bluuebunny/crossref_metadata_2025 huggingface dataset:
Aucubin alleviates oxidative stress and inflammation via Nrf2-mediated signaling activity in experimental traumatic brain injury
Authors: Wang Han , Zhou Xiaoming , Wu Lingyun , Liu Guangjie , Xu Weidong , Zhang Xiangsheng , Gao Yongyue , Tao Tao , Zhou Yan , Lu Yue , Wang Juan , Deng Chulei , Zhuang Zong , Hang Chunhua , Li Wei
Published: May 2020

Background: Aucubin (Au), an iridoid glycoside from natural plants, has anti-oxidative and anti-inflammatory bioactivities; however, its effects on a traumatic brain injury (TBI) model remain unknown. We explored the potential role of Au in a H 2 O 2 -induced oxidant damage in primary cortical neurons and weight-drop induced-TBI in a mouse model. Methods: In vitro experiments, the various concentrations of Au (50 μg/ml, 100 μg/ml or 200 μg/ml) were added in culture medium at 0h and 6h after neurons stimulated by H 2 O 2 (100μM). After exposed for 12 hours, neurons were collected for western blot (WB), immunofluorescence and M29,79-dichlorodihydrofluorescein diacetate (DCFH-DA) staining. In vivo experiments, Au (20 mg/kg or 40 mg/kg) was administrated intraperitoneally at 30 min, 12 h, 24 h, and 48 h after modeling. Brain water content, neurological deficits and cognitive functions were measured at specific time, respectively. Cortical tissue around focal trauma was collected for WB, TdT-mediated dUTP Nick-End Labeling (TUNEL) staining, Nissl staining, quantitative real time polymerase chain reaction (q-PCR), immunofluorescence/immunohistochemistry and enzyme linked immunosorbent assay (ELISA) at 72 h after TBI. RNA interference experiments were performed to determine the effects of Nuclear factor erythroid-2 related factor 2 (Nrf2) on TBI mice with Au (40 mg/kg) treatment. Mice were intracerebroventricularly administrated with lentivirus at 72 h before TBI establishment. The cortex was obtained at 72 h after TBI and used for WB and q-PCR. Results: Au enhanced the translocation of Nrf2 into the nucleus, activated antioxidant enzymes, suppressed excessive generation of reactive oxygen species (ROS) and reduced cell apoptosis both in vitro and vivo experiments. In the mice model of TBI, Au markedly attenuated brain edema, histological damages and improved neurological and cognitive deficits. Au significantly suppressed high mobility group box 1(HMGB1)-mediated aseptic inflammation. Nrf2 knockdown in TBI mice blunted the antioxidant and anti-inflammatory neuroprotective effects of the Au. Conclusions: Taken together, our data suggest that Au provides a neuroprotective effect in TBI mice model by inhibiting oxidative stress and inflammatory responses; the mechanisms involve triggering Nrf2-induced antioxidant system.
Framing and Self-Responsibility Modulate Brain Activities in Decision Escalation
Authors: Liang Ting-Peng , Li Yuwen , Yen Nai-Shing , Turel Ofir , Hsu Sen-Mou
Published: May 2020

Background: Escalation of commitment is a common bias in human decision making. The present study examined (1) differences in neural recruitment for escalation and de-escalation decisions of prior investments, and (2) how the activation of these brain networks are modulated by two contextual/confounding factors: (i) responsibility, and (ii) framing of the success probabilities. Results: Imaging data were obtained from functional magnetic resonance imaging (fMRI) applied to 29 participants. A whole-brain analysis was conducted to compare brain activations between conditions. ROI analysis, then, was used to examine if these significant activations were modulated by two contextual factors. Finally, mediation analysis was applied to explore how the contextual factors affect escalation decisions through brain activations. The findings showed that (1) escalation decisions are faster than de-escalation decisions, (2) the corresponding network of brain regions recruited for escalation (anterior cingulate cortex, insula and precuneus) decisions differs from this recruited for de-escalation decisions (inferior and superior frontal gyri), (3) the switch from escalation to de-escalation is primarily frontal gyri dependent, and (4) activation in the anterior cingulate cortex, insula and precuneus were further increased in escalation decisions, when the outcome probabilities of the follow-up investment were positively framed; and activation in the inferior and superior frontal gyri in de-escalation decisions were increased when the outcome probabilities were negatively framed. Conclusions: Escalation and de-escalation decisions recruit different brain regions. Framing of possible outcomes as negative leads to escalation decisions through recruitment of the inferior frontal gyrus. Responsibility for decisions affects escalation decisions through recruitment of the superior (inferior) gyrus, when the decision is framed positively (negatively).
Inferring the votes in a new political landscape. The case of the 2019 Spanish Presidential elections.
Authors: Grimaldi Didier , Diaz Javier , Arboleda Hugo
Published: May 2020

