bluuebunny/crossref_metadata_2025 huggingface dataset:
Genomic insight for Algicidal activity in Rhizobium sp. (AQ_MP)
Authors: Pal Mili , Qureshi Asifa , Purohit Hemant
Published: May 2021

Occurrence of Harmful Algal Blooms (HABs) creates a threat to aquatic ecosystem affecting the existing flora and fauna. Hence, the mitigation of HABs through an eco-friendly approach remains a challenge for environmentalists. The present study provides the genomic insights of Rhizobium sp. (AQ_MP), an environmental isolate that showed the capability of degrading Microcystis aeruginosa (Cyanobacteria) at laboratory scale. Genome sequence analysis of Rhizobium sp. (AQ_MP) was performed to determine the algal lysis properties and toxin degradative pathway. It is envisaged that Rhizobium sp. (AQ_MP) secreted CAZymes like Glycosyltransferases (GT), Glycoside Hydrolases (GH), polysaccharide lyases (PL), which allowed algal polysaccharide degradation (lysis) and enabled nutrient release for the subsequent growth of Rhizobium sp. (AQ_MP) Genome analysis also showed the presence of the glutathione metabolic pathway, which is the biological detoxification pathway responsible for microcystin degradation. The conserved region mlrC, a microcystin toxin degrading responsible gene, was also annotated in Rhizobium sp. (AQ_MP). This study confirmed that Rhizobium sp. (AQ_MP) harbours a wide range of crucial enzymes released for lysis of Microcystis aeruginosa (M. aeruginosa) cells and also for degradation of microcystin toxin. This study thus find promiscuity for scaling the lab based analysis to field level in future.
Influence of COVID-19 Epidemic on the Decision-making Process for Impacted Mandibular Third Molar Removal
Authors: Wang Chi , Xiao Jin , yang jingyuan
Published: May 2021

BackgroundSince December 2019, an infectious disease caused by SARS-CoV-2 has swept through the world and has had a significant impact on dental services. Methods: In this study, from April 21 to April 28, 2020, a questionnaire survey was taken by a self-made questionnaire in order to investigate the impact of the COVID-19 epidemic on the decision-making process for impacted mandibular third molar removal and related clinical teaching. The Wenjuanxing software was used as a survey platform to survey oral clinicians engaged in the extraction of mandibular third molars. ResultsA total of 321 valid questionnaires were returned in this study. Because of the COVID-19 pandemic. The results showed that 22.4% of clinicians were temporarily not performing tooth extractions in outpatient clinics, and 50.2% of clinicians were temporarily not performing impacted tooth extractions. The main reason cited was that “Aerosol-generating high-speed handpieces were not recommended to be used during the pandemic.” During the pandemic, the surgical handpiece with copious saline irrigation was the main method used for bone removal; the hammer-and-chisel method was considered to be too traumatic and posed too high a risk of iatrogenic injury.ConclusionThe implementation of epidemic control measures during the novel COVID-19 pandemic significantly affects clinical decision making regarding impacted mandibular third molar extractions, the main reason cited was the contraindication to using aerosol-generating high-speed handpieces. The hammer and chisel method may represent a valuable surgical application under the requirements for epidemic prevention and control.
Glutathionylation of fibronectin records mechanical history, priming an integrin switch and myofibroblast polarization
Authors: Li Wei , Moretti Leandro , Yeh Chiuan-Ren , Torres Matthew , Barker Thomas
Published: May 2021

The extracellular matrix (ECM) is a protein polymer network that physically supports cells within a tissue and also acts as an important biochemical stimulus directing cell behaviors. For fibronectin, a predominant component of the ECM, these physical and biochemical activities are inextricably linked as physical forces trigger conformational changes that impact its biochemical activity. We analyzed whether oxidative post-translational modifications, specifically glutathionylation, enable fibronectin to ‘record’ physical information through stretch-dependent protein modification. Posttranslational modifications of the ECM are understudied, but represent opportunities for time- or stimuli-dependent changes in structure-function relationships that both persist over time and could have dominant impacts on cell-ECM homeostasis. We provide direct evidence that stretch-dependent glutathionylation of fibronectin irreversibly and significantly alters its mechanical properties with concomitant changes in the binding of integrin receptors and downstream cell signaling events. Stretch-dependent glutathionylation of fibronectin could have significant impact on the balance between tissue homeostasis and pathological progression, particularly in tissues and organs that are exposed to high oxidative stress, such as the lung.
Cerebral mechanism of opposing needling for managing acute pain after unilateral total knee arthroplasty: Study protocol for a randomized, sham-controlled clinical trial
Authors: Zhao Chi , Xu Hui , Kang Bingxin , Xie Jun , Shen Jun , Sun Songtao , Zhong Sheng , Gao Chenxin , Xu Xirui , Xinyu A , Xiao Lianbo
Published: May 2021

