bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Psychometric Testing of a Generic Student Engagement Scale for Contemporary Healthcare Education
Authors: Li Shuang , LAM Simon Ching , Siu Summer Cho Nga , Chung Jessie Yuk Seng , Lam Hemio Chung Yan , Tsang Eva Yuen Mei , Li Kam Cheong
Published: July 2020

Background: Student engagement receives heightened research attention in traditional and contemporary education. This study aimed to develop and validate a Generic Student Engagement Scale (GSES) for the use in contemporary healthcare education including online, distance learning or e-learning.Methods:A 2-phased methodological study employed a cross-sectional design with repeated measures. Phase 1 aimed to develop the items of GSES for the use in generic learning environment of nursing students through item development/revision, content validation, face validation, and statement standardization. Phase 2 aimed to test the psychometric properties of the newly developed GSES on its internal consistency, stability, and factorial validity. Data was collected in 2016-2018. Results:Based on 45 items of the Distance Students Engagement Scale (i.e., 3-factor model), 39 items were revised and adapted to fit the generic learning environment in nursing education. Seven experts and 20 nursing students examined each items and indicated a satisfactory content (CVI = 0.71–1.00 except item G9) and face validity (100% comprehensibility and interpretability). By analyzing 451 valid data from nursing students, confirmatory factor analysis did not support this 3-factor model GSES. Exploratory factor analysis was used to explore the new internal structure of GSES. The 26-item 4-factor solution that accounted for a total of 41.0% variance was found the most optimal. The factors were labelled “self-regulated learning”, “cognitive strategy use”, “teacher-student interaction”, and “experienced emotion”. The internal consistency and stability of this new model was re-examined with satisfactory results.Conclusions:The newly developed 26-item 4-factor GSES is reliable and valid scale measuring student engagement among nursing students.
Multi-omic Single-Shot Technology for Integrated Proteome and Lipidome Analysis
Authors: He Yuchen , Rashan Edrees , Linke Vanessa , Shishkova Evgenia , Hebert Alexander , Westphall Michael , Pagliarini Dave , Overmyer Katherine , Coon Joshua
Published: July 2020

Mass spectrometry (MS) serves as the centerpiece technology for proteome, lipidome, and metabolome analysis. Despite the versatility of MS systems, fractured methodology drives nearly all MS laboratories to specialize in analysis of a single ome at the exclusion of the others. We describe a technology to achieve broad and deep coverage of multiple molecular classes simultaneously through multi-omic single-shot technology (MOST) requiring only one column, one LC-MS instrument and a simplified workflow.
Metastasis of the Right Thigh From Cholangiocarcinoma: A Case Report
Authors: Qian Hongwei , Huang Zhikun , Ren Peitu , Sun Xuezheng
Published: July 2020

Background: Cholangiocarcinoma (CCA) is a type of malignant tumor that arises from the epithelium of the bile ducts. CCA can invade and metastasize to other tissues in a variety of ways，but distal skeletal muscle metastasis is extremely rare. Case presentation: We present a case of metastasis of the right thigh from cholangiocarcinoma.Conclusion: Perineural invasion may be a pathway of distant metastasis in CCA that has not been not widely recognized. We advocate the complete removal of tumor with dissection of the nerve plexus around major vessels.
Laboratory Test Ordering in Inpatient Hospitals: A Scoping Review on the Effects and Features of Clinical Decision Support Systems
Authors: Zare Sahar , Meidani Zahra , Shirdeli Mohammad , Nabovati Ehsan
Published: July 2020

Background: Studies have revealed inappropriate laboratory testing as a source of waste. This review was aimed to evaluate the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals.Method: Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. The outcomes were categorized based on test-related, physician-related, and patient-related. The primary outcome measures were the number and cost of laboratory test ordered.Result: Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. Also, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare.Conclusion: CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes.
Calculus of the fractional order operators in a discrete time domain
Authors: Hawron Konrad , Siwczyński Maciej , Siwczyńska Zuzanna
Published: July 2020

The article presents the elementary theory of differential and integral operators of the fractional order in a discrete time approach. A notion of a simple proper fraction operator has been introduced. It has been done for the time equivalent by applying the Taylor series. On this basis a new theory of a certain complexity operators has been formed which includes differential operators of the fractional order. Somewhat more general approach has been presented in the later part of the article by introducing a rational power of the convolution operator. Both approaches to the fractional operators are realized by non–recursive digital filters of infinite impulse responses. The stability of such filters is also being considered. The article also contains the application to the distributed parameters electrical circuits theorem.
Distinct physical condition and social behavior phenotypes of CD157 and CD38 knockout mice during aging
Authors: Gerasimenko Maria , Lopatina Olga , Shabalova Anna A. , Cherepanov Stanislav M. , Salmina Alla B. , Yokoyama Shigeru , Goto Hisanori , Okamoto Hiroshi , Yamamoto Yasuhiko , Ishihara Katsuhiko , Higashida Haruhiro
Published: July 2020