The avalanche of personal and social data circulating in Online Social Networks over the past 10 years has attracted a great deal of interest from Scholars and Practitioners who seek to analyse not only their value, but also their limits. Predicting election results using Twitter data is an example of how data can directly influence the politic domain and it also serves an appealing research topic. This article aims to predict the results of the 2019 Spanish Presidential election and the voting share of each candidate, using Tweeter. The method combines sentiment analysis and volume information and compares the performance of five Machine Learning algorithms. Several data scrutiny uncertainties arose that hindered the prediction of the outcome. Consequently, the method develops a political lexicon-based framework to measure the sentiments of online users. Indeed, an accurate understanding of the contextual content of the tweets posted was vital in this work. Our results correctly ranked the candidates and determined the winner by means of a better prediction of votes than official research institutes.
Informing urban climate planning with high resolution data: the Hestia fossil fuel CO2 emissions for Baltimore, Maryland
Authors: Roest Geoffrey Scott , Gurney Kevin R , Miller Scot M , Liang Jianming
Published: May 2020

Background Cities contribute more than 70% of global anthropogenic carbon dioxide (CO2 ) emissions and are leading the effort to reduce greenhouse gas (GHG) emissions through sustainable planning and development. However, urban greenhouse gas mitigation often relies on self-reported emissions estimates that may be incomplete and unverifiable via atmospheric monitoring of GHGs. We present the Hestia Scope 1 fossil fuel CO2 (FFCO2 ) emissions for the city of Baltimore, Maryland – a gridded annual and hourly emissions data product for 2010 through 2015 (Hestia-Baltimore v1.6). We also compare the Hestia-Baltimore emissions to overlapping Scope 1 FFCO2 emissions in Baltimore’s self-reported inventory for 2014. Results The Hestia-Baltimore emissions in 2014 totaled 1487.3 kt C (95% confidence interval of 1,158.9 – 1,944.9 kt C), with the largest emissions coming from onroad (34.2% of total city emissions), commercial (19.9%), residential (19.0%), and industrial (11.8%) sectors. Scope 1 electricity production and marine shipping were each generally less than 10% of the city’s total emissions. Baltimore’s self-reported Scope 1 FFCO2 emissions included onroad, natural gas consumption in buildings, and some electricity generating facilities within city limits. The self-reported Scope 1 FFCO2 total of 1,182.6 kt C was similar to the sum of matching emission sectors and fuels in Hestia-Baltimore v1.6. However, 20.5% of Hestia-Baltimore’s emissions were in sectors and fuels that were not included in the self-reported inventory. Petroleum use in buildings were omitted and all Scope 1 emissions from industrial point sources, marine shipping, nonroad vehicles, rail, and aircraft were categorically excluded. Conclusions The omission of petroleum combustion in buildings and categorical exclusions of several sectors resulted in an underestimate of total Scope 1 FFCO2 emissions in Baltimore’s self-reported inventory. Accurate Scope 1 FFCO2 emissions, along with Scope 2 and 3 emissions, are needed to inform effective urban policymaking for system-wide GHG mitigation. We emphasize the need for comprehensive Scope 1 emissions estimates for emissions verification and measuring progress towards Scope 1 GHG mitigation goals using atmospheric monitoring.
Research on English Teaching System Based on Artificial Intelligence and WBIETS Wireless Network System
Authors: Tan Minghua
Published: May 2020

The English teaching network system is a distant teaching based on Web. This teaching method can stimulate students' interests, so that students can acquire knowledge voluntarily, and automatic test paper generation is one of the most important modules in English teaching network system. This paper first describes the automatic test problems, is a constrained multi-objective problem; then the design of genetic algorithm to improve the test paper, put forward questions based encoding method and based on the difficulty and test points of F fitness function for dynamic adjustment of the parameters in the iterative process. Finally, it is verified by experiments that the test paper made by this method satisfies users' requests for questions, contents and scores, and at the same time, it also improves the running efficiency of random optimization algorithm by 7-17 times.
The effects of clinical decision support system for prescribing medication on patient outcomes and physician practice performance: A systematic review and meta-analysis
Authors: Moghadam Sharare Taheri , Velayati Farnia , Sadoughi Farahnaz , Ehsanzadeh Seyedjafar , Poursharif Shayan
Published: May 2020

Background: The clinical decision support systems (CDSSs) for prescription medications is one of the technologies aimed at improving physician practice behavior and patient outcomes by reducing drug prescription errors. This study, thus, was conducted to investigate the effect of various CDSSs on physician practice behavior and patient outcomes.Methods: This systematic review was conducted by searching in PubMed, EMBASE, Web of Science, Scopus and Cochrane Library from 2005 to 2019. Two researchers independently evaluated the studies. Any discrepancies over the eligibility of the studies between the two researchers were then resolved by consulting a third researcher. Finally, we extracted data from the articles. Then, we conducted a meta-analysis based on medication subgroups and outcome categories; we also presented a narrative form of the findings. Meanwhile, we applied random-effects model to estimate the effects of CDSS on patient outcomes and physician practice performance with 95% confidence interval. Q statistics and I2 was then used to measure heterogeneity.Results: Based on the inclusion criteria, 46 studies were considered eligible for the analysis in this review. The CDSS for prescription medications had been used for various diseases such as cardiovascular diseases, hypertension, diabetes, gastrointestinal and respiratory diseases, AIDS, appendicitis, kidney disease, malaria, high blood potassium, and mental disease. Meanwhile, other cases such as the concurrent prescription of multiple drugs for patients and its effects on the above-mentioned outcomes were evaluated. The analysis shows that in some cases the application of CDSS provides positive effects on patient outcomes and physician practice behaviors. The effect was statistically significant (std diff in means =0.114, 95% CI: 0.090 to 0.138) as overall. It was also statistically significant for outcome groups such as those showing improved outcomes on physician practice performance and patient outcome or both. No significant difference was observed in comparison between some other cases and conventional methods. We think that this could be due to the disease type, the quantity, and the type of CDSS requirements that influenced the comparison. Conclusions: Our findings suggest that positive effects of the CDSS are due to factors such as user-friendliness, compliance with clinical guidelines, patient and doctor cooperation, integration of electronic health records, CDSS and pharmaceutical systems, consideration of the views of physicians in assessing the importance of CDSS alerts, and their real-time alerts in the prescription.
Effect of vaccine reminder and tracker bracelets on routine childhood immunization coverage and timeliness in urban Pakistan (2017-18): a randomized controlled trial
Authors: Siddiqi Danya Arif , Ali Rozina Feroz , Munir Mehr , Shah Mubarak Taighoon , Khan Aamir J , Chandir Subhash
Published: May 2020