Background: Opposing needling is a unique method used in acupuncture therapy to relieve pain, acting on the side contralateral to the pain. Although opposing needling has been used to treat pain in various diseases, it is not clear how opposing needling affects the activity of the central nervous system to relieve acute pain. We herein present the protocol for a randomized sham-controlled clinical trial aiming to explore the cerebral mechanism of opposing needling for managing acute pain after unilateral total knee arthroplasty (TKA).Methods: This is a randomized sham-controlled single-blind clinical trial. Patients will be allocated randomly to two parallel groups (A: opposing electroacupuncture group; B: sham opposing electroacupuncture group). The YINLINGQUAN (SP9), YANGLINGQUAN (GB34), FUTU (ST32), and ZUSANLI (ST36) acupoints will be used as the opposing needling sites in both groups. In group A, the healthy lower limbs will receive electroacupuncture, while in group B, the healthy lower limbs will receive sham electroacupuncture. At 72 h after unilateral TKA, patients in both groups will begin treatment once per day for 3 days. Functional magnetic resonance imaging will be performed on all patients before the intervention, after unilateral TKA, and at the end of the intervention to detect changes in brain activity. Changes in pressure pain thresholds will be used as the main outcome for the improvement of knee joint pain. Secondary outcome indicators will include the visual analogue scale (including pain during rest and activity) and a 4-m walking test. Surface electromyography, additional analgesia use, the self-rating anxiety scale, and the self-rating depression scale will be used as additional outcome indices.Discussion: The results will reveal the influence of opposing needling on cerebral activity in patients with acute pain after unilateral TKA and the possible relationship between cerebral activity changes and improvement of clinical variables, which may indicate the central mechanism of opposing needling in managing acute pain after unilateral TKA.Trial registration: ChiCTR2100042429, registered on January 21, 2021.
Soft EHL based Friction Mechanism of Unreinforced and GF-Reinforced PA66 in Contact with Steel under PAO8 Oil Lubrication
Authors: Kunishima Takeshi , BOUVARD Gaëtan , ABRY Jean Christophe , FRIDRICI Vincent , KAPSA Philippe
Published: May 2021

Polyamide 66 is widely used in polymer sliding parts including polymer gear. These parts are used under lubrication of oil and grease. In this study, the friction mechanism of the contact between polyamide 66 and a steel counterpart lubricated with additive-free polyalphaolefin8 oil was discussed by focusing on various parameters including the sliding surface roughness, normal load (contact pressure), sliding speed, temperature, and hardness of the steel counterpart. To explain the friction coefficient obtained under different test conditions, the theoretical minimum oil film thickness was calculated using the equation of the soft elastic hydrodynamic lubrication regime presented by Hamrock and Dowson considering the temperature dependence of oil viscosity and polymer mechanical properties, and the master curve of the relationship between Λ and the friction coefficient was proposed considering the change in the roughness on the sliding surface. In addition, the contributions of the oil film based on the proposed master curve and lubricated solid/solid contact based on the Bowden-Tabor theory to the friction coefficient were discussed. Furthermore, the friction mechanism using the glass fiber-reinforced PA66 composite was investigated and compared to that of the unreinforced PA66.
Variability and Trend Analysis of Temperature, Rainfall and Characteristics of Crop Growth Season in Eastern Zone of Tigray Region, Northern Ethiopia
Authors: Berhe Amdom Gebremedhin , Misgna Solomon Habtu , Abraha Girmay Gebre-Samuel , Abraha Amanuel Zenebe
Published: May 2021

Background: Long term weather analyses are very useful indicators in determining future directions and in making adjustments required to existing systems. And, in order to favor farmers to adjust their farming practices, seasonal climate outlooks are needed. The main purpose of this manuscript was thus to analyze the variability and trends of maximum and minimum temperature, monthly and seasonal rainfall series and characteristics of crop growth season in Eastern zone of Tigray region over the period of 1980–2009.Methods: Detail investigations were carried out using parametric (Linear regression) and nonparametric tests (Mankendall (Mk) and Sen’s slope estimator). Moreover, homogeneity test using a method developed by Van Belle and Hughes was used for general trend analysis. In addition, daily rainfall data to characterize crop growth season were analysed using R-Instat and XLSTAT software for trend analysis.Results: It was found that the general trend of monthly rainfall experienced an overall significant increasing trend. The seasonal rainfall experienced significantly increasing in summer main rainy season, June–September (Kiremt) while significantly decreasing in short rainy season, February– May (Belg). Likewise, the seasonal maximum temperature trends exhibited significant increase in each season while minimum temperature trend had inhomogeneous trend across seasons as well as stations. The trend of growing season characteristics (onset, cessation, LGP and dry spell length did not change significantly over the study period (1980–2009) in all stations. However, the coefficient of variability of LGP was (CV, >15%) and dry spell length was (CV, >25%) inassociation with short nature of LGP (68–85 days had a negative impact on the agricultural activities of the study area during the study period.Conclusions: Despite significant increase of rainfall in summer season, the variability of rainfall and dry spell length was very large. Hence, the study recommends crop production in the study area demands appropriate adaptation strategies that considers the erratic nature of the rainfall, the long dry spell length in the season and increasing trends of temperature.
Individual variability in the size and organization of the human arcuate nucleus of the medulla
Authors: Baizer Joan Susan , Witelson Sandra F.
Published: May 2021

