bluuebunny/crossref_metadata_2025 huggingface dataset:
Climatic and topographic changes since the Miocene influenced the diversification and biogeography of the tent tortoise (Psammobates tentorius) species complex in Southern Africa
Authors: Zhao Zhongning , Heideman Neil , Bester Phillip , Jordaan Adriaan , Hofmeyr Margaretha D.
Published: October 2020

Background Climatic and topographic changes function as key drivers in shaping genetic structure and cladogenic radiation in many organisms. Southern Africa has an exceptionally diverse tortoise fauna, harbouring one-third of the world’s tortoise genera. The distribution of Psammobates tentorius (Kuhl, 1820) covers two of the 25 biodiversity hotspots of in the world, the Succulent Karoo and Cape Floristic Region. The highly diverged P. tentorius represents an excellent model species for exploring biogeographic and radiation patterns of reptiles in Southern Africa.Results We investigated genetic structure and radiation patterns against temporal and spatial dimensions since the Miocene in the Psammobates tentorius species complex, using multiple types of DNA markers and niche modelling analyses. Cladogenesis in P. tentorius started in the late Miocene (11.63–5.33 Ma) when populations dispersed from north to south to form two geographically isolated groups. The northern group diverged into a clade north of the Orange River (OR), followed by the splitting of the group south of the OR into a western and an interior clade. The latter divergence corresponded to the intensification of the cold Benguela current, which caused western aridification and rainfall seasonality. In the south, tectonic uplift and subsequent exhumation, together with climatic fluctuations seemed responsible for radiations among the four southern clades since the late Miocene. We found that each clade occurred in a habitat shaped by different climatic parameters, and that the niches differed substantially among the clades of the northern group but were similar among clades of the southern group. Conclusion Climatic shifts, and biome and geographic changes were possibly the three major driving forces shaping cladogenesis and genetic structure in Southern African tortoise species. Our results revealed that the cladogenesis of the P. tentorius species complex was probably shaped by environmental cooling, biome shifts and topographic uplift in Southern Africa since the late Miocene. The Last Glacial Maximum (LGM) may have impacted the distribution of P. tentorius substantially. We found the taxonomic diversify of the P. tentorius species complex to be highest in the Greater Cape Floristic Region. All seven clades discovered warrant conservation attention, particularly Ptt-B–Ptr, Ptt-A and Pv-A.
Determinants of successful guideline implementation: A national cross-sectional survey
Authors: Jin Yinghui , Tan Li-Ming , Khan Khalid S. , Deng Tong , Huang Chao , Han Fei , Zhang Jing , Huang Qiao , Huang Di , Wang Dan-qi , Wang Yu , Zeng Xiantao , Wang Qiang , Wang Xing-huan
Published: October 2020

Background: CPGs are not uniformly successful in improving care and several instances of implementation failure have been reported. Performing a comprehensive assessment of the barriers and enablers is key to developing an informed implementation strategy. Our objective was to investigate determinants of guideline implementation and explore associations of self-reported adherence to guidelines with characteristics of participants in China.Methods: This is a cross-sectional survey, using multi-stage stratified typical sampling based on China's economic regional divisions (the East, the Middle, the West and the Northeast). 2-5 provinces were selected from each region. 2-3 cities were selected in each province, and secondary and tertiary hospitals from each city were included. We developed a questionnaire underpinned by recommended methods for the design and conduct of self-administered surveys and based on conceptual framework of guideline use, in-depth related literature analysis, guideline development manuals, related behavior change theory. At last, multivariate analyses were performed using logistic regression to produce adjusted odds ratios (OR) and 95% confidence intervals (95%CI).Results: The questionnaire consisted of four sections: knowledge on methodology for developing guidelines; barriers to accessing guideline; barriers to guideline implementation; and methods for improving guideline implementation. There were 1732 participants (87.3% response rate) from 51 hospitals. Of these, 77.2% reported to have used guidelines frequently or very frequently. The key barriers to guideline use were lack of education or training (46.2%), and overly simplistic wording or overly broad scope of recommendations (43.8%). Level of adherence to guidelines was associated with geographical regions (the northeast P＜0.001; the west P=0.02; the middle P＜0.001 compared with the east), hospital grades(P=0.028), length of practitioners’ practice (P =0.006), education background (PhD, P=0.027; Master, P=0.002), evidence-based medicine skills acquired in work unit (P=0.012), and medical specialty of practitioner (General Practice, P=0.006; Surgery, P=0.043). Conclusion: Despite general acknowledgement of the importance of guidelines, the use of guidelines was not as frequent as might have been expected. To optimize the likelihood of adherence to guidelines, guideline implementation should follow an actively developed dissemination plan incorporating features associated with adherence in our study.
Demographic and clinical characteristics of foreign nationals accessing psychiatric services in Japan: A multicenter study in a metropolitan area
Authors: Takubo Youji , Nemoto Takahiro , Iwai Momoko , Kashima Minako , Yamaguchi Eriko , Maruyama Akiko , Miura Sachio , Saito Hisaaki , Tsujino Naohisa , Mizuno Masafumi
Published: October 2020

