bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-Contamination by Disinfectant Towelettes Varies by Product Chemistry and Strain
Authors: Voorn Maxwell , Goss Summer , Nkemngong Carine , Li Xiaobao , Teska Peter , Oliver Haley F
Published: April 2020

Background: Disinfectant products are used frequently on environmental surfaces (e.g. medical equipment, countertops, patient beds) and patient care equipment within healthcare facilities. The purpose of this study was to assess the risk of cross-contamination of Staphylococcus aureus and Pseudomonas aeruginosa during and after disinfection of predetermined surface areas with ready-to-use (RTU) pre-wetted disinfectant towelettes.Methods: This study tested six disinfectant towelette products against S. aureus ATCC CRM-6538 and P. aeruginosa strain ATCC-15442 on Formica surfaces. Each disinfectant was evaluated on a hard nonporous surface and efficacy was measured every 0.5 m 2 using a modified version of EPA MLB SOP-MB-33 to study the risk of cross-contamination.Results: We found that all of the wipes used in this study transferred P. aeruginosa and S. aureus from an inoculated surface to previously uncontaminated surfaces. Disinfectant towelettes with certain chemistries also retained a high level of viable bacteria after disinfection of the surface area. The cross-contamination risk also varied by product chemistry and bacterial strain.Conclusion: Disinfectant wipes can cross-contaminate hard nonporous surfaces and retain viable bacterial cells post-disinfection, especially over larger surface areas. This highlights a need to further investigate the risk disinfectant wipes pose during and post-disinfection and guidance on maximum surface areas treated with a single towelette.
Exercise promotes satellite cell contribution to myofibers in a load-dependent manner
Authors: Masschelein Evi , D'Hulst Gommaar , Zvick Joel , Hinte Laura , Soro-Arnaiz Inés , Gorski Tatiane , von Meyenn Ferdinand , Bar-Nur Ori , De Bock Katrien
Published: April 2020

Background Satellite cells (SCs) are required for muscle repair following injury and are involved in muscle remodeling upon muscular contractions. Exercise stimulates SC accumulation and myonuclear accretion. To what extent exercise training at different mechanical loads drive SC contribution to myonuclei however is unknown. Results By performing SC fate tracing experiments, we show that 8-weeks of voluntary wheel running increased SC contribution to myonuclei in mouse plantar flexor muscles in a load-dependent but fiber type-independent manner. Increased SC fusion however was not exclusively linked to muscle hypertrophy as wheel running without external load substantially increased SC fusion in the absence of fiber hypertrophy. Due to nuclear propagation, nuclear fluorescent fate tracing mouse models were inadequate to quantify SC contribution to myonuclei. Ultimately, by performing fate tracing at the DNA level, we show that SC contribution mirrors myonuclear accretion during exercise. Conclusions Collectively, these findings provide direct evidence that mechanical load during exercise independently promotes SC contribution to existing myofibers.
Cerenkov luminescence imaging is an effective preclinical tool for assessing colorectal cancer PD-L1 levels in vivo
Authors: Zhao Sheng , Pan Wen-Bin , Jiang Hui-Jie , Zhang Rong-Jun , Jiang Hao , Liang Zong-Hui , Hu Hong-Bo
Published: April 2020

Background : Preclinical and clinical studies have demonstrated that immunotherapy has effectively delayed tumor progression, and the clinical outcomes of anti-PD-1/PD-L1 therapy were related to PD-L1 expression level in the tumors. A 131 I-labeled anti-PD-L1 monoclonal antibody tracer, 131 I-PD-L1-Mab, was developed to study the target ability of non-invasive Cerenkov luminescence imaging in colorectal cancer xenograft mice.Method: Anti-PD-L1 monoclonal antibody labeled with 131 I( 131 I-PD-L1-Mab), and in vitro binding assays were used to evaluate the affinity of 131 I-PD-L1-Mab to PD-L1 and their binding level to different colorectal cancer cells, and compared with flow cytometry, western blot analysis, and immunofluorescence staining. The clinical application value of 131 I-PD-L1-Mab was evaluated through biodistribution and Cerenkov luminescence imaging, and different tumor-bearing models expressing PD-L1 were evaluated.Results: 131 I-PD-L1-Mab showed high affinity to PD-L1, and the equilibrium dissociation constant was 1.069×10 -9 M. The competitive inhibition assay further confirmed the specific binding ability of 131 I-PD-L1-Mab. In four different tumor-bearing models with different PD-L1 expression, the biodistribution and Cerenkov luminescence imaging showed that the RKO tumors demonstrated the highest uptake of the tracer 131 I-PD-L1-Mab, with a maximum uptake of 1.613 ± 0.738% ID/g at 120 h.Conclusions: There is a great potential for 131 I-PD-L1-Mab noninvasive Cerenkov luminescence imaging to assess the status of tumor PD-L1 expression and select patients for anti-PD-L1 targeted therapy.
Three-dimensional reconstruction of welding pool surface by binocular vision
Authors: Gu Zunan , Chen Ji , Wu Chuansong
Published: April 2020

