bluuebunny/crossref_metadata_2025 huggingface dataset:
Accessing health services in India: Experiences of economic migrants returning to Nepal.
Authors: Adhikary Pratik , Aryal Nirmal , Dhungana Raja Ram , KC Radheyshyam Krishna , Regmi Pramod Raj , Wickramage Kolitha Prabhash , Duigan Patrick , Inkochasan Montira , Sharma Guna Nidhi , Devkota Bikash , Teijlingen Edwin van , Simkhada Padam
Published: July 2020

Background
Migration to India is a common livelihood strategy for poor people in remote Western Nepal. To date, little research has explored the degree and nature of healthcare access among Nepali migrant workers in India. This study explores the experiences of returnee Nepali migrants with regard to accessing healthcare and the perspectives of stakeholders in the government, support organizations, and health providers working with migrant workers in India.
Methods
Six focus group discussions (FGDs) and 12 in-depth interviews with returnee migrants were conducted by trained moderators in six districts in Western Nepal in late 2017. Another 12 key persons working in the health and education sector were also interviewed. With the consent of the participants, FGDs and interviews were audio-recorded. They were then transcribed and translated into English and the data was analysed thematically.
Results
The interviewed returnee migrants worked in 15 of India’s 29 states, most as daily wage labourers. Most were from among the lowest castes so called-Dalits. Most migrants had had difficulty accessing healthcare services in India. The major barriers to access were the lack of insurance, low wages, not having an Indian identification card tied to individual biometrics so called: Aadhaar card. Other barriers were unsupportive employers, discrimination at healthcare facilities and limited information about the locations of healthcare services.
Conclusions
Nepali migrants experience difficulties in accessing healthcare in India. Partnerships between the Nepali and Indian governments, migrant support organizations and relevant stakeholders such as healthcare providers, government agencies and employers should be strengthened so that this vulnerable population can access the healthcare they are entitled to.
Association Between Sexual Violence and Unintended Pregnancy Among Young Girls in South Africa
Authors: Ajayi Anthony Idowu , Ezegbe Henrietta Chinelo
Published: July 2020

Background: Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of young girls (aged 15–24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among young girls in South Africa, a country with high teenage pregnancy rates.Methods: Drawing from cross-sectional data obtained among young girls in a South African university between June and November 2018, we estimated the magnitude of unintended pregnancy among young girls and also examined the effect of sexual violence on unintended pregnancy. A final sample of 451 girls aged 17–24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy.Results: The analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 25.9% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (57.0%) compared to those who never experienced sexual abuse (36.8%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.76; 95% CI: 1.07–2.90).Conclusion: Addressing unintended pregnancies among young girls in South Africa requires interventions that not only increase access to contraceptive information and services, but also reduce sexual violence and cater for survivors.
Assessment of Knowledge, Attitude and Practice (KAP) on Human and Bovine Tuberculosis Among Cattle Owners in Ethiopia
Authors: Bihon Amare , Zinabu Solomon , Muktar Yimer , Assefa Ayalew
Published: July 2020

Background: Tuberculosis (TB) is a re-emerging disease occurring worldwide and causing multi-billion-dollar loss and human death annually. The situation is worse in developing countries like Ethiopia, where lower knowledge, attitude, and practice (KAP) of the people is imminent. Methods: A questionnaire-based cross-sectional study was conducted. A total of 349 study participants were addressed through face to face interview. Descriptive statistics and Pearson’s chi-squares analysis were used to observe the data and the association between outcome (KAP) and predictor variables. Results: Out of the 349 respondents interviewed, 223 (63.9%) of them were males, while 126 (36.1%) were females. The KAP measuring interview indicated that almost all (97.4%) of the participants know human tuberculosis, while 84(24.1%) are aware of bovine tuberculosis cause and mode of transmission. Inhalation was reported as a common route of transmission for human TB (41.1%). In contrast, 50% of the respondent mentioned inhalation, contact, and ingestion of raw animal products as the main route of TB transmission from animal to human. Among those who have heard of bTB, only 56 (66.7%) of respondents consider bovine tuberculosis as a significant threat to public health. Conclusion: The study showed that there is a lower KAP on bovine TB among cattle owners. Therefore, community awareness promotion and health education on human and bovine TB should be operated under a “One Health” umbrella.
Laparoscopic versus open pancreatic resection for ductal adenocarcinoma: separate propensity score matching analyses of distal pancreatectomy and pancreaticoduodenectomy
Authors: Chen Ke , Pan Yu , Huang Chao-jie , Chen Qi-long , Zhang Ren-chao , Zhang Miao-zun , Wang Guan-yu , Wang Xian-fa , Mou Yi-ping , Yan Jiafei
Published: July 2020

Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the most leading causes of cancer mortality worldwide. Laparoscopic pancreatic resection (LPR) has been widely used in the treatment of benign and low-grade pancreatic diseases. It is necessary to expand the current knowledge on the feasibility and safety of LPR for PDAC. Laparoscopic distal pancreatectomy (LDP) and pancreaticoduodenectomy (LPD) are two main surgical approaches for PDAC. We performed separate propensity score matching (PSM) analyses, aiming to assess the surgical and oncological outcomes of LPR for PDAC by comparing LDP with open distal pancreatectomy (ODP) as well as LPD with open pancreaticoduodenectomy (OPD).Methods: Data of patients who underwent DP and PD for PDAC from January 2004 to February 2020 in our hospital were obtained. Baseline characteristics, intraoperative effect, postoperative recovery, and survival outcomes were compared. One-to-one PSM was used to minimize selection biases by balancing factors including age, sex, BMI, and tumor size.Results: Patient demographics were well matched after PSM. The DP subgroup included 86 LDP patients and 86 ODP patients, whereas the PD subgroup included 101 LPD patients and 101 OPD patients. Compared to ODP, LDP was associated with shorter operative time, less blood loss, and comparable overall morbidity. Of the 101 patients who underwent LPD, 10 patients (9.9%) required conversion to laparotomy. LPD was associated with longer operative time, less blood loss, and comparable overall morbidity. For oncological and survival outcomes, there were no significant differences in tumor sizes, R0 resection rate and tumor stage in both DP and PD subgroup. However, laparoscopic procedures seems to have an advantage over open surgery in terms of retrieved lymph node (DP subgroup: 14.4 ± 5.2 vs. 11.7 ± 5.1, p = 0.03; PD subgroup 21.9 ± 6.6 vs. 18.9 ± 5.4, p = 0.07). There was no statistical signiﬁcance between both groups in recurrence pattern, and 3-year recurrence-free and overall survival were comparable between groups.Conclusions: Both LDP and LPD are feasible and oncologically safe procedures for PDAC. Postoperative outcomes and long-term survival of LDP and LPD are not inferior or superior to open surgery. However, the short-term surgical advantage of LPD is not as obvious as LDP mainly due to the conversions. Our findings should be further evaluated by multicenter or randomized controlled trials.
WITHDRAWN: The Prevalence of Complementary and Alternative Medicine amongst Multiple Sclerosis Patients in Iran
Authors: ranjbar aliyeh , izadi sadegh
Published: July 2020

Objective
The aim of this study was to determine the prevalence and patterns of complementary and alternative medicine (CAM) usage amongst multiple sclerosis (MS) patients in Iran and to evaluate the perceived effectiveness and factors affecting these therapies.
Methods
This is a descriptive and cross-sectional study. Data were collected from 194 patients with MS at the neurology clinics affiliated with Shiraz University of Medical Sciences by a semi-structured questionnaire.
Results
The prevalence of CAM usage was 67.9%. Herbs were the most common among patients (64.2%). Cupping therapy, relaxation therapies, acupuncture, leech therapy were the other common CAM modalities. Yoga had the highest perceived effectiveness.
Conclusions
Due to high prevalence of CAM usage, physicians should inform their patients about the advantages and disadvantages of CAM in order to make them aware of their choices.
Development of an Engineered Peptide Antagonist against Periostin to Overcome Doxorubicin Resistance in Breast Cancer
Authors: Oo Khine Kyaw , Kamolhan Thanpawee , Soni Anish , Thongchot Suyanee , Mitrpant Chalermchai , Thuwajit Chanitra , Thuwajit Peti
Published: July 2020

Background: Chemoresistance is one of the main problems in treatment of cancer. Periostin (PN) is a stromal protein which is mostly secreted from cancer associated fibroblasts in the tumor microenvironment and can promote cancer progression including cell survival, metastasis, and chemoresistance. The main objective of this study was to develop an anti-PN peptide from the bacteriophage library to overcome PN effects in breast cancer (BCA) cells. Methods: A twelve amino acids bacteriophage display library was used for biopanning against the PN active site. A selected clone was sequenced and analyzed for peptide primary structure. A peptide was synthesized and tested for the binding affinity to PN. PN effects including a proliferation, migration and a drug sensitivity test were performed using PN overexpression BCA cells or PN treatment and inhibited by an anti-PN peptide. An intracellular signaling mechanism of inhibition was studied by Western blot analysis. Lastly, PN expressions in BCA patients were analyzed along with clinical data. Results: The results showed that a candidate anti-PN peptide was synthesized and showed affinity binding to PN. PN could increase proliferation and migration of BCA cells and these effects could be inhibited by an anti-PN peptide. There was significant resistance to doxorubicin in PN-overexpressed BCA cells and this effect could be reversed by an anti-PN peptide in associations with phosphorylation of AKT and expression of survivin. In BCA patients, serum PN showed a correlation with tissue PN expression but there was no significant correlation with clinical data. Conclusions: This finding supports that anti-PN peptide is expected to be used in the development of peptide therapy to reduce PN-induced chemoresistance in BCA.
Widespread circulation of pertussis and poor protection against diphtheria among middle-aged adults in 18 European countries
Authors: Berbers Guy , Gageldonk Pieter van , de Kassteele Jan van , Wiedermann Ursula , Desombere Isabelle , Dalby Tine , Toubiana Julie , Tsiodras Sotirios , Ferencz Ildiko Paluska , Mullan Kathryn , Griskevicius Algirdas , Kolupajeva Tatjana , Vestrheim Didrik Frimann , Palminha Paula , Popovici Odette , Wehlin Lena , Kastrin Tamara , Maďarová Lucia , Campbell Helen , Ködmön Csaba , Bacci Sabrina , Barkoff Alex-Mikael , He Qiushui
Published: July 2020