The arcuate nucleus (Arc) of the medulla is found in almost all human brains and in a small percentage of chimpanzee brains. It is absent in the brains of other mammalian species including mice, rats, cats and macaque monkeys. The Arc is classically considered a precerebellar nucleus, presumably motor in function. However, several studies have found aplasia of the Arc in babies who died of SIDS (Sudden Infant Death Syndrome) suggesting a very different role for the Arc in the control of respiration. Aplasia of the Arc, however, has also been reported in adults suggesting that it is not critical for survival. We have examined the Arc in closely-spaced Nissl-stained sections in human cases to acquire a better understanding of the degree of variability of its size and location in adults. We have also examined immunostained sections to develop a neurochemical profile of this nucleus. Our data suggest that the Arc consists of rostral and caudal subdivisions. There is some degree of left-right asymmetry in Arc position, size and shape at all rostro-caudal levels. Neurons in the Arc express calretinin (CR), neuronal nitric oxide synthase (nNOS) and nonphosphorylated neurofilament protein (NPNFP) but not calbindin (CB) or parvalbumin (PV). There is also immunostaining for GAD and GABA receptors suggesting inhibitory input to Arc neurons. We support the classical idea of the Arc as a precerebellar nucleus; its absence in SIDS cases may not be the cause of death but rather a correlate of other brainstem abnormalities.
Evaluating The Implementation of A National COVID-19 Hospital Guideline In Wales
Authors: Jefferies Rhys , Ponsford Mark J , Barry Simon
Published: May 2021

BackgroundThe COVID-19 pandemic created a unique situation where a national clinical guideline would address uncertainty, and provide a trusted source for up-to-date information and advice. We developed a dynamic online infrastructure together with a dedicated implementation team to deliver this at scale and pace. The guideline was implemented through a digital implementation framework (SIMPSI framework) deploying facilitators to maximise guideline adoption, particularly targeting senior clinical decision makers (consultants) involved with the care of COVID-infected patients across six Health Boards (HB) in Wales. Methods We evaluated guideline implementation using the Taxonomy of Implementation Outcomes Model. The primary outcome was consultant engagement, with a target of 193 registrations. We assessed wider impact through analysis of guideline platform activity and a user survey, with additional sensitivity analysis to derive penetration ratios, catchment population, clinical staff, acute beds, and COVID-19 admissions. ResultsThe guideline platform had 4521 total registrants, with over 170,000 page views during the first wave. We exceeded the target nearly six-fold (1159 consultant registrants). This represented 45% of all medical consultants in Wales, and made up the highest proportion of guideline registrants of all professional groups (23%, 1159/4521). We observed significant variation in guideline penetration across the six HBs, ranging from 31% to 74% of consultants registered. The HB with highest penetration had the most active guideline facilitator. The HB with the lowest penetration was the region first impacted and most affected by COVID-19 at the time of guideline publication (37% inpatients of peak, versus 10% or less for the other HBs). ConclusionWe utilised a digital implementation framework to construct a system that could be rapidly applied throughout all hospitals in Wales. Whilst we exceeded the intended target demonstrating full implementation, we identified two key factors to account for differences in the penetration rates across the different HBs. First, an experienced and active facilitator with the capacity to undertake the role was associated with significantly better penetration. Second, timeliness of implementation was crucial as evidenced by lower penetrance is the one HB that was impacted earliest by COVID-19 at the time of guideline dissemination. Nevertheless, the rapid implementation of the guideline has coincided with Wales demonstrating more favourable intensive care survival rates and maintaining one of the lowest mortality rates when compared to the UK as a whole for the first wave of the COVID-19 pandemic.
QTL Mapping Integrated with BSA-Seq Analysis Identifies a Novel Gene Conferring Resistance to Brown Planthopper from Common Wild Rice (Oryza rufipogon Griff.)
Authors: Wang Xuan , Han Yue , Zhang Yuexiong , Deng Biao , Wu Biqiu , Guo Xinying , Qin Yufen , Fang Yaoyu , Liu Fang , Qin Baoxiang , Luo Jijing , Li Rongbai
Published: May 2021

The brown planthopper (Nilaparvata lugens Stål, BPH) is one of the most destructive rice pests worldwide. GXU202 is a germplasm of common wild rice (Oryza rufipogon Griff. ) with high resistance to the BPH. In this study, the genetic analysis indicated that the BPH resistant phenotype of GXU202 is controlled by a major gene. Through the combination and comparison of QTL linkage and BSA-seq analyses, a novel gene locus BPH41 conferring BPH resistance was identified, which has been finely mapped to a 114-kb region delimited by D01031 and W1 on chromosome 4. The markers D01031 and D01045 showed high accuracy in predicting resistant phenotypes to BPH, suggesting their reliability for marker-assisted selection of BPH41 in breeding for BPH resistant rice varieties. The present identification of BPH41 will establish a foundation for further map-based cloning and functional characterization of the gene.
Characterization of Root-Endophytic Actinobacteria From Cactus (Opuntia Ficus-Indica) for Plant Growth Promoting Traits
Authors: Govindasamy V , George Priya , Ramesh S V , Sureshkumar P , Rane Jagadish , Minhas PS
Published: May 2021

The present study is the first report of isolation and characterization of endophytic actinobacteria from cactus (Opuntia ficus-indica). A total of 179 morphologically distinct endophytic actinobacterial isolates were purified from the roots of two different genetic accessions of cactus. All these isolates were screened for their plant growth promotion traits namely growth on N-free medium, P-solubilization, siderophore production, ACC deaminase activity and IAA production. A majority of the endophytic actinobacterial isolates (85%) exhibited the potential for plant growth promotion under in vitro conditions. Ten among the isolates were selected based on their multi-PGP traits and were identified as Streptomyces sp. based on the 16S rRNA gene sequencing and phylogenetic analysis. Plant growth promoting potential of these selected endophytic Streptomyces was studied in wheat seedlings. All these selected isolates significantly enhanced the growth parameters like seedling length and rootlets number compared to the uninoculated control. The wheat seeds inoculated with Streptomyces tuirus VL-70-IX exhibited maximum number of rootlets (6.33) compared to uninoculated control (3.67). The inoculation of endophytic actinobacteria Streptomyces pseudogriseolus VL-70-XII caused maximum seedling length (20.53 cm) and root length (8.26 cm) while the inoculation of S. radiopugnans HV-VIII resulted in highest shoot length (12.33 cm). These endophytic actinobacteria isolated from the roots of cactus accessions showed potential PGP traits. This work lays foundation for characterization and selection of endophytic actinobacteria from the under-exploited, drought tolerant species such as cactus with potential cross-compatibility for the improvement of plant growth of field crops especially under abiotic stress conditions..
Preoperative Incentive Spirometry for Preventing Postoperative Pulmonary Complications in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Prospective, Randomized Controlled Trial
Authors: Sweity Essa M , Alkaissi Aidah A , Othman Wafiq , Salahat Ahmad
Published: May 2021

