bluuebunny/crossref_metadata_2025 huggingface dataset:
Angiotensin II Type 1 Receptor Antagonist Losartan Inhibits TNF-α Induced Inflammation and Degeneration Processes in Human Nucleus Pulposus Cells
Authors: Saravi Babak , Li Zhen , Pfannkuche Judith , Wystrach Laura , E. Albers Christoph , Grad Sibylle , Alini Mauro , Richards R. Geoff , Lang Corinna , Südkamp Norbert , Schmal Hagen , Lang Gernot
Published: November 2020

Our recent study detected the expression of a tissue Renin-Angiotensin System (tRAS) in human intervertebral discs (IVDs). The present study sought to investigate the impact of angiotensin II receptor type 1 (AGTR1) antagonist losartan on human nucleus pulposus (NP) cell inflammation and degeneration induced by tumor necrosis factor-α (TNF-α). Human NP cells (4 donors, Pfirrmann grade 2-3, 30-37 years old, male) were isolated and expanded. TNF-α (10 ng/mL) was used to induce inflammation and degeneration. We examined the impact of losartan supplementation and measured gene expression of tRAS, anabolic, catabolic, and inflammatory markers in NP cells after 24 h and 72 h of exposure, respectively. T0070907, a PPAR-gamma antagonist, was applied to examine the regulatory pathway of losartan. Losartan (1 mM) significantly impaired TNF-α induced increase of pro-inflammatory (nitric oxide and TNF-α), catabolic (matrix metalloproteinases), and tRAS (AGTR1a and Angiotensin Converting Enzyme) markers. Further, losartan maintained the NP cell phenotype by upregulating aggrecan and downregulating collagen type I expression. In summary, losartan showed anti-inflammatory, anti-catabolic, and positive phenotype modulating effects on human NP cells. These results indicate that tRAS signaling plays an important role in IVD degeneration, and tRAS modulation with losartan could represent a novel therapeutic approach.
Power Split Supercharging: A Mild Hybrid Approach to Boost Fuel Economy
Authors: Nazari Shima , Siegel Jason , Middleton Robert , Stefanopoulou Anna
Published: November 2020

This work studies a novel low voltage (<60 V) hybrid system that supports engine boosting and downsizing in addition to start-stop, regenerative braking, and constrained torque assist/regeneration. The hybrid power split supercharger (PSS) shares a 9 kW motor between supercharging the engine or providing hybrid functionalities through a planetary gear set, a brake and a bypass valve. The PSS operation is limited to only one of the parallel hybrid or boosting modes at a time, necessitating a highly optimized decision making algorithm to select the device mode and power split ratio. In this work an adaptive equivalent consumption minimization strategy (A-ECMS) is developed for energy management of the PSS. The A-ECMS effectiveness is compared against a dynamic programming (DP) solution with full drive cycle preview through hardware-in-the-loop experiments on an engine dynamometer testbed. The experiments show that the PSS with A-ECMS reduces a vehicle fuel consumption by 18.4% over standard FTP75 cycle compared to a baseline turbocharged engine, while global optimal DP solution decreases the fuel consumption by 22.8% compared to baseline.
Mitigating the Poverty Trap by Reinventing Donation as an Investment Plan in the Educational Needs of Underprivileged Children
Authors: Srivastava Shobhit
Published: November 2020

Underpinned by the research works on private returns on education in developing nations that have found a positive correlation between earning and subsequent level of schooling, this paper presents a concept of an investment policy which will help the impoverished children in becoming economically successful through systematic funding of their educational needs with an obligation of interest adjusted returns.
Patients with IVF complicated by moderate-to-critical OHSS experience increased thrombosis,GDM and neonatal NICU admission but slightly shorter gestation compared with matched IVF counterparts: A retrospective Chinese cohort study
Authors: Hu Linli , Xie Rui , Wang Mengying , Sun Yingpu
Published: November 2020

Background: Ovarian hyperstimulation syndrome (OHSS) is a common disease during controlled ovarian hyperstimulation treatment. However, the obstetric and neonatal outcomes of this group of patients are unknown. The aim of this study was to explore the effects of late moderate-to-critical OHSS on obstetric and neonatal outcomes.Methods: This prospective observational study included 17,537 patients who underwent IVF/ICSI-fresh embryo transfer (ET) between June 2012 and July 2016 and met the inclusion criteria, including 7,064 eligible patients diagnosed with clinical pregnancy. Ultimately, 6,356 patients were allocated to the control group, and 385 patients who were hospitalized and treated at the center for late moderate-to-critical OHSS were allocated to the OHSS group. Then, propensity score matching analysis was performed, matching nine maternal baseline covariates and the number of multiple gestations; 385 patients with late moderate-to-critical OHSS were compared with a matched control group of 1,540 patients. The primary outcomes were the live birth rate, preterm delivery rate, miscarriage rate, gestational age at birth (weeks), obstetric complications and neonatal complications.Results: The duration of gestation in the matched control group was significantly higher than that in the OHSS group. The live birth delivery rate did not significantly differ between the OHSS and matched control groups. The incidence rates of the obstetric complications venous thrombosis (VT) and gestational diabetes mellitus (GDM), neonatal complications and the number of neonates admitted to the NICU were significantly higher in the OHSS group than in the matched control group.Conclusions: Pregnant women undergoing IVF with fresh ET whose course is complicated by late moderate-to-critical OHSS appear to experience shortened gestation and increased obstetrical and neonatal complications compared with matched controls whose course is not complicated by OHSS. However, the live birth rate, average neonatal weight, and incidence rates of premature delivery, miscarriage, early abortion, hypertensive disorder of pregnancy (HDP), placenta previa (PP), intrahepatic cholestasis of pregnancy (ICP), and low neonatal birth weight (LBW) did not differ significantly between the two groups.
Novel thermoresponsive polymer outperforming Pluronic® F127
Authors: Constantinou Anna , Nele Valeria , Doutch James , Moiseev Roman , Khutoryanskiy Vitaliy , Stevens Molly , Georgiou Theoni
Published: November 2020

