bluuebunny/crossref_metadata_2025 huggingface dataset:
Preferensi Masyarakat Terhadap Rumah Sakit Syariah (Studi Kasus Terhadap Masyarakat Surabaya)
Authors: Latifah Luluk
Published: June 2020

Pada saat label syariah semakin menjamur, baik pada dunia perbankan maupun non perbankan, banyak produk-produk barang atau jasa halal yang ditawarkan oleh pelaku usaha, dan masyarakat sangat antusias untuk mengikutinya. Dari produk halal yang ditawarkan oleh para pelaku usaha yang baru-baru ini diluncurkan adalah di bidang pelayanan kesehatan yang secara legal juga sudah difatwakan oleh DSN MUI (Dewan Syariah Nasional Majelis Ulama Indonesia) No.107/DSN-MUI/X/2016 tentang Pedoman Penyelenggara Rumah Sakit Syariah, yang dimotori oleh MUKISI (Majelis Upaya Kesehatan Islam Seluruh Indonesia). Selama ini pembicaraan mengenai Rumah Sakit Syariah masih pada tatanan manajemen saja, pada penelitian ini ingin mengetahuinya dari aspek masyarakatnya, terutama pada faktor preferensinya.             Penelitian ini dilaksanakan di Kota Surabaya dengan menggunakan tehnik pengambilan sampel secara simple random sampling dan besar sampel dengan aplikasi simple size 2.0 berjumlah 217 sampel pada masyarakat Kota Surabaya. Untuk pengolahan datanya menggunakan chi-square test. Hasilnya, pada variabel usia dan jenis kelamin tidak signifikan mempengaruhi tingkat preferensi masyarakat  terhadap keberadaan rumah sakit syariah. Sikap, pendidikan dan pengetahuan mempunyai hubungan yang signifikan terhadap tingkat preferensi masyarakat terhadap  keberadaan rumah sakit syariah. Untuk variabel sikap: hasilnya masyarakat sangat mendukung sekali dengan keberadaan rumah sakit syariah. Variabel pendidikan, hasilnya semakin tinggi pendidikan masyarakat semakin tinggi pula tingkat preferensinya tentang keberadaan rumah sakit syariah. Variabel Pengetahuan, hasilnya semakin baik tingkat pengetahuan masyarakat maka semakin tinggi tingkat preferensinya terhadap keberadaan rumah sakit syariah.
The Correlation Analysis between the Oxford Classification of Chinese IgA Nephropathy Children and Renal Outcome -A retrospective cohort study
Authors: Wu Heyan , Xia Zhengkun , Gao Chunlin , Zhang Pei , Yang Xiao , Wang Ren , Wang Meiqiu , Peng Yingchao
Published: June 2020

Background: The 2016 Oxford Classification's MEST-C scoring system predicts outcomes in adults with IgA nephropathy (IgAN), but it lacks large cohort validation in children with IgAN in China. We sought to verify whether the Oxford classification could be used to predict the renal outcome of children with IgAN. Methods : A total of 1243 Chinese children with IgAN who underwent renal biopsy in Jinling Hospital were enrolled from January 1, 2000, to December 31, 2017, in this retrospective cohort study. The primary endpoint of the study was a composite of either ≥50% reduction in estimated glomerular filtration rate (eGFR) or end-stage renal disease (ESRD). We probed into the relationship between the Oxford classification and renal outcome. Results : There were 29% of children with mesangial proliferation(M1), 35% with endocapillary proliferation (E1), 37% with segmental sclerosis/adhesion lesion (S1), 23% with moderate tubular atrophy/interstitial fibrosis (T1 25–50% of cortical area involved), 4.3% with severe tubular atrophy/interstitial fibrosis (T2 >50% of cortical area involved), 44% with crescent in< 25% of glomeruli(C1), and 4.6% with crescent in>25% of glomeruli (C2).During a median follow-up duration of 7.2 (4.6–11.7) years, 171 children (14%) developed ESRD or 50% decline in eGFR. In the multivariate COX regression model, only segmental sclerosis/adhesion (HR2.7,95%CI 1.8～4.2, P ＜0.001) and tubular atrophy/interstitial fibrosis (HR6.6,95%CI 3.9～11.3, P ＜0.001) were confirmed to be independent risk factors of poor renal outcome in the whole cohort, whereas crescent showed significant association with prognosis only in children received no immunosuppressive treatment.Conclusions: This study revealed that segmental sclerosis/adhesion and tubular atrophy/interstitial fibrosis were independently associated with poor renal outcome in Chinese children with IgA nephropathy.
Endoscopic intraventricular hematoma evacuation surgery versus external ventricular drainage for the treatment of patients with moderate to severe intraventricular hemorrhage: a multicenter, randomized, controlled trial
Authors: Zhu Junhao , Tang Chao , Cong Zixiang , Yang Jin , Cai Xiangming , Liu Yuxiu , Ma Chiyuan
Published: June 2020

