bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting mathematical abilities from early mathematics and number-specific executive functions in informal and formal schooling
Authors: Wongupparaj Peera , Kadosh Roi Cohen
Published: May 2021

Background Current evidence on an integrative role of the domain-specific early mathematical skills and domain-general executive functions (EFs) from informal to formal schooling and their effect on mathematical abilities is so far unclear. The main objectives of this study were to (i) compare the domain-specific early mathematics, the number-specific EFs, and the mathematical abilities between preschool and primary school children, and (ii) examine the relationship among the domain-specific early mathematics, the number-specific EFs, and the mathematics abilities among preschool and primary school children.Methods In the present study, we recruited six- and seven-year-old children (Ntotal=505, n6yrs=238, and n7yrs=267). We compared domain-specific early mathematics as measured by symbolic and non-symbolic tasks, number-specific EFs tasks, and mathematics tasks between these preschool and primary school children. In addition, we tested the predictive power of domain-specific numerical and number-specific EFs on mathematics abilities among preschool and primary school children. MANOVA and Structural Equation Modeling (SEM) were used to test research hypotheses.Results We found that primary school children were superior to preschool children over more complex tests of the domain-specific early mathematics, the number-specific EFs, the mathematics abilities, particularly, for more sophisticated numerical knowledge and the number-specific EFs components. The SEM revealed that both the domain-specific early numerical and the number-specific EFs could predict the mathematics abilities across age groups. Nevertheless, the number comparison test and mental number line of the domain-specific early mathematics were clearly pronounced in predicting the mathematics abilities for formal school children. These results highlight the benefits of both the domain-specific early mathematics and the number-specific EFs in mathematical development, especially at the key stages of formal schooling. Understanding the causal effect of EFs in improving mathematical attainments could allow a more powerful approach in improving mathematical education at this developmental stage.
Favorable Trends of Lung Cancer Mortality-to-Incidence Ratios in Countries With High Computed Tomography Density
Authors: Wang Yao-Tung , Wu Han-Ru , Chang Ya-Chuan , Yu Chia-Ying , Wang Yao-Chen , Sung Wen-Wei
Published: May 2021

Background: Prognoses for lung cancer deteriorate dramatically with the progression of cancer stages. Therefore, early screening by techniques such as low-dose computed tomography (LDCT) is critical. However, the epidemiology regarding the association between the popularization of CT and the prognosis for lung cancer is not known.Methods: Data were obtained from GLOBOCAN and the health data and statistics of World Health Organization. MIRs and the changes in MIR over time (𝛿MIR), which were calculated as the difference between MIRs in 2018 and 2012, were used to evaluate the correlation to CT density disparities via Spearman's rank correlation coefficient.Results: Countries with zero CT density presented a relatively low incidence crude rate and a relatively high MIR in 2018 and a negative 𝛿MIR. Conversely, countries with CT density over 30 had a positive 𝛿MIR. The CT density was significantly associated with human development index (HDI) score and MIR in 2018 but demonstrated no association with MIR in 2012. The linear correlation between CT density and 𝛿MIR also shows a significant association.Conclusion: CT density was significantly associated with MIR in 2018 and with 𝛿MIR, indicating favorable clinical outcomes in countries with popularization of CT.
Microstrip Antenna Analysis with Aid of Ultra Wide Band Applications
Authors: N Parthiban , M Mohamed Ismail
Published: May 2021

Microstrip antenna is an essential choice for Ultra Wide Band (UWB) applications of its light weight, low profile and easy to form antenna arrays. However, the design of microstrip patch antenna bandwidth is greatly affects by the dielectric substrate material (FR4). In this research, the bandwidth enhancement of MPA was designed by minimizing the dimension of Defected GP (DGP) in GP for Ultra Wide Band wireless applications. But, the antenna design complexity increases with the number of an operating frequency band. In this research, the MPA was designed as small as size of 10×13×1.6 mm and operates on frequency band between 3.1GHz to 10.6GHz for VSWR less than 2. The microstrip patch antenna was designed at 3.1GHz to 10.6GHz using High-Frequency Structure Simulator (HFSS) software. The simulation result shows that the proposed microstrip patch antenna obtained <-10dB of return loss from 3.1GHz to 10.6GHz throughout the frequency range. The measured result proves that the proposed microstrip patch antenna has better characteristics to fulfill the requirements of UWB applications.
The effects of Suspension (TRX) versus core stabilization training on postural stability, lumbopelvic control and proprioception in women with DiastasisRecti Abdominis: A Randomized Controlled Trial
Authors: Yalfani Ali , Bigdeli Nahid , Gandomi Farzaneh
Published: May 2021