Background: Postoperative pulmonary complications (PPCs) often occur after cardiac operations, and are a leading cause of morbidity, inhibit oxygenation, and increase hospital length of stay, and mortality. Although clinical evidence for PPCs prevention is often unclear and crucial, measures take place to reduce PPCs. One device usually used for this reason is the incentive spirometry (IS). The Aim of the study is to evaluate the effect of preoperative incentive spirometry to prevent postoperative pulmonary complications, improve postoperative oxygenation, and decrease hospital stay following coronary artery bypass graft (CABG) surgery patients. Methods: This was a clinical randomized prospective study. A total of 80 patients were selected as candidates for CABG at An-Najah National University Hospital, Nablus-Palestine. Patients had been randomly assigned into two groups: incentive spirometry group (IS), SI performed before surgery (study group) and control group, preoperative spirometry was not performed. The 40 patients in each group received the same protocol of anesthesia and ventilation in the operating room. Result: The study findings showed that there was a significant difference between the IS group and control group in the incidence of postoperative atelectasis, there were 8 patients (20.0%) in IS group and 17 patients (42.5 %) in the control group (p= 0.03). Mechanical ventilation duration was significantly less in group IS group, the median was four hours versus six hours in the control group (p < 0.001). Hospital length of stay was significantly less in group IS group, the median was six days versus seven days in the control group (p < 0.001). Median of the amount of arterial blood oxygen and oxygen saturation was significantly effective improvement in IS group with (p < 0.005). Conclusion: Preoperative incentive spirometry for 2 days along with exercises of deep breathing, encouraged coughing and early ambulation following CABG are in connection with prevention and decrease incidence of atelectasis, hospital stay, mechanical ventilation duration and improved postoperative oxygenation with better pain control. A difference that can be considered both significant and clinically relevant.Trial registration Thai Clinical Trials Registry: TCTR20201020005. Registered 17 October 2020 - Retrospectively registered.
A Potential Mitigation Measure of the Seismic Distress of the Circuit Wall at the Acropolis of Athens
Authors: Katsirakis Manolis , Tsompanakis Yiannis , Psarropoulos Prodromos N.
Published: May 2021

The seismic design of new retaining structures is usually performed following modern seismic norms. Nonetheless, there are various monumental retaining structures (e.g., fortifications) with high seismic vulnerability, which must be protected against earthquakes, while there are several limitations on the type of mitigation measures that can be applied to such cultural heritage structures. The present study investigates numerically the seismic response and distress of the Circuit Wall of the Athenian Acropolis. The Wall is a monumental masonry retaining structure surrounding the world-class monuments of the archeological hill of the Acropolis. Given the fact that the wider region of Athens is characterized by moderate to high seismicity, it is necessary to protect the Wall from strong ground motions. For this purpose, the geological, seismological, and topographic conditions of the Acropolis hill, as well as the geometry and the mechanical properties of the Wall, are realistically taken into account. A representative finite-element model has been developed for a critical section of the Wall, which has been validated with available records from accelerometers being installed at the Wall. Subsequently, an efficient and suitable -according to international monument restoration guidelines- seismic mitigation measure is proposed. The results of dynamic earth-pressure distribution on the Wall are presented before and after the application of expanded polystyrene (EPS) blocks behind the Wall. Α detailed parametric study illustrates a substantial reduction of dynamic pressures on the Wall when the EPS blocks are applied, either along the entire height or only at the lower part of the Wall.
Association of energy adjusts Nutrient-rich foods (ENRF) on mental health among obese and overweight women: a cross-sectional study
Authors: Salehi Zahra , Shiraseb Farideh , Rasaei Niloufar , Mirzaei Khadijeh
Published: May 2021

Background
Mental health and obesity have a bilateral relationship with each other. No study has been done on the relation between mental health and the ENRF9.3 index so far. Therefore, for the first time, we examined the relationship between the ENRF9.3 index and mental health in women with overweight and obesity.
Methods
In this cross-sectional study, 124 overweight and obese women were selected. Food intakes in the last 1 year were collected with 147 items of semi-quantitative food frequency. Then, the ENRF9.3 index score was calculated for all individuals. Mental health was assessed with a 21-item Depression Anxiety Stress Scales (DASS) questionnaire.
Results
In the present study, before adjusting for potential confounders the total DASS score was marginal significance(P = 0.05), that after the adjustment, it became insignificant(P > 0.05), after adjusting for confounders stress also became significant(P = 0.04). But no significant relationship was observed between depression and anxiety, even after adjustment(P > 0.05).
Conclusions
The present study showed that a nutritious diet is not associated with overall mental health score, among subgroups of the DASS total score, the relationship was seen only for the stress subgroup.
The Peculiar Hydrology of West-Central Florida’s Sandhill Wetlands, Ponds, and Lakes – Part 1: Physical & Chemical Evidence of Connectivity to a Regional Water-Supply Aquifer
Authors: Nowicki ReNae S , Rains Mark C , LaRoche Jason J , Pasek Matthew A
Published: May 2021