Background: International immigration to Japan, where homogeneous ethnicity is a population characteristic, has been growing. Although immigration is recognized as a risk factor for multiple mental-health related issues, there are few regional reports on foreign nationals accessing the psychiatric services in Japan. We aimed to reveal their current status and provide information to develop an optimal service system.Methods: A multicenter retrospective chart review research was conducted. The subjects were foreign residents who presented at the psychiatry departments in three core regional hospitals in the Keihin region, which faces Tokyo Bay and is well known to include the largest traditional industrial zone in Japan, over a period of three years. We investigated the patients’ demographic and clinical information including country/region of origin, spoken language, use of a medical interpreter, pathway to hospitals, and outcome.Results: The percentage of foreign patients among all patients (1.4%) was quite low. Their age distribution (45.8 years on average) was dissociated from the age distribution of foreign residents in Japan Regarding the country/region of origin, China (35.1%) was the most common country, followed by the Philippines, Korea, and Brazil. Several subjects (22.9%) could not speak Japanese; therefore, interpretation was required by family members/friends (17.1%) or a professional interpreter (5.4%). Neurotic and stress-related disorders were the most common diagnosis (24.4%). The proportion of psychoactive substance use was higher than that for Japanese national data as immigrants are known to be at risk for it.Conclusions: The results suggest that foreign residents in Japan are less likely to contact appropriate services for mental illness, especially young people at relatively high risk of mental illness do not access services. Furthermore, lack of medical interpreters may impede the mental health conditions of foreign residents. The development of a community-based integrated care system accessible to foreign residents seems to be indispensable.
Patients' experiences of eHealth in palliative care: An integrative review
Authors: Widberg Cecilia , Wiklund Birgitta , Klarare Anna
Published: October 2020

Background: With a growing world population, a longer life expectancy, and more deaths due to chronic diseases, the need for palliative care is increasing. Palliative care aims to alleviate suffering and to promot e well-being for patients with progressive, incurable disease or injury. E - Health entails us ing of information and communication technology for healthcare provision . I t is unclear to how patients experience use of eHealth technology within palliative care Methods: The aim of this study was to describe patients’ experiences of eHealth in palliative care. A systematic integrative review w as performed using six databases: Cinahl Complete; MEDLINE; PubMed; Psychology and Behavioral Sciences Collection; Nursing and Allied Health; and PsycINFO . Twelve studies met the inclusion criteria of adult patients in palliative care, English language , published 2014-2019: comprising 397 patients . S ix studies were from European countries, four from North America, one from South America and one from Oceania . Seven were feasibility or pilot studies. Results: The findings are synthesized in the main theme: E-health applications – promoting communication on patients’ and families’ terms , and three sub- themes: usability and feasibility of eHealth applications; symptom control and individualized care; and use of eHealth applications increased sense of security and patient safety. Patients ’ experiences were that eHealth promoted individualized care, sense of security, better symptom management and participation in care . Communication was facilitated by the inherent flexibility provided by technology . Conclusions: E-Health applications seem promising in promoting equal, individualized care, and may be a tool to endorse accessibility and patient participation in palliative care settings. I ndications are that eHealth communication resulted in patients and families receiving more information, which contributed to experiences of patient safety and feelings of security. At organizational and societal levels, eHealth may contribute to sustainable development and more efficient use of resources.
Driving stress and seismotectonic implications of the 2013 Mw5.8 Awaji Island earthquake, southwestern Japan, based on earthquake focal mechanisms before and after the mainshock
Authors: Imanishi Kazutoshi , Ohtani Makiko , Uchide Takahiko
Published: October 2020

A driving stress of the M w 5.8 reverse-faulting Awaji Island earthquake (2013), southwest Japan, was investigated using focal mechanism solutions of earthquakes before and after the mainshock. The seismic records from regional high-sensitivity seismic stations were used. Further, the stress tensor inversion method was applied to infer the stress fields in the source region. The results of the stress tensor inversion and the slip tendency analysis revealed that the stress field within the source region deviates from the surrounding area, in which the stress field locally contains a reverse-faulting component with ENE-WSW compression. This local fluctuation in the stress field is key to producing reverse-faulting earthquakes. The existing knowledge on regional-scale stress (tens to hundreds of km) cannot predict the occurrence of the Awaji Island earthquake, emphasizing the importance of estimating local-scale (< tens of km) stress information. It is possible that the local-scale stress heterogeneity has been formed by local tectonic movement, i.e., the formation of flexures in combination with recurring deep aseismic slips. The coseismic Coulomb stress change, induced by the disastrous 1995 M w 6.9 Kobe earthquake, increased along the fault plane of the Awaji Island earthquake; however, the postseismic stress change was negative. We concluded that the gradual stress build-up, due to the interseismic plate locking along the Nankai trough, overcame the postseismic stress reduction in a few years, pushing the Awaji Island earthquake fault over its failure threshold in 2013. The observation that the earthquake occurred in response to the interseismic plate locking has an important implication in terms of seismotectonics in southwest Japan, facilitating further research on the causal relationship between the inland earthquake activity and the Nankai trough earthquake. Furthermore, this study highlighted that the dataset before the mainshock may not have sufficient information to reflect the stress field in the source region due to the lack of earthquakes in that region. This is because the earthquake fault is generally locked prior to the mainshock. Further research is needed for estimating the stress field in the vicinity of an earthquake fault via seismicity before the mainshock alone.
The Awareness of Women on Prostate Cancer: A Mixed-Methods Systematic Review Protocol
Authors: Wiafe Ebenezer , Mensah Kofi Boamah , Mensah Adwoa Bemah Boamah , Bangalee Varsha , Oosthuizen Frasia
Published: October 2020