Background: Inability to track children’s vaccination history coupled with parents’ lack of awareness of vaccination due dates compounds the problem of low immunization coverage and timeliness in developing countries. We evaluated the impact of two types of silicon immunization reminder bracelets for children in improving immunization coverage and timeliness of Pentavalent-3 and the Measles-1 vaccines. Methods: Children <3 months were enrolled in either of the 2 intervention groups (Alma Sana Bracelet Group and Star Bracelet Group) or the Control group. Children in the intervention groups were provided the 2 different bracelets at the time of recruitment. Each time the child visited the immunization center, a hole was perforated in the silicon bracelet to denote vaccine administration. Each child was followed up till administration of Measles-1 vaccine or till 12 months of age (if they did not come to the center for vaccination). Data was analyzed using the intention-to-treat population between groups. The unadjusted and adjusted Risk Ratios (RR) and 95% confidence interval (CI) for Pentavalent-3 and Measles-1 coverage at 12 months of age were estimated through bivariate and multivariate analysis. Time-to-Pentavalent-3 and Measles-1 immunization curves were calculated using the Kaplan–Meier method. Results: A total of 1,445 children were enrolled in the study between July 19, 2017 and October 10, 2017. Baseline characteristics among the three groups were similar. Up-to-date coverage for the Pentavalent-3 /Measles-1 vaccine at 12 months of age was 84.6%/72.0%, 85.4%/70.5% and 83.0%/68.5% in Alma Sana Bracelet group, Star Bracelet group and Control group respectively but the differences were not statistically significant. In the multivariate analysis, neither the Alma Sana bracelet (adjusted RR = 1.01; 95% CI: 0.96-1.06), (adjusted RR: 1.05; 95% CI: 0.97-1.13) nor the Star bracelet (adjusted RR = 1.01; 95% CI: 0.96-1.06) (adjusted RR: 1.03; 95% CI: 0.95-1.11) was significantly associated with Pentavalent-3 vaccination or Measles-1 vaccination. Conclusion: Although we did not observe any significant impact of the bracelets on improved immunization coverage and timeliness, our findings add to the existing literature on innovative, low cost reminders for health and make several suggestions for enhancing practical implementation of these tools.Trial Registration: ClinicalTrials.gov NCT03310762. Retrospectively Registered on October 16, 2017.
Comparative genomics and pangenome-oriented studies reveal high homogeneity of the agronomically relevant enterobacterial plant pathogen Dickeya solani
Authors: Motyka-Pomagruk Agata , Zoledowska Sabina , Misztak Agnieszka Emilia , Sledz Wojciech , Mengoni Alessio , Lojkowska Ewa
Published: May 2020

Background: Dickeya solani is an important plant pathogenic bacterium causing severe losses in European potato production. This species draws a lot of attention due to its remarkable virulence, great devastating potential and easier spread in contrast to other Dickeya spp. In view of a high need for extensive studies on economically important soft rot Pectobacteriaceae , we performed a comparative genomics analysis on D. solani strains to search for genetic foundations that would explain the differences in the observed virulence levels within the D. solani population. Results: High quality assemblies of 8 de novo sequenced D. solani genomes have been obtained. Whole-sequence comparison, ANIb, ANIm, Tetra and pangenome-oriented analyses performed on these genomes and the sequences of 14 additional strains revealed an exceptionally high level of homogeneity among the studied genetic material of D. solani strains. With the use of 22 genomes, the pangenome of D. solani , comprising 84.7% core, 7.2% accessory and 8.1% unique genes, has been almost completely determined, suggesting the presence of a nearly closed pangenome structure. Attribution of the genes included in the D. solani pangenome fractions to functional COG categories showed that higher percentages of accessory and unique pangenome parts in contrast to the core section are encountered in phage/mobile elements- and transcription- associated groups with the genome of RNS 05.1.2A strain having the most significant impact. Also, the first D. solani large-scale genome-wide phylogeny computed on concatenated core gene alignments is herein reported. Conclusions: The almost closed status of D. solani pangenome achieved in this work points to the fact that the unique gene pool of this species should no longer expand. Such a feature is characteristic of taxa whose representatives either occupy isolated ecological niches or lack efficient mechanisms for gene exchange and recombination, which seems rational concerning a strictly pathogenic species with clonal population structure. Finally, no obvious correlations between the geographical origin of D. solani strains and their phylogeny were found, which might reflect the specificity of the international seed potato market.
Characterization of WWOX Expression and Function in Canine Mast Cell Tumors and Malignant Mast Cell Lines
Authors: Makii Rebecca , Cook Hanna , Louke Darian , Breitbach Justin , Jennings Ryan , Premanandan Christopher , Green Eric M , Fenger Joelle M
Published: May 2020

