bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of Biomarkers of Hepatocellular Carcinoma Gene Prognosis Based on Immune-Related lncRNA Signature of Transcriptome Data
Authors: Ma Andi , Sun Yukai , Ogbodu Racheal O. , Xiao Ling , Deng Haibing , Zhou Hui
Published: August 2020

Background: It is well known that long non-coding RNAs (lncRNAs) play a vital role in cancer. We aimed to explore the prognostic value of potential immune-related lncRNAs in hepatocellular carcinoma (HCC). Methods: Validated the established lncRNA signature of 343 patients with HCC from The Cancer Genome Atlas (TCGA) and 81 samples from Gene Expression Omnibus (GEO). Immune-related lncRNAs for HCC prognosis were evaluated using Cox regression and Least Absolute Shrinkage and Selection Operator (LASSO) analyses. LASSO analysis was performed to calculate a risk score formula to explore the difference in overall survival between high- and low-risk groups in TCGA, which was verified using GEO, Gene Ontology (GO), and pathway-enrichment analysis. These analyses were used to identify the function of screened genes and construct a co-expression network of these genes. Results: Using computational difference algorithms and lasso Cox regression analysis, the differentially expressed and survival-related immune-related genes (IRGs) among patients with HCC were established as five novel immune-related lncRNA signatures (AC099850.3, AL031985.3, PRRT3-AS1, AC023157.3, MSC-AS1). Patients in the low‐risk group showed significantly better survival than patients in the high‐risk group ( P = 3.033e−05). The signature identified can be an effective prognostic factor to predict patient survival. The nomogram showed some clinical net benefits predicted by overall survival. In order to explore its underlying mechanism, several methods of enrichment were elucidated using Gene Set Enrichment Analysis. Conclusion: Identifying five immune-related lncRNA signatures has important clinical implications for predicting patient outcome and guiding tailored therapy for patients with HCC with further prospective validation.
Evaluation of SIMESON, A Training Program to Improve Access to Quality Health Care for Pregnant Women and Newborn in Different Health Care Facilities of Northern Bangladesh
Authors: Das Rina , Farzana Fahmida Dil , Sultana Zakia , Mukherji Kallol , Baayo Adnan , Sultana Marufa , Ali Nausad , Chisti Mohammod Jobayer , Sarker Shafiqul Alam , Ahmed Tahmeed , Faruque ASG
Published: August 2020

Background: Access to perinatal health care is improving in Bangladesh, but maternal and neonatal mortality is still a public health concern. SIMESON (simulation for essential skills for obstetrical and neonatal care) training was focused on expanding maternal-newborn health services for safe delivery by improving infrastructure, perinatal knowledge, and skills of health care providers working in health care facilities in northern Bangladesh. Our objective was to explore the current knowledge and skills of health care providers already trained by SIMESON, in reviewing perinatal health situation including the current status of health care facilities, cost estimation and most importantly delivering perinatal health services.Methods: It was an observational study involving 88 health care providers working in 20 health care facilities. Cost estimation following both quantitative and qualitative approaches was also attempted. Result: Knowledge and skills of health care providers regarding the provision of normal delivery and immediate postpartum care, management of postpartum hemorrhage (PPH), and retained placenta; and use of the bag and mask ventilation to help a baby breathe were found to be considerably strengthened following SIMESON training. During the 6 months after training, there were 477 PPH cases managed successfully with only 1 death; neonatal deaths observed were 6.6 per 1000 live births; twice the number of facility deliveries; and 80% use rate of Ambu bag for helping baby breathe. The estimated cost per trainee was 395.68 USD, and 5.85 USD per beneficiary.Conclusion: SIMESON training improved maternal and child health by facilitating the health care professionals’ improved knowledge and skills, enhancing access to health care facilities, and increasing facility delivery. Such a training program should be promoted within health system in hard-to-reach areas of the country that are burdened with other commitments.
Maternal, Foetal and Service-Related Risk Factors for Stillbirths During Conflict Situation, Yemen, 2015-2016
Authors: Al-Shahethi Ahmed Hamood , Zaki Rafdzah Ahmad , Serouri Abdullwahed Abdulgabar Al- , Mahmud Awang Bulgiba
Published: August 2020

Background: Stillbirth is a silent traumatic canker which is a major concern of various individuals, health institutions and the country as a whole. Stillbirth remains a Global major problem responsible for nearly three million deaths.Study objectives: To estimate the stillbirth rate (SBR) in Sana’a, Yemen and to identify potential risk factors for stillbirth.Methods: A community-based prospective cohort study was carried out between 8/2015 and 12/2016. Nine-hundred and eighty pregnant women were identified for the outcome of their pregnancy. We employed binomial regression together with generalised linear models.Results: The study included 952 pregnant women with 44 stillbirths. The stillbirth rate was 46.2 per 1000 and 45.2 per 1000. In multivariable analysis teenage mothers’ age at first childbirth (< 20 years) (RR 3.70), women with anemia (RR=2.23), smoking snuff (RR = 4.27), prolonged labour (> 24 hours) (RR = 2.02), prolonged rupture of membranes (≥ 24 hours) (RR = 2.22), foetal malposition (RR = 4.60), low birth weight (RR = 14.90) and foetal gestational age (weeks) (RR = 5.60) were significant factors associated with increased risk of stillbirths. Conclusions: This study identiﬁed many risk factors of stillbirth that are amenable to intervention. Encouraging women to deliver at health facilities, providing better management of obstetrical complications, proper antenatal care, and prompt referral services are essential for reduction of stillbirths in Yemen.
Developing Healthcare Team Observations for Patient Safety (HTOPS): Senior Medical Students Capture Everyday Clinical Moments
Authors: Anderson Elizabeth Susan , Griffiths Leyshon , Forey Teri , Wobi Fatima , Norman Robert , Martin Graham
Published: August 2020

