bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing a Virtual Reality for People With Dementia and Mild Cognitive Impairment Based on Their Psychological Needs: A Feasibility Study
Authors: Kim Jung-Hee , Park Seonmin , Lim Hyeongji
Published: October 2020

BackgroundPurpose of this study was to develop a virtual reality (VR) intervention program based on the psychological needs of patients with dementia and mild cognitive impairment residing in nursing facilities in Korea to relieve their behavioral and psychological symptoms, and to confirm the possibility of utilizing VR in patients with dementia and mild cognitive impairment.MethodsIn the first phase, surveys and questionnaires were used to identify activities that relieved the behavioral and psychological symptoms of dementia (BPSD) among patients. These activities were classified into five types of psychological needs. In the second phase, a fully immersive, interactive, easy-to-use VR platform was developed that reflected these psychological needs. The VR content was used with patients with dementia and mild cognitive impairment. The researchers assessed the level of the participants’ immersion, preference, and interaction with the VR, using a 5-point Likert scale. ResultsIn the feasibility test, the mean immersion score was 4.93 ± 0.16 points, the mean preference score was 4.35 ± 0.41 points, and the mean interaction score was 3.84 ± 0.43 points. Six out of 10 participants required assistance while using the VR. The mean VR experience duration was 10.00 ± 3.46 minutes.ConclusionsThe VR-based intervention program that was developed to reduce BPSD was feasible for the participants, and provided them with a high degree of satisfaction and immersion. Furthermore, this study also confirmed the convenience and safety of the program. These findings provide evidence for the potential of VR to provide BPSD intervention programs for patients with dementia and mild cognitive impairment, and potentially for other geriatric conditions.
PD-L1 Associates with The Expression of Cancer Cell-Intrinsic PD-1 and p-S6 Proteins and Predicts A Good Prognosis in Nasopharyngeal Carcinoma
Authors: Zhang Yuting , Zheng Hongmei , Zhan Yuting , Yang Yang , Ning Yue , Wang Haihua , Wang Weiyuan , Fan Songqing , Luo Ying
Published: October 2020

Aims: programmed cell death ligand 1 (PD-L1) is the ligand of programmed death 1 (PD-1), which is a host immunity inhibitory receptor. Expression of PD-L1 in diverse tumor types has been widely discussed, while there is little research about tumor intrinsic-PD-1. P-S6 is an important downstream effector in the PI3K/AKT/mTOR pathway. Our study was focus on investigating PD-L1/PD-1/ p-S6 protein expression and aimed to illustrate their relationship in nasopharyngeal carcinoma (NPC). Methods: the expression of PD-1, PD-L1 and p-S6 proteins in tissues of NPC, non-cancerous nasopharyngeal epithelia, primary lesions and matching metastases was detected by immunohistochemistry. Results: PD-1, PD-L1 and p-S6 expression and co-expression of PD-1 and PD-L1 proteins were significantly higher in NPC than in the non-cancerous control tissue, respectively (all P<0.05). Furthermore, there was evidently elevated PD-1 expression and co-expression of PD-1 and PD-L1 in matched metastasis of NPC compared to their primary lesions (all P<0.01). NPC patients with positive expression of PD-L1 showed significantly higher overall survival rate than others (P =0.035). Multivariate Cox proportional hazard regression analysis confirmed that positive expression of PD-L1 and p-S6 were independent prognostic factors for NPC patients. Conclusions: positive expression of PD-L1 associates with expression of cancer cell-intrinsic PD-1 and p-S6, PD-L1 might serve as a good prognostic biomarker and p-S6 could be a valuable independent poor prognostic biomarker for NPC patients.
Applying Random Forest Model Algorithm to GFR Estimation
Authors: Liu Peijia , Yang Dong , Li Shaomin , Chong Yutian , Hu Wentao , Wang Bohan , Liu Xun
Published: October 2020

Background The utilization of estimating-GFR equations is critical for kidney disease in the clinic. However, the performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation has not improved substantially in the past eight years. Here we hypothesized that random forest regression(RF) method could go beyond revised linear regression, which is used to build the CKD-EPI equationMethods 1732 participants were enrolled in this study totally (1333 in development data set from Tianhe District and 399 in external data set Luogang District). Recursive feature elimination (RFE) is applied to the development data to select important variables and build random forest models. Then same variables were used to develop the estimated GFR equation with linear regression as a comparison. The performances of these equations are measured by bias, 30% accuracy , precision and root mean square error(RMSE).Results Of all the variables, creatinine, cystatin C, weight, body mass index (BMI), age, uric acid(UA), blood urea nitrogen(BUN), hematocrit(HCT) and apolipoprotein B(APOB) were selected by RFE method. The results revealed that the overall performance of random forest regression models ascended the revised regression models based on the same variables. In the 9-variable model, RF model was better than revised linear regression in term of bias, precision ,30%accuracy and RMSE(0.78 vs 2.98, 16.90 vs 23.62, 0.84 vs 0.80, 16.88 vs 18.70, all P<0.01 ). In the 4-variable model, random forest regression model showed an improvement in precision and RMSE compared with revised regression model. (20.82 vs 25.25, P<0.01, 19.08 vs 20.60, P<0.001). Bias and 30%accurancy were preferable, but the results were not statistically significant (0.34 vs 2.07, P=0.10, 0.8 vs 0.78, P=0.19, respectively).Conclusions The performances of random forest regression models are better than revised linear regression models when it comes to GFR estimation.
Maximal Stress Ergometry Performance is Associated with Troponin T and Abdominal Aortic Calcification Score in Severe Chronic Kidney Disease
Authors: Lankinen Roosa , Hakamäki Markus , Metsärinne Kaj , Koivuviita Niina S , Pärkkä Jussi P , Saarenhovi Maria , Hellman Tapio , Järvisalo Mikko J
Published: October 2020

