bluuebunny/crossref_metadata_2025 huggingface dataset:
In-cylinder thermographic PIV combined with phosphor thermometry using ZnO:Zn
Authors: Kopf Andreas , Frattina Valerio , Bardi Michele , Endres Torsten , Bruneaux Gilles , Schulz Christof
Published: October 2021

Two-dimensional thermographic particle image velocimetry (T-PIV) is presented for the in situ measurement in optically accessible internal combustion (IC) engines. Temperature and velocity measurements are combined using thermographic phosphor particles as tracers for PIV. For three commercially available phosphors (BAM:Eu2+, ZnO, and ZnO:Zn), temperature sensitivity, luminescence intensity at high temperatures and laser-fluence dependence were evaluated for phosphor-coated surfaces in a high-temperature cell. ZnO:Zn was identified as the best-suited candidate for engine in-cylinder measurements and further analyzed in the aerosolized state at temperatures up to 775 K to generate calibration data required for signal quantification in engine experiments. T-PIV was successfully applied in the IC engine to simultaneously obtain instantaneous two-dimensional velocity and temperature fields using the intensity-ratio method. Despite a measurement uncertainty (±1σ basis) of only 3.7 K at 317 K (1.2%) to 24.4 K (4.2%) at 575 K, this technique suffers from low signal intensities due to thermal quenching at increasing temperatures, which leads to reduced accuracy as the piston approaches top dead center. Thermographic measurements were successful to visualize local temperature changes due to evaporative cooling after fuel injection. The measured mean gas temperatures agreed well with zero-dimensional simulations that use additional wall-temperature measurements from thermographic phosphor measurements based on the lifetime method as input for heat transfer calculations.
Impacts of structural parameters of baffle plate on jetting pigging robot in the underwater oil and gas pipeline
Authors: Liu Shangjunnan , Liu Shuhai , Xiao Huaping
Published: October 2021

During the operation of oil and gas transportation pipeline, condensate forms on the inner wall of the pipeline can lead to reduced transportation efficiency and potential safety hazards. Pigging is a widely used technology to remove deposition in pipelines. From the studies, it is found that the effect of pigging largely depends on the structure of the pig. The jetting pig is a new type of pigging device designed to prevent the blocking in the pigging process, and its baffles play an important role in guiding the jet fluid. In this paper, the impact of the structure of the baffle plate on the downstream flow field of the jetting pig is simulated and analyzed. The surface of the baffle plate is changed by using the curve of the contraction section of the water tunnel. It is found that the baffle plate structure has a great influence on the flow field at the outlet of the jet pig: (1) The increase of buffle area leads to the increase of turbulent kinetic energy and the decrease of velocity; (2) The rise of edge angle lead to the regular change of turbulent kinetic energy; (3) Different curved surfaces make the change of turbulent kinetic energy and velocity. The results in this study are helpful for a better understanding of mechanism of jetting pig and improved design of mechanical structure for improved pigging performance.
What are the Care Needs of Families Experiencing Cardiac Arrest Care? A Survivor and Family-Performed Systematic Review and Qualitative Meta-Synthesis Protocol
Authors: Douma Matthew J. , Graham Timothy A. D. , Bone Allison , Ali Samina , Dennett Liz , Brindley Peter G. , Kroll Thilo , Frazer Kate
Published: October 2021

Background: Sudden cardiac arrest is a leading cause of death. Family members can be deeply impacted by sudden loss or uncertainty about survivor outcomes. The objective of this systematic review will be to identify, appraise, and meta-synthesize qualitative evidence regarding family care-needs when experiencing cardiac arrest. Methods: This systematic review of qualitative studies and meta-synthesis will be conducted by multidisciplinary researchers in partnership with patient and family partners who have lived-experience of cardiac arrest. We will search MEDLINE, Embase, CINAHL, Theses and Dissertations Global, SocIndex, Scopus, Web of Science, PsycINFO, and Google Scholar. We will include qualitative research describing the experience and care needs of family members. We will also search reference lists, conduct forward citation searches, and contact content experts. We will assess the methodological quality of included studies using the Critical Appraisal Skills Programme tool. Two team members will independently review studies, extract data, and assess methodological quality. Disagreements will be resolved by consensus. We will use thematic framework analysis to analyze and synthesize narrative data, after which the review team and stakeholders discuss the findings and make any necessary changes. Our thematic synthesis will follow three steps: (i) initial coding and grouping of codes, (ii) formation of descriptive themes, and (iii) transcending the data to form novel insights and theories (analytical themes). The review will be reported in accordance with the ENTREQ and GRIPP2 guidelines. We will apply the Confidence in the Evidence from Reviews of Qualitative (CERQual) research to assess the robustness of our findings. Review Registration: This protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42021236431 and Open Science Framework https://osf.io/fxp5g .
Design and Development of Isolating Pods to Prevent the Spread of Coronavirus or Other Viruses for Hospital and Domestic Purposes
Authors: Bahadur Goonesh Kumar , Jodheea-Jutton Abha , Mowlabaccus Wafaa Binti , Callychurn Devkumar , Ramasamy Sabrina
Published: October 2021

Objectives:

This project investigated into the design and construction of an isolation pod to keep infected people in quarantine, thus avoiding the spread of viruses such as the COVID-19. This product was made to be used in hospitals and at homes.

