bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring Determinants of Hand Hygiene among Hospital nurses: a qualitative study
Authors: Ghaffari Mohtasham , Rakhshanderou Sakineh , Safari-Moradabadi Ali , Barkati Hassan
Published: December 2020

Background: The present research is a qualitative one aiming to determine factors affecting hand-hygiene behavior of the nursing staff in Shariati Hospital of Tehran, Iran. Methods: This was a qualitative study performed using content analysis approach. Considering the aim of the study, 16 in-depth semi-structured interviews were held with the nursing staff of Shariati Hospital of Tehran University of Medical Sciences. A convenient sampling was performed and continued until data saturation and until no new codes and categories were obtained. Data were analyzed through a qualitative content analysis based on the Graham and landsman method. Directed qualitative content analysis was done in order to analyze the data. Results: The results of this study revealed 3 main themes in the Theory of Planned Behavior (TPB) (attitude, subjective norms and perceived behavioral control) and 8 main themes in the outside the framework (environment, perceptions, life style, morality, education, organizational culture, salience and personality). Conclusion: Due to the other factors also found in this study, an integration of theories and models for designing of interventions is recommended to increase adherence to hand hygiene behavior.
Long-term radiographic outcomes and functional evaluation of ulnar shortening osteotomy in patients with ulnar impaction syndrome and reverse oblique sigmoid notch: a retrospective case series study
Authors: Huang Hui-Kuang , Lee Steve K. , Huang Yi-Chao , Yin Cheng-Yu , Chang Ming-Chau , Wang Jung-Pan
Published: December 2020

Background: Ulnar shortening osteotomy (USO) is an effective treatment for ulnar impaction syndrome. However, there has been a concern of osteoarthritis (OA) developing at the distal radioulnar joint (DRUJ) if USO is performed on patients with a reverse oblique sigmoid notch. This study aimed to evaluate the radiographic and functional outcomes following USO in patients with a reverse oblique sigmoid notch.Methods: We retrospectively reviewed our patients with a reverse oblique sigmoid notch who underwent USO to treat ulnar impaction syndrome between 2002 and 2013. We evaluated the radiographic changes of the DRUJ and the patients’ functional outcomes.Results: We enrolled 22 patients (22 wrists) with an average age at operation of 49.6 years and mean follow-up of 93.2 (range, 36 - 179; SD 38.2) months. We found that there were changes in the inclination angle of the sigmoid notch, from an average of reverse oblique 14.9o (range, 11o - 23o; SD 3.4o) preoperatively to a more parallel 5.1o (range, 0o - 11o; SD 3.2o) at the final follow-ups. The functional results at the final follow-ups were good with a mean VAS for pain of 0.2 (range, 0 - 1; SD 0.4) at rest and 1.3 (range, 0 - 3; SD 0.9) during activity, QuickDASH of 15.1 (range, 2.3 - 34.1; SD 8.8), and modified Mayo Wrist Score of 91.6 (range, 70-100; SD 6.4). Seven wrists (31.8%) were noted to have OA changes, but the wrists did not exhibit a significantly worse function when compared to wrists without OA changes, except for supination motion and grip strength.Conclusions: For those patients with a reverse oblique sigmoid inclination following USO, the inclination angle would have a tendency to become more parallel and some patients would develop OA changes at the DRUJ, but the functional outcomes could still be good in the long term. The reverse oblique sigmoid inclination seems not to be an absolute contraindication for USO.
Aboriginal Community Controlled Health Organisations address health equity through action on the social determinants of health of Aboriginal and Torres Strait Islander peoples in Australia.
Authors: Pearson Odette , Schwartzkopff Kate , Dawson Anna , Hagger Christina , Karagi Agape , Davy Carol , Brown Alex , Braunack-Mayer Annette
Published: December 2020

Background: Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented.Methods: The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed. A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. Results: Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes.Conclusions: This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.
Fruit ripening-associated leucylaminopeptidase with cysteinylglycine dipeptidase activity from durian suggests its involvement in glutathione recycling
Authors: Panpetch Pawinee , Sirikantaramas Supaart
Published: December 2020