Reported incidence of pertussis in member states of the European Union (EU) and the European Economic Area (EEA) varies and may not reflect the real situation. In the EU/EEA, vaccine-induced protection against diphtheria and tetanus seems sufficient as few cases are reported even among the adult population who was vaccinated many years ago. Aim of this study was to determine the seroprevalence of pertussis, diphtheria and tetanus antibodies in EU/EEA countries within the age groups of 40-49 and 50-59 years.
Eighteen countries collected around 500 samples between 2015 and 2018 (N=10,302 in total) and they were analysed for IgG-specific antibodies against pertussis toxin (PT), diphtheria toxoid (Dt) and tetanus toxin (TT).
The proportion of sera with IgG-PT antibody levels ≥100 IU/mL, indicative for recent pertussis infection was comparable for 13/18 countries ranging between 4.0-6.4%. For diphtheria the proportion of sera lacking the protective level (<0.1 IU/mL) varied between 22.8% and 82.0%. For tetanus the protection was sufficient: only very few sera showed unprotective IgG-TT antibody levels.
The seroprevalence of pertussis indicates that the circulation of B. pertussis is widespread across EU/EEA. The lack of vaccine-induced seroprotection against diphtheria in EU/EEA in these age groups is of concern and deserves further attention.
Pattern of white matter degeneration in remote brain areas from the basal ganglion lesion of ischemic stroke patients with motor impairment
Authors: cao xuejin , Wang Zan , Chen Xiaohui , Liu Yanli , Yang Xi , Wang Wei , Abdoulaye Idriss Ali , Zhang Shiyao , Guo Xiaoying , Wu Shanshan , Guo Yijing
Published: July 2020

Background
Diffusion tensor imaging (DTI) studies have revealed distinct white matter characteristic of brain following diseases. Beyond the lesion-symptom mapping, recent studies have demonstrate extensive structural and functional alterations of remote areas to local lesions caused by stroke in the brain. Here, we investigated the influences further from a global level by multivariate pattern analysis (MVPA) and network-based statistic (NBS).
Methods
Ten ischemic stroke patients with basal ganglia lesion and motor dysfunction and eleven demographically matched adults underwent brain Magnetic Resonance Imaging scans. DTI data was processed to obtain fractional anisotropy (FA) map and MVPA was used to explore brain regions that play an important role in classification based on FA map. White matter (WM) structural network was constructed by the deterministic fiber tracking approach according to the Automated Anatomical Labeling (AAL) atlas. NBS was used to explore differences of structural network between groups.
Results
MVPA applied to FA images correctly identified stroke patients with a statistically significant accuracy of 100% (P ≤ 0.001). Compared with the controls, the patients showed an FA reduction in the perilesional basal ganglia and brainstem, with a few in bilateral frontal lobes. Using NBS, we found the significant decreased FA-weighted WM subnetwork in stroke patients.
Conclusions
We identified some patterns of WM degeneration in the affected brain areas remote from the ischemic lesion, revealed the abnormal topological organization of WM network in stroke patients, which may be helpful for understanding of the neural mechanism of stroke sequela.
Large-area printing of ferroelectric surface and super-domains for efficient solar water splitting
Authors: Tian Yu , Wei Yaqing , Pei Minghui , Cao Rongrong , Gu Zhenao , Wang Jing , Liu Kunhui , Shang Dashan , Niu Jiebin , An Xiaoqiang , Long Run , Zhang Jinxing
Published: July 2020

Surface electronic structures of the photoelectrodes determine the activity and efficiency of the photoelectrochemical water splitting, but the controls of their surface structures and interfacial chemical reactions remain challenging. Here, we use ferroelectric BiFeO3 as a model system to demonstrate an efficient and controllable water splitting reaction by large-area constructing the hydroxyls-bonded surface. The up-shift of band edge positions at this surface enables and enhances the interfacial holes and electrons transfer through the hydroxyl-active-sites, leading to simultaneously enhanced oxygen and hydrogen evolutions. Furthermore, printing of ferroelectric super-domains with microscale checkboard up/down electric fields separates the distribution of reduction/oxidation catalytic sites, enhancing the charge separation and giving rise to an order of magnitude increase of the photocurrent. This large-area printable ferroelectric surface and super-domains offer an alternative platform for controllable and high-efficient photocatalysis.
Metabolic characterization of aggressive breast cancer cells exhibiting invasive phenotype: Impact of non-cytotoxic doses of 2-DG on diminishing invasiveness
Authors: Fujita Mayumi , Imadome Kaori , Somasundaram Veena , Kawanishi Miki , Karasawa Kumiko , Wink David A.
Published: July 2020