Background: Prostate cancer accounts for about 10% of cancers affecting and claiming the lives of men. Studies have reported that women are better than men in recognition of the early manifestations of various cancers. Besides, women have been recognized to show a profound interest in their partners' health and hence, make observations that men don't know. Several studies have reported on the knowledge gaps of prostate cancer among patients and the general population. It is vital to comprehensively review the available evidence and identify research gaps in our current understanding of knowledge of women on prostate cancer.Methods: A search of bibliographic databases, MEDLINE (EBSCOhost), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Web of Science, and EMBASE (Ovid) will be undertaken from January 1999 to December 2019. The search will be limited to studies published in the English language. Duplication of studies will be removed using the EndNote citation manager. After deduplication, citations will be screened independently by two authors according to prespecified criteria. Data extraction and quality assessment of the selected studies will be done independently by two authors. Meta-analytic methods will be used where appropriate. The convergent segregated method of synthesis will be adopted in this review. Ethics and dissemination: Primary data collection will not be involved in this study, hence formal ethical clearance will not be needed. The results of the study will be presented through a peer-reviewed journal and conference presentation.Patient and public involvement: Patients or the public will not be engaged in the conduct of this study.Trial registration number: Open Science Framework (OSF) registration DOI: https://doi.org/10.17605/OSF.IO/EYHF2
IPSE, an Abundant Egg-Secreted Protein of the Carcinogenic Helminth Schistosoma haematobium, Promotes Proliferation of Bladder Cancer Cells and Angiogenesis
Authors: Mbanefo Evaristus C. , Agbo Chinwike Terry , Zhao Yuanlong , Lamanna Olivia K. , Thai Kimberly H. , Karinshak Shannon , Khan Mohammad , Fu Chi-Ling , Odegaard Justin , Saltikova Irina , Smout Michael , Pennington Luke , Nicolls Mark , Jardetzky Theodore , Loukas Alex , Brindley Paul , Falcone Franco , Hsieh Michael
Published: October 2020

Background: Schistosoma haematobium, the helminth causing urogenital schistosomiasis, is a known bladder carcinogen. Despite the causal link between S. haematobium and bladder cancer, the underlying mechanisms are poorly understood. S. haematobium oviposition in the bladder is associated with angiogenesis and urothelial hyperplasia. These changes may be pre-carcinogenic events in the bladder. We hypothesized that the Interleukin-4-inducing principle of Schistosoma mansoni eggs (IPSE), an S. haematobium egg-secreted “infiltrin” protein that enters host cell nuclei to alter cellular activity, is sufficient to induce angiogenesis and urothelial hyperplasia. Methods: Mouse bladders injected with S. haematobium eggs were analyzed via microscopy for angiogenesis and urothelial hyperplasia. Endothelial and urothelial cell lines were incubated with recombinant IPSE protein or an IPSE mutant protein that lacks the native nuclear localization sequence (NLS-) and proliferation measured using CFSE staining and real-time monitoring of cell growth. IPSE’s effects on urothelial cell cycle status was assayed through propidium iodide staining. Endothelial and urothelial cell uptake of fluorophore-labeled IPSE was measured. Findings: Injection of S. haematobium eggs into the bladder triggers angiogenesis, enhances leakiness of bladder blood vessels, and drives urothelial hyperplasia. Wild type IPSE, but not NLS-, increases proliferation of endothelial and urothelial cells and skews urothelial cells towards S phase. Finally, IPSE is internalized by both endothelial and urothelial cells. Interpretation: IPSE drives endothelial and urothelial proliferation, which may depend on internalization of the molecule. The urothelial effects of IPSE depend upon its NLS. Thus, IPSE is a candidate pro-carcinogenic molecule of S. haematobium.
Implementation and factors affecting the nursing process among nurses working in selected government Hospitals in Southwest Ethiopia
Authors: Adasho Zerihun Adraro , Bekele Daniel Mengistu
Published: October 2020