Thermoresponsive polymers featuring the appropriate combination of structural characteristics, i.e. architecture, composition, and molar mass (MM), can form physically crosslinked networks in a solvent upon changes in temperature. This fascinating class of polymers finds utility in various sectors such as formulation science and tissue engineering. Here, we report a novel thermoresponsive triblock terpolymer which out-performs the most commonly used and commercially available thermoresponsive polymer, Poloxamer P407 (also known as Pluronic® F127) in terms of gelation concentration. Specifically, the in-house synthesised polymer forms gels at lower concentrations that is an advantage in biomedical applications. To elucidate the differences in their macroscale gelling behaviour, we investigate their micellization via differential scanning calorimetry, and their nanoscale self-assembly behaviour in detail by means of small-angle neutron scattering by simultaneously recording their rheological properties (Rheo-SANS). Two different gelation mechanisms for the two polymers are revealed and proposed. Ex vivo gelation study upon intracameral injections demonstrated excellent potential for its application to improve drug residence in the eye.
A Meta-Analysis of the Epidemiology of Giant Cell Arteritis Across Time and Space
Authors: Li Katherine , Semenov Daniel , Turk Matthew , Pope Janet
Published: November 2020

Introduction: Giant cell arteritis (GCA) is the most common large vessel vasculitis in those over age 50 years. This meta-analysis examined the geographical and temporal distribution of the incidence, prevalence and mortality of GCA.Methods: A systematic review was conducted using EMBASE, Scopus and PubMed from their inceptions until 2019. Studies were included if they reported at least 50 or more GCA patients and defined the location and time frame. Articles on mortality were included and standardized mortality ratio (SMR) was extracted where possible. Mean pooled prevalence, incidence, and SMR were calculated using a random effects model. Linear regression was used to explore correlations between latitude and incidence, prevalence, and mortality.Results: Of the 3569 citations identified, 107 were included. The pooled incidence of GCA was 10.00 [9.22, 10.78] cases per 100,000 people over 50 years old. This incidence was highest in Scandinavia 21.57 [18.90, 24.23], followed by North and South America 10.89 [8.78, 13.00], Europe 7.26 [6.05, 8.47], and Oceania 7.85 [-1.48, 17.19]. Pooled prevalence was 51.74 [42.04, 61.43] cases per 100,000 people over age 50. Annual mortality was 20.44 [17.84, 23.03] deaths/1000. Mortality generally decreased over the years of publication (p=0.0008). Latitude correlated significantly with incidence (p=0.0011), but not with prevalence, or mortality.Conclusions: GCA incidence varies nearly 3-fold between regions and is highest in Scandinavia but not significantly. Mortality may be improving over time.
Tripartite Motif-Containing 3 (TRIM3) Enhances ER Signaling and Confers Tamoxifen Resistance in Breast Cancer
Authors: Ye Run-yi , Kuang Xia-ying , Zeng Hui-juan , Shao Nan , lin ying , liu pian , wang shenming
Published: November 2020

Background: Tamoxifen resistance remains a tricky clinical problem in estrogen receptor (ER)-positive breast cancer. SUMOylation of ERα enhances ERα-induced transcription activity. TRIM proteins are a new class of SUMO E3 ligases, regulating SUMOylation of proteins. However, the precise molecular mechanism and function of TRIM3 in SUMOylation and response to tamoxifen remains unclear.Methods: The expression of TRIM3 was assessed in 48 cases with breast cancer which received tamoxifen therapy. The protein and RNA levels of TRIM3 in 12 ER+ breast cancer cell lines were assessed by Western blotting and qRT-PCR assays. Effects of TRIM3 in regulating tamoxifen resistance were evaluated both in vitro and in vivo via Cell viability, Colony formation, Anchorage-independent growth ability assays and Tumor xenografts. Molecular mechanism of TRIM3 in regulating SUMOylation of ERα was analyzed by Western blotting, Immunoprecipitation, Far Western blotting and Luciferase activity assays.Results: We reported that TRIM3 was dramatically overexpressed in breast cancer, which correlated with tamoxifen resistance., Furthermore,TRIM3 overexpression significantly correlated with poor survival of ER+ breast cancer treated with tamoxifen. TRIM3 overexpression conferred cell survival and tumorigenesis, whereas knocking downTRIM3 reduced these capabilities. Moreover, TRIM3, as a UBC9 binding protein, promoted SUMO modification of ESR1 and activated ER pathway. Silencing UBC9 abolished the function of TRIM3 in regulating tamoxifen resistance.Conclusions: These results suggest a novel biomarker for breast cancer therapy, indicating that inhibiting TRIM3 combined with tamoxifen may provide a potential treatment for breast cancer.
WITHDRAWN: Synthesis and Characterization of SrHfO3 Co-doped with Gd2O3 and Yb2O3 (SHGY)
Authors: Kandi Hemalatha , Koona Prof.Ramji , Raju G.M.J
Published: November 2020