BackgroundMetabolic reprogramming is being recognized as a fundamental hallmark of cancer, and efforts to identify drugs that can target cancer metabolism are underway. In this study, we used human breast cancer (BC) cell lines and established their invading phenotype (INV) collected from transwell inserts to compare metabolome differences and evaluate prognostic significance of the metabolome in aggressive BC invasiveness.MethodsThe invasiveness of seven human BC cell lines were compared using the transwell invasion assay. Among these, INV was collected from SUM149, which exhibited the highest invasiveness. Levels of metabolites in INV were compared with those of whole cultured SUM149 cells (WCC) using CE-TOFMS. The impact of glycolysis in INV was determined by glucose uptake assay using fluorescent derivative of glucose (2-NBDG), and significance of glycolysis, or tricarboxylic acid (TCA) and electron transport chain (ETC) in the invasive process were further determined in aggressive BC cell lines, SUM149, MDA-MB-231, HCC1937, using invasion assays in the presence or absence of inhibitors of glycolysis, TCA cycle or ETC.ResultsSUM149 INV sub-population exhibited a persistent hyperinvasive phenotype. INV were hyper-glycolytic with increased glucose (2-NBDG) uptake; diminished glucose-6-phosphate (G6P) levels but elevated pyruvate and lactate, along with higher expression of phosphorylated-pyruvate dehydrogenase (pPDH) compared to WCC. Notably, inhibiting of glycolysis with lower doses of 2-DG (1 mM), non-cytotoxic to MDA-MB-231 and HCC1937, was effective in diminishing invasiveness of aggressive BC cell lines. In contrast, 3-Nitropropionic acid (3-NA), an inhibitor of succinate dehydrogenase, the enzyme that oxidizes succinate to fumarate in TCA cycle, and functions as complex II of ETC, had no significant effect on their invasiveness, although levels of TCA metabolites or detection of mitochondrial membrane potential with JC-1 staining, indicated that INV cells originally had functional TCA cycles and membrane potential.ConclusionsHyper-glycolytic phenotype of invading cells caters to rapid energy production required for invasion while TCA cycle/ETC cater to cellular energy needs for sustenance in aggressive BC. Lower, non-cytotoxic doses of 2-DG can hamper invasion and can potentially be used as an adjuvant with other anti-cancer therapies without the usual side-effects associated with cytotoxic doses.
HLA-DPA1 gene is a potential predictor with prognostic values in multiple myeloma
Authors: Yang Jie , Wang Fei , Chen Baoan
Published: July 2020

Background: Multiple myeloma (MM) is an incurable hematological tumor, which is closely related to hypoxic bone marrow microenvironment. We took integrated bioinformatics analysis with expression profile GSE110113 downloaded from National Center for Biotechnology Information-Gene Expression Omnibus (NCBI-GEO) database, and screened out major histocompatibility complex, class II, DP alpha 1 (HLA-DPA1) as a hub gene related to hypoxia in MM.Methods: Differentially expressed genes (DEGs) were filtrated with R package “limma”. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway were performed using “clusterProfiler” package in R. Then, protein-protein interaction (PPI) network was established. Hub genes were screened out according to Maximal Clique Centrality (MCC). PrognoScan evaluated all the significant hub genes for survival analysis. ScanGEO was used for visualization of gene expression in different clinical studies.Results: HLA-DPA1 was finally picked out as a hub gene in MM related to hypoxia. MM patients with down-regulated expression of HLA-DPA1 has statistically significantly shorter disease specific survival (DSS) (COX p =0.005411). Based on the clinical data of GSE47552 dataset, HLA-DPA1 expression showed significantly lower in MM patients than that in healthy donors (HDs) (p=0.017).Conclusion: We identified HLA-DPA1 as a hub gene in MM related to hypoxia. HLA-DPA1 down-regulated expression was associated with MM patients’ poor outcome. Further function and mechanism studies are need to investigate HLA-DPA1 as potential therapeutic target.
“The kind of support that matters to exclusive breastfeeding” a qualitative study
Authors: Dasheka Zukiswa Theodorah , Rala Ntombana Mc'Deline
Published: July 2020

Background
Worldwide, only 41% of infants are exclusively breastfed for the first six months while South Africa has an alarming figure of only 12%. First-time mothers are inexperienced in the initiation and maintenance of exclusive breastfeeding, hence a need for support. Data on forms and quality of exclusive breastfeeding support as experienced by first-time mothers is minimal. The study explored the exclusive breastfeeding support available to the first time mothers in the Buffalo City Metro, South Africa.
Methods
A qualitative explorative, descriptive and contextual study, and a non-probability, purposive sampling was used with 10 first-time mothers within the first six months postpartum. The in-depth face-to-face semi-structured individual interviews for data collection and Creswell’s steps of thematic analysis was used.
Results
Two themes emerged; challenges, empowerment, support and resilience during initiation of exclusive breastfeeding, and diverse support and resilience during maintenance of exclusive breastfeeding. First-time mothers received practical support majorly from nurses and other mothers during the initiation; social support was from family members, friends, and community members for the maintenance of exclusive breastfeeding. Sometimes there was a disjuncture between practical support from nurses and that from family members and community. There were instances where the support was needed but not given or not supportive of exclusive breastfeeding.
Conclusion
These findings illustrate that professional, practical and social support for first-time mothers is crucial in the initiation and maintenance of exclusive breastfeeding for the first six months. Timing and the kind of support given to these mothers is crucial for successful exclusive breastfeeding.
Gene Expression Patterns of Red Sea Urchins (Mesocentrotus Franciscanus) Exposed to Different Combinations of Temperature and pCO2 During Early Development
Authors: Wong Juliet M. , Hofmann Gretchen E.
Published: July 2020