The sandhill wetlands, ponds, and lakes of west-central Florida, USA, are an understudied, poorly understood variant of geographically isolated features. Their karst origin and xeric setting impart a characteristic ecohydrology, which is a function of their connectivity to a regional water-supply aquifer. This study describes their general hydrologic character and provides physical and chemical evidence of this connectivity. These findings advance fundamental understanding of sandhill wetland/water ecohydrology and endeavor to ensure their proper management and protection amidst increasing groundwater demands, ever-expanding development, and a changing climate.Water level elevations and/or geochemistry were compared for 12 wetlands, five ponds, two lakes, and 12 monitor wells (10 constructed in limestone, two in surficial sand) in west-central Florida. Hydrograph and regression analyses indicate widely ranging water levels for most features and wells that are similar in elevation and very highly correlated with each other (0.84<R2<0.99). Water geochemistry varies from rainwater to water in contact with limestone as a function of feature depth relative to the depth of the rainwater-limestone water mixing zone. Results suggest sandhill wetland/water features are surface water expressions of the underlying regional aquifer hydrology, distinguishing them from isolated features elsewhere and establishing them as a groundwater endmember along the hydrologic continuum.
A Multicenter Study On Quality Of Life of The “Greater Patient” In Congenital Ichthyoses
Authors: Abeni Damiano , Rotunno Roberta , Diociaiuti Andrea , Giancristoforo Simona , Bonamonte Domenico , Schepis Carmelo , Neri Iria , Castiglia Daniele , Zambruno Giovanna , Hachem May El
Published: May 2021

Background: Autosomal recessive congenital ichthyoses (ARCI) are a genetically heterogeneous group of rare and chronic disorders characterized by generalized skin scaling and hyperkeratosis, erythroderma, and palmoplantar keratoderma. Additional features include ectropion, eclabium, ear deformities, foul-smell, joints contractures and walking problems, recurrent infections, as well as pruritus and pain. No curative therapy is available and disease care mainly relies on daily application of topical emollients and keratolytics to the whole-body surface. Altogether, disease signs and symptoms and treatment modalities have a major impact on quality of life of patients and their caregivers. However, very few studies have evaluated the family disease burden in ARCI. Methods: We have performed an Italian multicenter cross-sectional study to assess the secondary disease impact on family members of pediatric and adult patients with ARCI, using a validated dermatology-specific questionnaire, the Family Dermatology Life Quality Index (FDLQI). Disease severity was assessed by the dermatologist in each center.Results: Seventy-eight out of 82 patients who were accompanied by at least one family member filled the FDLQI. Forty-eight (61.5%) patients were aged less than 18 years. The mean FDLQI score was 10.3 (median 10), and the most affected dimensions were (i) time needed for care, (ii) extra-housework, and (iii) household expenditure. Higher total FDLQI score significantly correlated with more severe disease score (P= 0.003). Features associated with greater family burden included recurrent infections (P= 0.004), foul-smell (P=0.009), palmplantar keratoderma (P= 0.041), but also presence of scales on the face (P= 0.039) and ear deformities (P= 0.016). Conclusions: Our findings highlight the major socio-economic and psychological burden imposed by ARCI on the QoL of caregivers. In addition, they show that global evaluation of disease impact also on family members is an essential part of patient-reported outcomes. Finally, our data underline the need to develop specific measures for family support.
A Retrospective Study of the Impact of Health Worker Strikes on Maternal and Child Health Care Utilization in Western Kenya
Authors: Scanlon Michael L , Maldonado Lauren Y. , Ikemeri Justus E. , Jumah Anjellah , Anusu Getrude , Bone Jeffrey N. , Chelagat Sheilah , Keter Joann Chebet , Ruhl Laura J , Songok Julia , Christoffersen-Deb Astrid
Published: May 2021

BackgroundThere have been dozens of strikes by health workers in Kenya in the past decade, but there are few studies on their impact on maternal child health services and outcomes. We conducted a retrospective survey study to assess the impact of nationwide strikes by health workers in 2017 on utilization of maternal child health services in western Kenya. MethodsWe utilized a parent study to enroll women who were pregnant in 2017 when there were prolonged strikes by health workers (“strike group”) and women who were pregnant in 2018 when there were no major strikes (“control group”). Trained research assistants administered a close-ended survey to retrospectively collect demographic and pregnancy-related health utilization and outcomes data. Data were collected between March and July 2019. The primary outcomes of interest were antenatal care (ANC) visits, delivery location, and early child immunizations. Generalized estimating equations were used to estimate risk ratios between the strike and control groups, adjusting for socioeconomic status, health insurance status, and clustering. Adjusted risk ratios (ARR) were calculated with 95% confidence intervals (95%CI). ResultsOf 1,341 women recruited in the parent study in 2017 (strike group), we re-consented 843 women (63%) to participate in close-ended interviews. Of 924 women recruited in the control arm of the parent study in 2018 (control group), we re-consented 728 women (79%). Women in the strike group were 17% less likely to attend at least four ANC visits during their pregnancy (ARR 0.83, 95%CI 0.74, 0.94) and 16% less likely to deliver in a health facility (ARR 0.84, 95%CI 0.76, 0.92) compared to women in the control group. Whether a child received their first oral polio vaccine did not differ significantly between groups, but children of women in the strike group received their vaccine significantly longer after birth (13 days versus 7 days, p=0.002).Conclusion We found that women who were pregnant during nationwide strikes by health workers in 2017 were less likely to receive WHO-recommended maternal child health services. Strategies to maintain these services during strikes are urgently needed.
Content and Analysis of a Knowledge Translation Activity for an Elder Abuse Detection Tool: A Descriptive Study
Authors: Yaffe⃰ Mark J.
Published: May 2021