Welding pool geometry includes plenty of welding quality information. The observation and reconstruction of the welding pool surface is the basis of developing intelligent control system for welding process to substitute skilled welders. The binocular vision system was ameliorated to capture images of welding pool surface by suppressing the strong arc interference during gas metal arc welding (GMAW). Combining and improving the algorithms of speeded up robust features, binary robust invariant scalable keypoints and KAZE, the feature information of points (i.e. RGB value, pixel coordinates and so on) was extracted as the feature vector of the welding pool surface. Based on the characteristic of welding images, the mismatch elimination algorithm was developed to increase the accuracy of image matching algorithms. The world coordinates of matching feature points was calculated to reconstruct the 3D shape of the welding pool surface. The effectiveness and accuracy of reconstruction for welding pool surface were verified by the experimental results.
Effectiveness of exergames for improving mobility and balance in older adults: A systematic review and meta-analysis.
Authors: Pacheco Thaiana Barbosa Ferreira , de Medeiros Candice Simões Pimenta , de Oliveira Victor Hugo Brito , Vieira Edgar Ramos , Cavalcanti Fabrícia Azevêdo da Costa
Published: April 2020

Background: Exergaming is a fun, engaging, and interactive form of exercising and it may help overcome some of the traditional exercise barriers and help improve adherence by older adults providing therapeutic applications for balance recovery and functional mobility. The purpose of this systematic review is to summarize the effects of exergames in older adults’ mobility and balance. Methods: The PRISMA guidelines for systematic reviews were followed. The following databases were searched from inception to August 2019: Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PEDro, CINAHL and INSPEC. We selected randomized controlled trials that assessed the effects of exergames on balance or mobility of older adults without neurological conditions, in comparison to no intervention or health education. Two review authors independently screened the trials titles and abstracts and identified trials for inclusion according to the eligibility criteria. Trial selection presented an almost perfect agreement between the authors regarding the interrater reliability (kappa = 0.84; p<0,001). Then, a descriptive analysis of the quantitative data was performed to summarize the evidence. Meta-analysis was carried using Revman. Random effects model was used to compute the pooled prevalence at 95% confidence interval. Results: After screening 822 trials, twelve trials comparing exergames with no intervention were included. A total of 1520 older adults participated in the studies, with mean age of 76±6 years for the experimental group and 76±5 years for the control group. Three studies found significant improvements in balance based on center of pressure sway and Berg Balance Scale scores. Three studies found improved mobility based on the timed up and go, 30-second chair stand, and 8-foot up and go test. Conclusions: Exergames improved balance and mobility in older adults without neurological disorders. High quality studies with standardized assessment protocols are necessary to improve evidence.
Prevalence of alcohol use and associated factors among Dilla University Students, Dilla Town, Southern Ethiopia. 2018
Authors: Chekole Yigrem Ali
Published: April 2020

Introduction Compared to other deadly communicable diseases, Psychoactive Substance use is among the leading cause of death. Repeated use linked to addiction, dependence and predisposition for criminal and antisocial behaviors. Even though drug use in Africa relatively is short; however the abuse of drug in Africa is escalating rapidly. Substances use is also one of the most burning and growing public health problems in Ethiopia, as in many developing countries; alcohol is the most frequently used substance. Objective To Assess the Prevalence of alcohol Use and Associated factors among Dilla University undergraduate students in Southern Ethiopia. 2018. Methods An Institution based cross -sectional study was conducted at Dilla University among undergraduate regular students from January-February. Systematic random sampling technique was used to get a total of 803 samples of students from each year and department of the university. The collected data was coded, entered in to EPI-INFO version7.1 and analyzed by using SPSS version 20. Crude and adjusted OR were analyzed using logistic regression and the level of significance of association was determined at P- value <0.05. Result A total of 803 participants were interviewed with a response rate of 91.7%. Among the Participants, alcohol use was found to be 67.6%. (41.8%; n=336). Being 4 th year students (AOR =2.66, 95% CI: 1.64, 4.31), having friends who use substance (AOR=1.53, 95% CI: 1.09, 2.1), being Khat user (AOR= 1.48, 95% CI: 1.05, 2.09) and being Cigarette smoker (AOR=1.76, 95% CI: 1.09, 2.84) were found to be significantly associated with alcohol use. Conclusion Half of the participants found to have alcohol use. Therefore, early prevention, detection and alleviating of alcohol use should be implemented among students in the university.
Quantitative structure-property relationship study of alcohols water solubility based on a new model combined modified autocorrelation method and electro-topological indices
Authors: Jermouni Chaymae , Nohair Mohamed
Published: April 2020

In this study, structure water solubility modeling was performed to describe a set of 50 of aliphatic alcohols in a Quantitative Structure-Property Relationship model by developing of two descriptors types based on multifunctional autocorrelation method, which gives a general description of whole molecule; and electro-topological descriptors. The index combines the topological nature with electronic state of the atom. The Modified Autocorrelation Method was used in structure–property relationships to describe the local environment of the hydroxyl group. For the statistical studies, Multiple Linear Regression, Artificial Neural Networks and Principal Components Analysis were used. The approach efficiency approach was evaluated through the predictive ability of models by leave-p-Out cross-validation method. The coefficient of determination and errors of descriptors combination calculated respectively by multiple linear regression and artificial neural networks were r= 0.99, s = 0.18 and r = 0.99, s = 0.32. In order to simplify components computation, the molecules were coded by means of SMILES system and stored as input files. The results showed that aliphatic alcohols solubility is dominated by the shape and molecule branching, also the electro-topological descriptors had a considered model effect.
A high-efficiency hospital emergency-response mode is key to successful treatment of COVID-19 patients in Zhuhai
Authors: Huang Jin , Li Zhonghe , Qu Xiujuan , Zheng Xiaobin , Tu Changli , Shi Honglei , Chen Meizhu , Tan Cuiyan , Liu Jing , Shan Hong
Published: April 2020