Background:

Mauritius is among the few countries, which has not had any cases of COVID-19 since for since May 2020 for a period of 150 days. It has opened its borders since October 2020, and since Mauritius being a small country, the spread of any type of virus can be imminent if not controlled properly. In case there is another spread of the COVID-19 in Mauritius, then the isolation pod could be used to keep infected people in quarantine. The aims of the study were to develop a prototype of an isolation cubicle that is collapsible and can be easily erected at homes or in hospitals, whenever the need arises.

Methods:

A prototype of the pod was made with metal bars welded together and tarpaulin materials were sewn together. A HEPA Fan Extractor was fitted inside the pod to allow the air to circulate.

Results:

the tests carried out the pod could easily be assembled, transported and stored for further usage. From the volunteers’ feedback, it was found that the pod was comfortable, spacious, and practical. The air monitoring tests carried on the carbon dioxide, temperature, and relative humidity were within the acceptable ranges.
Patients’ and Nurses’ Experiences of All Single-Room Hospital Accommodation: A Scoping Review
Authors: Søndergaard Susanne Friis , Beedholm Kirsten , Kolbæk Raymond , Frederiksen Kirsten
Published: October 2021

Aim and Objective:

To identify, examine, and map literature on the experiences of single-room hospital accommodation, exploring what is known about how single-room accommodation in hospitals is viewed by patients and nurses.

Background:

Worldwide, hospital design is changing to mainly single-room accommodation. However, there is little literature exploring patients’ and nurses’ experiences of single-room designs.

Design:

Scoping review following the Joanna Briggs Institute guidance on scoping reviews.

Methods:

We conducted the search in medical databases for scientific and gray literature. The four authors independently used a data extraction tool to include sources from the searches. The sources were discussed during the process, and in case of a disagreement between two reviewers, the third and fourth reviewer would be invited to participate in the discussion until consensus was achieved.

Results:

We included 22 sources published during the period 2002–2020, with a majority ( n = 16) during the period 2013–2020. The sources were distributed on 10 different countries; however, England dominated with 14 publications. We found three main maps for reporting on patients’ experiences: (1) personal control, (2) dignity, and (3) by myself. For the nurses’ experiences, we found four main maps: (1) the working environment, (2) changes of nursing practice, (3) privacy and dignity, and (4) patient safety.

Conclusion:

We suggested that patients’ and nurses’ experiences are predominantly interdependent and that the implications of single-room accommodation is a large and complex issue which goes beyond hospital design.
Long-Term Outcomes of Nasoseptal Perforation Repair Using Anterior Maxillary Sinus Wall as an Interpositional Graft
Authors: Hwang Jae Woong , Han Mun Soo , Kang Sung Hoon , Kwak Ji Won , Kim Hyun Keun , Kim Tae Hoon , Lee Sang Hag
Published: October 2021

Background

Various graft materials have been used to repair nasoseptal perforation, but there is no standardized treatment method. The anterior maxillary sinus wall is flattened in appearance and can be easily obtained in a sufficient amount for a large-sized nasoseptal perforation.

Objectives

The aim of this study is to determine whether the anterior maxillary sinus wall is suitable as an interpositional graft in the surgical repair of septal or nasoseptal perforation.

Methods

This is a retrospective review of 21 patients who underwent repair of nasoseptal perforation using anterior maxillary sinus wall as an interpositional graft. The etiology, pre- and post-operative NOSE and GBI score, and perforation size were reviewed. The surgical outcome was considered successful if total closure was achieved after postoperative follow-up.

Results

19 of the 21 perforations were successfully repaired with anterior maxillary sinus wall. Failure of the repair was found in 2 patients. Causal etiology of perforation was previous septoplasty in 10 patients, and electrocautery in 1 case, but not identified in 10 cases. The largest size was 2.7 × 2.2 cm. The most common symptoms were epistaxis, crusting, and nasal obstruction. Closure of septal perforation resulted in improved subjective symptoms and quality of life which were evaluated with NOSE and GBI score.

Conclusion

Anterior maxillary sinus wall as interpositional graft between mucoperichondrial flaps can be used to reliably repair nasoseptal perforations.
Plasma ST6GAL1 regulates IgG sialylation to control IgA nephropathy progression
Authors: Liu Youxia , Yu Huyan , Wu Sijing , Yang Xia , Cao Congcong , Wang Fanghao , Jia Junya , Yan Tiekun
Published: October 2021

Background:

Our previous study revealed that plasma levels of a-2,6-sialyltransferase 1 (ST6GAL1) were increased in patients with IgA nephropathy (IgAN). ST6GAL1 catalyzes terminal sialylation of IgG to shift the antibody effector function to the anti-inflammatory pattern. However, the role of plasma ST6GAL1 in the progression of IgAN and underlying mechanisms are still unknown.

Methods:

A total of 180 IgAN patients were included. The kidney outcomes were defined as the eGFR decline or proteinuria remission. Peripheral blood mononuclear cells (PBMCs) were either stimulated with purified sialylated IgG (SA-IgG) or with non-sialylated IgG (NSA-IgG) from IgAN patients to detect the levels of interleukin (IL)-6 and tumor necrosis factor-α (TNF-α) in supernatant.

