CZP] to 3.3% [GLM]; P=0.9 between agents). Conclusions: Remarkable differences were observed in drug retention of 7 bDMARDs and TOF between bDMARDs-naïve and bDMARDs-switched cases.
Invasive growth of Aspergillus oryzae in rice koji and increase of nuclear number
Authors: Yasui Mizuki , Oda Ken , Masuo Shunsuke , Hosoda Shuji , Katayama Takuya , Maruyama Jun-ichi , Takaya Naoki , Takeshita Norio
Published: May 2020

Background: ‘Rice koji’ is a solid culture of Aspergillus oryzae on steamed rice grains. Multiple parallel fermentation, wherein saccharification of rice by A. oryzae and alcohol fermentation by the budding yeast occur simultaneously, lead to the formation of a variety of ingredients of Japanese sake. In sake brewing, the degree of mycelial invasive growth into the steamed rice, called ‘haze-komi’, highly correlates with the digestibility and quality of rice koji, since the hyphae growing into the rice secrete amylases and digest starch of rice. Results: In this study, we investigated mycelial distribution of GFP-tagged A. oryzae in rice koji made with different types of rice, such as sake rice and eating rice, with 50 or 90% polishing rate to remove abundant proteins and lipids near the surface. In addition, we compared transcriptomes of A. oryzae in the different types of rice koji. Finally, we found that A. oryzae increases the nuclear number and hyphal width in the course of 1-3 days cultivation. Conclusions: Our imaging analyses indicate that A. oryzae hyphae grew more deeply into 50% polished rice than 90% polished rice. The increases of nuclear number may be a selectively acquired characteristic for the high secretory capacity during the breeding in long history.
Engaging Stakeholders in the Adaptation of the Connect for Health Pediatric Weight Management Program for National Implementation
Authors: Simione Meg , Frost Holly M. , Cournoyer Rachel , Mini Fernanda Neri , Cassidy Jackie , Craddock Cassie , Moreland Jennifer , Wallace Jessica , Metlay Joshua , Kistin Caroline J. , Sease Kerry , Hambidge Simon J. , Taveras Elsie M.
Published: May 2020

Background: Connect for Health is an evidence-based weight management program with clinical- and family-facing components for delivery in pediatric primary care for families of children ages 2 to 12 years. We used the Consolidated Framework for Implementation Research (CFIR) to guide formative work prior to national implementation. The purpose of this study was to describe the process and results of stakeholder engagement and program adaptation.Methods: We used mixed qualitative and quantitative methods to iteratively adapt and optimize the program by assessing needs and perspectives of clinicians and parents, as well as contextual barriers, facilitators and organizational readiness for the uptake of the proposed program tools and implementation strategies. We conducted interviews with primary care clinicians from four health care organizations in Boston, MA, Denver, CO, and Greenville, SC and used principles of immersion-crystallization for qualitative analyses. We also conducted surveys of parents of children with a body mass index ≥ 85th percentile.Results: We reached thematic saturation after 52 clinician interviews. Emergent themes representing the CFIR domains of intervention characteristics, outer and inner setting, and process included: (1) importance of evidence-based clinical decision support tools that integrate into the workflow and do not extend visit time; (2) developing resources that respond to family’s needs; (3) using multimodal delivery options for family resources; (4) addressing childhood obesity while balancing competing demands; (5) emphasizing patient care rather than documentation and establishing sustainability plans; and (6) offering multiple training methods that incorporate performance feedback. Of the parents surveyed (n=400), approximately 50% were Spanish-speaking and over 75% reported an annual income < $50,000. Parents affirmed the importance of addressing weight management during well-child visits, being provided with referrals and resources, and offering multiple methods for resource delivery. Decisions about program modifications were made at the program and healthcare-system level and based on stakeholder engagement findings. Modifications included cultural, geographic, and target audience adaptations, as well as varied resource delivery options. Conclusions: To ensure the fit between the Connect for Health program and national implementation settings, adaptations were systematically made through engagement of clinician and parent stakeholders to support adoption, sustainability, and health outcomes. Trial Registration: NCT04042493
Extraction of nuclei from archived post-mortem tissues for single-nucleus sequencing applications
Authors: Maitra Malosree , Nagy Corina , Wang Yu Chang , Nascimento Camila , Suderman Matthew , Théroux Jean-Francois , Mechawar Naguib , Ragoussis Jiannis , Turecki Gustavo
Published: May 2020

