bluuebunny/crossref_metadata_2025 huggingface dataset:
Exercise interveNtion outdoor proJect in the cOmmunitY for older people – results from the ENJOY Seniors Exercise Park project translation research in the community
Authors: Levinger Pazit , Panisset Maya , Dunn Jeremy , Haines Terry , Dow Briony , Batchelor Frances , Biddle Stuart , Duque Gustavo , Hill Keith D.
Published: November 2020

Background

Many research studies evaluate physical activity interventions for older people in the community, however relatively few successfully promote maintenance of physical activity beyond the completion of the intervention. This study aimed to implement and evaluate the effects of sustained engagement in physical activity on mental, social and physical health outcomes through the use of the Seniors Exercise Park physical activity program for older people (the ENJOY project).

Method

People aged ≥60 years underwent a 12-week structured supervised physical activity program using outdoor exercise park equipment followed by 6 months unstructured independent use of the exercise park. Participants were assessed at baseline, 3 months and 9 months and completed a test battery evaluating physical activity, physical function and health related quality of life measures. Repeated measures ANOVA was used to compare differences between baseline, 3 and 9 months.

Results

Of the 95 participants, 80 (84.2%) completed the 3 months supervised program, and 58 (61%) completed the 9 month assessment (the latter impacted by COVID-19 restrictions). A significant increase in physical activity level was demonstrated following the 12 weeks intervention (p < 0.01). Significant improvements were also demonstrated in all physical function measures (p < 0.01), self-rated quality of life (p < 0.05), wellbeing (p < 0.01), fear of falls (p < 0.01), falls risk (p < 0.01), depressive symptoms (p = 0.01) and loneliness (p = 0.03) at 3 months. At the 9 months follow up, significant improvements from baseline were demonstrated in the frequency, duration and total of physical activity level (p < 0.05), and all physical function measures (p < 0.05), with no decline in these measures from 3 to 9 months. At 9 months, significant changes were observed in the health related quality of life mobility and self care domains with reductions in both fear of falls and falls risk (p < 0.05).

Conclusion

The Seniors Exercise Park may be an effective modality for improving and sustaining older people’s physical function and wellbeing and can be an important public health infrastructure investment in promoting physical activity for older people. Future work should focus on wider implementation of the program and on scaling up this initiative to achieve public health benefit for the community.

Trial registration

Trial registration number ACTRN12618001727235, Date of registration 19th October 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375979
Gender differences of depression and anxiety among social media users during the COVID-19 outbreak in China:a cross-sectional study
Authors: Hou Fengsu , Bi Fengying , Jiao Rong , Luo Dan , Song Kangxing
Published: November 2020

Background

Studies have shown that the outbreak of infectious diseases would result in mental health problems. Females are in greater risk for psychological problems than males. The present study investigated gender differences of depression and anxiety and explored associated factors during the COVID-19 epidemic among Chinese social media users.

Methods

We recruited 3088 participants through social media cross China. Participants completed sociodemographic and the COVID-19 epidemic related questions, the 2-item Patient Health Questionnaire (PHQ-2), and the 2-item Generalized Anxiety Disorder Scale (GAD-2), the Chinese version of the 10-item Connor-Davidson Resilience Scale. We applied Chi-square test and ANOVA for data description and linear regression analysis for exploring factors associated with depression and anxiety.

Results

Of 3063 participants eligible for analysis, the total prevalence of depression and anxiety was 14.14 and 13.25%. Females were experiencing more severe stress and anxiety symptoms, while males showed better resilience to stress. The severity of depression symptoms would decrease with the increase of age resilience, and it would increase if being unemployed, feeling less adapted, being more stressed. The severity of anxiety symptoms would decrease with higher education and better resilience, and it would increase if being female, spending over 60 min on COVID-19 related information, less adapted, and being more stressed.

Conclusion

The findings show the increased prevalence of depression and anxiety in Chinese population during the COVID-19 epidemic, and females are experiencing more severe anxiety symptoms than males. As social media is the current main resource of information related to COVID-19, interventions should be implemented to help users to limit the time they spend on social media and to get key information related to the epidemic from authoritative and authentic resource to avoid infodemic and prevent mental health problems.
Mental state of central sterile supply department staff during COVID-19 epidemic and CART analysis
Authors: Pan Wei , Hu Juan , Yi Liangying
Published: November 2020

Background

During the COVID-19 epidemic, the central sterile supply department (CSSD) staff handled many devices, implements and non-disposable protective articles used by suspected or confirmed COVID-19 patients. As a result, the CSSD staff may have experienced psychological stress, however, the mental state of the CSSD staff during the COVID-19 epidemic has been rarely studied. We aim to investigate the mental state of the CSSD staff and relevant influencing factors experienced during the COVID-19 epidemic.

Methods

The survey utilising a general information questionnaire, Chinese perceived stress scale (CPSS), self-rating anxiety scale (SAS), and Connor-Davidson resilience scale (CD-RISC) was conducted with 423 CSSD staff members from 35 hospitals in Sichuan Province, China. Data was analysed in SPSS24.0. Classification and regression tree (CART) was utilised to analyse variables and find variation between groups. A chi-square test was performed on enumeration data, and t-test and analysis of variance were performed on measurement data.