Background: In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan and has since rapidly spread throughout China. The mortality rates of novel coronavirus pneumonia (NCP) in severe and critical cases are very high. In this public-health emergency, a high-efficiency administrative emergency-response mode in designated hospitals is needed. Method: As an affiliated hospital of Sun Yat-sen University, ours, the Fifth Affiliated Hospital, is the only one designated for the diagnosis and treatment of COVID-19 in Zhuhai, a mid-sized city. The NCP department, for which the president of the hospital is also the direct administrative lead, was established at an early stage of the epidemic at our hospital. This department includes core members of the pulmonary and critical-care medicine (PCCM) specialist and multidisciplinary team. Rather than adhering to national guidelines on NCP, we have focused on individualized treatment, timely adjustment thereof and management strategies in working with COVID-19 patients based on the professional opinions of a professor of respiratory medicine and an expert group. Results: (1) High working efficiency: As of March 2, 2020, we have completed 2974 citywide consultations and treatment of 366 inpatients, including 101 who were diagnosed with COVID-19. (2) Excellent therapeutic effect: Of the 101 patients hospitalized with confirmed COVID-19, only 1 has died, and the rest were all cured and discharged. No secondary hospital infection, pipeline infection or pressure sores were found in any patient. (3) Finding and confirming person-to-person transmission characteristic of COVID-19 prior to the official press conference: Strengthened protection is key to zero infection among the healthcare providers and medical faculty, as well as to a lower rate of second-generation infectious patients. (4) Timely adjustment of management and treatment strategy prior to guideline updates: The first evidence of digestive-tract involvement in COVID-19 has been found, and the earliest clinical trial of chloroquine in the treatment of the disease was carried out at our hospital. Conclusions: At our hospital, establishment of an NCP department, which is directly administered by the hospital president and specialized operation guided by a professor of respiratory medicine, has been key to our success in managing and treating COVID-19 patients. Our hospital’s emergency-response mode could provide a reference for other hospitals and cities in this epidemic situation.
Improved high-order adjacent vertex assignment sequence for similarity vertices and isomorphism identification of planar kinematic chains
Authors: Sun Liang , Ye Zhizheng , Lu Fuwei , Cui Rongjiang , Wu Chuanyu
Published: April 2020

Isomorphism identification is fundamental to synthesis and innovative design of kinematic chains (KCs). The identification can be performed accurately by using the similarity of KCs. However, there are very few researches on isomorphism identification based on the properties of similarity vertices. In this paper, an improved high-order adjacent vertex assignment (IHAVS) sequence method is proposed to seek out the similarity vertices and identify the isomorphism of the planar KCs. First, the specific definition of IHAVS is described. Through the calculation of the IHAVS, the adjacent point value sequence reflecting the uniqueness of the structural features is established. Based on the value sequence, all possible similarity vertices, corresponding relations and isomorphism discrimination can be realized. By checking the topological diagrams of KCs of different number of links, the correctness of the proposed method are verified. Finally, the method is used to find the similarity vertices of all the 9-link 2-DOF(degree of freedom) planar KCs.
The preliminary comparative results between Covid-19 and non-Covid-19 patients in Western China
Authors: Yanzi Li , Hongxia Li , Jianfeng Han , Lin Yang
Published: April 2020

Background: This study aims to investigate the comparative clinical characteristics of Covid-19 and non-Covid-19 patients.Methods: Fifteen Covid-19 and 93 non-Covid-19 patients were included in RNA testing. All epidemiological and clinical data were collected and analyzed, and then comparative results were carried out.Results: Covid-19 patients were older (46.40±18.21 years vs 34.43±18.80 years) and hada higher body weight (70.27±10.67 kg vs 60.54±12.33 kg, P<0.05). The main symptoms that were similar between Covid-19 and non-Covid-19 patients, and Covid-19 patients showed a lower incidence of sputum production (6.67% vs 45.16%, P<0.01) and a lower white-cell count (4.83×109/L vs 7.43×109/L) and lymphocyte count (0.90×109/L vs 1.57×109/L) (P<0.01). Although there were no differences, C-reactive protein and interleukin-6 were elevated in Covid-19 patients. The sensitivity and negative predictive value of CT images were 0.87 and 0.97, respectively. Covid-19 patients showed a higher contact history of Wuhan residents (80% vs 30.11%) and higher familial clustering (53.33% vs 8.60%, P<0.001). Covid-19 patients showed a higher major adverse events (ARDS, 13.33%; death, 6.67%; P<0.05).Conclusion: Our results suggested that Covid-19 patients had a significant history of exposure and familial clustering and a higher rate of severe status; biochemical indicators showed lymphocyte depletion.
A genome-wide association study of deviated nasal septum using UK Biobank cohort
Authors: Liu Li , Wu CuiYan , Dai Xiaoxia , Wen Yan , Cheng Shiqiang , Cheng Bolun , Li Ping , Qi Xin , Ma Mei , Zhang Lu , Liang Chujun , Chu Xiaomeng , Ye Jing , Yao Yao , Guo Xiong , Zhang Feng
Published: April 2020

Background

Deviated nasal septum (DNS) is a common otolaryngology disease. The genetic mechanism underlying DNS remains largely unknown.