Background: Durian ( Durio zibethinus L.) is a highly popular fruit in Thailand and several other Southeast Asian countries. It is abundant in essential nutrients and sulphur-containing compounds such as glutathione (GSH) and γ-glutamylcysteine (γ-EC). Cysteinylglycine (Cys-Gly) is produced by GSH catabolism and occurs in durian fruit pulp. Cysteine (Cys) is a precursor of sulphur-containing volatiles generated during fruit ripening. The aforementioned substances contribute to the strong odour and flavour of the ripe fruit. However, the genes encoding plant Cys-Gly dipeptidases are unknown. The aim of this study was to measure leucylaminopeptidase (LAP) activity in durian fruit pulp. Results: We identified DzLAP1 and DzLAP2, which the former was highly expressed in the fruit pulp. DzLAP1 was expressed at various ripening stages and in response to ethephon/1-MCP treatment. Hence, DzLAP1 is active at the early stages of fruit ripening. DzLAP1 is a metalloenzyme ~ 63 kDa in size. It is activated by Mg 2+ or Mn 2+ and, like other LAPs, its optimal alkaline pH is 9.5. Kinetic studies revealed that DzLAP1 has K m = 1.62 mM for its preferred substrate Cys-Gly. DzLAP1-GFP was localised to the cytosol and targeted the plastids. In planta Cys-Gly hydrolysis was confirmed for Nicotiana benthamiana leaves co-infiltrated with Cys-Gly and expressing DzLAP1 . Conclusions: DzLAP1 has Cys-Gly dipeptidase activity in the γ-glutamyl cycle. The present study revealed that the LAPs account for the high sulphur-containing compound levels identified in fully ripened durian fruit pulp.
Construction of homologous cancer cell membrane camouflage in a nano-drug delivery system for the treatment of lymphoma
Authors: Zhao Qiangqiang , Sun Xiaoying , Wu Bin , Shang Yinghui , Huang Xueyuan , Dong Hang , Liu Haiting , Chen Wansong , GUI RONG , Li Jian
Published: December 2020

BackgroundNon-Hodgkin's lymphoma (NHL) possesses great heterogeneity in cytogenetics, immunophenotype and clinical features, and chemotherapy currently serves as the main treatment modality. Although employing monoclonal antibody targeted drugs has significantly improved its overall efficacy, various patients continue to suffer from drug resistance or recurrence. Chinese medicine has long been used in the treatment of malignant tumors. Therefore, we constructed a low pH value sensitivity drug delivery system based on the cancer cell membrane modified mesoporous silica nanoparticles loaded with traditional Chinese medicine, which can reduce systemic toxicity and improve the therapeutic effect for the targeted drug delivery of tumor cells.ResultsAccordingly, this study put forward the construction of a nano-platform based on mesoporous silica nanoparticles (MSNs) loaded with the traditional Chinese medicine isoimperatorin (ISOIM), which was camouflaged by the cancer cell membrane (CCM) called CCM@MSNs-ISOIM. The proposed nano-platform has characteristics of immune escape, anti-phagocytosis, high drug loading rate, low pH value sensitivity, good biocompatibility and active targeting of the tumor site, blocking the lymphoma cell cycle and promoting mitochondrial-mediated apoptosis.ConclusionsFurthermore, this study provides a theoretical basis in finding novel clinical treatments for lymphoma.
WNK1 Antagonist Decreased Sevoflurane-induced Neurotoxicity in HT22 Hippocampal Neurons via the WNK1/NKCC1 Signalling Pathway
Authors: Bai Ya-Fan , Li Wen-Jing , Zhang Li , Li Jun-Fa , An Li-Xin
Published: December 2020

Background: The GABAAR plays an important role in the neurotoxicity caused by sevoflurane, but the mechanism of its regulation in this context is unknown. The present study aimed to reveal the WNK1/NKCC1 pathway as a regulator of the neurotoxicity caused by sevoflurane on the HT22 hippocampal neuron cell line. Methods: HT22 cultured hippocampal neurons were divided into three groups: control group, 4.1% sevoflurane treatment group for 6h, WNK-463 (specific antagonist of WNK1, 1µmol) + sevoflurane treatment group. Cell viability and the optimum concentration of WNK-463 were measured by MTS method. Cell apoptosis was detected by Tunel method, and the content of cleaved caspase-3 protein apoptosis factor was detected by Western blot. Pathway protein detection including the expression of WNK1, NKCC1 were detected. Calcium imaging measures intracellular calcium ion concentration and verifies downstream targets.Results: The neurotoxic effects of sevoflurane on hippocampal neurons were observed. As setting the results of control group is “1”, compared with sevoflurane group, WNK-463 downregulated the protein expression of cleaved caspase-3 (1.96±0.49 vs 1.29±0.38), increased cell viability (0.68 vs 0.96) and decreased apoptosis (13.31±4.67/vision vs 7.05±3.82/vision, ***P < 0.001). Compared with the control group, sevoflurane treatment increased the expression of WNK1 kinase and NKCC1 protein, whereas WNK-463 reversed this increase without affecting the control HT22 cells (****P < 0.0001). Compared with the control group, sevoflurane exposure in HT22 cells increased intracellular Ca2+ concentrations, while WNK-463 reversed this change (1.0 vs 2.08±1.36 vs 1.26±0.77, **P < 0.01). Conclusion: This study demonstrated a neuroprotective role of the WNK1 antagonist WNK-463 in sevoflurane-induced neurotoxicity. WNK-463 promoted hippocampal neuron viability and reduced the apoptosis and intracellular calcium overload caused by sevoflurane on HT22 hippocampal neurons, possibly via the modulation of the WNK1/NKCC1 pathway.
Causal relationships between genetically determined metabolites and human intelligence: A Mendelian randomization study
Authors: Yang Jian , Zhao Binbin , Qian Li , Gao Fengjie , Fan Yanjuan , He Xiaoyan , Ma Qingyan , Yang Lihong , Yan Bin , Wang Wei , Ma Xiancang
Published: December 2020

