bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlates of Health Care Workers’ Knowledge and HIV-Exposed Infant Immunization Counseling Practice in Northern Nigeria
Authors: Hassan-Hanga Fatimah , Iliyasu Zubairu , Ajuji Sadiq , Bello Musa M. , Abdulkadir Safiyya , Nass Nafisa , Salihu Hamisu M. , Aliyu Muktar H.
Published: December 2020

Background: Human Immunodeficiency Virus (HIV)-exposed and HIV-infected infants are at increased risk of vaccine-preventable diseases. However, little is known about health care workers’ knowledge and immunization counseling practices in this population. We determined the predictors of health care workers’ knowledge of vertical transmission risks, HIV exposed/infected infant immunization, and counseling practices in a tertiary center in Northern Nigeria.
Methods: A cross-section of 297 health workers were interviewed using a structured, validated questionnaire. Knowledge and HIV-exposed infant immunization counseling practices were analyzed, and adjusted odds ratios for predictors were derived from logistic regression models.
Results: Of the 297 participating health care workers, (32.3%, n=96) had adequate knowledge of HIVexposed/infected infant immunization. Two-thirds (67%, n=199) of the participants appropriately identified the timing of infant diagnosis, while (73%, n=217) and (56.2%, n=167) correctly categorized infants as HIV-exposed and HIV-infected, respectively. Only (19.5%, n=58) participants had ever counselled a HIVpositive mother on infant immunization. Knowledge was predicted by work unit (HIV clinic vs. Obstetrics & Gynecology clinic), (Adjusted Odds Ratio (AOR) =3.78, 95% CI: 1.27-5.54), age (30-39 vs. <30 years), (AOR=2.24, 95% CI:1.19-5.67), years of experience (≥10 vs. <5), (AOR=1.76, 95% CI: 1.15-6.04), number of children (1 vs. 0), (AOR=1.73, 95% CI:1.14-4.23), infant immunization training (yes vs. no), (AOR=1.57, 95% CI:1.12-5.43), female sex (AOR = 1.17, 95% CI:1.06-2.21), profession (nurse/midwife vs. physician), (AOR=0.44, 95% CI:0.21-0.94) and previous HIV test (no vs. yes), (AOR=0.67, 95% CI:0.21-0.83).
Conclusion and Global Health Implications: Knowledge of HIV-exposed infant immunization was low and counseling practices were sub-optimal. Both immunization knowledge and counseling practices were predicted by demographic, professional, and training variables. Our findings indicate the need for educating health care workers on HIV exposed/infected infant immunization policy and improving counseling skills through capacity-building programs.
Key words: • Knowledge • Health care workers • HIV • Infant • Immunization • Nigeria
Copyright © 2021 Iliyasu et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.
Contextos da Política de Águas e Novas Abordagens pela Perspectiva das Reformas Administrativas no Brasil
Authors: Junior Adilson Pio da Trindade
Published: January 2021

O artigo busca apresentar a construção de um argumento ao explorar, através de uma leitura contextualizada da Política Nacional de Recursos Hídricos (PNRH), como as reformas que buscaram o modelo gerencial na administração pública brasileira estabeleceram variáveis e condicionantes a esta política participativa e descentralizada de gestão das águas. Assim, através de revisão bibliográfica, análise de documentos e algumas entrevistas com atores relacionados, foi possível construir uma análise crítica do processo de implementação e criação da PNRH. Desse modo, a contribuição a partir da abordagem desenvolvida, direciona a discussão para investigações que perpassam chaves analíticas específicas, a saber: modelos de análise combinadas de políticas públicas, arranjos institucionais e burocracias.
Taxa Interna de Retorno dos Regimes de Previdência Social no Brasil: Uma Análise das Reformas de 1988 a 2018
Authors: Pereira André Rodrigues , Campani Carlos Heitor d'Avila Pereira
Published: January 2021

Este estudo, através da estimativa de taxas internas de retorno e de taxas de reposição de segurados hipotéticos, verifica o impacto no custo previdenciário individual e na convergência entre regimes previdenciários geral e próprio das principais reformas desde a Constituição de 1988 até a proposta de emenda constitucional, PEC n° 287/2016, bem como a emenda aglutinativa global à proposta apresentada pelo relator no dia 07 de fevereiro de 2018. Foram analisadas as particularidades de cada uma dessas reformas, a trajetória das taxas e os subsídios cruzados existentes para, assim, sugerir as principais alterações a serem feitas para que se alcance um sistema previdenciário mais sustentável e regimes convergentes. As taxas de retorno mais elevadas para benefícios baixos apontam que o sistema possui características de progressividade. Apesar dos resultados indicarem alguma convergência no período e queda nos custos, as reformas anteriores se mostraram insuficientes para sanar o desequilíbrio. Concluiu-se, assim, pela necessidade de uma nova reforma, que pode ter como norte a proposta de 2016, porém mais profunda e abrangente.
Características Políticas e Eleitorais e o Efeito no Endividamento dos Estados Brasileiros
Authors: Baldissera Juliano Francisco , Araújo Maria Piedade
Published: January 2021