Background: The nursing process was initially adopted from the general system theory, and was developed and implemented in the field of education in the early years.Objective: The purpose of this study was to assess implementation and factors affecting the nursing process among nurses working in selected government hospitals in Southwest Ethiopia.Methods: An institution-based cross-sectional descriptive study was conducted from March 10 to April 1, 2015 in three hospitals in southwest Ethiopia using self-administered questionnaires. This study included a total of 138 nurses using simple random sampling. Data were classified, coded and entered into epidemiological information version 3.5.3, and exported to the statistical package for social science version 20 for analysis, descriptive statistics were used to describe the variables, bivariable and multivariable logistic regression were used to see the effect of each variable on the dependent variable.Result: The nursing process was found to be 73.9 per cent implemented. Compared to a Bachelor of Science, the likelihood of implementing the nursing process was less likely among diploma nurses. Nurses working in administratively supported hospitals implemented the nursing process more compared to those without administrative support. The nursing process had been implemented higher by trained nurses compared to untrained nurses.Conclusion: The implementation of nursing process was good where; nearly seven in every ten nurses implemented the nursing process. Low educational qualification, lack of training, and non-supportive hospital administration were predictors of the nursing process implementation.
Health-care organization for the management and surveillance of SARS-CoV-2 infection in children during pandemic in Campania Region, Italy
Authors: Nunziata Francesco , Bruzzese Eugenia , Poeta Marco , Pierri Luca , Catzola Andrea , Ciccarelli Gian Paolo , Vassallo Edoardo , Montella Emma , Vecchio Andrea Lo , Guarino Alfredo
Published: October 2020

Background: In comparison with adults, severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection in children has a milder course. The management of children with suspected or confirmed coronavirus disease (COVID-19) needs to be appropriately targeted.Methods: We designed a hub-and-spoke system to provide healthcare indications based on the use of telemedicine and stringent admission criteria, coordinate local stakeholders and disseminate information.Result: Between March 24th and September 24th 2020, the Hub Centre managed a total of 208 children (52% males, median age, 5.2, IQR 2-9.6 years) with suspected or confirmed COVID-19. Among them, 174 were managed in cooperation with family pediatricians and 34 with hospital-based physicians. One hundred-four (50%) received a final diagnosis of SARS-CoV-2 infection. Application of stringent criteria for hospital admission based on clinical conditions, risk factors and respect of biocontainment measures, allowed to manage the majority of cases (74, 71.1%) through telemedicine. Thirty children (28%) were hospitalized (median length 10 days, IQR 5-19 days), mainly due to the presence of persistent fever, mild respiratory distress or co-infection occurring in infant or children with underlying conditions. However, the reasons for admission slightly changed over time.Conclusion: An hub-and-spoke system is effective in coordinate territorial health-care structures involved in management paediatric COVID-19 cases through telemedicine and the definition of stringent hospital admission criteriaThe management of children with COVID-19 should be based on clinical conditions, assessed on a case-by-case critical evaluation, as well as on isolation measures, but may vary according to local epidemiological changes.
Comparative Analysis of Human Microglial Models for Studies of HIV Replication and Pathogenesis
Authors: Rai Mohammad A , Hammonds Jason , Pujato Mario , Mayhew Christopher , Roskin Krishna , Spearman Paul
Published: October 2020

Background: HIV associated neurocognitive disorders cause significant morbidity and mortality despite the advent of highly active antiretroviral therapy. A deeper understanding of fundamental mechanisms underlying HIV infection and pathogenesis in the central nervous system is warranted. Microglia are resident myeloid cells of the brain that are readily infected by HIV and may constitute a CNS reservoir. We evaluated two microglial model cell lines (C20, HMC3) and two sources of primary cell-derived microglia (monocyte-derived microglia [MMG] and induced pluripotent stem cell-derived microglia [iPSC-MG]) as potential model systems for studying HIV-microglia interactions.Results: All four microglial model cells expressed typical myeloid markers with the exception of low or absent CD45 and CD11b expression by C20 and HMC3, and all four expressed the microglia-specific markers P2RY12 and TMEM119. Marked differences were observed upon gene expression profiling, however, indicating that MMG and iPSC-MG cluster closely together with primary human microglial cells, while C20 and HMC3 were similar to each other but very different from primary microglia. Expression of HIV-relevant genes also revealed important differences, with iPSC-MG and MMG expressing relevant genes at levels more closely resembling primary microglia. iPSC-MG and MMG were readily infected with R5-tropic HIV, while C20 and HMC3 lack CD4 and require pseudotyping for infection. Despite many similarities, HIV replication dynamics and HIV-1 particle capture by Siglec-1 differed markedly between the MMG and iPSC-MG.Conclusions: MMG and iPSC-MG appear to be viable microglial models that are susceptible to HIV infection and bear more similarities to authentic microglia than two transformed microglia cell lines. The observed differences in HIV replication and particle capture between MMG and iPSC-MG warrant further study.
The GBA p.G85E mutation in Korean patients with non-neuronopathic Gaucher disease: founder and neuroprotective effects
Authors: Kim Yoo-Mi , Choi Jin-Ho , Kim Gu-Hwan , Sohn Young Bae , Ko Jung-Min , Lee Beom Hee , Cheon Chong Kun , Lim Han Hyuk , Heo Sun-Hee , Yoo Han-Wook
Published: October 2020