Intelligence predicts important life and health outcomes, but the biological mechanisms underlying differences in intelligence are not yet understood. The use of genetically determined metabotypes (GDMs) to understand the role of genetic and environmental factors, and their interactions, in human complex traits has been recently proposed. However, this strategy has not been applied to human intelligence. Here we implemented a two-sample Mendelian randomization (MR) analysis using GDMs to assess the causal relationships between genetically determined metabolites and human intelligence. The standard inverse-variance weighted (IVW) method was used for the primary MR analysis and three additional MR methods (MR-Egger, weighted median, and MR-PRESSO) were used for sensitivity analyses. Using 25 genetic variants as instrumental variables (IVs), our study found that 5-oxoproline was associated with better performance in human intelligence tests (PIVW = 9·25×10-5). The causal relationship was robust when sensitivity analyses were applied (PMR-Egger = 0·0001, PWeighted median = 6·29×10-6, PMR-PRESSO = 0·0007), and repeated analysis yielded consistent result (PIVW = 0·0087). Similarly, also dihomo-linoleate (20:2n6) and p-acetamidophenylglucuronide showed robust association with intelligence. Our study provides novel insight by integrating genomics and metabolomics to estimate causal effects of genetically determined metabolites on human intelligence, which help to understanding of the biological mechanisms related to human intelligence.
Comparative analysis of COVID-19 guidelines from six countries: A qualitative study on the US, China, South Korea, the UK, Brazil and Haiti
Authors: YOO JI YOUN , Dutra Samia Valeria Ozorio , Fanfan Dany , Sniffen Sarah , Wang Hao , Siddiqui Jamile , Song Hyo-Suk , Bang Sung Hwan , Kim Dong Eun , Kim Sihoon , Groer Maureen
Published: December 2020

Background: In late January, a worldwide crisis known as COVID-19 was declared a Public Health Emergency of International Concern by the WHO. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. It was a significant issue to prevent and control COVID-19 on both national and global scales due to the dramatic increase in confirmed cases worldwide. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals on how to take action to decrease the spread of COVID-19. We aimed to identify the differences and similarities between six different countries' (US, China, South Korea, UK, Brazil and Haiti) government-provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases.Methods: To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Documents were purposively sampled (N=55) and analyzed using content analysis.Results: The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country’s healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction.Conclusion: In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus’s spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries’ response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country’s communities and healthcare systems.
Psychometric Properties of the Moral Injury Symptom Scale among Chinese Health Professionals during the COVID-19 Pandemic
Authors: Wang Zhizhong , Koenig Harold G , Tong Yan , Wen Jing , Sui Mu , Liu Hongyu , Liu Guangtian
Published: December 2020

Background Moral injury among physicians and other health professionals has attracted attention in the mainstream literature, this study aim to assess the psychometric properties of the 10-item Moral Injury Symptoms Scale-Health Professional (MISS-HP) among healthcare professionals in China. Methods: A total of 583 nurses and 2,423 physicians were recruited from across mainland China. An online survey was conducted from March 27 to April 26, 2020 (during the middle of the COVID-19 pandemic) using the Chinese version of the MISS-HP. Reliability was assessed by internal consistency reliability and test-retest reliability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to determine scale structure. Results: Cronbach’s α of the scale for both samples was acceptable (0.71 for nurses and 0.70 for physicians), as was test-retest reliability ( ICCs for the individual items ranged from 0.41 to 0.74, with 0.77 for the overall scale in physicians). EFA suggested three factors, and the CFA indicated good fit to the data. Convergent validity was demonstrated with the 4-item Expressions of Moral Injury Scale (r=0.45 for physicians, r=0.43 for nurses). Discriminant validity was demonstrated by correlations with burnout and well-being (r=0.34–0.47), and concurrent validity was suggested by correlations with depression and anxiety symptoms (r=0.37–0.45). Known groups validity was indicated by a higher score in those exposed to workplace violence (B=4.16, 95%CI: 3.21-5.10, p<0.001). Conclusions: The MISS-HP demonstrated acceptable reliability and validity in a large sample of physicians and nurses in mainland China, supporting its use as a screening measure for moral injury symptoms among increasingly stressed health professionals in this country during the COVID-19 pandemic.
Presumed Sympathetic Ophthalmia after Scleral Buckling Surgery: Case Report
Authors: Hosseini Seyedeh Maryam , Shoeibi Nasser , Zadeh Mahdieh Azimi , Ghasemi Mahdi , Abrishami Mojtaba
Published: December 2020

Background: Scleral buckling (SB) is usually considered an extraocular operation, and it is presumed to have low risk of sympathetic ophthalmia (SO). We aimed to report a rare case of presumed SO in a young female patient following SB.