O objetivo da pesquisa é analisar a influência do ano eleitoral, mudança de gestor público e mandato eleitoral sobre o endividamento dos estados brasileiros. A partir de dados dos estados brasileiros no período de 2000 a 2016, utilizou-se da estatística descritiva e da regressão linear múltipla para estimar os efeitos das características políticas e eleitorais no endividamento. Os resultados sugerem que não existe determinação do endividamento em função do ano eleitoral, da mudança do gestor público e do mandato eleitoral. Entretanto, aspectos socioeconômicos e ideológicos mostraram relação significativa. A variação do endividamento em função dos ciclos políticos pode demonstrar um esforço dos políticos em demonstrarem compromisso com a gestão econômica e responsável e, com isso, buscar apoio eleitoral. Os aspectos legais, o controle social e externo, aspectos burocráticos restringem o endividamento em função do ciclo eleitoral. Entretanto, essas evidências indicam que poderia existir assimetria de informação e gerenciamento de resultados.
Reasoning about Climate Change
Authors: Bago Bence , Rand David , Pennycook Gordon
Published: December 2020

Why is disbelief in anthropogenic climate change widespread despite broad scientific consensus to the contrary? A widely-held explanation involves politically motivated (“system 2”) reasoning: Rather than helping uncover truth, people use their reasoning abilities to protect their partisan identities and reject beliefs that threaten those identities. Despite the popularity of this account, the evidence supporting it (i) does not account for the fact that partisanship is confounded with prior factual beliefs, and (ii) is entirely correlational with respect to the effect of reasoning. Here, we address these shortcomings by (i) measuring prior factual beliefs and (ii) experimentally manipulating participants’ extent of reasoning using cognitive load and time pressure while they evaluate arguments for or against anthropogenic global warming. The results challenge the politically motivated system 2 reasoning account: Rather than exacerbating the impact of partisanship per se, engaging in more reasoning led people to have greater coherence between judgments and their prior factual beliefs about climate change - a process that can be consistent with rational (unbiased) Bayesian reasoning. Thus, we challenge the dominant cognitive account of climate disbelief, and suggest that interventions aimed at providing accurate information about climate change may be effective in the long run.
Applying an inverse homeostasis perspective to simplify the design and implemention of robustly-nearly-homeostatic biological networks
Authors: Tang Zhe , McMillen David
Published: December 2020

A nearly-homeostatic system is able to maintain the steady state system output close to a fixed set point, despite varying levels of environmental perturbation. Studying such systems enables the de- sign of synthetic cellular systems able to function consistently under a wide range of environmental conditions. Here we present the inverse homeostasis perspective, a novel approach to studying and de- signing nearly-homeostatic systems. It represents a graphical approach allowing visualization of how each regulatory parameter affects near-homeostatic performance while being more accessible than situation- specific, mathematically complex approaches. Given the difficulty of precise parameter measurement in biology, we focus on adjusting experimentally-determined steady state response curves to implement near- homeostatic systems without requiring explicit parameter measurements. One implication of the inverse homeostasis perspective is an illustration of the much stronger dependence of nearly-perfect integral con- trollers on the properties of the existing system being controlled, compared to the system-independence of perfect integral controllers.
Vessel Diameter: A Key Factor Influencing Fractional Flow Reserve
Authors: Liu Jincheng , Huang Suqin , Li Bao , Liu Jian , Sun Hao , Xi Xiaolu , Zhang Liyuan , Du Tianming , Yang Haisheng , Liu Youjun
Published: December 2020

In this study, we explored the effect of vessel diameter of coronary artery where the stenosis is located on FFR at the same vascular level. This study is divided into two parts: clinical statistics and numerical simulation. In the clinical statistics section, we compared the blood vessel diameter where the stenosis is located of the ischemic group and the non-ischemic group. In the numerical simulation section, we further explored the effect of diameter on myocardial ischemia by using an ideal model. With the increase in stenosis rate and stenotic vessel flow, the FFR rate of the larger stenotic vessels was higher than that of smaller stenotic vessels. The larger blood vessels are more prone to ischemia when coronary artery stenosis occurs.
Transcription Factor EB Alleviates Endothelial Cell Inflammation Through NLRP3 Inflammasome-Mediated Cell Pyroptosis in Atherosclerosis
Authors: Guo Fengxia , Hu Bing , Sha Yanhua , Zhu Kangning , Li Gang
Published: December 2020

