bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of retrieved lymph nodes count on short-term complications in patients with gastric cancer
Authors: Sun Feng , Liu Song , Song Peng , Zhang Chen , Liu Zhijian , Guan Wenxian , Wang Meng
Published: August 2020

Background: It is well established that retrieved lymph nodes (RLNs) count were positively correlated with better overall survival in gastric cancer (GC). But little is known about the relationship between RLNs count and short-term complications after radical surgery. Methods: A total of 1487 consecutive GC patients between January 2016 and December 2018 at Nanjing Drum Tower Hospital were retrospectively analyzed. Univariate analyses were performed to elucidate the association between RLNs count and postoperative complications. We further identified clinical factors that might affect the RLNs count. Results: Among all of the patients, postoperative complications occurred in 435 (29.3%) patients. The mean RLNs count was 25.1 and 864 (58.1%) patients were diagnosed with lymph node metastasis. Univariate analyses showed no significant difference between RLNs count and postoperative complications (both overall and stratified by CDC grade). Univariate and multivariate analyses further revealed that type of resection, tumor invasion, and lymph node metastasis were associated with RLNs count. Conclusions: The current study demonstrated that RLNs count was not associated with postoperative short-term complications following gastrectomy of GC, which provided a rationale for the determination of a proper RLNs count of curative gastrectomy.
Identification of a metabolism-related gene expression prognostic model in endometrial carcinoma patients
Authors: Jiang Pinping , Sun Wei , Shen Ningmei , Huang Xiaohao , Fu Shilong
Published: August 2020

Background: Metabolic abnormalities have recently been widely studied in various cancer types. This study aims to explore the expression profiles of metabolism-related genes (MRGs) in endometrial cancer (EC). Methods: We analyzed the expression of MRGs using The Cancer Genome Atlas (TCGA) data to screen differentially expressed MRGs (DE-MRGs) significantly correlated with EC patient prognosis. Functional pathway enrichment analysis of the DE-MRGs was performed. LASSO and Cox regression analyses were performed to select MRGs closely related to EC patient outcomes. A prognostic signature was developed, and the efficacy was validated in part of and the entire TCGA EC cohort. Moreover, we developed a comprehensive nomogram including the risk model and clinical features to predict EC patients' survival probability.Results: Forty-seven DE-MRGs were significantly correlated with EC patient prognosis. Functional enrichment analysis showed that these MRGs were highly enriched in amino acid, glycolysis, and glycerophospholipid metabolism. Nine MRGs were found to be closely related to EC patient outcomes: CYP4F3, CEL, GPAT3, LYPLA2, HNMT, PHGDH, CKM, UCK2 and ACACB. Based on these nine DE-MRGs, we developed a prognostic signature, and its efficacy in part of and the entire TCGA EC cohort was validated. The nine-MRG signature was independent of other clinical features, and could effectively distinguish high- and low-risk EC patients and predict patient OS. The nomogram showed excellent consistency between the predictions and actual survival observations. Conclusions: The MRG prognostic model and the comprehensive nomogram could guide precise outcome prediction and rational therapy selection in clinical practice.
Geography Matters for Sanitation! Spatial Heterogeneity of the District-level Correlates of Open Defecation in India
Authors: Chakraborty Saurav , Novotný Josef , Das Jadab , Bardahn Aditi , Roy Srijanee , Mondal Swikriti , Patel Priyank Pravin , Santra Sneha , Maity Indranil , Biswas Rimi , Maji Aparajita , Pramanik Suvamoy
Published: August 2020

The authors have withdrawn this preprint due to author disagreement.
Impact of investigational microbiota therapeutic RBX2660 on the gut microbiome and resistome revealed by a placebo-controlled clinical trial
Authors: Kwak Suryang , Choi JooHee , Hink Tiffany , Reske Kimberly A. , Blount Kenneth , Jones Courtney , Bost Margaret H. , Sun Xiaoqing , Burnham Carey-Ann D. , Dubberke Erik R. , Dantas Gautam
Published: August 2020

