bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, Attitudes and Understanding of Probiotics Among Pediatricians in Different Regions of Saudi Arabia
Authors: Hasosah Mohammed , Qurashi Mansour , Balkhair Abdullah , Alzahrani Ziyad , Alabbasi Abdullah , Alzahrani Muhanad , Alnahdi Wejdan , Shafei Sohaib , Bafaqih Malak , Khan Muhammad A
Published: September 2020

BACKGROUND: Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Many studies reported that knowledge and attitudes of health professionals have a medium level of knowledge of probiotics.OBJECTIVE: Evaluate knowledge and practice styles among pediatricians working in different regions of Saudi Arabia regarding probiotics.DESIGN: Cross-sectional study.SETTING: Pediatric hospitals; central, western, eastern, northern, and southern regions, Saudi Arabia.PATIENTS AND METHODS: A survey of 550 pediatric providers (PPs) conducted and completed by pediatricians which included pediatric residents (PRs), pediatric specialist (PSs) and pediatric consultants (PCs) and pediatric gastroenterologists (PGs). They were asked anonymously about knowledge and practice of probiotics.MAIN OUTCOME MEASURES: Evaluate knowledge and practice styles among pediatricians working in Saudi Arabia regarding probiotics.SAMPLE SIZE: 550 pediatric providers (PPs) in the cross-sectional analysis.RESULTS: A response rate of 82% yielded 452 questionnaires. Among respondents, 261 of 452 (57.7%) were aware of the definition of probiotics. There were significant differences in the percentage of participants who have little knowledge of probiotics (P<0.05), with a maximum in PRs and a minimum in PGs. The most common probiotic used by all participants was lactobacillus acidophilus (63.3%), and mycobacterium avium was the probiotic least often prescribed (8.6%). The majority of participants reported that probiotics were used to improve digestion and improve GI immunity, but there were no significant differences found between groups (P=0.298). The majority of PRs and PSs correctly reported that probiotics reduce the risk of antibiotic-induced diarrhea (74.9% and 80.2%) respectively, but there were no significant differences among them. Internet (50.0%) was the source of probiotics-related information to all pediatricians.LIMITATION: There may be some response bias—PPs who have a special interest in probiotics may have been more likely to respond to the survey.CONCLUSION: Significant differences in knowledge and practice patterns exist regarding probiotics. Identification of knowledge gaps may be useful to develop educational materials to improve proper definition, knowledge, and the use of probiotics.
Depression And Cardiovascular Risk – Association Among Beck Depression Inventory, PCSK9 Levels And Insulin Resistance
Authors: Macchi Chiara , Favero Chiara , Ceresa Alessandro , Vigna Luisella , Conti Diana Misaela , Pesatori Angela Cecilia , Racagni Girogio , Corsini Alberto , Ferri Nicola , Sirtori Cesare Riccardo , Buoli Massimiliano , Bollati Valentina , Ruscica Massimiliano
Published: September 2020

Background. Depression and cardiovascular disease (CVD) are among the most common causes of disability in high-income countries, depression being associated with a 30% increased risk of future CV events. The association of depression with CV outcomes is likely via behavioral mechanisms, e.g. sedentary lifestyle and obesity, this last being more frequently linked to the occurrence of depressive symptoms. Proprotein convertase subtilisin/kexin type 9 (PCSK9) has been related to a large number of CV risk factors, e.g. insulin resistance. Aim of this study was to investigate whether in a population of obese subjects, depression could affect PCSK9 levels and how these changes may mediate potentially associated pre-diabetic risk. Results. In 389 obese individuals, mainly women, the Beck Depression Inventory (BDI-II) was significantly associated with PCSK9 levels, i.e. for every unit increment in BDI-II score, PCSK9 rose by 1.85 ng/mL and with the homeostatic model assessment index of insulin resistance (HOMA-IR). Mediation analysis suggested that PCSK9 levels partially mediates by 11% the effect of BDI-II on HOMA-IR. Conclusions. This study proposes a possible mechanism linking depression and insulin resistance, a well-known CV risk factor, providing evidence on a role for PCSK9.
Use of the Robson classification to understand the increased risk of cesarean section in case of maternal obesity.
Authors: Crequit Simon , Korb Diane , Morin Cécile , Schmitz Thomas , Sibony Olivier
Published: September 2020

Background: The aim of this study was to identify characteristics of pregnant women with obesity that contribute to increased cesarean rate.Methods: Retrospective cohort in a single academic institution between 2012 and 2019. Women who delivered during this period were classified according to the Robson classification. Women with normal body mass index (N=11797) and with obesity (N=2991) were compared. The contribution of each Robson group to the overall caesarean rate were compared.Results: The overall cesarean rate was higher for women with (28.1%) than without (14.2%, p < 0.001) obesity. This result came mainly from Robson group 5a (history of one cesarean). After adjustment for medical factors within this group, the association between maternal obesity and cesarean during labor was significant.Conclusions: The higher cesarean rate in women with obesity is explained by Robson group 5a in which obesity is an independent risk factor of in labor cesarean delivery.
Feasibility of Different Drying Methods to Remedy Deep-sea Mining Tailings Using the Formation of Alginate-rhamnolipid Complexes With Harmful Heavy Metals Contained in Manganese Nodules
Authors: Lee Aleum , KIM KYOUNGREN
Published: September 2020