A new material SHGY is obtained after synthesizing SrHfO3 co-doped with rare earth oxides (5 mol%Gd2O3 and 5 mol% Yb2O3). This process is carried out by a mechanical solid-state synthesis method. The synthesized powder is annealed at 1450ºC keeping rate of increase of 3ºC/min for 2hours. The phase and structural information of synthesized powder is characterized by X-Ray Diffraction (XRD) technique. The powder sample is sintered by Spark Plasma Sintering (SPS) at 1700ºC for 15 minutes to form into a pellet. The microstructure analysis is done by using Field Emission Scanning Electron Microscopy (FESEM) followed by composition analysis by Energy Dispersive Spectroscopy (EDS). The phase purity is examined by Thermal Gravimetric Analysis and Differential Thermal Analysis (TG-DTA) and studies conclude that weight loss is < 3% and there are no changes in phase transformation. Finally, Thermal Expansion Coefficient (CTE) is studied by a Dilatometer. Results stated there is an increase in the CTE in the range of 8.82-13.0 × 10− 6K− 1 calculated temperature range 100–1000ºC. This result of CTE showed there is a 19.2% (10.5 × 10− 6K− 1(200–1100ºC)) increase compared to the YSZ. This aids in the reduction of thermal mismatches between the substrate and topcoat in Thermal barrier applications (TBC).
Metagenomics Analysis Reveals An Extraordinary Bacterial Diversity in Anisakids (Nematoda: Anisakidae) L3 Larvae
Authors: Arcos Susana C. , Lira Felipe , Robertson Lee , González María Rosa , Carballeda-Sangiao Noelia , Sanchez-Alonso Isabel , Zamorano Laura , Careche Mercedes , Jiménez-Ruíz Yolanda , Ramos Ricardo , Llorens Carlos , González-Muñoz Miguel , Oliver Antonio , Martínez José Luis , Navas Alfonso
Published: November 2020

Background: L3 larvae of anisakid nematodes are an important problem for the fisheries industry and pose a potential risk for human health by acting as agents causing allergies and as potential vectors of pathogens microrganisms. In spite of the close bacteria-nematode relationship very little is known of the Anisakids microbiote. Fresh fish could be contaminated by bacteria vectored in the cuticle or in the intestine of Anisakids when the L3 larvae migrate through the muscles. As a consequence the bacterial inoculum will be spread, affecting the quality of the fish, and possible clinical effects cannot be discardedResults: A total of 2,689,113 16S rRNA gene sequences from a total of 113 L3 individuals obtained from fish captured along the FAO 27 area were studied. Bacteria were taxonomically characterized through 1803 representative OTUsequences. Fourteen Phyla, 31 Classes, 52 Orders, 129 Families and 187 genera were unambiguously identified. We have found as part of microbiome an average of 123 OTUs per L3 individual. Diversity Indices (Shannon and Simpson indices) indicate an extraordinary diversity of bacteria at a OTU level. There are clusters of Anisakids individuals (samples) defined by the associated bacteria which however are not significantly related with fish hosts or anisakid taxa. This suggests that association or relationship among bacteria in Anisakids, exists without the influence of fishes or nematodes. The lack of relationships with hosts of Anisakids taxa has to be necessarily expresssed by the association among bacterial OTUs or other taxonomical levels which are ranging from OTUs to phylum level. Conclusions: There are significant biological structural associations of microbiota in anisakid nematodes which manifest in clusters of bacteria ranging from plyllum to genus level which could also be anindicator of degree of fish contamination or from the geographic zone of fish capture. Actinobacteria, Aquificae, Firmicutes, and Proteobacteria are the phyla whose abundance value discriminate for difining such structures.
Overlap Time is An Independent Risk Factor of Radiation Pneumonitis for Patients Treated With Simultaneous EGFR-TKI and Thoracic Radiotherapy
Authors: Jia Wenxiao , Gao Qianqian , Wang Min , Li Ji , Jing Wang , Yu Jinming , Zhu Hui
Published: November 2020