Background Cardiac biomarkers Troponin T (TnT) and N-terminal pro-B-type natriuretic peptide (proBNP) and abdominal aortic calcification score (AAC) are associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD). The effects of cardiac biomarkers and AAC on maximal exercise capacity in CKD are unknown and were studied. Methods 174 CKD 4-5 patients not on maintenance dialysis underwent maximal bicycle ergometry stress testing, lateral lumbar radiograph to study AAC, echocardiography and biochemical assessments. Results The subjects with proportional maximal ergometry workload (WMAX%) less than 50% of the expected values had higher TnT, proBNP, AAC, left ventricular end-diastolic diameter, left ventricular mass index, E/e’ and pulse pressure, and lower global longitudinal strain compared to the better performing patients. TnT (β= -0.09, p=0.02), AAC (β= -1.67, p<0.0001) and diabetes (β= -11.07, p<0.0001) remained significantly associated with WMAX% in the multivariable model. Maximal ergometry workload (in Watts) was similarly associated with TnT and AAC in addition to age, male gender, hemoglobin and diastolic blood pressure in a respective multivariate model. AAC and TnT showed fair predictive power for WMAX% less than 50% of the expected value with AUCs of 0.70 and 0.75, respectivelyConclusions TnT and AAC are independent determinants of maximal ergometry stress test workload in patients with advanced CKD.http://www.ClinicalTrials.gov NCT04223726
Cultural adaptation, translation and validation of the Spanish version of Past-day Adults’ Sedentary Time
Authors: Aguilar-Farias Nicolas , Martino-Fuentealba Pía , Chandia-Poblete Damian
Published: October 2020

Background
To better understand sedentary behaviour and favour international comparisons, more evidence from different countries are needed. However, there are a few tools available in Spanish to measure sedentary behaviour. This study aimed to culturally adapt, translate and validate the Past-day Adults' Sedentary Time (PAST) questionnaire in Chilean adults compared with the ActivPAL (AP).
Method:
101 workers wore an AP for one week and were asked to respond to the Spanish version of the PAST twice on different visits at a 7-day interval. The PAST assesses sedentary behaviour in several domains, including working time, during the previous day. Reliability was assessed with the intraclass correlation coefficient (ICC). Correlations and Bland-Altman methods were used to determine accuracy properties of the PAST compared with the AP.
Results
77 participants provided valid data (51.0% male; age = 39.0 ± 12.39 years). The PAST showed moderate reliability (ICC = 0.63). For the total time in sedentary behavior per day, the PAST showed no correlation (r = 0.21, p = 0.07) and a mean bias of 54.9 min/day (LoA 95%: -484.3, 594.2 min/day) with the AP. For the total time in SB at work, the PAST showed moderate reliability (ICC = 0.40), weak correlation (r = 0.37, p < 0.002), and mean bias was 33.8 min/day (LoA 95%: -285.7, 353.3 min/day).
Conclusions
The PAST performed better when estimating sedentary behaviour during working hours compared with the whole day. In this setting, accuracy properties were comparable with other self-report tools.
Adverse Childhood Experiences and Depression Among Women in Rural Pakistan
Authors: LeMasters Katherine , Bates Lisa M , Chung Esther O , Gallis John A , Hagaman Ashley , Scherer Elissa , Sikander Siham , Staley Brooke S , Zalla Lauren C , Zivich Paul N , Maselko Joanna
Published: October 2020

BackgroundAdverse Childhood Experiences (ACEs) are a common pathway to adult depression. This pathway is particularly important during the perinatal period when women are at an elevated risk for depression. However, this relationship has not been explored in South Asia. This study estimates the association between ACEs and women’s (N=889) depression at 36 months postpartum in rural Pakistan.MethodData come from the Bachpan Cohort study. To capture ACEs, an adapted version of the ACE-International Questionnaire was used. Women’s depression was measured using both major depressive episodes (MDE) and depressive symptom severity. To assess the relationship between ACEs and depression, log-Poisson models were used for MDE and linear regression models for symptom severity.ResultsThe majority (58%) of women experienced at least one ACE domain, most commonly home violence (38.3%), followed by neglect (20.1%). Women experiencing four or more ACEs had the most pronounced elevation of symptom severity (β=3.90; 95% CL=2.13, 5.67) and MDE (PR=2.43; 95% CL=1.37, 4.32). Symptom severity (β=2.88; 95% CL=1.46, 4.31), and MDE (PR=2.01; 95% CL=1.27, 3.18) were greater for those experiencing community violence or family distress (β=2.04; 95%; CL=0.83, 3.25) (PR=1.77; 95% CL=1.12, 2.79). ConclusionsFindings suggest that ACEs are substantively distinct and have unique relationships to depression. They signal a need to address women’s ACEs as part of perinatal mental health interventions and highlight women’s lifelong experiences as important factors to understanding current mental health.Trial RegistrationNCT02111915. Registered 11 April 2014. NCT02658994. Registered 22 January 2016. Both trials were prospectively registered.
Association Between Social Support and Mental Health Status Among College Students: A Nationwide Survey
Authors: Wang Chao , Yan Shijiao , Gan Yong , Jiang Heng , Guo Yingying , Xu Hongbin , Lv Chuanzhu , Lu Zuxun
Published: October 2020