The authors have requested that this preprint be removed from Research Square.
Brucella Outer Membrane Proteins to Control Maturation and Antigen Presentation of Mouse Dendritic Cells
Authors: Yang Ningning , Tong Zhixia , Wang Zhen , Xu Mingguo , Zhang Qian , Zhang Huan , Wang Yueli , Yi Jihai , Sun Tianhao , Cui Buyun , Chen Chuangfu
Published: September 2020

Background: Brucellosis is a highly contagious zoonotic disease, which seriously endangers animal husbandry in China. Bone marrow- derived dendritic cells ( DCs ) are professional antigen presenting cells (APC) that play an important role in the interaction between pathogens and host immunity. Because of that DCs play an irreplaceable role in the initiation and orientation of the acquired immune response, establishing the model of interaction between Brucella and DCs may be more suitable than the traditional macrophage model for understanding the relationship between the pathogenic mechanism of Brucella and the specific immune response of the infected host. In this study, DCs were isolated from BALB/C female mice and stimulated with Brucella major outer membrane proteins (OMPs: OMP10, OMP19, OMP25, BP26 and OMP31) or brucella mutants (Δ omp10 , Δ omp19 , Δ omp25 , Δ bp26 , Δ omp31 ) to examine their effects on DC maturity and antigen presentation.Results: Brucella OMP10, OMP19, BP26, brucella mutants Δ omp10 , Δ omp19 , Δ omp25 , Δ bp26 , Δ omp31 and Brucella RB51 induced DC maturation and antigen presentation efficiency in mice, activated proliferation of T lymphocytes, and decreased apoptosis, which helped the host recognize antigens and eliminate pathogens. However, Brucella 2308 evaded the host immune function and established chronic infection by maintaining a balance between intracellular replication and inducing apoptosis, thus reducing DC maturation and antigen presentation to T cells. Toll-like receptor (TLR) -mediated signaling pathways were involved in the DC maturation and antigen presentation induced by Brucella OMPs. Conclusion: These results enhance understanding of Brucella pathogenesis and the host protective immune response mechanism and lay the foundation for the rational design of Brucella vaccines.
Social Support and Physical Activity in the Perioperative Period and Six Months After Colorectal Cancer Surgery.
Authors: Ocalewski Jarosław , Michalska Patrycja , Izdebski Paweł
Published: September 2020

Background: According to the recommendations of the ERAS protocol, physical activity is a key behavior for pre-surgical preparation of patients. The research aimed at determining the relationship between physical activity and social support, self-efficacy, cancer symptoms in preparation for colorectal cancer resection and half a year after surgery.Methods: The research was carried out among patients with colorectal cancer. The assessment was performed in a longitudinal study, a week before the surgery (T1) (N=151) and six months after the surgery (T2) (N=105). The data was collected through the following research tools: physical activity, social support (OSS-3), self-efficacy (GSES) and the experienced cancer symptoms (Brief IPQ).Results: In a week before the surgery, social support facilitated in the time of physical activity (β=.18), whereas half a year after the surgery social support had a negative impact on the time of physical activity (β=-.20). The variable of symptoms is related to the negative effect of physical activity, and this is particularly evident in the six-month period after surgery (a week before the surgery: β=-.16; six months after the surgery: β=-.34).Conclusions: It has been shown that social support, symptoms are important for shaping physical activity in the period before colorectal cancer surgery and six months after surgery. Patients with colorectal cancer living alone have had higher levels of physical activity than patients with colorectal cancer living in a partnership. In the period after colorectal cancer surgery social support may lead patients to believe that they do not need to make any physical effort because caregivers take care of their daily responsibilities.Trial registrations: Ocalewski J, Michalska P. Social support and physical activity in the preoperative period and six months after colon cancer surgery. [Internet]. OSF; 2020. Available from: osf.io/px2zk
Trichoderma Asperellum as A Promising Mycofungicide for Managing The Dieback Disease of Tea (Camellia Sinensis)
Authors: Kumhar Kishor Chand , Babu Azariah , Arulmarianathan John Peter , Deka Bhabesh , Bordoloi Mitali , Rajbongshi Hirakjyoti , Dey Pritam
Published: September 2020

Background: The dieback disease of tea caused by Fusariumsolani adversely affects its production and quality. Genus Trichoderma is a promising biocontrol agent to control it without any residual effect and most suitable for inclusion into an integrated disease management approach. Isolation of Trichoderma from rhizosphere soil of the Dooars zone was done. It was identified as T. asperellum based on its cultural characters and DNA fingerprinting. A liquid formulation (2% Aqueous Suspension) was prepared from it and bio-efficacy was evaluated under field conditions for the control of dieback disease and other parameters for two seasons in three zones. Its different concentrations, T. harzianum, and Hexaconazole were included in the study. Results: The fungal isolate (KBN-29), identified as T. asperellum, was found nearest to the isolate TV-3 (Genebank-KX538814.1) with 99% similarity. Plots treated with T. asperellum 2% AS at 1000 and 1200ml/ha concentration gave better disease control as the yield of green leaves as compared to Hexaconazole 5% EC. The formulation was safe to non-target beneficial organisms’ in all three zones without any phytotoxicity to tea leaves at 4, 8, and 16ml/L concentrations.Conclusions: The present study confirms that the developed liquid formulation of T. asperellum 2% AS was found significantly superior for the management of dieback disease of tea plantations in Darjeeling, Dooars, and Assam zones when used at concentrations of 1200 and 1000 ml followed by 800 and 600 ml/ha during both seasons. The maximum made tea yield was recorded in plots treated with T. asperellum at 1000 and 1200ml/ha followed by Hexaconazole 5% EC. The T. asperellum 2% AS was observed to be safe for non-target beneficial organisms viz., C. carnea, O. javanus, and S. gilvifrons. The developed T. asperellum 2% AS formulation was not phytotoxic to tea leaves at 4, 8, and 16ml/L concentrations.
Maternal and neonatal outcomes of repeated antepartum bleeding in 493 placenta previa cases: a retrospective study
Authors: ziyan Jiang , huang shiyun , zuo qing , ge zhiping , lu hongmei , zhou xin , wang tianjun , tang xiaotong
Published: September 2020