Background: This study compared the effectiveness of eight weeks of suspension training (TRX) with that of isometric-isotonic (ISOM-ISOT) core stabilization exercises in the treatment of diastasis recti abdominis (DRA) and its secondary complications such as impairment in proprioception, postural stability, and lumbopelvic control as well as low back pain and the disability in doing daily activities.Methods: Thirty-six women with DRA with a mean age of 29.11 (4.85) from whose delivery 2 to 4 months had passed participated in this study. They were divided into the three groups of TRX, ISOM-ISOT training, and control. DRA, proprioception, lumbopelvic control, postural balance, low back pain, and disability were respectively assessed with a digital caliper, a goniometer, a lateral step-down test, a Biodex balance system, VAS, and Oswestry questionnaire. Then, two intervention groups from these subjects underwent training for 8-week and the subjects in the control group resumed their normal lives.Results: After eight-week of intervention, significant differences were observed in the inter-recti distance (IRD) (p=0.001), lumbopelvic proprioception (p=0.001), lumbopelvic control (p=0.001), static balance (overall stability) (p=0.010), dynamic balance (overall stability) (p=0.012), pain (p=0.001), and disability (p=0.001). The results of the LSD test showed that there was no significant difference between the TRX and ISOM-ISOT training groups in the studied parameters (P≥0.05).Conclusion: It seems that the TRX exercises had a positive effect on women with DRA and like the ISOM-ISOT exercises can be used to treat this disorder. Trial registration: The Iranian Registry of Clinical Trials (code: IRCT20190219042761N1; 06/07/2019).
Distribution of Hounsfield Unit Values in the Pelvic Bones: A Comparison Between Young and Elderly Patients: A Retrospective Cohort Study
Authors: Inagaki Naoya , Tanaka Takaaki , Udaka Jun , Akiyama Shoshi , Matsuoka Tatsuki , Saito Mitsuru
Published: May 2021

Background

The fixation strength of bone screws depends on bone mineral density (BMD), so it is important to evaluate bone strength at fracture sites. Few studies have investigated BMD in the pelvis. The aims of this study were to measure the regional Hounsfield unit (HU) values in the cancellous bone of the acetabulum and pelvic ring and to compare these values between young and elderly patients.
Methods

This study enrolled young patients with high-energy trauma (aged 20–44 years; young group) and elderly patients with low-energy trauma (aged 65–89 years; elderly group). Patients without pelvic computed tomography (CT) scans, those with pelvic bone implants, and those who died were excluded. The HU values on the contralateral (non-fractured) side of the pelvis were measured on CT scans. The CT data were divided into 7 areas: the pubic bone, the anterior and posterior walls and roof of the acetabulum, the ischial tuberosity, the body of the ilium, and the third lumbar vertebra. The HU values in each area were compared between the young and elderly groups.
Results

Sixty-one young patients and 154 elderly patients were included in the study. The highest HU value was in the roof of the acetabulum regardless of age and sex. HU values were significantly higher in the ischial tuberosity and body of the ilium and lower in the pubic bone and anterior wall. The HU values in all pelvic areas were significantly lower in the elderly group than in the young group, especially in the anterior area.
Conclusions

HU values in the 6 pelvic areas were not uniform and were strongly related to load distribution. The HU distribution and age-related differences could explain the characteristic causes and patterns of acetabular fractures in the elderly and may help in surgical treatment.
Epidemiological Study and Analysis of Risk Factors for Elizabethkingia Meningoseptica Infection in a Large General Hospital in China
Authors: Gong yali , Luo xiaoqiang , Peng yuan , Zhang cheng , Li ming , Li ning , Li qimeng , Shi yunlong , Ma siyuan
Published: May 2021

Background

As a kind of nosocomial infection pathogen which can cause high mortality, its susceptibility and death risk factors are still unclear.
Aim

To analyze the epidemiological characteristics of and risk factors for Elizabethkingia meningoseptica infection.
Methods

Relevant literature from 2011 to 2019 with the key words “E. meningoseptica” or “Elizabethkingia meningoseptica” in the title and abstract was retrieved from the PubMed database. The risk factors of infection and death for infected patients treated at Southwest Hospital during the above period were analyzed by logistic regression.
Results

From 2011 to 2019, 366 patients infected with E. meningoseptica were reported in 132 articles in the PubMed database. The mortality rate was 63.20%. During the same period, 92 infected patients were treated at our hospital. The overall mortality rate was approximately 28.3% (26/92) to 39.1% (36/92). The resistance rate for carbapenems was 100%; for cephalosporins, it was more than 90%; and for minocycline, it was 0. Central venous catheterization (p < 0.001), mechanical ventilation (p = 0.015), bacteria type (p < 0.001), operation type (p = 0.001), fungal infection (p < 0.001), carbapenem use (p = 0.000), and triazole use (p = 0.016) were independent risk factors for E. meningoseptica infection. According to logistic regression, bacteria type (p = 0.037), platelet level (p = 0.014), and mechanical ventilation (p = 0.043) were risk factors for death.
Conclusion

The incidence of E. meningoseptica infection worldwide shows a trend toward increasing yearly. Invasive operations, multiple bacterial or fungal infections and the use of carbapenems may be predisposing factors, and platelet level, bacteria type, and mechanical ventilation were risk factors for death.
Systematic Team-Approach Rehabilitation After Knee Fracture Surgery Is Associated With Better Functional Outcomes
Authors: LIU Jingyu , Zhou Mouwang , Yang Yanyan , Li Tao
Published: May 2021

Purpose

In Western developed countries, patients commonly receive rehabilitation after orthopedic surgery to improve functional dysfunction. In China, however, rehabilitation is widely neglected. An appropriate perioperative rehabilitation model for early orthopedic rehabilitation is urgently needed in China. We evaluated the outcomes of perioperative rehabilitation patterns and promoted the functional recovery of orthopedic patients in China.
Methods

668 patients from 9 centers who underwent internal fixation surgery because of knee joint fracture were assigned to 2 groups: 1) control group: received the standard postoperative treatments, or 2) trial group: received perioperative rehabilitation in team-based approach. The visual analog scale (VAS), Hospital for Special Surgery (HSS) knee and Berg Balance Scale (BBS) scores were assessed 12 and 24 weeks postoperatively.
Results