Methods

Totally, 2, 978 DNS patients and 2,978 randomly selected controls from the UK biobank were used in this study. Genotyping was done using the Affymetrix UK BiLEVE Axiom or UK Biobank Axiom array. Genome-wide association study (GWAS) was performed by PLINK 2.0, using age, sex, population structure PC1, PC2 and PC3 as covariates. eQTLs analysis and gene set enrichment analysis (GSEA) were also performed to explore the functional relevance of identified loci with DNS.

Results

GWAS identified multiple candidate genetic loci for DNS, such as rs75651247 located in DLGAP1 (β=-5.3398, P=9.31×10-8), rs141366706 located in CCND3 (β=-4.7036, P=2.56×10-6), rs76606504 located in FAF1 (β=-4.5013, P=6.76×10-6), and rs142537880 located in SVIL (β= 4.4336, P=9.27×10-6). GSEA detected multiple DNS associated gene sets or pathways, such as KEGG_CALCIUM_SIGNALING_PATHWAY (FDR=3.35×10-3, P=5×10-5) and DAVICIONI_TARGETS_OF_PAX_FOXO1_FUSIONS_UP (FDR=1.60×10-3, P=5×10-5).

Conclusions

Our study reported multiple candidate genes and gene sets for DNS, providing novel clues for understanding the genetic mechanism of DNS.
Effects of dialysis modality choice on survival of end-stage renal disease patients in southern China: A retrospective cohort study
Authors: He Zhiren , Zhang Difei , Mo Yenan , Zhang La , Lin Junjie , Lu LiMing , Su Guobin , Huang Jingrao , Gu Yewen , Zhang Ying , Lin Jingxia , Yuan Fengling , Peng Yu , Liang Hui , Zhao Daixing , Lu Fuhua , Liu Xusheng , Hou Haijing , Wang Lixing
Published: April 2020

Background Up to date, whether hemodialysis (HD) or peritoneal dialysis (PD) is a better choice for end-stage renal disease (ESRD) patients has been debatable. Few study comparing HD and PD was from China, a large country with the largest number of dialysis patients in the world. Method A retrospective cohort study was conducted on ESRD patients who began renal replace treatment from January 1st, 2012 and December 31st, 2017 in Guangdong Provincial Hospital of Chinese Medicine. We used propensity scoring match model to balance the baseline conditions and Cox's multivariate regression analysis to compare mortality between HD and PD patients, and evaluated the relationship between mortality and various baseline covariates. Results 436 HD patients and 501 PD patients were included and we found that PD patients had better survival than HD patients (The 1-, 3- and 5-year survival rates were 98.1% vs 96.4%, 86.7% vs 83.0%, and 73.4% vs 71.9%), even though the difference was not statistically significant. For younger ESRD patients (<=60 years old), the overall survival of PD was better than that of HD, but HD was associated with lower risk of death in the patients who were older than 70 years of age. This difference was still significant after adjustment for a variety of confounding factors. Female, cardiovascular disease, cholesterol, and HD are risk factors of all-cause mortality in the younger subgroup while PD is risk factor in the older subgroup. Conclusion Younger ESRD patients may be more suitable for PD, and the elderly for HD.
Genotypic response to water deficit applied at reproductive stage in rice: is the response unique across two contrasted climates?
Authors: Lima Isabela Pereira de , Lafarge Tanguy , Castro Adriano Pereira , Roques Sandrine , Soutiras Armelle , Clement-Vidal Anne , Botelho Flávia Barbosa Silva , Raissac Marcel de
Published: April 2020

Background: Rice crop is known as very sensitive to water deficit, especially during the reproductive phase when growth of vegetative organs and formation of spikelets are concomitant. The present study questioned whether the maintenance of vegetative organ expansion during a water deficit at the reproductive phase affects the reproductive structure organogenesis, and if relevant traits for adaptation can be identified. To answer these queries, the response to a same reproductive water deficit of six contrasted japonica genotypes has been analyzed under two contrasted climates differing in incident radiation, air hygrometry and temperature (greenhouse in Brazil, Sitis, and growth chamber in France, GC).Results: Under irrigation, plant growth rate was reduced in GC while crop duration was extended: the trade-offs resulted in similar plant height and biomass. From a method able to determine a posteriori the date of panicle initiation (PI), elementary processes were positioned in time, allowing to evaluate how much each process was affected, despite the diversity in phenology across genotypes. Elongation rate decreased with water deficit and was highly associated with an increase in soluble sugars in stem and flag leaf in both experiments, while starch was reduced in Sitis and negligible in GC. This unique response, however, induced a different effect across experiments on branch and spikelet formation. In short, in both experiments, maintenance of spikelet number was highly associated with maintenance of flag leaf and internode width. All variables, including branch and spikelet number, were highly affected with IAC 25 in both experiments, while variations were non-significant with Cirad 409. In addition, some other genotypes expressed a differential response between Sitis and GC, conveying a specific sensitivity to low radiation or to high air temperature. Conclusions: This study highlighted the importance of finely mapping in time elementary growth processes, thanks to PI date determination, in order to detect key traits of adaptation to abiotic stress through phenotyping across genotypes of diverse phenology. The maintenance of flag leaf width or internode diameter under a mild water deficit was highlighted here as a trait associated with the maintenance of yield components.
Multiple Cold Tolerance Trait Phenotyping Reveals Shared Quantitative Trait Loci in Oryza sativa
Authors: Shimoyama Naoki , Johnson Melineeh , Beaumont André , Schlappi Michael
Published: April 2020

