bluuebunny/crossref_metadata_2025 huggingface dataset:
Mapping the Non-Structural Transmembrane Proteins of SARS-CoV-2
Authors: Thomas Sunil
Published: December 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for the disease COVID-19 has wreaked havoc on the health and economy of humanity. In addition, the disease is observed in domestic and wild animals. The disease has impacted directly and indirectly every corner of the planet. Currently, there are no vaccines and effective therapies for COVID-19. SARS-CoV-2 is an enveloped virus with a single-stranded RNA genome of 29.8 kb. More than two-thirds of the genome comprises Orf1ab encoding 16 non-structural proteins (nsps) followed by mRNAs encoding structural proteins, spike (S), envelop (E), membrane (M), and nucleocapsid (N). These genes are interspaced with several accessory genes (open reading frames [Orf] 3a, 3b, 6, 7a, 7b, 8, 9b, 9c and 10). The functions of these proteins are of particular interest for understanding the pathogenesis of SARS-CoV-2. Several of the nsps (nsp3, nsp4, nsp6) and Orf3a are transmembrane proteins involved in regulating the host immunity, modifying host cell organelles for viral replication and escape and hence considered drug targets. In this paper we report mapping the transmembrane structure of the non-structural proteins of SARS-CoV-2.
Human Plasma and Recombinant Hemopexins: Heme Binding Revisited
Authors: Karnaukhova Elena , Owczarek Catherine , Schmidt Peter , Schaer Dominik J. , Buehler Paul W.
Published: December 2020

Abstract: Plasma hemopexin (HPX) is the key antioxidant protein of the endogenous clearance pathway that limits the deleterious effects of heme released from hemoglobin and myoglobin. During intra-vascular hemolysis, heme partitioning to protein and lipid increases as the plasma concentration of HPX declines. Therefore, the development of HPX as a replacement therapy during high heme stress could be a relevant intervention for hemolytic disorders. A logical approach to enhance HPX yield involves recombinant production strategies from human cell lines. The present study focuses on a biophysical assessment of heme binding to recombinant human HPX (rhHPX) produced in the Expi293FTM (HEK293) cell system. In this report, we examine rhHPX in comparison with plasma HPX using a systematic analysis of protein structural and functional characteristics related to heme binding. Analysis of rhHPX by UV/Vis absorption spectroscopy, circular dichroism (CD), SEC-HPLC and catalase-like activity demonstrated a similarity to HPX fractionated from plasma. In particular, the titration of HPX apo-protein(s) with heme was performed for the first time using a wide range of heme concentrations to model HPX-heme interactions to approximate physiological conditions (from extremely low to more than 2-fold heme excess). The CD titration data showed an induced bisignate CD Soret band pattern typical for plasma and rhHPX versions at low heme-to-protein molar ratios and demonstrated that further titration is dependent on the amount of protein-bound heme to the extent that the arising opposite CD couplet results in a complete inversion of the observed CD pattern. The data generated in this study suggests more than one binding site in both plasma and rhHPX. Further, our study provides a useful analytical platform for detailed characterization of HPX-heme interactions and potentially, novel HPX fusion constructs.
Predictors of Household Spending on Out-patient Expenses in Kenya
Authors: Mwenda Ngugi , Kosgei Mathew , Kerich Gregory , Nduati Ruth
Published: December 2020

Spending on out-patient health care by citizens in limited resource countries has received little attention.The purpose of this study is to determine the predictors of household spending on out-patient expenses in a cross-sectional study in Kenya. We applied the GEE methods to determine the effect of various variables on outpatient care. We established that the best predictors for outpatient spending in Kenya are Age of the household head, wealth index, marital status and education, which had the lowest QICu of 976341.2. There were no differences on age in mean spending on outpatient care and was changing in a sinusoidal manner. The rich spend more on outpatient care, due to financial ability. Spending increased across the wealth quantiles while gender had a significant effect in the general performance of the models, it didn’t assist in lowering the QICu
Risk Management for Defense SoS in a Complex, Dynamic Environment
Authors: Kordova Sigal , Fridkin Shimon
Published: December 2020

Identifying and assessing risk is one of the most important processes in managing complex systems and requires careful consideration. The need for an effective, efficient approach to risk management is considerably more important for defense industries, because they are exposed to risk already in early stages of development. This paper uses Heterogeneity and Homogeneity analysis between risk factors with Cochran’s Q test and Multidimensional scaling in order to present the complexity of the risk factors relevant to defense SoS, and proposes a methodology for identifying, analyzing and monitoring the risks that they face. Findings from an in-depth analysis of 46 classified defense SoS shows a need to focus on three main risks faced by defense projects: insufficient human resources, changes in the original specifications, and lack of other (non-human) resources. The paper also presents some recommendations for minimizing risk factors in defense SoS.
Why Hyperuricemia Does Not Necessarily Induce Gout?
Authors: Zhang Wei zheng
Published: December 2020