BackgroundIncreasing evidence suggests that transcription factor EB (TFEB) inhibits inflammation in endothelial cell (ECs) and reduces development of atherosclerosis. However, little is known about the mechanism of action of TFEB on inflammation in atherosclerosis (AS).MethodsThe levels of TFEB, NLRP3, VCAM-1, ICAM-1, E-selectin, MCP-1, cleaved caspase-1, IL-1β and IL-18 in ECs were examined by immunoblotting, quantitative real time-polymerase chain reaction (qRT-PCR) , Enzyme-linked immunosorbent assay. The LDH activity were examined by LDH assay. TUNEL-positive cell were examined by TUNEL assay. The relationship between TFEB and NLRP3 were examined by immunofluorescence and coimmunoprecipitation. The effects of TFEB on atherosclerotic lesions by hematoxylin and eosin, TUNEL and collagen staining in the aortic valve of ApoE-/- mice fed a high fat diet (HFD).ResultsHere, we report that H2O2-induced cell pyroptosis and inflammatory response were mainly due to nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome activation. The nuclear protein TFEB was significantly increased by H2O2, and knockdown of TFEB aggravated cell pyroptosis and inflammatory response. TFEB directly bound to NLRP3 and blocked NLRP3-mediated cell pyroptosis and inflammatory response. The effect of H2O2 on TFEB might be associated with AMP-activated protein kinase/mechanistic target of rapamycin-dependent signaling pathways.ConclusionsOur findings indicated that a novel TFEB–NLRP3 axis was a critical regulator in EC pyroptosis and inflammation, which could be potential therapeutic targets in AS and related cardiovascular diseases.
Defining Movement Instabilities in Yips Golfers Using Motion Capture and Muscle Synergies.
Authors: Revankar Gajanan , Ogasawara Issei , Hattori Noriaki , Kajiyama Yuta , Shimoda Shingo , Garcia Alvaro , Uno Yuki , Nakano Tomohito , Gon Yasufumi , Kawamura Sadahito , Nakata Ken , Mochizuki Hideki
Published: December 2020

‘Yips’ is an involuntary movement disorder seen in some professional golfers. The diagnostic challenge in yips is to distinguish symptoms of task-specific dystonia from psychological ‘choking’. We hypothesized that in mild-yips golfers, the yips-like shots demonstrate features that are distinguishable from normal-shots allowing for an objective classification. 15 professional golfers with subjective complaints of yips were assessed via motion-capture and surface electromyography during a ‘putting’ task. Normal-hits and yips-shots were identified by golfers’ subjective responses over the trials. Angular velocities of putter club and muscle synergies were analyzed during the swing phase using 1-dimension statistical parametric mapping. Participants had long golfing careers with considerable duration of yips symptoms. While task-based video evidence was inconsequential, in a subset of golfers, we found significant differences in angular velocities of the putter club and altered synergy neural coefficients during the downswing phase. Our findings showed that golfers with mild-yips require precise motion-capture to define movement instabilities which may not be evident with simple videography. Particularly the downswing is affected, and the ensuing perturbations in phasic muscle activity share dystonic features that are consistently identified as abnormal muscle synergy patterns. Dystonia in mild-yips therefore obligates sensitive multimodal assessment to differentiate from golfers with ‘choking’.
Gender Differences in the Perception of and Willingness to Participate in Organ Donation - Experiences of Immigrants From Bosnia and Herzegovina Living in Sweden
Authors: Krupic Ferid , Grbic Kemal , Westin Olof , Svantesson Eleonor , Senorski Eric Hamrin
Published: December 2020

BackgroundOrgan donation is a personal choice and many ethical, legal, medical, organisational and social factors are involved. It is possible to transplant some organs from live donors and others only from deceased donors. Nevertheless, the shortage of organs worldwide is a problem. Gender differences may cause decission and willingnes to organ donation. Methods A total of 60 informants (30 men and 30 women), born in Bosnia and Herzegovina and living in Sweden were available for follow-up. Data was collected by a questionnaire and statisticaly analysed according to the chi-square test, the D’Agostino-Pearson test for checking normality of continuous data distribution and, based on the distribution of results, Student’s t test or the Mann-Whitney test. Statistical significance was defined as p < 0.05.Results The result showed that significant differences between men and women was highest in the question about definition of transplantation (p<0.0001), information about organ donation (p<0.0001), knowledge about OD (p<0.0001), importance about OD (p<0.003), religious permitting to OD (p=0.0001), religious opposite to OD (p=0.0007), donate to a special person or not (p=0.0062), religion as factor to donate (p=0.0007). It was not better in question about having the donor card (p<0.0001). ConclusionsWomen were found to have more positive attitudes toward organ donation than men. Different socioeconomic factors, cultural beliefs, a higher level of religiousness, a higher level of information and knowledge about organ donation, as well as the ownership of donor cards, may result in a better perception of and willingness to participate organ donation. More knowledge of the religious understanding of organ donations and the reduction in prejudice among respondents would make the awareness and desire for organ donation even greater.
A Four-Immune Gene Prognostic Risk Model for Colorectal Adenocarcinoma Based on the TCGA and Immport Data Sets
Authors: Xu Boyang , Peng Ziqi , An Yue , Yao Xue , Sun Mingjun
Published: December 2020

BackgroundAs one of the hot spots in oncology field, immune research provides new ideas for the diagnosis and treatment of tumors. Different histological types of colorectal cancer are different. Adenocarcinoma, as the type with the highest proportion, has a high research value. This study aims to build an immune gene prognostic risk model for colorectal adenocarcinoma to improve the diagnosis and prognosis prediction of colorectal adenocarcinoma.MethodsThe differentially expressed immune genes could be obtained from the gene expression data downloaded from The Cancer Genome Atlas (TCGA) and the immune gene data downloaded from the ImmPort Database. Univariate COX and multivariate COX analyses were used to construct the immune gene prognostic risk model of and the clinical application potential of this model. The correlation between the model and the immune cells infiltration and the influence of each immune cell on the survival were analyzed.Results5975 differentially expressed genes were obtained, and 497 differentially expressed immune genes were selected by combining the information of immune genes. Among them, 36 immune genes were associated with prognosis, and 4 immune genes (THRB, IL1RL2, LGR6, LTB4R2) were included in the prognostic risk model of immune genes. Patients with higher Risk Score had shorter survival. Compared with gender, age and pathological stage, the model has better prediction potential. In addition, the model was correlated with Macrophages M0, Macrophages M1, T cells follicular helper and NK cells activated. Among them, T cells follicular helper and Macrophages M0 were related to the survival of patients.ConclusionWe developed a prognostic risk model containing four immune genes, THRB, IL1RL2, LGR6 and LTB4R2, which accurately described the prognosis of the patient, and affected the survival of patients by influencing the infiltration of Macrophages M0 and T cells follicular helper.
Food Waste: Behavioral Intent of INDIAN Consumer’s. Yield of Food Security
Authors: nayyar varun
Published: December 2020