Background Gaucher disease (GD) is caused by a deficiency of β-glucocerebrosidase, encoded by GBA. Haplotype analyses previously demonstrated founder effects for particular GBA mutations in Ashkenazi Jewish and French-Canadian populations. This study aimed to investigate the clinical characteristics and mutation spectrum of GBA in Korean GD patients and to identify founder effect of GBA p.G85E in non-neuronopathic GD patients. Results The study cohort included 62 GD patients from 58 unrelated families. Among them, 18 patients from 17 families harbored the p.G85E mutation. Haplotype analysis was performed for 9 probands and their parents for whom DNA samples were available. In 58 unrelated probands, the GBA mutation p.L483P was the most common (30/116 alleles, 26%), followed by p.G85E (16%), p.F252I (13%), and p.R296Q (9%). The median age at diagnosis of the 18 patients harboring the p.G85E mutation was 3.8 (range 1.2–57) years. No patients developed neurological symptoms during follow-up periods of 2.2–20.3 (median 13.9) years. The size of the shared haplotype containing GBA p.G85E was 732 kbp, leading to an estimated age of 3,075 years. ConclusionThe GBA p.G85E mutation, which appears to be neuroprotective despite producing distinctive visceromegaly and skeletal symptoms, exhibited a potential founder effect in Korean GD patients.
Updates on malaria epidemiology and profile in Cabo Verde from 2010 to 2019: The goal of Elimination
Authors: DePINA Adilson José , Stresman Gillian , Barros Helga Sofia Baptista , Moreira António Lima , Dia Abdoulaye Kane , Furtado Ullardina Domingos , Faye Ousmane , Seck Ibrahima , Niang El Hadji Amadou Niang
Published: October 2020

Background: Located in West Africa, Cabo Verde is an archipelago consisting of nine inhabited islands. Malaria has been endemic since the settlement of the islands during the 16th century and is poised to achieve malaria elimination in January 2021. The aim of this research is to characterise the trends in malaria cases from 2010 to 2019 in Cabo Verde as the country transitions from endemic transmission to elimination and prevention of reintroduction phases.Methods: All confirmed malaria cases reported to the Ministry of Health between 2010 and 2019 were extracted from the passive malaria surveillance system. Individual-level data available included age, sex, municipality of residence, and the self-reported countries visited if travelled within the past 30 days, therby classified as imported. Trends in reported cases were visualised and multivariable logistic regression used to assess risk factors associated with a malaria case being imported and differences over time.Results: A total of 814 incident malaria cases were reported in the country between 2010 and 2019, the majority of which were Plasmodium falciparum. Overall, prior to 2017, when the epidemic occurred, 58.1% (95% CI: 53.6-64.6) of infections were classified as imported, whereas during the post-epidemic period, 93.3% (95% CI: 86.9-99.7) were imported. The last locally acquired case was reported in January 2018. Imported malaria cases were more likely to be 25-40 years old (AOR: 15.1, 95% CI: 5.9-39.2) compared to those under 15 years of age and more likely during the post-epidemic period (AOR: 56.1; 95% CI: 13.9-225.5) and most likely to be reported on São Vicente Island (AOR=4256.9, 95% CI=260-6.9e+4) compared to Boavista.Conclusions: Cabo Verde has made substantial gains in reducing malaria burden in the country over the past decade and are poised to achieve elimination in 2021. However, the high mobility between the islands and continental Africa, where malaria is still highly endemic, means there is a constant risk of malaria reintroduction. Characterisation of imported cases provides useful insight for program and enables better evidence-based decision-making to ensure malaria elimination can be sustained.
Prospective study on a fast-track training in psychiatry for medical students: The Psychiatric Hat Game
Authors: Clément Anthony , Delage Raphaël , Chollier Marie , Josse Laure , Gaudry Stéphane , Zahar Jean-Ralph , Baubet Thierry , Degos Bertrand
Published: October 2020