Background: The exact rate and relevant risk factors of radiation pneumonitis (RP) for non-small-cell cancer (NSCLC) patients treated with the combination of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) and thoracic radiotherapy have not been reported. Thus, this study aimed to investigate the rate and risk factors of RP for EGFR-positive NSCLC patients simultaneously treated with first-generation EGFR-TKI and TRT.Patients and Methods: We retrospectively evaluated NSCLC patients simultaneously treated with first-generation EGFR-TKI and thoracic radiotherapy between January 2012 and December 2019 at Shandong Cancer Hospital and Institute, Shandong, China. RP was diagnosed via computed tomography and was classified according to the Common Terminology Criteria for Adverse Events v5.0. The risk factors of RP were identified using uni- and multivariate analyses.Results: Of the 67 patients included, 44.78% (30/67) developed grade ≥2 RP. Grade ≥2 RP occurred within a median of 3.48 (range, 1.07-13.6) months. The EGFR-TKI icotinib, ipsilateral lung V30 >34%, and overlap time of >20 days between EGFR-TKI and thoracic radiotherapy were identified to be independent predictive factors of grade ≥2 RP.Conclusions: Grade ≥2 RP is highly frequent in NSCLC patients simultaneous treated with first-generation EGFR-TKI and thoracic radiotherapy. Icotinib, ipsilateral lung V30 <34%, and shorter overlap time of <20 days for EGFR-TKI and thoracic radiotherapy will help lower the risk of RP in these patients. The addition of thoracic radiotherapy should be cautious, and the treatment strategies can be optimized to reduce the rate of RP for patients treat with simultaneous EGFR-TKI and thoracic radiotherapy.
Origin, Behaviour, and Genetics of Reproductive Workers in an Invasive Ant
Authors: Lenancker Pauline , Feldhaar Heike , Holzinger Anja , Greenfield Melinda , Strain Angela , Yeeles Peter , Hoffmann Benjamin D , Tay Wee Tek , Lach Lori
Published: November 2020

Background: Worker reproduction has an important influence on the social cohesion and efficiency of social insect colonies, but its role in the success of invasive ants has been neglected. We used observations of 233 captive colonies, laboratory experiments, and genetic analyses to investigate the conditions for worker reproduction in the invasive Anoplolepis gracilipes (yellow crazy ant) and its potential cost on interspecific defence. We determined how common worker production of males is and whether it is triggered by queen absence; whether physogastric workers with enlarged abdomens are more likely to be reproductive, how normal workers and physogastric workers compare in their contributions to colony labour and defence; and whether worker-produced males and males that could have been queen- or worker-produced differ in their size and heterozygosity. Results: Sixty-six of our 233 captive colonies produced males, and in 25 of these, some males could only have been produced by workers. Colonies with more workers were more likely to produce males, especially for queenless colonies. The average number of days between the first appearance of eggs and adult males in our colonies was 54.1± 10.2 (mean ± SD, n=20). In our laboratory experiment, queen removal triggered an increase in the proportion of physogastric workers. Physogastric workers were more likely to have yolky oocytes (37-54.9%) than normal workers (2-25.6%), which is an indicator of fertile or trophic egg production. Physogastric workers were less aggressive during interspecific aggression tests and foraged less than normal workers. The head width and wing length of worker-produced males were on average 4.0% and 4.3% greater respectively than those of males of undetermined source. Our microsatellite DNA analyses indicate that 4.9% of worker-produced males and 21.1% of males of undetermined source were heterozygous, which suggests the presence of diploid males and/or genetic mosaics in A. gracilipes. Conclusions: Our experimental work provides crucial information on worker reproduction in A. gracilipes and its potential cost to colony defence. The ability of A. gracilipes workers to produce males in the absence of queens may also contribute to its success as an invasive species if intranidal mating can take place between virgin queens and worker-produced males.
Quantitative proteomics analysis of Mycoplasma pneumoniae identifies potential macrolide resistance determinants
Authors: li shaoli , xue guanhua , zhao hanqing , feng yanling , yan chao , cui jinghua , xie xianghui , yuan jing
Published: November 2020

Mycoplasma pneumoniae is one of the leading causes of community-acquired pneumonia in children and adolescents. Because of the wide application of macrolides in clinical treatment, macrolide-resistant M. pneumoniae strains have become increasingly common worldwide. However, the molecular mechanisms underlying drug resistance in M. pneumoniae are poorly understood. In the present work, we analyzed the whole proteomes of macrolide-sensitive and macrolide-resistant strains of M. pneumoniae using a tandem mass tag-labeling quantitative proteomic technique, Data are available via ProteomeXchange with identifier PXD022220. In total, 165 differentially expressed proteins were identified, of which 80 were upregulated and 85 were downregulated in the drug-resistant strain compared with the sensitive strain. Functional analysis revealed that these proteins were predominantly involved in protein and peptide biosynthesis processes, the ribosome, and transmembrane transporter activity, which implicates them in the mechanism(s) of resistance of M. pneumoniae to macrolides. Our results provide new insights into drug resistance in M. pneumoniae and identify potential targets for further studies on resistance mechanisms in this bacterium.
Reporting Quality of Clinical Practice Guidelines Regarding Gout and Hyperuricemia According to the Right Checklist
Authors: Wang Can , Luo Xufei , Li Maichao , Cui Lingling , Li Xinde , Han Lin , Wang Xuefeng , Ren Wei , He Yuwei , Sun Wenyan , Li Changgui , Chen Yaolong , Liu Zhen
Published: November 2020