The ability of CD38 and CD157 to consume nicotinamide adenine dinucleotide (NAD) has received much attention because aging-induced elevation of CD38 expression plays a role in the senescence-related decline in NAD levels. Therefore, it is of interest to examine and compare the effects of age-associated changes on the general health and brain function impairment of Cd157 and Cd38 knockout (CD157 KO and CD38 KO) mice. Body weight and behaviors were measured in 8-week-old (young adult) or 12-month-old (middle-aged) male mice of both KO strains. The locomotor activity, anxiety-like behavior, and social behavior of mice were measured in open field, and three-chamber tests. Middle-aged CD157 KO male mice gained more body weight than young adult mice, while little or no body weight gain was observed in middle-aged CD38 KO mice. Middle-aged CD157 KO mice displayed increased anxiety-like behavior and decreased sociability and interaction compared with young adult KO mice. Middle-aged CD38 KO mice showed less anxiety and hyperactivity than CD157 KO mice, similar to young adult CD38 KO mice. The results reveal marked age-dependent changes in male CD157 KO mice but not in male CD38 KO mice. We discuss the distinct differences in aging effects from the perspective of inhibition of NAD metabolism in CD157 and CD38 KO mice, which may contribute to differential behavioral changes during aging.
Cost-effectiveness of GeneXpert Compared to Smear Microscopy for Diagnosis of Tuberculosis in Ethiopia
Authors: Kaso Abdene , Hailu Alemayehu
Published: July 2020

Background

Early diagnosis is one of the pillars of the TB (TB) control, and there are strong efforts to detect and treat cases in Ethiopia. Smear microscopy testing has been a routine test for the diagnosis of pulmonary TB in resource-constrained settings for a long time. Recently, many countries, including Ethiopia, are scaling up the use of GeneXpert without a precise evaluation of the cost and cost-effectiveness of this technology. Therefore, this study aimed to evaluate the cost-effectiveness of GeneXpert compared to smear microscopy tests for the diagnosis of TB patients in Ethiopia.
Methods

We develop a decision tree model using TreeAge Pro 2020 software. The model accounts for the prevalence and incidence of TB in the study area. The costs were estimated from the health providers' perspective in one year (in 2017/18). We applied an ingredients-based costing approach to identify, measure, and evaluate the smear microscopy cost and GeneXpert. We employed the 'proportion of cases detected' as an outcome measure of effectiveness. The incremental cost-effectiveness ratio (ICER) was calculated by dividing the changes in cost and change effectiveness. One way and probabilistic sensitivity analysis were done by varying different input parameters. All costs and ICER are reported in 2018 US$.
Results

The unit cost per test for GeneXpert and smear microscopy testing was US$12.9 and $3.1, respectively. The average cost of testing using GeneXpert was $113.0 and $3.3 for smear microscopy. The cost of the cartridge ($10.7) was the primary (83%) parameter influencing the overall cost of GeneXpert, while it was the cost of reagent and consumables $1.28 (41%) for the smear microscopy. The ICER for GeneXpert strategy was $729.8 per new TB cases detected compared to smear microscopy. The sensitivity analysis indicates that TB prevalence was the most influential parameter on the ICER.
Conclusion

The present study indicates that testing all individuals with suspected TB using GeneXpert is a very cost-effective strategy compared to smear microscopy, and therefore, it can be part of the routine diagnostic testing strategy in Ethiopia.
iTRAQ-Based Quantitative Proteomic Analysis of Heat Stress-Induced Mechanisms in Pepper Seedlings
Authors: Wang Jing , Liang Chengliang , Yang Sha , Song Jingshuang , Li Xuefeng , Dai Xiongze , Wang Fei , Juntawong Niran , Tan Fangjun , Zhang Xilu , Jiao Chunhai , Chen Wenchao , Zou Xuexiao
Published: July 2020

Background: As one of the most important vegetable crops, pepper has rich nutritional value and high economic value. Increasing heat stress due to the global warming has a negative impact on the growth and yield of pepper. Result: In the present study, we investigated the changes of phenotype, physiology, and proteome in heat-tolerant (17CL30) and heat-sensitive (05S180) pepper seedlings in response to heat stress. Phenotypic and physiological changes showed that 17CL30 had a stronger ability to resist heat stress compared with 05S180. In proteomic analysis, a total of 3,874 proteins were identified, and 1,591 proteins were considered to participate in the process of heat stress response. According to bioinformatic analysis of heat-responsive proteins, the heat tolerance of 17CL30 might be related to a higher photosynthesis, signal transduction, carbohydrate metabolism, and stress defense, compared with 05S180. Conclusion: To understand the heat stress response mechanism of pepper, an iTRAQ-based quantitative proteomic analysis was employed to identify possible heat-responsive proteins and metabolic pathways in 17CL30 and 05S180 pepper seedlings under heat stress. This study provided new insights into the molecular mechanisms involved in heat tolerance of pepper and might offer supportive reference for the breeding of new pepper variety with heat resistance.
Association of evaluated glomerular filtration rate and incident diabetes mellitus: a secondary retrospective analysis based on a Chinese Cohort Study
Authors: Hu Haofei , Guan Mijie , Chen Zhuangsen , Wu Yang , Wan Qijun
Published: July 2020