Results

The CSSD staff’s SAS score was 37.39 ± 8.458, their CPSS score was 19.21 ± 7.265, and their CD-RISC score was 64.26 ± 15.129 (Tenacity factor score: 31.70 ± 8.066, Strength factor score: 21.60 ± 5.066, Optimism factor scores: 10.96 ± 3.189). The CPSS score was positively correlated with the SAS score (r = 0.66; P < 0.01), the CPSS score was negatively correlated with the CD-RISC score (r = − 0.617, P < 0.01), and the SAS score was negatively correlated with the CD-RISC score (r = − 0.477, P < 0.01). The job position, age, and political status of the CSSD staff were the main factors affecting their mental state; for example, the CPSS score and SAS score of the CSSD nurses were significantly different from those of the CSSD logistic staff (P < 0.01).

Conclusion

During the epidemic, the CSSD staff’s psychological resilience was at a low level; the anxiety level of the CSSD nurses was higher than that of the CSSD logistic staff. Therefore, more attention should be given to the mental health of the CSSD staff, including taking protective measures regarding the risk factors to ensure they can maintain a healthy mental state.
Ringworm in calves: risk factors, improved molecular diagnosis, and therapeutic efficacy of an Aloe vera gel extract
Authors: Tartor Yasmine H. , El-Neshwy Wafaa M. , Merwad Abdallah M. A. , Abo El-Maati Mohamed F. , Mohamed Rehab E. , Dahshan Hesham M. , Mahmoud Hala I.
Published: November 2020

Background

Dermatophytosis in calves is a major public and veterinary health concern worldwide because of its zoonotic potential and associated economic losses in cattle farms. However, this condition has lacked adequate attention; thus, to develop effective control measures, we determined ringworm prevalence, risk factors, and the direct-sample nested PCR diagnostic indices compared with the conventional methods of dermatophytes identification. Moreover, the phenolic composition of an Aloe vera gel extract (AGE) and its in vitro and in vivo antidermatophytic activity were evaluated and compared with those of antifungal drugs.

Results

Of the 760 calves examined, 55.79% (424/760) showed ringworm lesions; 84.91% (360/424) were positive for fungal elements in direct-microscopy, and 79.72% (338/424) were positive in culture. Trichophyton verrucosum was the most frequently identified dermatophyte (90.24%). The risk of dermatophytosis was higher in 4–6-month-old vs. 1-month-old calves (60% vs. 41%), and in summer and winter compared with spring and autumn seasons (66 and 54% vs. 48%). Poor hygienic conditions, intensive breeding systems, animal raising for meat production, parasitic infestation, crossbreeding, and newly purchased animals were statistically significant risk factors for dermatophytosis. One-step PCR targeting the conserved regions of the 18S and 28S genes achieved unequivocal identification of T. verrucosum and T. mentagrophytes in hair samples. Nested-PCR exhibited an excellent performance in all tested diagnostic indices and increased the species-specific detection of dermatophytes by 20% compared with culture. Terbinafine and miconazole were the most active antifungal agents for dermatophytes. Gallic acid, caffeic acid, chlorogenic acid, cinnamic acid, aloe-Emodin, quercetin, and rutin were the major phenolic compounds of AGE, as assessed using high-performance liquid chromatography (HPLC). These compounds increased and synergized the antidermatophytic activity of AGE. The treated groups showed significantly lower clinical scores vs. the control group (P < 0.05). The calves were successfully treated with topical AGE (500 ppm), resulting in clinical and mycological cure within 14–28 days of the experiment; however, the recovery was achieved earlier in the topical miconazole 2% and AGE plus oral terbinafine groups.

Conclusions

The nested PCR assay provided a rapid diagnostic tool for dermatophytosis and complemented the conventional methods for initiating targeted treatments for ringworm in calves. The recognized antidermatophytic potential of AGE is an advantageous addition to the therapeutic outcomes of commercial drugs.
Fatal systemic toxoplasmosis in a 3-month-old young tibetan goat (Capra hircus)
Authors: Pavone Silvia , Crotti Silvia , Cruciani Deborah , D’Avino Nicoletta , Zema Jacopo , Morelli Simone , Gobbi Marco , Madeo Laura
Published: November 2020

Background

Toxoplasmosis is one of the most common parasitic infections in both humans and animals. It is a frequent cause of abortion and stillbirth in intermediate hosts, especially sheep and goats but rarely causes fatal clinical form in adult animals.

Case presentation

In contrast, the study reports an unusual fatal case of toxoplasmosis in a young goat naturally infected with type II strain ofToxoplasma gondii. A three-month-old female goat was presented with dyspnea and died few days later. Grossly, lungs were firm, edematous and mottled with disseminated whitish areas. Generalized lymphadenopathy was found. The histopathological examination showed necrotic interstitial bronchopneumonia and necrotizing lymphadenitis with intralesional free and clustered within macrophages tachyzoites ofT. gondii. DNA extracted from lungs and lymph nodes was positive forT. gondiiby a fast qPCR. PCR-RFLP analysis and sequencing of GRA6 gene showed that the isolated strains belonged to type II genotype.