The VAS scores at 12 and 24 weeks postoperative showed that the trial group had significantly less pain than control group (P < 0.001). Compared to the control group, the trial group had significantly better HSS knee scores at 12 weeks (P < 0.05) and significantly better BBS scores at both 12 and 24 weeks postoperative (P < 0.05).
Conclusions

Compared to common postoperative treatments, patients with systematic team-approach rehabilitation had better functional outcomes and pain relief after knee fracture surgery.
Safety and Efficacy of Ayurvedic Interventions and Yoga on Long Term Effects of COVID-19: a Structured Summary of a Study Protocol for a Randomized Controlled Trial
Authors: Yadav Babita , Rai Amit , Mundada Pallavi Suresh , Singhal Richa , Rao BCS , Rana Rakesh , Srika Narayanam
Published: May 2021

Objectives: Primary Objective• To assess the efficacy of Ayurveda interventions and Yoga in rehabilitation of COVID-19 cases suffering with long term effects of COVID 19 as compared to WHO Rehabilitation Self-Management after COVID-19- Related Illness.Secondary Objective• To assess the safety of Ayurvedic interventions in cases suffering with long term effects of COVID 19Trial design: Multi-centric, randomized, controlled, parallel group, open-label, exploratory study. The study duration is 9 months and the intervention period is 90 days from the day of enrolment of the participant.
Routine Unenhanced 2D MRI for Maximal Segmental Diameters of Thoracic Aorta
Authors: Valeviciene Nomeda , Palionis Darius , Glaveckaite Sigita , Gumbiene Lina , Petrulioniene Zaneta
Published: May 2021

Background: Increasing demand for aortic dilatation imaging and complicated use of multiplanar image reconstructions (MPR) from 3D images for less experienced users inspired research of unenhanced 2D-MRI in order to reduce need for aortic MPR.Purpose: To research robustness of unenhanced 2D-MRI with no need for MPR from 3D images by comparing maximal axial measurements of thoracic aorta in unenhanced “dark blood” (DB) and “bright blood” (BB) 2D-MRI images vs. contrast enhanced 3D-T1 MR angiography (ce3D-MRA) both in patients with tricuspid (TAV) and bicuspid (BAV) aortic valves. Material and Methods: Prospective study. 68 subjects underwent MRI and US examinations of aorta and were divided into 2 groups: 1) TAV patients: 26 patients, age: 53.3±8.1 years, 14 males and 12 females; 2) BAV patients: 42 patients, age: 30.8±9.8, 31 males and 11 females.Results: Strongest correlation between repeated MRI studies for TAV thoracic aorta segmental measurements was in BB (AS R=0.94, AA R=0.94) as well between BB and US (AS R=0.9, AA R=0.86). Unenhanced techniques in BAV patients revealed statistically significant correlation in all segments (p˂0.05) with strongest correlation in AA (R=0.96) and weakest correlation in AS (R=0.86, influenced by asymmetry of sinuses in BAV). Conclusion: BB correlated better with ce3D-MRA than measurements performed in DB both in TAV and BAV cohorts, especially in the AA. Comparing aortic measurements between US and MRI unenhanced sequences - BB had the strongest correlation in TAV. Our results suggest that there is no strict need for intravenous contrast administration and MPR for routine MRI evaluation of thoracic aorta’s maximal diameters, except for AS in BAV.
Association between serum zonulin level and severity of house dust mite allergic asthma
Authors: Baioumy Shereen A. , Ibrahim Shereen Mahmoud , Elgendy Aya , Fouad Shaimaa Hani
Published: May 2021

Background: Increased intestinal permeability, either due to the exposure to antigens in asthmatic patients or due to a barrier defect, play a critical role in susceptibility to environmental allergens. House dust mites allergy occurs more commonly than any other allergens among Egyptian asthmatic patients.Aim:To assess the relation between serum zonulin level as a marker of increased intestinal permeability and the severity of house dust mites allergic asthma.Methods:A case control study which included 48 house dust mites allergic asthma and 48 healthy control subjects attending the allergy and immunology unit, microbiology and immunology department, Faculty of medicine, Zagazig University. Results:On comparing the 2 studied groups, there was a statistically significant difference between the 2 groups concerning serum IgE and serum zonulin levels ( p=0.000, 0.000 respectively)The mean serum zonulin was equal to 258.3±153.01 ng/ml in the asthmatic group and 80±13 ng/ml in the control group. Serum zonulin level significantly increased with the increase of asthma severity (p˂0.001). The cut off value of serum zonulin was ≥ 198 ng/ml, and the area under the curve was 0.76. It displayed sensitivity equal to 80% and specificity equal to 71.4%. Its negative predictive value was equal to 83.3%. Conclusion: Intestinal barrier dysfunction contributes in the pathogenesis of allergic asthma. Serum zonulin level reflects an increase in intestinal permeability and acts as prognostic factor of severity in Asthma. Correction of the gut barrier defect may be an additional novel approach for Asthma.
Task shifting of intravitreal injections from physicians to nurses: a qualitative study
Authors: Bolme Stine , Austeng Dordi , Gjeilo Kari Hanne
Published: May 2021