Background: Previous studies have revealed that chronic kidney disease (CKD) is one of major risk factors of insulin resistance and diabetes. However, there are few investigations of the correlations between the estimated glomerular filtration rate (eGFR) and incident diabetes, especially in Chinese population. This study was taken to explore the relationship between eGFR and incident diabetes in a large cohort in Chinese community population. Methods: The present study was a retrospective cohort study. A total of 199,435 adults from Rich Healthcare Group in China, which includes all medical records for participants who received a health check from 2010 to 2016. The target independent variable and the dependent variable were eGFR measured at baseline and incident diabetes mellitus appeared during follow-up respectively. Covariates involved in this study included age, gender, body mass index, diastolic blood pressure, systolic blood pressure, fasting plasma glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride, alanine aminotransferase, aspartate aminotransferase, smoking and drinking status and family history of diabetes. Cox proportional-hazards regression was used to investigate the association between eGFR and incident diabetes. Generalized additive model was used to identify non-linear relationships. Additionally, we also performed a subgroup analysis. It was stated that the data had been uploaded to the DATADRYAD website. Result: After adjusting gender, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride, alanine aminotransferase, aspartate aminotransferase, smoking and drinking status and family history of diabetes, result showed eGFR was negatively associated with incident diabetes (HR=0.987, 95%CI (0.984, 0.989)). A J shape relationship was detected between eGFR and incident diabetes, which had an inflection point of eGFR was 97.967 mL/min-1·(1.73 m2)-1. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 0.999 (0.994,1.004) and 0.977 (0.974,0.981), respectively. Subgroup analysis showed, the stronger association can be found in the population with FPG<6.1mmol/L, BMI<24kg/m2, SBP<140mmHg, DBP<90mmHg, HDL in middle level and family history without diabetes. The same trend was also seen in men and in the population with never or ever smoking. Conclusion: eGFR is independently associated with incident diabetes. The relationship between eGFR and incident diabetes is also non-linear. eGFR was strong negatively related to incident diabetes when eGFR is above 97.967 mL/min-1·(1.73 m2)-1.
Risk Factors of Early Stage Residual Back Pain After Percutaneous Kyphoplasty or Vertebroplasty: A Retrospective Study of 853 Patients
Authors: Zhang Bo-bo , Yang Yi-min , Ren Zhi-wei , Yang Wei-zhou , Xiu Jin-tao , Zhang Yin-gang
Published: July 2020

Background: A small but significant proportion of patients experienced residual back pain after PVP or PKP treatment. The aim of the present study was to explore risk factors that may affect residual back pain after PKP or PVP. This study identified the risk factors of residual back pain after PKP or PVP, allowing proper intervention and improved clinical outcome.Methods: From January 2010 to January 2017, a total of 853 patients were treated by PVP or PKP at The First Affiliated Hospital of Xi’an Jiaotong University. We recorded the Visual Analog Scale (VAS) scores. Patients with a VAS score > 3 post-operatively and at the 1 month follow-up evaluation were grouped into the “residual back pain” group. The others were grouped into the control group. The following possible risk factors were collected: age; gender; weight; bone mineral density (BMD); surgical approach; surgical type; cement distribution; anesthesia; hypertension; diabetes; smoking; alcohol consumption; vertebral fracture type, and vertebral fracture location. Risk factors associated with residual back pain were evaluated using logistic regression analysis.Results: The incidence of residual back pain after PVP/PKP is 9.61%. Results showed that cement distribution, smoking, vertebral fracture type and vertebral fracture location were independently associated with residual back pain after PVP or PKP in the early post-operative stage. Conclusion: Unsatisfactory cement distribution, smoking history, osteogenic vertebral tumors, osteolytic vertebral tumors, and thoracic fractures were independently associated with residual back pain after PVP or PKP at the early post-operative stage.
The Relationship between Health Anxiety and Prenatal Distress with Choosing the Type of Childbirth in Pregnant Women during Covid-19 Outbreaks in Iran
Authors: Nasab Maryam Beheshti , Bahmaei Hadis , Askari Saeedeh , Ghanbari Saeed , Iravani Mina -
Published: July 2020

Background This study investigates the relationship between health anxiety and prenatal distress with choosing the type of childbirth in pregnant women during Covid-19 outbreaks in Iran.Methods This is a descriptive-analytical study on 200 nulliparous pregnant women who referred to health centers of Iran to perform routine pregnancy care. Convenient sampling was used, and each nulli pari pregnant woman who tended to enter the study was enrolled. The questionnaires used in this work were demographic and midwifery information questionnaire, health anxiety index-short form (HAI 18), and Prenatal Distress Questionnaire (PDQ). After filing out the above questionnaires, two questions regarding the type of delivery selected by them before and during epidemic of covid-19 and the reason of the selection were asked from the participants and were recorded. The information was analyzed in the final stage using SPSS software version 22.Results In general, 200 nulliparous pregnant women participated in this study. A significant statistical association was observed between choosing the type of delivery before and during the covid-19 pandemic (P=0.016). Women health anxiety showed significant statistical difference among various groups (P=0.0001). The highest score was 35.06±07.34 which was observed in the group that choose vaginal delivery at first but they selected cesarean section during the covid-19 pandemic. Mean score of prenatal distress score showed significant statistical difference among various groups (P=0.0001). The highest score was 20.06±4.72 which was observed in the group that choose cesarean before and during the covid-19 pandemic. Conclusion The current study showed the higher health anxiety and Prenatal distress in pregnant women, the significantly higher probable of selecting cesarean as delivery method. Therefore, due to the increase in pregnant women Health anxiety and Prenatal distress during the Covid-19 epidemic and its effect on the choice of delivery, planning to promote the mental health of pregnant women is very important.
Fast Fluorine-18 Labeling and Preclinical Evaluation of Novel Mucin1 and its Folate Hybrid Peptide conjugate for Targeting Breast Carcinoma.
Authors: aljammaz ibrahim , Al-Otaibi B. , Al-Malki Y. , Abousekhrah A. , Okarvi S. M.
Published: July 2020