Single-cell and single-nucleus sequencing techniques are a burgeoning field with various biological, biomedical, and clinical applications. Numerous high and low-throughput methods have been developed for sequencing the RNA and DNA content of single cells. However, for all these methods the key requirement is high quality input of a single-cell or single-nucleus suspension. Preparing such a suspension is the limiting step when working with fragile, archived tissues of variable quality. This hurdle can prevent such tissues from being extensively investigated with single-cell technologies. We describe a protocol for preparing single-nucleus suspensions within the span of a few hours that reliably works for multiple post-mortem and archived tissues types using standard lab equipment. Moreover, these preparations are compatible with single-nucleus RNA-seq and ATAC-seq using the 10X Genomics’ Chromium system.
Functional benefits of corticosteroid and IVIG combination therapy in a coronary artery endothelial cell model of Kawasaki disease
Authors: Inoue Takashi , Murakami Shokei , Matsumoto Kenji , Matsuda Akio
Published: May 2020

Background Kawasaki disease (KD) is the most common pediatric systemic vasculitides of unknown etiology. Recent clinical studies led to reappraisal of the usefulness of initial combination therapy of intravenous immunoglobulin (IVIG) plus a corticosteroid for patients with severe KD. However, the molecular mechanisms underlying the clinical benefits of that combination therapy remain unclear. Here, we used cultured human coronary artery endothelial cells (HCAECs), as a mimic of KD, to study the possible mechanisms responsible for the clinical benefits of adding a corticosteroid to standard IVIG therapy for patients with severe KD.Methods HCAECs were stimulated with TNF-α, IL-1α or IL-1β in the presence and absence of high-dose IgG and/or dexamethasone (DEX). The mRNA and protein concentrations for high-mobility group box-1 (HMGB1), IL-1α, IL-6 and granulocyte-colony stimulating factor (G-CSF) in the culture supernatants were measured by quantitative PCR (qPCR) and ELISA, respectively. Apoptosis was evaluated by the caspase 3/7 activities.Results DEX, but not IgG, significantly inhibited apoptosis caused by inflammatory stimuli, resulting in effective reduction of HMGB1 and IL-1α protein release by HCAECs. As previously reported, DEX or IgG alone significantly suppressed TNF-α-induced production of IL-6 and G-CSF and mRNA expression, but induction of those cytokines by IL-1s (IL-1α and IL-1β) was resistant to high-dose IgG.Conclusions A corticosteroid can effectively inhibit the release of HMGB1 and IL-1α, which may be involved in IVIG resistance in KD. Since high-dose IgG does not have such beneficial anti-cytotoxic effects, adding a corticosteroid to standard IVIG therapy may help prevent the progression of IVIG resistance in KD.
The use of ultrasound in primary care: Longitudinal billing and cross-sectional survey study in Switzerland
Authors: Touhami Dima , Merlo Christoph , Hohmann Joachim , Essig Stefan
Published: May 2020

Background Ultrasound imaging is utilized in Swiss primary care; however, little is known regarding the extent to which it is performed. With this study, we aim to (1) provide an overview of ultrasound use by general practitioners (GPs), and (2) determine the clinical indications of ultrasound in Swiss general practice.Methods This is a quantitative study, analyzing fifteen years of billing data from 213 GPs in Central Switzerland, and cross-sectional survey data completed by 61 GPs attending 26 certification and refresher courses offered by the Swiss Society of Ultrasound in Medicine (SGUM).Results According to billing data, 49% of the GPs used ultrasound and provided 130,245 exams to 67,180 patients between 2004 and 2018. Over the years, ultrasound use became more frequent among GPs. Male GPs provide more ultrasound exams than female GPs. Patients that are female, ≥65 years, and multi-morbid had more ultrasound exams compared to males, patients <65 years, and those with only one morbidity, respectively. GPs provided a mean of 129 ultrasound exams per physician-year. Abdominal ultrasound comprised almost 69% of all exams. According to survey data, indications covered many organ systems and clinical conditions, with abdominal indications being most frequent among them.Conclusions The use of ultrasound is high among general practitioners and it covers a wide range of clinical indications. Ultrasound is utilized primarily in the diagnosis of clinical indications of the abdomen, and more often for female than male patients.
A multi-centre, pragmatic, three-arm, individually randomised, non-inferiority, open trial to compare Immediate Oral, Immediate Topical or Delayed Oral Antibiotics for Acute Otitis Media with Discharge in children: The Runny Ear Study (REST): Study protocol.
Authors: Curtis Kathryn , Taylor Jodi , Hay Alastair , Moore Michael , Morris Richard , Cabral Christie , Horwood Jeremy , Curcin Vasa , Prasad Vibhore , Schilder Anne , Wilkes Scott , Turner Nicholas
Published: May 2020