Background: The red sea urchin Mesocentrotus franciscanus is an ecologically important kelp forest herbivore and an economically valuable wild fishery species. To examine of how M. franciscanus responds to its environment on a molecular level, differences in gene expression patterns were observed in embryos raised under combinations of two temperatures (13 °C and 17 °C) and two pCO2 levels (475 matm and 1050 matm). The transcriptomic responses of the embryos were assessed at two developmental stages (gastrula and prism) in light of previously described plasticity in body size and thermotolerance under these temperature and pCO2 treatments.Results: Although transcriptomic patterns primarily varied by developmental stage, there were pronounced differences in gene expression as a result of the treatment conditions. Temperature and pCO2 treatments led to the differential expression of genes related to the cellular stress response, transmembrane transport, metabolic processes, and the regulation of gene expression. Temperature had a greater influence on gene expression than pCO2, and may have contributed to positive effects of temperature on body size and thermotolerance at the prism stage. On the other hand, a relatively muted transcriptomic response to pCO2 may have permitted the stunting effect of elevated pCO2 on embryo body size.Conclusions: M. franciscanus exhibited both transcriptomic and phenotypic plasticity in response to temperature and pCO2 stress during early development. As climate change continues, red sea urchins may benefit from moderate ocean warming, whereas they will be negatively affected by ocean acidification. Present-day pCO2 conditions that occur due to coastal upwelling may already be detrimental to populations of M. franciscanus.
Network analysis of firearm movement among US states
Authors: Takada Sae , Choi Kristen , Natsui Shaw , Saadi Altaf , Buchbinder Liza , Easterlin Molly , Zimmerman Frederick
Published: July 2020

Background: The movement of firearm across state lines may decrease the effectiveness of state-level firearm laws. Yet how state-level firearm policies affect cross-state movement have not yet been widely explored. This study aims to characterize the interstate movement of firearms and its relationship with state-level firearm policies. Methods: Cross-sectional time series network analysis of interstate firearm movement using Bureau of Alcohol, Tobacco, Firearms, and Explosives firearm trace data (2010 -2017). We constructed the network of firearm movement between 50 states. We used zero-inflated negative binomial regression to estimate the relationship between the number of a state’s firearm laws and number of states for which it was the source of 100 or more firearms, adjusting for state characteristics. We used a similar model to examine the relationship between firearm laws and the number of states for which a given state was the destination of 100 or more firearms.Results: Over the 8-year period, states had an average of 26 (SD 25.2) firearm laws. On average, a state was the source of 100 or more crime-related firearms for 2.2 (SD 2.7) states and was the destination of 100 or more crime-related firearms for 2.2 (SD 3.4) states. Greater number of firearm laws was associated with states being the source of 100 or more firearms to fewer states (IRR0.67 per SD, p<0.001), higher odds of not being a source to any states (aOR1.56 per SD, p<0.001), and states being the destination of 100 or more firearms from more states (IRR1.83 per SD, p<0.001).Conclusions: Restrictive firearm policies are associated with less movement of firearms to other states, but with more movement of firearms from outside states. The effectiveness of state-level firearm-restricting laws is complicated by a network of interstate firearm movement.
Formation and tuning of moiré excitons in large-twist angle WS2/MoSe2 heterobilayers
Authors: Zhang Long , Zhang Zhe , Wu Fengcheng , Wang Danqing , Gogna Rahul , Hou Shaocong , Watanabe Kenji , Taniguchi Takashi , Kulkarni Krishnamurthy , Kuo Thomas , Forrest Stephen , Deng Hui
Published: July 2020

Moire lattices formed in twisted van der Waals bilayers provide a unique, tunable platform to realize coupled electron or exciton lattices unavailable before. While twist angle between the bilayer has been shown to be a critical parameter in engineering the moire potential and enabling novel phenomena in electronic moire systems, studies of moire excitons so far have focused on closely angularly-aligned heterobilayers. The twist-angle degree of freedom has been largely considered detrimental to the observation of moire excitons. Here we report robust moire excitons in bilayers of even large twist angles formed due to Umklapp scattering by the moire reciprocal lattice vectors, and we furthermore demonstrate twist-angle tuning of the properties of the moire excitons as a result of varying moire reciprocal lattice periods. We develop an intuitive analytical model to explain our results, and, from the twist-angle dependence, obtain the effective mass of the interlayer excitons and the electron inter-layer tunneling strength, which are difficult to measure experimentally otherwise. These findings pave the way for understanding and engineering rich moire -lattice induced phenomena in angle-twisted semiconductor van der Waals semiconductor heterostructures.
Impact of COVID-19 on poverty and living standards in Ghana: A micro perspective
Authors: Bukari Chei , Essilfie Gloria , Aning-Agyei Millicent Abigail , Otoo Isaac Christopher , Kyeremeh Christian , Owusu Anothony Akwesi , Amuquandoh Kofi Fosu , Bukari Ibrahim Kpanja
Published: July 2020