Case Presentation: A nineteen year-old female patient was referred for visual loss in her left eye because of macula off inferior longstanding rhegmatogenous retinal detachment (RD). Best corrected visual acuity (BCVA) was 20/400 in the left eye. SB with 360 degrees encircling band and inferior segmental tire, with one spot cryoretinopexy at the break site and subretinal fluid drainage was performed. One week after operation, BCVA was improved to 20/80 and retina was totally attached. Six weeks later, patient came with severe visual loss in both eyes as counting finger 1 meter. Bilateral multifocal serous RD and vitreous cells was found. The patient was diagnosed as sympathetic Ophthalmia, and treated with intravenous corticosteroid pulse therapy and mycophenolate mofetil. The inflammation was controlled and serous RD resolved after five days intravenous treatment and was not relapsed after six months. BCVA became 20/20 in right eye and 20/50 in the left eye after six months. Systemic workup was negative for any extraocular disease or systemic involvement.

Conclusion: As SB usually considered as a procedure without manipulating intraocular tissues, it is considered to have low risk for SO. In this report, we presented SO occurance after successful SB. Inciting the choroid and retinal pigment epithelium with cryoretinopexy or perforating for drainage may induce SO.
MtNIP5;1, a novel Medicago truncatula boron diffusion facilitator induced under deficiency
Authors: Granado-Rodríguez Sara , Bolaños Luis , Reguera Maria
Published: December 2020

Background: Legumes comprise important crops that offer major agronomic benefits, including the capacity of establishing symbiosis with rhizobia, fixing atmospheric N2. It has been proven that legumes are particularly susceptible to boron (B) stress, which leads to important yield penalties. Boron (B) deficiency or toxicity in plants causes the inhibition of growth and an altered development. Under such conditions, the participation of two distinct protein families (the major intrinsic protein family MIP and the Boron transporter family BOR) is required to minimize detrimental effects caused by B stress. However, in legumes, little is known about the transport mechanisms responsible for B uptake and distribution, especially under deficiency. Results: A Medicago truncatula protein, MtNIP5;1 (Medtr1g097840) (homologous to the Arabidopsis thaliana AtNIP5;1) was identified as a novel legume B transporter involved in B uptake under deficiency. Further analyses revealed that this M. truncatula aquaporin expression was boron-regulated in roots, being induced under deficiency and repressed under toxicity. It localizes at the plasma membrane of root epidermal cells and in nodules, where B plays pivotal roles in symbiosis. Furthermore, the partial complementation of the nip5;1-1 A. thaliana mutant phenotype under B deficiency supports a functional role of MtNIP5;1 as a B transporter in this legume model plant. Conclusions: The results here presented support a functional role of MtNIP5;1 in B uptake under deficiency and provides new insights into B transport mechanisms in legume species.
LncRNA HOXA-AS2 promotes glioblastoma carcinogenesis by targeting miR-885-5p/RBBP4 axis
Authors: Shou Jixin , Gao Haidong , Cheng Sen , Wang Bingbing , Guan Haibo
Published: December 2020

Background: LncRNA HOXA-AS2 has been found in the literature to deteriorate glioblastoma. However, its regulatory mechanism is yet to be fully investigated. Our study focused chiefly on the interaction and role of the HOXA-AS2/miR-885-5p/RBBP4 axis in the development of glioblastoma. Methods: qRT-PCR analysis was performed to detect the expression of lncRNA, miRNA and mRNA in glioblastoma tissues and cells. Dual-luciferase assay, RIP assay and RNA pull-down assay were later carried out to reveal the interactions among HOXA-AS2, miR-885-5p and RBBP4. After that, CCK-8 assay, BrdU assay, nude mice xenografting assay, western blot assay, and flow cytometry were carried out to analyze the effect of the HOXA-AS2/miR-885-5p/RBBP4 axis on glioblastoma samples. Results: HOXA-AS2 and RBBP4 were found to be overexpressed in glioblastoma. Experimental results showed that HOXA-AS2 and RBBP4 contributed to the tumorigenesis of glioblastoma cells. However, miR-885-5p was observed to be downregulated in glioblastoma. Findings also indicated that HOXA-AS2 could negatively regulate miR-885-5p, thereby enhancing RBBP4 expression. Conclusion: Overall, HOXA-AS2 promoted the tumorigenesis of glioblastoma by targeting and regulating miR-885-5p to induce the expression of RBBP4.
Mental health status of Chinese residents during the COVID-19 epidemic
Authors: Jiang Wen , Liu Xuerong , Zhang Jingxuan , Feng Zhengzhi
Published: December 2020