BackgroundSocial support could improve college students’ mental health status. However, mental health varies across different geographic areas, and most of previous studies only included small sample sizes, thus the nationwide survey are warranted. This study sought to estimate the association between social support quality (SSQ) and mental health among Chinese college students using data yielding from a nationwide survey.MethodsA cross-sectional study with a web-based questionnaire survey was conducted in Wuhan, China, from October 2017 to February 2018. A total of 11093 college students were recruited from 18 colleges or universities through multi-stage random cluster sampling method. The Multidimensional Scale of Perceived Social Support scale and 12-items General Health Questionnaire were used to estimate students’ SSQ and mental health status, respectively. Logistic regression analysis was used to identify the association between SSQ and the mental health disorder in college students.ResultsA total of 10,676 (96.24%) college students were included in this study. Of them, 21.4% were identified as having a mental disorder. Students being a female, aged 18-22 years old, whose mother held a college degree and above, and drinking alcohol had more risks of being mental health problems (P <0.05). However, having general or higher family economic levels, working and resting regularly, and sleeping ≥ 7 hours could be preventive factors for mental health problem (P <0.05). Especially, with the improvement of SSQ, there was a decreasing trend in the risk of being mental disorder.ConclusionMental health disorder is an important public health challenge among college students in China. Improving SSQ could be the practical and valuable method to prevent college students’ mental problem.
Recruiting General Practitioners and Patients with Dementia into a Cluster Randomised Controlled Trial: Strategies, Barriers and Facilitators
Authors: Lech Sonia , O'Sullivan Julie Lorraine , Wellmann Leonard , Supplieth Juliana , Döpfmer Susanne , Gellert Paul , Kuhlmey Adelheid , Nordheim Johanna
Published: October 2020

Background: Recruitment of general practitioners (GPs) and their patients is reported as one of the most challenging steps when undertaking primary care research. The present paper describes the recruitment process of a cluster randomised controlled trial (cRCT) aiming to improve dementia care in the primary care setting.Methods: Recruitment data was analysed descriptively using frequency tables to investigate comparisons of recruitment rates and results of different recruitment strategies as well as reasons for participation and non-participation of GPs, patients with dementia (PwD) and their caregivers.Results: Over a period of 23 months, N = 28 GPs were successfully included in the cRCT. This represents an overall recruitment rate of 4.6%. The most efficient strategy in terms of high response and low labour-intensity involved the dissemination of calls for participation in a GP research network. Most frequently reported reasons for GP’s participation were Improvement of patient’s well-being (n = 22, 79%) followed by Interest in dementia research (n = 18, 64%). The most common reasons for non-participation were Lack of time (n = 71, 34%) followed by Not interested in participation (n = 63, 30%). On a patient level, N = 102 PwD were successfully recruited. On average, each GP referred about n = 7 PwD (range: 1-17; mdn = 6; IQR = 3.5) and successfully recruited about n = 4 PwD (range: 1-11; mdn = 3; IQR = 3.5).Conclusion: First, our findings propose GP research networks as a promising strategy to promote recruitment and participation of GPs and their patients in research. Second, present findings highlight the importance of including GPs and their interests in specific research topics in early stages of research in order to ensure a successful recruitment. Finally, results do not support cold calls as a successful strategy in the recruitment of GPs. Trial registration: The trial was prospectively registered with the ISRCTN registry (Trial registration number: ISRCTN15854413). Registered 01 April 2019, http://www.isrctn.com/ISRCTN15854413
Development of Multifactor Index for Assessing Quality of Life of a Tribal Population of India: Multilevel Analysis Approach
Authors: m Bagavandas
Published: October 2020