Results:

Compared with the lower ST6GAL1 (reference), the risk of eGFR decline decreased for the higher ST6GAL1 group after adjustment for baseline eGFR, systolic blood pressure (SBP), and proteinuria. The results showed that patients with higher ST6GAL1 levels had a higher rate of proteinuria remission. ST6GAL1, expressed as a continuous variable, was a protective factor for eGFR decline and proteinuria remission. An in vitro study showed that the administration of recombinant ST6GAL1 (rST6GAL1) decreased the levels of IL-6 and TNF-α in PBMCs. Furthermore, the administration of rST6GAL1 resulted in the enrichment of SA-IgG in a concentration-dependent manner. In addition, as compared to control, purified SA-IgG-treated PBMCs showed a significant decrease in the expression of IL-6 and TNF-α.

Conclusion:

Our study indicated that elevated ST6GAL1 was associated with a slower progression of IgAN, which may play a protective effect by increasing IgG sialylation to inhibit the production of proinflammatory cytokines in PBMCs.
Many ideas of nation, many national maps
Authors: Boria Edoardo
Published: October 2021

Contrary to the traditional approach to the analytical category of the national map, Tania Rossetto and Laura Lo Presti use it to highlight the cultural pluralism inherent to the national experience in Italy. Their study offers a conceptual framework with considerable potential, capable of developing an insightful observation into the practices of everyday nationhood through which nationalism takes on concrete meaning. Moreover, the category of the national map appears to be usable in different theoretical paradigms, provided that the conditions for its use are specified.
What is a nation?
Authors: Rankin William
Published: October 2021

Reimagining the national map should also invite a reimagining of ‘nation’ as a category. Maps do crucial work in stitching together the term's two overlapping meanings – nation as territorial state, and nation as group of people – and maps can, in turn, help to interrogate and reconstitute these meanings. In my commentary, I offer three ways that ‘nation’ is at stake in Rossetto and Lo Presti's argument: (1) in distinguishing cartographies of diversity from cartographies of belonging; (2) in distinguishing a pluralism of bodies from a pluralism of perspectives; and (3) in the choice between renegotiating and abandoning the term itself.
Return to Sport After ACL Reconstruction: Strength and Functionality Testing
Authors: Padanilam Simon J. , Dayton Steven R. , Jarema Ryan , Boctor Michael J. , Tjong Vehniah K.
Published: October 2021

Background:

Functionality testing following anterior cruciate ligament (ACL) reconstruction can benefit clinicians and patients in determining readiness for return to sport. While a component of a multifactorial decision, inability to perform well on these tests predicts increased risk of reinjury. As of 2013, only 41% of orthopaedic surgeons report using strength or functionality testing in evaluating patients for return to sport (RTS).

Indications:

In the intermediate to late stages of their rehabilitation program, patients may undergo these tests to determine readiness and safety to return to sport.

Technique Description:

The tests described in this video include the single and triple hop for distance, triple crossover hop, single and double vertical leg jump tasks, drop jump landing task, and isokinetic and isometric strength testing.

Results:

Clinicians who incorporate these tests into patient rehabilitation programs may reduce patient risk of ACL reinjury by 75% to 84%. The limb symmetry index (LSI) is a reliable calculated measure for these tests, with a strong reliability for the hop tests. The limb symmetry index can be calculated for each test and represents the ratio of measured performance of the involved, or post-ACL reconstruction, leg when compared against the uninvolved leg. The commonly used limb symmetry index threshold for passing each hop test is 90%. Patients who score 90% or greater on each of these tests are less likely to experience knee reinjury.

Discussion/Conclusion:

The ability of knee strength and functionality tests in determining RTS following ACL reconstruction has been highlighted as a tool in potentially reducing risk of knee reinjury. Other isometric and isokinetic testing can be used in addition to the described functionality tests but may not be possible in certain practices due to equipment and funding limitations. Usage of these strength and functionality tests, in conjunction with clinician evaluation, may lead to more optimal outcomes for patients and lower rates of reinjury. Psychological assessment may aid in evaluating patient readiness for return to sport. Importantly, further sport-specific testing is still recommended and will optimize patient outcomes.
Hazard characterization for alternative intensity measures using the total probability theorem
Authors: Greenfield Michael W , Makdisi Andrew J
Published: October 2021

Since their inception in the 1980s, simplified procedures for the analysis of liquefaction hazards have typically characterized seismic loading using a combination of peak ground acceleration and earthquake magnitude. However, more recent studies suggest that certain evolutionary intensity measures (IMs) such as Arias intensity or cumulative absolute velocity may be more efficient and sufficient predictors of liquefaction triggering and its consequences. Despite this advantage, widespread hazard characterizations for evolutionary IMs are not yet feasible due to a relatively incomplete representation of the ground motion models (GMMs) needed for probabilistic seismic hazard analysis (PSHA). Without widely available hazard curves for evolutionary IMs, current design codes often rely on spectral targets for ground motion selection and scaling, which are shown in this study to indirectly result in low precision of evolutionary IMs often associated with liquefaction hazards. This study presents a method to calculate hazard curves for arbitrary intensity measures, such as evolutionary IMs for liquefaction hazard analyses, without requiring an existing GMM. The method involves the conversion of a known IM hazard curve into an alternative IM hazard curve using the total probability theorem. The effectiveness of the method is illustrated by comparing hazard curves calculated using the total probability theorem to the results of a PSHA to demonstrate that the proposed method does not result in additional uncertainty under idealized conditions and provides a range of possible hazard values under most practical conditions. The total probability theorem method can be utilized by practitioners and researchers to select ground motion time series that target alternative IMs for liquefaction hazard analyses or other geotechnical applications. This method also allows researchers to investigate the efficiency, sufficiency, and predictability of new, alternative IMs without necessarily requiring GMMs.
Serum concentrations of oxytocin, DHEA and follistatin are associated with osteoporosis or sarcopenia in community-dwelling postmenopausal women
Authors: Du Yanping , Xu Cuidi , Shi Hongli , Jiang Xin , Tang Wenjing , Wu Xiaoqing , Chen Minmin , Li Huilin , Zhang Xuemei , Cheng Qun
Published: October 2021

