bluuebunny/crossref_metadata_2025 huggingface dataset:
Dowry Demand and other Risk Factors for Intimate Partner Violence Against Adolescent Girls: A Cross-sectional Study in India
Authors: Srivast Shobhit , Kumar Pradeep , Govindu Manideep , T Muhammad
Published: January 2021

Background: Violence against women is considered a fundamental violation of women’s human rights. According to the World Health Organization, worldwide one-third of women experience some form of intimate partner violence. The present study aims to examine the association of dowry demand and other associated risk factors with physical, sexual, or emotional violence against married adolescent girls in two major states of India by using large representative data.Methods: Understanding the lives of adolescents and young adults (UDAYA) project survey data was used for this study. The effective sample size for the study was 4893 married adolescent girls. Descriptive statistics along with bivariate analysis was performed to examine the preliminary results. For analyzing the association binary logistic regression method was used.Results: The prevalence of emotional, physical, and sexual violence was 28.6%, 22.9%, and 26.1% among married adolescent girls respectively. About 44% of married adolescent girls experienced any type of violence (emotional/physical/sexual). The prevalence of violence was significantly higher among girls who reported that dowry was demanded by their husbands (emotional-54%, physical-42.1%, sexual-39.6%, and any violence-68.4%). Results show that the likelihood of any violence was 3.66 times more likely among adolescent girls who reported that dowry was demanded by their husbands than their counterparts [OR: 3.66; CI: 3.06-4.37]. Other risk factors for intimate partner violence among adolescents included justifying wife-beating, low decision-making power, having a paid job, and longer marital duration.Conclusion: The results presented in this study suggest that policies that ensure equal inheritance and property rights for women and programs that help adolescent girls retain equal power and say in their family may be necessary to reduce their vulnerability to domestic violence.
“Molecular Anatomy”: A New Multi-Dimensional Hierarchical Scaffold Analysis tool 
Authors: Manelfi Candida , Gemei Marica , Talarico Carmine , Cerchia Carmen , Beccari Andrea R.
Published: January 2021

The scaffold representation is widely employed to classify bioactive compounds on the basis of common core structures or correlate compound classes with specific biological activities. In this paper, we present a novel approach called “Molecular Anatomy” as a flexible and unbiased molecular scaffold-based metrics to cluster large set of compounds. We introduce a set of nine molecular representations at different abstraction levels, combined with fragmentation rules, to define a multi-dimensional network of hierarchically interconnected molecular frameworks. We demonstrate that the introduction of a flexible scaffold definition and multiple pruning rules is an effective method to identify relevant chemical moieties. This approach allows to cluster together different molecular species with similar biological activity, capturing most of the structure activity information, in particular when libraries containing a huge number of singletons are analyzed. We also propose a procedure to derive a network visualization that allows a full graphical representation of compounds dataset, permitting an efficient navigation in the scaffold’s space and significantly contributing to perform high quality SAR analysis.
WITHDRAWN: IgG4-related Disease Presenting With Ataxia 
Authors: Tse George Hondag , Hadjivassiliou Marios , Devgire Vikrant , Hobson Esther , Connolly Daniel JA , Hoggard Nigel
Published: January 2021

Background:Immunoglobulin G4 related disease is a relatively rare multi-system disorder which can present with diverse manifestations including mass-lesions and, or, organ dysfunction. Although the orbits, salivary glands and sinuses are comparatively common sites of involvement there are few reports of isolated intracranial presentation. Case presentation:Although large vessel IgG4-RD vasculitis is an uncommon entity we report a case of a 84-year old male presenting with cerebellar ataxia. CT at presentation demonstrated bilateral low-density change in the middle cerebellar peduncles, which corelated to areas of elevated T2 signal demonstrating restricted diffusion on MRI. CT angiogram demonstrated marked thickening of the common carotid arteries and branches extending to the skull base. In addition, the vertebral arteries also demonstrated significant wall thickening and occlusive narrowing. Serum immunoglobulin IgG and IgA were elevated and in particular IgG immunoglobulin was extremely high.Conclusions:Bilateral symmetrical restricted diffusion in the middle cerebellar peduncles is a striking radiological feature and reported to occur with multiple aetiologies, we believe this is the first report to associate this with IgG4-RD and ataxia.
WITHDRAWN: Delivery of Ferulic Acid with PEGylated Diphenylalanine Nanoparticles for Pre-arthritis Therapy
Authors: He Liming , Zeng Yingchun , Qin Xianyan , Pan Lihua , Chen Tao , Wang Qin , Ma Yiping , Fang Jiyu
Published: January 2021