This current research analyzed data on the pretext of food waste, being initiated intentionally or unintentionally by Indian consumers that included sample of consumers being segmented all the way through gender, household size, professional qualification, e-commerce benefit and age. Data was collected from 744 respondents (342 males & 402 females) through well drafted questionnaire and proportional odd regression model was used to rate the different phases of consumer food choices according to their usage and wastage. This model drafted relationship among the covariates (acquisition, storage & preparation) phases and their succeeding impact on food waste. At every phase, the influences of the previous phase on the current modeled phase was evaluated to caliber the impact of explanatory variables (socio-economic factors of consumers of developing nation India) on food waste by using proportional odd regression model analysis, which also tried to uncover the major drivers for food waste. It was evident from the findings that every phase with (categorized socio-economic variables) emphasized in revealing positive relationship of variables in lowering the frequency of food waste among consumers. On the contrary it has also been apparent that gender having e-commerce benefits seems to have elevated blend for food waste. For corporate these research outcomes can be outlined on specific food brands rather than on common food items to hasten their manufacturing and meeting the significant supply and demand of the market.
Time to Appropriate Antibiotic Therapy is an Independent Indicator of Poor Outcome in Children with Nosocomial Klebsiella Pneumoniae Bloodstream Infection
Authors: Cheng Jie , Li Qinyuan , Zhang Guangli , Xu Huiting , Li Yuanyuan , Tian Xiaoyin , Chen Dapeng , Luo Zhengxiu
Published: December 2020

Objectives: To evaluate the effects of time to appropriate therapy (TTAT) on outcomes in children with nosocomial K. pneumoniae bloodstream infection, and to find an optimal time window for empiric antibiotics administration. Methods: Children with nosocomial K. pneumoniae bloodstream infection hospitalized in Children’s Hospital of Chongqing Medical University from April 2014 to December 2019 were enrolled retrospectively. TTAT cutoff point and risk factors were determined and analyzed by Classification and Regression Tree (CART) analysis and Logistic Regression analysis. Results: Overall, sixty-seven patients were enrolled. The incidence of septic shock and mortality was 17.91% (12/67) and 13.43% (9/67), respectively. The CART-derived TTAT cutoff point was 10.7 hours. The multivariate logistic regression analysis indicated delayed therapy (TTAT ≥ 10.7 h), PRISM III scores ≥ 10, early TTP (TTP ≤ 13 h), and need for invasive mechanical ventilation were independent risk factors of septic shock (OR 9.87, 95% CI 1.46-66.59, P = 0.019; OR 9.69, 95% CI 1.15-81.39, P = 0.036; OR 8.28, 95% CI 1.37-50.10, P = 0.021; OR 6.52, 95% CI 1.08-39.51, P = 0.042; respectively) and in-hospital mortality (OR 22.19, 95% CI 1.25-393.94, P = 0.035; OR 40.06, 95% CI 2.32-691.35, P = 0.011; OR 22.60, 95% CI 1.78-287.27, P = 0.016; OR 12.21, 95% CI 1.06-140.67, P = 0.045; respectively). Conclusions: TTAT is an independent predictor of poor outcome in children with nosocomial K. pneumoniae bloodstream infection. Initial appropriate antibiotic therapy should begin within 10.7 hours from the onset of bloodstream infection.
Inhibition of KIF20A by Transcription Factor IRF6 Affects the Progression of Renal Clear Cell Carcinoma
Authors: Ma Xinwei , Wang Xiaoqi , Dong Qian , Pang Hongquan , Xu Jianming , Shen Junkang , Zhu Jianbing
Published: December 2020