Objectives The Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist was used to assess the reporting quality of 2009–2019 Clinical Practice Guidelines (CPGs) regarding gout and hyperuricemia, aimed to improve the reporting quality of future guidelines.Methods We searched PubMed, the Chinese Biomedical Literature database, the Wan Fang Database, and the China National Knowledge Infrastructure from January 2009 to June 2019 for relevant guidelines. We also searched the websites of guideline development organizations (the Guidelines International Network, the National Institute for Health and Clinical Excellence, the American College of Rheumatology, and the European League Against Rheumatism) (EULAR). Furthermore, supplementary guidelines reported in included articles were systematically searched, as well as Medlive and Google Scholar. Results Seventeen guidelines were included, of which one was in Chinese and 16 were in English. The mean reporting rate of the 35 items specified was 14.9 (42.5%), only five CPGs (29.4%) had a reporting rate >50%. Of the 35 items, three were very frequently reported. The reporting proportion of the seven domains (Basic information, Background, Evidence, Recommendations, Review and quality assurance, Funding and declaration and management of interests, and Other information) were 64.7%, 36.8%, 50.6% 50.6%, 42.9%, 8.82%, 33.8%, and 31.4%, respectively.Conclusion The reporting quality of the present guidelines for gout and hyperuricemia is relatively poor. We suggest that the RIGHT reporting checklist should be used by CPG developers to ensure higher reporting quality of future guidelines.
Reducing the metabolic energy of walking and running using an unpowered hip exoskeleton
Authors: Zhou Tiancheng , Xiong Caihua , Zhang Juanjuan , Hu Di , Chen Wenbin , Huang Xiaolin
Published: November 2020

Background: Walking and running are the most common means of locomotion in human daily life. People have made advances in developing separate exoskeletons to reduce metabolic rate of walking or running. However, the combined requirements of overcoming fundamental biomechanical differences between the two gaits and minimizing the metabolic penalty of exoskeleton mass make it challenging to develop an exoskeleton that can reduce the metabolic energy for both gaits. Here we show that the metabolic energy of both walking and running can be reduced by regulating the metabolic energy of hip flexion during the common energy consumption period of the two gaits using an unpowered hip exoskeleton. Methods: We analyzed metabolic rates, muscle activities and spatio-temporal parameters from 9 healthy subjects (mean s.t.d; 24.9 ± 3.7 years, 66.9 ± 8.7 kg, 1.76 ± 0.05 m) walking on a treadmill at the speed of 1.5 m×s -1 and running at speed of 2.5 m×s -1 with different spring stiffnesses. After obtaining the optimal spring stiffness, we recruited the participants to walk and run with the optimal stiffness spring at different speeds to demonstrate the generality of the proposed approach. Results: We found that the optimal exoskeleton spring stiffnesses for walking and running were 140 N×m Rad -1 and 210 N×m Rad -1 respectively, corresponding to 8.2% ± 1.5% (mean ± s.e.m, two-sided paired t-test: p < 0.01) and 9.1% ± 1.3% ( p < 0.01) metabolic reductions compared to walking/running without exoskeleton. The metabolic energy within tested speed range can be reduced with the assistance except for low speed walking (1.0 m s -1 ). Participants showed different changes in muscle activities with the assistance of proposed exoskeleton. Conclusions: This paper first demonstrated that metabolic cost of walking and running can be reduced using an unpowered hip exoskeleton to regulate metabolic energy of hip flexion. The design method based on analyzing the common energy consumption characteristics between gaits may inspire future exoskeletons that assist multiple gaits. The results of different changes in muscle activities provided a new insight of human response to the same assistive principle in different gaits (walking and running).
Hydrodynamics-driven uncertainty study in simulating terrestrial carbon cycle with a coupled water-carbon cycle model
Authors: Sun Guodong , Mu Mu
Published: November 2020

In this study, an uncertainty degree of net primary production (NPP) simulation or prediction is estimated due to uncertainty of hydrodynamic processes. The Lund-Potsdam-Jena Wetland Hydrology and Methane Dynamic Global Vegetation Model (LPJ-WHyMe DGVM), which could describe the interaction between terrestrial carbon cycle and hydrological cycle, is applied to evaluate the above issue. Four regions with different climate backgrounds in China are chosen to explore different behaviors about the influence of the simulated NPP to hydrological physical processes on. It is found that the error of NPP modeling is 198.5 g C m− 2 yr− 1 (48.6%) in the arid and semiarid region of northern China due to the uncertainties in the hydrological processes, which is greater than those in other three regions. The errors of NPP modeling are 88.4 g C m− 2 yr− 1 (19.1%) in northeastern China, 117.0 g C m− 2 yr− 1 (21.1%) in southern China, and 64.4 g C m− 2 yr− 1 (13.2%) in the semi-humid region of northern China. Further numerical experiments reveal that the simulation ability of the NPP could be enhanced by reducing all hydrological parameter errors. Our results demonstrate the importance of hydrological processes to the simulation and prediction of the NPP.
Acceptability of Patient-centered Hypertension Education Delivered by Community Health Workers among People Living with HIV/AIDS in Rural Uganda
Authors: Batte Charles , Mukisa John , Rykiel Natalie , Mukunya David , Checkley William , Knauf Felix , Kalyesubula Robert , Siddharthan Trishul
Published: November 2020