Background: Intravitreal injections of anti-vascular endothelial growth factor are a high-volume procedure and represent a considerable workload on ophthalmology departments. Several departments have tried to meet this increase by shifting the task to nurses. To maintain high quality patient care, we developed a training program for nurses certifying them to administer injections. This qualitative study aimed to evaluate if the nurses were confident and in control after participating in the training program, and if they were satisfied with the training and the new task. Methods: During 2014-2018, twelve registered nurses were trained in a tertiary hospital in Central Norway. All nurses were interviewed individually (n=7) or in a group (n=5). We analyzed the interviews using Graneheim and Lundmans qualitative content analysis. Results: Twelve sub-themes clustered in four main themes 1) responsibility and safety, 2) motivation and respect, 3) collaboration and 4) reflection and evaluation. The nurses felt confident and in control when administering injections, but experienced moments of insecurity. The new task gave the nurses a sense of achievement and they highlighted improvement of patient’s lives as positive. A greater level of responsibility gave the nurses pride in their profession. They had suggestions that could improve training efficiency but were overall satisfied with the training program.Conclusion: Our study showed that the nurses were satisfied with the training and that learning a new task led to higher self-esteem and gained respect. Suggestions to improve the training were identified, which should be considered before implemented at other departments.
Family Relationships, Personality Disorder Functioning Styles and Emotional States in Generalized Anxiety and Major Depressive Disorders
Authors: YU Zhenghe , Xu You , ZHU Qisha , MAO Hongjing , ZHANG Bingren , SHAO Xu , WANG Wei
Published: May 2021

Objective: Family relationship affects personality development and emotional regulation, which might be more pronounced in generalized anxiety (GAD) and major depressive (MD) disorders. Method: Thirty patients with GAD, 31 MD, and 32 healthy volunteers answered the Family Relationship Questionnaire (FRQ), the Parker Personality Measure (PERM), and the Hamilton Anxiety and Depression Rating Scales. Results: Compared to healthy controls, both patient groups scored higher on FRQ Paternal Abuse and Paternal Dominance, and lower on Maternal Freedom Release; GAD in addition scored lower on Maternal Abuse and Maternal Dominance. All PERM scale scores except Narcissistic were higher in MD than those in GAD, and all scale scores except Schizotypal and Narcissistic were higher in MD than in controls. Maternal Encouragement was associated with the Paranoid and Schizotypal styles, and Maternal Freedom Release the Avoidant and Borderline in GAD; and Maternal Encouragement the Paranoid, Paternal Dominance the Avoidant, Paternal Freedom Release (-) and Maternal Freedom Release the anxiety, and the Dependent the depression in MD. Conclusions: Our study demonstrates different associations between family relationships and personality traits/ emotional states in MD and GAD, suggesting different forms of family therapy for the two disorders.
Effect of Different Types of Oil Intake on the Blood Index and the Intestinal Flora of Rats
Authors: Xu Yan , Zhu Wenzheng , Ge Qingfeng , Zhou Xiaoyan
Published: May 2021

The effect of different oil-based diets on the blood index and the gut microbiota of rats was investigated. Rats in sample treatment groups were fed with stewed lard, refined lard, fish oil and soybean oil at a normal dose of 16.9% for 6 weeks. Compared with refined lard group, stewed lard treatment group showed reduced fasting blood sugar and blood lipid levels and improved nutrient absorption capacity of the intestine. The blood indexes of glucose (Glu), total cholesterol (TC) and total triglyceride (TG) in fish oil treatment group were relatively low. The abundance of Bacteroidetes in the fat-free group decreased, and the abundance of Firmicutes increased. The Firmicutes/Bacteroidetes ratio of the fish oil group was relatively low, and the Firmicutes/Bacteroidetes ratio of the stewed lard group and the soybean oil group was lower than that of the refined lard group. The abundance of Bacteroidaceae in the stewed pork fat group was increased. Research results show that fat-free diets will increase the risk of obesity to a certain extent; compared with refined lard, stewed lard, soybean oil and fish oil can reduce the risk of obesity to a certain extent; the addition and types of dietary fat will affect the abundance and diversity of rat intestinal flora.
Mixed methods process evaluation of the Sundara Grama intervention promoting latrine use and safe disposal in rural Odisha, India
Authors: Sclar Gloria D , Routray Parimita , Majorin Fiona , Udaipuria Shivika , Portela Gerard , III William J Koehne , Nagel Corey L , Sola Steven , Caruso Bethany A
Published: May 2021