Background: While medical students are losing interest in lectures in favor of other educational materials, many studies suggest the benefit of active learning, combined with gamified educational tools. The authors developed a psychiatric adaptation of the « Hat Game ». It was hypothesised that this game would increase both knowledge and motivation in medical students toward psychiatric semiology. The aim of the study was to assess the benefit of a Psychiatric Hat Game session for learning psychiatric symptoms in third-year medical students. Student performance was also evaluated at 3 months. Methods: This gamified fast-track training consists of two teams and each team has to guess as many psychiatric semiology terms as possible using different techniques (i.e. speech, mime). The study involved a pre- and post-evaluation of knowledge (Multiple Choice Questions) and a satisfaction survey. Baseline, post-immediate, and three-months scores were compared by using Friedman analysis for paired samples. Comparisons of mean scores at two different times were performed by using Wilcoxon test for paired samples. Results: One hundred and sixty-six students were proposed to take part in the study. Among them 129 completed the whole program (response rate = 77.7%). Mean scores measured at the three points in time were significantly different (p < 0.001, N = 129). Knowledge mean scores were significantly higher after the game than before (+ 28.6%, p < 0.001). Improvement was maintained three months after the game (+ 18.9%, p < 0.001). Satisfaction survey items highlighted that students enjoyed and would recommend this type of gamified training. Conclusions: The Psychiatric Hat Game improved knowledge of psychiatric semiology in medical students. Results suggest that it is a promising and efficient tool to playfully teach medical semiology, with transferable features, utility and acceptability from one medical field to another. This study contributes to the growing body of knowledge advocating for serious games and gamified training in medical education.
LHH1, a Novel Antimicrobial Peptide with Anti-Cancer Cell Activity Identified from Lactobacillus casei HZ1
Authors: He Junfang , Jin Duxin , Luo Xuegang , Zhang Tongcun
Published: October 2020

Antimicrobial peptides have been attracting increasing attention for their multiple beneficial effects. In present study, a novel AMP with a molecular weight of 1875.5 Da, was identified from the genome of Lactobacillus casei HZ1. The peptide, which was named as LHH1 was comprised of 16 amino acid residues, and its α-helix content was 95.34% when dissolved in 30 mM SDS. LHH1 exhibited a broad range of antimicrobial activities against Gram-positive bacteria and fungus. It could effectively inhibit Staphylococcus aureus with a minimum inhibitory concentration of 3.5 μM and showed a low hemolytic activity. The scanning electron microscope, confocal laser scanning microscope and flow cytometry results showed that LHH1 exerted its antibacterial activity by damaging the cell membrane of Staphylococcus aureus. Meanwhile, LHH1 also exhibited anti-cancer cell activities against several cancer cells via breaking the cell membrane of MGC803, HCT116 and C666-1 cancer cells.
Association between Residual Feed Intake and Some Biochemical Metabolites of Growing Hamari Lambs
Authors: Elmnan Balgees Abu Elgasim Atta , Ali Tayseer Abass Karar
Published: October 2020

BackgroundRecently the use of residual feed intake (RFI) trait for the identification of animal that are more efficient in feed utilization has received much attention from scientist. Since basal metabolic processes are responsible for a large proportion of energy requirements; blood metabolites that reflect the workload placed on them may give indication of differences in animal efficiency. The objectives of this study were to estimate the differences in growth performance, some blood metabolites indices in growing Hammari lambs selected for high, medium and low residual feed intake (RFI). Moreover, correlation between RFI, feed conversion ratio (FCR), gross feed efficiency (GFE) and some blood indices was carried out. ResultsThe results indicated there were no significant differences among RFI classes for initial BW (P = 0.69) final BW (P = 0.84) and ADG (P = 0.51). Significant differences among RFI classes were observed for DM intake, RFI (P = 0.001), FCR ratio (P = 0.01), and GFE (P = 0.03). Low RFI animals consumed, on average, 0.62 kg/d DM less than high RFI animals. Low and med RFI animals had lower serum total protein (P=0.01), globulin (P=0.01), urea (P=0.02), and aspartate aminotransferase (AST) (P=0.01) levels than high RFI. A comparison of serum creatinine among RFI groups showed that the med and the low RFI groups had higher concentration than high RFI group. There were associations between RFI and the serum metabolites for total protein (rRFI = 0.44), globulin (rRFI = 0.31), urea (rRFI = 0.40), AST (rRFI = 0.76) and HDL (rRFI = 0.50). Also, associations between FCR and serum globulin (rFCR = 0.31) and AST (rFCR = 0.41) were detected. Results for serum mineral concentrations showed no significant (P>0.05) differences among RFI classes. The same trend was observed to results of correlation between mineral metabolites and RFI, except for phosphorus, which was positively correlated with RFI (rRFI = 0.32). ConclusionThe study concluded that the low RFI animals had less concentration of serum total protein, globulin, urea, AST and HDL. All these measures showed that low RFI animals were more efficient in feed utilization, than high RFI animals.
Identification of atypical mitogen-activated protein kinase MAPK4 as a novel regulator in acute lung injury
Authors: Mao Ling , Zhou Ya , Chen Longqing , Hu Lin , Liu Shiming , Zheng Wen , Zhao Juanjuan , Guo Mengmeng , Chen Chao , He Zhixu , Xu Lin
Published: October 2020