Background Placenta previa (PP) is a serious complication of late pregnancy. Exploring the effect of antepartum bleeding caused by PP on pregnancy outcomes is very important.Methods We retrospectively analyzed 493 women complicated with PP. Patients were divided into antepartum repeated bleeding and non-bleeding groups. Maternal characteristics and pregnancy outcomes were compared.Results The risk of antepartum hemorrhage was 2.038 times higher when gravidity was 5 (95% CI 1.104 ~ 3.760, P = 0.023). Pregnant women with a history of more than three intrauterine procedures had a 1.968 times higher risk of antepartum hemorrhage (95% CI 1.135 ~ 3,412, P = 0.016) compared to pregnant women without any intrauterine procedures. The risk of antepartum bleeding was found to be decreasing with the pregnancy advancing; When the placenta edge was noted to be over cervival os, the risk of antepartum bleeding was 4.385-fold than the low-lying plcaenta cases (95%CI2.454ཞ8.372,P = 0.000). In the respect of maternal outcomes, the repeated bleeding group, the risk of emergency surgery was 7.213 times higher than elective surgery (95% CI 4.402ཞ11.817, P = 0.000). As for the neonatal outcomes, the risk of asphyxia was 2.970 times and the risk of NICU admission was 2.542-fold higher in repeated bleeding group compared to non-bleeding group, respectively.Conclusions Obstetricians should be aware of the increased risk of antepartum bleeding especially for ≤ 34 weeks and placenta edge over cervical os PP patients, they have a higher risk of antepartum bleeding. These women have higher possibility of emergency c-section and need preterm newborn resuscitation.
Time spent in referral process and its determinants among clients of maternal and child health service in Jimma zone, Ethiopia, 2020; A cross-sectional study.
Authors: Kitila Sena Belina , Tesema Abebe Abera , Bedada Gadisa Bekele , Olika Ayantu Kebede , Terfa Yonas Biratu , Ololo Shimelis , Olika Alemi Kebede
Published: September 2020

Background The time spent between referring and receiving health facilities is an important determinant of the outcome of the referred patients/clients especially among women in low income countries due to poor access to early and appropriate referrals. Thus, the aim of this study is to assess the average time spent between referring and service utilization at receiving health facility.Methods A cross-sectional study was employed by using time and motion approach. Structured questionnaire and observation checklist were used for collecting data. SPSS 21 version was used for data analysis and binary and multivariable logistic regression analysis was carried out to identify a variable which has a significant association on the basis of OR, 95% CI and a P value of less than 0.05.Result A total of 266 women were participated in the study with the mean age of the study population is 24.65(± 5.03) years. Majority 223(83.8%) of the participants came for maternal health services and more than half 143(53.8%) of the respondents were self-referrals. Amongst the referred cases the main reason for the referral was for further evaluation and management. Women spent a maximum of 540 minutes on the way to arrive at receiving health facility. Residence and distance were the predictor variables for average time spent. More than two fifth of the women wait more than three hours to get the service at receiving health facility. Residence and distance were the determinant variables for average time spent.Conclusion In general, women wait a maximum of one and half hours to contact health care providers for assessment and more than two fifth of the women wait more than three hours to get the service at receiving health facility. Giving due emphasis to referral system as an integral part of maternal health was essential.
Functions and Clinical Significance of KLRG1 in the Development of Lung Adenocarcinoma and Immunotherapy
Authors: Yang Xiaodong , Zheng Yuexin , Han Zhihai , zhang xiliang
Published: September 2020

Background. As a marker of differentiation, Killer cell lectin like receptor G1 (KLRG1) plays an inhibitory role in human NK cells and T cells. However, its clinical role remains inexplicit. This work intended to investigate the predictive ability of KLRG1 in lung adenocarcinoma (LUAD) after immune-checkpoint inhibitor therapy, as well as to explore the role of a possible KLRG1 molecular mechanism on LUAD development.Methods. Using data from the Gene Expression Omnibus, the Cancer Genome Atlas and the Genotype-Tissue Expression, we compared the expression of KLRG1 and its related genes Bruton tyrosine kinase (BTK), C-C motif chemokine receptor 2 (CCR2), Scm polycomb group protein like 4 (SCML4) in LUAD and normal lung tissues. We further established a stable LUAD cell line with KLRG1 knockdown and investigate the effect of KLRG1 knockdown on tumor cell proliferation. We also studied the prognostic value of the four factors in terms of overall survival (OS) in LUAD. Using data from the Gene Expression Omnibus, we further investigated the expression of KLRG1 in the patients with different responses after immunotherapy.Results. The expression of KLRG1, BTK, CCR2 and SCML4 was significantly downregulated in LUAD tissues compared to normal controls. Knockdown of KLRG1 promoted the proliferation of A549 tumor cells. And low expression of these four factors was all associated with unfavorable overall survival in patients with LUAD. Furthermore, low expression of KLRG1 also correlated with poor responses in LUAD patients after immunotherapy.Conclusion. Based on these findings, we infer that KLRG1 had significant correlation with immunotherapy response. Meanwhile, KLRG1, BTK, CCR2 and SCML4 might serve as valuable prognostic biomarkers in LUAD. Key pointsKLRG1 inhibits the progress of LUAD.KLRG1 had significant correlation with immunotherapy response.KLRG1, BTK, CCR2 and SCML4 might serve as valuable prognostic biomarkers in LUAD.
Non- Specific Low Back Pain among Nurses in Qassim, Saudi Arabia: A Cross-Sectional Study
Authors: Elmannan Abeer Abuzeid Atta , AlHindi Hajar A. , AlBaltan Reema I. , AlSaif Mariah S. , AlMazyad Nouf S. , AlZurayer Ruba K. , AlRumayh Shouq S.
Published: September 2020