BackgroundThe main objective of this study is to develop multilevel multi-factor index to assess the quality of life of Malayali tribal population of India at the individual and village levels based on nine domains, namely, Demography, Economy, Health, Human Development, Infrastructure Development, Work Participation, Recreation, Social Capital and Self Perception. Also, an attempt is made to classify the individuals as well as villages on the basis of the overall scores of multifactor index within a community which will help policy makers to develop concrete policy recommendations for the improvement of quality of life of this tribal group.MethodMultilevel factor analysis is utilized to determine uncorrelated meaningful factors and their respective weights using Mplus software from the nested dataset consists of values of nine domains of 1096 individuals collected from 19 villages. Multilevel multifactor index is constructed using the weights of these factors. The qualities of lives of different households and of different villages are assessed using the scores of this index.ResultsThree different factors are identified at household as well as village levels. The quality of life at Households and at villages levels are classified as poor, low, moderate, good and excellent based on five quintiles of the scores of the multifactor index and the contribution of each domain in this classification is ascertained.DiscussionThis study finds that at household as well as at village levels, the quality of life of the individuals of this tribal population increases with increase in education, income and occupation status which make them to lead a healthy life and also make them to find time and money to spend on recreation. Infrastructure does not play a significant role at the house hold level whereas it is a matter at village level. ConclusionThe main purpose of developing this kind of multifactor index at different levels is to provide a tool for tribal development based on realistic data which can be used to monitor the key factors that encompass the social, health, environmental and economic dimensions of quality of lives at the individual/household and community levels of this tribal people.
A Systems Thinking Approach to Understanding Public Trust in Healthcare Services and Doctor-patient Relationship in the Contexts of Medical Errors
Authors: Kaewkamjonchai Phanuwich , Piancharoen Peeraya , Saringkarisate Kornkanok , Rojcheewin Sorrawit , Wananukul Pongpat , Suttawas Adithep , Sriyudtha Gunkawee , Limpanyalert Piyawan , Leerapan Borwornsom
Published: October 2020

Background: Medical malpractice lawsuits in Thailand have been increasing, often leading to conflicts among stakeholders that could deteriorate the doctor-patient relationship and the public trust in healthcare services. To address this complex problem, we report on a systems thinking approach to developing a mutual understanding among stakeholders on the root causes of deteriorating trust in healthcare services and weakening doctor-patient relationships in the contexts of medical errors.Methods: We adopted a systems thinking approach and conducted a series of group model building sessions with participating stakeholders from various organizations in Thailand (n=20), including policymakers, administrators of healthcare organizations, healthcare providers, advocates of patient rights, and the victims of medical errors. The initial causal loop diagram was mutually created during the group model building workshop. It was then reviewed and elaborated by community leaders and experts in patient safety and health systems development. Results: The group model building process revealed that the shared understanding of what causes this persistent problem is lacking, and that multiple perspectives are needed to create sustainable solutions. The final model of our causal loop diagram, which explains why both the public trust in healthcare services and the doctor-patient relationship have been deteriorating over time, consists of four domains: 1) medical errors and malpractice lawsuits; 2) the roles of third-party beneficiaries in medical lawsuits and the conflicts presented on mass and social media; 3) the public trust of healthcare services; 4) the healthcare quality improvement efforts.Conclusions: Our findings provide an insight into the potential high-leverage points within health systems for reducing medical errors, improving public trust in healthcare services, and strengthening the doctor-patient relationship in Thailand. One of the emerging policy recommendations was to change the existing law towards a balance of monetary and non-monetary remedies for victims of medical errors.
The Lymph Node Ratio Predicts Cancer-specific Survival of Node-positive Non-small Cell Lung Cancer Patients: a Population-based SEER Analysis
Authors: Kai Liu , Chen Zhoumiao , Shaohua Xun , Zhao Chen , Zhijun Li , Zhengfu He , Cai Xiujun
Published: October 2020

Background: Lymph node ratio (LNR) has been suggested to be an effective prognostic tool for stratifying non-small cell lung cancer (NSCLC) cases. In this study, we sought to determine cancer-specific survival (CCS) of NSCLC cases from the SEER registry and used the X-tile method to optimize CCS-based LNR cut-off points for prognostic stratification of node-positive NSCLC.Methods: CSS and other clinicopathologic variables were retrieved from the SEER registry. Kaplan-Meier methods were used to calculate CSS. The optimal cut-off points for LNR classification were determined by the X-tile approach. Multivariate Cox regression analysis was performed to identify independent risks of CSS. Results: Totally 11,341 lung cancer patients were included. Their median CSS was 22 months (range 0,143). The median LNR was 0.22 (Q1,Q3: 0.11, 0.50). X-tile analysis showed that the optimal LNR cut-off points were 0.28 and 0.81, dividing the cohort into low (LNR1≤0.28; n=6580, 58%), middle (0.28<LNR2<0.81; n=3025, 26.7%), and high (LNR3>0.81; n=1736, 15.3%) subsets. Kaplan-Meier analysis showed that patients with a low LNR had a significantly higher CCS versus patients with middle or high LNR (P<0.001). Multivariate competing risks regression analysis revealed that LNR was an independent and significant adverse predictor of CSS (LNR2 vs. LNR1: SHR: 1.56, 95%CI: 1.47,1.67, P<0.001; LNR3 vs. LNR1: SHR: 2.54, 95%CI: 2.30,2.80, P<0.001).Conclusions: LNR is an independent prognostic factor of node-positive NSCLC and its optimal cut-off values established using the robust x-tile method effectively define subpopulations of node-positive NSCLC cases, which is important in guiding selection of treatment strategies clinically.
Identification and Verification of the Molecular Mechanisms and Prognostic Values of the Cadherin Gene Family in Gastric Cancer
Authors: Luo Shanshan , Liao Xiwen , Mo Xianwei , Li Daimou , Qin Yuzhou
Published: October 2020