Background: In the therapy of rheumatoid arthritis (RA), treatment starting at the late stage of disease is probably associated with a worse disease outcome. Thus, blocking the RA developments at the early stage of inflammation with efficacious and safe agents might present a promising strategy. Ferulic acid (FA), a safe and active component extracted from Chinese medicine, shows excellent anti-inflammatory properties in various inflammatory diseases. However, the application of FA as an anti-inflammatory drug is hindered by its instability and short half-life in vivo. The aim of this study is to design a feasible drug delivery system to improve the therapeutic efficacy of FA in the treatment of RA and investigate whether treatment initiated at early stage of arthritis would effectively prevent the development of arthritis.Method: A diphenylalanine-based nanoparticle was constructed by the self-stacking of NH2-Phe-Phe-COOH and poly (ethylene glycol) methyl ether amine (PEG5k-NH2) using the glutaraldehyde (GTA) as a cross-linker. The therapeutic outcomes of treatment using FA-loaded PEGylated Phe-Phe nanoparticles were explored at both pre-arthritis stage and fully-developed arthritis stage. Results: We find that the FA-loaded PEGylated Phe-Phe nanoparticles are biocompatible and could effectively inhibit the production of reactive oxygen species in inflammatory condition. After being intravenously administrated in vivo, the FA-loaded PEGylated Phe-Phe nanoparticles show prolonged circulation time and enhanced accumulation in arthritic joints. More importantly, the pre-arthritis treatment with the FA-loaded PEGylated Phe-Phe nanoparticles can significantly block the progression of RA compared with treatment started at the late stage of arthritis.Conclusions: Our results demonstrated FA-loaded PEGylated Phe-Phe nanoparticles could greatly improve the therapeutic efficacy of FA and ultimately prevent the progression of arthritis in a low activity when applied in pre-arthritis phase. This therapeutic outcome confirmed the treatment initiated in very early disease phases is effective to prevent arthritis progression to full-blown disease.
Effect of COVID-19 on Epidemiological Characteristics of Road Traffic Injuries in Suzhou:A Retrospective Study
Authors: Huang Wenjuan , Lin Qi , Xu Feng , Chen Du
Published: January 2021

Background: To present the new trends in epidemiology of road traffic injuries (RTIs) in Suzhou under the impact of Coronavirus disease 2019 (COVID-19) and control measures.Methods: Pre-hospital care records of RTIs in January-May 2020 and January-May 2019 were collected from the database of Suzhou emergency center, Jiangsu, China， and relevant clinical data were extracted for a retrospective study. RTIs in 2020 and 2019 were defined as observation group and control group respectively.Results: There were 7288 RTIs in the observation group, accounting for 82.17% of the control group. The number of RTIs per month from January to May in the observation group were 79.72%, 47.69%, 79.30%, 85.72% and 99.39% of the control group, respectively. Subgroup analysis showed that the number and composition ratio of electric bicycle related RTIs in the observation group were significantly higher than those in the control group (2641, 36.24% vs 2380, 26.84%, P<0.001). We observed a statistically significant increase in proportion of RTIs with consciousness disorder in the observation group compared to the control group (7.22% vs 6.13%, P = 0.006).Conclusions: Under the impact of COVID-19, the total number of RTIs in Suzhou from January to May 2020 decreased obviously. Nevertheless, there was an obvious rise in electric bicycle related RTIs, and the proportion of RTIs with consciousness disorder also increased. It is necessary for electric bicycle riders to wear helmets.
Probiotic supplementation reduces systemic inflammation in dialysis patients: the effect on circulating regulatory T-cells and pro-inflammatory monocytes
Authors: Choi Eunho , Yang Jihyun , Ji Geun-Eog , Park Myeong Soo , Seong Yeongje , Oh Se Won , Kim Myung Gyu , Cho Won Yong , Jo Sang Kyung
Published: January 2021

BackgroundEmerging evidence suggests that intestinal dysbiosis contributes to systemic inflammation and cardiovascular diseases in dialysis patients. The purpose of this study was to evaluate the effects of probiotic supplementation on various inflammatory parameters in hemodialysis (HD) patients.MethodsTwenty-two patients with maintenance HD were enrolled (Institutional Review Board No. 2018AN0346). These patients were treated twice a day with 2.0 × 1010 colony forming units of a combination of Bifidobacterium bifidum BGN4 and Bifidobacterium longum BORI for 3 months. The microbiome and fecal short chain fatty acids (SCFAs) were analyzed. The percentages of CD14+ CD16+ pro-inflammatory monocytes, and CD4+ CD25+ regulatory T-cells (Tregs) before and after probiotic supplementation were determined by flow cytometry. Serum levels of calprotectin and cytokine responses upon lipopolysaccharide (LPS) challenge were compared before and after probiotic supplementation.ResultsFecal SCFAs increased significantly after probiotic supplementation. Serum levels of calprotectin and IL-6 upon LPS stimulation significantly decreased. The anti-inflammatory effects of probiotics were associated with a significant increase in the percentage of CD4+ CD25+ Tregs (3.5% vs 8.6%, p < 0.05) and also with a decrease of CD14+ CD16+ pro-inflammatory monocytes (310 vs. 194/mm2, p < 0.05).ConclusionProbiotic supplementation reduced systemic inflammatory responses in HD patients and this effect was associated with an increase in Tregs and a decrease in pro-inflammatory monocytes. Hence, targeting intestinal dysbiosis might be a novel strategy for decreasing inflammation and cardiovascular risks in HD patients.Trial registrationThe study was retrospectively registered in Clinical Research Information Service (CRIS) (KCT0005417) (09/09/2020).
A high-resolution, spatially explicit estimate of fossil-fuel CO2 emissions from the Tokyo Metropolis, Japan
Authors: Cong Richao , Saito Makoto , Fukui Tetsuo , Hirata Ryuichi , Ito Akihiko
Published: January 2021