Conclusions

This is an unusual report of acute systemic toxoplasmosis caused by the type II strain ofT. gondiiwith a fatal outcome in a young goat.
Biogenesis and functions of circular RNAs and their role in diseases of the female reproductive system
Authors: Ma Yalan , Xu Ying , Zhang Jingshun , Zheng Lianwen
Published: November 2020

A member of the newly discovered RNA family, circular RNA (circRNA) is considered as the intermediate product of by-product splicing or abnormal RNA splicing. With the development of RNA sequencing, circRNA has recently drawn research interest. CircRNA exhibits stability, species conservatism, and tissue cell specificity. It acts as a miRNA sponge in the circRNA-microRNA (miRNA-mRNA axis, which can regulate gene transcription and protein translation. Studies have confirmed that circRNA is ubiquitous in eukaryotic cells, which play an important role in the regulation of human gene expression and participate in the occurrence and development of various human diseases. CircRNA may be closely related to the occurrence and development of female reproductive system diseases. By analyzing the biological functions and mechanism of circRNA, we find that circRNA has certain development prospects as biomarkers of the female reproductive system diseases. The production and degradation of circRNA, biological functions, and their association with the occurrence of diseases of female reproductive system are reviewed in this article.
Developing strategies to attract, retain and support midwives in rural fragile settings: participatory workshops with health system stakeholders in Ituri Province, Democratic Republic of Congo
Authors: Baba Amuda , Martineau Tim , Theobald Sally , Sabuni Paluku , Nobabo Marie Muziakukwa , Alitimango Ajaruva , Katabuka John Kisembo , Raven Joanna
Published: November 2020

Background

Midwifery plays a vital role in the quality of care as well as rapid and sustained reductions in maternal and newborn mortality. Like most other sub-Saharan African countries, the Democratic Republic of Congo experiences shortages and inequitable distribution of health workers, particularly in rural areas and fragile settings. The aim of this study was to identify strategies that can help to attract, support and retain midwives in the fragile and rural Ituri province.

Methods

A qualitative participatory research design, through a workshop methodology, was used in this study. Participatory workshops were held in Bunia, Aru and Adja health districts in Ituri Province with provincial, district and facility managers, midwives and nurses, and non-governmental organisation, church medical coordination and nursing school representatives. In these workshops, data on the availability and distribution of midwives as well as their experiences in providing midwifery services were presented and discussed, followed by the development of strategies to attract, retain and support midwives. The workshops were digitally recorded, transcribed and thematically analysed using NVivo 12.

Results

The study revealed that participants acknowledged that most of the policies in relation to rural attraction and retention of health workers were not implemented, whilst a few have been partially put in place. Key strategies embedded in the realities of the rural fragile Ituri province were proposed, including organising midwifery training in nursing schools located in rural areas; recruiting students from rural areas; encouraging communities to use health services and thus generate more income; lobbying non-governmental organisations and churches to support the improvement of midwives’ living and working conditions; and integrating traditional birth attendants in health facilities. Contextual solutions were proposed to overcome challenges.

Conclusion

Midwives are key skilled birth attendants managing maternal and newborn healthcare in rural areas. Ensuring their availability through effective attraction and retention strategies is essential in fragile and rural settings. This participatory approach through a workshop methodology that engages different stakeholders and builds on available data, can promote learning health systems and develop pragmatic strategies for the attraction and retention of health workers in fragile remote and rural settings.
Feasibility study: one year fortnightly follow-up of the evolution of supra-spinatus degeneration via text-messages
Authors: Vincent Karl , Gagey Olivier , Leboeuf-Yde Charlotte
Published: November 2020

Background

The clinical follow-up of patients for degeneration of the supraspinatus tendon is limited by the lack of objective assessment of pain evolution over time. We therefore tested a new method to collect follow-up data on patients treated either by surgical cuff repair or rehabilitation.

Objectives

We report the feasibility this method in terms of recruitment of clinicians and patients and their compliance.

Methods

In this multicenter longitudinal observational study, between September 2015 and March 2019, patients consulting either for surgical repair or rehabilitation were examined at baseline and after twelve months by their clinician, including the Mini-DASH questionnaire. Fortnightlys, during one year, patients were asked about number of days their shoulder problem affected their daily life, number of nights woken up from shoulder pain, and present pain score, using text-messages for sending and responding to questions. A system administrator supervised responses and non-compliant subjects were contacted and assisted with the procedure. The CONSORT statement for pilot studies was followed.

Results

Four of 11 invited clinicians accepted participation and collected data till the end. Of the 410 patients we originally planned for, 252 were included in the study, but complete data for the clinicians’ follow-up at 12 months were missing for 30. Of the 222 subjects with SMS data files, 190 (85%) provided at least 80% of their fortnightly messages. All three SMS messages were answered equally often. In total, 160 study subjects answered at least 80% of timesandhad clinical data at twelve months, i.e. 39% of the intended study sample and 72% of the 222 subjects with SMS data.