Background. Intestinal microbiota restoration can be achieved by complementing a subject’s perturbed microbiota with that of a healthy donor. Recurrent Clostridioides difficile infection (rCDI) is one key application of such treatment. Another emerging application of interest is reducing antibiotic resistant genes (ARGs) and organisms (AROs). In this study, we investigated fecal specimens from a multicenter, randomized, double-blind, placebo-controlled phase 2b study of microbiota-based investigational drug RBX2660. Patients were administered either placebo, 1 dose of RBX2660 and 1 placebo, or 2 doses of RBX2660 via enema and longitudinally tracked for changes in their microbiome and antibiotic resistome.Results. All patients exhibited significant recovery of gut microbiome diversity and a decrease of ARG relative abundance during the first 7 days post-treatment. However, the microbiome and resistome shifts towards average configurations from unperturbed individuals were more significant and longer-lasting in RBX2660 recipients compared to placebo. We quantified microbiome and resistome modification by RBX2660 using a novel ‘transplantation index’ metric. We identified taxonomic and metabolic features distinguishing the baseline microbiome of non-transplanted patients and taxa specifically enriched during the process of transplantation. We elucidated the correlation between resistome and taxonomic transplantations and post-treatment dynamics of patient-specific and RBX2660-specific ARGs. Whole genome sequencing of AROs cultured from RBX2660 product and patient samples indicate ARO eradication in patients via RBX2660 administration, but also, to a lesser extent, introduction of RBX2660-derived AROs.Conclusions. Through shotgun metagenomic sequencing, we elucidated the effects of RBX2660 in the microbiome and resistome. Antibiotic discontinuation alone resulted in significant recovery of gut microbial diversity and reduced ARG relative abundance, but RBX2660 administration more rapidly and completely changed the composition of patients’ microbiome, resistome, and ARO colonization by transplanting RBX2660 microbiota into the recipients. Although ARGs and AROs were transmitted through RBX2660, the resistome post-RBX2660 more closely resembled that of the administered product—a proxy for the donor—than an antibiotic perturbed state.Trial registration: NCT02299570. Registered 19 November 2014, https://clinicaltrials.gov/ct2/show/NCT02299570
A Predictive Noise Correction Methodology for Manufacturing Systems Datasets
Authors: Oleghe Omogbai
Published: August 2020

In manufacturing systems, datasets intended for data driven decisions are majorly generated from time-sequenced sensor readings. Industrial sensors are prone to transmit inaccurate readings due to various reasons, which results in noisy datasets. Noisy datasets inhibit machine learning and knowledge discovery. This article reports a methodology that was developed to rectify a very noisy dataset of a multi-stage continuous manufacturing process, with multi-feature output. In the methodology, erroneous values are first swapped with missing values. Then, feature reduction modelling is used as a precursor of prediction learning to improve machine learning performance. Afterwards, a classifier model is built to predict replacement values for the missing values. Finally, predicted values are inputted to replace missing values in the dataset. With many attributes having erroneous values, the values replacement is done one attribute at a time. The flow direction and stages in the manufacturing process are used in partitioning the dataset to improve learning performance. With the methodology, important system relationships are identified and the dataset is learnt for predictive process monitoring. There is a paucity of this type of methodology for dealing with noisy datasets in manufacturing systems. In the future, the plan is to inject the prediction model into streaming data to enable real-time erroneous value correction and real-time predictive process monitoring at the same time.
Perception and Belief in Oral Health Among Karen Ethnic Group Living Along Thai-myanmar Border, Thailand
Authors: Thu Sai Wai Yan Myint , Ngeonwiwatkul Yaowaluk , Maneekan Pannamas , Phuanukoonnon Suparat
Published: August 2020

Background: Utilization of oral health services has been low among rural populations in Thailand, especially for minority ethnicity populations living along the borders. The aim of this study was to increase understanding of the determinants of the underutilization of oral health services among these populations.Methods: A qualitative study using in-depth interview and semi-structured interview was conducted among participants of Karen ethnicity living in Mae Tan Sub-district, Thasongyang District, Tak Province, Thailand. The interviews focused on exploring the participants’ perceptions of oral health problems, oral health and hygiene, and oral health-seeking behaviors. The verbatim-transcribed interviews were analyzed using thematic analysis.Results: A total of 101 participants (50 adults and 51 children) with a Karen ethnic background took part in the interviews. Most participants could not identify oral health problems and did not perceive dental disease as a problem unless there was severe pain that could not be relieved by painkillers. The Karen ethnic community worked as subsistence farmers, and their busy daily activities consisted of farming, going to the forest to hunt and gather, performing housework, and taking care of their children. Dental health was given a lower priority compared with general health. The perceived value of primary teeth was low, which was identified as an underlying factor resulting in delayed oral health care seeking among this population. The participants had relied on self-care throughout their lifetimes, using either traditional medicines or modern painkillers to relieve toothaches. Fear of dental procedures among children was also described as a barrier to seeking dental health care.Conclusions: This study found that the lifestyle and traditions of Karen people living in this area influence their oral health care and hygiene activities as well as their health-seeking behaviors. Further research should emphasize how to improve oral health promotion by providing necessary services and health education appropriately to Karen ethnic populations living along the Thai-Myanmar border.
Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease
Authors: Chakravarthy Krishnan V. , Chaturvedi Rahul , Agari Takashi , Iwamuro Hirokazu , Reddy Rajiv , Matsui Ayano
Published: August 2020

Background: In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson’s Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS). Methods: 15 patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst DR stimulation (40Hz, 500Hz, 1000μs), or cycle mode (on time of 10-15 sec, off time of 15-30 sec) with Burst DR (40Hz, 500Hz, 1000μs). Patients completed the Visual Analogue Scale (VAS), Unified Parkinson’s Disease Rating Scale, Self-Rating Depression Scale, Hamilton Depression Rating Scale, Profile of Mood State, 10-meter walking test, and the Timed Up and Go (TUG). Results: All patients experienced significant improvement in VAS scores. 73% of patients experienced improvement in the 10-meter walk, with a mean improvement of 12%. 82% of patients experienced improvements in the TUG, with a mean improvement of 15%. Conclusions: This study points to the utility of SCS to address both pain and motor symptoms in PD patients who have and have not received DBS therapy.
One-Stop Clinic for Patients with Suspected Ovarian Cancer Pathway from a Retrospective Outcome Study
Authors: Ashmore Ayisha Adeeba , Gnanachandran C. , Luqman I. , Horrocks K.
Published: August 2020