Background: Non-specific Low back pain (LBP) is a complex and multifactorial health problem. Evidence has shown that LBP is an important occupational hazard and nurses are particularly at high risk. While several studies have addressed the prevalence of LBP worldwide, the prevalence of LBP in Saudi Arabia remains unclear. In this study we aimed to estimate the prevalence and associated factors of LBP among nurses in Qassim region, Saudi Arabia.Methods: This was a multicenter cross-sectional study carried out in four major public hospitals in Qassim region. A total of 323 nurses were recruited through a two-stage sampling method. A previously validated questionnaire was used to gather data. The main outcome measures were; LBP prevalence during working life, demographic factors, life-style factors, work-related factors and psychological factors. Multivariable logistic regression analysis was used to determine factors independently associated with LBP.Results: The study showed that LBP prevalence was 65.6% (n = 212). Over one third of study participants sought treatment for LBP (n = 82, 38.7%). Age and the type of ward were found significantly associated with LBP (aOR: 0.39; 95% CI: 0.19, 0.77; p value = 0.007) & (aOR: 0.36; 95%CI: 0.15, 0.86; p value = 0.02), respectively. However, gender, working hours, number of patients, stress and smoking were not identified as LBP risk factors in this study.Conclusion: The findings of this study suggest that LBP is a highly prevalent occupational health problem among nurses in Qassim. Young nurses 20–30 years are more likely to suffer from LBP, while nurses working in the general surgery wards have lower risk for LBP in this study. On-the-job training is essential particularly for new and young nurses on proper body mechanics when mobilizing patients or lifting heavy equipment. In addition, there is a need for evidence –based interventions to improve the work-place environment for nurses in hospitals in order to lower LBP prevalence.
Contribution of Mitochondrial Structure and Respiratory Metabolism to The Cold-Resistance of Alfalfa Seedling Root
Authors: Liu Meijun , Zhao Wenjing , Zhang Haoyang , Wang Yuxiang , Sui Xiaoqing
Published: September 2020

Background: Fall dormancy of alfalfa is significantly associated with its cold tolerance, while root, the main body of alfalfa for overwintering, is critical for the cold resistance of alfalfa. The effect of low temperature on mitochondrial ultrastructure and respiratory metabolism of alfalfa seedling root with different fall dormancy was examined, to study the root cold resistance mechanism by which fall dormancy affects alfalfa cold tolerance. Results: Low temperature induced mitochondrial swelling, and the decline of ATP and accumulation of H 2 O 2 in alfalfa seedling root. Both the Cytochrome pathway (CP) and Alternative pathway (AP) respiratory rate were restrained and mETC complex I, II, III and IV activities were inhibited directly by low temperature in both kinds of alfalfa seedling root, while the decline of mETC complex II and III activities were more serious in Gannong No. 5. These results indicated that the damage of mitochondrial structure and the inhibition of mETC complex I , II, III and IV activities directly by low temperature declined the ATP synthesis and aggravated the ROS accumulation, which inhibit the growth of alfalfa seedling root. Moreover, the lower damage on mitochondrial structure and mETC complex II, III activities and higher the percent of AP to total respiratory rate lead to the lower ATP lack and H 2 O 2 accumulation, which contributed to the root growth of Xinmu No.4 seedling. Conclusions: Low sensitivity of mitochondrial structural stability and mETC complex II, III and Alternative respiration to low temperature contributed to the root cold resistance of alfalfa with low fall dormancy grade.
Structure and Properties of Lignin From Five Distinct Biomasses
Authors: hu chunyan , Ilangovan Manikandan , Guna Vijaykumar , Rizzarelli Paola , Mirabella Emanule Francesco , Reddy Narendra
Published: September 2020

We have investigated the structural, thermal and morphological properties of lignin extracted from five distinct biomasses in order to establish the influence of the age of the source, environmental conditions during growth and quantity present. In fact, lignin is an integral part of cellulosic biomass and affects the structure, properties, processing and applications. Presence of lignin is critical for structural integrity but detrimental for converting biomass into new products. Aerial roots from banyan tree, sugarcane bagasse, bamboo, cornhusk and rice straw were selected to extract Klason lignin using the sulfuric acid approach. Extent of lignin in the samples varied from 9.14 to 23.77 %. Overall, compositional analysis showed that the lignin from the five sources had considerable variation, particularly in terms of the trace elements. Nevertheless, structure and properties of lignin extracted from five distinct biomasses was found to be independent of the age of the source, conditions during growth or quantity present in the biomass.
Sociodemographic and Hematologic Profile of Breast Cancer Patients Attending a Tertiary Care Teaching Hospital in Ethiopia: Case Control Study
Authors: Dejene Fatuma Hassen , Gashe Fikre Enqusilassie , Ahmed Ahmed Ali , Nuramo Adamu Addise , aweke Girma Taye , Woldegeorgis Mathewos Assefa , Abebe Aster Tsegaye
Published: September 2020