Background: Acute otitis media (AOM) is a common painful infection in children, with around 2.8 million cases presenting to primary care in England and Wales annually. Nearly all children who present to their general practitioner (GP) with AOM or AOM with discharge (AOMd) are treated with oral antibiotics. These can cause side effects; contribute to the growing problem of antimicrobial resistance, and more rarely, allergic reactions. Alternative treatments, such as an antibiotic eardrops or “delayed” oral antibiotics, could be at least as effective and safe as immediate oral antibiotics for children with AOMd.Methods: REST is a pragmatic, three-arm, individually randomised, non-inferiority trial being conducted in 50 GP practices across the UK. The study aims to recruit 399 children aged (≥12m and <16yrs) presenting to their GP with AOMd. Children will be randomised to one of three arms: immediate ciprofloxacin 0.3% eardrops; delayed oral amoxicillin (clarithromycin if penicillin allergic); or immediate oral amoxicillin (clarithromycin). Recruitment, including eligibility screening, randomisation and data collection, are conducted using the innovative, TRANSFoRm electronic trial management platform. Integrated within the primary care electronic medical records it provides automatic eligibility checking, part-filling of e-CRFs, study workflow management and routine NHS follow up data collection. The primary outcome is time to resolution of all significant symptoms and will be collected by the parent using a Symptom Recovery Questionnaire (SRQ). Secondary outcomes, including cost-effectiveness, duration of moderately bad or worse symptoms and repeat AOMd episodes, will be collected at day 14 and at 3 months. Discussion: It is unclear whether prescribing oral antibiotics to children with AoMd results in a reduction in symptoms or a shorter duration of illness. The REST trial will allow us to compare the non-inferiority of: immediate topical ciprofloxacin ear drops, or delayed oral amoxicillin (clarithromycin) against immediate oral amoxicillin (clarithromycin). We aim to recruit 399 patients from 175 practices in the UK. Using the Transform software to randomise participants to the trial will enable recruitment for a relatively uncommon condition. Trial registration:Name of Registry: ISCRTNRegistration Number: ISRCTN12873692 This contains all items required to comply with the World Health Organization Trial Registration Data SetDate of Registration: 24th April 2018 http://www.isrctn.com/ISRCTN12873692Name of Registry: EudraCT Registration Number: 2017-003635-10Date of Registration: 6TH September 2017
Molecular detection of concurrent infections of Anaplasma sp. Omatjenne, Theileria mutans, Babesia bigemina and Anaplasma marginale in calves and yearlings in a tick endemic Guinea savannah ecosystem in Cameroon.
Authors: Achukwi Mbunkah Daniel , Sali Ngam , Madder Maxime , Youssouf Mfopit Mouliom , Waingeh Nain Caroline , Kingsley Manchang Tanyi , Daniel Ndzingu Awa , Geysen Dirk
Published: May 2020