Background: To investigate the mental health status of Chinese residents during the epidemic of COVID-19, as well as to identify the positive and negative factors and regulatory effect of negative cognitive processing bias on mental health.Methods: A total of 60199 residents in China were surveyed via an internet-based survey containing a general questionnaire, such as the self-rating depression scale, the state anxiety inventory, and the negative cognitive processing bias questionnaire. An ordered multiple logistic regression analysis model was used to analyze the collected data. Results: The survey revealed mild, moderate, and severe depressive symptoms in 62.65%, 11.33%, and 6.14% participants, respectively, and mild, moderate, and severe anxiety symptoms in 33.21%, 41.27%, and 22.99% participants, respectively. Multiple logistic regression analysis showed that factors, such as female gender, being older than 55 years, high school education level, medical staff, marital conflicts, negative attention bias, rumination, and death growth rate, positively affected depression and anxiety symptoms. The good family functionality, democratic working atmosphere, and a myriad of social activities negatively affected the level of depressive and anxiety symptoms.Conclusion: Chinese residents exhibited a high prevalence of anxiety and depressive symptoms during the epidemic. Thus, psychological interventions should focus on the vulnerable groups, and cognitive training should focus on reducing the negative cognitive processing bias. This might be an effective way to alleviate the mental stress of the general public during the COVID-19 pandemic.
When can total knee arthroplasty be safely performed following prior arthroscopy?
Authors: Ma Jin-Ning , Li Xiao-Lin , Liang Pan , Yu Sheng-Li
Published: December 2020

Background The optimal time to perform a total knee arthroplasty (TKA) after knee arthroscopy (KA) was controversial in the literature. We aimed to 1) explore the effect of prior KA on the subsequent TKA; 2) identify who were not suitable for TKA in patients with prior KA; and 3) determine the timing of TKA following prior KA.Methods We retrospectively reviewed 87 TKAs with prior KA and 174 controls using propensity score matching in our institution. The minimum followup was 2 years. Postoperative clinical outcomes were compared between groups. Kaplan-Meier curves were created with reoperation as an end point. Multivariate Cox proportional hazards regressions were performed to identify risk factors of severe complications in the KA group. The two-piecewise linear regression analysis was performed to examine the optimal timing of TKA following prior KA.Results The all-cause reoperation, revision and complication rates of KA group were significantly higher than those of control group (p<0.05). The survivorship of KA group and control group was 92.0% and 99.4% at the 2-year followup (p=0.002), respectively. Male (Hazards ratio [HR]=3.2) and prior KA for anterior cruciate ligament (ACL) injury (HR=4.4) were associated with postoperative complications in the KA group. There was a non-liner relationship between time from prior KA to TKA and postoperative complications with the turning point at 9.4 months.Conclusion Prior KA is associated with worse outcomes following subsequent TKA, especially male patients and those with prior KA for ACL injury. The optimal timing of TKA may be 9 months after prior KA. Surgeons should keep these findings in mind when treating patients who are scheduled to undergo TKA with prior KA.
Epidemic and molecular characterization of fluoroquinolone-resistant Shigella dysenteriae 1 isolates from calves with diarrhea
Authors: Cao Mingze , Wang Weiwei , Zhang Liwei , Liu Guanhui , Zhou Xuzheng , Li Bing , Shi Yuxiang , Zhu Zhen , Zhang Jiyu
Published: December 2020

Background: The widespread distribution of antimicrobial-resistant Shigella has become a recurrent challenge in many parts of the developing world. Previous studies indicate that the host of Shigella has expanded from humans to animals. This study aimed to investigate the prevalence of fluoroquinolone resistance and associated molecular characterization of S. dysenteriae 1 isolated from calves. Results: All 38 unduplicated S. dysenteriae 1 isolates were collected from calves in Gansu Province from October 2014 to December 2016. According to MLST and PFGE analysis, these isolates were separated into 4 and 28 genotypes, respectively. The most common STs identified were ST228 (34.21%, 13/38) and ST229 (39.47%, 15/38), which were first found in the present study. All isolates harbored virulence genes, and the incidence of the seven virulence genes were ipaH (100%), ipaBCD (92.11%), stx (73.68%), ial (57.89%), sen (28.95%), set1A and set1B (0%). According to the results of antimicrobial susceptibilities, 76.32% (29/38) were resistant to fluoroquinolone and showed multidrug resistance. In a study on the polymorphism of quinolone resistance–determining region (QRDR) of gyrA/B and parC/E genes, we identified two mutations in gyrA (Ser83→Leu and Asp87→Asn) and parC (Ser80→Ile and Ser83→Leu), respectively. Among them, 55.17% (16/29) of resistant strains had the gyrA point mutations (Ser83→Leu) and parC point mutation (Ser83→Leu). Moreover, 41.38% (12/29) of isolates had all five point mutations of gyrA and parC. In addition, the prevalence of the plasmid-mediated quinolone resistance (PMQR) determinant genes was also investigated. All 29 fluoroquinolone-resistant isolates were positive for the aac(6’)-Ib-cr gene but negative for qepA, except for SD001. In addition, only 6 (20.69%, 6/29) isolates harbored the qnr gene, including two with qnrB (6.90%, 2/29) and four with qnrS (13.79%, 4/29). Conclusion: Given the increased common emergence of multidrug resistant isolates, uninterrupted surveillance will be necessary to understand the actual epidemic burden and control this infection.
Temperament and character of patients with alcohol toxicity during COVID -19 pandemic
Authors: Estedlal AliReza , Mani Arash , Vardanjani Hossein Molavi , Kamali Mahsa , Zarei Leila , Heydari Seyed Taghi , Lankarani Kamran B
Published: December 2020