Background:Recent encouragement in early detection of cancer nationally has significantly increased the number of referrals made through the two-week wait suspected cancer pathway. In particular women with abdominal pain and bloating are frequently having their Ca-125 levels investigated for suspected ovarian cancer and this has led to a significant increase in referrals to the ovarian cancer service. We have conducted this study to help improve the efficiency in which these patients are investigated and to improve future pathways within the referral service. Methods:A retrospective observational outcome study. Data were collected from electronic documents of patients’ referrals, assessments, and clinical correspondences.The study was conducted in a tertiary gynaecology cancer centre with primary care direct referrals. The pelvic mass clinic was the clinic setup with consultation, scan and patient support was available. All patients referred by direct primary care for suspected ovarian cancer over two years with Ca-125 result. Data were collected and analysed from the pelvic mass clinic over 48 months, which was available through electronic documentation. Data included information on their consultation, ultrasound scan findings, any further intervention, surgery, and histological outcome of all patient who underwent biopsies or surgery.Results: Two hundred and eighty-six patients were referred from primary care where the NICE guideline, ‘two-week wait for ovarian cancer’, was applied. Two hundred and twenty-three patients were included in this analysis, who had a Ca-125 result reported at the time of their referral. Out of the 223 patients, 126 patients were discharged with or without a repeat Ca-125 after the initial assessment. Seventeen patients were diagnosed with cancer following the referral, but only 12 of them had a primary ovarian malignancy. Conclusion:Majority of the patients with Ca-125 of more than 35U/mL, who were referred through this pathway, did not have cancer. This message can be disseminated by primary care practitioners who may be able to reassure patients prior to their initial consultation with a gynaecologist. This review queries the future value of using Ca-125 as the basis for referrals from primary care referrals for suspected ovarian malignancy. Further studies are required to assess whether a higher Ca-125 cut off may be used as the basis of referrals for postmenopausal women. One-stop focused gynaecology ultrasound clinic (OSFGUC) where clinicians may assess patients with suspected ovarian cancer symptoms and perform ultrasound scans may be better for managing this patient population.
A Survey on Generative Adversarial Networks for Imbalance Problems in Computer Vision Tasks
Authors: Sampath Vignesh , Maurtua Iñaki , Martín Juan José Aguilar , Gutierrez Aitor
Published: August 2020

Any computer vision application development starts off by acquiring images and data, then preprocessingand pattern recognition steps to perform a task. When the acquired image is highly imbalanced and notadequate, the desired task may not be achievable. Unfortunately, the occurrence of imbalance problems inacquired image datasets in certain complex real-world problems such as anomaly detection, emotionrecognition, medical image analysis, fraud detection, metallic surface defect detection, disaster prediction,etc., are inevitable. The performance of computer vision algorithms can significantly deteriorate when thetraining dataset is imbalanced. In recent years, Generative Adversarial Networks (GANs) have gainedimmense attention by researchers across a variety of application domains due to their capability to modelcomplex real-world image data. It is particularly important that GANs can not only be used to generatesynthetic images, but also its fascinating adversarial learning idea showed good potential in restoringbalance in imbalanced datasets.In this paper, we examine the most recent developments of GANs based techniques for addressingimbalance problems in image data. The real-world challenges and implementations of synthetic imagegeneration based on GANs are extensively covered in this survey. Our survey first introduces variousimbalance problems in computer vision tasks and its existing solutions, and then examine key conceptssuch as deep generative image models and GANs. After that, we propose taxonomy to summarize GANsbased techniques for addressing imbalance problems in computer vision tasks into three major categories:Image level imbalances in classification, object level imbalances in object detection and pixel levelimbalances in segmentation tasks. We elaborate the imbalance problems of each group, and furtherprovide GANs based solutions in each group. Readers will understand how GANs based techniques canhandle the problem of imbalances and boost performance of the computer vision algorithms.
A Randomized, Open-Label, Adaptive, Proof-of-Concept Clinical Trial of Modulation of Host Thromboinflammatory Response in Patients with COVID-19: The DAWn-Antico Study
Authors: Vanassche Thomas , Engelen Matthias M , Thillo Quentin Van , Wauters Joost , Gunst Jan , Wouters Carine , Vandenbriele Christophe , Rex Steffen , Liesenborghs Laurens , Wilmer Alexander , Meersseman Philippe , Berghe Greet Van den , Dauwe Dieter , Verbeke Geert , Thomeer Michiel , Fivez Tom , Mesotten Dieter , Ruttens David , Heytens Luc , Dapper Ilse , Tuyls Sebastiaan , De Tavernier Brecht , Verhamme Peter
Published: August 2020