BackgroundProcess evaluations of public health programs are critical to understand if programs were delivered as intended and to identify improvements for future implementations. The aim of this paper is to describe a mixed methods process evaluation of the Sundara Grama intervention, which sought to improve latrine use and safe child feces disposal among latrine-owning households in rural Odisha, India.MethodsThe Sundara Grama intervention was delivered to 36 villages in Puri district by a grassroots NGO and included eight activities: palla performance (folk theater ‘edutainment’), transect walk, community meeting, community wall painting, mother’s meeting on child feces disposal, positive deviant household recognition, household visit, and latrine repairs. The process evaluation quantitatively assessed fidelity, dose delivered, and reach, and qualitatively examined recruitment, context, and satisfaction. Quantitative data collection included an activity observation survey, activity record, and endline trial survey. Qualitative data collection included an activity observation debrief and in-depth interviews with NGO mobilizers. Data collection took place during three time periods: during intervention delivery, immediately after, and several months post-implementation. For the quantitative data, a ‘delivery score’ was calculated for each activity, as well as the proportion of target participants in attendance. Qualitative data was analyzed using thematic analysis.ResultsMean delivery scores, reported as a percentage, were moderate to high. Household visit activities (97% general visit, 96% positive deviant visit) and the mother’s meeting (81%) had the highest delivery scores, followed by the palla (77%), transect walk (77%), and community meeting (60%). Activities were attended, on average, by 30–73% of latrine-owning households. Several factors aided delivery, including pre-intervention rapport building visits and village stakeholder support. Factors that hindered delivery included inclement weather, certain recruitment strategies, and village social dynamics related to caste and gender. With regard to satisfaction, participants and NGO mobilizers praised the palla but reported mixed reactions to other activities.ConclusionsOverall, the Sundara Grama intervention was implemented as intended and achieved good reach. The findings suggest edutainment and multi-level communication approaches are particularly beneficial, and offer lessons for community-wide programs on the importance of examining the implementer experience and broader context.Trial RegistrationThis trial is registered at clinicaltrials.gov: NCT03274245.
A 95-gene Signature Stratifies Recurrence Risk of Invasive Disease in ER-positive, HER2-negative, Node-negative Breast Cancer With Intermediate 21-gene Signature Recurrence Scores
Authors: Fujii Takeo , Masuda Hiroko , Cheng Yee Chung , Yang Fei , Sahin Aysegul A. , Naoi Yasuto , Matsunaga Yuki , Raghavendra Akshara , Sinha Arup Kumar , Fernandez Jose Rodrigo Espinosa , James Anjali , Yamagishi Keisuke , Matsushima Tomoko , Schuetz Robert , Tripathy Debu , Tada Sachiyo , Jackson Rubie S. , Noguchi Shinzaburo , Nakamura Seigo , Acoba Jared D. , Ueno Naoto T
Published: May 2021

Purpose A subset of patients with intermediate 21-gene signature assay recurrence score may benefit from adjuvant chemoendocrine therapy, but a predictive strategy is needed to identify such patients. The 95-gene signature assay was tested to stratify patients with intermediate RS into high (95GC-H) and low (95GC-L) groups that were associated with invasive recurrence risk.Methods Patients with ER-positive, HER2-negative, node-negative breast cancer and RS 11-25 who underwent definitive surgery and adjuvant endocrine therapy without any cytotoxic agents were included. RNA was extracted from archived formalin-fixed, paraffin-embedded samples, and 95-gene signature was calculated. Results Two hundred six patients had RS of 11-25 (95GC-L, N = 163; 95GC-H, N = 43). In Cox proportional hazards model, 95GC-H was significantly associated with shorter time to recurrence than was 95GC-L (HR 5.94; 95%CI 1.81-19.53; P = 0.005). The correlation between 95-gene signature and 21-gene signature assay scores was not strong (correlation coefficient r = 0.27), which might suggest that 95-gene signature reflects biological characteristics differing from what 21-gene signature shows.Conclusions The 95-gene signature stratifies patients with ER-positive, HER2-negative, node-negative invasive breast cancer and intermediate RS of 11-25 into high and low groups that are associated with recurrence risk of invasive disease. Further retrospective analysis in the prospectively-accrued TAILORx population is warranted to confirm that 95-gene signature can identify patients who would benefit from adjuvant chemoendocrine therapy.
Community-based model for the delivery of antiretroviral therapy in Cambodia: a quasi-experimental study protocol
Authors: Tuot Sovannary , Teo Alvin Kuo Jing , Prem Kiesha , Chhoun Pheak , Pall Chamroen , Ung Mengieng , Ly Penh Sun , Jimba Masamine , Yi Siyan
Published: May 2021

BackgroundMulti-month dispensing (MMD) is the mainstay mechanism for clinically stable people living with HIV in Cambodia to refill antiretroviral therapy (ART) every three to six months. However, less frequent ART dispensing through the community-based ART delivery (CAD) model could further reduce the clients’ and health facilities' burden. While community-based services have been recognized as an integral component of HIV response in Cambodia, their role and effectiveness in ART delivery have yet to be systematically assessed. This study aims to evaluate the CAD model's effectiveness on the continuum of care and treatment outcomes for stable people living with HIV in Cambodia.MethodsWe will conduct this quasi-experimental study in 20 ART clinics across the capital city and 10 provinces between May 2021 and April 2023. Study sites were purposively selected based on the availability of implementing partners, the number of people living with HIV each clinic serves, and the accessibility of the clinics. In the intervention arm, approximately 2,000 stable people living with HIV will receive ART and services from the CAD model. Another 2000 stable people living with HIV in the control arm will receive MMD—a standard care model for stable people living with HIV. The primary outcomes will be retention in care, viral load suppression, and the healthcare providers’ work burden. The secondary endpoints will include the model’s cost-effectiveness, quality of life, mental health, social support, stigma, and discrimination. We will compare the outcome indicators within each arm at baseline, midline, and endline using descriptive and inferential statistics. We will evaluate the differences between the intervention and control arms using the difference-in-differences method. We will perform economic evaluations to determine if the intervention is cost-effective.DiscussionThis study will build the evidence base for future implementation and scale-up of CAD model in Cambodia and other similar settings. Furthermore, it will strengthen engagements with community stakeholders and further improve community mobilization, a vital pillar of the Cambodian HIV response.Trial registrationClinicalTrials.gov, NCT04766710. Registered 23 February 2021,
Abnormal Variations in the Expressions of LRP5, Runx2, Osterix and RANKL in Bone Tissues Associated With Postmenopausal Osteoporotic Fractures
Authors: Wang Bin , Cao Yanming , Mai Caiyuan , Yadav Ram Ishwar , Gao Jianliang , Pan Lei
Published: May 2021