Conclusion

The most important difficulty of this study was the enrolment and compliance of clinicians. The collection of SMS data was less successful than in previous studies, but French people accepted well this new method which is much easier and specific than collecting data through clinical records. The quality of the SMS data was acceptable. However, because of the limited number of complete datasets, only a limited number of questions from the original study protocol can be answered.
A simplified method to isolate rice mitochondria
Authors: Xu Yanghong , Li Xiaoyi , Huang Jishuai , Peng Leilei , Luo Dinghui , Zhang Qiannan , Dan Zhiwu , Xiao Haijun , Yang Fang , Hu Jun
Published: November 2020

Background

Mitochondria play critical roles in plant growth, development and stress tolerance. Numerous researchers have carried out studies on the plant mitochondrial genome structure, mitochondrial metabolism and nuclear-cytoplasmic interactions. However, classical plant mitochondria extraction methods are time-consuming and consist of a complicated ultracentrifugation procedure with expensive reagents. To develop a more rapid and convenient method for the isolation of plant mitochondria, in this study, we established a simplified method to isolate rice mitochondria efficiently for subsequent studies.

Results

To isolate rice mitochondria, the cell wall was first disrupted by enzymolysis to obtain the protoplast, which is similar to animal mitochondria. Rice mitochondria were then isolated with a modified method based on the animal mitochondria isolation protocol. The extracted mitochondria were next assessed according to DNA and protein levels to rule out contamination by the nucleus and chloroplasts. Furthermore, we examined the physiological status and characteristics of the isolated mitochondria, including the integrity of mitochondria, the mitochondrial membrane potential, and the activity of inner membrane complexes. Our results demonstrated that the extracted mitochondria remained intact for use in subsequent studies.

Conclusion

The combination of plant protoplast isolation and animal mitochondria extraction methods facilitates the extraction of plant mitochondria without ultracentrifugation. Consequently, this improved method is cheap and time-saving with good operability and can be broadly applied in studies on plant mitochondria.
The prospects for sustaining evidence-based responses to the US opioid epidemic: state leadership perspectives
Authors: Caton Lauren , Yuan Mina , Louie Dexter , Gallo Carlos , Abram Karen , Palinkas Lawrence , Brown C. Hendricks , McGovern Mark
Published: November 2020

Background

The US 21st Century Cures Act provided $7.5 billion in grant funding to states and territories for evidence-based responses to the opioid epidemic. Currently, little is known about optimal strategies for sustaining these programs beyond this start-up funding.

Methods

Using an inductive, conventional content analysis, we conducted key informant interviews with former and current state leaders (n = 16) about barriers/facilitators to sustainment and strategies for sustaining time-limited grants.

Results

Financing and reimbursement, service integration, and workforce capacity were the most cited barriers to sustainment. Status in state government structure, public support, and spending flexibility were noted as key facilitators. Effective levers to increase chances for sustainment included strong partnerships with other state agencies, workforce and credentialing changes, and marshalling advocacy through public awareness campaigns.

Conclusions

Understanding the strategies that leaders have successfully used to sustain programs in the past can inform how to continue future time-limited, grant-funded initiatives.
Effectiveness of interventions to improve rates of intravenous thrombolysis using behaviour change wheel functions: a systematic review and meta-analysis
Authors: Hasnain Md Golam , Attia John R. , Akter Shahinoor , Rahman Tabassum , Hall Alix , Hubbard Isobel J. , Levi Christopher R. , Paul Christine L.
Published: November 2020

Background

Despite being one of the few evidence-based treatments for acute ischemic stroke, intravenous thrombolysis has low implementation rates—mainly due to a narrow therapeutic window and the health system changes required to deliver it within the recommended time. This systematic review and meta-analyses explores the differential effectiveness of intervention strategies aimed at improving the rates of intravenous thrombolysis based on the number and type of behaviour change wheel functions employed.

Method

The following databases were searched: MEDLINE, EMBASE, PsycINFO, CINAHL and SCOPUS. Multiple authors independently completed study selection and extraction of data. The review included studies that investigated the effects of intervention strategies aimed at improving the rates of intravenous thrombolysis and/or onset-to-needle, onset-to-door and door-to-needle time for thrombolysis in patients with acute ischemic stroke. Interventions were coded according to the behaviour change wheel nomenclature. Study quality was assessed using the QualSyst scoring system for quantitative research methodologies. Random effects meta-analyses were used to examine effectiveness of interventions based on the behaviour change wheel model in improving rates of thrombolysis, while meta-regression was used to examine the association between the number of behaviour change wheel intervention strategies and intervention effectiveness.

Results

Results from 77 studies were included. Five behaviour change wheel interventions, ‘Education’, ‘Persuasion’, ‘Training’, ‘Environmental restructuring’ and ‘Enablement’, were found to be employed among the included studies. Effects were similar across all intervention approaches regardless of type or number of behaviour change wheel-based strategies employed. High heterogeneity (I2 > 75%) was observed for all the pooled analyses. Publication bias was also identified.

Conclusion

There was no evidence for preferring one type of behaviour change intervention strategy, nor for including multiple strategies in improving thrombolysis rates. However, the study results should be interpreted with caution, as they display high heterogeneity and publication bias.
Clinical decision support improves the appropriateness of laboratory test ordering in primary care without increasing diagnostic error: the ELMO cluster randomized trial
Authors: Delvaux Nicolas , Piessens Veerle , Burghgraeve Tine De , Mamouris Pavlos , Vaes Bert , Stichele Robert Vander , Cloetens Hanne , Thomas Josse , Ramaekers Dirk , Sutter An De , Aertgeerts Bert
Published: November 2020

Background

Inappropriate laboratory test ordering poses an important burden for healthcare. Clinical decision support systems (CDSS) have been cited as promising tools to improve laboratory test ordering behavior. The objectives of this study were to evaluate the effects of an intervention that integrated a clinical decision support service into a computerized physician order entry (CPOE) on the appropriateness and volume of laboratory test ordering, and on diagnostic error in primary care.