Background
Aviation has used a real-time observation method to advance anonymised feedback to the front-line and improve safe practice. Seeking a patient-safety experiential learning method for final year medical students we embarked on a pilot study for similarly observing real-time clinical practice in context.
Methods
Using Participatory Action Research, we collected data on medical students’ observations of real time clinical practice. The observation data was analysed thematically and shared with a steering group of experts to agree a framework for recording observations. A sample of students (observers) and front-line clinical staff (observed) completed on-to-one interviews on their experiences. The interviews were analysed using thematic analysis.
Results
Thirty-seven medical students identified 917 issues in wards, theatres and clinics in an acute hospital Trust. They formed the themes of human factors, systems and environment. Aviation approaches were adapted to form an app capable of recording real time positive and negative clinical incidents. Five students and eleven clinical staff were interviewed and shared their agreement of the value of a process that helped them learn and has the potential to advance the quality of practice. Concerns were shared about how the observational process is managed.
Conclusion
The final product, an app called Healthcare Team Observations for Patient Safety (HTOPS), used by observing senior medical students can record both positive and negative clinical individual and team behaviours in acute-care practice. Early findings are promising as they highlight the totality of patient safety practice and can illuminate good and poor practice. The findings have been positively received and welcomed by the observed Hospital Trust. The next steps will further refine the app for use in all clinical areas for capturing light noise. HTOPS offers the opportunity for collective ownership of safety concerns without blame and has been positively received by staff and medical students.
Listen and learn: Using focus groups in program planning for a low-income population at cardiovascular risk
Authors: Kirzner Rachel S. , Robbins Inga , Privitello Meghan , Miserandino Marianne
Published: August 2020

Background: Poverty increases the risk of cardiac disease, while diminishing the resources available to mitigate that risk. Available prevention programs often require resources that low-income residents of urban areas do not possess, e.g. membership fees, resources to purchase healthy foods, and safe places for physical activity. The aim of this study is to obtain participant input in order to understand the health-related goals, barriers, and strengths as part of planning a program to reduce cardiovascular risk.Methods: In a mixed methods study, we used surveys and focus groups as part of planning an intervention specifically designed to meet the needs of lower income individuals. Based on prior research, we used Self-Determination Theory (SDT) and its core constructs of autonomy, competence, and relatedness as the theoretical framework for analysis. The study collected information on the perspectives of low-income urban residents on their risks of cardiovascular disease, their barriers to addressing health needs, and how they addressed those barriers. Focus group transcripts were analyzed using standard qualitative methods including paired coding and development of themes from identified codes.Results: Participants had health goals that aligned with accepted approaches to reducing their cardiovascular risks, however they lacked the resources to reach those goals. We found the need for support in the three SDT core constructs. The barriers that participants reported suggested that these basic psychological needs were often thwarted by their environments.Conclusions: Substantial disparities in both access to health-promoting resources and in support for autonomy, competence, and relatedness must be addressed in order to design an effective intervention for a low-income population at cardiac risk.
Reflection on the Reform of China's Emergency Medical Insurance System based on the Prevention and Control of COVID-19
Authors: Meng Luo , Cheng Hui , Li Shaohua
Published: August 2020

Objective: Based on the Prevention and Control of COVID-19, this paper points out the shortcomings of China's current medical insurance system, and puts forward the concept of establishing emergency medical insurance system.Methods: This paper analyzes the characteristics of the modern epidemic and its special requirements for medical insurance. Putting forward the idea of mechanism construction.Results:The operation of China's national medical insurance system is mainly operated by the insured, the government, medical institutions and medical institutions. However, the rapid spread of the epidemic has caused great disasters to the society. In the face of major public health events, medical insurance should have four characteristics: the "normalization" of the emergency medical insurance system, the fairness of guarantees, the public quality of treatment and positive externalities. China should establish an emergency system in line with these four characteristics from the four parties. Therefore, this paper analyzes the characteristics of modern epidemic risk, its development process and the requirements for the insurance industry in combination with the situation of China's response to dealing with COVID-19, and puts forward that China should further improve the universal medical insurance system and establish an emergency medical security system to better deal with all kinds of sudden public health events, which will still happen in the future.Conclusions:China's national medical insurance system should not be limited to meet people's conventional medical needs. When public health emergencies occur, it is also necessary to establish a sound medical insurance system to operate.The establishment of emergency medical security system is one of the important development directions of our country in the future.
An ingredients-based approach to costing integrated malaria elimination strategies: an example from Myanmar
Authors: Kyaw Shwe Sin , Delmas Gilles , Drake Tom L , Celhay Olivier , Pan-ngum Wirichada , Pukrittayakameee Sasithon , Lubell Yoel , Aguas Ricardo J , Maude Richard , White Lisa J , Nosten Francois
Published: August 2020