Hyperuricemia is a risk factor for gout. It has been well observed that a large proportion of hyperuricemia individuals have never had a gout attack(s), while some patients with gout can have a normuricemia. This raises a puzzle of the real role of serum uric acid (SUA) in the occurrence of gout attacks. As the molecule of uric acid has its dual effects in vivo with antioxidant property as well as being an inflammatory promoter, it has been placed in a delicate position in balancing metabolisms. Gout seems to be a multifactorial metabolic disease and its pathogenesis should not rely solely on hyperuricemia or MSU crystal. This critical review aims to unfold the mechanisms of the SUA role participating in gout development. It also discusses some key elements which are prerequisite for the formation of gout in association with the current therapeutic regime. The compilation should be helpful in precisely fighting for a cure of gout clinically and pharmaceutically.
PREVALENCE, IDENTIFICATION AND ANTIFUNGAL SUSCEPTIBILITY OF DERMATOPHYTES CAUSING TINEA CAPITIS IN A LOCALITY OF NORTH CENTRAL NIGERIA
Authors: Ayodele Ekundayo Halimat , Charles Nwabuisi , Abayomi Fadeyi
Published: December 2020

Background: Tinea capitis impacts negatively on the health of children, consequently affecting their education. Its prevalence is unknown in many African communities. Tinea capitis is faced with therapeutic challenges as resistance to all classes of antifungal agents continues to emerge. This study determined the prevalence, identified dermatophytes of Tinea capitis in Okelele community in North Central Nigeria; and evaluated the susceptibility of isolates to selected antifungal drugs. Materials and Methods: Three hundred and one pupils from seven primary schools in the locality who gave assent and those with parental consent were recruited into the study. Scalp scrapings and hairs were collected from participants and subjected to microscopy and culture. Isolates identified by colonial morphology and micromorphology were subjected to disk diffusion antifungal susceptibility testing. Results: Two hundred and twenty-eight of the participants had mycologically proven Tinea capitis giving a prevalence of 75.7%. The dermatophytes identified were T. rubrum (68.0%), M. ferrugineum (22.0%), T. mentagrophytes (8.0%) and T. verrucosum (2.0%). Resistance observed with these isolates was as low as 21.2% to as high as 100% while sensitivity ranged from 78.8% to 100%. Only large family size significantly influenced the occurrence of T. capitis among the risk factors. Conclusion: Prevalence of Tinea capitis from this study is high. T. rubrum being anthropophilic and the predominant dermatophyte identified corroborates large family size as an important risk factor. Antifungal resistance as a cause of therapeutic failure was demonstrated by some isolates in this study.
Publications of the U.S. Army Engineer Research and Development Center; Appendix E: FY20 (October 2019-September 2020)
Authors: Dolan James
Published: December 2020

Publications issued October 2019 through September 2020 by the U.S. Army Engineer Research and Development Center (ERDC) are listed. The publications are grouped according to the technical laboratories or technical program for which they were prepared. Procedures for obtaining ERDC reports are included in the Preface.
Influence of sherardizing on working properties of metal parts subjected to prior heat treatment
Authors: Konstantinov V. M. , Buloichyk I. A.
Published: December 2020

The article reveals the data concerning the mechanical properties changes of heat-treated steel articles subjected to thermo diffusion pack cementation. The temperature frames of thermo diffusion influence on tensile strength were determined for heat-treaded steel articles. Results of tensile test of high strength bolts treated using thermo diffusion pack cementation at 420 °C show no any effect from the side of pack cementation treatment on working properties of the tested samples. It is shown that in conditions of cyclic fatigue loading thermo diffusion pack cementation of heat treated article may leads to strength loss that can be explained by formation of solid intermetallic phases in a surface area of the article.
Increase in the heat resistance of carbon steels by thermodiffusion treatment and vacuum coating application
Authors: Kovalchuk A. V. , Patseko E. K. , Tkachenko G. A. , Vereshchak N. A.
Published: December 2020

Inthisarticleissubstantiatedthehypothesisof the possibility of increasing the heat resistance of hypoeutectoid carbon steels by preliminary thermal diffusion alloying followed by the application of vacuum nitride coatings. It was established that thermal diffusion layers obtained as a result of saturation with boron and aluminum have the greatest heat resistance in terms of relative mass gain, then in order of decreasing heat resistance: layers obtained as a result of saturation with boron and silicon, boron and chromium, boron and nitrogen, and as a result of boriding. New composite coatings of heat-resistant compositions “thermodiffusion layer – vacuum ion-plasma coating” have been developed, which are also solid, wear-resistant, and corrosion-resistant under atmospheric corrosion, solutions of salts and certain acids. The influence of ionic-plasma coatings on additional increase in heat resistance of steels with the produced thermodiffusion layers, during which the most efficient compositions of the developed coatings are defined and given to improve the temperature resistance of the surface, was assessed. The results of the calculation of the predicted heat resistance of the developed compositions “diffusion layer – ion-plasma coating” on hypoeutectoid carbon steels are given in the article.
On the influence of elastic interphase deformations on the width of reflections from the released phase in dispersion hard-ening alloys
Authors: Tolstoy A. V.
Published: December 2020