The novel Coronavirus disease 2019 (COVID-19), which has become a global epidemic, hit Ghana on 12th March 2020 and, in less than a week, increased by over 300 percent with two deaths. As of 11th June 2020, Ghana had recorded over 11,000 cases with 48 deaths. This study seeks to provide a micro-level evidence on how COVID-19 is posing a threat to some of the Sustainable Development Goals, particularly poverty and hunger in Ghana. Specifically, the study examined the effect of COVID-19 on poverty and living standards of Ghanaian households. It also analyzed which class of persons within the income distributions is mostly hit by the pandemic. Data on 3,905 households were obtained via concurrent online survey and telephone interviews. Multiple analytical approaches were employed: Ordinary least squares, probit model and simultaneous quantile regressions. The results showed that COVID-19 had significantly increased the poverty levels of households, while deteriorating living standards. The study also showed that gender and locational heterogeneities exist regarding the impact of COVID-19 with females and rural dwellers mostly disadvantaged. However, the simultaneous quantile regression showed that in terms of overall household consumption, those in the middle and upper classes were heavily affected compared to those in the lowest class. A key policy implication from this study is that Ghana needs to broaden its social protection programmes to assist both the new poor and existing poor.
COVID-19 Related Anxiety and Concerns Expressed by Pregnant and Postpartum Women- a Survey Among Obstetricians
Authors: Nanjundaswamy Madhuri H , Shiva Lakshmi , Desai Geetha , Ganjekar Sundarnag , Kishore Thomas , Ram Uma , Satyanarayana Veena , Thippeswamy Harish , Chandra Prabha S
Published: July 2020

This paper from India describes anxieties that pregnant and postpartum women reported to obstetricians during the COVID-19 pandemic. Of the 118 obstetricians who responded to an online survey, most had been contacted for concerns about hospital visits (72.65%), methods of protection (60.17%), the safety of the infant (52.14%); anxieties related to social media messages (40.68%), contracting the infection (39.83%). Obstetricians felt the need for resources such as videos, websites and counselling skills to handle COVID related anxiety among perinatal women.
Characterization of Rhamnolipids for the Inactivation of Enveloped Viruses
Authors: Jin Ling , Black Wendy , Sawyer Teresa
Published: July 2020

In the face of new emerging respiratory viruses, such as SARS-CoV2, vaccines, and drug therapies are not immediately available to curb the spread of the infection. Non-pharmaceutical interventions, such as mask-wearing and social distance, can slow the transmission. However, both mask and social distance are not 100% effective at preventing the spread of respiratory viruses, such as SARS-CoV2 and influenza viruses. There is an urgent need to develop an intervention that could reduce the spread of respiratory viruses. Rhamnolipids are environmentally friendly and biologically safe surfactants that can kill enveloped viruses. Two rhamnolipid products, 222A and 222B, were investigated in this study to determine their ability to inactivate two enveloped viruses, bovine coronavirus and herpes simplex virus 1. We found that 222B at 0.005%, which has no toxicity to cells, can inactivate 105 PFU/ml enveloped viruses in 3-5 min. Moreover, 50-100µl of 222B at 0.005% on 1 cm2 mask fabrics can inactivate ~ 103 PFU /10 µl in 3-5 min. These results suggest that 222B can be coated on masks to prevent or reduce the spread of enveloped viruses.
Hydroxysafflor yellow A promotes osteogenesis and bone development via epigenetically regulating β-catenin and prevents ovariectomy-induced bone loss
Authors: Wang Peng , Zhuo Tingling , Li Ying , Zhang Meng , Zhou Chi , Zhang Jinfang , Li Gang , Wang Haibin , Xu Liangliang
Published: July 2020

Objectives: Mesenchymal stem cells (MSCs) forming excessive adipocytes has been proven to be the pathogenesis of osteoporosis, leaving the bone more fragile. The approaches to promoting osteogenesis of MSCs are regarded as the promising direction to prevent osteoporosis. In clinical treatment, there is increasingly prevalent that traditional Chinese medicine treats common bone diseases including osteoporosis. HuoXue Tong Luo capsule (HXTL capsule) containing Safflower, Angelica sinensisetc, is one of the most frequently used prescriptions for osteoporosis with promising effects. In our study, we have demonstrated Hydroxysafflor yellow A (HSYA), belonging to one of essential compounds of Safflower, promote bone development and inhibit ovariectomized osteoporosis and explored its potential mechanisms in vitro.Materials and methods: We first investigated the effects of HSYA on viability and osteogenesis in human bone marrow-derived mesenchymal stem cells (hBMSCs). RNA sequencing analysis and ChIP assay were conducted to find out the potential mechanism of bone formation effect of HSYA. In vivo, through the chick embryo and ovariectomy (OVX)-induced osteoporosis rat model, we analyzed the function of bone development and formation of HSYA. Results: Taken all the results of our experiments together, it is safe to conclude that HSYA can promote osteogenesis via KDM7A as an epigenetic role to activate histone demethylation in β-catenin. More importantly, our study indicated that HSYA could promote bone development and protect against OVX-induced bone loss. Conclusion: These findings could pave the way to the potential development of HSYA-targeted therapeutic treatments for skeletal diseases such as osteoporosis.
A comprehensive analysis of cotton VQ gene superfamily reveals their potential and extensive roles in regulating cotton abiotic stress
Authors: Yu Shuxun , Chen Pengyun , wei Fei , Cheng Shuaishuai , Ma Liang , Wang Hantao , Zhang Meng , Mao Guangzhi , Lu Jianhua , Hao Pengbo , Ahmad Adeel , Gu Lijiao , Ma Qiang , Wu Aimin , Wei Hengling
Published: July 2020