Background: There is a need to develop new and more potent radiofluorinated peptide and their hybrid conjugates for multiple-receptors targeting properties that overexpress on many cancers.Methods: We have synthesized MUC1-[18F]SFB and MUC1-FA-[18F]SFB hybrid conjugates using a convenient and one-step nucleophilic displacement reactions. In vitro cell binding and in vivo evaluation in animals were performed to determine the potential of these radiolabeled compounds.Results: Radiochemical yields for MUC1-[18F]SFB and MUC1-FA-[18F]SFB conjugates were greater than 70% in less than 30 min synthesis time. Radiochemical purities were greater than 97% without HPLC purification, which makes these approaches amenable for automation. In vitro studies on MCF7 breast cancer cells showed that the significant amounts of the radiofluorinated conjugates were associated with cell fractions and held good affinity and specificity for MCF7 cells. In vivo characterization in Balb/c mice revealed rapid blood clearance with excretion predominantly by urinary as well as hepatobiliary systems for MUC1-[18F]SFB and MUC1-FA-[18F]SFB, respectively.Biodistribution in SCID mice bearing MCF7 xenografts, demonstrated excellent tumor uptake (12% ID/g) and favorable kinetics for MUC1-FA-[18F]SFB over MUC1-[18F]SFB. The tumor uptake was blocked by the excess co-injection of cold peptides suggesting the receptor-mediated process.Conclusion: Initial PET/CT imaging of SCID mice with MCF7 xenografts, confirmed these observations. These results demonstrate that MUC1-FA-[18F]SFB may be a useful PET imaging probe for breast cancer detection and monitoring tumor response to the treatment.
Rhythmic Control of The Plant-Microbiome Holobiont
Authors: Lu Tao , Zhang Zhenyan , Li Yan , Zhang Qi , Sun Liwei , Peijnenburg W.J.G.M. , Peñuelas Josep , Zhu Lizhong , Zhu Yong-Guan , Chen Jianmeng , Qian Haifeng
Published: July 2020

Background: Many physiological and metabolic processes in plants are modulated by a circadian clock. Rhizospheric microorganisms fed by root exudates provide beneficial functions to their plant host. The intricate connection between the circadian clock and the rhizospheric microbial community remains poorly understood. Results: We investigated the role of the Arabidopsis circadian clock in shaping the rhizospheric microbial community using wild-type plants and clock mutants (cca1-1 and toc1-101). We performed transcriptomic and metabolomic analyses and sequenced amplicons of the 16S ribosomal RNA gene to characterize gene transcription, root exudation and the bacterial communities, respectively, throughout the day (24 h). Deficiencies of the central circadian clock led to abnormal diurnal rhythms for thousands of expressed genes and dozens of root exudates. Bacterial community failed to follow obvious patterns in the 24-h period, and lack of coordination with plant growth in the clock mutants. Conclusions: Our findings suggested that the biological clock was an important force that drove plants to adjust their rhizospheric microbiomes for adapting to different growth stages.
An ADePT Evaluation for Incorporating the TIPPS Periodontal Health Intervention Into Primary Care Ante-Natal Programmes to Enhance Infant Birthweight in Palestine: A Feasibility Study
Authors: Abuhaloob Lamis , Helles Nahla , Mossey Peter , Freeman Ruth
Published: July 2020

Background: A feasibility study was conducted to implement the TIPPS intervention for pregnant women to enhance infant birthweight in a conflict area in a LMIC. The decision tool, ADePT examines the methodological factors, identified in a feasibility study, that may require modification for a full trial. Objectives: To use the ADePT decision tool to evaluate if the feasibility study had achieved its objectives and to identify the need for intervention, clinical context and trial design modification.Basic research design: Feasibility study: a one-arm, pre-test-post-test design. The ADePT framework was applied to evaluate the findings from the feasibility study.Clinical setting: Primary healthcare clinic located in Gaza City, Palestine. Participants: 25 pregnant women in their first trimester and clinic staff.Interventions: The TIPPS periodontal health intervention delivered by ante-natal nurses.Main outcome measures: ADePT checklist: sample size estimation, recruitment, consent, intervention adherence, intervention acceptability, costs and duration, completion and appropriateness of outcome assessments, retention, logistics and synergy between protocol components.Results: 25 pregnant women attended the baseline and 22 completed the second follow-up appointment. Data acquisition of the primary and secondary outcomes was mainly successful, the adherence and acceptability of the intervention was noted. The participants stated the value of the intervention. The clinic staff voiced concerns regarding time and costs of nurses providing the TIPPS intervention. This allowed suggestions to be made regarding modification of trial design and context of implementation. Conclusions: The ADePT evaluation showed it was possible to progress to full trial with modifications in trial design.
Personalized Hypertension Management Based on Serial Assessment and Telemedicine: a Cluster Randomize Controlled Trial Protocol in Anhui, China
Authors: Xiao Siyi , Shen Xingrong , Liu Rong , Tong Guixian , Liu Tongzhu , Wang Debin
Published: July 2020