Background Mass drug administration (MDA) has received growing interest to accelerate the elimination of multi-drug resistant malaria in the Greater Mekong Subregion. The potential effectiveness of delivering targeted MDA was demonstrated in a recent intervention in Kayin State, Myanmar. Policymakers and funders need to know what resources are required if MDA is to be included in elimination packages beyond existing malaria interventions. Methods We used financial data from a malaria elimination initiative, conducted in Kayin State, to estimate the programmatic costs of the MDA component using a micro-costing approach. Three activities (community engagement, identification of villages for MDA, and conducting mass treatment in target villages) were evaluated. We then estimate the programmatic costs of implementing targeted MDA to support P. falciparum malaria elimination in Kayin State. A costing tool was developed to aid future analyses.Results The cost of delivering MDA within an integrated malaria elimination initiative in Eastern Kayin State was approximately US$ 910 000. The cost per person reached for MDA was US$ 2·5. Conclusion This cost analysis can assist policy makers in determining the resources required to clear malaria parasite reservoirs. The analysis demonstrated the value of using financial data from research activities to predict programmatic implementation costs of MDA in different numbers of target villages.
Ultra-Processed Foods Are the Major Sources of Total Fat, Saturated and Trans-Fatty Acids Among Tunisian Preschool and School Children: A Cross-Sectional Study
Authors: Dogui Darine , Ati-Hellal Myriam El , Doggui Radhouene , Ati Jalila El
Published: August 2020

Background: Excessive intake of fat and fatty acids is associated with major health hazards such as obesity or chronic diseases. The aim of this study is to provide the first data on total fat, SFA and TFA intakes and their major food sources in Tunisian children. Methods: A total of 1200 children, aged 3 to 9 years old, were randomly selected from primary schools and kindergarten under a cross-sectional design. The 24hour recall method and food frequency questionnaire were used to assess dietary intake over a period of one week.Results: The energy percentages of total fat, SFA and TFA in Tunisian children were respectively 29.6, 11.4 and 0.15. No sex differences were found. The WHO recommendations for total fat, SFA and TFA were adopted by 58 %, 39 % and 89 % of the study population, respectively. The leading food groups of fat and fatty acids were ultra-processed foods, bread and cereals and dairy products. The meat, fish, eggs and fish alternatives were the fifth main contributors to the total fat and SFA intakes in Tunisian children.Conclusions: The implementation of a relevant strategy for fat reduction, especially from ultra-processed foods, considered as low nutrient energy-dense products, is needed to promote health among children and prevent diet-related chronic diseases.
Factors Influencing Adolescent Girls and Young Women’s Participation in a Combination Hiv Prevention Intervention in South Africa
Authors: Appollis Tracy McClinton , Duby Zoe , Jonas Kim , Dietrich Janan , Maruping Kealeboga , Abdullah Fareed , Slingers Nevilene , Mathews Catherine
Published: August 2020

Background: For interventions to reach those they are intended for, an understanding of the factors that influence their participation, as well as the facilitators and barriers of participation are needed. This study explores factors associated with participation in a combination HIV prevention intervention targeting adolescent girls and young women (AGYW) aged 15–24-years-old, as well as the experiences of AGYW, intervention implementers, and facilitators who participated in this intervention. Methods: This study used mixed-methods approach with quantitative household survey data from 4399 AGYW aged 15-24-years-old in six of the ten districts in which the intervention was implemented. In addition, qualitative methods included semi-structured in-depth interviews and focus group discussions in five of the ten intervention districts with 185 AGYW who participated in one or more of the key components of the intervention, and 13 intervention implementers and 13 facilitators. Results: Findings reveal that almost half of AGYW (48.4%) living in the districts where the intervention took place, participated in at least one of the components of the intervention. For both 15-19-year-olds and 20-24-year-olds, factors associated with increased participation in the intervention included being HIV negative, in school, never been pregnant, and having had a boyfriend. Experiencing intimate partner violence (IPV) and/or sexual violence in the past 12 months was associated with increased levels of participation in the intervention for 20-24-year-olds only. In our analysis of the qualitative data, facilitators to participation included motivating participants to join the interventions through explaining the benefits of the programme. Barriers included misguided expectations about financial rewards or job opportunities; competing responsibilities, interests or activities; family responsibilities including childcare; inappropriate incentives; inability to disrupt the school curriculum and difficulties with conducting interventions after school hours due to safety concerns; miscommunication about meetings; as well as struggles to reach out-of-school AGYW.Conclusion: Designers of combination HIV prevention interventions need to address the structural barriers to participation so that AGYW can attend without risking their safety and compromising their family, childcare and schooling responsibilities. Strategies to create demand need to include clear communication about the nature and potential benefits of such interventions, and the inclusion of valued incentives.
The Effectiveness of Moxibustion for Treating of Lumbar Disc Herniation(LDH): A Protocol for Systematic Review and Meta-ananlysis
Authors: Wu Zenan , Xiong Jun , Xu Guixing , Zuo Zhengyun , Yang Yi , Xie Qiongshan
Published: August 2020