Methods

This study was a pragmatic, cluster randomized, open-label, controlled clinical trial.

Setting

Two hundred eighty general practitioners (GPs) from 72 primary care practices in Belgium.

Patients

Patients aged ≥ 18 years with a laboratory test order for at least one of 17 indications: cardiovascular disease management, hypertension, check-up, chronic kidney disease (CKD), thyroid disease, type 2 diabetes mellitus, fatigue, anemia, liver disease, gout, suspicion of acute coronary syndrome (ACS), suspicion of lung embolism, rheumatoid arthritis, sexually transmitted infections (STI), acute diarrhea, chronic diarrhea, and follow-up of medication.

Interventions

The CDSS was integrated into a computerized physician order entry (CPOE) in the form of evidence-based order sets that suggested appropriate tests based on the indication provided by the general physician.

Measurements

The primary outcome of the ELMO study was the proportion of appropriate tests over the total number of ordered tests and inappropriately not-requested tests. Secondary outcomes of the ELMO study included diagnostic error, test volume, and cascade activities.

Results

CDSS increased the proportion of appropriate tests by 0.21 (95% CI 0.16–0.26, p < 0.0001) for all tests included in the study. GPs in the CDSS arm ordered 7 (7.15 (95% CI 3.37–10.93, p = 0.0002)) tests fewer per panel. CDSS did not increase diagnostic error. The absolute difference in proportions was a decrease of 0.66% (95% CI 1.4% decrease–0.05% increase) in possible diagnostic error.

Conclusions

A CDSS in the form of order sets, integrated within the CPOE improved appropriateness and decreased volume of laboratory test ordering without increasing diagnostic error.

Trial registration

ClinicalTrials.gov Identifier: NCT02950142, registered on October 25, 2016
APOE2: protective mechanism and therapeutic implications for Alzheimer’s disease
Authors: Li Zonghua , Shue Francis , Zhao Na , Shinohara Mitsuru , Bu Guojun
Published: November 2020

Investigations of apolipoprotein E (APOE) gene, the major genetic risk modifier for Alzheimer’s disease (AD), have yielded significant insights into the pathogenic mechanism. Among the three common coding variants,APOE*ε4increases, whereasAPOE*ε2decreases the risk of late-onset AD compared withAPOE*ε3. Despite increased understanding of the detrimental effect ofAPOE*ε4, it remains unclear howAPOE*ε2confers protection against AD. Accumulating evidence suggests thatAPOE*ε2protects against AD through both amyloid-β (Aβ)-dependent and independent mechanisms. In addition,APOE*ε2has been identified as a longevity gene, suggesting a systemic effect ofAPOE*ε2on the aging process. However,APOE*ε2is not entirely benign;APOE*ε2carriers exhibit increased risk of certain cerebrovascular diseases and neurological disorders. Here, we review evidence from both human and animal studies demonstrating the protective effect ofAPOE*ε2against AD and propose a working model depicting potential underlying mechanisms. Finally, we discuss potential therapeutic strategies designed to leverage the protective effect ofAPOE2to treat AD.
Prevalence and social determinants of psychological distress among people who use drugs in Cambodia
Authors: Saing Chan Hang , Prem Kiesha , Uk Ponha , Chann Navy , Chhoun Pheak , Mun Phalkun , Tuot Sovannary , Yi Siyan
Published: November 2020

Background

People who use drugs are at a disproportionately higher risk of mental disorders due to prolonged exposure to psychosocial challenges. However, studies on mental health among people who use drugs in resource-constrained countries are scarce. This study sheds light on the prevalence and correlates of psychological distress among people who use drugs in Cambodia.

Methods

We conducted this cross-sectional study in the capital city and 11 provinces in 2017. The Respondent Driven Sampling method was adapted to recruit 1677 people who used drugs for face-to-face interviews using a structured questionnaire. Psychological distress was measured using the General Health Questionnaire (GHQ-12). A total score of GHQ-12 > 2 indicated high psychological distress. We performed a multiple logistic regression analysis to identify factors associated with psychological distress.

Results

We included 1598 participants in the analyses, with a mean age of 28.6 years (SD = 7.8). Of the total, 42% had high psychological distress – 50% in women and 37% in men. The adjusted odds of having high psychological distress were significantly higher among participants who were 25–34 years old and 35 years and above, had been to a drug rehabilitation center, had been insulted by family members, and had been sexually harassed/abused by someone when they were growing up. The odds of having high psychological distress were significantly lower among participants who were male, lived in their own dwelling, reported injecting as the mode of the first drug use, and had someone taking care of them when they got sick.