Background: Despite tremendous investment worldwide, hypertension treatment and control rates remain low, suggesting that contemporary population-based hypertension management may have reached its efficacy ceiling. The complexity and long-term dynamics of influencing factors make personalized management inevitable and challenging. This protocol describes Personalized Hypertension Management in Anhui, China (PHMA), a project that uses a package of innovative approaches in tailoring interventions to individual patient’s dynamic complications and contexts.Methods/design: PHMA strives to reduce hypertension harms by eight proven “objective behaviors” (e.g., self-monitoring and reporting, healthy diet, physical exercise/activities). These objective behaviors are promoted through five intervention measures: support for self- monitoring, supervised machine communications, daily education or reminder messages, weekly blood pressure notification, and quarterly signed feedback. PHMA uses ten categories and over 300 variables in selecting and refining intervention procedures and content for individual patients. Efficacy of the intervention package is evaluated using a cluster randomized controlled trial design involving a total of 60 site communities and 3352 hypertension patients. Primary measure for the evaluation is systolic and diastolic blood pressure; while secondary evaluation measures include quality of life (EQ5D-5L), occurrence of hypertension-related complications (such as cerebral hemorrhage, coronary heart disease, myocardial or cerebral infarction), healthcare utilization and scores of objective behaviors.Discussion: PHMA uses novel, low cost and sustainable approaches to tailor interventions to the dynamic conditions and contexts of individual patients. Unlike contemporary approaches to hypertension management which are mainly population based, each participant patient in PHMA applies a unique intervention package and all messages, feedbacks and other materials sent out to individual patients are different from each other. PHMA is the first project that adopts so comprehensive tailoring and if proved effective, it should have important implications for future research, practice and policy-making.Trial registration: Registered July 17, 2020. ISRCTN10999269.
How do patient feedback systems work in low- and middle-income countries? Insights from a realist evaluation in Bangladesh.
Authors: Mirzoev Tolib , Kane Sumit , Azdi Zunayed Al , Ebenso Bassey , Chowdhury Ayesha Afroz , Huque Rumana
Published: July 2020

The authors have withdrawn this preprint due to author disagreement.
Role of community pharmacies in a population-based colorectal cancer screening program: opportunities for quality improvement
Authors: Vives Nuria , Milà Nuria , Binefa Gemma , Travier Noemie , Farre Albert , Vidal Carmen , Sattari Maryam , Bagaria Guillermo , Garcia Montse
Published: July 2020

Background

In Catalonia (Spain), most CRC screening hubs use the pharmacy-based model to distribute and collect the fecal immunochemical test (FIT) kits. The comprehensive evaluation of CRC screening programs, which include the role and implications of pharmacy involvement, is essential to ensure program quality and identify areas for further improvement. The present study aimed to analyze pharmacy collaboration with the screening program and pharmacy-based FIT kit distribution.
Methods

A descriptive study to describe the role of community pharmacies as well as the FIT distribution and collection data during 2018 was conducted. Time to FIT completion was assessed by Kaplan-Meier estimation, and with the log-rank test. A Cox regression model was used to adjust for other variables associated with the completion of FIT such as sex, age, deprivation score and previous screening behavior.
Results

Overall, 82.4% of pharmacies collaborated with CRC screening program. Out of 82,902 FIT kits distributed to screening invitees 77,524 completed FIT kits were returned to pharmacies (93.5%) with a participation of 39.8% among the 193,766 invitees. From those who completed a FIT, the median time to return the kit was 3 days. FIT completion time was significantly lower among women, older age, high deprivation score and previous CRC screening (p < 0.005).
Conclusions

In our cancer screening setting the engagement of community pharmacies is high. Our findings suggest that community pharmacists as part of an integrated screening program team and by providing key screening process data can enable a better understanding of CRC screening behavior.
Evaluation of the nephrotoxicity and safety of low-dose aristolochic acid, extending to the use of Xixin (Asurum), by determination of methylglyoxal and D-lactate
Authors: Lin Chia-En , Lin Po-Yeh , Yang Wen-Chi , Huang Yu-Shen , Lin Tzu-Yao , Chen Chien‐Ming , Chen Hung-Shing , Lee Jen-Ai , Chen Shih-Ming
Published: July 2020