Background: Corona virus epidemic may be acts as a stressor or trauma that affects both physical health and mental health. People exhibited various reactive behaviors to confront with this stressful situation. In Iran, one of the common motives for alcohol consumption is to scape problems and cope with stresses. It has been shown that personality factors influence alcohol consumption, since they are associated with drinking motives. The main purpose of this study was to investigate the correlation between temperament and character and alcohol abuse.Methods: This cross-section study was conducted on 135 alcohol intoxicated patients admitted to emergency room in March 2020 and 255 participants who were randomly selected from public in Shiraz. A questionnaire consisted of TCI (Temperament and character inventory) and several questions about COVID-19 pandemic. It was completed by a trained interviewer using the matched answer technique. Demographic factors were self-reported. Results: Among the alcohol intoxicated group, 117 (86.7%) were males and 18(13.3%) were females. The mean age of the participants was 32.43±10.81 years. Among control group, 99 (38.8%) were males and 156 (61.2%) were females. The mean age of control group was 33.12±14.77 years. Alcohol toxicity was mostly observed among the young males (male/female ratio was 6.45). Mean scores of novelty seeking, harm avoidant, and self-transcendent were higher in the alcohol toxicity group than normal population (P<0.01). Mean scores of reward dependent, cooperativeness, and self-directedness were higher in normal population than the alcohol toxicity group (P<0.001). The mean score of persistence was not significant in methanol intoxicated and normal population groups (P=0.718). Conclusion: Alcohol intoxicated patients had higher scores of novelty-seeking and self-transcendent and lower scores of reward-dependency scores, cooperativeness and self-directedness. These scores are associated with higher likelihood of personality disorders.
Developing a complex intervention to support pregnant women with mild to moderate anxiety: application of the Medical Research Council framework
Authors: Evans Kerry , Spiby Helen , Morrell Jane C
Published: December 2020

Background: To design and develop an intervention to support women with symptoms of mild to moderate anxiety in pregnancy. Methods: The development followed the MRC framework for complex interventions, utilising psychological theory, review level evidence and professional and public involvement. Two systematic reviews were completed which helped identify potentially beneficial intervention components. The theory underpinning the components was explored to consider the potential benefit for women with mild to moderate anxiety symptoms in pregnancy. Methods of delivering the intervention within maternity services were explored. The intervention comprised: group discussions, one to one support and assisted self-help resources. Midwives were identified as ideally placed to facilitate the intervention supported by midwifery support workers. A bespoke training package was provided by subject experts to prepare the facilitators. Results: The absence of established interventions and a paucity of evidence based approaches for pregnant women with symptoms of mild to moderate anxiety indicated the need for a rigorous and systematic approach to the intervention design. This approach led to the development of an intervention feasible for implementation in maternity care systems tailored to the needs of pregnant women. The involvement of a multi-professional advisory team and active engagement of service users helped to consider the acceptability of the intervention for women and the feasibility of delivering the intervention in the context of maternity care. Conclusion: The MRC Framework provided useful overarching guidance to develop a midwife facilitated intervention for women with symptoms of anxiety in pregnancy. The framework assisted the development of a robust rationale for each intervention component and considered the processes of evaluation and implementation into maternity care systems.
Genome-wide identification and function analysis of ERF2 gene family in response to disease resistance against Stemphylium lycopersici in tomato
Authors: Yang Huanhuan , Sun Yaoguang , Wang Hexuan , Jiang Jingbin , Li Jingfu
Published: December 2020

Background: APETALA2/ethylene responsive factor (AP2/ERF) transcription factors are a plant-specific family of transcription factors and one of the largest families of transcription factors. Ethylene response factors (ERF) regulate plant growth, development, and responses to biotic and abiotic stress. In a previous study, the ERF2 gene was significantly upregulated in both resistant and susceptible tomato cultivars in response to Stemphylium lycopersici. The main purpose of this study was to systematically analyze the ERF family and to explore the mechanism of ERF2 in tomato plants resisting pathogen infection by the Virus-induced Gene Silencing (VIGS) technique.Results: In this experiment, 134 ERF genes were explored and subjected to bioinformatic analysis. This experiment divided 134 ERF members into twelve groups based on the conserved domain of the genes. The spatiotemporal expression characteristics of ERF transcription factor family genes in tomato were diverse. Combined with RNA-seq, we found that the expression of 18 ERF transcription factors increased after inoculation with S. lycopersici. In ERF2-silenced plants, the susceptible phenotype was observed after inoculation with S. lycopersici. The hypersensitive response and ROS production were decreased in the ERF2-silenced plants. Physiological analyses showed that the superoxide dismutase, peroxidase and catalase activities were lower in ERF2-silenced plants than in control plants, and the SA and JA contents were lower in ERF2-silenced plants than in control plants after inoculation with S. lycopersici. Furthermore, the results indicated that ERF2 may directly or indirectly regulate Pto, PR1b1 and PR-P2 expression and enhance tomato resistance.Conclusions: In this study, we identified and analyzed members of the tomato ERF family by bioinformatics methods and classified, described and analyzed these genes. Subsequently, we used VIGS technology to significantly reduce the expression of ERF2 in tomatoes. The results showed that ERF2 had a positive effect on tomato resistance to S. lycopersici. Interestingly, ERF2 played a key role in multiple SA, JA and ROS signaling pathways to confer resistance to invasion by S. lycopersici. In addition, ERF2 may directly or indirectly regulate Pto, PR1b1 and PR-P2 expression and enhance tomato resistance to S. lycopersici. In summary, this study provides gene resources for breeding for disease resistance in tomato.
Impact of Robinia pseudoacacia stand conversion on soil properties and bacterial community composition in Mount Tai, China
Authors: li kun , han xu , ni ruiqiang , shi ge , de-Miguel Sergio , li chuanrong , shen weixing , zhang yikun , Zhang xingzhong
Published: December 2020