Background: While cadherin (CDH) genes are aberrantly expressed in cancers, the functions of CDH genes in gastric cancer (GC) remain poorly understood. The clinical significance and molecular mechanisms of CDH genes in GC were assessed in this study.Methods: Data from a total of 1226 GC patients included in The Cancer Genome Atlas (TCGA) and Kaplan-Meier plotter database were used to independently explore the value of CDH genes in clinical application. The TCGA RNA sequencing dataset was used to explore the molecular mechanisms of CDH genes in GC.Results: Using enrichment analysis tools, CDH genes were found to be related to cell adhesion and calcium ion binding in function. In TCGA cohort, 12 genes were found to be differentially expressed between GC para-carcinoma and tumor tissue. By analyzing GC patients in two independent cohorts, we identified and verified that CDH2, CDH6, CDH7 and CDH10 were significantly associated with a poor GC prognosis. In addition, CDH2 and CDH6 were used to construct a GC risk score signature that can significantly improve the accuracy of predicting the 5-year survival of GC patients. The GSEA approach was used to explore the functional mechanisms of the four prognostic CDH genes and their associated risk scores. It was found that these genes may be involved in multiple classic cancer-related signaling pathways, such as the Wnt and phosphoinositide 3-kinase signaling pathways in GC. In the subsequent CMap analysis, three small molecule compounds (anisomycin, nystatin and bumetanide) that may be the target molecules that determine the risk score in GC, were initially screened. Conclusions: Our current study suggests that four CDH genes can be used as potential biomarkers for GC prognosis. In addition, a prognostic signature based on the CDH2 and CDH6 genes was constructed, and their potential functional mechanisms and drug interactions explored.
Effects of Repeated Inhalation of Sevoflurane During Infancy on Cognitive Function and Hippocampal Volume of SD Rats in Childhood and Adulthood
Authors: Zhu YuHang , Ren JuanJuan , Zhang Chao , Gong TaoWu , Zhao PengCheng , Lin XiaFei , Yang Yang , Liu DeXing , Zhu ZhaoQiong
Published: October 2020

Background: It has been reported that repeated exposure to sevoflurane, a widely used general anesthesia in pediatric surgeries, may lead to brain defect in infant. However, the long-term effect of repeated exposure to sevoflurane during infancy on the learning behavior and neuro-development is less investigated yet.Methods: Sixty-four SD (sprague dawley) rats were randomly divided in to two groups, the experimental group (n=32) was exposed to sevoflurane (2.6%, 2 h) and the control group (n=32) was exposed to carrier gas (1 L/min O2 + 1 L/min Air, 2 h) for three times at infancy (P (postnatal day) 7, P14, and P21). At childhood (P32 to P36), SD rats in each group (n=16) received Morris Water Maze (MWM) test, and then Magnetic Resonance Imaging (MRI) was used to scan their brain and hippocampus at P37. Subsequently, the same NWM test and MRI scanning was conducted for the remaining SD rats in their adulthood (P92 to P97) (n = 16/group).Results: After being exposed to sevoflurane in infancy, the hippocampal volume of SD rats significantly decreased in their childhood and adulthood, their whole brain volume was also shrunken in adulthood; however, MWM test showed there is no obvious change in their spatial learning and memory recall performance either in childhood or in adulthood.Conclusions: Although repeated exposure to sevoflurane in infancy did not affect the spatial learning and memory performance of rats, however, it could result in the decease of hippocampal and brain volume in their adulthood. This study suggests that repetitive sevoflurane exposure in infancy may exert long-term risk in brain development.
Expression and Prognostic Impact of FZDs in Pancreatic Adenocarcinoma
Authors: Li Yang , Liu Zirong , Zhang Yamin
Published: October 2020

Background: Despite the high number of researches on pancreatic adenocarcinoma (PAAD) over past decades, little progress had been made due to lack of effective treatment regimens. we aimed to investigate the expression level, mutation, and clinical significance of the Frizzled (FZD) family in PAAD so as to establish a sufficient scientific evidence for clinical decisions and risk management.Methods: PAAD samples were extracted from The Cancer Genome Atlas (TCGA). Oncomine, Gene expression profiling interactive analysis (GEPIA), Human Protein Atlas (HPA), Kaplan-Meier Plotter, cBioPortal, LinkedOmics, DAVID database, and R software (x64 3.6.2) were used to comprehensively analyze the roles of FZDs. p-value below to 0.05 was considered as significant difference.Results: In total, 179 PAAD tissues and 171 paracancerous tissues were included. The expression levels of FZD1, 2, 6, 7, and 8 were higher in PAAD tissues than those in normal pancreatic tissue. The higher the expression levels of FZD2 and FZD7, the higher the clinical stage. PAAD patients with high expression of FZD6 had shorter overall survival (OS) than those with low expression, indicating that FZD6 could be a potential prognostic and predictive marker in PAAD. PAAD patients with high expression of FZD8 had shorter recurrence free survival (RFS) than those with low expression, indicating that FZD8 could be a potential therapeutic target in PAAD. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed that FZDs played a critical role in the Wnt signaling pathway, which was further confirmation that FZDs were transmembrane receptors of Wnt signaling pathway. Conclusions: Our results strongly indicated a crucial role of the FZD family in PAAD. FZD3, 4, 5, 6, and 9 could be potential prognostic and predictive markers, and FZD4 and 8 might function as potential therapeutic targets in PAAD.
Mapping Brain-Behavior Space Relationships Along the Psychosis Spectrum
Authors: Ji Jie Lisa , Helmer Markus , Fonteneau Clara , Burt Joshua , Tamayo Zailyn , Demsar Jure , Adkinson Brendan , Savic Aleksandar , Preller Katrin , Moujaes Flora , Vollenweider Franz , Martin William , Repovs Grega , Murray John , Anticevic Alan
Published: October 2020