Background The prevalence of hypertension is increasing among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). However, knowledge of the complications and management of hypertension among PLWHA in Uganda remains low. We explored the acceptability of implementing hypertension (HTN) specific health education by community health workers (CHWs) among PLWHA in rural Uganda. Methods We conducted a qualitative study consisting of 22 in-depth interviews (14 PLWHA/HTN and 8 CHWs), 3 focus group discussions (FGDs), 2 with PLWHA/HTN and 1 with CHWs from Nakaseke district, Uganda. Participants were interviewed after a single session interaction with the CHW. Data were transcribed from luganda (local language) into English and analyzed using thematic analysis. We used Sekhon’s model of acceptability of health Interventions to explore participants’ perceptions. Results Participants believed CHWs utilized easy-to-understand, colloquial, non-technical language during education delivery, had a pre-existing rapport with the CHWs that aided faster communication, and had more time to explain illness than medical doctors had. Participants found the educational material ( PocketDoktor Ô ) to be simple and easy to understand, and perceived that the education would lead to improved health outcomes. Participants stated their health was a priority and sought further disease-specific information. We also found that CHWs were highly motivated to carry out the patient-centered education. While delivering the education, CHWs experienced difficulties in keeping up with the technical details regarding hypertension in the PocketDoktor Ô , financial stress and patient questions beyond their self-perceived skill level and experience. PLWHA/HTN had challenges accessing the health facility where the intervention was delivered and preferred a household setting.Conclusions Hypertension patient-centered education delivered by CHWs using the PocketDoktorÔ was acceptable to PLWHA and hypertension in Nakaseke area in rural, Uganda. There is need for further studies to determine the cost implications of delivering this intervention among PLWHA across LMIC settings.
The Role of Managerial Leadership in Sickness Absence in Health and Social Care: Antecedent or Moderator in the Association between Psychosocial working Conditions and Register-based Sickness Absence? A Longitudinal Study based on a Swedish Cohort.
Authors: Stengård Johanna , Peristera Paraskevi , Johansson Gun , Nyberg Anna
Published: November 2020

Background: The prevalence of sickness absence is particularly high among employees in health and social care, where psychosocial work stressors are pertinent. Managerial leadership is known to affect sickness absence rates, but the role leadership plays in relation to sickness absence is not fully understood; that is, whether poor leadership i) is associated with sickness absence directly, ii) is associated with sickness absence indirectly through the establishment of poor psychosocial working conditions, or iii) whether good leadership rather has a buffering role in the association between work stressors and sickness absence.Methods: Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, 2010–2016, N=2333) were used. Autoregressive cross-lagged analyses within a multilevel structural equation modelling (MSEM) framework were conducted to test hypotheses i)–iii), targeting managerial leadership, register-based sickness absence and psychosocial work stressors (high psychological demands, poor decision authority and exposure to workplace violence).Results: A direct association was found between poor leadership and sickness absence two years later, but no associations were found between leadership and the psychosocial work stressors. Finally, only in cases of poor leadership was there a statistically significant association between workplace violence and sickness absence.Conclusions: Poor managerial leadership may increase the risk of sickness absence among health and social care workers in two ways: first, directly and, second, by increasing the link between workplace violence and sickness absence.
Analysis of Epidemiological Indices of Coronavirus Disease 2019 (COVID-19) in Countries with High-incidence
Authors: Javan-Noughabi Javad , Mousavi Sayed Ali , Faramarzi Ahmad , Shabanikiya Hamidreza
Published: November 2020

Background: Coronavirus disease 2019 (COVID-19) poses an extraordinary threat to global public health. According to a report by WHO, COVID-19 has affected approximately 20 million patients in the world and has caused nearly 728 thousand deaths as of 10 August 2020. The purpose of the current study was to provide an estimate and comparison of epidemiological indices on COVID-19 in 10 countries with high-incidence. Methods: We did a descriptive and comparative study intending to analyze the epidemiological indices of COVID-19 in countries with high-incidence, using the data published by the WHO until August 10, 2020. We estimated the incidence and mortality rate per 100,000 population on a daily and general level. Results: The mean of fatality rate in 10 countries was almost 3.26%. The highest value on the fatality rate was obtained with 10.93% in Mexico, followed by 5.64% in Iran and 4.43 in Peru. The lowest value on the fatality rate is related to the Russian Federation and South Africa at 1.68% and 1.86%, respectively. Chile had the highest incidence rate with 1951 cases per 100,000 population. This rate is followed by 1496, 1428 and 1417 in the United States of America (USA), Peru and Brazil, respectively. Conclusions: Until August 10, 2020, COVID-19 has affected 13.7 million patients and caused 445.2 thousand deaths in 10 countries with high-incidence. This study shows that each country has a specific pattern of COVID-19.
A Community Pharmacist-led Smoking Cessation Intervention Using a Smartphone App (PharmQuit): A Randomized Controlled Trial
Authors: Asayut Narong , Olson Phayom Sookaneknun , Kanjanasilp Juntip , Thanarat Preut , Senkraigul Bhattaraporn , Sittisarn Chuthathip , Suksawat Suratsawatee
Published: November 2020