Objective: To investigate the variations in the expressions of LRP5, Runx2, Osterix, and RANKL factors in bone tissues associated with postmenopausal osteoporotic fractures (PMOPF). Method: Postmenopausal patients with femur fractures were initially divided into control (31 cases) and PMOPF groups (83 cases). All control group patients were operated within 1 day after injury. The patients with PMOPF were operated based on the time after fracture in the respective groups (patients were divided into groups A, B, and C based on the time after fracture). Samples were collected from femurs at fracture sites during the operation. The expression level of each factor in bone tissues was detected using RT-qPCR, and the bone mass samples were decalcified and then histologically analyzed by immunohistochemistry. We subsequently analyzed significant differences in the expressions of factors (LRP5, Runx2, Osterix, and RANKL) between PMOPF and control groups. Results: (1) LRP5, β-catenin, Runx2, and Osterix were under-expressed in patients with PMOPF relative to the controls (P<0.05). In contrast, RANKL was over-expressed in the PMOPF group when compared to the control group (P<0.05); (2) the expressions of LRP5 and Runx2 were lowest in Group A patients (1–3 days after fracture). Osterix expression was lowest in Group C patients (8–14 days after fracture). Conversely, RANKL expression was highest in Group B patients (4–7 days after fracture). Conclusion: The inhibition or reduction in the expressions of osteogenic factors including LRP5, Runx2, and Osterix of the Wnt/β-catenin and BMP-2/Runx2/Osterix signaling pathways are associated with PMOPF incidence. Specifically, upregulation of RANKL in the RANKL/RANK signaling pathway is associated with the incidence of PMOPF. LRP5 and Runx2 expressions decreased considerably within 1-3 days after fracture; Osterix expression decreased considerably within 8-14 days after fracture; RANKL expression was highest within 4-7 days after fracture, which could be associated with bone repair in PMOPF. The expression level of the aforementioned factors affects the development and progression of PMOPF.
Knowledge and attitude of community towards trachoma and trichiasis in Arba Minch Zuria district, Gamo Zone, Southern Ethiopia, 2019
Authors: Churko Chuchu , Asfaw Mekuria Asnakew , Zerdo Zerihun
Published: May 2021

Background

Trachoma is a preventable and treatable disease caused by Chlamydia trachomatis which is the leading cause of blindness in the world affecting mostly the poorest community. Despite so many intervention undertaken on prevention and control for trachoma, Ethiopia is failed to achieve 2020 elimination goal for trachoma. We hypothesized that the knowledge of communities towards trachoma was inadequate in the study area.
Methods

a community based cross sectional study was conducted in Arba Minch zuria district from December 2019 to June 2020. The total sample size was allocated by probability proportional to size to each kebele based on the number of households they had. Then, systematic random sampling was employed to select 811 study participants from the five kebeles. Data were collected using a pretested interviewer administered structured questionnaire and then entered into EPI/INFO version 7 and exported to SPSS V20 for analysis.
Findings:

All of the respondents heard about trachoma. Less than one forth 185 (23.2%) of the study subjects had adequate knowledge towards trachoma. One hundred forty eight (18.6%) strongly agreed that trachoma can be transmitted through gene. On the other hand, 240 (30.1%) of the respondents were unsure that trichiasis patients may loss vision if not operated. Factors like education, occupation, walking distance from home to clean water source and wealth index were significantly associated with knowledge status of the participants.
Conclusion

the proportion of people who had adequate knowledge about trachoma and trichiasis was low. Attention should be given by the district health office, regional government and different stakeholders, who designing and implementing trachoma elimination programs especially improving awareness of community regarding trachoma and trichiasis. Interventions with the F and E components of SAFE strategy are also strongly recommended.
Zebrafish as a model for haloperidol-induced catalepsy-like immobilization
Authors: Hasumi Akihiro , Maeda Hideyuki , Yoshida Ken-ichi
Published: May 2021

This study investigated the validity of screening for antipsychotic-induced catalepsy-like immobilization in zebrafish (Danio rerio), as an alternative to the standard rodent model. To induce the desired symptoms, we used haloperidol, a typical antipsychotic that disturbs dopamine D2-receptors. In addition to observing swimming behaviors generally, we used the light and dark test to assess how drug exposure influences locomotive responses to those stimuli. We selected this test instead of the commonly used bar test for catalepsy in rodents, because fish cannot perform the necessary motions to participate in the latter. Normally, light attenuated activity and decreased locomotion, whereas darkness greatly increased activity levels in zebrafish. We confirmed that haloperidol had a dose-dependent inhibitory effect on activity; the highest dose of 10 mg/L almost stopped fish activity even in darkness. We did not observe any significant differences in heart rate or morphology across the control and treatment groups, whereas abnormal movements like rigid and erratic behaviors occurred in haloperidol-treated groups. Therefore, we found that immobilization and abnormal movements qualify as haloperidol-induced catalepsy. In conclusion, zebrafish appear to be a suitable model for antipsychotic-induced catalepsy-like immobilization.
Title Patient Involvement in the Encounter between General Practice and Patients with Chronic Diseases – A Scoping Review
Authors: Titlestad Signe Beck , Marcussen Michael , Rasmussen Marie Sandstød , Nørgaard Birgitte
Published: May 2021