Conclusions

This study documents a high prevalence of psychological distress among people who use drugs in Cambodia. Intervention programs that attempt to address mental health problems among people who use drugs in resource-limited settings should be gender- and age-sensitive and target more marginalized subpopulations. Mental health services can be integrated into HIV and harm-reduction programs for people who use drugs.
A comprehensive overview of metaplastic breast cancer: clinical features and molecular aberrations
Authors: Reddy Tejaswini P. , Rosato Roberto R. , Li Xiaoxian , Moulder Stacy , Piwnica-Worms Helen , Chang Jenny C.
Published: November 2020

Metaplastic breast cancer (MpBC) is an exceedingly rare breast cancer variant that is therapeutically challenging and aggressive. MpBC is defined by the histological presence of at least two cellular types, typically epithelial and mesenchymal components. This variant harbors a triple-negative breast cancer (TNBC) phenotype, yet has a worse prognosis and decreased survival compared to TNBC. There are currently no standardized treatment guidelines specifically for MpBC. However, prior studies have found that MpBC typically has molecular alterations in epithelial-to-mesenchymal transition, amplification of epidermal growth factor receptor, PI3K/Akt signaling, nitric oxide signaling, Wnt/β-catenin signaling, altered immune response, and cell cycle dysregulation. Some of these molecular alterations have been studied as therapeutic targets, in both the preclinical and clinical setting. This current review discusses the histological organization and cellular origins of MpBC, molecular alterations, the role of radiation therapy, and current clinical trials for MpBC.
The rescue intervention strategy for asthma patients under severe air pollution: a protocol for a single-centre prospective randomized controlled trial
Authors: Yang Xiaoyu , Huang Junjun , Hu Yan , Guo Cuiyan , Wang Xi , Yang Zhao , Zhou Tianyu , Wang Guangfa
Published: November 2020

Background

Asthma is a common chronic airway inflammatory disease. Exacerbations of asthma not only accelerate the progression of the disease but also increase the incidence of hospitalization and death. Studies have shown that air pollution is a high-risk factor for asthma exacerbations. However, few treatment strategies have been recommended to reduce the risk of severe air pollution-related asthma exacerbations.

Methods/design

This is a single-centre, prospective, randomized and standard treatment parallel control clinical trial. Seventy-two asthma patients in the nonexacerbation stage according to GINA guidelines 2017 will be recruited and randomized into the rescue intervention strategy (RIS) group and control group. Original treatments for the participants will include no use of inhaled medicine, the use of short-acting β-agonists (SABA) on demand or the use of budesonide/formoterol (160 μg/4.5 μg/dose, 1–2 dose/time, b.i.d.). The rescue intervention strategy for the RIS group will be budesonide/formoterol plus the original treatment until the severe pollution ends (air quality index, AQI < 200). The control group will maintain the original treatment. The follow-up observation period will last 1 year. The primary outcome is the frequency of asthma exacerbations per year. Secondary outcomes include the mean number of unplanned outpatient visits, emergency visits, hospitalizations, medical costs and mortality caused by asthma exacerbations per patient per year.

Discussion

The results of this trial will provide a novel strategy to guide clinical practice in decreasing the risk of asthma exacerbations under severe air pollution.

Trial registration

ChiCTR ChiCTR1900026757. Registered on 20 October 2019—retrospectively registered
Glucose metabolism-related gene polymorphisms as the risk predictors of type 2 diabetes
Authors: Li Cuilin , Yang Yuping , Liu Xin , Li Zhongyu , Liu Hong , Tan Qiuhong
Published: November 2020

Type 2 diabetes mellitus (T2DM) is a complex polygenic metabolic disease characterized by elevated blood glucose. Multiple environmental and genetic factors can increase the risk of T2DM and its complications, and genetic polymorphisms are no exception. This review is mainly focused on the related genes involved in glucose metabolic, including G6PC2, GCK, GCKR and OCT3. In this review, we have summarized the results reported globally and found that the genetic variants of GCK and OCT3 genes is a risk factor for T2DM while G6PC2 and GCKR genes are controversial in different ethnic groups. Hopefully, this summary could possibly help researchers and physicians understand the mechanism of T2DM so as to diagnose and even prevent T2DM at early time.
Draft genome assembly of Passalora sequoiae a needle blight pathogen on Leyland cypress
Authors: Copes Warren E. , Ibarra Caballero Jorge , Babiker Ebrahiem , Stewart Jane E. , Orner Valerie A. , Windham Alan S. , Arias Renee S.
Published: November 2020

Objective

Passalora sequoiae (family Mycosphaerellaceae) causes a twig blight on Leyland cypress that requires numerous fungicide applications annually to minimize economic losses for ornamental plant nursery and Christmas tree producers. The objective was to generate a high-quality draft assembly of the genome of P. sequoiae as a resource for primer development to investigate genotype diversity.

Data description

We report here the genome sequence of P. sequoiae 9LC2 that was isolated from Leyland cypress ‘Leighton Green’ in 2017 in southern Mississippi, USA. The draft genome was obtained using Pacific Biosciences (PacBio) SMRT and Illumina HiSeq 2500 sequencing. Illumina reads were mapped to PacBio assembled contigs to determine base call consistency. Based on a total of 44 contigs with 722 kilobase (kb) average length (range 9.4 kb to 3.4 Mb), the whole genome size was estimated at 31,768,716 bp. Mapping of Illumina reads to PacBio contigs resulted in a 1000 × coverage and were used to confirm accuracy of the consensus sequences.
Structural and Physicochemical Characterization of Rhamnolipids produced by Pseudomonas aeruginosa P6
Authors: El-Housseiny Ghadir S. , Aboshanab Khaled M. , Aboulwafa Mohammad M. , Hassouna Nadia A.
Published: November 2020