BackgroundThe peak of the global COVID-19 pandemic has not yet been reached and many countries face the prospect of a second wave of infections before effective vaccinations will be available. After an initial phase of viral replication, some patients develop a second illness phase in which the host thrombotic and inflammatory responses seems to drive complications. Severe COVID-19 disease is linked to high mortality, hyperinflammation, and a remarkably high incidence of thrombotic events. We hypothesize a crucial pathophysiological role for the contact pathway of coagulation and the kallikrein-bradykinin pathway. Therefore, drugs that modulate this excessive thromboinflammatory response should be investigated in severe COVID-19.MethodsIn this adaptive, open-label multicenter randomized clinical trial we compare low molecular weight heparins at 50 IU anti-Xa/kg twice daily - or 75 IU anti-Xa twice daily for intensive care (ICU) patients - in combination with aprotinin to standard thromboprophylaxis in hospitalized COVID-19 patients. In the case of hyperinflammation, the interleukin-1-receptor antagonist anakinra will be added on top of the interventional drugs. In a pilot phase, the effect of the intervention on thrombotic markers (D-dimer) will be assessed. In the full trial, the primary outcome is defined as the effect of the interventional drugs on clinical status.DiscussionIn this trial we target the thromboinflammatory response at multiple levels. We intensify the dose of low molecular weight heparins to reduce thrombotic complications. Aprotinin is a potent kallikrein pathway inhibitor that reduces fibrinolysis, activation of the contact pathway of coagulation, and local inflammatory response. Additionally, aprotinin has shown in vitro inhibitory effects on SARS-CoV-2 cellular entry. Because the excessive thromboinflammatory response is one of the most adverse prognostic factors in COVID-19, we will add anakinra, a recombinant interleukin-1 receptor antagonist, to the regimen in case of severely increased inflammatory parameters. This way, we hope to modulate the systemic response to SARS-CoV-2 and avoid disease progressions with a potentially fatal outcome. Trial registrationThis trial is registered in the EU Clinical Trials Register. Registration number: 2020-001739-28. Registered on 2020-04-10.
Renal Function is Preserved Following Tenofovir Disoproxil Fumarate (TDF) Initiation Among Rwandan’s Living with HIV
Authors: Rwibasira Gallican Nshogoza , Kim Hae-Young , Twizere Christella , Hoover Donald R , Shi Qiuhu , Adedimeji Adebola , Ross Jonathan , Murenzi Gad , Sinayobye Jean d’Amour , Anastos Kathryn
Published: August 2020

Background: Tenofovir disoproxil fumarate (TDF) is the antiretroviral drug most commonly associated with renal dysfunction. However, few studies have examined this association in sub-Saharan Africa despite recent scale-up of antiretroviral therapy (ART) to all people living with HIV (Treat All) in this region. We assessed estimated glomerular filtration rate (eGFR) change among HIV infected Rwandan adults following first line TDF-based therapy initiation.Methods: This prospective, observational study was conducted in 10 Rwandan health centers. Participants were ART-naive adults (≥18 years) living with HIV who initiated TDF-based ART from 1st July 2016 through 30th July 2018. The primary outcome was eGFR change from pre- (within 12 months) to post-TDF initiation (within 6 months).Results: Of 476 patients with pre- and post- TDF eGFR measurements, 264 (55.5%) were women and mean age was 35.9 years (SD 9.6). Mean pre-TDF eGFR was 92.4 (SD 24.0) and mean post-TDF was 96.0 (SD 21.0) mL/min/1.73m2. Mean pre- to post-TDF change thus increased 3.60 (SD, 26.6) mL/min/1.73m2 (p=0.001). Conclusion: We detected a statistically significant clinically small renal function improvement within 6 months following TDF initiation among 476 ART-naïve patients. This supports continued TDF use for first-line treatment.
YouTube as a source of information for do-it-yourself face masks: A content analysis
Authors: Lim Kathryn , Chughtai Abrar Ahmad , Seale Holly
Published: August 2020

Background

Homemade cloth products are increasingly being used as a preventive measure against COVID-19, with various methods promoted through do-it-yourself (DIY) videos available on YouTube and other websites. While guidance has been provided by key organisations on how to create face masks, the extent to which this is being accurately disseminated is currently unknown.
Methods

A key word search of YouTube using the terms “face/cloth mask” and “diy face/cloth mask” was completed on 18 April 2020. Total and category video content scores determined using the 18-point scoring system in the author-designed checklist. Criteria grouped by: reasons and caveats for use (three criteria), manufacturing instructions (six criteria), instructions for use (five criteria), re-use (three criteria), and cleaning instructions (one criteria). Total scores of ≥ 9 were classified as useful, and those < 9 classified as not useful out of a maximum score of 18.
Results

Of the 400 videos screened, 261 videos were retained for analysis. 91.7% (n = 242) were categorised as non-useful, compared to 8.3% (n = 22) as useful. Overall, useful videos scored higher across all assessed content evaluation categories. Manufacturing instructions were the most common content featured in the videos, with re-use and cleaning instructions featuring the least.
Conclusions