Background: The application of neuroendoscopy in intraventricular hemorrhage (IVH) has attracted more and more attention in recent years. Studies have shown that the use of neuroendoscopy for IVH evacuation has advantages over external ventricular drainage (EVD) alone. However, the cases of most current research are small and all of them are retrospective studies. The aim of this study is to explore the prognosis of patients with moderate to severe IVH who undergo endoscopic IVH evacuation surgery versus those who undergo EVD alone.Methods: The study is a prospective, randomized, controlled, multi-center clinical trial. Nine hundred and fifty-six subjects with moderate to severe IVH across four tertiary hospitals in China will be randomly assigned (1:1) to receive either endoscopic IVH evacuation surgery or EVD. The primary objective is to compare patients’ survival rate at 12 months after surgery.Discussion: The trial is designed to investigate the prognostic benefits of endoscopic IVH evacuation surgery for patients with moderate to severe IVH. Currently, it has never been investigated in a prospective randomized controlled clinical trial.Trial registration: ClinicalTrials.gov, NCT04037267. Registered on 26 July 2019.
Assessing the role of two populations of Aedes japonicus japonicus for Zika virus transmission under a constant and a fluctuating temperature regime.
Authors: Glavinic Uros , Varga Jasmin , Paslaru Anca Iona , Hauri Jeannine , Torgerson Paul , Schaffner Francis , Veronesi Eva
Published: June 2020

Background Since the huge epidemic of Zika virus (ZIKV) in Brazil in 2015, questions were raised to understand which mosquito species could transmit the virus. Aedes aegypti has been described as the main vector. However, other Aedes species (e.g. Ae. albopictus and Ae. japonicus) proven to be competent for other Flaviviruses (e.g.West Nile, dengue and yellow fever), have been described as potential vector for ZIKV under laboratory conditions. To name one, the Asian bush mosquito Ae. japonicus which is widely distributed with high abundances in Central-Western Europe. In the present study, infection, dissemination and transmission rates of ZIKV (Dak84 strain) in two populations of Ae. japonicus from Switzerland (Zürich) and France (Steinbach, Haut-Rhin) were investigated under constant (27 °C) and fluctuating (14-27 °C, mean 23 °C) temperature regimes.Results The two populations were each able to transmit ZIKV under both temperature regimes. Infectious virus particles were detected in the saliva of females from both populations, regardless of the incubation temperature regime, from 7 days post exposure to infectious rabbit blood. The highest amount of Plaque Forming Unit (PFU) (400/ml) were recorded 14 days post oral infection in the Swiss population incubated at constant temperature. No difference in term of infection, dissemination and transmission rate were found between mosquito populations.Temperature had no effect on infection rate but the fluctuating temperature regime resulted in higher dissemination rates comparing to constant temperature, regardless of the population. Finally, transmission efficiency ranged between 7-23% and 7-10% for the constant temperature and 0-10% and 3-27% under fluctuating temperatures for the Swiss and the French populations, respectively.Conclusions This is the first work confirming vector competence for ZIKV of Ae. japonicus originating from Switzerland and France at realistic summer temperatures under laboratory conditions. Considering the continuous spread of this species in the northern part of Europe and its adaptation at cooler temperatures, preventative control measures should be adopted to prevent possible ZIKV epidemics.
Detection of gray matter microstructural changes in Alzheimer’s disease continuum using fiber orientation
Authors: Lee Peter , Kim Hang-Rai , Jeong Yong
Published: June 2020

Background: This study aims to investigate feasible gray matter microstructural biomarker with higher sensitivity for early Alzheimer’s disease (AD) detection. We propose diffusion tensor imaging (DTI) measure, ‘radiality’, for early AD biomarker. It is a dot product between cortical surface normal vector and primary diffusion direction, which reflects the fiber orientation within the cortical column. Methods: We gathered neuroimages from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database: 78 cognitive normal, 50 early mild cognitive impairment (EMCI), 34 late mild cognitive impairment (LMCI), and 39 AD patients. Then, we evaluated cortical thickness (CTh), mean diffusivity (MD), amount of amyloid and tau accumulations using positron emission tomography (PET), which are conventional AD magnetic resonance (MR) imaging biomarkers. Radiality was projected on gray matter surface to compare and validate the changes along stages with other neuroimage biomarkers. Results: Results showed decreased radiality primarily in entorhinal, insula, frontal and temporal cortex as disease progresses onward. Especially, radiality could delineate the difference between cognitive normal and EMCI group while other biomarkers could not. We looked into the relationship between the radiality and other biomarkers to validate its pathological evidence in AD. Overall, radiality showed high association with conventional biomarkers. Additional ROI analysis exhibits dynamics of AD related changes as stages onward. Conclusion: Radiality in cortical gray matter showed AD specific changes and relevance with other conventional AD biomarkers with higher sensitivity. Besides, it could show group differences in early AD changes from EMCI which show advantage for early diagnosis than using conventional biomarkers. We provide the evidence of structure changes with cognitive impairment and suggest radiality as a sensitive biomarker for early AD.
Serum A Proliferation-Inducing Ligand and MicroRNA-223 are Associated with Rheumatoid Arthritis: Diagnostic and Prognostic Implications
Authors: Taha Mohamed , Shaker Olfat Gamil , Taha Enas , Taha Noha
Published: June 2020