Rhamnolipids are important biosurfactants for application in bioremediation, enhanced oil recovery, pharmaceutical, and detergent industry. In this study, rhamnolipids extracted from P. aeruginosa P6 were characterized to determine their potential fields of application. Thin-layer chromatographic analysis of the produced rhamnolipids indicated the production of two homologues: mono- and di-rhamnolipids, whose structures were verified by 1H and 13C nuclear magnetic resonance spectroscopy. Additionally, high performance liquid chromatography-mass spectrometry identified seven different rhamnolipid congeners, of which a significantly high proportion was di-rhamnolipids reaching 80.16%. Rha-Rha-C10-C10 was confirmed as the principal compound of the rhamnolipid mixture (24.30%). The rhamnolipids were capable of lowering surface tension of water to 36 mN/m at a critical micelle concentration of 0.2 g/L, and exhibited a great emulsifying activity (E24 = 63%). In addition, they showed excellent stability at pH ranges 4–8, NaCl concentrations up to 9% (w/v) and temperatures ranging from 20 to 100 °C and even after autoclaving. These results suggest that rhamnolipids, produced by P. aeruginosa P6 using the cheap substrate glycerol, are propitious for biotechnology use in extreme and complex environments, like oil reservoirs and hydrocarbon contaminated soil. Moreover, P. aeruginosa P6 may be considered, in its wild type form, as a promising industrial producer of di-RLs, which have superior characteristics for potential applications and offer outstanding commercial benefits.
Rescue therapy with inhaled nitric oxide and almitrine in COVID-19 patients with severe acute respiratory distress syndrome
Authors: Bagate François , Tuffet Samuel , Masi Paul , Perier François , Razazi Keyvan , de Prost Nicolas , Carteaux Guillaume , Payen Didier , Mekontso Dessap Armand
Published: November 2020

Background

In COVID-19 patients with severe acute respiratory distress syndrome (ARDS), the relatively preserved respiratory system compliance despite severe hypoxemia, with specific pulmonary vascular dysfunction, suggests a possible hemodynamic mechanism for VA/Q mismatch, as hypoxic vasoconstriction alteration. This study aimed to evaluate the capacity of inhaled nitric oxide (iNO)–almitrine combination to restore oxygenation in severe COVID-19 ARDS (C-ARDS) patients.

Methods

We conducted a monocentric preliminary pilot study in intubated patients with severe C-ARDS. Respiratory mechanics was assessed after a prone session. Then, patients received iNO (10 ppm) alone and in association with almitrine (10 μg/kg/min) during 30 min in each step. Echocardiographic and blood gases measurements were performed at baseline, during iNO alone, and iNO–almitrine combination. The primary endpoint was the variation of oxygenation (PaO2/FiO2 ratio).

Results

Ten severe C-ARDS patients were assessed (7 males and 3 females), with a median age of 60 [52–72] years. Combination of iNO and almitrine outperformed iNO alone for oxygenation improvement. The median of PaO2/FiO2 ratio varied from 102 [89–134] mmHg at baseline, to 124 [108–146] mmHg after iNO (p = 0.13) and 180 [132–206] mmHg after iNO and almitrine (p < 0.01). We found no correlation between the increase in oxygenation caused by iNO–almitrine combination and that caused by proning.

Conclusion

In this pilot study of severe C-ARDS patients, iNO–almitrine combination was associated with rapid and significant improvement of oxygenation. These findings highlight the role of pulmonary vascular function in COVID-19 pathophysiology.
Steerable differential beamformers with planar microphone arrays
Authors: Huang Gongping , Chen Jingdong , Benesty Jacob , Cohen Israel , Zhao Xudong
Published: November 2020

Humanoid robots require to use microphone arrays to acquire speech signals from the human communication partner while suppressing noise, reverberation, and interferences. Unlike many other applications, microphone arrays in humanoid robots have to face the restrictions in size and geometry. To address these challenges, this paper presents an approach to differential beamforming with arbitrary planar array geometries. The major contributions of this work are as follows: (1) a method is presented to design differential beamformers, which works for regular geometries such as linear, circular, and concentric circular ones, as well as irregular geometries, as long as the sensors’ positions are given or can be measured; (2) fundamental requirements for the design of different orders of linear differential microphone arrays (DMAs), partially steerable DMAs, fully steerable DMAs, and robust DMAs are discussed; (3) the validity and limitations of the Jacobi-Anger expansion approximation is analyzed, where we discuss how to achieve an optimal approximation by properly choosing the reference point; and (4) we show how to design an Nth-order DMA with 2N microphones using the Jacobi-Anger expansion.
Association of sexually-transmitted infection and African–American race with Streptococcus agalactiae colonization in pregnancy
Authors: Capraro Gerald A. , Lala Sajel , Khaled Khaldia , Gosciniak Elizabeth , Saadat Brianna , Alvarez Sarah M. , Kumar Seema , Calhoun Tara , Landry Edward , Caldito Gloria , Bocchini Joseph A. , Vanchiere John A.
Published: November 2020

Background

Group B Streptococcus (GBS) remains a significant cause of neonatal infection, but the maternal risk factors for GBS colonization remain poorly defined. We hypothesized that there may be an association between antibiotic exposure during pregnancy and GBS colonization and/or the presence of inducible clindamycin resistance (iCLI-R) in GBS isolates from GBS-colonized pregnant women.