Difficulties in advancing effective patient-specific therapies for psychiatric disorders highlights a need to develop a neurobiologically-grounded, quantitatively stable mapping between neural and symptom variation. This gap is particularly acute for psychosis-spectrum disorders (PSD). Here, in a sample of 436 cross-diagnostic PSD patients, we derived and replicated a data-driven dimensionality-reduced symptom space across hallmark psychopathology symptoms and cognitive deficits, which was predictive at the single patient level. In turn, these data-reduced symptom axes mapped onto distinct and replicable univariate brain maps. Critically, we found that multivariate brain-behavior mapping techniques (e.g. canonical correlation analysis) did not show stable results. Instead, we show that a univariate brain-behavioral space (BBS) mapping can resolve stable individualized prediction. Finally, we show a proof-of-principle framework for relating personalized BBS metrics with molecular targets via serotonin and glutamate receptor manipulations and gene expression maps. Collectively, these results highlight a stable and data-driven BBS mapping across PSD, which offers an actionable quantitative path that can be iteratively optimized for personalized clinical biomarker endpoints.
Data Analysis of Ambient Intelligence in a Healthcare Simulation System: A Pilot Study in High-end Health Screening Process Improvement
Authors: Chen Ming-Shu , Wu Kun-Chih , Tsai Yu-Ling , Jiang Bernard C.
Published: October 2020

This study aimed to reduce the total waiting time for high-end health screening processes. The subjects of this study were recruited from a health screening center in a tertiary hospital in northern Taiwan from September 2016 to February 2017 and a total of 2,342 high-end customers were collected. Arena software was used to simulate the examination process. We presented the simulation results of three different policies and compared those results to the current state. The first policy presented a predetermined proportion of customer types, in which the total waiting time was increased from 72.29 to 83.04 mins. The second policy was based on increased bottleneck resources and provided significant improvement, with the total waiting time was decreased from 72.29 to 28.39 mins. However, this policy also caused the cost to increase dramatically, while lowering the utilization of this exam station. The third policy was adjusting customer arrival times, which reduced the waiting time significantly, as the total waiting time was reduced from 72.29 to 55.02 mins. Although the wait time of this policy was slightly longer than that of the second policy, the additional cost was much lower than the second plan. Scheduled arrival intervals could help to reduce customer waiting time in the health screening department base on FIFO rule. The simulation model of this study could be utilized and the parameters could be modified to comply with different health examination centers to improve process and service quality.
Effect of Health Transformation Plan on the Public Hospitals Performance Indicators; A Case Study in Iran
Authors: Ranjbar Mohammad , Jafari Hassan , Baziyar Mohammad , Pakdaman Mohsen , Pirasteh Vahid
Published: October 2020

IntroductionHealth systems need constant changes and reforms in their structure in order to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in the context of Yazd. MethodsThe present cross-sectional study was carried out in all public hospitals in Yazd. Six performance indicators were examined on a monthly basis and in two time periods of 12 months before and after the implementation of HTP. Data were analyzed using SPSS software program version 22, the paired T-test and the Interrupted Time Series model. FindingsThe implementation of the health transformation plan did not have a significant effect on the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators (p> 0.05). However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates (p <0.05). Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy indicator (P <0.05), but did not have a significant effect on the trend of this indicator (p> 0.05).ConclusionBased on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which in a way showed the effect of this plan on the performance of hospitals. Therefore, the continuation of such a plan, provided that sustainable financial resources are planned and human and physical resources are organized properly, can be an important step towards achieving universal health coverage and increasing justice in access to services.
A Deep-learning Algorithm With the Real World Validation for Detecting Acute Myocardial Infarction
Authors: Liu Wen-Cheng , Lin Chin-Sheng , Tsai Chien-Sung , Tsao Tien-Ping , Cheng Cheng-Chung , Liou Jun-Ting , Lin Wei-Shiang , Cheng Shu-Meng , Lou Yu-Sheng , Lee Chia-Cheng , LIN CHIN
Published: October 2020