Background
Valine-glutamine (VQ) motif-containing proteins play important roles in plant growth, development and abiotic stress response. For many plant species, the VQ genes have been identified and their functions have been described. However, little is known about the origin, evolution, and functions (and underlying mechanisms) of the VQ family genes in cotton.
Results
In this study, we comprehensively analyzed the characteristics of 268 VQ genes from four Gossypium genomes and found that the VQ proteins evolved into ten clades, and each clade had a similar structural and conservative motif. The expansion of the VQ gene was mainly through segmental duplication, followed by dispersal. Expression analysis revealed that the VQ genes play important roles in response to salt and drought stress, especially GhVQ18 and GhVQ84 were significantly high expression in PEG stress and salt stress. Further analysis showed that GhVQ genes were co-expressed with GhWRKY transcription factors (TFs), and microRNAs (miRNAs) could hybridize to their cis-regulatory elements.
Conclusions
The results in this study broaden our understanding of the VQ gene family in plants, and the analysis of the structure, conserved elements, and expression patterns of the VQ genes provide a solid foundation for exploring their specific functions in the abiotic stress responses in cotton. Our study provides significant insight into the potential functions of VQ genes in cotton.
Pharmacy Stakeholder Reports on Ethical and Logistical Considerations in Anti-Opioid Vaccine Development
Authors: Wartenweiler Vincent M , Chung Grace S , Stuart Amy , Wenthur Cody
Published: July 2020

BACKGROUND: As opioid use disorder (OUD) incidence and its associated deaths continue to persist at elevated rates, the development of novel treatment modalities is warranted. Recent strides in this therapeutic area include novel anti-opioid vaccine approaches. OBJECTIVES: Compare logistical and ethical considerations surrounding currently available interventions for opioid use disorder with an anti-opioid vaccine approach. METHODS: The opinions of student pharmacists and practicing pharmacists regarding utilization and perceived efficacy of current and future OUD management strategies were assessed using a staged, multi-modal research approach incorporating a focus group, pilot survey development and refinement, and final survey deployment. Survey responses were assessed using one- and two-way parametric and non-parametric analyses where appropriate, and multi-dimensional matrix profiles were compared using z-tests following an exhaustive combinatorial sum of differences calculation between items within each compared matrix. RESULTS: Focus group content analysis revealed a high level of agreeableness among participants regarding anti-opioid vaccine technology and a sense of shared ownership regarding solutions to the opioid epidemic at large. Pilot survey results demonstrated subject ability to consider both pragmatic and ethical considerations related to current therapeutics and novel interventions in a single instrument, with high endurance amongst engaged subjects. Access inequality was the most concerning ethical consideration identified for anti-opioid vaccines. Support for anti-opioid vaccine implementation across various clinical scenarios was strongest for voluntary use amongst individuals in recovery, and lowest for mandatory use in at-risk individuals. CONCLUSIONS: Ethical and logistical concerns surrounding anti-opioid vaccines were largely similar to those for current OUD therapeutics overall. Anti-opioid vaccines were endorsed as helpful potential additions to current OUD therapeutic approaches, particularly for voluntary use in the later stages of clinical progression.
Clinical Features and Genotypes of Laing Distal Myopathy in a Group of Chinese Patients, With In-Frame Deletions of MYH7 as Common Mutations
Authors: Yu Meng , Zhu Ying , Lu Yuanyuan , Lv He , Zhang Wei , Yuan Yun , Wang Zhaoxia
Published: July 2020

Background: Laing distal myopathy is a rare autosomal dominant inherited distal myopathy caused by mutations of the MYH7 gene affecting mainly the rod region. We described the clinical features, muscle MRI and pathological changes as well as genetic mutations in a group of Chinese patients of Laing distal myopathy. Results: Six patients with the confirmed diagnoses of Laing distal myopathy were recruited. Ankle dorsiflexion and finger extension weakness were common in our patients as well as neck flexion weakness. Myopathic as well as neurogenic lesions were suggested by electromyography in different patients. Respiratory abnormality of sleep apnea was detected in two of our patients stressing the necessity of close respiratory monitoring in this disease. Muscle MRIs showed similar features of concentric fatty infiltration of anterior thigh muscles together with early involvement of tibialis anterior and extensor hallucis longus. However, muscle pathological presentations were varied depending on the biopsied muscles and severity of the disease. In-frame deletions of the MYH7 gene made up 3/4 of mutations in our patients, suggesting these are common mutations of Laing distal myopathy. Conclusions: Our study further expanded the phenotypes and genotypes of Laing distal myopathy. In-frame deletions of MYH7 gene are common causes of Laing distal myopathy.
A network pharmacology-based analysis to distinguish the differences between Lonicerae Japonicae Flos and Lonicerae Flos
Authors: Gao Yu , Wang Fengxue , Liu Qing , Qi Yaodong , Wang Qiuling , Liu Haibo
Published: July 2020