Background

Osteoporosis and sarcopenia are major health issues in postmenopausal women due to their high prevalence and association with several adverse outcomes. However, no biomarkers may be used for screening and diagnosis. The current study investigated potential biomarkers for osteoporosis and/or sarcopenia in postmenopausal women.

Methods

A cross-sectional study on 478 healthy community-dwelling postmenopausal women aged 50–90 years was performed. Osteoporosis and sarcopenia were defined according to the World Health Organization (WHO) and Asian Working Group for Sarcopenia (AWGS).

Results

Dehydroepiandrosterone (DHEA) was related to muscle strength (β = 0.19, p = 0.041) and function (β = 0.58, p = 0.004). Follistatin (β = − 0.27, p = 0.01) was related to muscle mass. Oxytocin (β = 0.59, p = 0.044) and DHEA (β = 0.51, p = 0.017) were related to bone mass. After adjusting for age, oxytocin (odds ratio (OR) 0.75; 95% confidence intervals (CI) 0.63–0.98; p = 0.019) was associated with osteoporosis, and DHEA (OR 0.73; 95% CI 0.51–0.96; p = 0.032) and follistatin (OR 1.66; 95% CI 1.19–3.57; p = 0.022) were associated with sarcopenia.

Conclusions

Postmenopausal women with sarcopenia were more likely to have lower DHEA levels and higher follistatin levels, and postmenopausal women with osteoporosis were more likely to have lower oxytocin levels.
Sarcopenia index based on serum creatinine and cystatin C predicts the risk of postoperative complications following hip fracture surgery in older adults
Authors: Chen Xiaoyan , Shen Yanjiao , Hou Lisha , Yang Binyu , Dong Birong , Hao Qiukui
Published: October 2021

Objective

To assess the utility of the preoperative Sarcopenia index (SI) as a predictive marker of the risk of postoperative complications following hip fracture surgery in older adults.

Study design

This observational study enrolled older adults with hip fracture who were hospitalized in the Department of Orthopedics of West China Hospital, Sichuan University, from December 7, 2010 - June 14, 2017, and who underwent hip fracture surgery.

Primary outcome and measures

Clinical data were collected from medical records and serum creatinine and cystatin C were measured before surgery. Outcomes included postoperative complications such as pneumonia, urinary tract infection, respiratory failure, heart failure, and non-grade A healing. Binary logistic regression analyses were used to analyze association between SI and postoperative complications.

Results

A total of 897 patients aged 60 years and over were enrolled in this study (age range: 60 – 100 years), of whom 306(34.1%)were male, and 591(65.9%)were female. Postoperative complications included pneumonia (12%), urinary tract infections (1.8%), respiratory failure (1.5%), heart failure (1.6%), and non-A- grade healing (3.6%). In the patient group that received joint replacements, the incidence of pneumonia was negatively associated with SI values. After adjusting for potential confounding factors, binary logistic regression analyses showed that a higher SI was independently associated with a lower risk of pneumonia after joint replacement surgery (OR:0.39, 95% CI:0.18-0.89, P<0.05). However, we did not find statistically significant association between SI and the risk of postoperative complications other than pneumonia among patients with two types of hip fracture surgery.

Conclusion

The SI based on serum creatinine and cystatin C can predict pneumonia rather than other postoperative complications among older patients with hip fracture after joint replacement surgery.
The health perceptions, dengue knowledge and control willingness among Dai ethnic minority in Yunnan Province, China
Authors: Liu Hui , Fang Cheng-Jiang , Xu Jian-Wei
Published: October 2021

Background

Outbreaks of dengue fever are often found among Dai ethnical communities along China-Myanmar border. The objective of this study was: 1) to investigate residents’ health perceptions, knowledge and control willingness to participate in dengue control and 2) to identify factors associated with control willingness among the Dai ethnic community.

Methods

This is a mixed method study of a cross-sectional design, in which qualitative in-depth interviews and quantitative household questionnaire surveys are included.