Currently, there is a lack of comprehensive, best-practice information on face masks being disseminated through YouTube. The information gaps identified in these findings present an opportunity for authoritative sources to focus communication efforts on promoting best-practice guidance while advice continues to be updated on universal face mask use.
Combination of phenotype and polygenic risk score in breast cancer risk evaluation in the Spanish population
Authors: Trivino Juan , Ceba A , Rubio-Solsona E , Serra D , Sanchez-Guiu I , Ribas G , Rosa R , Cabo M , Bernad L , Pita G , Gonzalez-Neira A , Legarda G , Diaz JL , García-Vigara A , Martínez-Aspas A , Escrig M , Bermejo B , Eroles P , Ibáñez J , Salas D , Julve A , Cano A , Lluch A , Miñambres R , Benitez Javier
Published: August 2020

Background: In the last years, the identification of different genetic and phenotypic biomarkers for prevention, early diagnostics and patient stratification have been a main objective in cancer research. Different proposals for multivariable models using biomarkers have been presented for the evaluation of individual risk of women to develop breast cancer. Methods: In this study, we describe and evaluate a multivariable model using 92 Single-nucleotide polymorphisms (SNPs) and five different phenotypic variables in a Spanish population of 642 healthy women and 455 breast cancer patients. Results: We were able to stratify both groups with our model. The 9th decile included 1% of controls vs 9% of cases, with an Odds ratio (OR) of 12.9 and a p-value of 3.43E-07. The first decile presented an inverse proportion: 1% of cases and 9% of controls, with an OR of 0.097 and a p-value of 1.86E-08. Conclusions: These results indicate the ability of the multivariable model to stratify women according to their risk to develop breast cancer over a maximum period of 5 years. The analysis present a proof of concept in a poorly studied population and it opens the possibility of using this type of method for routine screening in the Spanish population.
Minimal invasive versus open esophagectomy for patients with esophageal squamous cell carcinoma after neoadjuvant treatments
Authors: Chen Dongni , Wang Weidong , Mo Junxian , Ren Qiannan , Miao Huikai , Chen Youfang , wen zhesheng
Published: August 2020

Background
Although previous studies have discussed whether the minimally invasive esophagectomy (MIE) is superior to open surgery, the data concerning esophageal squamous cell carcinoma (ESCC) patients underwent neoadjuvant treatment followed by radical resection is limited. The purpose of our study was to compare the short- and long-term clinical outcomes of the two surgical approaches in treating ESCC patients.
Methods
Between January 2010 and December 2016, ESCC patients who had received neoadjuvant therapy and underwent Mckeown esophagectomy at our institute were eligible. The baseline characteristics, pathological data, short-and long-term outcomes of these patients were collected and compared based on the surgical approach.
Results
A total of 195 patients was included in the current study. Compared to patients underwent open surgery, patients underwent MIE had shorter operative time and less intraoperative bleeding (390 min vs 330 min, P = 0.001; 204 ml vs 167 ml, P = 0.021). In addition, the risk of anastomotic leakage was decreased in MIE group (20.0% vs 3.3%, P < 0.001), while the occurrence of other complications did not have statistical significance between two groups. Overall survival (OS) and disease-free survival (DFS) was no difference in patients received neoadjuvant chemotherapy between the two approaches. For the patients underwent neoadjuvant chemoradiotherapy, OS was significantly better in the MIE group (log rank = 6.197; P = 0.013).
Conclusion
Minimally invasive Mckeown esophagectomy is safe and feasible for ESCC patients who underwent neoadjuvant therapy. MIE approach presented better perioperative results than open esophagectomy. The effect of surgical approaches on survival was depending on the scheme of neoadjuvant treatment.
Comparative Chloroplast Genomics of Four Pilea Species (Urticaceae): High Levels of Sequences Divergence Provides New Insight into Interspecific Diversity in Pilea
Authors: Li Jingling , Tang Jianmin , Zeng Siyuan , Han Fang , Yuan Jing , Yu Jie
Published: August 2020

Background
Pilea is a genus of perennial herbs from the family Urticaceae, which are used for courtyard ornamental. For some species, they are used as medicinal plants in traditional Chinese medicine as well. The morphological characteristics of medicinal species from Pilea are similar, and it is difficult to accurately distinguish them based only on morphological characteristics. Besides, the species classification of Pilea are still controversial. The classification of many species are still in an unresolved state. At present, there is no information about the chloroplast genomes of Pilea, which limits our further understanding of this genus. Here, we first reported 4 chloroplast genomes of Pilea taxa (P. mollis, P. glauca, P. peperomioides and P. serpyllacea), and performed comprehensive comparative analysis.
Results
The four chloroplast genomes have similar structural characteristics and gene order with other angiosperms. These genomes all have a typical quartile structure, which contains 113 unique genes, including 79 protein-coding genes, 4 rRNA genes, and 30 tRNA genes. Besides, we detected SSRs and repeat sequences, and analyzed the expansion/contraction of IR regions. In particular, the comparative analysis showed a rather level of sequence divergence in the non-coding regions, even in the protein-coding regions of the four genome sequences, suggesting a high level of genetic diversity in Pilea. Moreover, we identified eight hypervariable regions, including petN-psbM; psbZ-trnG-GCC; trnT-UGU-trnL-UAA; accD-psbI; ndhF-rpl32; rpl32-trnL-UAG; ndhA-intron and ycf1, are proposed for use as DNA barcode regions. Phylogenetic analysis showed that four Pilea species form a monophyletic cluster with a 100% bootstrap value.
Conclusion
The results obtained here could provide abundant information for the phylogenetic position of Pilea and further species identification. High levels of sequences divergence promote our understanding of the interspecific diversity of this genus, also provide reference for the rational classification of unsolved species in the future.
Assembly of Gentamicin and Zn2+ Loaded Coatings on TiO2 Nanotubes to Synergistically Improve the Blood Compatibility, Endothelial Cell Growth and Antibacterial Activities
Authors: Pan Changjiang , Yang Ya , Hu Youdong , Quan Li , Wei Yanchun , Liu Sen , Yang Zhongmei , Lin Yuebin
Published: August 2020