Background: Lumbar disc herniation (LDH) refers to lumbar disc degeneration or external pressure, resulting in annulus fibrosus rupture, nucleus pulposus protrusion or bulging, compression of nerve roots, cauda equina nerve, and then some clinical symptoms of a clinical syndrome, clinical symptoms are often manifested as unilateral or bilateral lumbar pain, leg numbness. L3/L4,L4/L5, and L5/S1 intervertebral disc herniations are common in the lesion sites of lumbar disc herniations, and the incidence rate is as high as 90%. Typical manifestations are tenderness at the corresponding surface of the body. This disease is a common and frequently-occurring disease in the department of rehabilitation and acupuncture of the hospital, and is a common cause of lumbago and leg pain. At present, the common external treatment for LDH includes many methods,mostly acupuncture and moxibustionMethods: We're going to use systematic electronic search, including PubMed,MEDLINE, Cochrane library, SinoMed,CNKI,WF,VIPand checked references of retrieved articles. Randomized controlled trials (RCTs) on acupotomy treatment in LDH patients will be searched for independently by 2 reviewers in the databases from their inception to August 2020. We will combine data from clinically homogenous studies in a fixed effect meta-analysis using RevManV.5.3.5, and the evidence level will be assessed by using the method for Grading of Recommendations Assessment, Development, and Evaluation (GRADE).Discussion: The results of this review will provide reliable evidence for effectiveness and safety of moxibustion for treating LDH.Systematic review registration: CRD42020187626
Bloodstream infections caused by ST2 Acinetobacter baumannii over 6 years in China: risk factors, antibiotic regimens and virulence
Authors: Yu Kaihang , Zeng Weiliang , Xu Ye , Liao Wenli , Xu Wenya , Zhou Tieli , Cao Jianming , Chen Lijiang
Published: August 2020

Background
Acinetobacter baumannii (Ab) is an important pathogen of medical-related infections, A.baumannii sequence type 2 (ST2) has spread all over the world. To the best of our knowledge, this is the first study to analyze the clinical and microbiological characteristics of patients with bloodstream infection (BSI) due to ST2 A.baumannii.
Methods
A retrospective study was conducted in a large tertiary hospital in China. From January 2013 to December 2018, the clinical and microbiological data of all consecutive hospitalized patients with bacteremia due to multidrug-resistant A.baumannii (MDR-AB) were included and analyzed comprehensively.
Results
A total of 108 episodes of BSI due to MDR-AB cases were enrolled during the study period. Overall, 30-day mortality was 69.4% (75/108). The use of mechanical ventilation, intensive care unit (ICU) stay and thrombocytopenia may cause higher mortality (P = 0.048, P < 0.001, and P < 0.001, respectively). Change antimicrobial within 48 h after isolating from blood, use of antibacterial combination and more inpatient days were significantly associated with survival (P < 0.001, P = 0.037, and P = 0.007, respectively). All MDR isolates belong to ST2, and have strong biofilm formation ability and high pathogenicity.
Conclusions
BSI caused by ST2 A.baumannii represents a difficult challenge for physicians, considering the high mortality associated with this infection. The combination of cefoperazone/sulbactam and tigecycline may be a meaningful treatment option.
Early Prediction of the Carbapenem Resistance Gram-negative Bacteria Carriage in Intensive Care Unit using Machine-Learning
Authors: Liang Qiqiang , Zhao Qinyu , Xu Xin , Zhou Yu , Huang Man
Published: August 2020

Background

The prevention and control of carbapenem-resistance gram-negative bacteria (CR-GNB) is the difficulty and focus for clinicians in the intensive care unit (ICU). This study construct a CR-GNB carriage prediction model in order to predict the CR-GNB incidence in one week.
Methods

The database is comprised of nearly 10,000 patients. the model is constructed by the multivariate logistic regression model and three machine learning algorithms. Then we choose the optimal model and verify the accuracy by daily predicted and recorded the occurrence of CR-GNB of all patients admitted for 4 months.
Results

There are 1385 patients with positive CR-GNB cultures and 1535 negative patients in this study. Forty-five variables have statistical significant differences. We include the 17 variables in the multivariate logistic regression model and build three machine learning models for all variables. In terms of accuracy and the area under the receiver operating characteristic (AUROC) curve, the random forest is better than XGBoost and multivariate logistic regression model, and better than decision tree model (accuracy: 84% >82%>81%>72%), (AUROC: 0.9089 > 0.8947 ≈ 0.8987 > 0.7845). In the 4-month prospective study, 81 cases were predicted to be positive in CR-GNB culture within 7 days, 146 cases were predicted to be negative, 86 cases were positive, and 120 cases were negative, with an overall accuracy of 84% and AUROC of 91.98%.
Conclusions

Prediction models by machine learning can predict the occurrence of CR-GNB colonization or infection within a week period, and can real-time predict and guide medical staff to identify high-risk groups more accurately.
Effect of Timely Lactate Measurement on In-hospital Mortality among Adults with Hypotension and Hyperlactatemia: An Observational Study on Two Cohorts
Authors: Chen Hui , Bao Xiebing , Xu Ying , Guo Yanxia , Zhou Mingqin , Zhao Chenyan , Wei Yao , Jin Jun
Published: August 2020