Results

Questionnaire was administered to 261 household heads, and in-depth interview was conducted with 18 key informants. Of them, many participants (70%, 182/259) and 12 key informants (66.7%) from the two rural communities believed that the Lord Buddha would protect the good people. Majority of the participants (81.4%, 206/253) knew that fever was one of dengue fever symptoms and most of them (82.2%, 213/259) indicated that mosquitoes could transmit dengue fever. However, only one third of the participants (30.1%, 78/259) indicated the perceived susceptibility of dengue fever, and only a half of them (50.2%, 130/259) indicated the perceived severity of dengue fever. Multivariate logistic analysis (MLA) indicated that the participants with family wealth index (FWI) 4–5 (OR: 22.9728; 95%CI: 2.4257–217.5688, p = 0.0063) were more likely to turn containers upside down (TCUD) compared to those with FWI 1–3; and the participants in the urban community (OR: 0.0239; 95%CI: 0.0019–0.3032, p = 0.004) were less likely to TCUD compared to those in the two rural communities. Around one third of the participants (36.8%, 96/239) reported that they were willing to seek treatment first for dengue fever from public health facilities. The MLA identified that the participants with the perceived severity of dengue fever (OR: 5.0564; 95%CI: 2.0672–12.3683, p = 0.0004), and with beliefs of sound hygiene helpful to people’s health (OR: 11.5671; 95%CI: 2.0505–65.2502, p = 0.0055) were more likely to seek treatment first for dengue fever from the public health facilities.

Conclusion

The study finds that most of Dai people have sound knowledge. However, health educational interventions should target to promote the perceived susceptibility and the perceived severity of dengue fever among Dai people.
Palliative care integration: a critical review of nurse migration effect in Jamaica
Authors: Edwards Rebecca L. , Patrician Patricia A. , Bakitas Marie , Markaki Adelais
Published: October 2021

Background

Provision of palliative care to individuals with late-stage serious illnesses is critical to reduce suffering. Palliative care is slowly gaining momentum in Jamaica but requires a highly skilled workforce, including nurses. Out-migration of nurses to wealthier countries negatively impacts the delivery of health care services and may impede palliative care capacity-building. This critical review aimed to explore the evidence pertaining to the nurse migration effect on the integration of palliative care services in Jamaica and to formulate hypotheses about potential mitigating strategies.

Methods

A comprehensive search in the PubMed, CINAHL, and ProQuest PAIS databases aimed to identify articles pertinent to nurse migration in the Caribbean context. Grant and Booth’s methodologic framework for critical reviews was used to evaluate the literature. This methodology uses a narrative, chronologic synthesis and was guided by the World Health Organization (WHO) Public Health Model and the Model of Sustainability in Global Nursing.

Results

Data from 14 articles were extracted and mapped. Poorer patient outcomes were in part attributed to the out-migration of the most skilled nurses. ‘Push-factors’ such as aggressive recruitment by wealthier countries, lack of continuing educational opportunities, disparate wages, and a lack of professional autonomy and respect were clear contributors. Gender inequalities negatively impacted females and children left behind. Poor working conditions were not necessarily a primary reason for nurse migration. Four main themes were identified across articles: (a) globalization creating opportunities for migration, (b) recruitment of skilled professionals from CARICOM by high income countries, (c) imbalance and inequities resulting from migration, and (d) mitigation strategies. Thirteen articles suggested education, partnerships, policy, and incentives as mitigation strategies. Those strategies directly align with the WHO Public Health Model drivers to palliative care integration.

Conclusion

Emerged evidence supports that nurse migration is an ongoing phenomenon that strains health systems in Caribbean Community and Common Market (CARICOM) countries, with Jamaica being deeply impacted. This critical review demonstrates the importance of strategically addressing nurse migration as part of palliative care integration efforts in Jamaica. Future studies should include targeted migration mitigation interventions and should be guided by the three working hypotheses derived from this review.
An in vitro study of an Artocarpus heterophyllus substance as a hepatitis C antiviral and its combination with current anti-HCV drugs
Authors: Permanasari Adita Ayu , Aoki-Utsubo Chie , Wahyuni Tutik Sri , Tumewu Lidya , Adianti Myrna , Widyawaruyanti Aty , Hotta Hak , Hafid Achmad Fuad
Published: October 2021

Background

Current therapy of chronic hepatitis C virus (HCV) with direct-acting antivirals (DAAs) has dramatically improved the sustained virologic response (SVR) of affected patients; however, treatment with DAAs remains expensive, and drug-resistant HCV variants remain a threat. As a result, there is still a need to continue to develop affordable and effective drugs for the treatment of HCV. Previously, we have demonstrated that a crude extract from Artocarpus heterophyllus leaves is a potential anti-HCV candidate. In this study, we have further purified this crude extract, examined which sub-fraction possesses the highest antiviral activity, and then explored its efficacy at different HCV life cycle stages. We also assessed synergistic antiviral effects between the A. heterophyllus extract and commercially available anti-HCV drugs.

Methods

We used vacuum liquid chromatography (VLC) and high-performance liquid chromatography (HPLC) to fractionate a dichloromethane extract of A. heterophyllus leaves. We then examined the anti-HCV activity of the fractions using HCV genotype 2a, JFH1a; the antiviral mode of action was determined by exploring adding the treatments at different times. We examined the antiviral effects on the viral entry stage through a virucidal activity test, viral adsorption examination, and pretreatment of cells with the drug. The effects on the post-viral entry stage were determined by the levels of HCV protein expression and HCV RNA expression in infected cells.