Background: Acute lung injury (ALI) is a serious disease with highly morbidity and mortality that causes serious health problems worldwide. Atypical mitogen activated protein kinases (MAPKs) play critical roles in the development of tissues and have been proposed as promising therapeutic targets for various diseases. However, the potential role of atypical MAPKs in ALI remains elusive. In this study, we investigated the role of atypical MAPKs family member MAPK4 in ALI using LPS-induced murine ALI model. Results: We found that MAPK4 deficiency mice exhibited prolonged survival time after LPS challenge, accompanied by alleviated pathology in lung tissues, decreased levels of pro-inflammatory cytokines and altered composition of immune cells in BALF. Furthermore, the transduction of related signaling pathways, including MK5, AKT, JNK, and p38 MAPK pathways, was reduced obviously in LPS-treated MAPK4 -/- mice. Notably, the expression of MAPK4 was up-regulated in lung tissues of ALI model, which was not related with MAPK4 promoter methylation, but negatively orchestrated by transcriptional factors NFKB1 and NR3C1. Further studies have shown that the expression of MAPK4 was also increased in LPS-treated macrophages. Meanwhile, MAPK4 deficiency reduced the expression of related pro-inflammatory cytokines in macrophage in response to LPS treatment. Finally, MAPK4 knockdown using shRNA pre-treatment could ameliorate the pathology of lung tissues and prolong the survival time of mice after LPS challenge. Conclusions: Collectively, these findings reveal an important biological function of atypical MAPK in mediating the pathology of ALI, indicating that MAPK4 might be a novel potential therapeutic target for ALI treatment.
Comparative analysis of some bioactive compounds in leaves of different Aloe species
Authors: Andrea Bunea , Rugina Dumitrita , Florina Copaciu , Francisc Dulf , Anastasia Veres , Socaci Sonia , Adela Pintea
Published: October 2020

Although a vast number of Aloe species are known, only the Aloe vera and Aloe arborescens species are currently used by cosmetic and pharmaceutical industries. Therefore, the current study aims to complete the existent literature data with new information on the phytochemical composition of some lesser-known Aloe species, with the main focus on carotenoids and fatty acids. Among the analyzed species, Aloe aculeata and Aloe ferox had the highest content in carotenoids, the major pigments being lutein and β-carotene (according to HPLC analysis). The fatty acid profile of each Aloe species was analysed by GC-MS. Linolenic and linoleic acids were the major polyunsaturated fatty acids found in higher percent in Aloe ferox, Aloe spectabilis and Aloe marlothii. Instead, Aloe aculeata proved to have a distinct fatty acid profile, rich in monounsaturated fatty acids. Species such as Aloe arborescens and Aloe marlothii proved to have the highest antioxidant potential according to data of DPPH, ORAC, HPS assays, even if the richest one in vitamin C was found to be Aloe spectabilis. Though the scientific research is mainly focused on the common species Aloe barbadensis, the current data suggests that other Aloe species could receive more attention from industry part, being great sources of bioactive compounds.
Reporting of screening and diagnostic AI rarely acknowledges ethical, legal, and social implications: a mass media frame analysis
Authors: Frost Emma Kellie , Carter Stacy M
Published: October 2020

Introduction. Healthcare is a rapidly expanding area of application for Artificial Intelligence (AI). Although there is considerable excitement about its potential, there are also substantial concerns about the negative impacts of these technologies. Since screening and diagnostic AI tools now have the potential to fundamentally change the healthcare landscape, it is important to understand how these tools are being represented to the public via the media.Methods. Using a framing theory approach, we analysed how screening and diagnostic AI was represented in the media and the frequency with which media articles addressed the benefits and the ethical, legal, and social implications (ELSIs) of screening and diagnostic AI.Results. All the media articles coded (n=136) fit into at least one of three frames: social progress (n=131), economic development (n=59), and alternative perspectives (n=9). Most of the articles were positively framed, with 135 of the articles discussing benefits of screening and diagnostic AI, and only 9 articles discussing the ethical, legal, and social implications.Conclusions. We found that media reporting of screening and diagnostic AI predominantly framed the technology as a source of social progress and economic development. Screening and diagnostic AI may be represented more positively in the mass media than AI in general. This represents an opportunity for health journalists to provide publics with deeper analysis of the ethical, legal, and social implications of screening and diagnostic AI, and to do so now before these technologies become firmly embedded in everyday healthcare delivery.
Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?
Authors: Chen Yu-Ta , Wu Kuan-Ting , Jhan Shun-Wun , Hsu Shan-Ling , Liu Hao-Chen , Wang Ching-Jen , Ko Jih-Yang , Chou Wen-Yi
Published: October 2020

Background Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is an easy-to-master and minimally-invasive approach to surgical intervention. Overstress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction alongside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities. Methods We retrospectively enrolled 38 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene sutures (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and 12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up. Results There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90 ± 6.16 versus 94.47 ± 7.26, p = 0.47; UCLA score: 32.84 ± 2.91 versus 34.32 ± 1.16, p = 0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47 ± 27.47 versus 100.75 ± 48.70, p = 0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p = 0.038). Conclusion Concomitant hook plate fixation with loop suspensory reconstruction yielded excellent functional outcomes and superior maintenance of the rCCD with fewer acromion complications than hook plate fixation alone.
Social Justice in Health System; a Neglected Component of Academic Nursing Education: A Qualitative Study
Authors: Habibzadeh Hosein , Jasemi Madineh , Hosseinzadegan Fariba
Published: October 2020