Background: Whether patients presented with hypotension and hyperlactatemia can benefit from timely lactate measurement and further lactate-guide resuscitation were not fully understood.Methods: This was a retrospective observational study based on the data from the Medical Information Mart for Intensive Care (MIMIC)-III Database and the eICU Collaborative Research Database (eICU). Patients with hypotension (defined as a minimal systolic blood pressure ≤90 mm Hg or minimal mean arterial pressure ≤65 mm Hg or requiring any vasopressors support during the first 24 h after ICU admission) and hyperlactatemia (defined as an initial lactate level > 2.0 mmol/L after ICU admission) were eligible.The primary exposure was the timely lactate measurement, which was defined as an initial lactate level measured within 1 h after ICU admission. The primary outcome was in-hospital mortality. The statistical approaches included multivariate regression, propensity score matching (PSM) and an inverse probability of treatment weighing (IPTW) and causal mediation analysis (CMA) were utilized to elucidate the relationship between timely lactate measurement and in-hospital mortality. Results: A total of 9978 patients were identified, of which 4257 in MIMIC-III and 5721 in eICU. Timely lactate measurement was associated with lower risk-adjusted in-hospital mortality both in MIMIC (OR 0.70 (95%CI 0.58-0.85; p<0.001)) and eICU (OR 0.75 (95%CI 0.64-0.88; p<0.001)). Time to initial intravenous fluid (IVF) in MIMIC mediated 6.7% (95%CI 1.4%-38%; p<0.001) of the beneficial effect of timely lactate measurement (p<0.001 for average causal mediation effect (ACME)) in terms of in-hospital mortality. Finally, delayed initial lactate measurements are also associated an increased in-hospital mortality in MIMIC and eICU.Conclusions: Timely lactate measurement is associated with a lower risk-adjusted in-hospital mortality among patients with hypotension and hyperlactatemia, which was proportional mediated through shortening the time to IVF. Delay in initial lactate measurement showed a positive association with in-hospital mortality.
Cox regression of factors associated with the onset of chronic kidney disease in HIV/AIDS patients in Albert Luthuli Municipality of South Africa
Authors: Bengura Pepukai , Ndlovu Principal , Managa Mulalo Annah
Published: August 2020

Background: Current research indicates that chronic kidney disease is a global problem which poses a major health threat to people of poor countries with HIV/AIDS and on antiretroviral treatment. In this study, the prevalence of chronic kidney disease and the factors associated with it were investigated among the HIV/AIDS patients in a rural community of South Africa. Methods: A cohort of HIV+ terminal ill patients was retrospectively followed from 2010 to 2017 until chronic kidney disease was diagnosed or until the end of the observation period at two hospitals (Carolina and Embhuleni). Patient information was obtained from the routine hospitals’ records, and the data were analysed using Cox regression and survival analysis (Kaplan-Meier hazard functions and ratios, and log-rank tests) methods. Results: Out of a random sample of 320 HIV/AIDS patients, 51 patients (15.9%) had chronic kidney disease. The factors associated with chronic kidney disease were: Gender (p-value=0.0356), Age (p-value=0.00077), Baseline creatinine (p-value=0.00253), Follow-up alanine transaminase (p-value=0.0152), ART treatments (p-value<0.00193) and Hospital (p-value=0.00258). Discussion: Whilst antiretroviral treatment is associated with some improvement in virology and immunology in HIV-infected patients, research is still needed for the assessment of the impact of ART and other risk factors on renal function in marginalised communities in Africa. Conclusion: The research findings on HIV+ patients in Albert Luthuli Municipality concurred with several previous research findings on risk factors to CKD. The expected action to alleviate the health threat due to CKD in South Africa is to educate the nation on prevention, early detection and on the management of the disease.
Social Distancing Intentions to Reduce the Spread of COVID-19: The Extended Theory of Planned Behavior
Authors: Adiyoso Wignyo , Wilopo Wilopo
Published: August 2020