Background: Most Aristolochiaceae plants are prohibited due to aristolochic acid nephropathy (AAN), except Xixin ( Asarum spp. ). Xixin contains trace amounts of aristolochic acid (AA) and is widely used in Traditional Chinese Medicine. Methylglyoxal and D-lactate are regarded as biomarkers for nephrotoxicity. Thus, this study aimed to evaluate tubulointerstitial injury and interstitial renal fibrosis by determining urinary methylglyoxal and D-lactate after withdrawal of low-dose AA in a chronic mouse model. Methods: C3H/He mice in the AA group ( n =24/group) were given ad libitum access to distilled water containing 3 µg/mL AA (0.5 mg/kg/day) for 56 days and drinking water from days 57 to 84. The severity of tubulointerstitial injury and fibrosis were evaluated using the tubulointerstitial histological score (TIHS) and Masson’s trichrome staining. Urinary and serum methylglyoxal were determined by high-performance liquid chromatography (HPLC); urinary D-lactate were determined by column-switching HPLC. Results: After AA withdrawal, serum methylglyoxal in the AA group increased from day 56 (429.4±48.3 μg/L) to 84 (600.2±99.9 μg/L), and peaked on day 70 (878.3±171.8 μg/L; p <0.05); TIHS and fibrosis exhibited similar patterns. Urinary methylglyoxal was high on day 56 (3.522±1.061 μg), declined by day 70 (1.583±0.437 μg) and increased by day 84 (2.390±0.130 μg). Moreover, urinary D-lactate was elevated on day 56 (82.10±18.80 μg) and higher from day 70 (201.10±90.82 μg) to 84 (193.28±61.32 μg). Conclusions: Methylglyoxal is induced after AA-induced tubulointerstitial injury, thus methylglyoxal excretion and metabolism may be a detoxification and repair strategy. A low cumulative AA dose is the key factor that limits tubulointerstitial injury and repair. Thus, AA-containing herbs, especially Xixin, should be used at low doses for short durations (less than one month).
Neural Processing of Speech Sounds in ASD and First-Degree Relatives
Authors: Patel Shivani P. , Winston Molly , Guilfoyle Janna , Nicol Trent , Martin Gary E. , Kraus Nina , Losh Molly
Published: July 2020

Background: Efficient neural encoding of sound plays a critical and widespread role in speech and language, and when impaired, may have reverberating effects on a range of communication skills. Autism spectrum disorder (ASD) is a condition involving impaired communication abilities, including atypical prosody (e.g., intonation modulation, rate, rhythm), in which atypical neural processing of speech has been implicated. Parallel patterns of communication differences have been noted in parents of individuals with ASD, who may exhibit subclinical language-related differences believed to reflect genetic liability to ASD. The present study investigated disruptions to neural processing of temporal and spectral (i.e., frequency/pitch) properties of speech sounds as a potential neurobiological mechanism underlying specific language-related impairments in ASD and related subclinical differences documented among first-degree relatives of individuals with ASD. Methods: Participants included individuals with ASD, their parents, and respective control groups. Group differences in temporal and spectral processing based on the neural FFR were assessed using MANCOVAs controlling for chronological age. Relationships between the FFR, pragmatic language ability, and receptive and expressive prosody skills were assessed using Pearson correlations. Familiality of the FFR in mother-child dyads were also examined using Pearson correlations.Results: Findings revealed inefficiencies in neural encoding of speech sounds in both individuals with ASD and their parents (specifically, increased neural noise and delayed neural processing of speech sounds), as well as a less robust neural representation of spectral properties of speech sounds in individuals with ASD. Associations between neural processing of speech sounds and language-related abilities were detected in both groups, along with evidence of familiality of neural pitch processing in the ASD family groups. Limitations: Additional investigation is necessary to determine whether relationships between FFR and pragmatic language and prosody extend to individuals with more severe language and/or cognitive impairments. Conclusions: Overall, results suggest atypical neural processing of speech sounds may constitute an important, heritable ingredient contributing to the ASD language phenotype and subclinical phenotypic expression of genetic liability in parents.
First Report of Thelazia Callipaeda Infection in Amiota Okadai and Wildlife in Wildlife Home Range, China
Authors: Jin Yipeng , Liu Zichen , Wei Jiaqi , Wen Yifan , He Nianjun , Tang Liubin , Lin Degui , Lin Jiahao
Published: July 2020

Background: Thelazia callipaeda is a nematode of the sucking nematode genus of the sucking family, with Amiota okadai as the intermediate host and vector in China. China has the largest number of cases of thelaziosis in humans in the world. It is generally believed that domestic animals (dogs and cats) are the most important reservoir host of Thelazia callipaeda and directly threaten humans. At present, there is not much research and attention on the role of wildlife in the transmission cycle of thelaziosis in wildlife home range.Methods: During 2016-2019, we selected four wildlife national nature reserve across the country as monitoring points for Amiota okadai and wildlife. And we chose to use fly-trap method for monitoring Amiota okadai density. Morphological analysis of the parasites collected from the conjunctival sac of the wildlife was taken as the first step, and a specific PCR was used for exact confirmation.Results: In 2019, the density of Amiota okadai in Foping National Nature Reserve, in China, increased sharply and infected Amiota okadai were newly found in wildlife home range. And it was newly found that wild giant pandas, wild boars, leopard cats, black bears were infected with Thelazia callipaeda. A total of 4 nematodes were collected. The morphologic characteristics of the nematode led to its identification as Thelazia callipaeda, which was molecularly confirmed by a specific PCR amplification.Conclusions: This is the first time in China that Amiota okadai has been reported to be infected with Thelazia callipaeda in wildlife home range, while a variety of wildlife, including wild giant pandas, have been infected. This suggests that there has been a transmission cycle of thelaziosis among wildlife in wildlife home range. This has undoubtedly increased the risk of infection of Thelazia callipaeda in villagers around wildlife home range.
Extraction And Quality Evaluation of Exosomes From Joint Effusion
Authors: Ruan Anmin , Chen Pu , Zhou Jun , Zhang Xiaozhe , Ma Yufeng , Wang Qingfu
Published: July 2020