Background: In recent decades, increasing social and health inequalities all over the world has highlighted the importance of social justice as a core nursing value. Therefore, proper education of nursing students is necessary for preparing them to comply with social justice in health systems. This study is aimed to identify the effective factors in teaching the concept of social justice in the nursing curriculum.Method: This is a qualitative study, in which the conventional content analysis approach was employed to analyze a sample of 13 participants selected using purposive sampling method. Semi-structured interviews were conducted to collect and analyze the data.Results: Analysis of the interviews indicated that insufficient education content, incompetency of educators, and inappropriate education approaches made social justice a neglected component in the academic nursing education. These factors were the main sub-categories of the study and showed the negligence of social justice in academic nursing education.Conclusion: Research findings revealed the weaknesses in teaching the concept of social justice in the nursing education. Accordingly, it is necessary to modify the content of nursing curriculum and education approaches in order to convey this core value. Since nursing educators act as role models for students, especially in practical and ethical areas, more attention should be paid to competency of nursing educators.
Comparison of deep learning with regression analysis in creating predictive models for SARS-CoV-2 outcomes
Authors: Abdulaal Ahmed , Patel Aatish , Charani Esmita , Denny Sarah , Alqahtani Saleh A , Davies Gary W , Mughal Nabeela , Moore Luke SP
Published: October 2020

Background Accurately predicting patient outcomes in Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could aid patient management and allocation of healthcare resources. There are a variety of methods which can be used to develop prognostic models, ranging from logistic regression and survival analysis to more complex machine learning algorithms and deep learning. Despite several models having been created for SARS-CoV-2, most of these have been found to be highly susceptible to bias. We aimed to develop and compare two separate predictive models for death during admission with SARS-CoV-2.Method Between March 1 - April 24, 2020, 398 patients were identified with laboratory confirmed SARS-CoV-2 in a London teaching hospital. Data from electronic health records were extracted and used to create two predictive models using: 1) a Cox regression model and 2) an artificial neural network (ANN). Model performance profiles were assessed by validation, discrimination, and calibration.Results Both the Cox regression and ANN models achieved high accuracy (83.8%, 95% confidence interval (CI): 73.8 - 91.1 and 90.0%, 95% CI: 81.2 - 95.6, respectively). The area under the receiver operator curve (AUROC) for the ANN (92.6%, 95% CI: 91.1 - 94.1) was significantly greater than that of the Cox regression model (86.9%, 95% CI: 85.7 - 88.2), p=0.0136. Both models achieved acceptable calibration with Brier scores of 0.13 and 0.11 for the Cox model and ANN, respectively. Conclusion We demonstrate an ANN which is non-inferior to a Cox regression model but with potential for further development such that it can learn as new data becomes available. Deep learning techniques are particularly suited to complex datasets with non-linear solutions, which make them appropriate for use in conditions with a paucity of prior knowledge. Accurate prognostic models for SARS-CoV-2 can provide benefits at the patient, departmental and organisational level.
Delirium is associated with high mortality in elderly patients with acute decompensated heart failure
Authors: Pak Misun , Hara Masahiko , Miura Shoko , Furuya Motohide , Tamaki Masatake , Okada Taiji , Watanabe Nobuhide , Endo Akihiro , Tanabe Kazuaki
Published: October 2020

Background: Delirium is associated with high mortality after cardiac surgery. However, evidence on the epidemiology of delirium in patients with acute decompensated heart failure (ADHF) is limited. This study aimed to assess the incidence and prognostic impact of delirium in patients with ADHF.
Methods: This single-center prospective observational study enrolled 132 consecutive patients with ADHF. We utilized the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and classified the patients into two groups according to the presence or absence of delirium. The primary endpoint was 90-day all-cause mortality. The prognostic impact and risk factors of delirium were evaluated using multivariable Cox and logistic regression analyses, respectively.
Results: The median patient age was 83 (interquartile range, 75–87) years. Approximately 51.5% were men. Delirium occurred in 36 (27.3%) patients, and hyperactive delirium was the most frequent type (86.1%). The 90-day all-cause mortality was higher in the patients with delirium than in those without (21.6% versus 3.9%, log-rank p=0.002). Delirium was associated with higher mortality with an adjusted hazard ratio of 6.8 (95% confidence interval, 1.1–42.6, p=0.042). The risk factors associated with delirium included advanced age, male sex, higher clinical frailty scale score, and dementia.
Conclusions: Delirium was associated with a higher 90-day all-cause mortality in the elderly patients with ADHF. Hyperactive delirium was the most common subtype.