Background: Knowledge translation (KT) is challenging to carry out and assess. The content of a program developed to foster KT activities pertaining to the Elder Abuse Suspicion Index (EASI) ©, a tool to help identify elder abuse, is described, along with reporting and analysis of some of its outcomes. Methods: Enquiries about the use of the EASI were encouraged through completion of a structured questionnaire available on an EASI website. These were submitted by email and guided individualized responses. Descriptive data collated anonymously from the questionnaires described in aggregate corresponders’ occupations, countries of work, information needs about the tool, and intent of use. The processes that generated this data were evaluated as to whether they conformed to established elements of KT.Results: 138 queries were received over 6 years coming from enquirers with 12 different professional backgrounds, working in 25 countries. The information sought aimed to facilitate EASI use in clinical, quality improvement, public health, research, teaching, KT, and commercial ventures..Conclusions: This activity, incorporating recognized elements of a KT undertaking, documents specific global interests in elder abuse detection. It suggests a model for researchers to guage interest in their findings and to promote exchange around them.
Biomechanical Comparison of Vertbroplasty, Kyphoplasty, Vertebrae Stent for Osteoporotic Vertebral Compression Fractures -A Finite Element Analysis
Authors: Liao Jen-Chung , Chen Michael Jian-Wen , Lin Tung-Yi , Chen Weng-Pin
Published: May 2021

Vertebroplasty (VP), balloon kyphoplasty (BKP), and vertebral stent (VS) are usually used for osteoporotic compression fracture. However, these procedures may pose risks of secondary adjacent level fractures. This study simulates finite element models of osteoporotic compression fractures treated with VP, BKP, and VS. Vertebral resection method was used to simulate vertebra fracture with Young’s modulus set at 70 MPa to replicate osteoporosis. A compressive force of 1000N was applied on the T11 vertebra while the L1 vertebra were fully constrained as boundary condition. Moment loadings of 4.2 N-m in flexion, 1.0 N-m in extension, 2.6 N-m in lateral bending, and 3.4 N-m in axial rotation were applied. The VS model had the highest von Mises stresses on the bone cement under all different loading conditions (flexion/5.91 Mpa; extension/3.74 Mpa; lateral bending/3.12 Mpa; axial rotation/3.54 Mpa). The stress distribution and maximum von Mises stresses of the adjacent segments, T11 inferior endplate and L1 superior endplate, showed no significant difference among three surgical models. The postoperative T12 stiffness for VP, BKP, and VS are 2898.48 N/mm, 4123.18 N/mm, and 4690.34 N/mm, respectively. VS is the most effective surgical method to maintain vertebral body height without significantly increasing the risks of adjacent fracture.
Perspectives of Gynecologic Oncologists on Minimally Invasive Surgery During COVID-19 Pandemic: A Turkish Society of Minimally Invasive Gynecologic Oncology (MIJOD) Survey
Authors: dogan nasuh utku , Bilir Esra , Taskin Salih , Vatansever Dogan , Dogan Selen , Taskiran Cagatay , Celik Husnü , Ortac Fırat , Gungor Mete
Published: May 2021

Study ObjectiveTo evaluate gynecologic oncologists’ trends and attitudes towards the use of Minimally invasive surgery (MIS) in active period of the COVID-19 pandemic in Turkey.DesignOnline national survey sent to members of Turkish Endoscopy Platform consisting of six sections and 45 questions between the dates 1-15 June 2020 in Turkey to explore their surgical practice during the pandemic. SettingThree hospital types: Education and research hospital/university hospital, state hospital and private HospitalParticipantsGynecologic oncologists who are members of Turkish Endoscopy PlatformMeasurements and Results58 % of participants canceled all operations except for cancer surgeries and emergent operations. About a quarter of participants (28%) continued to operate laparoscopically and/or robotically. For the evaluation of the suspected adnexial mass (SAM) 64% used laparotomy and only 13 % operated by laparoscopy (L/S). For the management of low-risk early-stage endometrial cancer only fifth of the participants preferred to perform L/S. For endometrial cancer with high-intermediate risk factors more than half of participants preferred complete staging with laparotomy. For advanced stage ovarian cancer, one-fifth of the participants preferred to perform an explorative laparotomy, whilst 15 % preferred diagnostic laparoscopy to triage the patients for either NACT or cytoreductive surgery. On the contrary 41 % of participants chose to have cytology by paracentesis for neo-adjuvant chemotherapy (NACT). Gynecologic oncologists with >10 years L/S experience used MIS more for SAM. Furthermore, experienced surgeons used L/S more for endometrial cancer patients. In busy COVID hospitals, more participants preferred laparotomy over L/S. Conclusion﻿Use of MIS decreased during the pandemic in Turkey. More experienced surgeons continued to perform MIS. Surgical treatment was the preferred approach for SAM, early-stage endometrial cancer. However, NACT was more popular compared to radical surgery.
Exosome-Mediated Transfer of circRNA-GLIS3 Enhances Temozolomide Resistance in Glioma Cells Through miR-548m/MED31 Axis
Authors: Li Guowei , Jin YanPing
Published: May 2021