The influence of fields of elastic interphase deformations on the amount of broadening of reflections from the separation phase is studied. It is established that elastic interphase deformations in strongly distorted crystals have a significant effect on the amount of broadening of reflections from the separation phase. Due to the fact that the broadening of the diffraction lines is used to judge the size of the selection particles, this leads to a significant error in estimating their true value. Therefore, the influence of elastic interphase strain fields should certainly be taken into account when determining particle sizes from x-ray data.
Analisys of thermal processes during induction surfacing
Authors: Marukovich E. I. , Kharkov V. A. , Meshkov D. A. , Kovalev A. M. , Sazonenko I. O. , Komissarov G. V.
Published: December 2020

Aspects of thermal phenomena associated with the production process of bimetallic billets in conditions of small penetration depths of eddy currents compared to the size of the heated body are considered. Various conditions of heat distribution in the heated layer and its removal are modeled using differentiated thermal resistance. Based on the analysis of the temperature distribution in various situational variants, promising ways to improve this technology are identified.
HISTOLOGY AND HISTOMORPHOMETRY OF GAYO MARE OVARIES
Authors: Melia Juli
Published: December 2020

This study aims to determine the histology, the number and diameter of follicles, and the corpus albican of the Gayo mare ovary. The micro technical process was applied to 3 pairs of ovarian samples for further hematoxylin-eosin (HE) staining. Observation of ovarian structure was carried out microscopically and the data were analyzed statistically. The results showed that the Gayo mare ovary consists of the medulla on the outside and the cortex on the inside. Medulla consists of small follicles, blood vessels, nerves, and connective tissue. Meanwhile, the cortex consists of de Graff's follicle, corpus luteum, corpus albican, and ovulatory fossa. Follicles are composed of oocytes, granulosa cells, internal and external theca cells, oophorous cumulus, follicular antrum, and follicular fluid. Atretic follicles contain lutein cells that have been damaged. The corpus luteum is composed of granulosa lutein tissue, internal theca and external. The corpus albican is composed of scar tissue and lutein cells. The measurement results showed that the primordial follicle diameter was 26.60±2.37 µm, primary follicle 54.33±6.70 µm, secondary follicle 119.32±25.55 µm, tertiary follicle 250.86±49.46 µm, atretic follicle 49.03±45.47 µm, the corpus albican 511.10±132.41 µm. Thus, it can be concluded that the Gayo mare ovary has a histological structure that is not different from the ovary of other mares. Follicular growth occurs in the medulla of the ovary, and de Graff's follicles are present in the cortex of the ovaries.
Mejor en caminos separados: la Iglesia y el Estado
Authors: Torres-Manrique Bibiana
Published: December 2020

El objetivo general de este artículo es analizar a grandes rasgos la relación entre las instituciones religiosas y el Estado a través de dos diferentes momentos: pasado y presente. Para esto son expuestos y examinados varios episodios de la historia colombiana y latinoamericana en los que esta relación ha sido clave en el desarrollo de los eventos. Además, serán citadas fuentes críticas en el tema de modo que se expongan las perspectivas principales de esta relación, a favor y en contra. Con este artículo se pretende dar un espacio de reflexión en el que se analice la influencia de la Iglesia Católica, como institución, en diferentes acontecimientos y decisiones del Estado colombiano. Su relación en el país resalta y es tema de polémica debido a la complejidad de su participación en la sociedad después de la colonia. En la actualidad, la Iglesia Católica sigue ejerciendo una influencia clave que no es desestimada ni por el Estado ni por el pueblo colombiano, incluso en varias ocasiones sobrepasa los campos de dominio que corresponden a cada uno, provocando así conflictos en los que el dogma religioso no debería influir. El artículo presenta hechos históricos fundamentales en la historia de Colombia como son: la guerra de los mil días, el plebiscito de 2016 y el proceso de paz. Además, son expuestos otros ejemplos en el contexto latinoamericano como la elección del presidente Jair Messias Bolsonaro y su manejo de la pandemia por el virus COVID-19.
Effects of social network incentives and financial incentives on physical activity and social capital among older women: a randomized controlled trial
Authors: Yamashita Ryo , Sato Shinji , Akase Ryoichi , Doi Tatsuo , Tsuzuku Shigeki , Yokoi Toyohiko , Otsuki Shingo , Harada Eisaku
Published: December 2020