Background: Renal clear cell carcinoma (ccRCC) is one of the most common malignant tumors, and its incidence is increasing year by year. IRF6 plays an important role in the occurrence of tumors, but the expression of IRF6 in ccRCC has not been reported so far.Methods: The expression of IRF6 and KIF20A in ccRCC was predicted by GEPIA and HAP database. In addition, the GEPIA database predicted the relationship between the expression of IRF6 and KIF20A and the pathological staging, overall survival, and disease-free survival of ccRCC. The possible binding sites of IRF6 and KIF20A promoters were predicted by JASPAR database and verified by luciferase and ChIP experiments. The specific effects of IRF6 on proliferation invasion and apoptosis of ccRCC were subsequently examined at the cellular level. The expression of IRF6 and KIF20A in ccRCC cell lines was detected by RT-qPCR and western blot. Cell transfection techniques were used to construct IRF6 and KIF20A overexpressed or interfering plasmids. CCK-8 and clone formation assays were used to detect cell activity. Apoptosis was detected by TUNEL assay. Wound healing and Transwell assays detected the ability of cell migration and invasion, respectively.Results: The database predicted that IRF6 expression was down-regulated in renal carcinoma tissues and correlated with poor prognosis. Cell experiments showed that overexpression of IRF6 inhibited proliferation, invasion and migration of ccRCC. In addition, the database predicted that KIF20A was up-regulated in renal carcinoma tissues and associated with prognosis, and cell experiments demonstrated that interference with KIF20A inhibited proliferation, invasion, and migration of ccRCC. Finally, we confirmed that KIF20A is a functional target of IRF6, and KIF20A partially reverses the effects of IRF6 on the proliferation, invasion and migration of ccRCC.Conclusion: Inhibition of KIF20A by transcription factor IRF6 affects the cell proliferation, invasion, migration of renal clear cell carcinoma.
Migraine patients in Germany - Need for Medical Recognition and New Preventive Treatments: Results from the PANORAMA Survey
Authors: Koch Mirja , Katsarava Zsazsa , Baufeld Caroline , Schuh Katrin , Gendolla Astrid , Straube Andreas , Pannwitz Wolfram von , Hofmann Werner E. , Ortler Sonja
Published: December 2020

Background: Migraine is a primary headache disorder characterized by recurrent attacks that may have a significant impact on patients’ daily life. Treatment options must often be re-evaluated in light of efficacy, tolerability and compliance issues. Few data on commonly applied treatment algorithms and treatment failures have existed in Germany in 2017/2018. The PANORAMA survey was designed to explore and characterize the migraine healthcare landscape and to demonstrate the medical treatment need at that time in Germany.Methods: Three different questionnaires were used to assess the profile of the 119 participating centers, characterize migraine patients at centers and evaluate qualitative aspects of the current migraine healthcare situation from a physician´s professional perspective. Data were analyzed as observed and summarized by descriptive statistics.Results: The results demonstrate that once referred to a migraine specialist, the majority of patients continue to be treated at a specialist. At specialized centers, 41.6% of migraine patients receive prophylactic treatment. 45.4% of prophylactic treatments are initiated with a beta-blocker and 28.1% with an anti-epileptic. Pivotal factors to initiate prophylactic treatment are migraine attack frequency and intensity (58.0%). Treatment decisions are largely based on prior / concomitant diseases and physical constitution of the patient (52.1%). Following an inadequate treatment, most patients either switch substance class or discontinue prophylactic treatment. Conclusions: PANORAMA gives a comprehensive overview of the migraine healthcare landscape in Germany in 2017/2018, elucidates a lack of common treatment algorithms and reveals a high demand for defined therapy strategies and new prophylactic treatment going forwards.
Changes in Gut Viral and Bacterial Species Correlate with Altered 1,2-Diacylglyceride Levels and Structure in the Prefrontal Cortex in a Non-Human Primate Model of Depression.
Authors: Wu Jing , Chai Tingjia , Zhang Hanping , Huang Yu , Perry Seth W , Li Yifan , Duan Jiajia , Tan Xunmin , Hu Xi , Liu Yiyun , Pu Juncai , Wang Haiyang , Jin Xin , Song Jinlin , Ji Ping , Zheng Peng , Xie Peng
Published: December 2020

Background: Major depressive disorder (MDD) is a debilitating mental disease, but its underlying molecular mechanisms remain obscure. Gut microbiome can modulate brain function and behaviors through the microbiota-gut–brain (MGB) axis in depression. Our previously established non-human primate model of naturally occurring depression-like behaviors, which is characterized by MGB axis disturbances, can be used to interrogate how a disturbed gut ecosystem may modulate the MDD onset. To better clarify the molecular interrelationships and downstream functional consequences in the MGB axis on MDD pathology, here, gut metagenomics were used to characterize how gut virus and bacterial species, and associated metabolites, change in depressive monkey model.Results: We identified a panel of 33 gut virus and 14 bacterial species that could discriminate the depression-like (DL) from control M. fascicularis. In addition, using lipidomic analyses of central and peripheral samples obtained from these animals, we found that the DL macaque were characterized by alterations in the relative abundance, carbon-chain length, and unsaturation degree of 1,2-diacylglyceride (DG) in the prefrontal cortex (PFC), in a brain region-specific manner. In addition, lipid-reaction analysis identified more active and inactive lipid pathways in PFC than in amygdala or hippocampus, with DG being a key nodal player in these lipid pathways. Significantly, co-occurrence network analysis showed that altered gut viral and bacterial species, and their interaction may be relevant to the onset of negative emotions behaviors by modulating the DG levels in PFC in the depressive macaque. Conclusions: Our findings suggest that altered gut virus and bacteria as well as DG levels and structure in the PFC are hallmarks of the DL macaque, thus providing a new framework for understanding the gut microbiome's role in depression.
Challenges in Providing Surgical Procedures During the COVID-19 Pandemic: Qualitative Study Among Operating Department Practitioners in Pakistan
Authors: Jafree Sara Rizvi , Momina Ain ul , Malik Nudra , Naqi Syed Ashgar , Fischer Florian
Published: December 2020