Titanium and its alloys are widely used in blood contacting implantable and interventional medical devices; however, their biocompatibility is still facing great challenges. In this study, with the aim of improving the biocompatibility and antibacterial activities of titanium, TiO2 nanotubes with a diameter of about 30 nm were firstly prepared on the titanium surface by anodization, followed by the introduction of polyacrylic acid (PAA) and gentamicin (GS) on the nanotube surface by layer-by-layer method, and finally zinc ions were loaded into the surface to improve the bioactivities. The nanotubes have excellent hydrophilic properties and special nanotube-like structure, which can selectively promote the albumin adsorption and enhance the blood compatibility and promote the growth and functional expression of endothelial cells to a certain extent. After the introduction of PAA and GS, although the super-hydrophilicity cannot be achieved, the results of platelet adhesion, cGMP activity, hemolysis rate and partial thromboplastin time (APTT) showed that the blood compatibility was improved, and the blood compatibility was further enhanced after zinc ions loading on the surface. On the other hand, the surface modified materials showed good cytocompatibility to endothelial cells. The introduction of PAA and zinc ions not only promoted the adhesion and proliferation of endothelial cells, but also up-regulated expression of vascular endothelial growth factor (VEGF) and nitric oxide (NO). The slow and continuous release of GS and Zn2+ for more than 14 days, which can significantly improve the antibacterial properties of the materials. Therefore, the present study provides an effective method for the surface modification of titanium-based blood-contacting materials to simultaneously endow with good blood compatibility, endothelial growth behaviors and antibacterial properties.
Nurses’ and midwives’ perspectives on participation in national policy development, review and reforms in Ghana: A qualitative study
Authors: Acheampong Angela Kwartemaa , Ohene Lillian Akorfa , Asante Isabella Naana Akyaa , Kyei Josephine , Dzansi Gladys , Adjei Charles Ampong , Adjorlolo Samuel , Boateng Francis , Woolley Philomena , Nyante Felix , Aziato Lydia
Published: August 2020

Background: The World Health Organization has admonished member countries to strive towards achieving universal health coverage (UHC) through actionable health policies and strategies. Nurses and midwives have instrumental roles in achieving UHC via health policy development and implementation. However, there is a paucity of empirical data on nurses and midwives’ participation in policy development in Ghana. The current study explored nurses and midwives’ participation in policy development, reviews and reforms in Ghana.Methods: A qualitative descriptive exploratory design was adopted for this study. One-on-one individual interviews were conducted after 30 participants were purposefully selected. Data was audiotaped with permission, transcribed, and analyzed inductively using the content analysis procedures.Results: Two main themes emerged from the data: participation in policy development and perspectives on policy reviews and reforms. The findings showed that during health policy development and reviews, nurses in Ghana were overlooked and unacknowledged. Policy reforms regarding bridging the theory-practice gap, remunerations and political influence in nursing education were raisedConclusion: The authors concluded that nurses and midwives are crucial members of the healthcare systems and their inputs in policy development and reviews would improve health delivery in Ghana.
The Effect of Driver Variables on the Estimation of Bi-variate Probability Density of Peak Loads for Robust Design of Multi-Energy Systems
Authors: Kaheh Zohreh , Shabanzadeh Morteza , Sangrody Hossein
Published: August 2020

It stands to reason that developing more accurate forecasting methods is the pillar of building robust multi-energy systems. In this context, long-term forecasting is also indispensable to have a robust expansion planning program for modern power systems. While very short-term and short-term forecasting are usually represented with point estimation, this approach is highly unreliable in medium-term and long-term forecasting due to inherent uncertainty in predictors like weather variable in long terms. Accordingly, long-term forecasting is usually represented by probabilistic forecasting values which are based on probabilistic functions. In this paper, a self-organizing mixture network (SOMN) is developed to estimate the probability density function (PDF) of peak load in long-term horizons considering the most important drivers of seasonal similarity, population, GDP, and electricity price. The proposed methodology is applied to forecast the PDF of annual and seasonal peak load in Queensland Australia.
Global Nursing - A Qualitative Case Study of Tanzanian Nursing Students' Experiences of Student Exchange in Sweden
Authors: Alden-Joyce Tara , Scheers-Andersson Elina , Rogathi Jane , Kidayi Paulo , Cadstedt Jenny , Björling Gunilla
Published: August 2020