Background: Developing chilling tolerant accessions of domesticated Asian rice is a potential source of significant crop improvement. The uniquely chilling sensitive nature of the tropically originating Oryza sativa make it the most important cereal crop that can gain significantly from improved tolerance to low temperatures. However, mechanisms underlying this complex trait are not fully understood. Oryza sativa has two subspecies with different levels of chilling tolerance, JAPONICA and INDICA, providing an ideal tool to investigate mechanistic differences in the chilling stress tolerance responses within this important crop species. Results: The Rice Diversity Panel 1 (RDP1) was used to investigate a core set of Oryza sativa accessions. The tools available for this panel allowed for a comprehensive analysis of two chilling tolerance traits at multiple temperatures across a 354-cultivar subset of the RDP1. Chilling tolerance trait values were distributed as mostly subpopulation specific clusters of Tolerant, Intermediate, and Sensitive accessions. Genome-wide association study (GWAS) mapping approaches using all 354 accessions yielded a total of 245 quantitative trait loci (QTL), containing 178 unique QTL covering 25% of the rice genome, while 40 QTL were identified by multiple traits. QTL mappings using subsets of rice accession clusters yielded another 255 QTL, for a total of 500 QTL. The genes within these multiple trait QTL were analyzed for GO term and potential pathway enrichments. Terms related to “carbohydrate biosynthesis”, “carbohydrate transmembrane transport”, “small molecule protein modification”, and “plasma membrane” were enriched from this list. Filtering was done to identify more likely candidate pathways involved in conferring chilling tolerance, resulting in enrichment of terms related to “Golgi apparatus”, “stress response”, “transmembrane transport”, and “signal transduction”. Conclusions: Taken together, these GO term clusters revealed a likely involvement of Golgi-mediated subcellular and extracellular vesicle and intracellular carbohydrate transport as a general cold stress tolerance response mechanism to achieve cell and metabolic homeostasis under chilling stress.
Predictive modeling of novel coronavirus spreading in European regions based on worldwide data-sets
Authors: Vechet Stanislav , Krejsa Jiri
Published: April 2020

Background The novel coronavirus 2019-nCoV outbreak which was reported by World Health Organization (WHO) at 21th of January 2020 situation report spreads around the globe during next few weeks and causes serious health, social and financial issues. The primary epicentre was reported is Wuhan City, China and together with other affected regions in Asia remains the most monitored area. On the other hand, the European region was experiencing only a few cases until February 29th when the number of confirmed cases reached one thousand infections. Within a few days during the 8th of March the Italian most infected places were locked by restrictive quarantine. In this study we present probabilistic model to track the infection spread trough the European regions based on the model adjusted with worldwide data-sets. Methods To track and predict the officially reported number of cases we developed probabilistic model with the ability to predict the number of confirmed cases one day ahead. The model has internal/hidden parameters which cannot be directly observed such as the number of infectious individuals or transmissibility rate which is represented by reproduction number $R_t$. The model starts with assumed number of infectious individuals and reproduction number $R_0$ and as more data are gathered from data-sets during time the internal parameters are further estimated. The model is updated each day as the new number of confirmed cases are reported. Particle filters algorithm is used as the back-end method due to its ability to handle multi-modal data distribution. Results Presented results show the performance of the probabilistic model which is able to handle short-term prediction (in number of days) of confirmed and recovered cases. The estimated reproduction rate is further used in long-term simulation which fits the data gathered world-wide. The one day prediction error is below 5\% of nominal value and as we are located in Czechia the prediction model for our region was tested 4 days forward with the same error. The overal performance of the model was compared to data gathered from China due to the longer history of measurements. Conclusion We have proposed a probabilistic model which is used with particle filters to predict next moves of the confirmed cases. As a side effect we were able to model internal parameters as reproduction number or recovery rate which can be used for running long-term simulations of virus spreading.
The Competence of Village Doctors in the Diagnosis and Treatment of Heart Disease in Rural China: A Nationally Representative Assessment
Authors: Guo Wilson , Sylvia Sean , Umble Karl , Chen Yunwei , Zhang Xiaoyuan , Yi Hongmei
Published: April 2020