Background: The quantification of urban greenhouse gas (GHG) emissions is an important task in combating climate change. Emission inventories that include spatially explicit emission estimates facilitate the accurate tracking of emission changes, identification of emission sources, and formulation of policies for climate-change mitigation. Many currently available gridded emission estimates are based on the disaggregation of country- or state-wide emission estimates, which may be useful in describing city-wide emissions but are of limited value in tracking changes at subnational levels. Urban GHG emissions should therefore be quantified with a true bottom-up approach. Results: Multi-resolution, spatially explicit estimates of fossil-fuel carbon dioxide (FFCO2) emissions from the Tokyo Metropolis, Japan, were derived. Spatially explicit emission data were collected for point (e.g., power plants and waste incinerators), line (mostly traffic), and area (e.g., residential and commercial areas) sources. Emissions were mapped on the basis of emission rates calculated for source locations. Activity, emissions, and spatial data were integrated, and the results were visualized using a geographic information system approach.Conclusions: The annual total FFCO2 emissions from the Tokyo Metropolis in 2014 were 43,916 Gg CO2, with the road-transportation sector (16,323 Gg CO2) accounting for 37.2% of the total. Spatial emission patterns were verified via a comparison with the East Asian Air Pollutant Emission Grid Database for Japan (EAGrid-Japan) and the Open‐source Data Inventory for Anthropogenic CO2 (ODIAC), which demonstrated the applicability of this methodology to other prefectures and therefore the entire country.
Continuous monitoring of plant sodium transport dynamics using clinical PET
Authors: Ruwanpathirana Gihan P. , Plett Darren , Williams Robert C. , Davey Catherine E. , Johnston Leigh A. , Kronzucker Herbert J.
Published: January 2021

Background The absorption, translocation, accumulation and excretion of substances are fundamental processes in all organisms including plants, and have been successfully studied using radiotracers labelled with 11C, 13N, 14C and 22Na since 1939. Sodium is one of the most damaging ions to the growth and productivity of crops. Due to the significance of understanding sodium transport in plants, a significant number of studies have been carried out to examine sodium influx, compartmentation, and efflux using 22Na- or 24Na-labeled salts. Notably, however, most of these studies employed destructive methods, which has limited our understanding of sodium flux and distribution characteristics in real time, in live plants.Positron emission tomography (PET) has been used successfully in medical research and diagnosis for decades. Due to its ability to visualise and assess physiological and metabolic function, PET imaging has also begun to be employed in plant research. Here, we report the use of a clinical PET scanner with a 22Na tracer to examine 22Na-influx dynamics in barley plants (Hordeum vulgare L. spp. vulgare – cultivar Bass) under variable nutrient levels, alterations in the day/night light cycle, and the presence of sodium channel inhibitors.Results 3D dynamic PET images of whole plants show readily visible 22Na translocation from roots to shoots in each examined plant, with rates influenced by both nutrient status and channel inhibition. PET images show that plants cultivated in low-nutrient media transport more 22Na than plants cultivated in high-nutrient media, and that 22Na uptake is suppressed in the presence of a cation-channel inhibitor. A distinct diurnal pattern of 22Na influx was discernible in curves displaying rates of change of relative radioactivity. Plants were found to absorb more 22Na during the light period, and anticipate the change in the light/dark cycle by adjusting the sodium influx rate downward in the dark period, an effect not previously described experimentally.Conclusions We demonstrate the utility of clinical PET/CT scanners for real-time monitoring of the temporal dynamics of sodium transport in plants. The effects of nutrient deprivation and of ion channel inhibition on sodium influx into barley plants are shown in two proof-of-concept experiments, along with the first-ever 3D-imaging of the light and dark sodium uptake cycles in plants. This method carries significant potential for plant biology research and, in particular, in the context of genetic and treatment effects on sodium acquisition and toxicity in plants.
Analysis of Bioavailable Toluene by Using Recombinant Luminescent Bacterial Biosensors with Different Promoters
Authors: Wang Guey-Horng , Tsai Teh-Hua , Kui Chun-Chi , Cheng Chiu-Yu , Huang Tzu-Ling , Chung Ying-Chien
Published: January 2021

In this study, we constructed recombinant luminescent Escherichia coli with T7, T3, and SP6 promoters inserted between tol and lux genes as toluene biosensors and evaluated their sensitivity, selectivity, and specificity for measuring bioavailable toluene in groundwater and river water. The luminescence intensity of each biosensor depended on temperature, incubation time, ionic strength, and concentrations of toluene and coexisting organic compounds. Toluene induced the highest luminescence intensity in recombinant lux-expressing E. coli with the T7 promoter [T7-lux-E. coli, limit of detection (LOD) = 0.05 μM], followed by that in E. coli with the T3 promoter (T3-lux-E. coli, LOD = 0.2 μM) and SP6 promoter (SP6-lux-E. coli, LOD = 0.5 μM). Luminescence may have been synergistically or antagonistically affected by coexisting organic compounds other than toluene; nevertheless, low concentrations of benzoate and toluene analogs had no such effect. In reproducibility experiments, the biosensors had low relative standard deviation (4.3%–5.8%). SP6-lux-E. coli demonstrated high adaptability to environmental interference. T7-lux-E. coli biosensor—with low LOD, wide measurement range (0.05–500 μM), and acceptable deviation (−14.3% to 9.1%)—is an efficient toluene biosensor. This is the first study evaluating recombinant lux E. coli with different promoters for their potential application in toluene measurement in actual water bodies.
Why do pregnant women prefer cesarean birth? A qualitative study in a tertiary care center in Southern Thailand
Authors: Suwanrath Chitkasaem , Chunuan Sopen , Matemanosak Phawat , Pinjaroen Sutham
Published: January 2021