Background
The WW domain-containing oxidoreductase (WWOX) tumor suppressor gene is frequently lost in solid and hematopoietic malignancies in humans. Dysregulation of WWOX has been implicated as playing a key role in tumor cell survival, DNA damage repair, and genomic stability. The purpose of this study was to characterize WWOX expression in spontaneous canine mast cell tumors (MCTs) and malignant cell lines and investigate the potential contribution of WWOX loss on malignant mast cell behavior.
Results
WWOX expression is decreased in primary canine MCTs and malignant mast cell lines compared to normal canine bone marrow-cultured mast cells. In transformed canine mastocytoma cell lines, overexpression of WWOX or WWOX knockdown had no effect on mast cell viability. Inhibition of WWOX enhanced clonogenic survival following treatment with ionizing radiation in the C2 mast cell line. Lastly, immunohistochemistry for WWOX was performed using a canine MCT tissue microarray, demonstrating that WWOX staining intensity and percent of cells staining for WWOX is decreased in high-grade MCTs compared to low-grade MCTs.
Conclusions
These data suggest that WWOX expression is attenuated or lost in primary canine MCTs and malignant mast cell lines. Given the observed increase in clonogenic survival in WWOX-deficient C2 mast cells treated with ionizing radiation, further investigation of WWOX and its role in mediating the DNA damage response in malignant mast cells is warranted.
'We need more big trees as well as the grass roots’: Going beyond research capacity building to develop sustainable careers in mental health research in African countries
Authors: Langhaug Lisa , Jack Helen , Hanlon Charlotte , Holzer Stephan , Sorsdahl Katherine , Mutedzi Barbara , Mangezi Walter , Merritt Christopher , Alem Atalay , Stewart Robert , Bandawe Chiwoza , Musesengwa Rosemary , Abas Melanie , Chibanda Dixon , Lund Crick
Published: May 2020

Background There are substantial gaps in our knowledge regarding the aetiology of mental, neurological and substance use disorders in sub-Saharan Africa, and the cost-effectiveness and scalability of interventions to reduce the burden of these conditions on the continent. To address these gaps, international investment has focussed on building research capacity, including funding doctoral students in African countries, to support development of high quality, contextually relevant interventions. Absent, however, is an understanding of how capacity building feeds into research careers.Methods Within a broader mental health research capacity-building initiative (African Mental Health Research Initiative), we conducted 52 qualitative interviews with early-career researchers, policymakers, academics, and service users from four African countries (Ethiopia, Malawi, South Africa, and Zimbabwe) and with international funders of mental health research. The interview guide focused on the research context, planning, and priorities and how respondents perceive research careers and funding. Thematic analysis was applied to the transcribed interviews.Results Five components of a research career emerged: i) research positions; ii) research skills; iii) funding; iv) research commitment from African countries; and v) advocacy. All stakeholders wanted more high-impact African researchers, but few saw a clear, replicable track for developing their careers within universities or their Ministries of Health in their African countries. This stemmed, in part, from the lack of support for infrastructure that enables high-quality research: grants administration, mentorship, university leadership, research culture, and open communication between policymakers and researchers.Conclusions This study highlights the importance of developing research infrastructure alongside capacity-building efforts. International funders should invest in grant management at African universities which would place them at the centre of research initiatives. African universities should prioritise the creation of a research culture by developing and promoting well-defined research tracks for both clinicians and academics, investing in grant management, and raising the profile of research within their institutions.
Improvement of cardiac dysfunction by L-arginine combined with vitamin C through restoring angiogenesis associated with NADPH/NOS/NO signal pathway in diabetic rats
Authors: Su Jie , Cai Beibo , Li Xiao-Xue , Xu Ming
Published: May 2020

Background

In diabetic patients, the occurrence of ischemic events such as myocardial infarction is significantly higher than that of normal patients. L-arginine and vitamin C are commonly used adjuvant drugs in clinical practice. But whether L-arginine and vitamin C can be used together, the role of promoting angiogenesis to improve vascular dysfunction and its mechanism of action are not clear. To this end, we investigated whether L-arginine in combination with vitamin C promotes revascularization after myocardial infarction in patients with type 2 diabetes by inhibiting angiogenesis disorders associated with NADPH oxidase.
Methods

Experimental myocardial infarction (MI) was induced by left anterior descending coronary artery ligation in diabetic Sprague-Dawley rats and non-diabetic controls. Cardiac function was studied by echocardiography and LDH activity. Western blotting was used to study VEGF, Nox4, Nox1, Nox2, eNOS and phospho-eNOS (Ser1177), CAT-1. Angiogenesis, cell proliferation and migration were detected by micro-vessel density assay, cell viability assay, scratch wound-healing assay and tube formation assay.
Results