Background: Due to globalization and a shift in population demographics, needs within healthcare are changing and nurses require new skills and knowledge. Nursing education needs to facilitate these new demands and student exchange programmes provide an opportunity to develop necessary skills.Aim: The aim of this study was to explore Tanzanian nursing students' experiences of student exchange in Sweden. Method: A qualitative design was used for this empirical study. Semi-structured interviews were conducted with six Tanzanian nursing students who had participated in student exchange in Sweden. The participants were recruited by purposeful sampling. Inductive reasoning and qualitative content analysis were applied.Results: The findings revealed that the students experienced new approaches in Sweden, allowing them to develop skills and competences. Furthermore, they increased their global perspectives on nursing and interest in working with global health issues. However, they also experienced challenges in the new environment.Conclusion: The present study showed that the Tanzanian nursing students benefitted from their student exchange, both personally, as well as for their future careers as nurses. More research is needed examining nursing students from low-income countries participating in student exchange in high-income countries.
Ultrafast X-ray diffraction measurements of shock-compressed iron and iron alloys
Authors: Krygier Andrew , Harmand Marion , Albertazzi Bruno , McBride Emma , Miyanishi Kohei , Antonangeli Daniele , Inubushi Yuichi , Kodama Ryosuke , Koenig Michel , Matsuoka Takeshi , Mogni Gabriele , Pietrucci Fabio , Saitta Marco , Togashi Tadashi , Umeda Yuhei , Vinci Tommaso , Yabashi Makina , Yabuuchi Toshinori , Fiquet G. , Ozaki Norimasa
Published: August 2020

The extreme pressures achievable with dynamic compression holds great promise for studying planetary interiors. Phase stability of Fe-Si alloys, which are complex to address, is particularly relevant to understanding telluric planetary cores due to the widely varying properties produced by small changes in Si concentration. Here we report the study of phase stability of pure iron and Fe-Si alloys by x-ray diffraction measurements carried out on shocked samples using an x-ray free electron laser (XFEL). Our setup combined with the brilliance of the XFEL allows us to observe the rapid onset of high-pressure solid-solid phase transformation in Fe and Fe-Si8.5wt%; we observe no such evidence in Fe-Si16wt% up to 110 GPa on the nanosecond timescale. Density Functional Theory calculations provide the conceptual framework to rationalize these observations. Taken together our experiments and calculations support recent dynamic compression measurements and shed light on conflicting static compression results. Our work highlights the need to properly consider the differing intrinsic timescales of the static and dynamic experiments when comparing results, and the complementarity of the techniques in assessing phase diagram and transition mechanisms.
Dentists’ Entrepreneurial Intention and Associated Factors in Public Hospitals in Southeastern China: A Cross-sectional Study
Authors: Wang Jiabi , Peng Bin , Zhou Hongzhi , Zhang Jing Hua
Published: August 2020

Background: Due to the rising demand and fast growth opportunities, the private dental care sector in China tried to attracted experienced dentists from the public hospital system, which hence are faced with challenges of talents outflow and shortage.Methods：A dentist’s entrepreneurial intention (EI) was represented by his/her intention of leaving the public hospital system to be engaged in the private sector..Dentists from public hospitals in 9 major cities of 5 provinces in Southeastern China were surveyed in this study. Through a snowball sampling method, a total of 336 questionnaires were collected. The association between the dentists’ EI and their individual characteristics (basic demographic and professional characteristics, entrepreneurial behaviors) were analyzed using logistic regression analysis.Results: In the public hospitals in China studied, female dentists are consistently less likely to report entrepreneurial intention (EI) (OR=0.365, p=0.001). Dentists in the age group of 36 to 45 and those aged over 45 reported much stronger EI (OR=14.205, p=0.012; OR=8.45, p=0.066) than those in 20’s did. Compared with intern dentists, Attending Dentists (OR=7.812, p=0.016) and Associate/Chief Dentists (OR=9.857, p=0.021) were significantly more likely to report EI. Those with master level (OR=0.221, p=0.021) or Doctorate degrees (OR=0.118, p=0.005) are much less likely to report EI. Meanwhile, those in small hospitals ( with employee numbers < 50) reported much stronger EI than those in large hospitals (OR=2.398, p=0.044). Additionally, dentists’ entrepreneurial behaviors, risk aversion attitudes and their family background all have significant associations.Conclusions: The small public hospitals in China especially face a high risk of talented dentist outflow. As an offsetting strategy, these hospitals may consider more active recruiting policy for female dentists or those holding post-graduate degrees due to their good possibility of long term career path in the public hospital system.
Explaining Factors Affecting Help-Seeking Behaviors in Women with Urinary Incontinence for Early Diagnosis by Healthcare Providers: A Qualitative Study
Authors: Fakari Fahimeh Rashidi , Hajian Sepideh , Darvish Soodabeh , Majd Hamid Alavi
Published: August 2020