Background: Robinia pseudoacacia is a widely planted pioneer tree species in reforestations on barren mountains in northern China. Because of its nitrogen-fixing ability, it can play a positive role in soil and forest restoration. After clear-cutting of planted stands, R. pseudoacacia stands become coppice plantations. The impacts of shifting from seedling to coppice stands on soil bacterial community and soil properties have not been well described. This study aims to quantify how soil properties and bacterial community composition vary between planted seedling versus coppice stands.Methods: Nine 20×20 m plots were randomly selected in seedling and coppice stands. The bulk soil and rhizosphere soil were sampled in summer 2017. Bulk soil was sampled at 10 cm from the soil surface using a soil auger. Rhizosphere soil samples were collected using a brush. The soil samples were transported to the laboratory for chemical analysis, and bacterial community composition and diversity was obtained through DNA extraction, 16S rRNA gene amplification and high-throughput sequencing.Results: The results showed that, compared to seedling plantations, soil quality decreased significantly in coppice stands, but without affecting soil exchangeable Mg2+ and K+. Total carbon (C) and nitrogen (N) were lower in the rhizosphere than in bulk soil, whereas nutrient availability showed an opposite trend. The conversion from seedling to coppice plantations was also related to significant differences in soil bacterial community structure and to the reduction of soil bacterial α-diversity. Principal component analysis (PCA) showed that bacterial community composition was similar in both bulk and rhizosphere soils in second generation coppice plantations. Specially, the conversion from seedling to coppice stands increased the relative abundance of Proteobacteria and Rhizobium, but reduced that of Actinobacteria, which may result in a decline of soil nutrient availability. Mantel tests revealed that C, N, Soil organic matter (SOM), nitrate nitrogen (NO3--N) and available phosphorus positively correlated with bacterial community composition, while a variation partition analysis (VPA) showed that NO3--N explained a relatively greater proportion of bacterial distribution (15.12%), compared with C and SOM. Surprisingly, N showed no relationship with bacterial community composition, which may be related to nitrogen transportation. Conclusions: The conversion from seedling to coppice stands reduced soil quality and led to spatial-temporal homogenization of the soil bacterial community structure in both the rhizosphere and bulk soils. Such imbalance in microbial structure can accelerate the decline of R. pseudoacacia. This may affect the role of R. pseudoacacia coppice stands in soil and forest restoration of barren lands in mountain areas.
Antimicrobial resistance and metallo-beta-lactamase producing among commensal Escherichia coli isolates from healthy children of Khuzestan and Fars provinces; Iran 
Authors: Mahmoodi Fahimeh , Rezatofighi Seyedeh Elham , Akhoond Mohammad Reza
Published: December 2020

Background: The emergence of metallo-β-lactamase (MBL)-producing isolates is alarming since they carry mobile genetic elements with great ability to spread; therefore, early detection of these isolates, particularly their reservoir, is crucial to prevent their inter- and intra-care setting dissemination and establish suitable antimicrobial therapies. The current study was designed to evaluate the frequency of antimicrobial resistance (AMR), MBL producers and identification of MBL resistance genes in Escherichia coli strains isolated from fecal samples of the healthy children under three years old. A total of 412 fecal E. coli isolates were collected from October 2017 to December 2018. The study population included healthy infants and children aged <3 years who did not exhibit symptoms of any diseases, especially gastrointestinal diseases. E. coli isolates were assessed to determine the pattern of AMR. E. coli isolates were assessed to determine the pattern of AMR, the production of extended spectrum β-lactamase (ESBL) and MBL by phenotypic methods. Carbapenem-resistant isolates were investigated for the presence of MBL and carbapenemase genes, plasmid profiling, and the ability of conjugation.Results: In sum, AMR, multi-drug resistance (MDR) and ESBL production were observed in more than 54.9%, 36.2% and 11.7% of commensal E. coli isolates, respectively. Out of six isolates resistant to imipenem and meropenem, four isolates were phenotypically detected as MBL producers. Two and one E. coli strains carried the blaNDM-1 and blaVIM-2 genes, respectively and were able to transmit imipenem resistance through conjugation. Conclusion: Our findings showed that children not exposed to antibiotics can be colonized by E. coli isolates resistant to the commonly used antimicrobial compounds and can be a good indicator for the occurrence and prevalence of AMR in the community. These bacteria can act as a potential reservoir of AMR genes including MBL genes of pathogenic bacteria and lead to the dissemination of resistance mechanisms to other bacteria.
Determinants of students' physical activity: a 12-month follow-up study in Ningxia Province
Authors: Huang Wei , Shi Xiangrong , Wang Yujie , Li Xiaoling , Gao Pengpeng , Lu Jieguo , Zhuang Jie
Published: December 2020