Objective: The aim of this study was to compare the quality and efficiency of exosomes extracted from knee joint effusion by different methods, laying a foundation for further research on exosomes from knee joint effusion. Methods: Separate and extract joint exosomes by 8% polyethylene glycol (PEG) precipitation method, ultracentrifugation method (UC) and ultrafiltration with exclusion chromatography (SECF). Transmission electron microscopy (TEM) and nanoparticle tracing technology (NTA) were used to detect particle morphology and particle size, and Western Blot (WB) was used to detect granule protein surface marker proteins (CD9, CD63, Flotillin-1 and calnexin).Results: All three methods successfully separated vesicle-like round particles from joint effusion. TEM results show that the particles obtained by the three extraction methods are round or oval vesicles, the plasma membrane is intact, the size is different, and the diameter is distributed between 30 and 150 nm. Compared with SECF group, PEG group had more background particle impurities. and the broken vesicle fragments can be seen in the UC group; NTA results show that the main peaks of the three groups of particles are between 100-120nm, and the particle concentration is greater than 1×1010/ml; WB results show that the expressions of CD9, CD63 and Flotillin-1 protein in the suspension extracted by the three methods were all higher, the expression of calnexin protein was higher in the PEG group than the UC group and SECF group.Conclusion: The three extraction methods can successfully extract the exosomes of joint effusion. The quality of exosomes obtained by the SECF method is relatively high, while the PEG precipitation method contains a small amount of impurity particles. UC method does not guarantee the integrity of exosomes. In summary, when further studying the role of exosomes in the pathogenesis of knee osteoarthritis, we recommend the SECF method to extract and isolate joint exudates.
In-laboratory breast specimen radiography reduces tissue block utilization and improves turnaround time of pathologic examination
Authors: Arudra Sri Krishna Chaitanya , Garvey Laura C. , Hagemann Ian
Published: July 2020

Background
This study was performed to determine whether in-laboratory specimen radiography reduces turnaround time or block utilization in surgical pathology.
Methods
Specimens processed during a 48-day trial of an in-lab cabinet radiography device (Faxitron) were compared to a control group of specimens imaged in the mammography suite during a prior one-year period, and to a second group of specimens not undergoing imaging of any type.
Results
Cases imaged in the mammography suite had longer turnaround time than cases not requiring imaging (by 1.15 days for core biopsies, and 1.73 days for mastectomies; p < 0.0001). In contrast, cases imaged in-lab had turnaround time that was no longer than unimaged cases (p > 0.05 for core biopsies, lumpectomies and mastectomies). Mastectomies imaged in-lab required submission of fewer blocks than controls not undergoing any imaging (mean reduction of 10.6 blocks).
Conclusions
Availability of in-lab radiography resulted in clinically meaningful improvements in turnaround time and economically meaningful reductions in block utilization.
Analysis and prediction of the effects of temperature extremes on the environment heating in the Central Part of Iran, Iran, Southwest Asia
Authors: Safarianzengir Vahid , Sobhani behrouz , Kianian Mohammadkia
Published: July 2020

The authors have requested that this preprint be removed from Research Square.
Analysis of Synchronization of Respiration-induced Motions in the Duodenum and Stomach for the Primary Tumor in Pancreatic Cancer Using Four-Dimensional Computed Tomography
Authors: Umezawa Rei , Wakita Akihisa , Katsuta Yoshiyuki , Ito Yoshinori , Nakamura Satoshi , Okamoto Hiroyuki , Kadoya Noriyuki , Takahashi Kana , Inaba Koji , Murakami Naoya , Igaki Hiroshi , Jingu Keiichi , Itami Jun
Published: July 2020

Background: We investigated the synchronization of respiration-induced motions at the primary tumor and organs at risk at radiation planning for pancreatic cancer.Methods: Four-dimensional (4D) computed tomography images were acquired under the condition of shallow free breathing in patients with pancreatic cancer. The gross tumor volume (GTV), duodenum (DU) and stomach (ST) were contoured. With reference to the 50% phase (exhale phase), excursions of respiration-induced motions of the GTV, DU and ST were measured. Based on the shift of the GTV, we investigated the synchronization of respiration-induced motions between each contouring target. We examined the differences in the overlap volumes between PTV and the planning organ at risk volume (PRV) in ST and DU and the differences in mean doses to the ST and DU in each respiratory phase.Results: Nine patients with pancreatic cancer were analyzed in this study. The mean maximum three-dimensional excursions at the GTV, DU and ST were 9.6, 9.8 and 11.4 mm, respectively. At phase 0% and 90% (inhale phases), mean distance changes in the positional relationship with the GTV were 0.3 and 0.7 mm, respectively, for the DU, and -2.5 and -2.4 mm, respectively for the ST, respectively. There was no significant difference in distance changes between each respiratory phase in the DU (p = 0.568), while there was a significant difference in distance changes in the ST (p < 0.001). There was a slight increase in the overlap volume between PTV and PRV in the expiratory phase in ST, but there were no significant differences between the respiratory phases either in ST or DU (p = 0.101 and 0.559). There was a significant difference in the change rates of mean doses in the respiratory phases in ST (p = 0.023), but there was no significant difference in DU (p = 0.933). Conclusions: Our results indicate that the DU but not the ST might move synchronously with GTV due to respiration.
Diagnostic value of miR-106a-5p in patients with psoriasis and its regulatory role in inflammatory responses
Authors: Miao Xiaolin , Tong Xinyun , Hu Jingsang , Wang Juan
Published: July 2020