Background While strengthening primary care quality is key to China’s health system reforms, evidence to guide this work has been limited, particularly for rural areas. This study provides the first nationally representative assessment of village doctors’ competence in diagnosing and managing presumptive heart disease. Methods A cross-sectional study of village clinics was conducted across five provinces. We presented standardized clinical vignettes to evaluate doctors’ competence in diagnosing and managing unstable angina. Enumerators accompanying mock patients documented the interaction, including questions, examinations, diagnoses, and management options provided by the doctor. We measured diagnostic process competence as degree of adherence to both “recommended” and “essential” questions and physical examinations stated in national clinical practice guidelines for patients stating typical symptoms of unstable angina. We assessed diagnostic competence according to whether doctors stated a correct or partially correct diagnosis. Finally, we assessed management as whether doctors provided correct or partially correct medication and/or referral. Management was assessed twice: following doctors’ own diagnoses determined through questioning and physical examinations, and after enumerators provided doctors with the correct diagnosis. Results Doctors completed 26% of recommended and 39% of essential diagnostic questions and examinations; 21% of doctors arrived at a correct diagnosis. Rates of correct management were 44% following doctors’ own diagnosis and 50% after being given the correct diagnosis. When we gave doctors the correct diagnosis and only asked them to provide a treatment, they prescribed 82% fewer potentially harmful medications than when they had provided their own (potentially incorrect) diagnosis. Conclusions The ability of village doctors to diagnose a textbook case of unstable angina is limited. Deficits in diagnostic competence led to low rates of correct management.
Ethnobotany as A Science of Preserving Traditional Knowledge: A Case Study of Herbal Uses of Plants in Trans-Himalaya (Ladakh), India
Authors: Haq Shiekh Marifatul , Calixto Eduardo Soares , Malik Zubair A. , Kunwar Ripu M.
Published: April 2020

Background - The sixth anthropocene mass extinction in the last 540 million years indicates that human activities including illegal trade is the fundamental threat to the endangered species, their habitats and to the global biodiversity as well. In this context, it is paramount keeping in view the role of hotspot regions in the conservation of biodiversity and their varied potential of ethnobotanical services.The present study quantified the traditional ethnobotanical usage and people’s choices of plants and evaluated the composition, distribution, trade and conservation of plants in Ladakh region, India.Methods - During 2018-2019, ethnobotanical documentation of the plants growing in Ladakh (a part of trans-Himalaya), India, was carried out to collect information regarding different usages of plant species growing in the region through open and close-ended questionnaire surveys and interviews. Multivariate ecological community analysis was used to find the relationship between ethnobotanical usage and plant species.Results - Floristically, a total of 103 species belonging to 80 genera and 38 families were reported to be used as medicine, food, fodder, fuelwood, fragrance, dye, flavor and oil. Asteraceae was the largest family with 20% species, followed by Ranunculaceae (10% species) and Fabaceae (7% species). Three plant usage clusters were determined at a vertical distance value of 0.4 where the clusters are distinctly separated. Preference analysis showed the highest priority of local people for medicinal use of plants followed by fodder and fuelwood. The most frequently used plant parts were leaves followed by roots and flowers. Local Amchis and elderly people had great familiarity with medicinal plants and their ethnic usage. The plant species harvested were sought for self-consumption (65%) and for commercial purposes (35%).Conclusions - The present study provides unique information regarding the ethnobotanical knowledge in Ladakh region and baseline data for future researchers, policymakers, public, land managers, and the other stakeholders to develop scientifically-informed strategies for conservation of natural resources and sustainable use of plant diversity in hotspot regions like trans-Himalayas and other similar biodiversity-rich sites.
First month of the epidemic caused by COVID-19 in Italy: current status and real-time outbreak development forecast
Authors: Megna Rosario
Published: April 2020

Background: The first outbreaks of COVID-19 in Italy occurred during the second half of February 2020 in some areas in the North of the country. Due to the high contagiousness of the infection, further spread by asymptomatic people, Italy has become in a few weeks the country with the greatest number of infected people in the World. The large number of severe cases among infected people in Italy led to the hospitalization of thousands of patients, with a heavy burden on the National Health Service. Methods: We analyzed data provided daily by Italian Authorities for the period from 24 February 2020 to 30 March 2020. Considering such information, we developed a forecast model in real-time, based on the cumulative logistic distribution. We then produced an estimate of the overall number of potentially infected individuals and epidemic duration at a national and Regional level, for the most affected Regions. Results: We reported the daily distribution of performed swabs and confirmed cases, and the cumulative distribution of confirmed cases, of patients quarantined at home (43.0%), hospitalized in non-intensive care (27.3%), recovered or discharged (14.4%), deceased (11.4%), and hospitalized in intensive care (3.9%). The forecast model estimated a number of infected persons for Italy of 130,000 about, and a duration of the epidemic greater than 2 months. Conclusions: Once month after the first outbreaks there seems to be the first signs of a decrease in the number of infections, showing that we could be now facing the descending phase of the epidemic. The forecast obtained thanks to our model could be used by decision-makers to implement coordinative and collaborative efforts in order to control the epidemic.
Mahjong: A routine activity that has chronically harmed the health of land-lost peasants in Southwest China
Authors: Xie Xiaoyun , Zhao Yong , Zhang Fan , su Shu , Zhang Nachuan , Liu Ruiyi , Shi Zhumin , Zeng Huan
Published: April 2020