Background: Increasing worldwide rates of cesarean section are of global concern. In recent years, cesarean births upon maternal request have become a hotly debated issue. Hence, this study aimed to explore maternal reasons for cesarean preference without medical indications.Methods: A descriptive qualitative study was conducted, using in-depth interviews with 27 pregnant women who preferred cesarean birth, attending antenatal care in Songklanagarind Hospital from September 2018 to June 2019. Data were analyzed using content analysis.Results: Maternal reasons for cesarean preference were classified into six main categories: fear of childbirth, safety concerns related to health risk perceptions, negative previous birth experiences, positive attitudes toward cesarean birth, access to biased information and superstitious beliefs in auspicious birth dates. Most women had more than one reason for opting cesarean birth. Conclusion: Several reasons for cesarean birth preference have been elucidated. One striking reason was superstitious beliefs in auspicious birth dates, which are challengable for obstetricians to deal with. Obstetricians should explore the exact reasons why women request cesarean birth in order to prevent or diminish unnecessary cesarean births.
Patient perceptions of students in a longitudinal integrated clerkship in Taiwan: a qualitative study
Authors: Chang Yaw-Wen , Hirsh David A. , Fang Wen-Hui , Li Honghe , Tzeng Wen-Chii , Kao Senyeong
Published: January 2021

Background: Longitudinal integrated clerkships (LICs) are a model of clinical education growing rapidly in Western contexts. LICs use educational continuity to benefits students’ clinical learning and professional identity formation. Patient-centered care is a core component of medical professionalism in the West. To support patient-centered care, education leaders in Taiwan restructured clinical education and implemented the first longitudinal integrated clerkship in East Asia. We aimed to investigate patients’ perceptions of longitudinal relationships with the LIC students within Taiwan’s Confucian cultural and social context.Methods: We invited patients or their family members who were cared for longitudinally by a LIC student to participate in the study. Participating patients or their family members undertook semi-structured interviews. We analyzed data qualitatively using a general inductive approach to identify themes in the patients’ descriptions of their experiences interacting with the LIC students. Results: Twenty-five patients and family members participated in interviews: 16 patients and 9 family members. Qualitative analysis of interview transcripts identified three themes from patients’ experience receiving care from their LIC students: care facilitation, companionship, and empathy. To provide care facilitation, LIC students served as a bridge between the physicians and patients. Students served patients by reminding, consulting, tracking disease progression, and researching solutions for problems. To provide companionship, students accompanied patients interpersonally like a friend or confidant who listens and provides a presence for patients. To provide empathy, patients reported that students showed sincere concern for patients’ experience, feelings, and mood.Conclusion: In our study, Taiwanese patients’ perspectives of LIC students suggested the value of care facilitation, companionship, and empathy. We discuss these themes within the context of Confucian culture and the Taiwanese context of care.
Prognostic factors in patients who underwent surgery for common peroneal nerve injury：a nest case-control study
Authors: Liu Zhenhui , Yushan Maimaiaili , Liu Yanshi , Yusufu Aihemaitijiang
Published: January 2021

Background：Common peroneal nerve (CPN) injury is one of the most common nerve injuries in the lower extremities and the motor functional recovery of injured common peroneal nerve (CPN) was often unsatisfactory, the mechanism of which is still controversial. The purpose of this retrospective study was to determine the prognostic factors in patients who underwent surgery for CPN injury and provide a tool for clinicians to assess the patients’ prognosis. Methods：This is a retrospective cohort study of all patients who underwent neural exploration for injured CPN from 2009 to 2019. A total of 387 patients with postoperative follow-up more than 12 months were included in the final analysis. We used univariate logistics regression analyses to explore explanatory variables which were associated with recovery of neurological function. By applying multivariable logistic regression analysis, we determined variables incorporated into clinical prediction model, developed a nomogram by the selected variables, and then assessed discrimination of the model by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.Results：The case group included 67 patients and the control group 320 patients. Multivariate logistic regression analysis showed that area (urban vs rural, OR=3.35), occupation(“blue trouser” worker vs “white-trouser” worker, OR=4.39), diabetes (OR=11.68), cardiovascular disease (OR=51.35), knee joint dislocation (OR=14.91), proximal fibula fracture (OR=3.32), tibial plateau fracture (OR=9.21), vascular injury (OR=5.37) and hip arthroplasty (OR=75.96) injury increased the risk of poor motor functional recovery of injured CPN, while high preoperative muscle strength (OR=0.18) and postoperative knee joint immobilization (OR=0.11) decreased this risk of injured CPN. AUC of the nomogram was 0.904 and 95% CI was 0.863-0.946.Conclusions：Area, occupation, diabetes, cardiovascular disease, knee joint dislocation, proximal fibula fracture, tibial plateau fracture, vascular injury and hip arthroplasty injury are independent risk factors of motor functional recovery of injured CPN, while high preoperative muscle strength and postoperative knee joint immobilization are protective factor of motor functional recovery of injured CPN. The prediction nomogram can provide a tool for clinicians to assess the prognosis of injured CPN.
UGT1A1 Mutation Association with Increased Bilirubin Levels and Severity of Unconjugated Hyperbilirubinemia in ABO Incompatible Newborns of China
Authors: Yang Hui , Lin Fen , Chen Zikai , Zhang Lin , Xu JiaXin , Wu YongHao , Gu JingYing , Ma YuBin , Li JianDong , Yang Liye
Published: January 2021