Background: Financial incentives have been used to increase physical activity. However, the benefit of financial incentives is lost when an intervention ends. Thus, for this study, we combined social network incentives that leverage the power of peer pressure with financial incentives. Few reports have examined the impact of physical activity on social capital. Therefore, the main goal of this study was to ascertain whether a combination of two incentives could lead to more significant changes in physical activity and social capital during and after an intervention.Methods: The participants were 39 older women over 65 years of age in Kumamoto, Japan. The participants were randomly divided into a financial incentive group (FI group) and a social network incentive plus financial incentive group (SNI+FI group). Both groups underwent a three-month intervention. Measurements of physical activity and social capital were performed before and after the intervention. Additionally, the effects of the incentives on physical activity and social capital maintenance were measured six months postintervention. The financial incentive group received a payment ranging from US$4.40 to US$6.20 per month, depending on the number of steps taken during the intervention. For the other group, we provided a social network incentive in addition to the financial incentive. The SNI+FI group walked in groups of three people to use the power of peer pressure.Results: A two-way ANOVA revealed that in terms of physical activity, there was a statistically significant interaction between group and time (p=0.017). The FI group showed no statistically significant improvement in physical activity during the observation period. The FI group showed no statistically significant improvement in physical activity during the observation period. In terms of the value of social capital, there was no significant interaction between group and time. Conclusion: Our results suggest that social network incentives, in combination with financial incentives, are more effective for promoting physical activity than financial incentives alone among older women and that these effects can continue after an intervention. In the meantime, further studies should be conducted on the effect of physical activity on social capital.Trial registration: UMIN000038080, registered on 09/22/2019 (Retrospectively registered).
Prophylactic use of Hydroxychloroquine among Physicians working in Pandemic Hospitals
Authors: Gönenli Mehmet , Kayı İlker , Kanıtez Nilüfer Alpay , Baydaş Tuba , Köse Murat , Nalbantoğlu Emine , Keskinler Miraç Vural , Akpınar Timur , Ergönül Önder
Published: December 2020

Background: Throughout the pandemic, physicians working at the frontlines have embarked on various quests to protect themselves, and many physicians preferred the use of hydroxychloroquine (HQN) as a prophylactic agent. This study aimed to investigate the reasons leading physicians to use HQN and the effects of HQN use on physicians.Methods: This study is a cross-sectional study with a target population of physicians working in pandemic hospitals in İstanbul, Turkey. We have recruited the participants from seven different hospitals via an invitation email between May 14 and June 13, 2020. An online questionnaire, including 57 questions in total, was sent to each physician.Results: A total of 148 (26%) physicians used hydroxychloroquine for prevention. Older physicians and ones who have a story of exposure to COVID-19 patients without any protection used more prophylactic HQN. Hydroxychloroquine did not differ statistically in terms of being infected among the exposed physicians (p=0.52). Nineteen (13%) physicians using hydroxychloroquine developed side effects related to the drug. Diarrhea and nausea were the most common.Conclusion: Prophylactic HQN use was more common among the physicians older than 40 years and who had higher exposure rates to a COVID-19 patient without any protection. The physicians working at the frontlines had the highest rate of infection. Hydroxychloroquine was not effective in the prophylaxis of COVID-19 among the exposed physicians.
Trends of Malaria on Hotspot and Ivermectin Mass-drug Administration Zone of Amhara Regional State, 2020
Authors: Yenew Chalachew , Mulatu Sileshi
Published: December 2020

Background:- Public health surveillance (PHS) is the continuing organized gathering, investigation, elucidation, and well-timed distribution of health-related information for activities and program evaluation. Conducting a surveillance system evaluation is crucial for monitoring the efficacy and effectiveness of intervention programs in health care systems. This study aimed to Evaluate the Trends of Malaria in the hotspot and Ivermectin mass-drug administration Zone of Amhara Regional State, Ethiopia, 2020.Methods: - A descriptive prevalence study design was used to evaluate the surveillance system of the Awi zone selected woreda. 25 study sources were incorporated in the survey (5 District Health Offices (5HOs), 10 Health Centers (10HCs), and 10 Health Posts (10 HPs). Purposive sampling techniques were utilized. Data were obtained by communicable diseases control the standard format of systematic evaluation of four surveillance units from January to August 2020 through observation, document review, and interviewing surveillance officers and focal persons using a semi-structured Survey.Results: - Average report fullness and aptness were 97.9% and 96% respectively. The average annual malaria incidence rate was a decline from the year 2015 to 2019 with an average reduction rate of 5.5% and the average annual parasitic incidence rate was 52 (22-199). In 2019/2020, 43131 Malaria cases were reported in the zone. Supervisions were made as integrated supportive supervision in the last six months. However, there was no program specific supportive supervision of public health emergency management. Data analysis was not routinely practiced in both visited districts and was not used for decision making.Conclusions: This result revealed that the malaria incidence rate showed a remarkable decline. However, the annual parasitic incidence rate remains constant. This indicates that ivermectin did not affect malaria elimination. The structure of the surveillance information transfer as of Kebel to Zone was well organized. However, coordination and supervision of the surveillanc activities were not frequent. From those supervised health facilities, most of them are not receiving feedback. There was no budget line, written feedback, epidemic and preparedness, and a response plan regular based on supportive supervision at all visited health facilities. Depending on this, we recommend that districts and sub-city health offices should conduct regular surveillance data analysis, perform supportive supervision, avail budgets and mitigate resource constraints and improve data quality on the job training and supportive supervision. Further laboratory investigations should be done to investigate the effect of ivermectin on the parasites under laboratory conditions.
Psychomotor Skills in Root Canal Treatment: Influence of Preclinical Training Time on Clinical Performance and Confidence Level of Undergraduate Dental Students
Authors: Barakat Reem , Matoug-Elwerfelli Manal , Almohareb Rahaf , Balto Hanan
Published: December 2020