Background
The novel SARS-CoV-2 virus pandemic has caused over a hundred thousand deaths and has affected countries and economies worldwide. Due to the absence of a vaccine, the most effective way to reduce transmission of the virus is by applying social distancing practices. Exploring factors that determine whether people adopt social distancing measures is, therefore, critical to reducing the spread of the virus. This study aimed to investigate people’s intentions to socially distance based on the extended Theory of Planned Behavior. An online survey of 823 individuals was conducted and their responses analyzed using partial least square structural equation modeling.
Results
Study found that the factors influencing the intention to perform social distancing were subjective norms and perceived behavior control. Risk perception affected attitudes, subjective norms, and perceived behavioral control. Media exposure was found to determine attitudes, subjective norms, and risk perceptions. The relationship between attitudes and intentions, and media use and perceived behavior control were not significant. The better and effective risk communication that can change the level of risk perception, raise family and religious leader as well as increase to control behavior are the keys to people’s perform social distancing. Results from a multigroup analysis revealed partial differences across demographic variables. Younger individuals showed a stronger relationship between the influence of risk perception and PBC and media use on risk perception. The predictive strength of subjective norms from risk perception and risk perception from media use was more strongly associated with rural populations.
Conclusions
The results of study provide an initial understanding of the level of the public’s risk perception to reduce the spread of SARS-CoV-2. Findings also revealed the role of media use in determining risk perception, attitudes and subjective norms. Effective risk communication can change the level of risk perception, attitudes and subjective norms and, in turn, change people’s intention to socially distance. This study may add to the literature, as it explores notions of behavioral changes in the context of an infectious disease pandemic. These results provide a framework for both policymakers and practitioners to formulate interventions for effective social distancing practices in the future.
Usefulness of the Degree of Blood–brain Barrier Disruption to Predict Neurological Prognosis in Cardiac Arrest Survivors who Wnderwent Target Temperature Management: A Retrospective Study
Authors: Jeon Ga Ram , Ahn Hong Joon , Park Jung Soo , Yoo Insool , You Yeonho , Min Jin Hong , Jeong Wonjoon , Cho Yong Chul , Kang Changshin , Lee Byung KooK
Published: August 2020

Background: This study aimed to compare the day-specific association of blood–brain barrier (BBB) disruption with neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors treated with target temperature management (TTM).Methods: This retrospective single-center study included 68 OHCA survivors, who underwent TTM between April 2018 and December 2019. The albumin quotient (QA) was calculated as [albuminCSF] / [albuminserum] immediately (day 1), and at 24 h (day 2), 48 h (day 3), and 72 h (day 4) after return of spontaneous circulation (ROSC). The degree of BBB disruption was weighted using the following scoring system: 0.07 ≥ QA (normal), 0.01 ≥ QA > 0.007 (mild), 0.02 ≥ QA > 0.01 (moderate), and QA > 0.02 (severe). This system gave it 0 (normal), 1 (mild), 4 (moderate), and 9 (severe) points. Poor neurological outcome was determined at six months after ROSC and was defined as cerebral performance categories 3–5.Results: We enrolled 68 patients (males, 48; 71%); 37 (54%) of them had a poor neurological outcome. The distributions of this outcome at six months in patients with moderate and severe BBB disruption versus the other groups were 19/22 (80%) vs. 18/46 (50%) on day 1, 31/37 (79%) vs. 6/31 (32%) on day 2, 32/37 (81%) vs. 5/31 (30%) on day 3, and 32/39 (85%) vs. 5/29 (30%) on day 4 (P < 0.001). Using ROC analyses, the optimal cutoff values of QA levels for prediction of neurological outcomes were determined as: day 1, > 0.009 (sensitivity 56.8%, specificity 87.1%); day 2, > 0.012 (sensitivity 81.1%, specificity 87.1%); day 3, > 0.013 (sensitivity 83.8%, specificity 87.1%); day 4, > 0.013 (sensitivity 86.5%, specificity 87.1%); sum of all time points, > 0.039 (sensitivity 89.5%, specificity 79.4%); and scoring system, > 9 (sensitivity 91.9%, specificity 87.1%). Conclusions: Our results suggested that QA is a useful tool for predicting neurological outcomes in OHCA survivors treated with TTM. However, the prediction of poor neurological outcome using QA showed low sensitivity at 100% specificity. Thus, it could be used as part of a multimodal approach than as a single prognostic prediction tool.
Aβ-Induced Damage Memory in hCMEC/D3 Cell Mediated by Sirtuin-1
Authors: Liu Haochen , Zhang Yixuan , Zhang Hong , Xu Sheng , Zhao Huimin , liu Xiaoquan
Published: August 2020

Background: It is well accepted that accumulation of beta-amyloid (Aβ) may involve in endothelial dysfunction during the Alzheimer’s disease (AD) progression. However, anti-Aβ antibodies, which remove Aβ plaques, do not improve cerebrovascular function in AD animal models. The reasons for these paradoxical results still remain to be further investigated. We hypothesize that Aβexposure may cause persistent damage to cerebral endothelial cell even after Aβ is removed (termed as cerebrovascular endothelial damage memory). The aim of this study is to investigate whether cerebrovascular endothelial damage memory exists in endothelial cells. Method: The hCMEC/D3 cells are treated with Aβ1-42 for 12h and then withdraw Aβ1-42 for another 12h incubation to investigate whether cerebrovascular endothelial damage memory exists in endothelial cells. A mechanism based kinetics progression model is developed to investigate the dynamic characters of the cerebrovascular endothelial damage. Results: After Aβ1-42 was removed, the level of sirt-1 recovered but the cell vitality did not improved which suggested that the cerebrovascular endothelial damage memory may exist in endothelial cells. Sirt-1 activator SRT2104 and NAD+ supplement may relieve the cerebrovascular endothelial damage memory dose dependently. sirt-1 inhibitor EX527 may exacerbate the cerebrovascular endothelial damage memory. Kinetics analysis suggested that sirt-1 involves in initiating the cerebrovascular endothelial damage memory otherwise NAD+ exhaustion plays a vital role in maintaining the cerebrovascular endothelial damage memory. Conclusions: This study provides a novel feature of cerebrovascular endothelial damage induced by Aβ.
SEMA6D, Negatively Regulated by miR-7, Contributing to Chondrocyte Catabolic and Anabolic Activities via p38 Signaling Pathway
Authors: Zhou Xindie , Zhang Yi , Zhang Junjie , Yang Zhicheng , Yang Haoyu , Li Jin , Huang Yong , Xu Nanwei
Published: August 2020