Background: Neonatal hyperbilirubinemia causing jaundice is common in East Asian population. Uridine diphosphate glucuronosyltransferase isoenzyme (UGT1A1) glucuronidates bilirubin and converts the toxic form of bilirubin to its nontoxic form.Method: A retrospective study was conducted to review clinical information of ABO hemolysis neonates (ABO HDN) admitted to the Department of Neonatology, referred for neonatal hyperbilirubinemia, in a large general hospital of southern China from 2011 to 2017. Variation status of UGT1A1 was determined by direct sequencing or genotype assays.Result: Sixty-nine ABO HDNs were included into the final analysis. UGT1A1 c.211 G>A mutation (UGT1A1*6, p.Arg71Gly, rs4148323) was significantly associated with the increased bilirubin level in ABO HDNs, after adjusted by age, sex and feeding method (P=0.019 for TBIL, P=0.021 for IBIL). Moreover, heterozygous and/or homozygous UGT1A1 mutations in the coding sequence region were significantly associated with the increased risk of developing hazardous hyperbilirubinemia (as defined by TSB>427 umol/L) as compared those with a normal UGT1A1 genotype (ORadj=9.16, 95%CI 1.99- 42.08, P=0.002) in the study cohort.Conclusion: UGT1A1 variant in coding region is actively involved in the pathogenesis of ABO hemolysis related neonatal hyperbilirubinemia. Genetic assessment of UGT1A1 may be useful for clinical diagnosis of neonatal unconjugated hyperbilirubinemia.
Variations in haematological and biochemical parameters in healthy ponies
Authors: Olga Witkowska-Piłaszewicz , Cywinska Anna , Katarzyna Michlik-Połczyńska , Michal Czopowicz , Katarzyna Strzelec , Anna Biazik , Marta Parzeniecka-Jaworska , Mark Crisman , Lucjan Witkowski
Published: January 2021

Background: Breed specific reference ranges for selected blood parameters are recommended for proper interpretation of blood tests, but there are only few reports dealing with ponies. The purpose of this study was to investigate if blood parameters differ among ponies’ classes and to check if general normal values for equine species are applicable to ponies.Results: All, except total protein concentration, biochemical parameter significantly (p<0.05) differed among ponies’ classes. The most pronounced difference was noted in blood lactate concentrations, higher (p<0.001) in the smallest ponies (class A). In all groups of ponies muscle enzymes (aspartate aminotransferase and creatine kinase) and urea were high when compared to normal values for equine species, but triglycerides and creatinine were low. Blood lactate concentration was high in comparison with normal values for horses only in class A ponies’.Conclusions: In healthy ponies, blood lactate concentration significantly differs between height classes. Normal values for equine species should not be directly applied to interpret the lactate, triglycerides, aspartate aminotransferase and creatine kinase values in ponies.
Person-centered, non-pharmacological intervention in reducing psychotropic medication use among residents with dementia in Australian rural aged care homes
Authors: Parajuli Daya Ram , Kuot Abraham , Hamiduzzaman Mohammad , Gladman Justin , Isaac Vivian
Published: January 2021

Background High rates of psychotropic medications are prescribed in aged care homes despite their limited effectiveness and associated adverse effects. We aim to evaluate the changes in prescription patterns for elderly residents with dementia in the ‘Harmony in the Bush Dementia Study’. Harmony in the Bush is a person-centered model of dementia care in nursing homes, based on the principles of Progressively Lowered Stress Threshold and person-centered music intervention. Methods Our larger study (12 weeks period) was a quasi-experimental design conducted in five rural nursing homes in Australia. Medication charts (n=31) were collected retrospectively from three rural aged care facilities. Medication data for each resident was collected from a three-month medication charts, pre-intervention, and post-intervention. Fifty-three staff participated in 31 semi-structured interviews and 8 focus groups at post-intervention, and at 1-month and 3-months follow up.Results The median age of the participants was 83 years, and 68% of them were female. Polypharmacy was measured in 87% (n=27) of the participants. Hypertension, hyperlipidemia, diabetes, and the Alzheimer’s disease were the major comorbidities identified in residents. None of the residents received more than the maximum dose of psychotropic medications recommended by the guidelines. There was a reduction of 22.4% (77.4% vs 55%) in the use of at least any psychotropic medication, 19.6% (39% vs, 19.4%) reduction in antipsychotics and benzodiazepines (39% vs 19.4%), and 6.5% (42% vs 35.5%) reduction in antidepressants prescription medicines, when comparing residents’ medication charts data covering 3-months pre- and post-intervention, however, these changes were not statistically significant. Additionally, there was a decreasing trend in the use of inappropriate medications. Psychotropic medications were prescribed in up to 43% and anti-dementia medications in 44% of participants for more than 6 months. Three themes extracted from qualitative data include decrease behavioral and psychiatric symptoms of dementia due to medication weaning or dose tapering, other strategies to reduce medication use, and environmental or noise control. Conclusions Our findings indicate that the Harmony in the Bush model as a non-pharmacological approach reduces the prescription of psychotropic medications in rural nursing homes as supported by findings from both quantitative and qualitative data. Trial registration: ANZCTR, ACTRN12618000263291. Registered on 20th February 2018. http://www.ANZCTR.org.au/ACTRN12618000263291p.aspx).
Influence of Indications on Perinatal Outcomes After Radio frequency Ablation in Complicated Monochorionic Pregnancies: A Retrospective Cohort Study
Authors: Wang Hongmei , Zhou Qian , Wang Xietong , Song Jia , Chen Pengzheng , Wang Yanyun , Li Lei , Li Hongyan
Published: January 2021