Background: Performing root canal treatment is complex and requires the development of psychomotor skills adapted to working without the advantage of vision. Students have allocated special importance to preclinical training in helping them acquire these skills. The aim of this prospective study was to investigate the influence of exposure to additional preclinical training on undergraduate students’ confidence level and clinical performance defined by technical quality and quantity of root canal treatment. Methods: Clinical root canal treatment performed by a cohort of fifth-year undergraduate dental students was followed after half of them attended an additional (elective) endodontic preclinical course the year before. Root canal treatment was radiographically evaluated according to root canal filling length, density and presence of procedural errors. Technical quality and quantity of root canal treatment performed by students who had attended the elective course (attendees) and non-attendees, were compared. All students were also invited to participate in a survey to rate their undergraduate endodontic training and confidence levels performing root canal treatment. Statistical analysis of data was performed using Person chi-square test, Fisher Freeman Halton exact test, and T-test. A p-value <0.05 was considered statistically significant. Results: No significant difference between the two groups in overall root canal treatment quality (p=0.619) was found. Although elective attendees performed significantly less procedural errors (p=0.004), non-attendees completed more root canal treatments (p=0.012). Despite, no significant difference in the reported level of confidence between the attendees and the non-attendees, significantly more elective attendees rated their undergraduate endodontic training as adequate (p=0.002).Conclusion: While there was no significant difference in overall technical quality of root canal treatment, nor confidence levels, between both groups, undergraduate students who attended additional preclinical training performed significantly fewer procedural errors. Furthermore, students who attended additional preclinical training were more satisfied with their undergraduate endodontic education.
Genome-wide Identification of PbrbHLH Family Genes, and Expression Analysis in Response to drought and Cold Stresses in Pear (Pyrus Bretschneideri)
Authors: Dong Huizhen , Chen Qiming , Dai Yuqin , Hu Wenjie , Zhang Shaoling , Huang Xiaosan
Published: December 2020

Background: The basic helix-loop-helix (bHLH) transcription factors play important roles in many processes in plant growth, metabolism and responses to abiotic stresses. Although, the sequence of Chinese white pear genome (cv. ‘Dangshansuli’) has already been reported, there is still a lack of clarity regarding the bHLH family genes and their evolutionary history. Results: In this work, a genome-wide identification of the bHLH genes in Chinese white pear was performed, and we characterized the functional roles of these PbrbHLH genes in response to abiotic stresses. Based on the phylogenetic analysis and structural characteristics, 197 identified bHLH genes could be well classified into 21 groups. Expansion of PbrbHLH gene family were mainly driven by WGD and dispersed duplication with the purifying selection from the recent WGD. The functional annotation enrichment showed that the majority of PbrbHLHs were enriched in the GO terms and KEGG pathways involved in responds to stress conditions as TFs. Transcriptomic profiles and qRT-PCR revealed that PbrbHLH7, PbrbHLH8, PbrbHLH116, PbrbHLH128, PbrbHLH160 and PbrbHLH195 were significantly up-regulated under cold and drought treatments. In addition, PbrbHLH195-silenced pear seedlings display significant reduced cold tolerance, exhibiting reduced chlorophyll content, as well as increased Electrolyte leakage and concentrations of malondialdehyde and H2O2.Conclusion: For the first time, a comprehensive analysis identified the bHLH genes in Chinese white pear and demonstrated that PbrbHLH195 is involved in the production of ROS in response to cold stress, suggesting that members of the PbrbHLH family play an essential role in the stress tolerance of pear.
The intermittent fasting-dependent gut microbial metabolite indole-3 propionate promotes nerve regeneration and recovery after injury
Authors: Giovanni Simone Di , serger elisabeth , Chadwick Jessica , Luengo Lucia , Kong Guiping , Zhou Luming , Crawford Greg , Danzi Matt , Myridakis Antonis , Brandis Alexander , Bello Adesola , De Virgiliis Francesco , Dumas Marc-Emmanuel , Strid Jessica , Dodd Dylan
Published: December 2020

The regenerative potential of mammalian peripheral nervous system (PNS) neurons after injury is critically limited by their slow axonal regenerative rate1. Since a delayed target re-innervation leads to irreversible loss of function of target organs2, accelerated axonal regeneration is required to enhance functional outcomes following injury. Regenerative ability is influenced by both injury-dependent and injury-independent mechanisms3. Among the latter, environmental factors such as exercise and environmental enrichment have been shown to affect signalling pathways that promote axonal regeneration4. Several of these pathways, including modifications in gene transcription and protein synthesis, mitochondrial metabolism and release of neurotrophins, can be activated by intermittent fasting (IF)5,6. IF has in turn been shown to increase synaptic plasticity7,8 and neurogenesis9, partially sharing molecular mechanisms with axonal regeneration. However, whether IF influences the axonal regenerative ability remains to be investigated. Here we show that IF promotes axonal regeneration after sciatic nerve crush in the mouse via an unexpected mechanism that relies upon the gram + gut microbiome and an increase of the gut bacteria-derived metabolite indole-3-propionic acid (IPA) in the serum. IPA production by Clostridium sporogenes is required for efficient axonal regeneration, and delivery of IPA after sciatic injury significantly enhances axonal regeneration, accelerating recovery of sensory function. Mechanistically, RNA sequencing analysis from sciatic dorsal root ganglia suggested a role for neutrophil chemotaxis in the IPA-dependent regenerative phenotype that was confirmed by the inhibition of neutrophil chemotaxis. Our results demonstrate for the first time the ability of a microbiome derived metabolite, such as IPA, in facilitating regeneration and functional recovery of sensory axons via an immune-mediated mechanism. Since IPA is a naturally occurring metabolite with a very favourable toxicity profile, it represents a realistic translational possibility for human axonal injuries.
Multi-material Braids for Multifunctional Laminates: Conductive Through-thickness Reinforcement
Authors: O'Keeffe Caroline , Pickard Laura Rhian , Cao Juan , Allegri Giuliano , Partridge Ivana , Ivanov Dmitry
Published: December 2020