Background: Breast cancer is among the leading causes of cancer death in women. Different socio-demographic factors have impact on early diagnosis and treatment of breast cancer. Hematological abnormalities are also some of the conditions to be monitored during diagnosis and treatment of breast cancer.Objective: To describe socio demographic and hematologic profile of patients with breast cancer at Tikur Anbessa Specialized Hospital.Methods: Case control study was conducted from May 2018 to June 2019. A total of 230 cases and 230 controls participated in the study. Descriptive analysis was made to assess the socio demographic characteristics. Blood samples for hematological parameters were analyzed, using SYSMEXKX21N hematology analyzer. Independent student t- test was performed to compare the mean hematological parameters of cases and controls. Results: The mean age was 42.8 + 12.1 and 39.3 + 11.1 years for cases and controls, respectively. One hundred (43%) of cases and 34 (14.8%) of controls were illiterate. Moreover, 175 (76.1%) of cases and 155 (67.4%) of controls were married. The mean value of Hemoglobin, Red Blood cell, Packed Cell Volume (13.1 + 1.6g/dl, 4.6 + 0.54/1012/L , 38.7 + 4.5 %, respectively) of cases were significantly lower than the controls (14.0 + 1.3g/dl, 4.8 + 0.47 / 1012/L, 40.5 + 3.5% respectively). The mean platelet and total WBC count were 323.4+ 108.1 x 109/L and 7.1 + 2.8 x 109/L for cases and 282.0 +70.0 x 109/L, and 7.1 + 2.4 x 109/L for controls respectively. In addition, 20.4% of cases and 5.6 % of controls were anemic based on their hemoglobin value.Conclusion and recommendations: The majority of breast cancer cases were less than 40 years of age and illiterate. Most of the RBC parameters of cases were significantly lower than the controls. Therefore, attention should be given to those with the designated hematologic abnormalities.
Biomarkers to Predict the Renal Response to Cardiac Resynchronization Therapy During a Three-Month Follow-Up: Prospective Clinical Trial
Authors: Gala-Bladzinska Agnieszka , Kubrak Tomasz , Czech Joanna , Aebisher David , Gargasz Krzysztof , Danuta Mazur , Przybylski Andrzej
Published: September 2020

BackgroundChronic cardiorenal syndrome type 2 (CRS-T2) has a complex pathophysiology. The objective of this study was to assess renal function using biomarkers associated with nephron injury sites in patients with CRS-T2 following cardiac resynchronization therapy (CRT). MethodsThe research included patients with heart failure in NYHA classes II-IV, in whom CRT devices had been implanted. After 3 months of follow-up, the research group was divided into CRT responders and CRT non-responders. Prior to CRT and after 3 months, renal function was assessed using biomarkers measured in urine and blood samples.ResultsCRT was implanted in 56 patients (aged 66 ± 10 years) with CRS-T2 in the course of coronary artery disease (n = 38; 67.9%) or dilated cardiomyopathy (n = 18). Estimated glomerular filtration rate (eGFRCKD-EPI) was 68.55 ± 20.34 mL/min/1.73m2. After three months follow-up CRT responder group were assessed showing a significant decrease in serum prostaglandin D2 synthase (sPGD2S) and albuminuria (uACR) concentrations. Urine samples of the CRT non-responder group showed significant (p <0.05) increases in lipocalin associated with neutrophil gelatinase (uNGAL) concentrations, and a decrease in cystatin C (uCysC) concentration. There were no significant changes in the concentration of serum creatinine (sCr), CysC and eGFRCKD-EPI between the CRT responders and CRT non - responders groups.ConclusionsThe sCr and eGFRCKD-EPI assessment are useless in evaluation of renal function three months after CRT implantation. Biomarkers that account for the pathophysiology of nephron injury in CRS-T2 and change significantly after CRT are: sPGD2S, uACR, uCysC, and uNGAL. Trial registrationThis study is registered with ClinicalTrials.gov, Identifier: NCT04516525. Registered 15 August 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04516525.
Magnitude of late initiation of antenatal care and its associated factors among pregnant women attending antenatal care in Woldia Public Health Institution, North Wollo, Ethiopia.
Authors: Adere Ashete , Tilahun Sewnet
Published: September 2020

Background: The World Health Organization states that every pregnant woman is at risk of complications. Antenatal care is vital to reduce complications and more likely to be effective if women begin receiving care in the first trimester of pregnancy and continue to receive care throughout pregnancy. The maternal mortality ratio in Ethiopia was estimated at 412 deaths per 100,000 live births in 2016.Methods: Institutional based cross-sectional study design was used. Data collection was collected using an interviewer-administered questionnaire. A systematic sampling technique with proportional allocation was used to get the final 390 study participants. Data was entered, cleared, and analyzed with Statistical Package for Social Sciences Version (SPSS) 20. Descriptive measures were presented with frequencies, tables, and diagrams. A binary logistic regression model was used to identify predictors of late antenatal care initiation.Results: The prevalence of late antenatal care initiation was 59.5% with 95% CI [54.6–64.1]. Residence of the mother [AOR = 5; 95% CI:(1.423, 17.86), Paying for health services [AOR = 13.9;95% CI 3.531, 54.86], Planed for pregnancy [AOR = 13.4; 95% CI:4.018, 44.487], Counseled for ANC [AOR = 13.6; 95% CI:6.090, 63.127] and number of lifetime pregnancies (gravidity) [AOR = 5.5; 95% CI:2.077, 14.36] were factors significantly associated with late initiation of ANC.Conclusion: More than 50% of women attended antenatal care follow-up late from the recommended time of initiation. Residence, payment for pregnancy-related health services, plan for pregnancy, counseling, and advice regarding antenatal care follow-up and gravidity were factors significantly associated with late antenatal care initiation.
Geographic Distribution of Family Physicians in Japan and the United States: A Cross-sectional International Comparative Study
Authors: Okazaki Yuji , Yoshida Shuhei , Kashima Saori , Koike Soichi , Matsumoto Masatoshi
Published: September 2020