First, we cultured rat aortic endothelial cells in a high glucose environment for 48 hours, then treated L-arginine and vitamin C alone or together. It was shown that high glucose significantly damaged cell proliferation, migration and tube formation, which was normalized by L-arginine with vitamin C combined application. Furthermore, we found that co-treatment of L-arginine and vitamin C activated NOS/NO signaling pathway via inhibited NADPH oxidase activity, which regulated angiogenesis in RAECs. In vivo, L-arginine and vitamin C co-intervention improved cardiac function by implementing echocardiographic examination and LDH activity. This therapy also relieved the vasodilatory response to acetylcholine and restored the expressions of p-eNOS and VEGF, together with reducing Nox2 and iNOS production in the ischemic myocardium of high-fat diet (HFD)-fed rats following streptozocin (STZ) injection.
Conclusion

Overall, for the first time, this study reveals that the combination of L-arginine and vitamin C restores the blood supply to myocardial infarction in rats with type 2 diabetes by promoting angiogenesis, which was attributed to activating NOS/NO signaling pathway via blocking NADPH-dependent O2− generation.
Common sampling and modeling approaches to analyzing readmission risk that ignore clustering produce misleading results
Authors: Zhao Huaqing , Tanner Samuel , Golden Sherita H. , Fisher Susan , Rubin Daniel J.
Published: May 2020

Background
There is little consensus on how to sample hospitalizations and analyze multiple variables to model readmission risk. The purpose of this study was to compare readmission rates and the accuracy of predictive models based on different sampling and multivariable modeling approaches.
Methods
We conducted a retrospective cohort study of 17 284 adult diabetes patients with 44 203 discharges from an urban academic medical center between 1/1/2004 and 12/31/2012. Models for all-cause 30-day readmission were developed by four strategies: logistic regression using the first discharge per patient (LR-first), logistic regression using all discharges (LR-all), generalized estimating equations (GEE) using all discharges, and cluster-weighted (CW) GEE using all discharges. Multiple sets of models were developed and internally validated across a range of sample sizes.
Results
The readmission rate was 10.2% among first discharges and 20.3% among all discharges, revealing that sampling only first discharges underestimates a population’s readmission rate. Number of discharges was highly correlated with number of readmissions (r = 0.87, P < 0.001). Accounting for clustering with GEE and CWGEE yielded more conservative estimates of model performance than LR-all. LR-first produced falsely optimistic Brier scores. Model performance was unstable below samples of 6 000–8 000 discharges and stable in larger samples. GEE and CWGEE performed better in larger samples than in smaller samples.
Conclusions
Hospital readmission risk models should be based on all discharges as opposed to just the first discharge per patient and utilize methods that account for clustered data.
Determinants of Utero-vaginal prolapse in Western Ethiopia
Authors: Firdisa Gamachis , Tilahun Temesgen , Kejela Gemechu
Published: May 2020

IntroductionIn Ethiopia, gynecological problems are important health problems affecting maternal health outcomes and women’s productivity. Uterovaginal prolapse is a significant public health concern in developing countries like Ethiopia where access to health care is limited.ObjectiveTo identify determinants of utero-vaginal prolapse among women attending gynecologic outpatient department at public hospitals in Nekemte town, Western Ethiopia, 2019.Methods and materialA hospital based unmatched case-control study was conducted with the total sample of 341 women attending gynecologic outpatient department in Nekemte town, from May 1 to July 30/2019. 86 cases and 258 controls were included in the study. Cases were women with utero-vaginal prolapse while controls were women free from utero-vaginal prolapse but with other gynecologic disease during the same period as of cases. Data were collected using pretested questionnaire and measurement on height and weight was taken to calculate body mass index of women. Data was entered using Epi Data version 3.1 and analysis was carried out by SPSS version 24.0. Descriptive, bivariate and multivariable logistic regressions were performed. Adjusted odds ratio with 95% confidence interval was used and statistical significance was considered at p < 0.05.ResultsThis study revealed, age ≥ 40 years (AOR = 10.49; 95%CI: 4.03, 27.35), duration of labor ≥ 24 hours (AOR = 8.32; 95%CI: 3.58, 19.33), instrumental delivery (AOR = 7.40; 95%CI: 1.21, 45.28), non- utilization of family planning (AOR = 3.14; 95%CI: 1.32, 7.47) and underweight (BMI < 18.5 kg/m2) 5.30 (AOR = 5.30; 95%CI: 1.83, 15.33) were determinants of utero-vaginal prolapse.Conclusion and RecommendationAge ≥ 40 years, prolonged labor, instrumental delivery, non-utilization of family planning and underweight were identified as determinant factors of utero-vaginal prolapse. Thus, family planning service utilization and appropriate obstetric care are advisable.
Clinical characteristics and manifestations in older patients with COVID-19
Authors: Wei Chenchen , Liu Ya , Liu Yapeng , Zhang Kai , Su Dezhen , Zhong Ming , Meng Xiao
Published: May 2020