Background: Psoriasis is a multifactorial, recurring, and chronic inflammatory skin disease. This study was designed to explore the potential role of microRNA-106a-5p (miR-106a-5p) in psoriasis.Methods: The expression levels of miR-106a-5p in the serum of psoriasis patients and healthy individuals were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The diagnostic value of miR-106a-5p in serum was evaluated by the receiver operating characteristics curve (ROC). The levels of interleukin-22 (IL-22), interleukin-17A (IL-17A), and tumor necrosis factor-alpha (TNF-alpha) were determined by enzyme-linked immunosorbent assay.Results: The serum expression of miR-106a-5p was found to be up-regulated in psoriasis patients. ROC curve showed that miR-106a-5p had high specificity and sensitivity in the diagnosis of psoriasis. The correlation between the serum expression level of miR-106a-5p and PASI was positive. The relative expression levels of IL-17A, IL-22 and TNF-alpha in serum of psoriasis patients were significantly upregulated compared with that in healthy control, and showed positive association with serum miR-106a-5p levels. Cell experiments demonstrated that upregulation of miR-106a-5p could promote cell proliferation, and the levels of IL-22, IL-17A and TNF-alpha were upregulated significantly in M5-induced HaCaT cells.Conclusion: Considering the novel and vital role in psoriasis progression, miR-106a-5p is expected to be a new potent target for treatment of psoriasis. MiR-106-5p was expected to use for more immunity diseases research and therapy.
A diagnostic pitfall in hepatic mesenchymal hamartoma mimicking hepatoblastoma: A case report
Authors: Chen Zhihong , Fang Lutong , Zhang Ying , Ye Yuanzi , Ji Wenshu , Meng Gang
Published: July 2020

Background: Hepatic mesenchymal hamartoma (HMH) is an uncommon benign tumor in children. While mesenchymal hamartomas may be angiomatous and blood vessels may be identified, HMH with a malignant tumor symptom on the contrast-enhanced hepatic computed tomography angiography (CTA) has not been described. Here, we present the first case of HMH mimicking hepatoblastoma on the hepatic CTA from pathological point of view and review the imaging and histological features of this unique lesion. Case presentation: A 2-year-old female child was found a distention in the right abdomen and was admitted to our hospital. The Hepatic CTA showed that the blood vessels were thickened, the tumor blood vessels were clustered in the tumor. According to the hepatic CT findings, the tumor was considered to be malignant, possibly a hepatoblastoma. Microscopic examination showed a tumor arranged in lobules, composed of loose myxoid mesenchyme surrounding ductal structures, with intervening vascular channels. The Immunohistochemical staining revealed positive CK7 and CD34 for the bile duct elements and the lining endothelial cells of the vascular channels. There were abundant blood vessels around the nodules and the margins of remaining hepatocytes, but few in the central region. The blood vessels are small, thin-walled vessels and presented like capillaries and venules. Conclusions: A histological diagnosis of Hepatic Mesenchymal Hamartoma was confirmed by the microscopic examinations. This case adds learning points to radiologists when heterogeneous reinforcement on enhanced CT scan was presented in such a large childhood liver tumor.
Community-Based Peer Support Intervention to Mitigate Social Isolation and Stigma of Adolescent Motherhood in Harare, Zimbabwe
Authors: Tinago Chiwoneso B. , Frongillo Edward A. , Warren Andrea , Chitiyo Vivian , Cifarelli Ashley K. , Fyalkowski Shannon , Pauline Victoria
Published: July 2020

Background Adolescent mothers in Zimbabwe often experience isolation and lack coping skills and resources to successfully navigate motherhood. To develop a community-based peer support intervention, we need to understand the unique needs of adolescent mothers and how peer support groups could address those needs. Methods Focus group discussions were conducted with 85 adolescent mothers aged 14-18 years, 24 community health workers, and 25 key community stakeholders in a low-income high-density community in Harare. Data were analyzed thematically using NVivo 12 software. Results Participants described adolescent motherhood challenges and gaps in services and programming. Participants preferred bi-weekly one-hour group sessions addressing topics including income generation, mental health, and gossip, facilitated by community health workers at health and community centers. Use of WhatsApp Messenger to support intervention efforts was welcomed as an affordable and user-friendly platform to share information. Conclusions Adolescent mothers need strong adult community support and health knowledge to address important social issues that impact their health and well-being. Facilitated peer support groups can strengthen social networks and mitigate the adverse effects of social isolation and stigma among adolescent mothers. The community supported participatory engagement that empowers, meets needs, and improves the health of adolescent mothers.