Results

Through activity guided purification, we identified the sub-fraction FR3T3 as possessing the most robust anti-HCV activity with an IC50 value of 4.7 ± 1.0 μg/mL. Mode-of-action analysis revealed that FR3T3 inhibited post-viral entry stages such as HCV NS3 protein expression and HCV RNA replication with marginal effects on the viral entry stage. Thin-layer Chromatography (TLC) indicated that FR3T3 contained terpenoids and chlorophyll-related compounds. We also found a synergistic antiviral activity when the DCM extract of A. heterohyllus was used in combination therapy with commercial anti-HCV drugs; Ribavirin, Simeprevir, Cyclosporin A.

Conclusions

The extract of A. heterophyllus and its sub-fraction, FR3T3, presented here have anti-HCV activities and could be candidate drugs for add-on-therapy for treatment of chronic HCV infections.
Capacity development and safety measures for health care workers exposed to COVID-19 in Bangladesh
Authors: Nath Tapan Kumar , Paul Alak , Sikdar Dwaipayan , Mahanta Janardan , Paul Sujat , Amin Md Robed , Chowdhury Shahanara , Bhuiyan Md. Nur Hossain , Rob Md. Abdur , Rahim Abdur , Islam Md Khairul , Sharif Md Mohiuddin , Navaneetham Kannan
Published: October 2021

Background

The safety of health care workers (HCWs) in Bangladesh and the factors associated with getting COVID-19 have been infrequently studied. The aim of this study was to address this gap by assessing the capacity development and safety measures of HCWs in Bangladesh who have been exposed to COVID-19 and by identifying the factors associated with respondents’ self-reported participation in capacity development trainings and their safety practices.

Methods

This cross-sectional study was based on an online survey of 811 HCWs working at 39 dedicated COVID-19 hospitals in Bangladesh. A pretested structured questionnaire consisting of questions related to respondents’ characteristics, capacity development trainings and safety measures was administered. Binary logistic regressions were run to assess the association between explanatory and dependent variables.

Results

Among the respondents, 58.1% had been engaged for at least 2 months in COVID-19 care, with 56.5% of them attending capacity development training on the use of personal protective equipment (PPE), 44.1% attending training on hand hygiene, and 35% attending training on respiratory hygiene and cough etiquette. Only 18.1% reported having read COVID-19-related guidelines. Approximately 50% of the respondents claimed that there was an inadequate supply of PPE for hospitals and HCWs. Almost 60% of the respondents feared a high possibility of becoming COVID-19-positive. Compared to physicians, support staff [odds ratio (OR) 4.37, 95% confidence interval (CI) 2.25–8.51] and medical technologists (OR 8.77, 95% CI 3.14–24.47) were more exhausted from working in COVID-19 care. Respondents with longer duty rosters were more exhausted, and those who were still receiving infection prevention and control (IPC) trainings were less exhausted (OR 0.54, 95% CI 0.34–0.86). Those who read COVID-19 guidelines perceived a lower risk of being infected by COVID-19 (OR 0.44, 95% CI 0.29–0.67). Compared to the respondents who strongly agreed that hospitals had a sufficient supply of PPE, others who disagreed (OR 2.68, 95% CI 1.31–5.51) and strongly disagreed (OR 5.05, 95% CI 2.15–11.89) had a higher apprehension of infection by COVID-19.

Conclusion

The findings indicated a need for necessary support, including continuous training, a reasonable duty roster, timely diagnosis of patients, and an adequate supply of quality PPE.
Systematical analysis reveals a strong cancer relevance of CREB1-regulated genes
Authors: Zheng Tianyu , Huang Jinrong , Xiang Xi , Li Siyuan , Yu Jiaying , Qu Kunli , Xu Zhe , Han Peng , Dong Zhanying , Liu Yang , Xu Fengping , Yang Huanming , Jäättelä Marja , Luo Yonglun , Liu Bin
Published: October 2021

The transcription factor cyclic-AMP response element-binding protein 1 (CREB1) responds to cAMP level and controls the expression of target genes, which regulates nutrition partitioning. The promoters of CREB1-targeted genes responsive to cAMP have been extensively investigated and characterized with the presence of both cAMP response element and TATA box. Compelling evidence demonstrates that CREB1 also plays an essential role in promoting tumor development. However, only very few genes required for cell survival, proliferation and migration are known to be constitutively regulated by CREB1 in tumors. Their promoters mostly do not harbor any cAMP response element. Thus, it is very likely that CREB1 regulates the expressions of distinct sets of target genes in normal tissues and tumors. The whole gene network constitutively regulated by CREB1 in tumors has remained unrevealed. Here, we employ a systematical and integrative approach to decipher this gene network in the context of both tissue cultured cancer cells and patient samples. We combine transcriptomic, Rank-Rank Hypergeometric Overlap, and Chipseq analysis, to define and characterize CREB1-regulated genes in a multidimensional fashion. A strong cancer relevance of those top-ranked targets, which meet the most stringent criteria, is eventually verified by overall survival analysis of cancer patients. These findings strongly suggest the importance of genes constitutively regulated by CREB1 for their implicative involvement in promoting tumorigenesis.
Molecular surveillance for polymorphisms associated with artemisinin-based combination therapy resistance in Plasmodium falciparum isolates collected in Mozambique, 2018
Authors: Chidimatembue Arlindo , Svigel Samaly S. , Mayor Alfredo , Aíde Pedro , Nhama Abel , Nhamussua Lídia , Nhacolo Arsénio , Bassat Quique , Salvador Crizólgo , Enosse Sónia , Saifodine Abuchahama , De Carvalho Eva , Candrinho Baltazar , Zulliger Rose , Goldman Ira , Udhayakumar Venkatachalam , Lucchi Naomi W. , Halsey Eric S. , Macete Eusébio
Published: October 2021

Background

Due to the threat of emerging anti-malarial resistance, the World Health Organization recommends incorporating surveillance for molecular markers of anti-malarial resistance into routine therapeutic efficacy studies (TESs). In 2018, a TES of artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) was conducted in Mozambique, and the prevalence of polymorphisms in the pfk13, pfcrt, and pfmdr1 genes associated with drug resistance was investigated.