Background
To investigate the clinical characteristics and manifestations of older patients with coronavirus disease 2019 (COVID-19).
Methods
In this retrospective study, 566 patients with confirmed COVID-19 were enrolled and the clinical characteristics, laboratory findings, complications and outcome data were collected and analyzed.
Results
Among the 566 patients (median age, 61.5 years) with COVID-19, 267 (47.2%) patients were male and 307 (54.2%) were elderly. Compared with younger patients, older patients had more underlying comorbidities and laboratory abnormalities. A higher rate of acute respiratory distress syndrome (ARDS), acute cardiac injury and heart failure was observed in the older group as compared with younger and middle-aged groups, particularly those oldest-old patients (> 75y) had more multi-organ damage. Older patients with COVID-19 were more likely to suffer from acute cardiac injury in cases with preexistenting cardiovascular diseases, while there was no difference among the three groups when patients had no history of cardiovascular diseases. Older patients present more severe and the mortality was 18.6%, which was higher than that in younger and middle-aged patients (P < 0.05). Multivariable analysis showed that age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were associated with the death in older patients, while glucocorticoids should be carefully administered since it may increase the mortality in older patients.
Conclusions
Older patients, especially the oldest-old patients were more likely to exhibit significant systemic inflammation, pulmonary and extrapulmonary organ damage and a higher mortality. Advanced age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were independent predictors of death in older patients and glucocorticoids may be harmful for older patients with COVID-19.
Sex and Foxp3 -924a/g Gene Polymorphism May Be Associated With the Clinical and Pathological Aspects of Chronic Viral Diseases
Authors: Pereira Leonn Mendes Soares , Madureira Max Willy da Silva , de Castro Renata Bezerra Hermes , Abreu Isabella Nogueira , Conde Simone Regina Souza da Silva , Demachki Sâmia , de Sousa Maisa Silva , Queiroz Maria Alice Freitas , Silva Andrea Nazaré M. Rangel da , Ishak Marluísa de Oliveira Guimarães , Ishak Ricardo , Vallinoto Antonio C. R.
Published: May 2020

Background: The forkhead box protein 3 (FOXP3) transcription factor is one of the main markers of immunological suppression in different pathological profiles, and the presence of polymorphic variants may alter the gene expression of this factor. Despite descriptions of an association between the presence of the -924A/G polymorphism and chronic diseases, the role of the sex variant in this context has not yet been elucidated,as the FOXP3 gene is located on the human sex chromosome X. Results: To contribute to this topic, 323 women and 373 men diagnosed with chronic viral infections or coronary artery disease and a healthy group of blood donors were genotyped for the -924A/G polymorphism. The -924A/G polymorphism was associated with clinical and pathological aspects and biomarkers of viral infections only in men, with functional differences between different infections. Conclusions:A relationship is suggested between sex and FOXP3polymorphisms, resulting in different biological repercussions.
Epidemiologic, Clinical, and Laboratory Findings of the COVID-19 in the current pandemic
Authors: Xie Yewei , Wang Zaisheng , Liao Huipeng , Marley Gifty , Wu Dan , Tang Weiming
Published: May 2020

Background
The COVID-19 caused the pandemic affected the world deeply, with more than 3,000,000 people infected and nearly 200,000 deaths. This article aimed to summarize the epidemiologic traits, clinical spectrum, CT results and laboratory findings of COVID-19 pandemic.
Methods
We scoped for relevant literatures published during 1st Dec 2019 to 23rd Apr 2020 based on four databases by using English and Chinese. The evidence was synthesized narratively.
Results
The COVID-19 pandemic was found to have a higher transmission rate compared to SARS and MERS, and involved 4 stages of evolution. The basic reproduction number (R0) is 3.32 (95% CI:3.24–3.39) and the incubation period was 5.24 days (95% CI:3.97–6.50, 5 studies) on average, and the average time for symptoms onset varied by countries. Common clinical spectrums identified included fever (38.1–39.0℃), cough and fatigue, with Acute Respiratory Distress Syndrome (ARDS) being the most common complication reported. Body temperatures above 39.0 ℃, dyspnea, and anorexia were more common symptoms in severe patients. Aged over 60 years old, having co-morbidities, and developing complications were the commonest high-risk factors associated with severe conditions. Leucopenia and lymphopenia were the most common signs of infection while liver and kidney damage were rare but may cause bad outcomes for patients. The bilateral, multifocal Ground-Glass Opacification (GGO) on peripheral, and the consolidative pulmonary opacity were the most frequent CT results and the tendency of mortality rates differed by region.
Conclusions
We provided a bird’s-eye view of the COVID-19 during the current pandemic, which will help better understanding the key traits of the disease. The findings could be used for disease’s future research, control and prevention.
Visceral Fat Area to Leg Muscle Mass Ratio Are Significantly Associated With the Risk of Hyperuricemia Among Women: A Cross-sectional Study
Authors: WANG Xiao-He , JIANG Wei-Ran , ZHANG Min-Ying , SHI Ying-Xin , JI Yun-Ping , Li Chun-Jun , LIN Jing-Na
Published: May 2020