Background: Current blood-based tests for rheumatoid arthritis (RA) have inherent limitations, necessitating the need for additional new biomarkers for its diagnosis and monitoring disease activity and responsiveness to therapy. microRNAs (miRNAs) and a proliferation-inducing ligand (APRIL) are deregulated in RA and were linked to its pathogenesis. This study investigated serum levels of APRIL, miR-223 and miR-155 in RA patients, their potential as diagnostic and prognostic biomarkers, and their correlation with disease activity and clinicopathological data.Methods: 120 Egyptian patients with RA and 130 healthy controls were included. Serum miRNAs and APRIL were assayed by RT-qPCR and ELISA, respectively. Results: Serum APRIL and miR-223 were significantly upregulated, while miR-155 was unchanged in RA patients compared to controls. Serum miR-223 discriminated RA patients from controls with AUC=0.85, whereas serum APRIL superiorly distinguished the two groups with AUC=1 (sensitivity and specificity= 100% at cutoff>4.19 ng/ml) by receiver-operating-characteristic analysis. Serum miR-223 was a significant predictor for RA diagnosis in multivariate logistic regression analysis. In RA group, serum APRIL was positively correlated with disease activity score (DAS28-CRP). Serum miR-223 expression was positively correlated with serum miR-155, APRIL levels and with the presence of subcutaneous nodules. Serum miR-155 levels were correlated with antinuclear antibody titer in reverse direction.Conclusion: our results suggest serum APRIL and miR-223 could serve as potential biomarkers of RA, with miR-223 as a predictor of RA risk and APRIL as an excellent biomarker of disease activity. Our data could be implicated for accurate and blood-based non-invasive diagnosis and prognosis of RA.
Dietary L-citrulline supplementation modulates nitric oxide synthesis and anti-oxidant status of laying hens during summer season
Authors: UYANGA VICTORIA ANTHONY , Jiao Hongchao , Zhao Jingpeng , Wang Xiaojuan , Lin Hai
Published: June 2020

Background: L-citrulline (L-Cit), a non-protein amino acid, has been implicated in several physiological functions including anti-inflammatory, anti-oxidative, and hypothermic roles, however, there is a paucity of information with regards to its potential in poultry production. This study was designed to investigate the effects of dietary L-Cit supplementation on the production performance, nitric oxide production, and antioxidant status of laying hens during summer period. Hy-Line Brown laying hens (n=288, 34 weeks old) were allotted to four treatment, 6 replicates of 12 chickens each. Dietary treatments of control (basal diets), 0.25%, 0.50 % and 1.00 % L-Cit supplementation were fed to chickens for eight (8) weeks. Production performance, free amino acid profiles, nitric oxide production, and antioxidant properties were measured. Blood samples were collected at the 4th and 8th weeks of the experiment. Results: Air temperature monitoring indicated an average daily minimum and maximum temperatures of 25.02 oC and 31.01 oC respectively. Dietary supplementation with L-Cit did not influence (P > 0.05) the production performance, and rectal temperature of laying hens. Egg shape index was increased (P < 0.05) with increasing levels of L-Cit. Serum-free content of arginine, citrulline, ornithine, tryptophan, histidine, GABA, and cystathionine were elevated, but taurine declined with L-Cit diets. Plasma nitric oxide (NOx) concentration was highest at 1% L-Cit. Likewise, nitric oxide synthase (NOS) activity for total NOS (tNOS) and inducible NOS (iNOS) were upregulated with increasing L-Cit levels, although, tNOS was not affected at the 4th week. Anti-oxidant enzymes including catalase and superoxide dismutase (SOD) were increased with L-Cit supplementation, however, SOD activity was unchanged at 4th week, while total anti-oxidant capacity increased at the 8th week. L-Cit supplementation attenuated the extent of lipid peroxidation, and also inhibited glutathione peroxidase activity. Conclusion: Dietary L-Cit supplementation modulated systemic arginine metabolism, nitric oxide synthesis, antioxidant defense system, and increased the egg shape index of laying hens during the summer season. 1% L-Cit supplementation proved most effective in potentiating these effects and may be adopted for feed formulation strategies.
Population structure and geographic segregation of Cryptosporidium parvum IId subtypes in cattle in China
Authors: Zhang Zhenjie , Hu Suhui , Zhao Wentao , Guo Yaqiong , Li Na , Zheng Zezhong , Zhang Longxian , Kvac Martin , Xiao Lihua , Feng Yaoyu
Published: June 2020

Background: Cryptosporidium parvum is a zoonotic pathogen worldwide. Extensive genetic diversity and complex population structures exist in C. parvum in different geographic regions and hosts. Unlike the IIa subtype family, which is responsible for most zoonotic C. parvum infections in industrialized countries, IId is identified as the dominant subtype family in farm animals, rodents, and humans in China. Thus far, the population genetic characteristics of IId subtypes in calves in China are not clear. Methods: In the present study, 46 C. parvum isolates from dairy and beef cattle in six provinces and regions, China were characterized using sequence analysis of eight genetic loci, including msc6-7 , rpgr , msc6-5 , dz-hrgp , chom3t , hsp70 , mucin1 , and gp60 . They belonged to three IId subtypes in the gp60 gene, including IIdA20G1 (n = 17), IIdA19G1 (n = 24) and IIdA15G1 (n = 5). The data generated were analyzed for population genetic structures of C. parvum using DnaSP and LIAN, and subpopulation structures using STRUCTURE, RAxML, Arlequin, GENALEX and Network. Results: Seventeen multilocus genotypes were identified. The results of linkage disequilibrium analysis indicated the presence of an epidemic genetic structure in the C. parvum IId population. When isolates of various geographical areas were treated as individual subpopulations, maximum likelihood inference of phylogeny, pairwise genetic distance analysis, sub-structure analysis, principal component analysis and network analysis all provided evidence for geographic segregation of subpopulations in Heilongjiang, Hebei, and Xinjiang. In contrast, isolates from Guangdong, Shanghai, and Jiangsu were genetically like each other. Conclusions: Data from the multilocus analysis have revealed a much higher genetic diversity of C. parvum than gp60 sequence analysis. Despite an epidemic population structure, there is apparent geographic segregation in C. parvum subpopulations within China.
An Implementation History of Primary Health Care Transformation: Alberta’s Primary Care Networks and the People, Time and Culture of change
Authors: Leslie Myles , Khayatzadeh-Mahani Akram , Birdsell Judy , Forest PG , Henderson Rita , Gray Robin Patricia , Schraeder Kyleigh , Seidel Judy , Zwicker Jennifer , Green Lee A.
Published: June 2020