Conventional carbon fibre laminates are known to be moderately electrically conductive in-plane, but have a poor through-thickness conductivity. This poses a problem for functionality aspects that are of increasing importance to industry, such as sensing, current collection, inductive/resistive heating, electromagnetic interference (EMI) shielding, etc. This restriction is of course more pronounced for non-conductive composite reinforcements such as glass, organic or natural fibres. Among various solutions to boost through-thickness electrical conductivity, tufting with hybrid micro-braided metal-carbon fibre yarns is one of the most promising. As a well-characterised method of through thickness reinforcement, tufting is easily implementable in a manufacturing environment. The hybridisation of materials in the braid promotes the resilience and integrity of yarns, while integrating metal wires opens up a wide range of multifunctional applications. Many configurations can be produced by varying braid patterns and the constituting yarns/wires. A predictive design tool is therefore necessary to select the right material configuration for the desired functional and structural performance. This paper suggests a fast and robust method for generating finite-element models of the braids, validates the prediction of micro-architecture and electrical conductivity, and demonstrates successful manufacturing of composites enhanced with braided tufts.
Incidence and Risk Factors for Amputation in Patients With Diabetes in Japan: A Historical Cohort Study Using a Nationwide Claims Database
Authors: Kaneko Masanori , Fujihara Kazuya , Osawa Taeko , Yamamoto Masahiko , Harada Mayuko Yamada , Kitazaws Masaru , Matsubayashi Yasuhiro , Yamada Takaho , Seida Hiroyasu , Kodama Satoru , Sone Hirohito
Published: December 2020

Background: Because amputation negatively affects the quality of life of patients with diabetes and increases the risk of cardiovascular events and mortality, predictors of amputation must be identified. However, no large cohort studies have been conducted regarding the incidence of amputation in patients with diabetes in East Asia.Methods: We analyzed data from a nationwide claims database in Japan accumulated from 2008–2016, involving 17,288 patients with diabetes aged 18–72 y (2942 women, mean age 50.2 y, HbA1c 7.2%).Results: The mean follow-up time was 5.3 years, and 16 amputations occurred (0.17/1000 person-years). Multivariate Cox regression analysis showed that age and HbA1c levels were independent predictors of amputation (hazard ratios [HRs], 1.09 and 1.43; 95% confidence intervals [CIs], 1.01–1.16 and 1.12–1.82, respectively). Compared with patients aged <60 y and with HbA1c <8%, the HR for patients aged ≥60 y and with HbA1c ≥8% was 32.1 (95% CI, 7.30–141.2).Conclusions: Improved glycemic control may lower amputation risk.
Adenosine A1 Receptor Ligands Bind to α-Synuclein: Implications for α-Synuclein Misfolding and α-Synucleinopathy in Parkinson’s Disease
Authors: Jakova Elisabet , Moutaoufik Mohamed Taha , Lee Jeremy , Babu Mohan , Cayabyab Francisco Sandoval
Published: December 2020