Background: TMZ resistance plays a critical role in the treatment of glioma, our research try to explore how circRNAs affect the chemosensitivity of glioma cells. Methods: In this study, we proceeded gene sequencing, and selected circRNAs specifically expressed in TMZ resistant cells and use them as target genes for subsequent studies; by knocking out the target gene we clarify its effect on TMZ resistant glioma proliferation, invasion, migration and cell apoptosis; through tumor-burdened animals we explore the effect of target gene in vivo environment. Results: In our research we revealed that circ-GLIS3 was significantly upregulated in TMZ resistant glioma cells. Functionally, knocking down circ-GLIS3 could inhibit proliferation, invasion, and migration abilities of TMZ resistant glioma cells; moreover, the downregulation of circ-GLIS3 could induce cell cycle arrest and apoptosis, while miR-548m inhibition and MED31 mRNA could reverse this progress. In vivo condition, the silencing of circ-GLIS3 could induce cell apoptosis and suppressed tumor growth. Mechanistically, circ-GLIS3 positively upregulated MED31 expression by sponging miR-548m. Conclusions: All these research findings demonstrate that circ-GLIS3 accelerates TMZ resistant glioma progression through miR-548m/MED31 axis.
Genetic regulation of DNA methylation across tissues reveals thousands of molecular links to complex traits
Authors: Oliva Meritxell , Demanelis Kathryn , Jasmine Farzana , Lu Yihao , Hahsan Habibul , Kibriya Muhammad , Chen Lin , Pierce Brandon
Published: May 2021

Epigenetic modifications of chromosomes, including DNA methylation (DNAm), play a fundamental role in gene regulation in humans. We generated DNAm data for 987 samples from the Genotype-Tissue Expression (GTEx) project, representing 9 tissue types and 424 subjects. We integrated GTEx RNA-seq data to examine methylome-transcriptome associations, their tissue specificity, and their overlap with regulatory regions. We mapped DNAm quantitative trait loci in cis (mQTLs), contrasted mQTLs with expression QTLs (eQTLs) with respect to functional elements, and assessed their relative contributions to complex traits. We identified thousands of mQTL links to traits in locations lacking a relevant eQTL. By integrating genetic, diverse -omics and phenotype data, we contribute to the understanding of molecular regulatory mechanisms in human tissues and their association with complex traits.
COVID-19 Vaccine Hesitancy in People With Migratory Backgrounds: A Cross-Sectional Study Among Turkish- and German-Speaking Citizens in Munich
Authors: Aktürk Zekeriya , Linde Klaus , Hapfelmeier Alexander , Kunisch Raphael , Schneider Antonius
Published: May 2021

BackgroundThis study aimed to investigate the knowledge, attitudes, behaviors, and vaccine hesitancy of people with migratory backgrounds among Turkish- and German-speaking patients in Munich regarding the COVID-19 pandemic.MethodsPrimary outcomes were the intention to get vaccinated for COVID-19 and COVID-19 knowledge levels (25 true/false items). Other variables included demographics, attitudes to COVID-19 and vaccination (7 items), and behaviors regarding COVID-19 (7 items). The attitude and behavior questions had 5-point Likert scales. Of the 10 Turkish-speaking family physicians in Munich, 6 agreed to administer Turkish or German questionnaires to consecutive patients during February 2021. Participants with either citizenship, country of origin, native language, or place of birth being non-German were categorized as “Having a migratory background.” Data from 420 respondents were analyzed.ResultsWomen constituted 41.4% (n=174), the mean age was 42.2±15.5 years, 245 (58.3%) preferred the Turkish questionnaire, 348 (82.9%) had a migratory background, and 197 (47.9%) intended to be vaccinated. The mean knowledge, attitude, and behavior scores were 21.5±3.2 (max=25), 3.7±0.8 (max=5), and 4.0±0.5 (max=5). While 42.3% (n=145) of the participants with a migratory background considered getting vaccinated, this proportion was 76.5% (n=52) for non-immigrant Germans (Chi-square=26.818, p<0.001). Non-migratory background (Odds Ratio (OR): 3.082), high attitude scores (OR: 2.877), male sex (OR: 2.185), years of schooling (OR: 1.064), and age (OR: 1.022) were positively associated with vaccination intention.ConclusionsWe suggest initiating or supporting projects run by persons or groups from inside the immigrants targeting to elaborate and change their vaccination attitudes.
Low Density Lipoprotein Cholesterol Is Associated With Increased Risk of Cardiovascular Disease in Participants Over 70 Years Old: A Prospective Cohort Study
Authors: Su xin , Zheng Deqiang , Wang Meiping , Zuo Yingting , Wen Jing , Zhai Qi , Zhang Yibo , He Yan
Published: May 2021