Background: Primary care, and its transformation into Primary Health Care (PHC), hasbecome an area of intense policy interest around the world. As part of this trendAlberta, Canada, has implemented Primary Care Networks (PCNs). These aredecentralized organizations, mandated with supporting the delivery of PHC, fundedthrough capitation, and operating as partnerships between the province’s healthcareadministration system and family physicians. This paper provides an implementationhistory of the PCNs, giving a detailed account of how people, time, and culturehave interacted to implement bottom up, incremental change in a predominantly Fee-For-Service (FFS) environment.Methods: Our implementation history is built out of an analysis of policy documentsand qualitative interviews. We conducted an interpretive analysis of relevant policydocuments (n=20) published since the first PCN was established. We then grounded12 semi-structured interviews in that initial policy analysis. These interviews explored11 key stakeholders’ perceptions of PHC transformation in Alberta generally, and theformation and evolution of the PCNs specifically. The data from the policy review andthe interviews were coded inductively, with participants checking our emerginganalyses.Results: Over time, the PCNs have shifted from an initial Frontier Era thatemphasized local solutions to local problems and featured few rules, to a present Eraof Accountability that features central demands for standardized measures,governance, and co-planning with other elements of the health system. A core groupof people – clinician and administration leaders – emerged to create the PCNs and,over time , to develop a long-term Quality Improvement (QI) vision and governanceplan for them as organizations. The continuing willingness of both these groups towork at understanding and aligning one another’s cultures to achieve thetransformation towards PHC has been central to the PCNs’ survival and success.Conclusions: Generalizable lessons from the implementation history of this emergingpolicy experiment include: The need for flexibility within a broad commitment toimproving quality. The importance of time for individuals and organizations to learnabout: quality improvement; one another’s cultures; and how best to support thetransformation of a system while delivering care locally.
A video protocol for rapid dissection of mouse dorsal root ganglia from defined spinal levels
Authors: Sleigh James Nicholas , West Steven J , Schiavo Giampietro
Published: June 2020

Objective: Dorsal root ganglia (DRG) are heterogeneous assemblies of assorted sensory neuron cell bodies found in bilateral pairs at every level of the spinal column. Pseudounipolar afferent neurons convert external stimuli from the environment into electrical signals that are retrogradely transmitted to the spinal cord dorsal horn. To do this, they extend single axons from their DRG-resident somas that then bifurcate and project both centrally and distally. DRG can be dissected from mice at embryonic stages and any age post-natally, and have been extensively used to study sensory neuron development and function, response to injury, and pathological processes in acquired and genetic diseases. We have previously published a step-by-step dissection method for the rapid isolation of post-natal mouse DRG. Here, the objective is to extend the protocol by providing training videos that showcase the dissection in fine detail and permit the extraction of ganglia from defined spinal levels. Results: By following this method, the reader will be able to swiftly and accurately isolate specific lumbar, thoracic, and cervical DRG from mice. Dissected ganglia can then be used for RNA/protein analyses, subjected to immunohistochemical examination, and cultured as explants or dissociated primary neurons, for in-depth investigations of sensory neuron biology.
The High Expression of CD276/HAVCR2 and CD163 is an Adverse Immune Subtype of Glioblastoma and is Closely Related to Epithelial-Mesenchymal Transition
Authors: Hou Xiaohong , Zhou Guiyin , Fan Yinchun , Zhang Qiang , Xiang Chengming , Cao Fang , Yao Shengtao
Published: June 2020

Background

Glioblastoma (GBM) is one of the most malignant tumors that can afflict the central nervous system. Previous studies have observed that there are individual differences in the treatment response of immune checkpoint inhibitors in glioblastoma. This study’s aim is to ascertain the factors that may affect the efficacy of immunosuppressant therapy.

Methods

The clinical data of this study were obtained from a public database. Then, the data was analyzed and processed by R software and corresponding R package. To verify the results of the analysis, information was gathered from 89 GBM patients in our hospital and thereafter the corresponding paraffin sections were stained and quantitatively analyzed by immunohistochemistry.

Results

From the analysis, it was observed that both CD276 and HAVCR2 were significantly overexpressed in GBM and could be associated with patient prognosis. The analysis of single cell RNA sequencing data and GBM data analysis found an immune subtype with poor prognosis. Further analysis found that the high expression of CD276, HAVCR2 and CD163 was closely related to epithelial-mesenchymal transition (EMT) and could affect the patient prognosis of PD-L1 high expression. GSVA enrichment analysis showed that CD276, HAVCR2 and CD163 might induce EMT by JAK-STAT3 signaling pathway, and RUNX1 and IKZF1 might be transcription factors that regulate CD276/HAVCR2 high expression.