Background: Mahjong is a four-player gambling game that originated in China. It is a very popular recreational hobby among land-lost Chinese peasants who have moved to the city due to urbanization. This study aims to identify the influencing factors of Mahjong playing behaviors and their effects on the health of land-lost peasants. Method: A cross-sectional study was conducted in two districts of Chongqing (Southwest China), which is the first pilot area of the urban–rural integration in China. Researchers recruited 539 land-lost peasants to implement a self-report questionnaire survey. Logistic regression was conducted to identify the key factors associated with Mahjong playing behaviors. Result: This study found that age is a crucial factor affecting the Mahjong playing behaviors of land-lost peasants. The middle-aged (30–49 years old) and elderly (>= 50 years old) are extremely prone to be problematic Mahjong players when compared with young people (18–29 years old). Moreover, people with a high monthly income are more likely to be problematic Mahjong players compared with those with a low monthly income. In addition, the high frequency of playing and long duration of sessions in the enclosed, smoky environment of Mahjong parlors introduce significant hazards to the health of land-lost peasants. However, Mahjong can help them build a social network, provide them with spiritual comfort, and ultimately integrate them into a new environment.Conclusion: Therefore, we call for measures that can make Mahjong an activity for entertainment rather than gambling and reduce the adverse effects of Mahjong playing behaviors on the players’ health.
FASCE, benefit of spironolactone for treating acne of adult female: study protocol for a randomized double-blind trial
Authors: Poinas Alexandra , Lemoigne Marie , Naour Sarah Le , Nguyen Jean-Michel , Schirr-Bonnans Solène , Riche Valery-Pierre , Vrignaud Florence , Machet Laurent , Claudel Jean-Paul , Leccia Marie-Thérèse , Hainaut Ewa , Beneton Nathalie , Dert Cécile , Boisrobert Aurélie , Flet Laurent , Chiffoleau Anne , Corvec Stéphane , Khammari Amir , Dréno Brigitte
Published: April 2020

Background Acne vulgaris of adult woman has increased over the past 10 years; it affects currently 20 to 30% of adult women. The physiopathology of adult woman acne is distinguished from the teenager one essentially by 2 factors: hormonal one with a peripheral hyperandrogeny coupled with an hypersensibility of cutaneous androgens receptors and an inflammatory one linked with Cutibacterium acnes. On a therapeutic plan, in female acne, four types of systemic treatment, approved in this indication are: cyclines which are problematic for the bacterial resistance; zinc salts which target only the inflammatory lesions and are less effective as cycline; antiandrogens, with acetate of cyproterone associated with risks of phlebitis and pulmonary embolism and recently meningioma. The last alternative is represented by isotretinoin but the use in women of childbearing potential is binding because of the teratogen risks and in addition, peripheral hyperandrogenia represents an identified risk of relapse. In this context, the spironolactone could represent an interesting alternative. It blocks the 5-alpha-reductase receptors at sebaceous gland and inhibits LH production at the pituitary level. It has not isotretinoin constraints, does not lead to bacterial resistance and targets the peripheral hyperandrogenia. Currently, very few studies have been performed on a weak number of patients. They showed that at low doses (lower than 200mg/day), spironolactone can be effective against acne. Methods: In that context, it seemed clearly interesting to perform the first double-blind randomized study spironolactone vs cyclines, which remains the moderate acne reference treatment and to demonstrate the superiority of spironolactone’s efficacy in order to establish it as an alternative way to cyclines. Discussion: Acne’s treatment frequently used in female acne is systemic antibiotics with many courses as it is a chronic inflammatory disease. In the context of recent WHO revelation about serious, worldwide threat to public health about antibiotic resistance, this trial could permit to give to the physician another alternative in adult female acne before using isotretinoin whose management is more complex. Trial registration : On ClinicalTrials.gov, registration number NCT03334682, first published on 7 November, 2017. Recruitment is still ongoing. Keywords : acne vulgaris, spironolactone, cycline
Internet-based psychodynamic therapy versus cognitive behavior therapy for adolescents with depression: Study protocol for a non-inferiority randomized controlled trial (the ERiCA study)
Authors: Mechler Jakob , Lindqvist Karin , Carlbring Per , Lilliengren Peter , Falkenström Fredrik , Andersson Gerhard , Topooco Naira , Johansson Robert , Midgley Nick , Edbrooke-Childs Julian , Dahl Hanne-Sofie J , Sandell Rolf , Thorén Agneta , Ulberg Randi , Bergsten Katja Lindert , Philips Björn
Published: April 2020