BackgroundPrevious studies, in which the data were collected about half a century ago, suggested that elevated low density lipoprotein cholesterol (LDL-C) is not associated with increased risk of cardiovascular disease (CVD) in patients over 70 years old. However, what is the relationship between LDL-C and CVD risk in a contemporary population aged over 70 years has not been well examined in China.MethodsThe China Health and Retirement Longitudinal Study (CHARLS) is an ongoing nationally representative study. In this analysis, participants of CHARLS who did not taking statins and did not have heart disease and stroke at 2011 were include and were followed up to 2018. The outcome of this analysis was occurrence of CVD at follow up, which include heart disease and stroke. Cox regression was used to assess the harmful effect of LDL-C on CVD occurrence. We calculated e-values to quantify the effect of unmeasured confounding on our results.ResultsOf the 9,631 participants, 15.2% (N=1,463) were aged over 70 years and 52.5% (N=5,060) were female. During the 7 years follow-up, 1,437 participants had a first CVD attack. Risk of CVD occurrence increased 8% with each 10 mg/mL elevation in LDL-C in whole participants (adjusted HR, 1.08; 95% CI, 1.06-1.10) and age groups of ≥70 years, 60-69years and <60 years. Similar results were observed in subgroup analyses, in which participants were stratified by sex, hypertension, diabetes and chronic kidney disease. According to the restricted cubic spline, we noted a U-shaped relationship between LDL-C and risk of CVD occurrence in group over 70 years old, however, we further found that in the left side of U-shape curve, LDL-C was not associated with occurrence of CVD and its attribution to CVD occurrence was only 2.1%, which indicated that lower level of LDL-C could not increase the risk of CVD occurrence as it was demonstrated by a U-shape association. E-value analysis suggested robustness to unmeasured confounding.ConclusionsIn contemporary society of China, elevated the level of LDL-C also increased the risk of CVD in participants over 70 years old as in the relatively younger participants. These results should strengthen guideline recommendations for the use of lipid lowering therapies in those elderly.
Triglyceride-glucose index in the development of peripheral artery disease: findings from the Atherosclerosis Risk in Communities (ARIC) Study
Authors: Gao Jing-Wei , Hao Qing-Yun , Gao Ming , Zhang Kun , Li Xiong-Zhi , Wang Jing-Feng , Vuitton Dominique A. , Zhang Shao-Ling , Liu Pin-Ming
Published: May 2021

Background

It remains unclear whether triglyceride-glucose (TyG) index, a surrogate marker of IR, was prospectively associated with incident PAD.
Methods

We included 12573 ARIC (Atherosclerosis Risk in Communities Study) participants free of PAD at baseline (1987–1989). The TyG index was determined using ln(fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2), and measured during 5 visits between 1987 and 2013. Incident PAD was defined as the first hospitalization with PAD diagnosis. We quantified the association of both baseline and trajectories of TyG index with incident PAD using Cox regression and logistic regression analysis, respectively.
Results

Over a median follow-up of 23 years, there were 1331 cases of incident PAD. After adjustment for traditional PAD risk factors, each 1-SD (0.58) increase in TyG index was associated with an 18.9% higher risk of incident PAD (hazard ratio, 1.189 [95% CI, 1.106–1.278]). Results were similar when individuals were categorized by TyG index quartiles (hazard ratio, 1.363 [95% CI, 1.125–1.652]; comparing extreme quartiles). Four distinct trajectories of TyG index were identified (low-increasing [43.0%], moderate-stable [22.3%], moderate-decreasing [27.6%], and high-decreasing [7.1%]). Trajectories of elevated TyG index levels had greater incident PAD after multivariable adjustment for potential cardiovascular risks. Compared with moderate-stable group (reference), high-decreasing group was associated with the highest risk of future incident PAD (odds ratio, 2.314 [95%CI, 1.687–3.175]).
Conclusion

Higher TyG index is independently associated with incident PAD. Long-term trajectories of TyG index help identify individuals at a higher risk of future PAD who deserve appropriate follow-up to detect asymptomatic disease.
Crosstalk between RPE cells and choroidal endothelial cells via the ANXA1/FPR2/SHP2/NLRP3 inflammasome/pyroptosis axis promotes choroidal neovascularization
Authors: Zhu Manhui , Wang Ying , Zhu Linling , Du Shu , Wang Zhenzhen , Zhang Yuting , Guo Yang , Tu Yuanyuan , Song E
Published: May 2021

One type of age-related macular degeneration (AMD), neovascular (nAMD), characterized by choroidal neovascularization (CNV), accounts for the majority of the severe central vision impairment associated with AMD. Endothelial cells (ECs) in direct contact with retinal pigment epithelial (RPE) cells are more prone to the pathological angiogenesis involved in CNV. Herein, we investigated the effect of crosstalk between RPE cells and choroidal endothelial cells (CECs) via the ANXA1/FPR2/NLRP3 inflammasome/pyroptosis axis on the development of choroidal neovascularization (CNV) in vitro and in vivo. ANXA1 expression and secretion from ARPE-19 cells were upregulated by hypoxia. FPR2 expression, especially on the plasma membrane, in HCECs was upregulated under hypoxic conditions. ANXA1 secreted from ARPE-19 cells inhibited NLRP3 inflammasome activation and NLRP3 inflammasome-mediated pyroptosis in HCECs by activating the FPR2/SHP2 axis. Moreover, ANXA1 secreted by ARPE-19 cells promoted behaviors of HCECs, including proliferation, migration and tube formation, by activating the FPR2/SHP2 axis and inhibiting NLRP3 inflammasome-mediated pyroptosis. Inhibiting the upregulated ANXA1/FPR2/SHP2/NLRP3 inflammasome/pyroptosis axis decreased the volume of CNV. Our data suggest that the crosstalk between RPE cells and CECs via the ANXA1/FPR2/NLRP3 inflammasome/pyroptosis axis promotes CNV. This finding could identify a potential target for the prevention and treatment of CNV.