Conclusions

We found an immune subtype with poor prognosis of GBM, the high expression of CD276, HAVCR2 and CD163 with EMT are closely related and may be one of the factors affecting the efficacy of Anti-PD-L1.
A novel method for 3D face symmetry reference plane based on Weighted Procrustes Analysis algorithm
Authors: Yujia Zhu , Zheng Shengwen , Yang Guosheng , Fu Xiangling , Zhao Yijiao , Wang Yong
Published: June 2020

Background
We aimed to establish a novel method based on Weighted Procrustes Analysis (WPA) algorithm that assigns weight to facial anatomical landmarks to automatically construct a three-dimensional facial Symmetry Reference Plane (SRP) for mandibular deviation patients.
Methods
Three-dimensional facial SRPs were extracted independently from 15 mandibular deviation patients, using both our WPA algorithm and the standard PA algorithm. A reference plane defined from professional experience served as the ground truth. To test whether the WPA SRP or the PA SRP was closer to the ground truth, we measured the position error of mirrored landmarks, the facial asymmetry index (FAI) error, and the angle error for the global face and for each facial third partitions.
Results
The average angle error between the WPA SRP and the ground truth was 1.66 ± 0.81°, which was smaller than that between the PA SRP and the ground truth. The position error of mirrored landmarks constructed using the WPA algorithm in the global face (3.64 ± 1.53 mm) and each facial partition was lower than the error of those constructed using the PA algorithm. The average FAI error of the WPA SRP was − 7.77 ± 17.02 mm, which was smaller than that of the PA SRP.
Conclusions
This novel automatic algorithm based on weighted anatomic landmarks provided a more adaptable SRP than the standard PA algorithm when applied to severe mandibular deviation patients and better simulated the diagnosis strategy of clinical experts.
Pancreatic Cancer With Ovarian Metastasis: Clinical Features, Diagnosis and Management
Authors: Zhou Xingtong , Cao Hongtao , Zhao Banbo , Zheng Zhibo , Qin Cheng , Li Tianhao , Liu Xudong , Wang Weibin
Published: June 2020

Background: To summarize the clinical features, diagnosis and management of pancreatic cancer with ovarian metastasis.Methods: We retrospectively analyzed the clinical data of patients with ovarian metastases of primary pancreatic cancer who were admitted to our hospital from 01/01/1985 to 04/01/2020.Results: In total, there were 3757 female pancreatic-cancer patients. 9 of them were diagnosed with ovarian metastasis at an average age of 51.89 (38-69) years. The reason for the patients’ visit was generally a mass in the lower abdomen and/or abdominal pain. 7 patients had significantly higher serum CA19-9 levels. 8 patients had pancreatic tumors located in the body or tail; 1 patient, in the pancreatic head. All patients underwent excision of ovarian tumors and resection or biopsy of pancreatic tumors. 6 patients had pancreatic ductal adenocarcinoma (PDAC), 2 had pancreatic cystadenocarcinoma (PCC), and 1 had pancreatic neuroendocrine carcinoma (PNEC), all revealed by the pathological results. Ovarian tumors were assessed by pathology and were consistent with pancreatic metastasis. Currently, 2 patients are still alive (followed until 04/2020). The median survival time for all patients was 7 months (2.9-22 months).Conclusions: Pancreatic cancer with ovarian metastases is rare and easily misdiagnosed. When ovarian tumors are suspected to be metastatic, elevated serum CA19-9 may indicate that the primary cancer is pancreatic. Enhanced CT can facilitate diagnostic localization. In addition, if the pancreatic tumor cannot be removed, the ovarian tumor should still be resected to reduce the tumor load and improve quality of life.
Psychological Distress During the COVID-19 Pandemic in Ethiopia: The Need for Equal Attention of Intervention
Authors: Ambelu Argaw , Birhanu Zewdie , Yitayih Yimenu , Kebede Yohannes , Mecha Mohammed , Abafita Jemal , Belay Ashenafi , Fufa Diriba
Published: June 2020

Background: The COVID-19 pandemic led individuals to suffer from different levels of mental health problems such as psychological distress, anxiety, depression, denial, panic, and fear. This study aimed at determining the prevalence of psychological distress and associated factors among the Ethiopian population during the COVID-19 pandemic. Methods:A cross-sectional study was performed through an online survey using different online platforms. The questionnaire was created through Google Form and the survey link was administered by e-mail,LinkedIn,Telegram, and Facebook. Educated Ethiopian population who have access to the internet were invited to participate through an online survey and addressed to 929respondents. The psychological distress was assessed using the Kessler 10 item tool to measure psychological distress. Data were analyzed using SPSS andlogistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios.A generalized additive model was also employed to identify additional predictors using R.Results:The prevalence of high psychological distress among the study population was 236(25.5%). Of all respondents, 421(45.1%) had low psychological distress, 274(29.4%) had moderate psychological distress, 164 (17.6%) had high psychological distress, and 72 (7.3%) had very high psychological distress.Psychological distress increased with being at young and middle-aged adults, getting information from social media, and not correctlypracticing infection prevention and control measures to prevent COVID-19 infection. Respondents with high perceived severity had increased psychological distress. On the contrary, those with the highest score of perceived response efficacy had low distress.Conclusion:Prevalence of psychological distress was substantial. Intervention of psychological distress is critically essential. The intervention target groupsare those whose information sourcesare from social media, young and middle-aged adults, and those who do not properly practice infection prevention and control measures to COVID-19 infection.
End-stage knee osteoarthritis with and without sarcopenia – and the effect of knee arthroplasty
Authors: Ho Kevin Ki-Wai , Lau Lawrence Chun-Man , Chau Wai Wang , Poon Queena , Chung Kwong-Yin , Wong Ronald Man-Yeung
Published: June 2020