BackgroundThe initial detection and diagnosis of ST-segment or non-ST-segment elevation myocardial infarction (STEMI or NSTEMI) definitely rely on a 12-lead electrocardiogram (ECG). Delay or misdiagnosis is not unusual by subjective interpretation. Our aim is to develop a DLM as a diagnostic support tool to detect MI based on a 12-lead ECG and to evaluate the performance of this model.MethodsThis study included 1,051 ECGs from 737 coronary angiography (CAG)-validated STEMI patients, 697 ECGs from 287 CAG-validated NSTEMI patients, and 140,336 not-MI ECGs from 76,775 patients at emergency departments. DLM was trained and validated for the performance using 80% and 20% of the ECGs, respectively. A human-machine competition was conducted. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were used to evaluate the performance of DLM and experts. STEMI versus not-STEMI, and MI versus not-MI were evaluated by DLM.ResultsThe AUCs of DLM for identifying STEMI and MI were 0.976 and 0.944 in the human-machine competition, respectively, which were significantly better than those of our best clinicians. In the real world setting, DLM presented with AUC of 0.995/0.916 with corresponding sensitivities of 96.9%/77.0%, and specificities of 96.2%/92.9% in the identification of STEMI and MI, respectively. Furthermore, DLM demonstrated sufficient diagnostic capacity for STEMI without the aid of troponin I (TnI) (AUC= 0.996) with corresponding sensitivity and specificity of 98.4% and 96.9%. The AUC of combined DLM and the first recorded TnI for the detection of NSTEMI were increased to 0.978 with corresponding sensitivity and specificity of 91.6% and 96.7%, which was better than that of DLM (0.877) or TnI (0.949) alone. ConclusionsDLM may serve as a diagnostic decision tool to assist intensive or emergency medical system-based networks and frontline physicians in identifying STEMI and NSTEMI in a timely and precise manner to prevent delay or misdiagnosis, and thereby to facilitate subsequent reperfusion therapy.
Space Use and Seasonal Movement of Isolated Mountain Goat Populations in the North Cascades, WA
Authors: Sevigny Jennifer , Summers Amanda , George-Wirtz Emily
Published: October 2020

Background: The spatial distribution and seasonal movement patterns of isolated populations of mountain goats (Oreamnos americanus) in the North Cascade range of Washington State is not fully understood. Determining harvest potential in these populations is challenging without a clear understanding of spatiotemporal movement, space use, and spatial overlap. Mountain goat populations in the North Cascades are fragmented and many have declined considerably from historic estimates. Identification of harvestable populations requires a clear understanding of population size, distribution, and movement. We investigated the population trends and spatial distribution of mountain goats in the Boulder River North Harvest Area in Boulder River Wilderness of Washington State. Methods: We reviewed recent mountain goat population estimates and used Global Positioning System collar data to determine year-round and seasonal home range distributions, spatial overlap within these ranges, and proximity of mountain goats to roads and trails.Results: We found 2 populations of mountain goats inhabiting the Whitehorse and Three Fingers Mountains in the Boulder River North Harvest Area. These 2 populations were spatially distinct and did not intermix during our study period. We also found mountain goats using exclusive areas seasonally on Whitehorse Peak that may represent separate or isolated groups. The Whitehorse population appeared to be more vulnerable to harvest than Three Fingers based on its proximity to roads and trails. Conclusions and Management Recommendations: This study provides space use and movement information on mountain goats in the North Cascades Range that can be used to improve harvest management of fragmented and isolated populations. Our results indicate that a re-evaluation of harvest level, harvest unit boundary, and monitoring strategy may be warranted for the Boulder River North mountain goat harvest area.
Preparation of Gold Nanoplates Using Ortho Carbonyl Compounds as Capping Agents for Electrochemical Sensing of Lead Ions
Authors: Jiang Xinde , Ma Jianye , Jiang Guixian , Xu Manqing , Huang Xueping , Gao Guiqing , Dai Xin
Published: October 2020

In this study, gold nanoplates were synthesized using plant molecules (gallic acid) following a kinetic control mode. The growth of nanoplates is mainly due to the specific adsorption of capping agents on certain crystal facets. Through systematical characterizations, it is found that the distance between two oxygen atoms in ortho carbonyl compounds matches well with the lattice spacing of gold (111) facets exactly, which is beneficial to the formation of twin seeds and further the growth of plate-like gold nanoparticles. The gold nanoplates on glassy carbon electrode shows a remarkably improved electrochemical sensing activity of lead ions compared to the bare glassy carbon electrode or spherical gold nanoparticle modified electrode. The modified electrode is expected to be used in the detection of lead ion concentration in heavy metal wastewater.
Ibuprofen and NSAIDs use in COVID-19 infected patients is Not Associated with Worse Outcomes
Authors: Esba Laila Carolina Abu , Alqahtani Rahaf Ali , Thomas Abin , Shamas Nour , Alswaidan Lolowa , Mardawi Gahdah
Published: October 2020