Background: Radiofrequency ablation (RFA) is recommended to prevent potential neurological injury or intrauterine foetal death (IUFD) of the co-twin(s) in complicated monochorionic (MC) pregnancies. However, the impacts of various indications on the pregnancy outcome following RFA remain unclear. This study aimed to determine how the indications influence the perinatal outcomes in complicated MC pregnancies undergoing radiofrequency ablation.Methods: This was a retrospective cohort study performed in a single centre. All consecutive MC pregnancies treated with RFA between July 2011 and July 2019 were included. The adverse perinatal outcomes and the survival rate were analysed based on various indications. The continuous variables with and without normal distribution were compared between the groups using Student’s t-test and Mann–Whitney U test, respectively, and for categorical variables, Chi-square and Fisher’s exact tests were used. P < 0.05 indicated a significant difference.Results: We performed 272 RFA procedures in 268 complicated MC pregnancies, including 60 selective intrauterine growth restriction (sIUGR), 64 twin–twin transfusion syndrome (TTTS), 12 twin reversed arterial perfusion sequence (TRAPs), 66 foetal anomaly and 66 elective foetal reduction (EFR) cases. The overall survival rate of the co-twin was 201/272 (73.9%). The overall technical successful rate was determined at 201/263 (76.7%). The IUFD rate in the co-twin was 20/272 (7.4%). The TTTS group had recorded the lowest survival rate (37/64, 57. 8%), and the survival rate significantly correlated with Quintero stages (P = 0.029). Moreover, the sIUGR III subgroup had a lower survival rate compared with sIUGR II (55.6%, versus 84.3%). The subgroup of foetal anomaly of gastroschisis or exomphalos had the highest IUFD rate (4/10, 40%), followed by sIUGR III (2/9, 22.2%) and dichorionic triamniotic (DCTA) subgroup (8/46, 17.9%). In EFR group, eight IUFD cases were all coming from the DCTA subgroup and received RFA before 17 weeks.Conclusions: The perinatal outcome of RFA was correlated with the indications, with the lowest survival rate in TTTS IV and the highest IUFD incidence in abdominal wall defect followed by sIUGR III. Elective RFA after 17 weeks may prevent IUFD in DCTA pregnancies.
Maternal Obesity Influences Birth Weight more than Gestational Diabetes
Authors: Alfadhli Eman M
Published: January 2021

BACKGROUNDMaternal obesity and gestational diabetes (GDM) are commonly encountered during pregnancy. Both conditions are independently associated with unfavorable pregnancy consequences. The objective of this study was to compare the effects of obesity and GDM on birth weight, macrosomia, and other adverse pregnancy outcomes.METHODSThis cohort study involved 531 women with a singleton pregnancy attending the Maternity and Children’s Hospital, Medina, Saudi Arabia, between June 2014 and June 2015. Participants underwent a 75-g oral glucose tolerance test between 24 and 28 weeks. The International Association of Diabetes and Pregnancy Study Groups criteria were used for GDM diagnosis. BMI was assessed at the first antenatal visit, and obesity was defined as a BMI ≥30.0 kg/m2. All women were followed up until delivery. Women were divided into 4 groups: non-GDM nonobese (reference group), GDM nonobese, obese non-GDM, and obese GDM. Clinical characteristics and adverse pregnancy outcomes were compared. RESULTSThe mean age and BMI of the participants were 30.5 years and 29.3 kg/m2, respectively. GDM was diagnosed in 50.2% of the participants, and obesity was diagnosed in 47.8% of the participants. Obese women with GDM were the oldest and heaviest among all women. The mean birth weight increased in order among the four groups; it was highest in the infants in the obese GDM group, followed by those in the obese non-GDM, GDM nonobese and reference groups. Obesity and GDM alone or in combination were associated with higher rates of macrosomia and cesarean deliveries than the reference group. Neonatal intensive care unit (NICU) admission was higher in infants in the GDM nonobese and obese GDM groups. The frequency of low Apgar score was significantly higher in infants in the obese GDM group than in infants in the reference group.CONCLUSIONSMaternal obesity seems to influence birth weight more than GDM, while GDM is associated with a greater risk of admission to the NICU. The combination of both conditions is associated with the greatest risk of adverse pregnancy outcomes.
Using Baidu search values to monitor and predict the confirmed cases of COVID-19 in China - evidence from Baidu Index
Authors: Tu Bizhi , Wei Laifu , Jia Yaya , Qian Jun
Published: January 2021