Background: MiR-7 has been recognized as a promoting factor of osteoarthritis (OA), but the specific down-stream pathway of miR-7 still remains unknown. Further investigation of the molecular regulatory mechanism of miR-7 might help develop a novel therapeutic method for OA.Results: Here we revealed that Semaphorin 6D (SEMA6D) was a direct target gene of miR-7, of which presented a negatively regulatory relation in vitro and in vivo. Lucubration of SEMA6D suggested that SEMA6D is validated to promote the anabolic metabolism and reduce the catabolism of chondrocytes via inhibiting the activation of p38 pathway.Conclusions: Present research illustrated that SEMA6D is a negatively regulatory factor of miR-7 and a pivotal mediator of the catabolism and anabolism of chondrocytes. SEMA6D exerts its function via inhibiting the activation of p38 pathway.
Continuum of Care for Older Adults With Concurrent Hearing and Vision Impairment: A Systematic Review Protocol
Authors: Jaiswal Atul , Gupta Shikha , Dupont Patrice , Wittich Walter
Published: August 2020

Background: A recent global report estimates around 2% of the world population (~150 million people) to have concurrent hearing and vision difficulties (referred to as dual sensory impairment/DSI). Older adults with DSI often experience poorer levels of health and barriers to accessing health services in long-term care, home care and hospitals. Yet, the evidence is limited to inform the healthcare planning for this vulnerable population. Understanding the current state of the continuum of care for older adults with DSI is paramount to determine ways to promote healthy ageing. Hence, the objective of this systematic review is to summarize the information available on the continuum of care and synthesize evidence on existing and emergent strategies of screening, assessment and interventions to optimize care for older adults with DSI.Methods: The review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA). Electronic research databases (CINAHL, Embase, MEDLINE, PsycINFO, Cochrane Library, Global Health and Web of Science), clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) will be searched. Editorials, conference publications, thesis/dissertations, books or letters will be excluded. There is no date and language restriction applied, and databases are searched since inception.Discussion: Healthcare professionals have little guidance on how to screen, assess, and provide best possible care to older adults with DSI while accommodating for their hearing and vision challenges; thus, the results of this review will be a relevant resource for policymakers, decision-makers, healthcare organizations, clinicians/professionals, and informal care providers of older adults with DSI. This review will document current practices, determine the evidence gaps, synthesize research findings, and make recommendations for future research priorities.Systematic Review Registration: PROSPERO registration # CRD42020180545
Effects of the German Renewable Energy Act and Environmental, Social and Economic Factors: Biogas Plants Adoption and Agricultural Landscape Change
Authors: Yang Xueqing , Liu Yang , Thrän Daniela , Bezama Alberto , Wang Mei
Published: August 2020

Background: The German energy transition strategy calls for reform of the German energy sector. Against this background, the Germany Renewable Energy Sources Act, or EEG, was issued in 2000 and is widely regarded as a successful legislation for promoting bioenergy development, as more than 9000 biogas plants were built in Germany until 2017. However, the impact from different EEG periods on regional biogas plants’ development and the long-term influence to regional landscape change are rarely simultaneously studied. Methods: This study aimed to quantitatively analyse the impact of the EEG on promotion the biogas plant development in central Germany (CG) by using the event study econometric technique. A GIS-based spatial analysis was further conducted to provide insight into the changes of the agricultural landscape, which was resulted from the development of biogas plants during the EEG from 2000 to 2014. Results: One of the main findings was that the EEGs had time-varying effects on motivating biogas plants construction and selecting the plants size. The comparison between different EEG emendations suggested that the EEG 2009 was the most successful one in market implementation. Besides, the adoption of the biogas plant in CG was mainly driven by the farmer’s financial incentive and taken as an investment to secure the farming business. At the landscape scale, the expansion of silage maize was remarkable in CG from 2000 to 2014. The silage maize was intensively cultivated in the regions with high biogas plant installed capacity. Since EEG 2009, the regional livestock number increased rapidly, which was also associated with increasing pasture land area in CG. This phenomenon suggested a promising regional animal farming and its potential of manure as biogas feedstock. Conclusions: These findings imply that the policy makers should take the EEG 2009 emendation as reference to promote the marketing of future new renewable energy technologies and cautions should be paid on the potential land conflicts of agricultural-based bioenergy development.
Modulation of atypical brain activation during executive functioning in autism: a pharmacological MRI study of tianeptine
Authors: Wichers Robert , Findon James , Jelsma Auke , Giampietro Vincent , Stoencheva Vladimira , Roberton Dene , Murphy Clodagh , Blainey Sarah , McAlonan Grainne , Ecker Christine , Rubia Katya , Murphy Declan , Daly Eileen
Published: August 2020