Background: Adolescent depression is a common mental health problem and there is an urgent need for effective and accessible treatments. Internet-based interventions solve many obstacles for seeking and receiving treatment, thus increasing access to effective treatments. Internet-based cognitive behavioural therapy (ICBT) for adolescent depression has demonstrated efficacy in previous trials. In order to broaden the range of evidence-based treatments for young people we evaluated a newly developed affect-focused internet-based psychodynamic treatment (IPDT) in a previous study with promising results. The purpose of the planned study is to evaluate the efficacy of IPDT for adolescent depression in a non-inferiority trial, comparing it to ICBT. Methods: The study will employ a parallel randomized non-inferiority design (ratio 1:1; n = 210). Eligible participants are adolescents 15-19 years suffering from depression. The primary hypothesis is that IPDT will be non-inferior to ICBT in reducing depressive symptoms from pre-treatment to end of treatment. Secondary research questions include comparing outcomes of IPDT and ICBT regarding anxiety symptoms, emotion regulation and self-compassion. Additional data will be collected to evaluate cost-effectiveness as well as investigating predictors, moderators and mediators of outcome. In addition, we will examine long-term outcome up to one year after end of treatment. Diagnostic interviews with MINI 7.0 will be used to establish primary diagnosis of depression as well as ruling out any exclusion criteria. Both treatments consist of eight modules over ten weeks, complemented with therapist support through text messages and weekly chat sessions. Primary outcome measure is the Quick Inventory of Depressive Symptomatology in Adolescents Self-Rated (QIDS-A17-SR). Primary outcome will be analyzed using data from all participants entering the study using a multilevel growth curve strategy based on the weekly measurements of QIDS-A17-SR. The non-inferiority margin is defined as d = 0.30. Discussion: This trial will demonstrate whether IPDT is non-inferior to ICBT in the treatment of adolescent depression. The study might therefore broaden the range of evidence-based treatment alternatives for young people struggling with depression. Further analyses of data from this trial may increase our knowledge about "what works for whom" and the pathways of change for two distinct types of interventions.
Should we keep hope? Key 8 weeks - Spatiotemporal epidemic characteristics of COVID-19 in Sichuan Province and its comparative analysis with other provinces in China and global epidemic trend
Authors: Xu Xinyin , Zeng Jing , Liu Runyou , Liu Yang , Zhou Lijun , Dong Ting , Cha Yuxin , Wang Zhuo , Deng Ying , Zhang Yu , Feng Liao , Pu Chen , Wu Xianping , Zhong Bo
Published: April 2020

To compare the epidemiological characteristics of Sichuan Province, other provinces in China and the world epidemic trends by analyzing the prevalence and length of epidemic time. Visualizing the development and changes of epidemic situation by layer through maps. 539 cases were reported in Sichuan Province, with the incidence rate of 0.6462 / 100,000. The closer to Hubei, the heavier the epidemic. Eight weeks after Wuhan lockdown, all became better. The longest epidemic length in city level was 53 days, median 23 days. It was released quickly in the 1st month, and accelerated in the 2ed month (three times of 1st month). Most countries outside China began to rise rapidly 4 weeks after their first case. Some European countries was earlier than USA. Most countries now entered the second phase of the rise. Adopting positive isolation and control measures in key 8 weeks will help us to fight the epidemic.
Prevalence and Genotypic Characterization of HBV in HIV-Infected Patients from Kwazulu-Natal, South Africa
Authors: Modise Lorato Mosetsanagape , Sithebe Nomathamsanqa Patricia
Published: April 2020

Introduction: The co-infection of HIV with HBV is very common due to shared mode of transmission. HBV/HIV co-infection impact on low HBeAg expression, high HBV replication, causes progressive liver disease, cirrhosis, liver cancer and high mortality. Coinfection may lead to cross-resistance of HBV and HIV drugs due to drug-related immune therapeutic pressure or hepatotoxicity. These challenges necessitate continuous surveillance for HBV among HIV infected individuals to aid patient treatment management. Hence we conducted this study to characterise HBV among HIV infected patients in Durban, KwaZuluNatal of South Africa.Methods: Serum was screened for HBsAg using ELISA, followed by DNA extraction from all samples. Genotyping of HBV was done through PCR amplification, Sanger sequencing and phylogenetic analysis. Results: Of the 50 samples in this study 100% (n=50/50) were HBsAg positive. HBV/HIV coinfection was 78% (n=41/50) based on PCR amplification of the HBV partial surface gene and 92% (n=38/41) of the amplicons were successfully sequenced. Phylogenetic and sequence analyses identified patients nucleotide sequence as Genotype A. Mutations prevalence in the HBsAg region was 47% (n=18/38); including mutations associated with diagnostic failure (K122R and T143S) and 7 vaccines escape mutations (P127T, G145R, S207N, Y200T, E164D, Y206H and L209V). Prevalence of mutations associated with drug resistance was 57% (n=8/14) within the reverse transcriptase region. Drug resistance mutations included lamivudine resistance at 71% (n=5/7), telbivudine resistance at 57% (n=4/7), 14% (n=1/7) for entecavir resistance and 43% (n=3/7) for adefovir resistance. Mutations causing resistance to lamivudine and telbivudine were M204V, L180M, V163I, and S202K; with S202K also causing resistance to entecavir and adefovir resistance mutation were I253Y, I223V and M250I. The drug susceptibility prevalence was 68% (n=26/38). Multiple drug resistance mutations within a single sample contained L180M, M204V, S202K and M250I mutations. Conclusion: This study shows the predominance of HBV genotype A in HIV-infected patients and the HBV mutations present in HBV/HIV co-infected individuals. HBV mutations associated with drug resistance suggest the need for continuous HBV screening and use of tenofovir ART regimen among HBV/HIV co-infected individuals.