Background Sarcopenia often accompanies osteoarthritis but the relationship between them is still unclear and no strong consensus can be reached. Previous studies revealed that OA in the hip or knee is associated with declines in muscle mass and strength. This study aims to examine the status of sarcopenia in individuals with symptomatic end-stage OA of the knee, the effect of this condition on their peri-operative TKA rehabilitation and functional outcome. Methods This prospective study was conducted between 2015 to 2018 at our hospital. Patients with end-stage osteoarthritis of the knee on queue for total knee arthroplasty were recruited into the study. Primary outcome measures were DEXA in lean muscle mass, muscle strength, knee motion and function. Secondary outcomes measures were Quality of Life (QOL) measurements in pain, psychological and physical health. Results Fifty-eight patients were recruited, of which 79.3% were female and 32.8% already had sarcopenia at baseline. The average age of sarcopenic subjects and non-sarcopenic subjects were comparable (67.89±7.07 vs. 67.92±6.85; p=0.99) but sarcopenic subjects tend to have lower BMI (25.64±2.64 vs. 28.57±4.04; p=0.01). There was a statistically significant improvement in walking speed and range of movement in both sarcopenic and non-sarcopenic patients after TKA (p<0.01). This was accompanied by an improvement trend in muscle mass in all subjects. A sarcopenic female that were overweight or obese had statistically significant improvement in both Appendage Lean Mass Index and Lean Mass Index after total knee arthroplasties in 12 months (p=0.04). There was no change in handgrip power before and after TKA and subsequent follow-up (p=0.97). Quality of life measured with WOMAC, SF12v2 and IPAQ revealed progressive significant improvement (p≤0.01). Further analysis at the IPAQ also found increased engagement of high-intensity activities. Conclusions To conclude, our study showed that sarcopenia among patients with end-stage OA of the knee is not uncommon. The mechanical mal-alignment and degenerative process in OA of the knee can be corrected with TKA. However, the rehabilitation and recovery in the elderly population may never fully recover. Further studies focusing on this group of patient and employment of multimodal therapy with a supervised exercise program is warranted.
Characteristics of Esophagus Flora in Patients with Esophageal Squamous Cell Carcinoma in Central China
Authors: He Shuixiang , Liu Xiao-bo , Gao Zi-ye , Jin Shu , Pandey Sandeep , Gao Bo , Tong Qiang
Published: June 2020

Microecology may be involved in tumorigenesis and development through the introduction of chronic inflammation and may be related to esophageal squamous cell carcinoma (ESCC). This study was to observe the characteristics of ESCC flora and to preliminarily analyze the key genera in ESCC. A total of 72 ESCC patients and 20 healthy individuals esophageal tissue samples, genomic DNA was extracted, PCR was performed on the bacterial 16SrRNA gene sequence V4 hypervariable region, and bacterial characteristics were analyzed by IlluminMiSeq sequencing. The esophageal flora abundance of ESCC patients (Alpha diversity: Shannon index, P = 0.5088; Simpson index, P = 0.5894; Chao1 index, P = 0.0029) and variability (Beta diversity: PC1 16.62%, P PC1 = 0.0034, P PC2 =8.5e-08) were significantly higher than HC tissue. The five most abundant phylum in ESCC group were Firmicutes, Bacteroidietes, Proteobacteria, Fusobacteria and Actinobacteria, while the HC group were Proteobacteria, Firmicutes, Bacteroidietes, Fusobacteria and Actinobacteria. The top five genus in the ESCC group were Streptococcus, Prevotella, Haemophilus, Neisseria and Veillonella; while the top five genus in the HC group were Streptococcus, Neisseria, Veillonella, Prevotella and Haemophilus. The ESCC group has advantages over HC in Aerobic、Anaerobic、Contains-Mobile-Elements、Facultatively-Anaerobic、Forms-Biofilms、Potentially-pathogenic、Stress-Tolerant, and the difference was statistically significant (P <0.05). The esophageal microbial community structure of ESCC patients is different from that of HC, suggesting that the corresponding changes in esophageal microflora have a certain correlation with ESCC. It indicates that the detection of esophageal microorganisms has potential as a means of early diagnosis or screening of future ESCC.
Graphene-Modified CePO4 Nanorods Effectively Treat Breast Cancer-induced Bone Metastases and Regulate Macrophage Polarization to Improve Osteo-Inductive Ability
Authors: Ge Yuwei , Liu Xiao-Liang , Yu De-gang , Zhu Zhen-An , Ke Qin-Fei , Mao Yuan-Qing , Guo Ya-Ping , Zhang Jing-Wei
Published: June 2020

Background: Breast cancer bone metastasis has become one of the most common complications; however, it may cause cancer recurrence and bone nonunion and local bone defects.Methods: Herein, In vitro, we verified the effect of bioscaffold materials on cell proliferation and apoptosis through CCK8 experiment, staining of living dead cells, and flow cytometry. We used immunofluorescence technology and flow cytometry to verified whether bioscaffold materials regulated the polarization of macrophages, and we use ALP staining, alizarin red staining and PCR to verify whether the bioscaffold material promotes bone regeneration. In vivo, we once again studied the effect of bioscaffold materials on tumors by measuring tumor volume in mice, Tunel staining, and caspase-3 immunofluorescence. We also constructed a mouse skull ultimate defect model to verify the effect on bone regeneration.Results: Graphene oxide (GO) nanoparticles, hydrated CePO4 nanorods and bioactive chitosan (CS) are combined to form a bioactive multifunctional CePO4/CS/GO scaffolds, which has the following characteristics such as photothermal therapy to kill tumors, macrophage polarization promotes blood vessel formation and induces bone formation. The CePO4/CS/GO scaffold activates the caspase-3 proteasein local tumor cells, thereby lysing DNA between nucleosomes and causing apoptosis. On the one hand, the as-released Ce3+ ions promote the M2 polarization of macrophages, which secretes vascular endothelial growth factor (VEGF) and Arginase-1 (Arg-1), which promotes angiogenesis. On the other hand, the as-released Ce3+ ions also activated BMP-2/Smad signaling pathway that facilitated bone tissue regeneration.Conclusion: the multifunctional CePO4/CS/GO scaffolds may become a promising platform for therapy of breast cancer bone metastases.
Determination of the Prevalence of Postpartum Depression and Risk Factors Among Postpartum Patients at a Tertiary Government Urban Hospital Using the Edinburgh Postnatal Depression Scale-Filipino Translation (EPDS-F): A Cross-Sectional Study
Authors: Santiago Maria Carmina Lorenzana , Habana Maria Antonia Esteban
Published: June 2020