Background Globally, there is increasing interest in patient involvement in healthcare. Research has shown improved health outcomes when patients are involved in managing their own health conditions and when their individual needs are considered. The aim of this scoping review was to map the existing research regarding chronic disease patients’ involvement in their encounters with general practice, with a specific focus on patients with Type 2 diabetes (TD2) or (Chronic obstructive pulmonary disease (COPD).Methods Studies of any design, date, and language reporting the involvement of adult patients with T2D or COPD were included. A systematic search was conducted using the following databases: MEDLINE, CINAHL, Psycinfo Scopus, and EMBASE. All databases were searched from August 2020 until October 2020. Data were systematically charted by the following study characteristics: Bibliographic aims; study aims; setting; area of interest; results; conclusion.Results 19 studies were included and published between 2001 and 2020 and conducted qualitative methods, survey, or mixed methods. Three and 17 studies contained knowledge on the involvement of patients with COPD and TD2, respectively. The patients reported the importance of being more involved in treatment discussions during consultations as well as a friendly environment. A good relationship and relational continuity make it easier for patients to be more involved in treatment decisions. The general practitioners(GP) mentioned their high work load, long-standing relationships, knowledge about the patients, and prepared patients as factors influencing their ability to involve patients in treatment discussions.Conclusion The existing knowledge within patient involvement in general practice clearly indicates that focus and action must be directed towards research exploring the perspectives of patients with COPD on their involvement in general practice.
Predictor of Recurrence of Allergic Fungal Rhinosinusitis
Authors: Chen yanmin , Zhen Hongtao
Published: May 2021

ObjectivesBy analyzing the clinical manifestations related to allergic fungal sinusitis (AFRS), the aim of this study was to try to make the first step to establish a prognostic evaluation system for predicting the recurrence of AFRS patients after operating.MethodsA descriptive and retrospective study of 19 AFRS out of 272 chronic rhinosinusitis (CRS) who underwent endoscopic sinus surgery were enrolled from April 2011 to April 2019. ResultsThe incidence of AFRS was 7.0% (19/272) in this study. The postoperative recurrence rate was 26.3% (5/19). Nasal discharge (73.7%) and nasal obstruction (57.9%) were the most common clinical manifestations. There were significant differences in the age of onset, preoperative duration of symptoms and a total Lund-MacKay CT score between the relapsing group and non-relapsing group.ConclusionsAFRS is less prevalent and high recurrent in Chinese patients. Our preliminary data support that age, duration and Lund-MacKay CT scores as the focus of preoperative clinical evaluation of AFRS: a long duration of symptoms (≥15 months) and a high Lund-MacKay CT score (≥11) are at a high risk of relapse, in further prospective and larger investigations as part of the preoperative work-up for patients with AFRS in order to develop a personalized and effective management approach.
Monitoring of seven industrial anaerobic digesters supplied with biochar
Authors: Heitkamp Kerstin , Latorre-Pérez Adriel , Nefigmann Sven , Gimeno-Valero Helena , Vilanova Cristina , Jahmad Efri , Abendroth Christian
Published: May 2021

Background: Recent research articles indicate that direct interspecies electron transfer (DIET) is an alternative metabolic route for methanogenic archaea that improves microbial methane productivity. It has been shown that multiple conductive materials such as biochar can be supplemented to anaerobic digesters to increase the rate of DIET. However, the industrial applicability, as well as the impact of such supplements on taxonomic profiles, has not been sufficiently assessed to date.

Results: Seven industrial anaerobic digesters were supplemented with biochar for one year. A positive effect was observed for the spectrum of organic acids as the concentration of acetic, propionic, and butyric acid decreased significantly. Quantification of the cofactor F420 using fluorescence microscopy showed a reduction in methanogenic archaea. 16S-rRNA gene amplicon sequencing showed a higher microbial diversity within biochar particles as well as an accumulation of secondary fermenters and halotolerant bacteria. Taxonomic profiles indicate microbial electroactivity, and show the frequent occurrence of Methanoculleus , which has not been described in this context before.

Conclusions: Our results shed light on the interplay between biochar particles and microbial communities in anaerobic digesters. Both the microbial diversity and the absolute frequency of the microorganisms involved were significantly changed between sludge samples and biochar particles. This is particularly important against the background of microbial process monitoring. In addition, it could be shown that biochar is suitable for reducing the content of inhibitory, volatile acids on an industrial scale.
The Roles of Anti-RNP Antibodies in Primary Sjögren’s Syndrome Pathogenesis and Severity May Be Underestimated
Authors: lin wei , Xin Zhifei , Peng Kenan , Ning Xiaoran , Guo Shaoying , Yang Liu , Li Yang , Yang Yupeng , Liu Yixuan , Ren Xiuying , Su Yashuang , Cao Jingjing , Liu Meilu , Sun Lijun , Zhang Fengxiao , Zhang Wen
Published: May 2021