Background: Operating Department Practitioners (ODPs) are neglected human resources for health with regard to both professional development and research for patient safety. The surgical theatre is associated with the highest mortality rates and with the onslaught of the COVID-19 pandemic. ODPs are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics.Methods: A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes.Results: Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. Conclusions: The public health sector, in Pakistan and other developing regions, need to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.
N2O Fluxes and Related Processes of Denitrification in Acidified Soil
Authors: Zheng Qian , Ding Junjun , Li Qiaozhen , Xu Chunying , Lin Wei , Zhuang Shan , Kou Xinyue , Li Yuzhong
Published: December 2020

In North China, high levels of N fertilizer and irrigation water are used in fields, which cause considerable N2O fluxes via several pathways, especially anaerobic denitrification. Anaerobic denitrification is regarded as an important microbial process for N2O production in soils with a low O2 level and high N and labile C availability (the typical soil conditions caused by high levels of N fertilizer and irrigation water in the field). We conducted an anaerobic incubation experiment to determine the impact of soil acidification (with a series of soil pH levels, pH 6.2, pH 7.1, and pH 8.7) on N2O source partitioning with the addition of KNO3 and glucose. Natural abundance isotope techniques and gas inhibitor technique were applied to analyze the N2O flux derived from fungal denitrification and bacterial denitrification and its isotopocule characteristics emitted from soils after the addition of NO- 3 and glucose. A mapping approach was used to obtain further insight into the N2O production processes. Our findings confirmed that soil pH strongly controlled the N2O production and reduction rates of denitrification. Soil acidification significantly increased N2O emissions varied from 0.76 mg N kg-1 for natural soil (pH 8.7), to 1.88 mg N kg-1 for pH 7.1, and to 2.35 mg N kg-1 for pH 6.2, and had a blockage effect on the reduction of N2O to N2. The addition of carbon sources promoted complete denitrification. We assumed a higher contribution of fungal denitrification to N2O production compared to total N2O emission associated with acidified soil. A promotion of the contribution of fungal denitrification-derived N2O was indeed observed with decreasing pH, increasing from 0.28 mg N kg-1 for pH 8.7 to 0.94 mg N kg-1 for pH 6.2. The addition of glucose further increased the contribution of fungal denitrification to N2O production from 0.99 mg N kg-1 for pH 8.7 to 3.66 mg N kg-1 for pH 6.2. The mapping approach provided rational results for correcting N2O reduction compared with the acetylene inhibition method. The results calculated by both methods indicated a reasonably large contribution of fungal denitrification to total N2O production in acidified soils.
Rare, Fatal Pulmonary Fat Embolism after Acupuncture Therapy: A Case Report and Literature Review
Authors: Xu Luyao , Tan Xiaohui , Chen Xuebing , Du Sihao , Yue Xia , Qiao Dongfang
Published: December 2020

Background: In the clinic, death from nontraumatic pulmonary fat embolism associated with minor soft tissue contusion, surgery, cancer chemotherapy, hematologic disorders and so on has been reported. Patients often present with atypical manifestations and rapid deterioration, making diagnosis and treatment difficult. However, there are no reported cases of death from pulmonary fat embolism after acupuncture therapy. This case aims to emphasize that awareness of nontraumatic pulmonary fat embolism as a complication of acupuncture therapy needs to be improved. In addition, it suggests that in such cases, autopsy should be used to identify the source of fat emboli. Case presentation: The patient, a 72-year-old woman, experienced symptoms of dizziness and fatigue after silver-needle acupuncture therapy. She experienced a significant drop in blood pressure and died 2 hours later despite treatment and resuscitation. A systematic autopsy and histopathology examination (H&E and Sudan Ⅲ staining) were performed. More than 30 pinholes were observed on the surface of the lower back. Focal hemorrhages were seen surrounding the pinholes in the subcutaneous fatty tissue. Microscopically, numerous fat emboli were observed in the interstitial pulmonary artery and a large number of alveolar wall capillaries, in addition to the vessels of the heart, liver, spleen and thyroid gland. The lungs showed congestion and edema. However, the cause of death was identified as pulmonary fat embolism. Conclusion: This article suggests that high vigilance for risk factors and the complication of pulmonary fat embolism following silver-needle acupuncture therapy should be exercised. In postmortem examinations, examining the peripheral arterial system and the venous system draining from noninjured sites for the formation of fat emboli is helpful to differentiate posttraumatic and nontraumatic pulmonary fat embolism.
Association Between Obesity and Blood Pressure in Common Korean People
Authors: Kang Nam Lyong
Published: December 2020

Background The aim of this study was to the investigate association of high blood pressure (BP) and wide pulse pressure (PP) with obesity among common Korean people. Method This study analyzed data from the Seventh Korean National Health and Nutrition Examination Survey (2017). The associations of BP with body mass index (BMI) and waist-to-height ratio (WHT2R) were investigated using their lump mean values.Results The BPs of males and females increased with BMI, the PP of females increased with BMI and then decreased, and the PP of males is nearly independent of BMI. The BPs of males and females increased to their maximum values with WHT2R and then decreased. The PPs of males and females increased with WHT2R.Conclusions BMI can be used as a useful predictor for high BP, and WHT2R can be used as a useful predictor for wide PP.
The Protection Effect of Ulinastatin on Freshwater Instillation-Induced Acute Lung Injury in Rabbits
Authors: Xi Shaosong , Huan Le , Wu Hongyan , Zhu Ying , Hu Wei , Lin Zhaofen , Diao Mengyuan
Published: January 2021