Background: Family physicians are known to distribute more equally among the population than other physicians. The maturity of family medicine, i.e. the length of its history as a part of healthcare system and the population of qualified family medicine experts, may affect the distribution, but this has not been shown in the literature. This study compares the geographic distribution of family physicians in Japan and the United States (U.S.), both of which are developed countries without a physician allocation system by the public sector, but the two countries differ greatly in the maturity of family medicine as a clinical specialty.Methods: This is a cross-sectional international comparative study using publicly available online database on the number of physicians in Japan (Board-certification Database of Japan Primary Care Association, and Survey of Physicians, Dentists and Pharmacists by Ministry of Health, Labour and Welfare) and the U.S. (Area Resource File by Health Resources and Services Administration). The municipalities in Japan and counties in the U.S. were divided into quintile groups according to population density. The number of family physicians per unit population in each group of areas was calculated. The geographic distribution of all physicians in Japan was simulated assuming that the proportion of family physicians among all physicians in Japan (0.16%) was increased to that in the U.S (11.8%).Results: The distribution of family physicians in Japan noticeably shifted to the areas with the lowest population density. In contrast, family physicians in the U.S. distributed equally across areas. The distribution of physicians with other specialties (general internists, pediatricians, surgeons and obstetricians/gynecologists) shifted heavily to the areas with highest population density in both countries. The simulation analysis showed the geographic maldistribution of all physicians improved substantially if the proportion of family physicians in Japan increases to that in the U.S. Conclusion: The distribution of family physicians is more equal than other medical specialists, and the immaturity of family medicine can even lead to a rural-biased distribution. In a country with emerging family medicine such as Japan, increasing the number of family physicians may effectively mitigate the urban-rural imbalance of physician supply.
Genome-Wide Identification of AP2/EREBP in Fragaria Vesca and Expression Pattern Analysis of The FvDREB Subfamily Under Drought Stress
Authors: Dong Chao , Xi Yue , Chen Xinlu , Cheng Zong-Ming (Max)
Published: September 2020

Background: Drought is a common phenomenon worldwide. It is also one of the main abiotic factors that affect the growth and quality of strawberry. The dehydration-responsive element binding protein (DREB) members that belong to the APETALA2/ethylene-responsive element binding protein (AP2/EREBP) superfamily are unique transcription factors in plants, which play an important role in the abiotic stress response. Results: Here, a total of 119 AP2/EREBP genes were identified in F. vesca, and the AP2/EREBP superfamily was divided into AP2, RAV, ERF, DREB, and soloist subfamilies, containing 18, 7, 61, 32, and 1 member(s), respectively. The DREB subfamily was further divided into six subgroups (A-1 to A-6) based on phylogenetic analysis. Gene structure, conserved motifs, chromosomal location, and synteny analysis were conducted to comprehensively investigate the gene characteristics of FvDREBs. Furthermore, transcriptome analysis revealed distinctive expression patterns among the FvDREB genes in strawberry plants exposed to drought stress. The expression of FvDREB6 of the A-2 subgroup was down-regulated in old leaves and up-regulated in young leaves in response to drought. Furthermore, qRT-PCR analysis found that FvDREB8 of the A-2 subgroup had the highest expression when plants were subjected to drought stress. Both analyses combined with promoter analysis suggested that FvDREB18 may play a critical role in regulating the expression of FvDREB1 and FvDREB2. Conclusions: Our findings provide new insights into the characteristics and potential functions of FvDREBs. And these FvDREB genes should be further studied as they appear to be excellent candidates for drought tolerance improvement of strawberry.
The abnormal regulation of spliceosome may be a key factor for coronary heart disease: a simple bioinformatics analysis
Authors: Li Zhaoshui , Sheng Wei , Chi Yifan
Published: September 2020