Background:Accumulating α-synuclein (α-Syn) aggregates in neurons and glial cells are the staples of many synucleinopathy disorders, such as Parkinson’s disease. Since brain adenosine becomes greatly elevated in ageing brains and chronic adenosine A1 receptor (A1R) stimulation leads to neurodegeneration, we determined whether adenosine or A1R receptor ligands mimic the action of known compounds that promote α-Syn aggregation (e.g., the amphetamine analogue 2-aminoindan) or inhibit α-Syn aggregation (e.g., Rasagiline metabolite 1-aminoindan). In the present study, we determined whether adenosine, the A1R receptor agonist N6-Cyclopentyladenosine (CPA) and antagonist 8-Cyclopentyl-1,3-dipropylxanthine (DPCPX) directly interact with α-Syn to modulate α-Syn aggregation and neurodegeneration of dopaminergic neurons in the substantia nigra (SN). Methods:Nanopore analysis and molecular dynamics simulation were used to test the binding properties of CPA and DPCPX with α-Syn in vitro. Sprague-Dawley rats were administered 7-day intraperitoneal injections of the A1R ligands and 1- and 2-aminoindan, and levels of α-Syn aggregation and neurodegeneration were examined in the substantia nigra pars compacta region. Results:Using nanopore analysis, we showed that the A1R agonists (CPA and adenosine) interacted with the N-terminus of α-Syn, similar to 2-aminoindan, which is expected to promote a “knot” conformation and α-Syn misfolding. In contrast, the A1R antagonist DPCPX interacted with the N- and C-termini of α-Syn, similar to 1-aminoindan, which is expected to promote a “loop” conformation which prevents α-Syn misfolding. Molecular docking studies revealed that adenosine, CPA and 2-aminoindan interacted with the hydrophobic core of α-Syn N-terminus, whereas DPCPX and 1-aminoindan showed direct binding to the N- and C-terminal hydrophobic pockets. Histological and confocal imaging studies revealed that chronic treatments with CPA alone or in combination with 2-aminoindan increased α-Syn aggregation and neurodegeneration in SN pars compacta. In contrast, DPCPX and 1-aminoindan attenuated CPA-induced neurodegeneration but did not significantly reduce α-Syn aggregation.Conclusions:The results indicate A1R agonists and drugs promoting a “knot” conformation of α-Syn can cause α-synucleinopathy and increase neuronal degeneration, whereas A1R antagonists and drugs promoting a “loop” conformation of α-Syn can be harnessed for possible neuroprotective therapies to decrease α-synucleinopathy in Parkinson’s disease.
Prophylactic or therapeutic administration of Holarrhena floribunda hydro ethanol extract suppresses Complete Freund’s Adjuvant-induced arthritis in Sprague-Dawley rats    
Authors: Antwi Stephen , Oduro-Mensah Daniel , Obiri David Darko , Lewis Clara , Oduro-Mensah Ebenezer , Ocloo Augustine , Okine Laud
Published: December 2020

Ethnopharmacological relevance In Ghanaian folk medicine, Holarrhena floribunda has anecdotal use for the treatment of inflammatory conditions. A hydro ethanol extract of the stem bark has previously been shown to be effective in the management of acute inflammation and anaphylaxis in rodents.Aim of the study This study was aimed at evaluating the usefulness of H. floribunda stem bark hydro ethanol extract (HFE) for the management of chronic inflammation in a murine model.Materials and Methods Anti-arthritic effect of the extract was evaluated using Complete Freund’s Adjuvant-induced arthritis in male Sprague-Dawley rats. Using both prophylactic and therapeutic treatment models, parameters assessed included oedema, serology of inflammatory response, radiology, bone tissue histology and haematology. Data were analysed by ANOVA followed by Tukey’s multiple comparisons post hoc test.Results HFE at 50–500 mg/kg dose-dependently [P ≥ 0.0354 (prophylactic) and P ≥ 0.0001 (therapeutic)] inhibited swelling of the injected paw upon prophylactic [≤ 81.26 % (P < 0.0001)] or therapeutic [≤ 67.92 % (P < 0.01)] administration — and prevented spread of arthritis to the contralateral paw. Inflammation alleviation activity of HFE was further demonstrated by decrease in arthritis score, radiologic score and erythrocyte sedimentation rate. HFE at all doses significantly reduced serum IL-1α (P < 0.0197), and 500 mg/kg HFE reduced serum IL-6 (P = 0.0032). In contrast, serum concentrations of IL-10, protein kinase A and cyclic adenosine monophosphate were enhanced (P ≤ 0.0436). HFE consistently showed better prophylactic activity than when administered therapeutically.Conclusions The data demonstrate that HFE suppresses CFA-induced arthritis and modulates regulators of inflammation; including IL-1α, -6 and -10 which also play mediatory roles in several immune response pathways. These make HFE a strong candidate for development as an agent for management and modulation of inflammation and the inflammatory response, including immune response-related adverse events such as seen in severe COVID-19.
Building Community and Medical School Partnerships: Impact on Undergraduate Medical Education and Research
Authors: Nauhria Samal , Derksen Irene , Nauhria Shreya , Basu Amitabha
Published: December 2020

Background: Community service provides avenues for social learning in medical education. Partnerships between medical schools and local healthcare agencies has paved the path for an active participation of a medical student in the community. This seems to have a positive impact on the medical knowledge and skills of students and also leads to a betterment of healthcare services for the community. National accreditation agencies and medical boards have emphasized that medical schools should provide opportunities for such learning to occur in the medical school curriculum. Various medical schools around the globe have adopted this active learning pedagogy and thus we wanted to explore how we can establish such a learning framework at out university.Methods: This was a qualitative study based on feedback from volunteer students who attended the annual health fare conducted in collaboration with local healthcare agencies. Two focus group interviews were recorded, transcribed and coded for thematic analyses.Results: Overall, the students enjoyed learning various clinical procedural skills. This activity was an opportunity to apply the medical knowledge learnt in classrooms. The students developed various competencies like communication skills, professionalism, team work and social responsibility. Prevalent health conditions discovered by the students included diabetes mellitus, hypertension and nutritional imbalance.Conclusions: This study explores how serving the community can bring about an educational change for a medical student. The community service framework promotes social learning, interprofessional education, peer learning and active learning amongst medical students.
Evidence for Use of Damage Control Surgery and Damage Control Interventions in Civilian Trauma Patients: A Systematic Review
Authors: Roberts Derek J. , Bobrovitz Niklas , Zygun David A. , Kirkpatrick Andrew W. , Ball Chad G. , Faris Peter D. , Stelfox Henry T.
Published: December 2020