Methods

Children aged 6–59 months were enrolled in four study sites. Blood was collected and dried on filter paper from participants who developed fever within 28 days of initial malaria treatment. All samples were first screened for Plasmodium falciparum using a multiplex real-time PCR assay, and polymorphisms in the pfk13, pfcrt, and pfmdr1 genes were investigated by Sanger sequencing.

Results

No pfk13 mutations, associated with artemisinin partial resistance, were observed. The only pfcrt haplotype observed was the wild type CVMNK (codons 72–76), associated with chloroquine sensitivity. Polymorphisms in pfmdr1 were only observed at codon 184, with the mutant 184F in 43/109 (39.4%) of the samples, wild type Y184 in 42/109 (38.5%), and mixed 184F/Y in 24/109 (22.0%). All samples possessed N86 and D1246 at these two codons.

Conclusion

In 2018, no markers of artemisinin resistance were documented. Molecular surveillance should continue to monitor the prevalence of these markers to inform decisions on malaria treatment in Mozambique.
Catalytic core–shell nanoparticles with self-supplied calcium and H2O2 to enable combinational tumor inhibition
Authors: Kong Hanjing , Fang Chao , Chu Qiang , Hu Zefeng , Fu Yike , Han Gaorong , Li Xiang , Zhou Yi
Published: October 2021

Nanoparticles, presenting catalytic activity to induce intracellular oxidative species, have been extensively explored for tumor treatment, but suffer daunting challenges in the limited intracellular H2O2 and thus suppressed therapeutic efficacy. Here in this study, a type of composite nanoparticles, consisting CaO2 core and Co-ferrocene shell, is designed and synthesized for combinational tumor treatment. The findings indicate that CaO2 core can be hydrolyzed to produce large amounts of H2O2 and calcium ions at the acidic tumor sites. Meanwhile, Co-ferrocene shell acts as an excellent Fenton catalyst, inducing considerable ROS generation following its reaction with H2O2. Excessive cellular oxidative stress triggers agitated calcium accumulation in addition to the calcium ions released from the particles. The combined effect of intracellular ROS and calcium overload causes significant tumor inhibition both in vitro and in vivo.
Nanoselenium transformation and inhibition of cadmium accumulation by regulating the lignin biosynthetic pathway and plant hormone signal transduction in pepper plants
Authors: Li Dong , Zhou Chunran , Ma Jinling , Wu Yangliu , Kang Lu , An Quanshun , Zhang Jingbang , Deng Kailin , Li Jia-Qi , Pan Canping
Published: October 2021

Selenium (Se) can promote the growth and resistance of agricultural crops as fertilizers, while the role of nano-selenium (nano-Se) against Cd remains unclear in pepper plants (Capsicum annuum L.). Biofortification with nano-Se observably restored Cd stress by decreasing the level of Cd in plant tissues and boosting the accumulation in biomass. The Se compounds transformed by nano-Se were primarily in the form of SeMet and MeSeCys in pepper tissues. Differential metabolites and the genes of plant signal transduction and lignin biosynthesis were measured by employing transcriptomics and determining target metabolites. The number of lignin-related genes (PAL, CAD, 4CL, and COMT) and contents of metabolites (sinapyl alcohol, phenylalanine, p-coumaryl alcohol, caffeyl alcohol, and coniferaldehyde) were remarkably enhanced by treatment with Cd1Se0.2, thus, maintaining the integrity of cell walls in the roots. It also enhanced signal transduction by plant hormones and responsive resistance by inducing the biosynthesis of genes (BZR1, LOX3, and NCDE1) and metabolites (brassinolide, abscisic acid, and jasmonic acid) in the roots and leaves. In general, this study can enable a better understanding of the protective mechanism of nano-Se in improving the capacity of plants to resist environmental stress.
Community health workers at the dawn of a new era: 5. Roles and tasks
Authors: Glenton Claire , Javadi Dena , Perry Henry B.
Published: October 2021

Background

This is the fifth of our 11-paper supplement on “Community Health Workers at the Dawn of a New Era.” When planning new community health worker (CHW) roles or expanding existing roles, programme planners need to analyse global and local research evidence and evidence-based guidance on the effectiveness and safety of relevant tasks performed by CHWs.

Methods

In this paper, we explore key areas of consideration when selecting roles and tasks; present current knowledge regarding these issues; and suggest how decision-makers could consider these issues when assigning tasks in their setting. This paper draws on the chapter “Community Health Worker Roles and Tasks” in Developing and Strengthening Community Health Worker Programs at Scale: A Reference Guide and Case Studies for Program Managers and Policymakers, as well as on a recently published compendium of 29 case studies of national CHW programmes and on recently published literature pertaining to roles and tasks of CHWs.