Background: Drowning is an important cause of accidental death in humans. The main cause of death following drowning is pulmonary oedema or lung injury, eventually leading to acute respiratory distress syndrome. The present study aimed to determine the protective effects of Ulinastatin on freshwater-induced acute drowning lung injury. Methods: Rabbits were randomly divided into a control, freshwater, freshwater + small-dose Ulinastatin, freshwater + medium-dose Ulinastatin, freshwater + large-dose Ulinastatin group. The arterial blood gas analysis was performed before modelling (baseline) and at various time points after freshwater instillation. And then, the wet-to-dry weight ratio lung permeability index were measured to detect the effect of Ulinastatin on lung endothelial permeability. Furthermore, histopathological staining and ELISAs were used to analyse the histological changes and inflammatory cytokines expression resulted from lung injury, respectively. Western blotting and Quantitative real-time polymerase chain reaction were used to measure the protein and mRNA levels of Hypoxia inducible factor-lα (HIF-1α)/ Vascular endothelial growth factor (VEGF) in the lung tissues. Results: By inhibiting the HIF-1α/VEGF pathway, treatment with Ulinastatin at a large dose could markedly attenuate changes in the PaO2/FiO2 (P/F), lung endothelial permeability, histopathology, and the expression of inflammatory cytokines induced by freshwater instillation. Conclusion: Ulinastatin is a potential candidate treatment for freshwater drowning-induced acute lung injury that targets the HIF-1α/VEGF pathway.
Recombinant Adiponectin Peptide Ameliorates Cortical Neuron Damage Induced by Chronic Cerebral Hypoperfusion by Inhibiting NF-κB Signaling and Regulating Microglial Polarization
Authors: Huang li'an , Li Wenxian , Wei Di , Zhu Zheng , Zhan Shuqin , Zhang Ru , Wang Huqing , Zhang Guilian
Published: January 2021

Background Chronic cerebral hypoperfusion (CCH) is common in multiple central nervous system diseases that are associated with neuronal death and cognitive impairment. Microglial activation-mediated polarization changes may be involved in CCH-induced neuronal damage. Adiponectin (APN) is a fat-derived plasma protein that affects neuroprotection. This study investigated whether a recombinant APN peptide (APN-P) improved the cognitive function of CCH rats by regulating microglial polarization in the cortex. Methods A CCH rat model was established through bilateral common carotid artery occlusion (BCCAO) surgery. An antibody microarray was used to analyze differentially expressed proteins in the cerebral cortex of CCH rats compared to the sham rats. APN-P and a solvent control were used to intervene at different time points. Western blotting and immunofluorescence staining were conducted to examine the status of microglial polarization in different treatment groups. qRT-PCR was used to detect the expression levels of inflammatory and anti-inflammatory genes. Neuronal morphology was assessed via Nissl staining, and cognitive function was assessed with the Morris water maze test. In vitro , by inhibiting the expression of NF-κB in BV2 microglia and using Transwell co-culture systems of BV2 microglia and neurons, the effects of APN-P on neuroprotection and the underlying mechanism were investigated. Results In the cortical microglia of 12-week-old CCH rats, the expression of APN protein was significantly downregulated compared to the sham rats. CCH damages neurons and activates cortical microglial polarization to an M1-type by upregulating inflammatory factors. APN-P supplementation upregulated APN expression in cortical microglia, with neuronal survival as well as microglial polarization from an M1 toward an M2 phenotype in CCH cortex. In vivo and in vitro experiments revealed that APN-P promoted the expression of anti-inflammatory factors and neuronal survival by inhibiting NF-κB signaling, thus improving the cognitive function in CCH rats. Conclusions Our study revealed a novel mechanism by which APN-P suppresses the NF-κB pathway and promotes microglial polarization from M1 toward the M2-type to reduce neuron damage in the cortex after CCH.
Evaluation of an Alternative Learning System for Youths at Risk of Involvement in Urban Violence in Bagong Silang, Manila, Philippines - Outcome Analysis, Cost-Analysis, and Economic Evaluation.
Authors: Mehra Nishant , Wang Shr-Jie , Reyes Juancho , Ambjornsen Mette Mohl , Jarl Johan
Published: December 2020