Background: WHO supports the harnessing of mobile technologies to improve access to smoking cessation services. PharmQuit, a smartphone app, was developed to support smoking cessation efforts by pharmacists taking into consideration the design of the app according to the needs of smokers. This study evaluated the effectiveness of smoking cessation services conducted by community pharmacists using PharmQuit compared with standard care.Methods: An open-label prospective, randomized, controlled trial was conducted. Stratified random sampling by sex, age, and nicotine addiction was used to allocate participants to either the intervention group or control group. Eligible participants were smokers 18 years old or older who smoked at least one cigarette daily for a month, were ready to quit, willing to participate, and had a smartphone. The study was performed at seven community pharmacies situated in three provinces in Thailand. In the intervention group, participants received smoking cessation services by community pharmacists using PharmQuit. The control group received standard care delivered by community pharmacists. Both groups were scheduled follow-ups at day 7, 14, 30, 60, 120, and 180. The primary outcomes were quit rate and number of cigarettes smoked per day. Secondary outcomes were exhaled carbon monoxide levels, adherence rate to the program, and satisfaction with PharmQuit. Analysis using the intent-to-treat principle was carried out. Results: A total of 156 smokers were randomly assigned to either the intervention (n=78) or control (n=78) group. Smoking cessation rates and the number of cigarettes smoked per day were significantly better over the follow-up visits in both groups (p<0.05). However, there were no statistically significant differences between the two groups. Adherence rate to the smoking cessation program was higher in the intervention group than the control group (74 days vs 60 days, p>0.05). Relapse rate was found to be lower in the intervention group as compared to the control group (28.6% vs 71.4%). Conclusions: The results showed obvious benefits of the community pharmacist’s contribution in helping smokers quit smoking. PharmQuit was not better than just pharmacist’s counselling but it might help to obtain better adherence to smoking cessation programs, and have less likelihood of relapse. Trial registration: Thai Clinical Trials Registry: TCTR20200925004. Registration date September 25, 2020 – Retrospectively registered, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=6841
The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis
Authors: Clarke Jenelle Marie , Waring Justin , Bishop Simon , Hartley Jean , Exworthy Mark , Fulop Naomi , Ramsay Angus , Roe Bridget
Published: November 2020

Background The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Leadership development programmes increasingly call for the development and use of ‘political skill’ as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature.Methods The article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in health care services.Results 62 papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is compromised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through six dimensions of leadership: personal performance, contextual awareness, inter-personal influence, stakeholder engagement, networking and policy influence.Conclusion There is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes.
Netrin-1 Ameliorates Postoperative Delirium-like Behavior in Aged Mice by Suppressing Neuroinflammation and Restoring Impaired Blood Brain Barrier Permeability
Authors: Li Ke , Wang Jiayu , Chen Lei , Guo Meimei , Zhou Ying , Li Xiaofeng , Zhang Zongze , Peng Mian
Published: November 2020

Background Postoperative delirium (POD) is a common and serious postoperative complication in elderly patients, of which the underlying mechanism is elusive and without effective therapy at present. In recent years, the neuroinflammatory hypothesis has been developed in the pathogenesis of POD. Netrin-1, an axonal guidance molecule, has been reported to have strong inflammatory regulatory and neuroprotective effects.Methods We applied treatment with Netrin-1(45 µg/kg) in aged mice by using the POD model with a simple laparotomy to assess systemic inflammatory, neuroinflammation by detecting interleukin-6 (IL-6), interleukin-10 (IL-10), high mobility group box chromosomal protein-1(HMGB-1) and assessing the reactive states of microglia, permeability of blood-brain barrier (BBB) by detecting cell junction proteins and leakage of dextran, and behavior of the aged mice.Results We found that a single dose of Netrin-1 prophylaxis decreased the expression of IL-6 and HMGB-1, and upregulated the expression of IL-10 in peripheral blood, hippocampus and prefrontal cortex. Nerin-1 reduced activation of microglia cells in the hippocampus and prefrontal cortex and improved the POD-like behavior. Besides, Netrin-1 also attenuated the anesthesia/surgery-induced increase in BBB permeability by up-regulating the expression of tight junction-associated proteins such as ZO-1, claudin-5, and occludin.Conclusions These findings confirm the anti-inflammatory and BBB protective effects of Netrin-1 in an inflammatory environment in vivo and provide better insights into the pathophysiology and potential treatment of POD.
Discovery of metabolic biomarkers for gestational diabetes mellitus in a Chinese population
Authors: Lu Wenqian , Luo Mingjuan , Fang Xiangnan , Zhang Rong , Tang Mengyang , Yu Xiangtian , Hu Cheng
Published: November 2020