Results

This paper provides a list of questions that aim to help programme planners think about important issues when determining CHW roles and tasks in their setting. Planners need to assess whether the recommended roles and tasks are considered acceptable and appropriate by their target population and by the CHWs themselves and those who support them. Planners also need to think about the practical and organizational implications of each task for their particular setting with regard to training requirements, health systems support, work location, workload, and programme costs.

Conclusion

When planning CHW roles and tasks, planners, programme implementers, and policy-makers should draw from global guidance and research evidence, but they also need to engage with the experiences, needs, and concerns of local communities and health workers. By drawing from both sources of information, they will stand a better chance of developing programmes that are effective in achieving their goals while remaining acceptable to those affected by them, feasible to implement, and sustainable over time.
Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All”
Authors: Perry Henry B. , Chowdhury Mushtaque , Were Miriam , LeBan Karen , Crigler Lauren , Lewin Simon , Musoke David , Kok Maryse , Scott Kerry , Ballard Madeleine , Hodgins Steve
Published: October 2021

Background

This is the concluding paper of our 11-paper supplement, “Community health workers at the dawn of a new era”.

Methods

We relied on our collective experience, an extensive body of literature about community health workers (CHWs), and the other papers in this supplement to identify the most pressing challenges facing CHW programmes and approaches for strengthening CHW programmes.

Results

CHWs are increasingly being recognized as a critical resource for achieving national and global health goals. These goals include achieving the health-related Sustainable Development Goals of Universal Health Coverage, ending preventable child and maternal deaths, and making a major contribution to the control of HIV, tuberculosis, malaria, and noncommunicable diseases. CHWs can also play a critical role in responding to current and future pandemics. For these reasons, we argue that CHWs are now at the dawn of a new era. While CHW programmes have long been an underfunded afterthought, they are now front and centre as the emerging foundation of health systems. Despite this increased attention, CHW programmes continue to face the same pressing challenges: inadequate financing, lack of supplies and commodities, low compensation of CHWs, and inadequate supervision. We outline approaches for strengthening CHW programmes, arguing that their enormous potential will only be realized when investment and health system support matches rhetoric. Rigorous monitoring, evaluation, and implementation research are also needed to enable CHW programmes to continuously improve their quality and effectiveness.

Conclusion

A marked increase in sustainable funding for CHW programmes is needed, and this will require increased domestic political support for prioritizing CHW programmes as economies grow and additional health-related funding becomes available. The paradigm shift called for here will be an important step in accelerating progress in achieving current global health goals and in reaching the goal of Health for All.
Community health workers at the dawn of a new era: 9. CHWs’ relationships with the health system and communities
Authors: LeBan Karen , Kok Maryse , Perry Henry B.
Published: October 2021

Background

This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major challenge in large-scale CHW programmes is the need for CHWs to establish and maintain beneficial relationships with both sets of actors, who may have different expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.

Methods

The authors conducted a selective review of journal articles and the grey literature, including case study findings in the 2020 book Health for the People: National CHW Programs from Afghanistan to Zimbabwe. They also drew upon their experience working with CHW programmes.

Results

The space where CHWs form relationships with the health system and the community has various inherent strengths and tensions that can enable or constrain the quality of these relationships. Important elements are role clarity for all actors, working referral systems, and functioning supply chains. CHWs need good interpersonal communication skills, good community engagement skills, and the opportunity to participate in community-based organizations. Communities need to have a realistic understanding of the CHW programme, to be involved in a transparent process for selecting CHWs, and to have the opportunity to participate in the CHW programme. Support and interaction between CHWs and other health workers are essential, as is positive engagement with community members, groups, and leaders.

Conclusion

To be successful, large-scale CHW programmes need well-designed, effective support from the health system, productive interactions between CHWs and health system staff, and support and engagement of the community. This requires health sector leadership from national to local levels, support from local government, and partnerships with community organizations. Large-scale CHW programmes should be designed to enable local flexibility in adjusting to the local community context.
Management of HIV-2 resistance to antiretroviral therapy in a HIV-1/HIV-2/HBV co-infected patient
Authors: Cardoso Margarida , Vasconcelos Joana , Baptista Teresa , Diogo Isabel , Gonçalves Fátima , Mansinho Kamal , Gomes Perpétua
Published: October 2021

Background

The current standard of care is to start antiretroviral therapy in all patients diagnosed with HIV-1, as for HIV-2 current DHHS guideline suggests ART for HIV-2 as soon as diagnosis is established, although this practice is not universal, for instance, in Portugal there are specific criteria to start treatment.

Case presentation

We present a case of a man, chronically infected with HIV-1, HIV-2 and hepatitis B virus who developed resistance to HIV-2 while maintaining HIV-1 under control. 6 years after starting antiretroviral therapy he had his first virologic failure. We performed HIV-2 resistance tests that revealed high-grade resistance to all nucleoside reverse-transcriptase inhibitors except tenofovir and to all protease inhibitors except darunavir. After a decade of permanent poor adherence to therapy he developed resistance to both tenofovir and darunavir. We put together a new regiment with tenofovir alafenamide + emtricitabine + dolutegravir + maraviroc and nowadays he is with undetectable HIV-1 and HIV-2 viral loads.

Conclusions

This shows the importance of having access to HIV-2 viral load determination and HIV-2 resistance testing.