Background: Ticks play a major role in limiting profitable livestock production in sub-Saharan Africa and the region is beleaguered by a paucity of data on diseases implicated in high morbidity and mortality in most of its livestock production systems.Methods: In a tick endemic Guinea savannah ecosystem, ticks infesting calves and yearlings during their first eighteen months of life were collected weekly and morphologically identified. PCR, Restriction Fragment Length Polymorphism (RFLP) and sequencing were applied on DNA of tick-borne pathogens in animal blood buffy coat to amplify and characterize the 16S rRNA genes of Anaplasma , Ehrlichia and 18S rRNA gene for Babesia spp .Results: Of 31 364 adult ticks, nymphs and larvae collected from the 20 experimental animals, 6525 (20.1%), 7399 (23.6%), 990 (3.2%), 16450 (52.4%) were Amblyomma variegatum, Rhipicephalus spp ., other genera, and tick nymphs/larvae respectively . Tick infestation rates during the rainy season for A.variegatum, Rhipicephalus spp . and nymph/larvae were 50.3, 12.4 and 28.3, respectively, while in the dry season the proportions were one, 26.2 and 72.8 respectively. High Rhipicephalus spp. ( Boophilus ) infestation rates significantly reduced haematocrit (P<0.01). All animals had mixed infections of haemoparasites. The presence of Anaplasma marginale and Anaplasma sp. Omatjenne in the blood significantly reduced haematocrit (p<0.0001) while Babesia bigemina and Theileria mutans had no effect (P>0.05). No E. ruminantium was detected. We report for the first time in Cameroon, the detection of Anaplasma sp. Omatjenne and T.mutans infecting all and four of these animals, respectively. Babesia bigemina , and Anaplasma sp. Omatjenne concurrently occurred in all 20 experimental animals, A.marginale in 15. The mean first-time contact periods (in weeks) for B.bigemina , T.mutans , Anaplasma sp. Omatjenne and A.marginale were 15(3-37), 30(9-43), 21(5-55) and 25(7-55) respectively; and they were not significantly different (P>0.05).Conclusion: The absence of disease conditions demonstrate an endemically stable situation in the region for these infections. With no clinical data on A. sp. Omatjenne and T.mutans infections in this area, further insights into their epizootiology should be of interest.
Effect of the Pumping-injection flow rate on Heat Transfer Characteristic of Borehole Heat Exchangers for Coupling Ground-Source Heat Pump System
Authors: Ma Jiuchen , Jiang Qian , Zhang Qiuli , Xie Yacheng , Wang Yahui , Yi Feiyu
Published: May 2020

A coupling ground source heat pump system (CGSHP) is established in areas where groundwater is shallow but the seepage velocity is weak, which sets up pumping and injection wells on both sides of borehole heat exchangers (BHEs). A convection-dispersion analytical model of excess temperature in aquifer that considers groundwater forced seepage and axial effects and thermal dispersion effects is proposed. A controllable forced seepage sandbox is built by equation analysis method and similarity criteria. Through indoor test and the proposed analytical model, the correctness and accuracy of the numerical simulation software FEFLOW7.1 is verified. The influence of different pumping-injection flow rate on the heat transfer characteristic of BHEs is studied by numerical simulation. The results show that the average heat efficiency coefficient of BHEs increases and the heat influence range of downstream BHEs expands with the increasing of pumping-injection flow rate. The relation curve between Pe and the increment of heat transfer rate per unit depth of BHEs (Δ`q) is distributed as Gaussian function. The pumping-injection flow rate that makes Darcy velocity reaches 0.6×10-6~1.4×10-6 m∙s-1 in the aquifer is the best reference range for CGSHP system，so 400~600 m3∙d-1 is taken as the best pumping-injection flow rate in this paper.
Chicago sky blue 6B (CSB6B), an allosteric inhibitor of macrophage migration inhibitory factor (MIF), suppresses osteoclastogenesis and promotes osteogenesis through the inhibition of the NF-κB signaling pathway.
Authors: Jin Kangtao , Zheng Lin , Xie Ziang , Ye Lin , Gao Jiawei , Lou Chao , Pan Wenzheng , Pan Bin , Liu Shijie , Chen Zhenzhong , He Dengwei
Published: May 2020