BackgroundAutism spectrum disorder (ASD) is associated with deficits in executive functioning (EF), and these have been suggested to contribute to core as well as co-occuring psychiatric symptoms. The biological basis of these deficits is unknown but may include the serotonergic system, which is involved in both regulating EF in neurotypical populations and in the pathophysiology of ASD. We previously demonstrated that reducing serotonin by acute tryptophan depletion (ATD) ‘normalizes’ differences in brain function during performance of EF tasks. However, ATD cannot be easily used in the clinic, and we therefore need to adopt alternative approaches to challenge the serotonin system. Hence, we investigated the role of the serotonergic modulator tianeptine on EF networks in ASD. MethodWe conducted a pharmacological magnetic resonance imaging (phMRI) study to compare the effect of an acute dosage of 12.5 mg tianeptine and placebo on brain activation during during two EF tasks (of response inhibition and sustained attention) in 38 adult males; 19 with ASD and 19 matched controls. ResultsUnder placebo, compared to controls, individuals with ASD had atypical brain activation in response inhibtion regions including inferior frontal cortex, premotor regions and cerebellum. During sustained attention, individuals with ASD had decreased brain activation in right middle temporal cortex, right cuneus and left precuneus. Most of the case-control differences in brain function observed under placebo conditions were abolished by tianeptine administration. Also, within ASD individuals, brain functional differences were ‘normalized’ during response inhibition in inferior frontal and premotor cortices.LimitationsOur sample only consisted of high functioning male adults. Therefore, our findings may not be generalizable to other autistic subgroups (e.g. children or women). ConclusionsOur findings provide the first evidence that tianeptine can ‘normalize’ atypical brain activation during EF in adults with ASD. Future studies should investigate whether this shift in the biology of ASD is maintained after prolonged treatment with tianeptine; and if it improves clinical symptoms.
A Research Protocol for a Systematic Review of Automatic Literature Screening in Medical Evidence Synthesis
Authors: Zhang Yuelun , Liang Siyu , Feng Yunying , Wang Qing , Sun Feng , Chen Shi , Yang Yiying , He Xin , Zhu Huijuan , Pan Hui
Published: August 2020

Background: Systematic review is an indispensable tool for optimal evidence collection and evaluation in evidence-based medicine. However, the explosive increase of the original literatures makes it difficult to accomplish critical appraisal and regular update. Artificial intelligence (AI) algorithms have been applied to automate the literature screening procedure in medical systematic reviews. In these studies, different algorithms were used and results with great variance were reported. It is therefore imperative to systematically review and analyse the developed automatic methods for literature screening and their effectiveness reported in current studies.Methods: An electronic search will be conducted using PubMed, Embase and IEEE Xplore Digital Library databases, as well as literatures found through supplementary search in Google scholar, on automatic methods for literature screening in systematic reviews. Two reviewers will independently conduct the primary screening of the articles and data extraction, in which nonconformities will be solved by discussion with a methodologist. Data will be extracted from eligible studies, including the basic characteristics of study, the information of training set and validation set, the function and performance of AI algorithms, and summarised in a table. The risk of bias and applicability of the eligible studies will be assessed by the two reviewers independently based on Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Quantitative analyses, if appropriate, will also be performed.Discussion: Automating systematic review process is of great help in reducing workload in evidence-based practice. Results from this systematic review will provide essential summary of the current development of AI algorithms for automatic literature screening in medical evidence synthesis, and help to inspire further studies in this field. Registration: PROSPERO registration number CRD42020170815 (28 April 2020).
Risk Factors for Revisiting After Emergency Department Discharge: a Longitudinal Retrospective Chart Review
Authors: Teramoto Chie , Nagata Satoko , Naruse Takashi , Nakajima Susumu , Yokota Shinichiroh , Gunshin Masataka , Sonoo Tomohiro , Iwai Satoshi , Yamamoto-Mitani Noriko
Published: August 2020

Background: Emergency department (ED) patients are often discharged after treatment for minor illnesses. However, many of these patients revisit the ED. This study aimed to describe ED revisit rate and investigate the risk factors for 3-day/30-day ED revisit. Methods: A longitudinal retrospective chart review was used to extract data regarding predisposing factors (e.g. gender, age), enabling factors (e.g. economic status, ambulance use) and need factors (e.g. diagnosis at ED discharge, history of diseases), from the medical charts of patients discharged from an ED in Tokyo, Japan, from February to December 2013. Multiple logistic regression analyses were used to predict 3-day/30-day ED revisit based on initial visit information. Results: During the studied period, 8,754 patients were discharged from the ED, of whom 48.8% were men, and the mean age was 39.7 years. Of these, 338 (3.9%) revisited the ED within three days and 682 (7.8%) revisited the ED within 30 days of discharge. In the multiple logistic regression analysis, risk factors for 3-day ED revisits were: having a history of same hospital use, arriving by ambulance, having a common problem (e.g. fever), and history of asthma. Risk factors for 30-day ED revisits were using health care services and having a history of same hospital use. Conclusions: In this study, the rate of ED revisit was less than that reported by other studies, which might be because most patients included in this study usually visited the hospital. Our results show that the predictive factors for 3-day/30-day ED revisit in Japan were similar to those in other countries. Patients with the abovementioned factors should be carefully screened on their initial ED visit, and some follow-up care in clinical and community settings should be arranged.