Background
Postpartum depression (PPD) occurs in 10-15% of deliveries worldwide. Unfortunately there is a dearth of local studies on its exact prevalence.

Method
This cross-sectional study aimed to determine the prevalence of and risk factors for PPD among postpartum patients at a tertiary government hospital using the Edinburgh Postnatal Depression Scale-Filipino Translation (EPDS-F), a 10-point questionnaire translated into Filipino and previously validated. Four hundred patients within 8 weeks postpartum were recruited and their EPDS-F scores and sociodemographic, medical and personal history, and delivery and perinatal outcome data were obtained.

Results
The overall prevalence of PPD was 14.5%, which is within the known worldwide prevalence. Among those that had family incomes below PhP10,000, the proportion that had high EPDS-F scores was 68.8%, while those that had low EPDS-F scores was 48.8% (significant at p=0.001). Among those that finished below tertiary education, the proportion that had high EPDS-F scores was 81%, while those that had low EPDS-F scores was 59.9% (significant at p=0.002). Among those who delivered vaginally, 62.1% had high EPDS-F scores vs 44.2% low EPDS-F (p=0.03). Of those that had epidural anesthesia (106 or 26.5%), 44.8% had high EPDS scores and 26.0% had low EPDS-F scores (p=0.04). Regression analysis showed that having an abdominal delivery is correlated with a lower EPDS-F score by 0.87% by logistic regression and 0.46 % by probit regression. Having a higher educational attainment and monthly income are associated with a lower EPDS-F score by regression analysis.

Conclusions
The prevalence may be skewed because a tertiary government institution caters to delicate pregnancies and those in low socioeconomic brackets. It may be worthwhile to compare responses from a public versus a private institution, also urban versus rural areas. It would be interesting also to evaluate the mode of delivery variable and how exactly it correlates with the development of postpartum depression.
Impacts of Smoking and Alcohol Consumption on Workplace Presenteeism: A Cross-Sectional Study
Authors: Lee So Young , Lee Jinhwa , Kwon Min
Published: June 2020

Background: Presenteeism refers to the practice of going to work despite poor health, resulting in subpar performance. The problems caused by smoking and drinking alcohol while on company premises have received limited attention despite their health hazards, which are linked to sick leave, occupational injuries, and reduced productivity. This study aimed to investigate the effects of smoking and alcohol drinking on presenteeism. Methods: The study participants were 60,051 wage workers from the database of the second and third Korean Working Conditions Surveys (KWCS) in 2010 and 2011 , respectively. A total of 41,672 workers aged 19 and over who had worked for at least one hour in the previous week answered the survey questions. Chi-squared tests and multiple logistic regression analyses were conducted using SPSS 18.0 to determine the impacts of smoking and drinking alcohol on presenteeism. Results: Of the 41,672 Korean workers, 8565 (20.6%) had experienced presenteeism in the past 12 months. Presenteeism was higher among women; the elderly; people with low educational status; people with low income; people with 5-11 days absenteeism; people with more working time; people with health problems; heavy smokers; and high-risk alcohol drinkers than other participants. Based on the results of multiple regression analysis, heavy smoking (AOR = 2.10, 95% CI [1.56, 2.82]) and high-risk drinking of alcohol (AOR = 1.20, 95% CI [1.10, 1.31]) were significantly related to presenteeism among workers.Conclusions: Smoking and alcohol drinking are associated with and potentially influence presenteeism; therefore, interventions for employees, and for the general public, may improve workplace productivity and reduce accidents. Companies that encourage employees to receive treatments for reduction of smoking or alcohol consumption may benefit from greater productivity. Hence, we should consider the impact of smoking and alcohol in the workplace and build appropriate strategies and implementation programs to help reduce heavy smoking and high-risk alcohol drinking behaviors.
COVID-19 detection and disease progression visualization: Deep learning on chest X-rays for classification and coarse localization
Authors: Zebin Tahmina , Rezvy Shahadate , Pang Wei
Published: June 2020