Background: Globally, violence disproportionately affects young people, leading to injury, hospitalisation, death, social dysfunction, and poor mental wellbeing. Moreover, it has far-reaching economic consequences for whole nations, due to loss of productivity. Research suggests that attaining a higher level of education promotes factors which insulate youths from poverty and violence. Purpose: In this study we investigated the outcomes, the cost, and the efficiency of a non-formal education program with an additional psychosocial component. The short-term outcome measure was an increase in educational attainment, a crucial step for youth empowerment. The program analysed was the Alternative Learning System (ALS) offered by the Balay Rehabiliation Centre in Bagong Silang, an urban slum in Manila, which targeted out of school youth. Methods: The cost-effectiveness analysis of ALS compared to a ‘do nothing approach’ was performed from the perspective of the service provider. The study sample comprised 239 learners who were enrolled in the ALS during 2015-2018. For the comparator ‘do nothing approach’, a counterfactual scenario was hypothesised. The average cost of the intervention per enrolled learner, and the incremental cost effectiveness ratio (ICER) for passing the Accreditation and Evaluation (A&E) exam at elementary or secondary level, were calculated. Results: The ALS intervention studied resulted in 41%(n=97) of the learners passing the examination over a period of four years (from 2015 – 2018). The estimated total cost of the intervention was $371,110, corresponding to $1,550 per enrolled learner. The incremental cost-effectiveness ratio for a pass in the exam was found to be $3,830. Compared to other alternative learning interventions, the ALS intervention as used in Bagong Silang was found to be more cost-effective.Conclusion: From the service provider perspective, the ALS for out-of-school young people was found to be a valuable investment to benefit poor young people living in slums in Manila.
An Integrated Cost Model Based on Real Patient Flow: Exploring Surgical Hospitalization in a Teaching Hospital
Authors: Vieira Bruno Barbosa , Reis Augusto Cunha , Loures Alan de Paiva , Plácido Eliel Carlos , Sousa Fernanda Ferreira de
Published: December 2020

Background: Several studies have been carried out with the objective of identifying health costs and developing methods to improve this research, thus contributing to better decision making based on more reliable evidence. However, there are some gaps to be filled to provide such information. This research aims to fill one of these gaps, proposing a cost calculation model for surgical hospitalizations based on real patient flow to determine hospital institutions' costs.Methods: An empirical-theoretical study was developed. The empirical approach adopted the three-step modeling process to propose a cost model based on patient flow, considering CHEERS guidelines. For the theoretical approach, a systematic literature review using PRISMA recommendation was applied.Results: The modeling process made it possible to identify the real flow of the surgical patient. This step made it possible to identify cost sources and comprehend that costs incurred by patient occur from admission (preoperative stage) to discharge (postoperative stage). The literature review showed that most studies only address the surgical stage, neglecting the costs of the two stages mentioned. The cost model was developed with a top-down approach allowing a balance between the accuracy of the information and the feasibility of the cost estimate. The proposed model fills two gaps in the literature, the standardization of a cost model and the ability to assess a vast number of different surgery costs in the same hospital.Conclusions: Flexibility stands out as an important advantage of the proposed model, as its application is possible to encompass elective and urgent surgeries of medium and high complexity performed in public and private hospitals. As a limitation, the hospital should have a HIS and cost system implemented. The proposed cost model can provide important information that can induce better decision making. This becomes more relevant in the health sector, especially public health, which faces the lack of resources and whose positive effects can improve health care.
Genome-Wide Identification of the DUF668 Gene Family in Cotton and Expression Profiling Analysis of GhDUF668 in Gossypium Hirsutum Under Adverse Stress
Authors: Zhao Jieyin , Wang Peng , Gao Wenju , Long Yilei , Wang Yuxiang , Geng Shiwei , Su Xuening , Jiao Yang , Chen Quanjia , Qu Yanying
Published: January 2021

Background: Domain of unknown function 668 (DUF668) may play a crucial role in the plant growth and developmental response to adverse stress. However, our knowledge of the function of the DUF668 gene family is limited.Results: Our study was conducted based on the DUF668 gene family identified from cotton genome sequencing. Phylogenetic analysis showed that the DUF668 family genes can be classified into four subgroups in cotton. We identified 32 DUF668 genes, which are distributed on 17 chromosomes and are mostly located in the nucleus of Gossypium hirsutum. Gene structure and motif analyses revealed that the members of the DUF668 gene family can be clustered in G. hirsutum into two broad groups, which are relatively evolutionarily conserved. Transcriptome data analysis showed that the GhDUF668 genes are differentially expressed in different tissues under various stresses (cold, heat, drought, salt, and Verticillium dahliae), and expression is generally increased in roots and stems. Promoter and expression analyses indicated that Gh_DUF668-05, Gh_DUF668-08, Gh_DUF668-11, Gh_DUF668-23 and Gh_DUF668-28 in G. hirsutum might have evolved resistance to adverse stress. Additionally, qRT-PCR revealed that these 5 genes in four cotton lines, KK1543 (drought resistant), Xinluzao 26 (drought sensitive), Zhongzhimian 2 (disease resistant) and Simian 3 (susceptible), under drought and Verticillium wilt stress were all significantly induced. Roots had the highest expression of these 5 genes before and after the treatment. Among them, the expression levels of Gh_DUF668-08 and Gh_DUF668-23 increased sharply at 6 h and reached a maximum at 12 h under biotic and abiotic stress, which showed that they might be involved in the process of adverse stress resistance in cotton.Conclusion: The significant changes in GhDUF668 expression in the roots after adverse stress indicate that GhDUF668 is likely to increase plant resistance to stress. This study provides an important theoretical basis for further research on the function of the DUF668 gene family and the molecular mechanism of adverse stress resistance in cotton.