Background Associations between anti-ribonucleoprotein (RNP) antibodies status and distinct clinical primary Sjögren’s syndrome (pSS) subtypes have not yet been firmly established. The aim of our study is to determine whether associations exist between RNP antibody status and the clinical manifestations, laboratory features, or disease activity in pSS. Methods A retrospective cohort of 39 anti-RNP antibody-positive and 294 anti-RNP antibody-negative pSS patients was assembled. Data regarding demographic information, glandular and extraglandular manifestations, laboratory findings, and disease activity (scored according to the European League Against Rheumatism SS disease activity index (ESSDAI)) were extracted from patient records. Univariate methods followed by multivariable logistic regression analysis were used to evaluate potential associations between anti-RNP antibody status and clinicopathologic features. Results Patients with anti-RNP antibody-positive pSS had a higher prevalence of Raynaud’s phenomenon (RP) and hematological, pulmonary, lymphatic system, and mucocutaneous involvement; higher erythrocyte sedimentation rates and serum IgG levels; lower lymphocytes counts; and significantly higher ESSDAI scores (median (interquartile range): 13 (7–18) versus 7 (3–12), p < 0.001). No significant differences were observed between groups for C-reactive protein levels and rheumatoid factor or anti-Ro/SSA or -La/SSB antibody positivity. Multivariate analysis identified RP, interstitial lung disease (ILD), and lymphatic system involvement as independent predictors of anti-RNP antibody positivity in pSS patients. Conclusions In this cohort, anti-RNP antibodies were associated with several clinicopathologic features of severe pSS, such as RP and hematologic, lymphatic, and pulmonary disorders. Therefore, anti-RNP antibodies may play an important role in the pathogenesis and severity of pSS.
Do faecal samples represent the primary site of microbial plant fermentation in hindgut fermenters?
Authors: Eisenhofer Raphael , D’Agnese Erin , Taggart David , Carver Scott , Penrose Beth
Published: May 2021

BackgroundMost herbivorous mammals have symbiotic microbes living in their gastrointestinal tracts that help with harvesting energy from recalcitrant plant fibre. The bulk of research into these microorganisms has focused on samples collected from faeces, representing the distal region of the gastrointestinal (GI) tract. However, the GI tract in herbivorous mammals is typically long and complex, containing different regions with distinct physico-chemical properties that can structure resident microbial communities. Therefore, to determine how representative faeces are to other regions of the GI tract in hindgut-fermenting mammals, we characterised the microbial biogeography of the GI tract of two species of wombats.ResultsUsing 16S rRNA gene sequencing, our results show that GI microbial communities of wombats are structured by GI region. For both the bare-nosed wombat (Vombatus ursinus) and the southern hairy-nosed wombat (Lasiorhinus latifrons), we observed a trend of increasing microbial diversity from stomach to distal colon. The microbial composition in the first proximal colon region was more similar between wombat species than the corresponding distal colon region in the same species. We found several microbial genera that were differentially abundant between the first proximal colon and distal colon regions. Surprisingly, only 99 (10.6%) and 204 (18.7%) amplicon sequence variants (ASVs) were shared between the first proximal colon region and the distal colon region for the bare-nosed and southern hairy-nosed wombat, respectively. ConclusionThese results suggest that microbial communities in the first proximal colon region—the putative site of primary plant fermentation in wombats—are distinct from the distal colon, and that faecal samples have limitations in capturing the diversity of these communities. While faeces are still a valuable and effective means of characterising the distal colon microbiota, future work seeking to better understand how GI microbes impact the energy economy of wombats (and potentially other hindgut-fermenting mammals) may need to take gut biogeography into account.
Validation of a Clinical-Genomic Model for Patients With Early-Stage Breast Cancer Enrolled in a Taiwanese Multicenter Study
Authors: Pennarun Nicolas , Lee Yi-Hsuan , Tseng Ling-Ming , Yang Po-Sheng , Liang Ji-An , Hsieh Chia-Ming , Chang Yuan-Ching , Wang Ming-Yang , Huang Chiun-Sheng , Shih Kuan-Hui
Published: May 2021

BackgroundNumerous prospective studies, predominantly in the Caucasian population, have proven the clinical utility of using multigene expression tests to prevent overtreatment in early-stage breast cancer patients with early-stage disease. In this study, we used an Asian population to validate a clinical-genomic assay (RecurIndex®) for estimating the risk of distant recurrence and relapse in early-stage breast cancer patients. MethodsA total of 298 patients with early-stage breast cancer, luminal-like subtype (85.6%) and HER2-enriched/ triple-negative subtype (14.4%), was enrolled in a retrospective study across five participating medical centers in Taiwan. The inclusion criteria were as follows: women (1) who underwent primary surgery without prior induction treatments, (2) with an early pathologic N stage and (3) who received either mastectomy or breast-conserving surgery. Kaplan Meier method and Cox proportional hazards model were used to, respectively, identify independent prognostic factors and calculate the 5- and 10-year survival rates of patients in the low- and high-risk groups assigned by the diagnostic test. A forest plot was produced to assess hazard ratios and 95% confidence intervals. The primary endpoint was distant recurrence-free survival (DRFS) and the secondary endpoint was relapse-free survival (RFS).ResultsThe 10-year DRFS rate was significantly higher in the good prognosis group than in the poor prognosis group (91.9% [95% CI, 86.1-98.1%] versus 62.9% [95% CI, 49.8-79.4%]). The overall hazard ratio for distant recurrence was 1.031 [95% CI, 1.017 - 1.046] per unit Recurrence index-distant recurrence (RI-DR) score increment. ConclusionsThe present study provides robust evidence of the clinical utility of using the RI-DR score to accurately predict clinical outcomes. RecurIndex® could be used to determine the utility of adjuvant chemotherapy in Asian patients, especially those having hormone-receptor positive tumors, leading to a meaningful reduction in adjuvant chemotherapy recommendations.