Background: New coronavirus disease 2019 (COVID-19) has posed a severe threat to human life and caused a global pandemic. The current research aimed to explore whether the search-engine query patterns could serve as a potential tool for monitoring the outbreak of COVID-19.Methods: We collected the number of COVID-19 confirmed cases between January 11, 2020, and April 22, 2020, from the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). The search index values of the most common symptoms of COVID-19 (e.g., fever, cough, fatigue) were retrieved from the Baidu Index. Spearman's correlation analysis was used to analyze the association between the Baidu index values for each COVID-19-related symptom and the number of confirmed cases. Regional distributions among 34 provinces/ regions in China were also analyzed.Results: Daily growth of confirmed cases and Baidu index values for each COVID-19-related symptom presented robust positive correlations during the outbreak (fever: rs=0.705, p=9.623×10-6; cough: rs=0.592, p=4.485×10-4; fatigue: rs=0.629, p=1.494×10-4; sputum production: rs=0.648, p=8.206×10-5; shortness of breath: rs=0.656, p=6.182×10-5). The average search-to-confirmed interval (STCI) was 19.8 days in China. The daily Baidu Index value's optimal time lags were the four days for cough, two days for fatigue, three days for sputum production, one day for shortness of breath, and 0 days for fever.Conclusion: The searches of COVID-19-related symptoms on the Baidu search engine were significantly correlated to the number of confirmed cases. Since the Baidu search engine could reflect the public's attention to the pandemic and the regional epidemics of viruses, relevant departments need to pay more attention to areas with high searches of COVID-19-related symptoms and take precautionary measures to prevent these potentially infected persons from further spreading.
Differences of tensile strength in knot tying technique between orthopaedic surgical instructors and trainees
Authors: Harato Kengo , Yagi Mitsuru , Kaneda Kazuya , Iwama Yu , Masuda Akihiko , Kaneko Yosuke , Oya Akihito , Matsumura Noboru , Suzuki Taku , Nakayama Robert , Kobayashi Shu
Published: January 2021

Background: Knot tying technique is an extremely important basic skill for all surgeons. Clinically, knot slippage or suture breakage will lead to wound complications. Although some previous studies described the knot-tying technique of medical students or trainees, little information had been reported on the knot-tying technique of instructors. The objective of the preset study was to assess surgeons’ manual knot tying techniques and to investigate the differences of tensile strength in knot tying technique between surgical instructors and trainees.Methods: A total of 48 orthopaedic surgeons (postgraduate year: PGY 2-18) participated. Surgeons were requested to tie surgical knots manually using same suture material. They were divided into two groups based on each career; instructors and trainees.　Although 4 open conventional knots with 4 throws were chosen and done with self-selected methods, knot tying practice to have the appropriate square knots was done as education only for trainees before the actual trial. The knots were placed over a 30 cm long custom made smooth polished surface with 2 cylindrical rods. All knots were tested for tensile strength using a tensiometer. The surgical loops were loaded until the knot slipped or the suture broke. The tensile strength of each individual knot was defined as the force (N) required to result in knot failure. Simultaneously, knot failure was evaluated based on knot slippage or suture rupture. In terms of tensile strength or knot failure, statistical comparison was performed between groups using two-tailed Mann-Whitney U test or Fisher exact probability test, respectively.Results: Twenty-four instructors (PGY6- PGY18) and 24 trainees (PGY2-PGY5) were enrolled. Tensile strength was significantly greater in trainees (83.0 ± 27.7N) than in instructors (49.9 ± 34.4N, P=0.0246). The ratio of slippage was significantly larger in instructors than in trainees (P<0.001). Knot slippage (31.8 ± 17.7N) was significantly worse than suture rupture (89.9 ± 22.2N, P<0.001) in tensile strength.Conclusions: Mean tensile strength of knots done by trainees after practice was judged to be greater than that done by instructors in the present study. Clinically, knot slippage can lead to wound dehiscence, compared to suture rupture.
Influence of psycho-sexual factors on the quality of life in pregnant women during the COVID-19 pandemic: A Path Analysis
Authors: Alijanpour Masoumeh , Sadatmahalleh Shahideh Jahanian , Samaneh Youseflu , Mahnaz Bahri Khomami , Majid Yousefi Afrashteh , Moini Ashraf , Kazemnejad Anoshiravan
Published: January 2021

Introduction: COVID-19 has spread rapidly around the world. This epidemic has created stress and anxiety for pregnant women in different parts of the world. Objective: The aim of this study was to investigate the relationship between quality of life (QoL) with anxiety, depression, coronavirus induced anxiety, sexual function (SF), and marital satisfaction (MS) in pregnant women during the Covid-19 pandemic.Methods: The present study is a cross-sectional study involving 261 pregnant women, administered through an online survey.Outcomes: The Short-Form Health Survey (SF_12), Marital Satisfaction Scale (MSS), Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Scale (HADS), and coronavirus induced anxiety questionnaire, Padua Obsession Questionnaire, General Health Questionnaire (GHQ) are used for data collection. Data were analyzed using the Pearson correlation coefficient and path analysis.Results: The overall goodness-of-fit statistics revealed that the predictors of QoL had excellent fitness indices (RMSEA=0.02; AGFI=0.99). The results show that coronavirus induced anxiety, marital satisfaction (MS), sexual function (SF), depression, and anxiety have a direct effect on women’s QoL. Among the variables, GHQ has a more direct effect on women’s QoL. General health (GH) is considered as a mediator variable; variables such as anxiety, depression, and coronavirus induced anxiety with effect on GH can impress QoL. Anxiety as a main predictor of QoL, with direct and indirect effects through GH, depression, SF, and MS can impress QoL.Conclusion: Since the QoL in pregnant women is associated with coronavirus epidemics, these results can be used to plan to improve the health and QoL of these people.
Evolutionary pattern of Macaca fascicularis in Southeast Asia inferred using Y-chromosomal gene
Authors: Rovie-Ryan Jeffrine J , Khan Faisal Ali Anwarali , Abdullah Mohd Tajuddin
Published: January 2021