Background： Macrophage migration inhibitory factor (MIF) is a pleiotropic pro-inflammatory mediator involved in various pathophysiological and inflammatory states.Accumulating line of evidence suggests a role for MIF in regulating bone metabolism and therefore a prime candidate for therapeutic targeting. In this study, we showed that Chicago sky blue 6B (CSB6B), an unique allosteric inhibitor of MIF catalytic and cytokine activity, suppresses RANKL-induced osteoclast and promotes osteogenesis in vitro via the inhibition of NF-κB signaling activationMethods: We examined the effects of CSB6B on osteoclast differentiation and bone resorption and the bone formation ability of osteoblasts in vitro . The effect of CSB6B on the NF-κB pathway was subsequently detected using western blotting and Co-IP. Finally, the model of mouse skull dissolution and ovarian severing were modeled and intraperitoneally injected with different doses of CSB6B to observe the anti-osteolytic and anti-osteoporosis effects of the drug in vivo.Results: In this study, we showed that Chicago sky blue 6B (CSB6B) suppresses RANKL-induced osteoclast and bone resorption in vitro via the inhibition of NF-κB signaling activation and promoting proteasome-mediated degradation of MIF. Consequently, the induction of NFATc1 was impaired resulting in downregulation of NFATc1-responsive osteoclast genes. We also demonstrated that CSB6B treatment enhanced primary calvarial osteoblast differentiation and bone mineralization in vitro via the suppression of NF-κB activation and upregulation of Runx expression. Using two murine models of osteolytic bone disorders, we further showed that administration of CSB6B protected mice against pathological inflammatoryc calvarial bone destruction induced by titanium particles mice as well as estrogen-deficiency induced bone loss as a result of ovariectomy.Conclusion: Together, as an MIF inhibitor, CSB6B can inhibit osteoclast differentiation and absorption function and enhance the mineralization of osteoblasts through the inhibition of NF-κB pathway. MIF is a prime target for therapeutic targeting for the treatment of osteolytic bone disorders and the MIF inhibitor CSB6B could be potential anti-osteoporosis drug.
Evaluation of Matrix Metalloproteinase-7 and Matrix Metalloproteinase-9 as Biomarkers in Ureteropelvic Junction Obstruction in Children- a preliminary report
Authors: Xie Chong , Liu Xuan , Qin Shuangli , Zhou Ling , Yu Liang , Liu Yanfang , Li Shuixue
Published: May 2020

Background

In children with congenital ureteropelvic junction obstruction (UPJO), Urinary biomarker may provide understanding of the health of the kidney, the need to intervene surgically, and the expected response and recoverability of the kidney following successful surgery. We evaluate whether the urinary matrix metalloproteinase-7(MMP-7) and matrix metalloproteinase-9(MMP-9) might be served as biomarkers in UPJO patients.
Methods

In this study, 24 unilateral UPJO patients and 16 healthy childrens were enrolled. Of which, 20 patients underwent 99mTc-DTPA (Diethylenetriaminepentaacetic Acid) renal dynamic imaging. And 16 patients underwent pyeloplasty and 8 others were followed. Postoperative follow-ups included ultrasonography, as well as MMP-7 and MMP-9 levels in urine, six months and one year after pyeloplasty. Study population was divided in 4 categories according to Society of Fetal Urology classification. For DTPA we subdivided the UPJO patients in 2 groups, obstructive (T 1/2 more than 20 min) and partial obstructive (T 1/2 less than 20 min). Quantitative urine protein analysis was performed and urinary creatinine levels were used to normalize protein levels for the markers analyzed.
Results

The results showed Creatinine-normalized urinary levels of MMP-7 and MMP-9 proteins were higher in patients with UPJO compared to healthy control subjects(P༜0.05). Moreover, urinary levels of MMP-7 and MMP-9 proteins in operation group were higher than non-operation group. Studies revealed that normalized urinary levels of MMP-7 and MMP-9 proteins in obstruction group were higher than partial obstruction group, although this differences were not statistically significant(P༞0.05). No significant differences in the Creatinine-normalized urinary levels of MMP-7 and MMP-9 in different degrees of hydronephrosis (P༞0.05). And normalized MMP-7 and MMP-9 levels were not correlated with the glomerular filtration rate of affected side(r = -0.128, P = 0.592; r = -0.157, P = 0.507).
Conclusions

Compared to control group, the levels of MMP-7 and MMP-9 in urine of unilateral UPJO patients are significantly elevated, and they can potentially be used as determining indices for surgical plan. Although preliminary results indicate no significant correlation between them and clinical parameters, they would be potential biomarkers for UPJO.