Background
Urinary incontinence is widely accepted to be among the most important issues in the global health system. However, only a limited number of women refer for treatment as different factors make help-seeking behaviors more complicated than they initially seem to be. The aim of this study was to explain the factors affecting help-seeking behaviors in women suffering from urinary incontinence.
Methods
The present study used a qualitative method, the conventional content analysis approach, and in-depth semi-structured interviews. The study was conducted between December 2018 and August 2019 in Tehran, Iran. The participants of the study included 34 women with urinary incontinence selected using purposive sampling method. The content analysis approach was based on the Graneheim and Lundman method, and qualitative data management software was used to analyze data.
Results
Data analysis illustrates two facilitating and deterring themes; the categories "not perceiving disease ", "shame", "negative influence of important others", and "the health care system" were among the deterrents and the categories "weakening the quality of life" and "positive effect of important others" were found to be facilitators.
Conclusions
The findings of the present study highlight the need for understanding the underlying facilitators and obstacles to help-seeking behaviors in women with urinary incontinence and suggest that healthcare providers consider an open dialogue with patients taking into account their subjective beliefs and life context during routine referrals so as to facilitate early diagnosis of the disease and ultimately lead to an improvement in the woman's quality of life.
Wearable Sensors for Turning Assessment to Discriminate Frailty Syndrome Among Community-Dwelling Older Adults
Authors: Chiu Huei-Ling , Tsai Chen-Ying , Liu Yu-Lin , Kang Chun-Wei , Lee Shu-Chun
Published: August 2020

Background: Mobile health technologies such as wearable inertial sensors are emerging as complementary clinical assessments and potential to evaluate and analyze postural stability, mobility and gait. Turning is a challenging task and is reported to be one of the daily activities that leads to falling in older populations. We investigated differences in 180° walking turns and 360° turning on the spot among frail, pre-frail, and non-frail older adults utilizing wearable sensors, and determined cutoff points of the turning measures that best discriminated older adults with frailty from those without.Methods: A cross-sectional study was conducted with community-dwelling older adults aged over 65 years. Frailty was assessed using Fried's phenotype method, and turning tasks were measured by wearable sensors. The turn duration (s) and angular velocity (°/s) in 180°and 360° turns were recorded for analysis.Results: In total, 109 participants were enrolled including 50 pre-frail and 12 frail individuals. Frail older adults took significantly longer and had slower angular velocities to complete the 180° and 360° turning than either pre-frail (p=0.002 and p<0.001, respectively) or non-frail (p=0.03 and p<0.001, respectively) older adults after adjustments for gait speed. Cutoff times of 2.45 and 3.46 s were found to best discriminate frail people from those without frailty in both 180° (sensitivity 83.3%, specificity 71.1%, AUC 0.796) and 360° (sensitivity 91.7%, specificity 74.2%, AUC 0.857) turn tasks.Conclusions: Older individuals with frailty syndrome had difficulty turning as evidenced by a longer turning duration and a slower angular velocity. The turn duration could be a potential biomarker of frailty in older populations. This simple and portable wearable technique could improve early detection of the onset of frailty, allowing the clinician to prescribe prevention and rehabilitation interventions for reversing their physical decline.
Analysis of Genomic DNA Methylation and Gene Transcription Modulation Induced by DNMT3A Deficiency in HEK293 Cells
Authors: Zhang Mengxiao , Wang Jiaxian , Tian Qiuxiang , Feng Lei , Yang Hui , Zhu Nan , Pan Xingchen , Zhu Jianwei , Chen Peng , Lu Huili
Published: August 2020

Background DNA methylation is an important epigenetic modification associated with transcriptional repression, and plays key roles in normal cell growth as well as oncogenesis. Among the three main DNA methyltransferases (DNMT1, DNMT3A, and DNMT3B), DNMT3A mediates de novo DNA methylation with partial functional redundancy with DNMT3B. However, the general effects of DNMT3A and its downstream gene regulation profile are yet to be unveiled. Results In the present study, we used CRISPR/Cas9 technology to successfully create DNMT3A deficient human embryonic kidney cell line HEK293, with frameshift mutations in its catalytic domain. Our results showed that the cell growth slowed down in DNMT3A knockout cells. UPLC-MS analysis of DNMT3A deficient cells showed that the genome-level DNA methylation was reduced by 21.5% and led to an impairment of cell proliferation as well as a blockage of MAPK and PI3K-Akt pathways. Whole genome RNA-seq revealed that DNMT3A knockout up-regulated expression of genes and pathways related to cell metabolism but down-regulated those involved in ribosome function, which explained the inhibition of cell growth and related signal pathways. Further, bisulfite DNA treatment showed that DNMT3A ablation reduced the methylation level of DNMT3B gene as well, indicating the higher DNMT3B activity and thereby explaining those down-regulated profiles of genes.Conclusions Our work is the first report on the effect of DNMT3A disruption in its catalytic domain, demonstrating that DNMT3A plays a key role on genomic DNA methylation and expression, and suggesting that DNMT3A could be an ideal target for the development of personalized treatment or to predict tumor prognosis.