Background: Cardiovascular Diseases (CVDs) has become a major disease threatening human health. As the main species of CVDs, coronary heart disease (CHD) is becoming more and more common. The pathogenesis of CHD, especially at the molecular level, is not entirely clear up to now. Explaining the pathogenesis of CHD is particularly important for its treatment and prognosis. Biological database data analysis via bioinformatics has been an important method for studying gene expression strategy in multiple human disease. The aim of this study was to identify key different expressed genes (DEGs) in CHD and elucidate the biological process of it.Methods: A total of two published microarray datasets of CHD was downloaded from the Gene Expression Omnibus (GEO). Then, bioinformatics analyses including differentially expressed genes (DEGs) analysis, venn analysis, gene ontology (GO) annotation, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, protein and protein interaction (PPI) network construction was performed. Quantitative real-time polymerase chain reactions (RT-qPCR) were used to detect the expression levels of DEGs in CHD.Results: A total of 122 dysregulated genes were selected as DEGs in CHD. The GO annotation analysis displayed these DEGs involved in DNA transcription and mRNA splicing regulation. The DEGs regulatory network showed the downregulated genes LUC7L3, HNRNPA1, SF3B1, ARGLU1, SRSF5, SRSF11, SREK1, PNISR, DIDO1, ZRSR2 and NKTR were located in the network control center, which were the spliceosome related genes. The RT-qPCR results were consistent with our microarray analysis.Conclusion: The abnormal regulation of spliceosome might be a key factor in the development of CHD, which must play key roles in cardiovascular disease (CVD), especially in CHD. Our study has provided a new idea for the treatment and prognosis of CHD, and the spliceosome might be the potential prognostic biomarkers of it.
A combined tie-fastening method for the reusable surgical gown with two neck tie belts to improve wearing comfort
Authors: Chang Kai-Hui , Chen Yu-Ling , Dai Shu-Yi
Published: September 2020

Objective The reusable surgical gowns made of slippery materials have the tendency to slip down as they are being worn. The rear neck tie(s) can sometimes loosen, and this would cause the surgical gown to slip down somewhat, making the medical staff feel uncomfortable. To fasten the neck ties of the surgical gown with 2 neck tie belts, we proposed a simplified method of fastening the 2 sets of tie belts together as one tie, instead of fastening them separately. We evaluated this combined tying method for its ability to secure the gown and its wearing comfort.Results We found that combined tying tends to loosen more than separate tying after vigorous upper extremities exercise. But, for wearing comfort during the actual performance of the surgeries, the combined tying method was significantly better than the separate tying method. As a result, for reusable surgical gowns that have 2 rear neck ties, we suggest the 2 sets of rear neck ties could be fastened together as one combined tie. With this, tying could be performed easier and faster, and wearing comfort could be improved.
[18F]-Fluciclovine PET discrimination of recurrent intracranial metastatic disease from radiation necrosis
Authors: Parent Ephraim Edward , Patel Dhruv , Nye Jonathon A , Zhuo Li , Olson Jeffrey , Schuster David , Goodman Mark
Published: September 2020

Background
Stereotactic radiosurgery (SRS) is often the primary treatment modality for patients with intracranial metastatic disease. Despite advances in magnetic resonance imaging, including use of perfusion and diffusion sequences and molecular imaging, distinguishing radiation necrosis from progressive tumor remains a diagnostic and clinical challenge. We investigated the sensitivity and specificity of 18F-fluciclovine PET to accurately distinguish radiation necrosis from recurrent intracranial metastatic disease in patients who had previously undergone SRS.
Methods
Fluciclovine PET imaging was performed in 8 patients with a total of 15 lesions that had previously undergone SRS and had subsequent MRI and clinical features suspicious for recurrent disease. The SUVmax of each lesion and the contralateral normal brain parenchyma were summated and evaluated at 4 different time points (5 minutes, 10 minutes, 30 minutes, and 55 minutes). Lesions were characterized as either recurrent disease (11 of 15 lesions) or radiation necrosis (4 of 15 lesions) and confirmed with histopathological correlation (7 lesions) or through serial MRI studies (8 lesions).
Results
Time activity curve analysis found statistically greater radiotracer accumulation for all lesions, including radiation necrosis, when compared to contralateral normal brain. While the mean and median SUVmax for recurrent disease was statistically greater than that of radiation necrosis at all time points, the difference was more significant at the earlier time points (p = 0.004 at 5 min – 0.025 at 55 min). Using a SUVmax threshold of ≥ 1.3, fluciclovine PET demonstrated a 100% accuracy in distinguishing recurrent disease from radiation necrosis up to 30 minutes after injection and an accuracy of 87% (sensitivity = 0.91, specificity = 0.75) at the last time point of 55 minutes. However, tumor to brain ratios (TBRmax) were not significantly different between recurrent disease and radiation necrosis at any time point due to variable levels of fluciclovine uptake in the background brain parenchyma.
Conclusions
Fluciclovine PET may play an important role in distinguishing active intracranial metastatic lesions from radiation necrosis in patients previously treated with SRS but needs to be validated in larger studies.
Integrating CO2 capture with electrochemical conversion using amine based capture solvents as electrolytes
Authors: Pérez-Gallent Elena , Vankani Chirag , Anastasopol Anca , Goetheer Earl
Published: September 2020

Carbon dioxide (CO2) is currently considered as a waste material due to its negative impact on the environment. However, it is possible to create value from CO2 by capturing and utilizing it as a building block for commodity chemicals. Electrochemical conversion of CO2 has excellent potential for reducing greenhouse gas emissions and reaching zero net emissions by 2050. To date, Carbon Capture and Utilization (CCU) technologies have been studied independently. We report a novel methodology based on the integration of CO2 capture and conversion by the direct utilization of a CO2 capture media as electrolyte for electrochemical CO2 conversion. This has a high potential for reducing capital and operational cost when compared to traditional methodologies. A novel mixture of chemical and physical absorption solvents allowed for the captured CO2 to be converted to formic acid with faradaic efficiencies up to 50 % and with carbon conversion of ca. 30 %. By increasing the temperature in the electrochemical reactor from 20 °C to 75 °C, the productivity towards formic acid increased by a factor of 10, reaching up to 0.7 mmol∙m-2·s-1. The direct conversion of captured CO2 was also demonstrated for carbon monoxide formation with faradaic efficiencies up 45 %.
Atrial Matrix Remodeling in Atrial Fibrillation Patients With Aortic Stenosis
Authors: Fragão-Marques Mariana , Miranda I , Martins D , Barroso Isaac , Mendes C , Pereira-Neves A , Falcão-Pires I , Leite-Moreira A
Published: September 2020