Background: Previous studies have found a significant positive association between obesity, visceral fat accumulation and hyperuricemia. The purpose of the study was to explore the association between the ratio of visceral fat area to leg muscle mass(VFA-to-LMM) and hyperuricemia, and verify the role of sex differences in the association.Methods:In this cross-sectional study, a total of 3393 (43.3% for men) participants from Tianjin Union Medical Center-Health Management Center were recruited. Body composition were measured by multielectrode bioelectrical impedance analyzer. The VFA-to-LMM ratio was used as independent variable. Hyperuricemia, defined as a serum uric acid level ≥ 416 μmol/L in men and menopausal women, and ≥ 357 μmol/L in premenopausal women, was used as the dependent variable. Multiple logistic regression analysis was used to estimate the odds ratio and 95% confidence interval between VFA-to-LMM ratio and hyperuricemia.Results:The overall prevalence of hyperuricemia was 14.8%, and the prevalence of hyperuricemia in women (8.9%) was significantly lower than that in men (22.5%). After adjustment for age, smoking status (for males), menopause status (for females), drinking status, exercise frequency, blood pressure, alanine aminotransferase, fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, creatinine, and history of diseases, a strong positive association was observed between VFA-to-LMM ratio and hyperuricemiain bothmen (4th vs. 1st quartile 1.60, 95%CI: 1.03-2.49) and women (4th vs. 1st quartile 5.22, 95%CI: 2.44-12.56).After additionally adjustment for BMI, there was still a significant positive association in women (4th vs. 1st quartile 2.57, 95%CI: 1.06-6.77), while the association disappeared in men(4th vs. 1st quartile 0.97, 95%CI: 0.55-1.70).Conclusions:The VFA-to-LMM ratio was positively associated with the risk of hyperuricemia in women after adjustments for confounders. In addition, the highest risk of hyperuricemia was observed when both VFA and LMM were at the highest quartile. However, well-controlled prospective studies are needed to further confirm the causality between VFA-to-LMM ratio and hyperuricemia.
Evaluation of impact of daily Laurus nobilis tea consumption on the lipid profile and on the increased anti-oxidant activity in healthy volunteers
Authors: chbili chahra , Maher Maoua , Sawssen Mrad , Mejda Selmi , Hajer Boudriga , Hedi Khairi , Khalifa Limem , Nejib Mrizek , Saad Saguem , Maha Ben Fredj
Published: May 2020

The authors have withdrawn this preprint due to author disagreement.
Surgical treatment in nervous system echinococcosis in Qinghai-Tibet Plateau
Authors: Du Chaonan , Li Jing , Zhang Qiang , Yang Mingfei
Published: May 2020

Purpose: To summarize the experience of diagnosis and treatment of echinococcosis in nervous system in Qinghai-Tibet Plateau.Methods: Patients with echinococcosis of nervous system treated in Qinghai Provincial People's Hospital from January 2010 to September 2018 were selected. All patients were examined by enzyme linked immunosorbent assay and imaging examination. During the hospital, all patients received surgery. After operation, patients exanimated regularly and followed up for one year.Results: A total of 13 patients were included in this study. The average age was 38.8±13.7 and seven cases (54%) were male. Among these patients, six cases had cystic echinococcosis and seven cases with alveolar echinococcosis, meanwhile, eight patients had cerebral echinococcosis and five patients with spinal echinococcosis. The enzyme linked immunosorbent assay indicated positive results in 8 cases and one patient was misdiagnosed as vertebral metastases by imaging examination before operation. One patient recurred after operation but refused treatment. After follow-up for one year, the mRS (Modified Rankin Scale) of cerebral echinococcosis improved from 3.3±0.5 to 2.1±0.4, four cases of spinal echinococcosis improved in ASIA (American Spinal Injury Association).Conclusion: Current evidence indicated that early surgical treatment and oral albendazole might improve the outcome of patients with nervous system echinococcosis in short time.
Factors Associated with the Performance of Routine Health Information System in Yaoundé-Cameroon: A cross-sectional survey
Authors: Nguefack-Tsague Georges , Tamfon Brian Bongwong , Ngnie-Teta Ismael , Ngoufack Marie Nicole , Keugoung Basile , Bataliack Serge Marcial , Ndongo Chanceline Bilounga
Published: May 2020

Background
Routine Health Information Systems (RHIS) of low-income countries function below the globally expected standard, characterised by the production and use of poor-quality data, or the non-use of good quality data for informed decision making. This has negatively influenced the health service delivery and uptake. This study focuses on identifying the factors associated with the performance of RHIS of the health facilities (HF) in Yaoundé, so as to guide targeted RHIS strengthening.
Methods
A HF-based cross-sectional study in the 6 health districts (HDs) of Yaoundé was conducted. HFs were chosen using stratified sampling with probability proportional to size per HD. Data were collected, entered into Microsoft Excel 2013 and analysed with IBM- SPSS version 25. Consistency of the questionnaire was measured using Cronbach’s alpha coefficient. Pearson’s chi-square (and Fisher exact where relevant) tests were used to establish relationships between qualitative variables. Associations were further quantified using unadjusted Odd ratio (OR) for univariate analysis and adjusted odds ratio (aOR) for multivariate analysis with 95% confidence interval (CI). A p-value of less than 0.05 was considered statistically significant.
Results
Of 111 selected HFs; 16 (14.4%) were public and 95 (85.6%) private. Respondents aged 24–60 years with an average of 38.3 ± 9.3 years; 58 (52.3%) male and 53(47.7%) female. Cronbach’s alpha was 0.96 (95%CI: 0.95–0.98, p < 0.001), proving that the questionnaire was reliable in measuring RHIS performances. At Univariate level, the following factors were positively associated with good performances: supportive supervision (OR = 3.03 (1.1, 8.3); p = 0.02), receiving feedback from hierarchy (OR = 3.6 (0.99, 13.2); p = 0.05), having received training on health information (OR = 5.0 (1.6, 16.0); p = 0.003), and presence of a performance evaluation plan (OR = 3.3 (1.4, 8.2), p = 0.007). At multivariate level, the only significantly associated factor was having received training on health information (aOR = 3.3 (1.01, 11.1), p = 0.04).
Conclusions
Training of health staff in the RHIS favors RHIS good performance. Hence, emphasis should be laid on training and empowering staff, frequent and regular RHIS supervision, and frequent and regular feedback mechanisms, for an efficient RHIS strengthening in Yaoundé.
'Going off track': The consequences of barriers to Ghanaian midwives’ ability to provide quality care.
Authors: Ismaila Yakubu , Bayes Sara , Geraghty Sadie
Published: May 2020