Background: Ibuprofen disappeared off the pharmacy shelves during the COVID-19 pandemic. However, a while later circulating information was that ibuprofen should be avoided as it could worsen COVID-19 symptoms. The aim of our study was to assess the association of NSAID acute and chronic use with worse COVID-19 outcomes.Methods: We did a prospective cohort study between April 12 and June 1, 2020. Adults consecutively diagnosed with COVID-19 were included. Information on NSAID use was collected through a telephone questionnaire and patients were followed up for COVID-19 infection outcomes, including death, admission, severity, time to clinical improvement, oxygen requirement, and length of stay.Findings: Ibuprofen acute use was not associated with a greater risk of mortality relative to nonusers (adjusted hazard ratio (HR) 0·632 [95% CI, 0·073- 5·441; P=0·6758]). NSIAD chronic use was also not associated with greater risk of mortality (adjusted HR, 0·492 [95% CI, 0·178 - 1·362; P= 0·1721]). Ibuprofen acute use was not associated with a higher risk of admission compared to non-NSAID users (adjusted odds ratio OR, 1·271; 95% CI, 0·548 - 2·953). NSAID users did not have a significantly longer time to clinical improvement, or length of stay.Interpretation: Ibuprofen and other NSAID acute or chronic use were not associated with worse COVID-19 disease outcomes.
New challenges to mental health needs in response to the COVID-19 outbreak in India: Insights from a pilot survey
Authors: Ray Suman
Published: October 2020

With the pandemic rapidly rising at the global level and so its impact on the mental health, a pilot survey (online) using DASS Scale 21 was conducted to know how COVID-19 has affected mental health status of general population in India. The results showed that anxiety and stress were prevalent from mild to moderate level and depression in mild level. As the uncertain future due to COVID-19 is becoming dominant, it is high time to prepare ourselves so as to prevent the second wave of mental health crises post COVID-19 pandemic.
An Alternative Healing Method for Grafted Tomato Transplants: The Effect of Light Exclusion and Substrate Temperature on Plant Survival and Growth
Authors: Lang Kristine M. , Nair Ajay , Litvin Alexander G.
Published: October 2020

The use of tomato (Solanum lycopersicum) grafting is gaining traction across the United States, but small-scale growers face the challenge of creating optimum postgrafting healing conditions. The practice of blocking light for a period of 2 to 4 days while maintaining high humidity is commonly recommended for healing grafted tomato transplants; however, research is exploring alternatives to this practice. The present study investigated a low-input healing method for grafted tomato transplants with a specific focus on light and the use of propagation heat mats to regulate substrate and healing chamber air temperatures during the 7-day healing process. We hypothesized that 4 days of light exclusion and the use of propagation heat mats would improve grafted tomato transplant survival and growth. ‘Cherokee Purple’ was used as the scion and ‘RST-04-106-T’ was used as the rootstock. The whole plot factor was heat [propagation mats set at 80 °F (heat) or no propagation mat (no heat)] and the subplot factor was light exclusion (0, 4, or 6 days of dark). The highest survival rate among treatments was 97% in 0 days of dark with no heat treatment; survival decreased to 84% in 4 and 6 days of dark with no heat treatments. The plant survival rate was 96% with 0 days of dark and heat treatment; however, the survival rates were 63% and 45% for the 4- and 6-day dark treatments, respectively. The scion stem diameter was largest for transplants grown in 0 days of dark, but there was no difference in stem diameter due to heat treatments. There were no differences among scion or rootstock biomasses due to heat or light treatments. These results demonstrate that propagation mats set at 80 °F to regulate the substrate temperature were detrimental to grafted transplant survival under extended periods of light exclusion. However, this finding creates the basis to explore lower levels of substrate temperature modification. Our work also indicates that light exclusion may not be necessary for healing grafted tomato plants regardless of root-zone temperature treatments. Future work should examine the interactions of various substrate and air temperatures under full light conditions and their effects on grafted tomato transplant survival and growth. This work contributes to the ongoing research of how to optimize low-input healing methods that may be readily adopted by small-scale tomato growers.
CLASSIFICATION AND CHARACTERISTIC OF SOILS IN URBAN AREAS (ON THE EXAMPLE OF ODESSA CITY)
Authors: Khokhryakova Anastasiya
Published: October 2020

The purpose of the research – 1) establishment of classification and diagnostic characteristics of soils under different functional using of the city territory; 2) parameterization of the structure, composition and properties of anthropogenically transformed and anthropogenically created soils; 3) development of a classification scheme, taking into account its use in cadastral and economic grouping. General scientific (systematic, analysis, synthesis, generalization, statistics) and traditional (soil-genetic, profile-morphological, laboratory-analytical and cartographic) research methods were used to study the genetic characteristics of soils of Odessa and their classification. The ecological-profile-genetic classification of soils of urban areas, which combines profile-genetic and factor-ecological approaches, is proposed. Within the city there are natural, anthropogenically transformed and anthropogenically created soils. Soils during cadastral and economic grouping are united into two groups of transformed and technological soils of human settlements and other territories with anthropogenically transformed soil cover, are distinguished. According to cadastral and economic grouping, within Odessa the area of transformed soils is 11,915.6 ha, technological soils is 1922.5 ha. The proposed scheme of soil classification of urban areas includes 2 supertype levels, 3 types and 13 subtypes of soils, which are divided according to their genetic profile and combined according to the characteristics of natural and anthropogenic factors of soil formation. For urban cadastre, organization, planning and implementation of land management, economic activity, a scheme of supplementing the list of agricultural soils of Ukraine with cadastral and economic grouping of soils of urban areas was proposed. The grouping of soils includes two associations: 1) transformed and 2) technological (artificially created) soils - a total of 14 cadastral and economic groups