Methods

A retrospective cohort study was performed at Louisiana State University Health Sciences Center – Shreveport including demographic and clinical data from 1513 pregnant women who were screened for GBS between July 1, 2009 and December 31, 2010.

Results

Among 526 (34.8%) women who screened positive for GBS, 124 (23.6%) carried GBS strains with iCLI-R (GBS-iCLI-R). While antibiotic exposure, race, sexually-transmitted infection (STI) in pregnancy, GBS colonization in prior pregnancy and BMI were identified as risk factors for GBS colonization in univariate analyses, the only independent risk factors for GBS colonization were African–American race (AOR = 2.142; 95% CI = 2.092–3.861) and STI during pregnancy (AOR = 1.309; 95% CI = 1.035–1.653). Independent risk factors for GBS-iCLI-R among women colonized with GBS were non-African–American race (AOR = 2.13; 95% CI = 1.20–3.78) and younger age (AOR = 0.94; 95% CI = 0.91–0.98). Among GBS-colonized women with an STI in the current pregnancy, the only independent risk factor for iCLI-R was Chlamydia trachomatis infection (AOR = 4.31; 95% CI = 1.78–10.41).

Conclusions

This study identified novel associations for GBS colonization and colonization with GBS-iCLI-R. Prospective studies will improve our understanding of the epidemiology of GBS colonization during pregnancy and the role of antibiotic exposure in alterations of the maternal microbiome.
Fluoroquinolone resistance of Staphylococcus epidermidis isolated from healthy conjunctiva and analysis of their mutations in quinolone-resistance determining region
Authors: Kang Jung Youb , Lee Woonhyoung , Noh Gwang Myeong , Jeong Bo Hyun , Park Indal , Lee Sang Joon
Published: November 2020

Background

Staphylococcus epidermidisis the most common pathogen in postoperative endophthalmitis and causes various infectious eye diseases. However, there is very little information on fluoroquinolone antibiotic resistance toS. epidermidisidentified in conjunctival microbe and analysis of related genes. Here, the authors investigated the rate of resistance to fluoroquinolones ofStaphylococcus epidermidisisolated from normal conjunctival microbes and mutations in the quinolone-resistance determining region (QRDR).

Methods

377 eye samples from 187 patients who underwent intravitreal injection and cataract surgery were included. Specimens were taken from the bilateral lower conjunctival sacs using a cotton swab and cultured. The cultures were identified using MALDI-TOP MS andgyrA, gyrB, parC, andparEgene mutations of QRDR were confirmed by DNA extraction from resistant strains ofS. epidermidiswith a micro-dilution method using ciprofloxacin, levofloxacin, and moxifloxacin.

Results

The culture positive rate was 61.8% (231) for 374 eye samples. Of the 303 total strains cultured,S. epidermidiswas the most common with 33.7% (102). Ten types of gene mutations were observed in the resistantS. epidermidisof 21 strains. One-point mutation was observed mainly ingyrAandparC, and a small number of mutations were observed inparEin the form of a double point mutations. When there were multiple point mutations in bothgyrAandparC, the highest minimum inhibitory concentration was observed.

Conclusions

The quinolone resistance rate ofS. epidermidisincreased in comparison with previous studies, and resistantS. epidermidisshowed mostly QRDR mutations, which were mainly found ingyrAandparC, and showed strong resistance when mutated in both genes.
Disinfectant wipes transfer Clostridioides difficile spores from contaminated surfaces to uncontaminated surfaces during the disinfection process
Authors: Nkemngong Carine A. , Chaggar Gurpreet K. , Li Xiaobao , Teska Peter J. , Oliver Haley F.
Published: November 2020

Background

Pre-wetted disinfectant wipes are increasingly being used in healthcare facilities to help address the risk of healthcare associated infections (HAIs). However, HAIs are still a major problem in the US with Clostridioides difficile being the most common cause, leading to approximately 12,800 deaths annually in the US. An underexplored risk when using disinfectant wipes is that they may cross-contaminate uncontaminated surfaces during the wiping process. The objective of this study was to determine the cross-contamination risk that pre-wetted disinfectant towelettes may pose when challenged with C. difficile spores. We hypothesized that although the tested disinfectant wipes had no sporicidal claims, they will reduce spore loads. We also hypothesized that hydrogen peroxide disinfectant towelettes would present a lower cross-contamination risk than quaternary ammonium products.

Methods

We evaluated the risk of cross-contamination when disinfectant wipes are challenged with C. difficile ATCC 43598 spores on Formica surfaces. A disinfectant wipe was used to wipe a Formica sheet inoculated with C. difficile. After the wiping process, we determined log10 CFU on previously uncontaminated pre-determined distances from the inoculation point and on the used wipes.

Results

We found that the disinfectant wipes transferred C. difficile spores from inoculated surfaces to previously uncontaminated surfaces. We also found that wipes physically removed C. difficile spores and that hydrogen peroxide disinfectants were more sporicidal than the quaternary ammonium disinfectants.

Conclusion

Regardless of the product type, all disinfectant wipes had some sporicidal effect but transferred C. difficile spores from contaminated to otherwise previously uncontaminated surfaces. Disinfectant wipes retain C. difficile spores during and after the wiping process.