Background: We analyzed a combined segment (2,032-bp) of the sex-determining region and the testis-specific protein of the Y-chromosome (Y-DNA) gene to clarify the gene flow and phylogenetic relationships of the long-tailed macaques (Macaca fascicularis) in Southeast Asia. Phylogenetic relationships were constructed using the maximum likelihood, Bayesian inference, and the median-joining network from a total of 164 adult male M. fascicularis from 62 localities in Malaysia, including sequences from the other regions from previous studies. Results: Based on Y-DNA, we confirm the presence of two lineages of M. fascicularis: the Indochinese and Sundaic lineages. The Indochinese lineage is represented by M. fascicularis located northwards of the Surat Thani-Krabi depression region and is introgressed by the Macaca mulatta Y-DNA. The Sundaic lineage is free from such hybridization event, thus defined as the original carrier of the M. fascicularis Y-DNA. We further revealed that the Sundaic lineage differentiated into two forms: the insular and the continental forms. The insular form, which represents the ancestral form of M. fascicularis, consists of two haplotypes: a single homogenous haplotype occupying the island of Borneo, Philippines, and southern Sumatra; and the Javan haplotype. The more diverse continental form consists of 17 haplotypes in which a dominant haplotype was shared by individuals from southern Thai Peninsular (south of Surat Thani-Krabi depression), Peninsular Malaysia, and Sumatra. Uniquely, Sumatra contains both the continental and insular Y-DNA which can be explained by a secondary contact hypothesis. Conclusions: Overall, the findings in this study are important: 1) to help authority particularly in Malaysia on the population management activities including translocation and culling of conflict M. fascicularis, 2) to identify the unknown origin of captive M. fascicularis used in biomedical research, and; 3) the separation between the continental and insular forms warrants for the treatment as separate management units.
Novel fusion peptide-mediated siRNA delivery using self-assembled nanocomplex
Authors: Ryu Yeong Chae , Kim Kyungah , Kim Byoung Choul , Wang Hui-Min David , HWANG BYEONG HEE
Published: January 2021

Background: Gene silencing using siRNA can be a new potent strategy to treat many incurable diseases at the genetic level, including cancer and viral infections. Treatments using siRNA essentially requires an efficient and safe method of delivering siRNA into cells while maintaining its stability. Thus, we designed novel synergistic fusion peptides, i.e., SPACE and oligoarginine.Results: Among the novel fusion peptides and siRNAs, nanocomplexes have enhanced cellular uptake and gene silencing effect in vitro and improved retention and gene silencing effects of siRNAs in vivo. Oligoarginine could attract siRNAs electrostatically to form stable and self-assembled nanocomplexes, and the SPACE peptide could interact with the cellular membrane via hydrogen bonding. Therefore, nanocomplexes using fusion peptides showed improved and evident cellular uptake and gene silencing of Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) via the lipid raft-mediated endocytosis pathway, especially to the HDFn cells of the skin, and all of the fusion peptides were biocompatible. Also, intratumorally injected nanocomplexes had increased retention time of siRNAs at the site of the tumor. Finally, nanocomplexes demonstrated significant in vivo gene silencing effect without immunogenicity.Conclusions: The new nanocomplex strategy could become a safe and efficient platform for the delivery of siRNAs into cells and tissues to treat various target diseases through gene silencing.
Anti-Platelet Aggregation of Panax Notoginseng Triol Saponins by Regulating GP1BA for Ischemic Stroke Therapy
Authors: Xu Zhiyi , Xu Yang , Xie Xiaofang , Tian Yin , Sui Junhui , Sun Yong , Lin Dasheng , Gao Xing , Peng Cheng , Fan Yujiang
Published: January 2021

Background: Panax notoginseng triol saponins (PTS) has been used clinically for ischemic stroke therapy (IST) in China for more than seventeen years due to its anti-platelet aggregation and neuro-protective effects, but its mechanism of action is not fully understand. In this study, anti-platelet aggregation-related protein analysis and computer simulations of drug-protein binding interactions were performed to explore the mechanism of the effects of PTS against ischemic stroke in an ischemia reperfusion model. Methods: Three oral doses of PTS were administered in a model of middle cerebral artery occlusion (MCAO) in rats. Panax notoginseng total saponins (PNS) and a combination of PTS and aspirin were chosen for comparison. To evaluate therapeutic effects and explore possible mechanisms of anti-platelet aggregation, we measured cerebral infarct size and water content in brain tissue, histomorphological changes, expression of related factors (such as arachidonic acid metabolites) and platelet receptors in serum, as well as the binding affinity of PTS for platelet adhesion receptors. Results: Compared with PNS, PTS showed a stronger and more potent anti-platelet aggregation effect in MCAO model rats. The combination of PTS and aspirin could reduce adverse gastrointestinal effects by regulating the TXA2/PGI2 ratio. We demonstrated for the first time that PTS was able to regulate Glycoprotein Ib-α (GP1BA) in a model animal. The binding of ginsenoside Rg1 and GP1BA could form a stable structure. Moreover, PTS could reduce von Willebrand factor (VWF)-mediated platelet adhesion to damaged vascular endothelium, and thus enhance the probability of anti-platelet aggregation and anti-thrombosis under pathological conditions.Conclusions: Our results showed that GP1BA was closely related to the anti-platelet aggregation action of PTS, which provided new scientific and molecular evidence for its clinical application.