Background: Although damage control (DC) surgery is widely assumed to reduce mortality in critically injured patients, survivors often suffer substantial morbidity, suggesting that it should only be used when indicated. The purpose of this systematic review was to determine which indications for DC have evidence that they are reliable and/or valid (and therefore in which clinical situations evidence supports use of DC or that DC improves outcomes).Methods: We searched 11 databases (1950-April 1, 2019) for studies that enrolled exclusively civilian trauma patients and reported data on the reliability (consistency of surgical decisions in a given clinical scenario) or content (surgeons would perform DC in that clinical scenario or the indication predicted use of DC in practice), construct (were associated with poor outcomes), or criterion (were associated with improved outcomes when DC was conducted instead of definitive surgery) validity for suggested indications for DC surgery or DC interventions. Results: Among 34,979 citations identified, we included 36 cohort studies and three cross-sectional surveys in the systematic review. Of the 59 unique indications for DC identified, 10 had evidence of content validity [e.g., a major abdominal vascular injury or a packed red blood cell (PRBC) exceeding the critical administration threshold], nine had evidence of construct validity (e.g., unstable patients with combined abdominal vascular and pancreas gunshot injuries or an iliac vessel injury and intraoperative acidosis), and six had evidence of criterion validity (e.g., penetrating trauma patients requiring >10 U PRBCs with an abdominal vascular and multiple abdominal visceral injuries or intraoperative hypothermia, acidosis, or coagulopathy). No studies evaluated the reliability of indications.Conclusions: Few indications for DC surgery or DC interventions have evidence supporting that they are reliable and/or valid. DC should be used with respect for the uncertainty regarding its effectiveness, and only in circumstances where definitive surgery cannot be entertained.
Implementing Healthy Food Environment Policies in New Zealand: Nine Years of Inaction.
Authors: Mackay Sally , Gerritsen Sarah , Sing Fiona , Vandevijvere Stefanie , Swinburn Boyd
Published: December 2020

Background: The INFORMAS Healthy Food Environment Policy Index (Food-EPI) was developed to evaluate the degree of implementation of widely recommended food environment policies by national governments against international best practice, and has been applied in New Zealand in 2014, 2017 and 2020. This paper outlines the 2020 Food-EPI process and compares policy implementation and recommendations with the 2014 and 2017 Food-EPI. Methods: In March-April 2020, a national panel of over 50 public health experts participated in Food-EPI. Experts rated the extent of implementation of 47 ‘good practice’ policy and infrastructure support indicators compared to international best practice, using an extensive evidence document verified by government officials. Experts then proposed and prioritised concrete actions needed to address the critical implementation gaps identified. Progress on policy implementation and recommendations made over the three Food-EPIs was compared. Results: In 2020, 60% of the indicators were rated as having ‘low’ or ‘very little if any’ implementation compared to international benchmarks; less progress than 2017 (47%) and similar to 2014 (61%). Of the nine priority actions proposed in 2014, there was only noticeable action on one (Health Star Ratings). The majority of actions were therefore proposed again in 2017 and 2020. In 2020 the proposed actions were broader, reflecting the need for multi-sectoral action to improve the food environment, and the need for a mandatory approach in all policy areas. Conclusions: There has been little to no progress in the past three terms of government (nine years) on the implementation of policies and infrastructure support for healthy food environments, with implementation overall regressing between 2017 and 2020. The proposed actions in 2020 have reflected a growing movement to locate nutrition within the wider context of planetary health and with recognition of the social determinants of health and nutrition, resulting in recommendations that will require the involvement of many Government entities to overcome the existing policy inertia. The increase in food insecurity due to Covid-19 lockdowns may provide the impetus to stimulate action on food polices.
An Assessment of the Implementation of the Re-structured Community Health Fund in Gairo District in Tanzania
Authors: Maluka Stephen , Asantemungu Raphael
Published: December 2020

While the government of Tanzania has been implementing community health fund (CHF) for more than two decades, the uptake of the scheme has been persistently low due to management and performance problems. As a response, from 2011 a new initiative was adopted that changed the overall structure, management and benefit packages of the CHF. This paper assesses the implementation of the newly re-structured CHF in Gairo District in Morogoro Region. This study employed a descriptive qualitative case study design using three types of data collection techniques, namely individual interviews (n=14), focus group discussions (n=4) and document review. A thematic approach was used to analyse the data. Findings show that the re-structured CHF has improved the pooling and provider payment mechanism compared to the old CHF. Benefit packages have been expanded to include referral services up to regional level. However, stakeholders, including community members, had negative perceptions of the restructured CHF owing to high annual premium rates, low incentive to enrolment officers, weak registration network and poor quality of health care services. In order to improve CHF performance and achieve universal health coverage, the central Government needs to invest more in the improvement of the quality of health care services, particularly availability of drugs and medical supplies. Additionally, the government should make CHF scheme compulsory to all members of the community who do not have alternative health insurance.