Background Metabolomics has provided new insights into the pathology of GDM and has revealed potential biomarkers related to GDM; however, previous findings lack consistency, and systemic analysis of GDM with metabolites is required for providing more clues for GDM diagnosis and mechanism research. This study aims to reveal metabolic differences between normal pregnant women and GDM patients in the second- and third-trimester stages and to confirm the clinical relevance of these new findings.Methods Using ultra-performance liquid chromatography coupled to tandem mass spectrometry system, metabolites were quantitated with the serum samples of GDM and normal pregnancies in second- and third-trimester stages in a Chinese population. Samples were obtained from 200 healthy pregnant women and 200 GDM women in the second trimester, 199 normal controls, and 199 GDM patients in the third trimester at the University of Hong Kong-Shenzhen Hospital. Both function and pathway analyses were applied to find biological roles involved in the two sets of metabolites. We then identified the trimester stage-specific GDM metabolite biomarkers by combining a few machine learning approaches, and the logistic regression models based on selected biomarkers were constructed to evaluate predictive efficiency. Finally, the weighted gene co-expression network analysis method was used to further capture the associations between metabolite modules with biomarkers and clinical indices.Results The associations of metabolites with GDM were evaluated, with 57 differentially expressed metabolites (DEMs) in the second-trimester group and 72 DEMs in the third-trimester group. The DEMs, functions, and pathways showed remarkable differences between second- and third-trimester groups. Thus, stage specific GDM biomarkers were further identified, and the logistic regression models for these metabolite biomarkers achieved the area under the curve values of 0.807 and 0.81 for the second- and third-trimester groups, respectively. The significant associations between the discovered DEMs/biomarkers and GDM-related indices suggest their clinical relevance with GDM and hyperglycemia in pregnant women.Conclusions The present study shows the metabolomics profile in the second- and third-trimester stages in pregnant women with and without GDM. Pathways, DEMs and their associations with GDM related indices have been found. Indeed, further studies are warranted to confirm our findings.
Microdialysis for Chronic Exertional Compartment Syndrome
Authors: Lohrer Heinz , Klein Jochen , Nauck Tanja , Schönberg Tobias
Published: November 2020

Background: Diagnosing chronic exertional compartment syndrome (CECS) is still a challenge. An increase in intramuscular pressure during and following exercise is accepted as the diagnostic standard. However, neither the methods used nor the interpretation of the obtained results are sufficiently standardized. Methods: In the present study, the metabolic state of CECS patients was investigated using microdialysis. We hypothesized that there was no difference in intramuscular concentrations of glucose, lactate, glutamate, and glycerol before and after exercise (H10) or between patients suffering from CECS and healthy control subjects (H20). This study was designed as an explorative case-control study (level of evidence III). Twelve patients suffering from CECS of the lower leg and six matched asymptomatic control subjects underwent microdialysis in the anterior (n = 7) or deep posterior compartment (n = 11) of the leg. Following ultrasound-guided insertion of the microdialysis catheters, ten-minute fractions of the dialysates were collected first during rest and then following fatigue- or pain-induced discontinuation of exercise. Dialysates were analysed for lactate, glucose, glutamate, and glycerol concentrations 6 × 10 min before and 6 × 10 min after exercise. Results: Exercise-induced increases in lactate, glutamate, and glycerol concentrations were detected in both CECS patients and control subjects (all p < 0.001). No differences between CECS patients and control subjeccts were found by comparing the intramuscular glucose, lactate, glutamate, and glycerol concentrations at rest and following exercise (all p > 0.05). Conclusions: We found exercise-induced increases in the lactate, glutamate, and glycerol levels in skeletal muscle. However, the metabolic changes did not differentiate CECS patients from healthy subjects. Trial registration: The registration trial number is DRKS00021589 on DRKS. 'Retrospectively registered'. Date of registration: April 4, 2020
Mitochondrial protein CMPK2 regulates IFN-alpha-enhanced foam cell formation, potentially contributing to premature atherosclerosis in SLE
Authors: Lai Jenn-Haung , Hung Li-Feng , Huang Chuan-Yueh , Wu De-Wei , Wu Chien-Hsiang , Ho Ling-Jun
Published: November 2020

Background: Premature atherosclerosis occur in patients with systemic lupus erythematosus (SLE); however, the mechanisms remain unclear. Both mitochondrial machinery and proinflammatory cytokine interferon-alpha (IFN-α) potentially contribute to atherogenic processes in SLE. Here, we explore the roles of the mitochondrial protein cytidine/uridine monophosphate kinase 2 (CMPK2) in IFN-α-mediated pro-atherogenic events.Methods: Foam cell measurements were performed by oil red O staining, Dil-oxLDL uptake and the BODIPY approach. The mRNA and protein levels were measured by qPCR and Western blotting, respectively. Isolation of CD4+ T cells and monocytes was performed with monoclonal antibodies conjugated with microbeads. Manipulation of protein expression was conducted by either small interference RNA (siRNA) knockdown or CRISPR/Cas9 knockout. The expression of mitochondrial reactive oxygen species (mtROS) was determined by flow cytometry and confocal microscopy.Results: IFN-α enhanced oxLDL-induced foam cell formation and Dil-oxLDL uptake by macrophages. In addition to IFN-α, several triggers of atherosclerosis, including thrombin and IFN-γ, can induce CMPK2 expression, which was elevated in CD4+ T cells and CD14+ monocytes isolated from SLE patients compared to those isolated from controls. IFN-α-induced CMPK2 expression was inhibited by Janus kinase (JAK)1/2 and tyrosine kinase 2 (Tyk2) inhibitors. Both the knockdown and knockout of CMPK2 attenuated IFN-α-mediated foam cell formation, which involved the reduction of scavenger receptor class A (SR-A) expression. CMPK2 also regulated IFN-α-enhanced mtROS production and inflammasome activation.Conclusions: The study suggests that CMPK2 plays contributing roles in the pro-atherogenic effects of IFN-α and may represent a novel potential therapeutic target for SLE that should be further evaluated.