Background Physical activity has many health benefits for children and adolescents. However, the prevalence of physical inactivity in school-aged children and adolescents remains high in China. Many factors impact student’s moderate- and vigorous- physical activity (MVPA). This study investigated the factors associated with student's MVPA level, and the determinants of the change of student’s MVPA behavior.Methods This is a longitudinal study with a 12-month follow-up. The study samples came from 2016 and 2017 Physical Activity and Fitness in China—The Youth Study, 1597 students (aged 9-18 years) from 31 primary, junior high, and high schools, in Ningxia province, were included. Factors about the individual and external environment were measured by questionnaire at baseline and after 12 months. Multiple logistic regression was analyzed to examine the factors that impact student’s MVPA level and the determinants of the change of student’s MVPA behavior.Results There is no difference in students MVPA level between 2016 and 2017. Boys were more physically active than girls at baseline(RR 1.55, 95%CI 1.10, 2.20), as well as children than adolescents but not significant(RR 1.33, 95%CI 0.93, 1.90). Neighborhood factors associated students MVPA level significant, but all of these factors were removed from the longitudinal model(neighborhood sport event, organization, facility, et al). Individual and school factors were important for students MVPA maintaining and positively development(i.e. gender, attitude, school PE class and PA time, et al).Conclusions In conclusion, both neighborhood and school factors affect students MVPA behavior, but school play a more meaningful role in maintaining and promoting students MVPA level. In addition, the internal motivation may be more important than external environment for students MVPA level. Our research provide some evidences for future intervention program for promoting MVPA behavior, but more large samples and objective-assessed researches should be conduct to explore the determinants of MVPA.
The NeST (Neoadjuvant Systemic Therapy in Breast Cancer) Study: National Practice Questionnaire of United Kingdom Multi-Disciplinary Decision Making
Authors: Whitehead Ian , Irwin Gareth , Bannon Finian , Coles Charlotte , Copson Ellen , Cutress Ramsey , Dave Rajiv , Gardiner Matthew , Grayson Margaret , Holcombe Chris , Irshad Sheeba , O'Brien Ciara , O'Connell Rachel , Palmieri Carlo , Shaaban Abeer , Sharma Nisha , Singh Jagdeep , Potter Shelley , McIntosh Stuart
Published: December 2020

Background: Neoadjuvant systemic therapy (NST) is increasingly used in the treatment of breast cancer, yet it is clear that there is significant geographical variation in its use in the UK. This study aimed to examine stated practice across UK breast units, in terms of indications for use, radiological monitoring, pathological reporting of treatment response, and post-treatment surgical management. Methods: Multidisciplinary teams (MDTs) from all UK breast units were invited to participate in the NeST study. A detailed questionnaire assessing current stated practice was distributed to all participating units in December 2017 and data collated securely usingREDCap. Descriptive statistics were calculated for each questionnaire item.Results: Thirty-nine MDTs from a diverse range of hospitals responded. All MDTs routinely offered neoadjuvant chemotherapy (NACT) to a median of 10% (range 5-60%) of patients. Neoadjuvant endocrine therapy (NET) was offered to a median of 4% (range 0-25%) of patients by 66% of MDTs. The principal indication given for use of neoadjuvant therapy was for surgical downstaging. There was no consensus on methods of radiological monitoring of response, and a wide variety of pathological reporting systems were used to assess tumour response. Twenty-five percent of centres reported resecting the original tumour footprint, irrespective of clinical/radiological response. Radiologically negative axillae at diagnosis routinely had post-NACT or post-NET sentinel lymph node biopsy (SLNB) in 73.0% and 84% of centres respectively, whereas 16% performed SLNB pre-NACT. Positive axillae at diagnosis would receive axillary node clearance at 60% of centres, regardless of response to NACT.Discussion: There is wide variation in the stated use of neoadjuvant systemic therapy across the UK, with general low usage of NET. Surgical downstaging remains the most common indication of the use of NAC, although not all centres leverage the benefits of NAC for de-escalating surgery to the breast and/or axilla. There is a need for agreed multidisciplinary guidance for optimising selection and management of patients for NST. These findings will be corroborated in phase II of the NeST study which is a national collaborative prospective audit of NST utilisation and clinical outcomes.