Multiple basal plants are commonly used as materia medica in the traditional medicine of various nationalities and ethnicities worldwide. We call this practice “multibasal-plant materia medica” (MBPMM). So we proposed the application of network pharmacological method that it can provide a new way of distinguishing the differences among the different basal plants used in traditional medicines. We apply the method in investigating the differences and similarities in the material bases and mechanisms of anti-inflammatory activities of Lonicerae Japonicae Flos and Lonicerae Flos. Lonicerae Japonicae Flos and Lonicerae Flos share plenty of similarities in terms of anti-inflammatory mechanisms and material bases. Both of them mainly act on airway inflammation and tumour inflammation via the NF-κB signalling pathway and immune response, oxidation and signal transduction. However, Lonicerae Flos acts on inflammation with greater intensity than Lonicerae Japonicae Flos. We argue that they can be used interchangeably for the prevention and treatment of tumours and airway inflammation at a proper dosage. Otherwise, Lonicerae Flos may be more appropriate for treating neurological and metabolism-related inflammation, whereas Lonicerae Japonicae Flos is more suitable for the treatment of inflammation of systemic organs, such as intestines.
Identification of Biomarkers with Therapeutic And prognostic Value in Skin Cutaneous Melanoma
Authors: Wang Guangwen , Ling Yonghuo , Zhuang Qianru , Li Yingbang , Bai Yunpeng , Huang Yisheng , Huang Wendong
Published: July 2020

Background

The morbidity and mortality of skin cutaneous melanoma (SKCM), the most deadly type of skin cancer, are on the rise worldwide. Through in-depth study of the tumor microenvironment (TME) of SKCM, this study further identified biomarkers with therapeutic and prognostic value.
Methods

The gene expression profiles and clinical data of SKCM patients were downloaded from The Cancer Genome Atlas database. Then we calculated the immune score and stromal score of patients with skin melanoma by using the estimate algorithm, and divided all patients into the high/low immune/stromal score groups and discussed the correlation between them and clinical characteristics.Then, limma R package was used to screen out the differential genes in the high/low immune/ stromal score groups, and the heat map of the differential genes was drawn. At the same time, the functional enrichment analysis of the differential genes was carried out. The protein‒protein interaction (PPI) network of different genes was constructed by using STRING and Cytoscape, and the key genes related to the prognosis of cutaneous melanoma were further selected. Finally, kinase target, co expression genes and immune infiltrating cells of key genes were discussed.
Results

Patients in the low-immune/stromal score group had poorer survival outcome. The immune and stromal scores are associated with specific clinicopathologic variables (age, tumor grade, tumor stage) in SKCM. In total, 914 DEGs (909 upregulated and 5 downregulated genes) were screened from the gene expression profiles of patients with high immune and stromal scores. Functional enrichment analysis demonstrated a correlation between DEGs and the tumor microenvironment, tumor immune response and RCC tumorigenesis.Kaplan-Meier survival curves showed that 15 out of the 914 identified tumor microenvironment related genes are involved in the prognosis of SKCM. Finally CXCR8 and CCR5 were selected as the hub genes. A positive correlation was obtained between the expression of CXCR8/CCR5 and the abundance of six immune cells.
Conclusions

We studied the tumor microenvironment of SKCM, and finally screened out the biomarkers with therapeutic and prognostic effects.
Collaborative Chronic Care Model Implementation within Outpatient Behavioral Health Care Teams: Qualitative Results from a Multisite Trial using Implementation Facilitation
Authors: Sullivan Jennifer L , Kim Bo , Miller Christopher , Elwy A. Rani , Drummond Karen , Connolly Samantha , Riendeau Rachel , Bauer Mark
Published: July 2020

Background: This paper reports on a qualitative evaluation of a hybrid II stepped-wedge trial using implementation facilitation to implement team-based care in the form of the Collaborative Chronic Care Model (CCM) in interdisciplinary outpatient mental health teams. The objective of this study was to compare the alignment of sites’ clinical processes with the CCM elements at baseline (Time 1) and after 12 months of implementation facilitation (Time 2) from the perspective of providers.Methods: We conducted semi-structured interviews to assess the extent to which six CCM elements were in place: work role redesign, patient self-management support, provider decision support, clinical information systems, linkages to community resources, and organizational/leadership support. Interviews were transcribed and a priori CCM elements were coded using a directed content analysis approach at Time 1 and 2. We sought consensus on, and compared, the extent to which each CCM element was in place at Times 1 and 2.Results: We conducted 27 and 31 telephone interviews at Times 1 and 2, respectively, with outpatient mental health providers at nine participating sites. At Time 1 and Time 2, three CCM elements were most frequently present across the sites: work role redesign, patient self-management support, and provider decision support. The CCM elements with increased implementation from Time 1 to Time 2 were: work role redesign, patient self-management support, and clinical information systems. For two CCM elements, linkages to community resources and organizational/leadership support, some sites had increased implementation at Time 2 compared to Time 1, while others had reductions.Conclusions: Sites increased the extent of implementation on several CCM elements. The most progress was made in the CCM elements where sites had CCM-aligned processes already in place at Time 1. Teams made progress on elements they could more easily control, such as work role redesign. Our results suggest that maximizing the benefits of CCM-based outpatient mental health care may require targeting resources and training toward specific CCM elements—especially in the use of clinical information systems and linking with community resources. Trial Registration: Clinical Trials NCT02543840Registered 7 September 2015.