Chest X-rays are playing an important role in the testing and diagnosis of COVID-19 disease in the recent pandemic. However, due to the limited amount of labelled medical images, automated classification of these images for positive and negative cases remains the biggest challenge in their reliable use in diagnosis and disease progression. We applied and implemented a transfer learning pipeline for classifying COVID-19 chest X-ray images from two publicly available chest X-ray datasets {https://github.com/ieee8023/covid-chestxray-dataset},{https://www.kaggle.com/paultimothymooney/chest-xray-pneumonia}}. The classifier effectively distinguishes inflammation in lungs due to COVID-19 and pneumonia (viral and bacterial) from the ones with no infection (normal). We have used multiple pre-trained convolutional backbones as the feature extractor and achieved an overall detection accuracy of 91.2% , 95.3%, 96.7% for the VGG16, ResNet50 and EfficientNetB0 backbones respectively. Additionally, we trained a generative adversarial framework (a cycleGAN) to generate and augment the minority COVID-19 class in our approach. For visual explanations and interpretation purposes, we visualized the regions of input that are important for predictions and a gradient class activation mapping (Grad-CAM) technique is used in the pipeline to produce a coarse localization map of the highlighted regions in the image. This activation map can be used to monitor affected lung regions during disease progression and severity stages.
Using prenatal blood samples to validate COVID-19 rapid serologic tests
Authors: Alger Jackeline , Cafferata Maria Luisa , Alvarado Tito , Ciganda Alvaro , Corrales Arturo , Desale Hans , Drouin Arnaud , Fusco Dahlene , Garcia Jorge , Gibbons Luz , Harville Emily , Lopez Wendy , Lorenzana Ivette , Muñoz-Lara Fausto , Palou Elsa , Retes Eduardo , Sierra Manuel , Stella Candela , Xiong Xu , Zambrano Lysien I. , Buekens Pierre
Published: June 2020

IntroductionBackground cross-reactivity with other coronaviruses may reduce the specificity of COVID-19 rapid serologic tests. Blood collected during prenatal care is a unique source of population-based samples appropriate for validation studies. We used stored 2018 serum samples from an existing pregnancy cohort study to evaluate the specificity of COVID-19 serologic rapid diagnostic tests. MethodsWe randomly selected 120 stored serum samples from pregnant women enrolled in a cohort in 2018, at least one year before the COVID-19 pandemic. We used stored serum to evaluate four lateral flow rapid diagnostic tests, following manufacturers’ instructions. Pictures were taken for all tests and read by two blinded trained evaluators. Results We evaluated 120, 80, 90, and 90 samples, respectively. Specificity for both IgM and IgG was 100% for the first two tests. The third test had a specificity of 98.9% for IgM and 94.4% for IgG. The fourth test had a specificity of 88.9% for IgM and 100% for IgG.Discussion COVID-19 serologic rapid tests are of variable specificity. Blood specimens from sentinel prenatal clinics provide an opportunity to validate serologic tests with population-based samples.
Diagnostic classification of coronavirus disease 2019 (COVID-19) and other pneumonias using radiomics features in CT chest images
Authors: Yang Ning , Liu Faming , Li Chunlong , Xiao Wenqing , Xie Shuangcong , Yuan Shuyi , Zuo Wei , Ma Xiaofen , Jiang Guihua
Published: June 2020

We propose a classification method using the radiomics features of CT chest images to identify patients with coronavirus disease 2019 (COVID-19) and other pneumonias. The chest CT images of two groups of participants (90 COVID-19 patients and 90 other pneumonias patients) were collected, and the two groups of data were manually drawn to outline the region of interest (ROI) of pneumonias. The radiomics method was used to extract textural features and histogram features of the ROI and obtain a radiomics features vector from each sample. Finally, using the radiomics features as an input, a support vector machine (SVM) model was constructed to classify patients with COVID-19 and patients with other pneumonias. This model used 20 rounds of 10-fold cross-validation for training and testing. In the COVID-19 patients, correlation analysis (multiple comparison correction—Bonferroni correction, p<0.05/7) was also conducted to determine whether the textural and histogram features were correlated with the laboratory test index of blood, i.e., blood oxygen, white blood cell, lymphocytes, neutrophils, C-reactive protein, hypersensitive C-reactive protein, and erythrocyte sedimentation rate. The results showed that the proposed method had a classification accuracy as high as 88.33%, sensitivity of 83.56%, specificity of 93.11%, and an area under the curve of 0.947. This proved that the radiomics features were highly distinguishable, and this SVM model can effectively identify and diagnose patients with COVID-19 and other pneumonias. The correlation analysis results showed that some texture features were positively correlated with WBC, NE, and CRP and also negatively related to SPO2H and NE.
The Practice of Obtaining Informed Consent for Elective Surgery and Anesthesia from Patients’ Perspective: An Institutional based Cross-Sectional Study
Authors: Negash Tadese Tamire , Tesfaw Aragaw
Published: June 2020

Background : Informed consent is a body of shared decision making process and voluntary authorization of patients to receive medical or surgical intervention. There are limited studies conducted so far to examine the practice of informed consent in Ethiopia. The aim of the study was to assess the practice of informed consent for surgery and Anesthesia from patients’ perspective.Method: An institutional-based cross-sectional study was conducted from March to May 2019. The data were collected using an interviewer-administered structured questionnaire and entered and analyzed using Microsoft Excel and SPSS version 23.Results: A total of 139 patients were interviewed in this study. Most 42(30.2%) of patients were in the age group of 29-38 years. The majority 74(53.2%) of the population were females and most 85 (61.2%) were from a rural residence. Nearly half 68 (48.9%) of the patients were informed of the benefits of the surgical procedure and 78(56.1%) of the patients were informed on the type of anesthesia to be administered while 65 (46.8% ) were not informed on any complications related to the anesthesia. About 66 (47.5%) of the patients interviewed were informed on alternatives to the surgery done. Of these patients, 39(59%) were not informed of any benefits and possible risks associated with the alternative modes of treatment. More than half 75 (54%) of the patients reported as they were understood the information provided during the pre-operative counseling and about 114 (82%) of the patients interviewed satisfied with the current process of obtaining informed consent.Conclusions and recommendation: The current practice of obtaining informed consent addressed only certain aspects of the informed consent component which reflects that patients were inadequately informed on complications related to surgery and anesthesia, alternative forms of treatment and their risks and benefits.