Despite global efforts to reduce maternal and neonatal mortality rates, the problem continues to persist, especially in Lower- and Middle-Income Countries like Ghana. For years it has been acknowledged that the deployment of well-trained and regulated midwives could provide a cost-efficient way of reducing maternal and neonatal mortality. However, multiple factors including; recently increasing demands made by birthing women, the growing complexity of midwifery work and a shortage of midwives as well as other barriers have affected the ability of midwives to provide quality maternal and neonatal care. This study aims to provide insight into some of the consequences of these barriers that midwives face in their workplaces.MethodsGlaserian Grounded Theory was applied in this study. Semi structured interviews were conducted with twenty-nine (29) midwives and four (4) other workers whose roles impacts on the work of midwives. In accordance with the requirements of grounded theory, data collection and analysis occurred concurrently while building on the data that has already been analyzed. Constant comparison was used throughout the data analysis.ResultsThe analysis of the data indicated that barriers to midwives’ ability to provide quality care have physiological, psychological and socioeconomic consequences on midwives thereby affecting the quality of the care that they offer to women and newborns. ConclusionThe effects of the barriers to midwives’ abilities to provide quality care are intertwined and have consequences on both the midwives as well as on the quality of the care that they provide to patients. By implementing measures to ameliorate or mitigate the effects of the barriers that midwives face in their work, the quality of the care that they provide to women and neonates will be enhanced, which in turn will positively affect the retention of midwives and maximize the benefits of implementing the midwifery model of care.
Integrated Metabolic Profiling and Transcriptome Analysis of Pigment Accumulation in Diverse Petal Tissues in the Lily Cultivar 'Vivian'
Authors: Yin Xiaojuan , Lin Xinyue , Liu Yuxuan , Irfan Muhammad , Chen Lijing , Zhang Li
Published: May 2020

Background: Petals are the colorful region of many ornamental plants. Quality traits of petal color directly affect the value of ornamental plants. Although the regulatory mechanism of flower color has been widely studied in many plants, that of lily flower color is still worth further exploration.Results: In this study, the pigmentation regulatory network in different regions of the petal of lily cultivar ‘Vivian’ was analyzed through tissue structure, metabolites biosynthesis, and gene expression. We found that cell morphology of the petal in un-pigmented region was differed with in pigmented region. The cell morphology tends to flatten in un-pigmented region where the color is lighter. Moreover, high level anthocyanin was found in the pigmented regions by metabonomic analysis, especially cyanidin derivatives. However, flavanones were accumulated, contrast with anthocyanin in the un-pigmented regions of lily petal. To understand the relationship of these different metabolites and lily flower color, RNA-Seq was used to analyze the differentially expressed genes-related metabolite biosynthesis. Among these genes, the expression levels of several genes-related cyanidin derivatives biosynthesis were significantly different between the pigmented and un-pigmented regions, such as LvMYB5, LvMYB7, LvF3'H, LvDFR, LvANS and Lv3GT.Conclusions: This data will help us to further understand the regulation network of lily petal pigmentation and create different unique color species.
Assessing the Lognormal Distribution Assumption For the Crude Odds Ratio: Implications For Point and Interval Estimation
Authors: Newstein David Douglas
Published: May 2020

Background: The assumption that the sampling distribution of the crude Odds Ratio (ORcrude) is a lognormal distribution with parameters mu and sigma leads to the incorrect conclusion that the expectation of the log of ORcrude is equal to the parameter mu. Here, the standard method of point and interval estimation (I) is compared with a modified method utilizing ORstar where ln(ORstar) = ln(ORcrude )– sigma **2/2. Methods: Confidence intervals are obtained utilizing ln(ORstar) by both parametric bootstrap simulations with a percentile derived confidence interval (II), and a simple calculation done by replacing ln(ORcrude) with ln(ORstar) in the standard formula (III) as well as a method proposed by Barendregt (IV), who also noted the bias present in estimating ORtrue by ORcrude. Simulations are conducted for a “protective” exposure (ORtrue < 1) as well as for a “harmful” exposure (ORtrue >1). Results: In simulations the estimation methods (II and III) exhibited the highest level of statistical conclusion validity for their confidence intervals as indicated by one minus the coverage probability being close to alpha. Also, as demonstrated by the MC simulations, these two methods exhibited the least biased point estimates and the narrowest confidence intervals of the four estimation approaches. Conclusions: Monte Carlo simulations prove useful in validating the inferential procedures used in data analysis. In the case of the odds ratio, the standard method of point and interval estimation is based on the assumption that the crude odds ratio has a sampling distribution that is lognormal. Utilizing this assumption, as well as the formula for the expectation of this distribution function, an alternative estimation method was obtained for ORtrue (but different from a method from the earlier report (Barendregt)), that yielded point and interval estimates that MC simulations indicate are the most statistically valid.