Background: This study aimed to evaluate atrium extracellular matrix remodeling in Atrial fibrillation (AF) patients with severe aortic stenosis, through histological fibrosis quantification and extracellular matrix gene expression analysis, as well as serum quantification of selected protein targets. Methods: A posthoc analysis of a prospective study was performed in a cohort of aortic stenosis patients. Between 2014 and 2019, 56 patients with severe aortic stenosis submitted to Aortic valve replacement (AVR) surgery in a tertiary hospital were selected. Results: Fibrosis was significantly increased in the AF group when compared to Sinus Rhythm (SR) patients (p=0.024). Moreover, cardiomyocyte area was significantly higher in AF patients vs SR patients (p=0.008). Conversely, collagen III gene expression was increased in AF patients (p=0.038). TIMP1 was less expressed in the atria of AF patients. MMP16/TIMP4 ratio was significantly decreased in AF patients (p=0.006). TIMP1 (p=0.004) and TIMP2 (p=0.012) were significantly increased in the serum of AF patients. Aortic valve maximum (p=0.0159) and mean (p=0.031) gradients demonstrated a negative association with serum TIMP1. Conclusion: Atrial fibrillation patients with severe aortic stenosis present increased atrial fibrosis and collagen type III synthesis, with extracellular matrix remodelling demonstrated by a decrease in the MMP16/TIMP4 ratio, along with an increased serum TIMP1 and TIMP2 proteins.
Alternative Oxidase Gene Induced by Nitric Oxide is Involved in the Regulation of ROS and Enhance the Resistance of Pleurotus Ostreatus to Heat Stress
Authors: Hou Ludan , Zhao Mengran , Huang Chenyang , He Qi , Zhang Lijiao , Zhang Jinxia
Published: September 2020

Background: Pleurotus ostreatus is easily affected by temperature during its cultivation. Nitric oxide (NO) plays an important regulatory role in the response to abiotic stress, and previous studies have found that NO can induce alternative oxidase (aox) in response to heat stress (HS) by regulating aconitase. However, the regulatory pathway of NO is complex, and the function and regulation of the aox gene in the response to HS remain unclear.Results: In this study, we found that NO affected the NADH and ATP levels, reduced the H2O2 and O2- contents, and slowed the production of O2-. Further RNA-Seq results showed that NO regulated the oxidation-reduction process and oxidoreductase activity, affected the cellular respiration pathway and activated aox gene expression. The function of aox was determined by constructing overexpression (OE) and RNA interference (RNAi) strains. The results showed that the OE-aox strains showed obvious advantages in experiencing growth recovery after exposure to HS. During exposure to HS, the OE-aox strains exhibited reduced levels of NADH, the product of the TCA cycle, and decreased synthesis of ATP, which reduced the production and accumulation of ROS, whereas the RNAi-aox strains exhibited the opposite result. In addition, aox mediated the expression of antioxidant enzyme genes in the mycelia of P. ostreatus under HS through the retrograde signaling pathway. Conclusions: This study shows that the aox gene in P. ostreatus mycelia can be induced by NO under HS, regulates the TCA cycle and cell respiration to reduce the production of ROS, and can mediate the retrograde signaling pathway involved in the mycelial response to HS.
Paediatric Invasive Pneumococcal Disease : A 5-year Experience and Review of Hospital-Based Studies in Malaysia
Authors: Rengasamy Sithra , Othman Norlijah
Published: September 2020

Background: Invasive pneumococcal disease (IPD) is a serious preventable disease-causing significant mortality and morbidity among children below five years of age.Methods: A five-year retrospective study involving hospitalised children aged below 14-years-old with IPD to two tertiary centres of two different states in Malaysia were conducted between year 2012- 2016. IPD was defined as isolates of Streptococcus pneumoniae from normally sterile body sites. This article reviewed previous hospital-based studies on paediatric IPD in Malaysia to provide an overview of the disease over the last three decades. A comparison was also made with the current study. Results: A total of 54 children were identified with IPD in this study. Sixty per cent of the study population was below the age of two-years-old. A significantly higher number of IPD cases were found among the indigenous group. Both spectrums of malnourished children were also susceptible to the infection. This study found that the majority of children developed septicaemia (43/54, 80%), followed by pneumonia (34/54, 63%) and meningitis (13/54, 24%). Pneumonia (p=0.001) and meningitis p=0.03) were more likely to occur in children less than one-year old. The study also showed that meningitis (p=0.01) was significantly associated with fatal cases. The second component of this article focussed on the review of the disease in Malaysia. There were 8 articles included, of which four each were clinical and microbiological studies. The review concurred that the young ones were vulnerable to the disease. The overall antibiotic resistance in Malaysia was low but on an increasing trend (10-30%). The mortality documented were only from the clinical studies, which showed a disparity of fatality rates in the different regions studied. The rate was low in Selangor (0-11%), in contradiction of a higher rate in Perak, the less developed area (26%). Conclusions: The study highlighted that the younger age group, extremes of nutritional status and indigenous children were at risk of IPD. On the literature review of paediatric IPD in Malaysia, there was inadequate information on the disease. A concerted effort to better describe the disease is needed.